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Vitamin Deficiencies – Diagnosis and Treatment
Published in Jennifer Doley, Mary J. Marian, Adult Malnutrition, 2023
Compared to macronutrients, only small quantities of vitamins are needed; however, they are still considered essential nutrients because they cannot be synthesized in amounts sufficient to meet the body’s needs and must be obtained from the diet or a synthetic source. The functions of vitamins are of a catalytic or regulatory nature, where they aid in chemical reactions in the body’s cells. Vitamin deficiencies may develop if intake is insufficient, absorption or metabolism is impaired, or excretion is increased.1 Clinicians need to perform a comprehensive physical exam to assess for micronutrient deficiencies while considering disease states, intake and biochemical markers to assess adequacy.
Pellagra
Published in Charles Theisler, Adjuvant Medical Care, 2023
Diet and B Vitamins: Because patients are often malnourished and have other vitamin deficiencies, provisions for a high-protein diet (1 gm/kg/day) and the administration of B-complex vitamins are needed for complete recovery.4, 5
Cancer
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
The initial symptoms of pancreatic cancer are pain and weight loss. Upon diagnosis, about 90% of patients have locally advanced tumors that have affected the regional lymph nodes, liver, and lungs. Abdominal pain is severe and common, radiating to the back. An adenocarcinoma of the head of the pancreas may cause obstructive jaundice and itching. Splenomegaly and GI hemorrhage also occur. Up to 50% of patients with the cancer may develop diabetes mellitus. The cancer can shift production of digestive enzymes, causing malabsorption of foods, which resulting in bloating, gas, and foul-smelling diarrhea. Vitamin deficiencies and weight loss may occur.
Food and beverages promoting elderly health: six food-based dietary guidelines to plan good mixed meals for elderly South Africans
Published in South African Journal of Clinical Nutrition, 2021
Sanjoy Saha, Upasana Mukherjee, Makenzie Miller, Li-Ling Peng, Carin Napier, Heleen Grobbelaar, Wilna Oldewage-Theron
Besides playing an important role in elderly individuals’ health status, protein intake can be utilised as a conduit for addressing larger-scale health problems, such as nationwide nutrient deficiencies or common health problems.124 One of the areas for concern for the elderly population is the inadequate consumption (i.e. consumption below recommended levels), of animal-based proteins, namely fish, lean meat, chicken and eggs.62 Under-consumption of animal-sourced foods can result in low protein, iron, zinc, calcium, vitamin A and vitamin B12 in the diet, which can lead to anaemia, vitamin deficiencies, and poor physical and cognitive function.124 The promotion of consumption of animal-based protein foods could also help to combat micronutrient deficiencies in SA.
Non-alcoholic Wernicke’s encephalopathy: toxic ingestion or an honest mis-steak?
Published in Journal of Community Hospital Internal Medicine Perspectives, 2021
Salahuddin Nasir, Moustafa Abou Areda, Elise L. Ma, Robert D. Chow, Avelino Verceles, Carol Chiung-Hui Peng
Given the patient’s restricted diet, we could not rule out if the patient had concomitant nutritional deficiencies besides thiamine. According to the nutrition fact lists from the official website of Asia Pacific Journal of Clinical Nutrition, certain meats such as pork and fish, do contain thiamine, but the levels per 100 g of these meats are much lower than the daily needed value of 1 mg to 2 mg [12].Common vitamin deficiencies in a meat-only diet can include Vitamin A, Vitamin C, Vitamin E, and Vitamin K [13]. Therefore, he was also treated with multivitamin along with thiamine during hospitalization. The patient also presented with several dermatologic findings as well as microscopic hematuria, which were not related to thiamine deficiency. However, these symptoms could potentially be explained by his use of the herbal supplement, such as Chinese Skullcap, as it was reported to be related to some skin, digestive, and renal side effects[14].
Frontotemporal dementia as underlying cause of newly altered mental status in a 59-year-old female: a case presentation and literature review
Published in Journal of Community Hospital Internal Medicine Perspectives, 2020
When evaluating a patient in the emergency setting presenting with acute on chronic behavioral abnormalities and possible dementia, as in the case of our patient, it is useful to consider other possible etiologies underlying the patient’s altered mental status. These may be related to metabolic (vitamin deficiencies, e.g., cobalamin or thiamine deficiency, uremia) or electrolytic abnormalities (hyponatremia or hypernatremia; hypercalcemia), as well as infectious, toxic, hypoxemic, psychiatric, or iatrogenic causes. Vascular accidents including stroke, hypertensive encephalopathy, or hypercoagulability disorders (DIC) need to be considered, as well as endocrine abnormalities such as derangements in glycemia, cortisol or thyroid hormone levels. Acute events including seizures or trauma must be ruled out as well in the diagnostic workup of altered mental status.