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PubMedDate not supplied

Hyperhomocysteinemia is associated with venous thrombosis in patients with short bowel syndrome.

BACKGROUND: Hyperhomocysteinemia is associated with venous thrombosis and vitamin deficiency. Patients with short bowel syndrome have increased risk of venous thrombosis due to central catheters, and of vitamin deficiency due to malabsorption. The current investigation was designed to evaluate the relationship between history of venous thrombosis and current hyperhomocystinemia and vitamin deficiency in patients with short bowel syndrome. METHODS: Plasma total homocysteine (tHcy), serum vitamin B12, folate, B6, and methylmalonic acid (MMA) were measured. Venous thrombosis was documented by venogram or ultrasound. RESULTS: Ten of 17 patients had venous thromboses, including 17 of 38 observed superior and 12 of 26 inferior veins. Total homocysteine was correlated with number of thromboses. The relative risk of multiple thromboses in the highest tHcy tertile was 3.6-fold that of the lowest tertile. Vitamin B12 and folate levels were within normal limits, but B12 deficiency by MMA or tHcy level was apparent in 7 patients. Vitamin-deficient patients had higher tHcy and MMA than those without deficiency. CONCLUSIONS: Venous thrombosis in patients with short bowel syndrome is related to hyperhomocystinemia, which is also related to vitamin B12 deficiency, not detected by serum vitamin B12 concentration. Whether treatment of vitamin deficiencies and associated reduction in tHcy will reduce recurrent venous thrombosis in these patients is not known.

Absorption↗
PubMedDate not supplied

Enteral nutrition: frequency of formula modification.

A retrospective study was undertaken to determine with what frequency one of the 12 standard enteral formulations routinely used by the Metabolic Support Service could not be used without modification. Forty-three percent of the 83 patients studied required modification of one or more of the 5 individual components of the enteral product being utilized (ie, carbohydrate, protein, fat, electrolytes, and vitamins). Organ dysfunction was the reason for 31% of those changes in formula, other conditions included vitamin deficiencies (30%), electrolyte imbalances (27%), and essential fatty acid deficiencies (12%). The results of the study confirm the fact that no single formula can be effective in meeting every patient's fluid and electrolyte requirements while addressing the specific nutritional aspects of their disease. It would appear that a totally modular system for enteral nutrition similar to that used in parenteral nutritional support would allow maximum flexibility in the preparation of formulae that conform to patient's needs.

Acute Kidney Injury↗
PubMed1996

Nutrition and immunity with emphasis on infection and autoimmune disease.

Nutrition and nutritional status can have profound effects on immune functions, resistance to infection and autoimmunity in man and other animals. Nutrients enhance or depress immune function depending on the nutrient and level of its intake. Protein-energy malnutrition and vitamin A deficiency are strongly associated with impaired immunity and infectious disease. The essential role vitamin A plays in infection and maintenance of mucosal surfaces has long been known. Recent evidence shows that T-cell subpopulations, cytokines and antibody subclasses are all affected by vitamin A. In animal studies supplementation with vitamin E protects against infection and is linked to stimulatory effects on the immune system. In man vitamin E and other anti-oxidants increase the number of CD4+ cells. Dietary lipids and zinc have a substantial impact on autoimmunity from protective to potentiation of immuno-pathological processes in animals. There is considerable potential to modify human autoimmune disease by manipulation of lipid nutrition. Deficiency of pyridoxine induces atrophy of lymphoid organs, marked reduction in lymphocyte numbers, impairs antibody responses and IL-2 production. Dietary copper is important in the prevention of infection in some animal species and T-cell function is defective under deficiency states due to an inability to produce IL-2. Selenium has been linked to viral infection, enhanced T-cell functions and TNF beta induced increase in natural killer cell activity. Understanding the molecular and cellular immunological mechanisms involved in nutrient-immune interactions will increase our applications for nutrition of the immune system in health and in disease

Animals↗
PubMedDate not supplied

Differentiation and treatment of anemia in HIV disease.

Anemia is a frequent complication of HIV disease that contributes to decreased quality of life and increased morbidity and mortality. The three major categories of anemia in HIV disease are anemia due to impaired red blood cell production, anemia due to increased red blood cell destruction, and anemia due to increased red blood cell loss. Although anemia of chronic illness is the most common type of anemia in HIV disease, other classifications of anemia may be encountered. Understanding the pathophysiology of anemia and laboratory tests that are frequently used to establish the differential diagnosis of anemia helps to ensure that HIV-infected individuals will receive appropriate treatment.

Anemia↗
PubMedDate not supplied

Changes in biochemical indices of vitamin nutrition in women using oral contraceptives during treatment with "Surbex 500".

A study was conducted on 10 healthy young women who had taken oral contraceptives of the combined type for several cycles. Daily treatment was instituted with a high-potency vitamin B complex with vitamin C ("Surbex 500"). Blood specimens were collected before and after treatment with this vitamin supplement and plasma levels of ascorbic acid and vitamin B12 were measured. Activity of red cell aspartate amino-transferase (AST) was determined before and after the in vitro addition of excess pyridoxal phosphate, and of glutathione reductase (GTR) before and after the in vitro addition of excess flavin adenine dinucleotide. Women taking oral contraceptives showed plasma concentrations of ascorbic acid and vitamin B 12 below the range seen in a matched group of untreated women, while red cell AST and GTR were less saturated by their essential co-factors. Daily treatment with"Surbex 500" restored all four biochemical indices of vitamin nutrition to the normal ranges.

Adult↗
PubMed2005

The impact of national and international guidelines on newborn care in the nurseries of Piedmont and Aosta Valley, Italy.

BACKGROUND: Care procedures for preventing neonatal diseases are carried out according to nurseries' traditions and may be not consistent with the evidence based medicine issues. METHODS: A multi-centric survey was conducted in 2 Regions located in NW Italy (Piedmont and Aosta Valley) in order to collect information on some healthy newborn care procedures. During 2001, a questionnaire was sent to the chief pediatrician in charge to the all 33 nurseries of the region asking the methods used during 2000 as prevention of ophthalmia neonatorum, early and late hemorrhagic disease of newborn, umbilical cord care and recommendations of vitamin D administration. Thereafter, during 2004 the same questionnaire was sent to the 34 chief pediatrician of nurseries to evaluate if the procedures were changed during 2003 according to guidelines. The nurseries care for 32,516 newborns in 2000 and 37,414 in 2003. RESULTS: Aminoglycoside eyes drops as prevention of ophthalmia neonatorum were the first choice in both periods (23 out 33 nurseries in 2000 and 24 out 34 in 2003 p > 0.05; the corresponding figures for newborns were 18,984 out 32,516 newborns vs. 28,180 out of 37,414 p < 0.05). The umbilical cord care was carried out with alcohol in 12/33 centers (13,248 newborns) and dry gauze in 3/33 centers (2,130 newborns) in 2000, the corresponding figures in 2003 were 6/34 centers (p > 0.05), (6,380 newborns, p < 0.05) and 12/34 centers (p < 0.05), (18,123 newborns, p < 0.05). The percentage of newborns receiving of i.m. vitamin K. at birth increased during the study period (15,923/32,104 in 2000 vs. 19,684/37,414 in 2003, p < 0.01), but not the number of nurseries (16 in 2000 and 17 in 2003 p > 0.05). The numbers of parents of newborns who receive the recommendations of oral vitamin K during the first months life decreased from 2000 (25,516/30,606) to 2003 (29,808/37,414, p < 0.01) as well as for Vitamin D recommendation (14,582/30,616 in 2000 vs. 11,051/37,414 in 2003, p < 0.01). Oral vitamin K during the first months of life was recommended by 25 nurseries in 2000 and 27 in 2003 (p > 0.05), the corresponding figures for Vitamin D were 15 and 14 (p > 0.05). CONCLUSION: In the present study a large variability of procedures among the nurseries was observed. During the study periods, guidelines and evidence based medicine issues have only partially modified the neonatal care procedures In Piedmont and Aosta Valley nurseries. These observations suggest to implement local forum/consensus conference to standardized procedures as much as possible.

Avitaminosis↗
PubMed1985

Nutritional state of elderly women on admission to mental hospital.

Since nutritional deficiencies might worsen the severity of symptoms and prolong the length of illness in non-nutritional disorders, particularly in the elderly, we examined the nutritional status of 216 elderly women newly admitted to a mental hospital. Compared to healthy elderly women, they had lower values for plasma prealbumin, vitamin C, and B vitamins. This was particularly common in senile dementia, and appeared to be the result of inadequate intake of protein or vitamins. Regular hospital diet for one month corrected the very low levels of prealbumin, but supplements were essential to remove deficiency of the water-soluble vitamins. Although vitamin supplements did not influence the length of stay in hospital, we did not exclude the possibility that nutritional deficiencies have a significant effect on the severity of mental illness.

Aged↗
PubMed1986

Comparison of the nutritional state of new and long-term patients in a psychogeriatric unit.

Nutritional deficiencies have been implicated in the pathophysiology of various mental disorders. Life in institutions has been associated with development of nutritional deficiencies, the elderly being most at risk especially those with senile dementia. In this study nutritional status, particularly vitamin and essential mineral status was assessed in a group of 64 new admissions to a psychogeriatric unit and 49 long-term patients. The results indicated that psychogeriatric patients were at risk of experiencing nutritional deficiencies and those with senile dementia were likely to have more abnormalities than those with functional illnesses. Those patients in long-term care would appear to have a better nutritional state than those on admission.

Aged↗
PubMed2005

Mild neonatal hypoxia exacerbates the effects of vitamin-deficient diet on homocysteine metabolism in rats.

Elevated plasma homocysteine has been linked to pregnancy complications and developmental diseases. Whereas hyperhomocysteinemia is frequently observed in populations at risk of malnutrition, hypoxia may alter the remethylation of homocysteine in hepatocytes. We aimed to investigate the combined influences of early deficiency in nutritional determinants of hyperhomocysteinemia and of neonatal hypoxia on homocysteine metabolic pathways in developing rats. Dams were fed a standard diet or a diet deficient in vitamins B12, B2, folate, month, and choline from 1 mo before pregnancy until weaning of the offspring. The pups were divided into four treatment groups corresponding to "no hypoxia/standard diet," "hypoxia (100% N2 for 5 min at postnatal d 1)/standard diet," "no hypoxia/deficiency," and "hypoxia/deficiency," and homocysteine metabolism was analyzed in their liver at postnatal d 21. Hypoxia increased plasma homocysteine in deficient pups (21.2 +/- 1.6 versus 13.3 +/- 1.2 microM, p < 0.05). Whereas mRNA levels of cystathionine beta-synthase remained unaltered, deficiency reduced the enzyme activity (48.7 +/- 2.9 versus 83.6 +/- 6.3 nmol/h/mg, p < 0.01), an effect potentiated by hypoxia (29.4 +/- 4.7 nmol/h/mg, p < 0.05). The decrease in methylene-tetrahydrofolate reductase activity measured in deficient pups was attenuated by hypoxia (p < 0.05), and methionine-adenosyltransferase activity was slightly reduced only in the "hypoxia/deficiency" group (p < 0.05). Finally, hypoxia enhanced the deficiency-induced drop of the S-adenosylmethionine/S-adenosylhomocysteine ratio, which is known to influence DNA methylation and gene expression. In conclusion, neonatal hypoxia may increase homocysteinemia mainly by decreasing homocysteine transsulfuration in developing rats under methyl-deficient regimen. It could therefore potentiate the well-known adverse effects of hyperhomocysteinemia.

5-Methyltetrahydrofolate-Homocysteine S-Methyltran↗
PubMed1985

Tropical myeloneuropathies: the hidden endemias.

Tropical myeloneuropathies include tropical ataxic neuropathy and tropical spastic paraparesis. These disorders occur in geographic isolates in several developing countries and are associated with malnutrition, cyanide intoxication from cassava consumption, tropical malabsorption (TM), vegetarian diets, and lathyrism. TM-malnutrition was a probable cause of myeloneuropathies among Far East prisoners of war in World War II. Clusters of unknown etiology occur in India, Africa, the Seychelles, several Caribbean islands, Jamaica, and Colombia. Treponemal infection (yaws) could be an etiologic factor in the last two. Tropical myeloneuropathies, a serious health problem, are multifactorial conditions that provide unsurpassed opportunities for international cooperation and neurologic research.

Ataxia↗
PubMed1999

Diagnosis and detection of vitamin deficiencies.

Vitamin deficiencies can be detected in several ways, none of which is entirely unambiguous. Evidence of several types is, therefore, required. For instance, it is rare for clinical signs to result from a single cause, except in controlled experiments. Natural diets are rarely deficient in only a single nutrient, and individual requirements vary considerably. Biochemical and functional status indices can help bridge the gap between inadequate diet and resulting pathology. Some indices are very specific for individual vitamins; others, although only semi-specific, are useful if closely linked to tissue malfunction and hence to pathology. Ideally, biochemical indices should separate severe deficiency, mild subclinical deficiency, normal status and overload toxicity. Vitamin concentrations in plasma, serum, red cells, urine, and other accessible tissues have been used, and metabolic products of vitamin-dependent metabolic pathways have been exploited. However, many of the assays are difficult to perform and interpret, and are limited to few laboratories, world-wide. There is a need for simpler and more 'portable' tests, for routine laboratories and for the medical profession.

Avitaminosis↗