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PubMed1986

Nutritional deficiencies in the neonate.

This article reviews common nutritional deficiencies that have been identified in newborn infants, including deficiencies of protein; vitamins A, D, K, C, and E; calcium and phosphorus; folate; zinc; and copper. The etiology, clinical presentation, diagnosis, and treatment of these nutritional deficiencies are discussed.

Ascorbic Acid Deficiency↗
PubMed1976

Hematologic abnormalities following gastric resection.

The anemia observed in patients with partial gastric resection results from a complex interrelationship of deficiencies of these three important hematemics-iron, vitamin B12, and folic acid. Reliance upon morphological evidence of anemia in the peripheral blood smear may be difficult and confusing since deficiency of one hematemic may mask the coexisting deficiency of another. It is common for deficiencies of more than one hematemic to occur in these patients. A number of studies have demonstrated the masking effect of iron deficiency on concurrent vitamin B12 or folic acid deficiency. In addition, the morphologic hallmarks of iron deficiency may be modified by the presence of deficiencies of either vitamin B12 or folate or both. Full hematologic recovery may not occur until more than one hematemic is given to the patient. It is our policy at the University of Florida to rely on serum levels of these three hematemics, especially vitamin B12 and iron, to detect the cause of the anemia in a patient with partial gastric resection. Less reliance is placed upon the appearance of the peripheral smear because of the masking effect described above. If either the serum iron level or vitamin B12 level is decreased, we treat the patient with a preparation such as ferrous sulfate (300 mg. orally three times a day) and vitamin B12 (100 mug. intramuscularly once a month). We are less concerned with folic acid deficiency because of its relatively infrequent occurrence in this setting and because a good diet will usually suffice as adequate therapy for the folic acid deficiency when present. In patients who have had partial gastric resection but who are not anemic, we assess vitamin B12 absorption by the conventional vitamin B12 urinary excretion test (Schilling test) on a yearly basis since deficiency of this hematemic may lead to serious hematologic and neurologic sequelae. If the patient manifests decreased vitamin B12 absorption uncorrected by the administration of pancreatic extract or antibiotics, this patient is also treated with 100 mug. of vitamin B12 intramuscularly on a monthly basis. We have not evaluated the absorption of food B12 as suggested by Doscherholmen. Perhaps more attention should be paid to this aspect of vitamin B12 absorption in these patients. Indeed, because of the serious complications of vitamin B12 deficiency and the observations that deficiencies of this vitamin may occur even when the absorption of crystalline vitamin B12 is normal in the fasting state (the conventional Schilling test), some authors, such as Rygvold, have suggested that prophylactic vitamin B12 be administered to all patients with partial gastric resection.

Anemia, Hypochromic↗
PubMed1995

Folate deficiency, anticonvulsant drugs, and psychiatric morbidity.

The folic acid (FOA) level was determined in serum and erythrocytes in 100 epileptic patients and 100 control patients using a luminescence assay. A lowered FOA concentration in serum, erythrocytes, or both was observed in 15% of the epileptic patients and in 2% of the control group. In the epileptic patients, the FOA in the serum and in the erythrocytes was significantly lower than that in the control group. Patients receiving carbamazepine monotherapy had a significantly lower FOA level in the erythrocytes than did patients receiving phenytoin monotherapy. The FOA level showed a negative correlation to the duration of epilepsy. None of the patients with lowered FOA had a normal mental status. The course of the supplementation treatment with 5 mg folinic acid (or FOA) of four patients with FOA deficiency could be monitored psychopathometrically. All four patients showed an improvement in their well-being and the majority of measured variables of the cognitive performance.

Adult↗
PubMed2003

[Plasma homocysteine levels in systemic lupus erythematosus].

BACKGROUND AND OBJECTIVE: Cardiovascular disease is a major cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). An association between hyperhomocysteinemia and increased cardiovascular risk has been reported. On the other hand, renal failure and deficiency of vitamin B12 and/or folic acid are common causes of hyperhomocysteinemia. The aims of this study were to determine plasma total homocystein (tHcy) concentrations in SLE patients and to analyze the association of plasma tHcy with age, sex, plasma creatinine, vitamin B12, folates and total cholesterol, as well as with other clinical conditions linked to atherothrombosis in SLE patients. PATIENTS AND METHOD: Fasting plasma levels of tHcy, vitamin B12, folates, total cholesterol and creatinine were measured in 94 SLE patients (11 males, 83 females) and in a control group of 308 healthy volunteers (122 males, 186 females). A review of the medical records of SLE patients was performed. RESULTS: Plasma tHcy concentrations were higher in patients with SLE (median 10.54 (mol/L) than in controls (median 8.49 (mol/L, p < 0.001). Hyperhomocysteinemia (tHcy >=15 (mol/L) was found in 17.02% SLE patients. In a multivariate analysis, plasma creatinine (p < 0.001), total cholesterol (p = 0.038), male sex (p = 0.003) and smoking (p = 0.001) were associated with higher plasma tHcy concentrations. No associations were found between plasma tHcy and hypertension, SLE duration, prednisone therapy and antiphospholipid antibodies. CONCLUSIONS: Plasma tHcy concentrations are higher in SLE patients than in healthy controls. High concentrations of plasma creatinine and total plasma cholesterol, male sex and smoking are associated with a higher concentration of plasma tHcy in SLE. Since the clinical consequences of hyperhomocysteinemia are not well established, routine determination of plasmatic tHcy and supplemental therapy in patients with high levels of tHcy are not recommended.

Adolescent↗
PubMed1997

[A case of acranial fetus with placenta partially grown into the bony cranium in pregnancy complicated by carotid artery aneurysm].

It was shown in this paper rarely appearing fetus defect namely,acranial fetus with placenta growing into the osteocranium. The aneurysm of the left carotid artery in the mother was the second complication in this pregnancy what was the indication to finish the pregnancy by cesarean section. The symptoms of osteocranium destruction caused by the trophoblast were not identified. The appearance of so heavy a CNS defect could be associated with deficiency of vitamin compounds particularly folic acid in the periconception period.

Adult↗