How drugs act 7. Vitamins.
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The human organism is continuously exposed to a variety of xenobiotics, as drugs, pesticides, food additives and many environmental contaminants, all of which are potentially toxic. The body metabolizes these highly reactive chemicals to pharmacologically-inert compounds, which are readily eliminated from the body. This process of deactivation is dependent on nutritional status. Malnutrition, almost invariably, leads to a reduced capacity to deactivate these exogenous materials with consequent increase in toxicity.
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OBJECTIVE: To provide an overview of the outcomes from an outpatients' clinic for preconceptional counselling in the Netherlands and to assess its activities in terms of referrals, referral indications, supplementary investigations, treatment policy and a possible future pregnancy. DESIGN: Retrospective, descriptive. METHOD: Data were collected from the medical records of women who were seen at the outpatients' clinic for preconceptional counselling, University Medical Centre St Radboud, Nijmegen, the Netherlands, during the period 1 January 1996-6 July 2000. RESULTS: Of the 484 women studied, medical records were available for 459 (95%); their median age was 31 years (range: 19-44). Most of the women with one or more risk factors were referred by gynaecologists (65%), followed by general practitioners (17%) and other specialists (14%). The main categories of referral were previous complicated obstetric history, previous fetal abnormality, and chronic maternal disease. Half of the women were subjected to supplementary investigations on the basis of an indication; hyperhomocysteinaemia was diagnosed in 24%, other form of thrombophilia (coagulopathy) in 21% and vitamin deficiency in 18%. The most frequent preconceptional interventions were the correction of hyperhomocysteinaemia by means of administering folic acid or other vitamin supplements and a change of therapy or cessation of therapy for potentially teratogenic medications. CONCLUSION: The outpatients' clinic for preconceptional counselling helped to minimise risk factors for adverse pregnancy outcome amongst high-risk women by providing extensive advice as well as by means of the early detection and treatment of diagnosed abnormalities.
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Managing venous leg ulcers involves management techniques that are indicated both in the treatment of all chronic leg ulcers and those that are specific to venous leg ulcers. The first step in managing venous leg ulcers is performing a holistic assessment of the patient. Once this is complete, any systemic or local factors that may affect wound healing should be addressed. This approach to managing the whole patient is critically important because if significant general wound healing factors are not treated, other specific attempts at healing the venous ulcer will be fruitless. This paper reviews nutritional supplementation, wound bed preparation, antimicrobial therapy, venous insufficiency, compression therapy, different bandage systems, therapeutic adjuncts to compression therapy, and recent advances in vascular surgery. Recurrence prevention also is discussed.
The multimodal evoked potentials (visual, somatosensory and auditory brainstem) in 23 patients with malabsorption syndrome of different origin were investigated. The diagnosis of the disease was confirmed on the basis of histological examination and result of D-ksyloza test. The control group consisted of 30 healthy persons. Examination of visual evoked potentials revealed significant prolongation of latency of P 100 component in examined group in comparison with controls. Latency of N13 and N20 of somatosensory evoked potentials in patients with malabsorption syndrome were also significantly prolonged when compared to controls, otherwise transit time to cortex (TTC) was merely prolonged. Auditory brainstem potentials were also abnormal. Changes involved prolongation of latency of I, III and V responses and prolongation of interpeak latencies of I-III, III-V, I-V as well. The amplitudes of the examined evoked potentials between patients and controls did not differ significantly. On the basis of obtained results in was pointed out that different specific afferent systems are affected in patients with malabsorption syndrome what seems to be connected with vitamin's deficiency, especially B12 and E. Authors conclude that multimodal evoked potentials examinations are useful in the diagnosis and monitoring of the disease, specially in subclinical cases.
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Recurrent aphthous stomatitis is a very common condition seen frequently by dentists in practice. Although the majority of cases are benign and resolve in less than two weeks, these ulcerations may be indicative of underlying systemic diseases ranging from vitamin deficiency to autoimmunity. Awareness of these correlations can help the dentist make or aid the diagnosis of potentially serious conditions. There are treatments of which the practitioner should be aware that may ameliorate the pain of the ulcerations or shorten their duration. The diagnosis and management of this important condition is reviewed in this article.
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The literature review concerning selected nutritional and health aspects of applying different vegetarian diets by breastfeeding women was presented. The only two types of vegetarian diets: lactoovo- and semi-vegetarian, when properly composed, seem to be relatively safe for mother and her child. The most threatening vegetarian diets for lactating women are those including exclusively products of plant origin (so called restricted diets: vegan or macrobiotic). The results of studies performed on mothers consuming these vegetarian diets showed deficiencies in: vitamin B12 and vitamin D (in mothers and their infants) and calcium (only in lactating women). The low intake of docosahexaenoic acid (DHA) was also characteristic in this group. Additionally the endogenous metabolism of DHA is inhibited due to high proportion of linoleic vs. linolenic acid intake. It considered that lactating women on vegetarian diet should have a greater nutritional knowledge in order to avoid deficiencies which would adversely affect mother's and her child's health.
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PURPOSE: To investigate the effect of food, protein, and vitamin restriction on the susceptibility of lens crystallins to aggregation and chaperone activity of alpha-crystallin. METHODS: Thirty day old Wistar/NIN rats were maintained on regular rodent diet (C), 50% food restriction (FR), 75% protein restriction (PR), and 50% vitamin restriction (VR) diet for 20 weeks. At the end, alpha-, beta-, and gamma-crystallins were isolated from the lenses of these animals and subjected to in vitro aggregation induced by oxidation, UV irradiation and heat. Aggregation and chaperone activity was assessed by light scattering methods. RESULTS: Dietary restriction has been shown to extend the mean and maximum life span and retard age-related diseases, including cataract. In this study, we demonstrate that while beta- and gamma-crystallins isolated from FR and PR groups were less susceptible to in vitro induced aggregation, beta- and gamma-crystallins from the VR group were more susceptible, compared to controls. Alpha-crystallin from any of the groups did not shown a considerable amount of aggregation. On the other hand, the chaperone activity of alpha-crystallin from FR and PR groups was not significantly different from controls. However, alpha-crystallin from the VR group demonstrated substantially higher chaperone activity than controls. CONCLUSIONS: These results indicate that while food and protein restriction appear to lower the susceptibility of beta- and gamma-crystallins towards aggregation, vitamin restriction tends to increase the aggregation. Chaperone activity of alpha-crystallin is affected (improved) by only vitamin restriction.
Vitamin status of 36 children 5-8 years old (Moscow) from the decreased bone mineral density risk group has been evaluated. Only 6-14 per cent of children had deep vitamin deficit. Vitamin B1 and B2 insufficiency has been observed 1.6 fold rarely among children additionally receiving vitamin supplement. The relation between urinary calcium and vitamins B1, B2 and B6 excretion has been shown. No difference was found in calcium excretion rate irrespective of additional vitamin intake. Although no correlation between urinary calcium/creatinine excretion and urinary vitamins C, B1, B2 and B6 excretion has been found children with increased calcium/creatinine index are insufficiently supplied with four vitamins more often. The data obtained could not be regarded as negation of the vitamin sufficiency importance for calcium metabolism and osteogenesis disturbance prevention.
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