Nutritional Optic Neuropathy
Vivek Lal in A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
Another controversial entity is the so-called tobacco–alcohol amblyopia [14,15]. This is not common in industrialized countries not withstanding that smoking and alcohol abuse are, pointing out the role of general nutrition. It has been established that cyanide in tobacco can cause toxic effects on the optic nerve. Alcohol on the other hand, appears to produce nutrient malabsorption via gut irritation and liver dysfunction [8]. Chronic alcohol ingestion also induces CYP450 and a subsequent increase in ROS production. Furthermore, many historical cases were in fact Leber's hereditary optic neuropathy precipitated by smoke [16]. Visual symptoms in tobacco–alcohol amblyopia seem to be related to a nutritional deficit or genetic predisposition triggered by smoke and potentially alcohol. The cases related to nutritional deficiency often improve and resolve with adequate nutritional supplementation [17].
The Problems of Undernutrition
R. J. Jarrett in Nutrition and Disease, 1979
It is paradoxical that such a widespread, serious and extensively studied form of nutritional disorder still continues to be a controversial subject in almost every aspect. This is especially so with regard to classification and pathogenesis. The reason is that the presenting features of nutritional deficiency vary from one part of the world to another, due mainly to the great variation in the nutrient content of the diet, the prevalence of antecedent illnesses, the variability of the host, and the time over which the causative factors operate. Two distinct clinical syndromes have been described, viz. kwashiorkor and marasmus. They occupy the two ends of a spectrum with a mixture of the clinical features of both in between. The biochemical features also form a spectrum though they are more evident in kwashiorkor than in marasmus. It is not unusual to find that a child diagnosed as suffering from kwashiorkor shows the typical features of marasmus after the oedema (see ‘clinical features’) subsides, while a child with nutritional marasmus often develops oedema and progresses to marasmic kwashiorkor.
Systemic illnesses (diabetes mellitus, sarcoidosis, alcoholism, and porphyrias)
Jacques Corcos, David Ginsberg, Gilles Karsenty in Textbook of the Neurogenic Bladder, 2015
Unfortunately, identification of alcohol abuse is often difficult because it involves elements of denial and lack of rationalization. Often, information from relatives and surveys can be of help. Biological confirmation via laboratory and physical examinations may also help expose the problem. Several abnormalities are seen in laboratory analysis such as, elevated aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), carbohydrate-deficient transferrin (CDT), and erythrocyte mean corpuscular volume (MCV). A high AST/ALT ratio, elevated GGT and CDT are virtually 80% specific for the diagnosis.54 Clinical symptoms can develop acutely within days or progress increasingly over weeks. During the early stage of nutritional deficiency patients experience fatigue, muscle cramping, and irritability. If nutritional deficiency is prolonged for an extended period, signs of neuropathy begin to appear. First, patients experience distal sensory loss accompanied with weakness in both hands and feet, followed by cramping and aching particularly of the lower extremities associated with mild sensory loss and dysesthesias.
Nutritional, immunological and antioxidant defense status of outpatients diagnosed with colorectal cancer – a case–control study of the little-studied population
Published in Nutrition and Cancer, 2020
Ifitikhar Alam, Wajid Alam, Ghadeer S. Aljuraiban, Mahmoud Abulmeaty, Nitin Shivappa, Suhail Razak
Prevalence of malnutrition varies in cancer patients mainly depending on cancer type (2, 3), ranging from 9% in urologic cancers up to 85% in pancreatic cancers (4, 5). Cancer patients are thought to be more likely to be malnourished than patients with other diseases (6, 7), which may lead to undesirable treatment outcomes (2, 8–10). Increased metabolic demands, insufficient nutrient intake, or nutrient losses are some of the common reasons for malnutrition in these patients (11). In addition, many cancer patients may require surgical intervention, which imposes further metabolic demands and compounds preexisting nutritional disorders. If patients require surgery during treatment, their metabolic condition (3) and weight status (12) should be optimal at the time of intervention. Weight loss in cancer patients is significantly correlated with increased surgical site infections and longer hospital stay (12).
Reconsidering the relation between serum homocysteine and red blood cell distribution width: a cross-sectional study of a large cohort
Published in Biomarkers, 2018
Ili Margalit, Eytan Cohen, Elad Goldberg, Ilan Krause
The finding of a positive association between age and RDW has already been described (Hoffmann et al.2015), however its causative mechanism is yet to be understood. RDW, an indicator for anisocytosis, has been associated with many human disorders and diseases (Salvagno et al.2015). The inverse association between RDW and haemoglobin is expected in individuals with anaemia or critical illness (Bazick et al.2011). However, this finding amongst healthy individuals with normal haemoglobin levels and no FA or vitamin B12 deficiencies is surprising. It was suggested that an increased RDW may be an early marker of iron deficiency, preceding other blood count components (Dabbah et al.2010). Iron deficiency is the only significantly prevalent nutritional deficiency in industrialized countries and is more common amongst women within the fertile age (World Health Organization 2001). Indeed, when only non-anaemic men were analysed, the association between RDW and haemoglobin disappeared. It is therefore likely that the iron deficiency in non-anaemic women in the study population confounded this relation.
Subjective Global Assessment of Nutritional Status in Head and Neck Cancer Patients Treated with Radiotherapy – A Prospective Observational Study from North East India
Published in Nutrition and Cancer, 2022
Hima Bora, Mouchumee Bhattacharyya, Apurba Kumar Kalita, Partha Pratim Medhi, Gautam Sarma, Jyotiman Nath, Manoj Kalita, Dimi Ingtipi, Biswajit Sarma
Physical examination: Three features suggestive of nutritional deficiency were to be noted and graded during physical examination of patients. These were, firstly, the Loss of Subcutaneous Fat- to be evaluated over the triceps, under the eyes, at the mid-axillary line over lower ribs, lower back and sides of the trunk. Secondly, the Loss of bulk and tone of muscles (Muscle Wasting) over the temple, clavicle, shoulder, scapula/ribs, quadriceps and interosseous muscle of hand were observed. Lastly, the Presence of edema over the ankles and/or sacral region along with presence of ascites was to be recorded as features of fluid retention. The presence of ascites was verified with 3 weekly whole abdomen ultrasonography. The findings were classified as None, Mild/Moderate and Severe for all the three features as described in SGA form.
Related Knowledge Centers
- Obesity
- Protein
- Underweight
- Vitamin Deficiency
- Nutrient
- Deficiency
- Undernutrition In Children
- Overnutrition
- Stunted Growth
- Wasting