vitamin-b-12 and Acute-Disease

Topics: Abscess; Acute Disease; Antiviral Agents; Child; Ear Diseases; Electromyography; Facial Paralysis; Humans; Hypertension; Leukemia; Magnetic Resonance Imaging; Neoplasms; Neurophysiology; Radionuclide Imaging; Steroids; Virus Diseases; Vitamin B 12

Topics: Acute Disease; Anemia, Pernicious; Burning Mouth Syndrome; Combined Modality Therapy; Erythrocyte Transfusion; Female; Glossitis; Humans; Injections, Intramuscular; Middle Aged; Vitamin B 12

This contribution deals with the occurrence of cyanide and its biological pathways in the body. Especially possibilities of detoxification are pointed out. Intoxications are caused by acute and chronical cyanide uptake. Tobacco amblyopia, retrobulbar neuritis in pernicious anaemia, Leber's optic atrophy, Nigerian nutritional neuropathy, and sterility in female heavy smokers are attributed to cyanide intoxication. Various methods for treating acute and chronic cyanide intoxication are discussed.

Topics: Acute Disease; Amblyopia; Anemia, Pernicious; Animals; Antidotes; Chronic Disease; Cyanides; Female; Humans; Inactivation, Metabolic; Infertility, Female; Manihot; Nigeria; Optic Atrophy; Optic Neuritis; Plants, Edible; Scotoma; Smoking; Syndrome; Thiocyanates; Thiosulfate Sulfurtransferase; Vitamin B 12

Topics: Abetalipoproteinemia; Acrodermatitis; Acute Disease; Age Factors; Amino Acid Metabolism, Inborn Errors; Animals; Celiac Disease; Child; Chlorides; Cystic Fibrosis; Diarrhea; Diet Therapy; Endopeptidases; Enteritis; Food Hypersensitivity; Humans; Lactose Intolerance; Malabsorption Syndromes; Metabolism, Inborn Errors; Milk; Vitamin B 12

This pilot study aimed to evaluate the feasibility effectiveness and safety of transcutaneous electrical nerve stimulation (TENS) for patients with acute tinnitus.. A total of 46 eligible patients with acute tinnitus were entered and included in this randomized controlled trial. All the included patients were equally and randomly divided into a verum TENS group and a sham TENS group, each group 23 participants. All patients received parenteral intramuscular therapy of 1 ml Vitamin B12 weekly for a total of 4 weeks. In addition, they also underwent verum or sham TENS 30 min daily, 3 times weekly for 4 weeks. The primary efficacy endpoint was measured by the Tinnitus Severity Scale (TSS) and Tinnitus Questionnaire (TQ) sum score. The secondary efficacy endpoints were assessed by the Tinnitus Handicap Inventory (THI), 12-Item Short Form Health Survey (SF-12) questionnaire, and adverse events. All outcome efficacy endpoints were measured at baseline and after 4 weeks of treatment.. After 4-week treatment, the patients undergoing verum TENS showed statistically efficacy of symptoms relief, as measured by the scales of TSS (P < .01), TQ (P < .01), and THI (P < .01), and improvement of quality of life, as assessed by the SF-12 (P < .01), compared with patients receiving sham TENS. In addition, no adverse events related to the treatment were recorded in either group.. The results of this study showed that verum TENS may benefit patients with acute tinnitus after 4 weeks of treatment.

Topics: Acute Disease; Adult; Female; Humans; Injections, Intramuscular; Male; Middle Aged; Parenteral Nutrition; Pilot Projects; Quality of Life; Severity of Illness Index; Surveys and Questionnaires; Tinnitus; Transcutaneous Electric Nerve Stimulation; Treatment Outcome; Vitamin B 12

To observe the clinical therapeutic effect of acupoint injection of medicine in the treatment of patients with acute cerebral ischemia stroke (ACIS).. Ninety ACIS patients were randomized into control, Cobalamin and Gangliosides groups (. After the treatment, of the three 30 cases in the control, Cobalamin and Gangliosides groups, 0, 4 and 2 were cured, 9, 15 and 14 experienced marked improvement in their symptoms, 12, 8 and 10 were improved, 9, 3 and 4 invalid, with the effective rates being 70.0%(21/30), 90.0%(27/30) and 86.7%(26/30), respectively. In comparison with pre-treatment, the CNDS of the three groups were all significantly decreased and the ADLS notably increased (. Acupoint injection of both Cobalamin and Gangliosides can effectively improve acute ischemic stroke patients' neurological function and daily life living ability.

Topics: Acupuncture Points; Acute Disease; Adult; Aged; Aged, 80 and over; Female; Gangliosides; Humans; Male; Middle Aged; Stroke; Treatment Outcome; Vitamin B 12

To determine the efficacy of methylcobalamin combined with lidocaine for acute herpetic neuralgia.. Randomized controlled trial with longitudinal analysis.. The authors recruited 204 patients (>50 years) with T5-10 dermatomal acute herpetic neuralgia with rash onset within 7 days. Patients were divided into two groups based on the time of onset: immediate-early (IE, 1-3 days) and early stage (ES, 4-7 days) groups and then subdivided randomly into control (IE-Ctl, ES-Ctl) and treatment (IE-Tr, ES-Tr) groups.. Control groups received intramuscular methylcobalamin in addition to local lidocaine injection, while treatment groups received local methylcobalamin combined with lidocaine injection for 14 days. Treatment efficacy was assessed based on rash healing time, alteration in pain intensity, and interference with quality of life. Multilevel mixed modeling and survival analysis were employed to examine treatment responses.. There was no significant difference in the rash healing time between IE and ES. The mean pain scores in IE-Tr (2.4 ± 0.7) and ES-Tr (1.3 ± 0.7) decreased significantly compared with those in the control groups. The median satisfactory response time was 6 days in ES-Tr and 11 days in IE-Tr. The benefit ratio for ES-Tr versus IE-Tr was 14.94. The subjects in IE-Tr and ES-Tr had higher quality of life scores (81.2 ± 6.9 vs 88.3 ± 8.6, respectively) than those in the control groups. The incidence of postherpetic neuralgia was 1.1% at 3 months.. Local methylcobalamin combined with lidocaine, optimally administered within 4-7 days of onset, may be an effective therapeutic option for acute herpetic neuralgia.

Topics: Acute Disease; Aged; Anesthetics, Local; Drug Therapy, Combination; Female; Humans; Injections, Subcutaneous; Lidocaine; Longitudinal Studies; Male; Middle Aged; Neuralgia, Postherpetic; Prospective Studies; Vitamin B 12

Although a number of studies have reported raised total plasma homocysteine (tHcy) concentrations in free-living older people, there are no data on homocysteine response to a mixed nutrient supplement in older patients. A raised plasma homocysteine concentration in older patients is partly a reflection of their co-morbidity, including impaired renal function, and there is uncertainty about the extent to which dietary interventions can improve plasma tHcy.. To determine the plasma tHcy response to dietary supplements during acute illness.. Two-hundred and thirty-six hospitalized, acutely ill older patients, who were part of a randomized double-blind placebo-controlled trial, were assigned to receive a daily oral nutritional supplement drink containing 1.3 mg of vitamin B2, 1.4 mg of vitamin B6, 1.5 μg of B12, 200 μg of folic acid, or a placebo, for 6 weeks. Outcome measures were plasma tHcy concentration at baseline, 6 weeks, and 6 months.. The mean plasma tHcy concentration fell among patients given the supplements (mean difference 4.1 µmol/L [95 % C.I, 0.14 to 8.03), p = 0.043], but tHcy concentration increased between 6 weeks and 6 months, after patients stopped taking the supplements [mean difference -2.0 µmol/L (95 % C.I, -03.9 to -0.18), p = 0.033]. About 46 % of patients in the placebo group and 55 % of patients in the supplement group had hyperhomocysteinemia (>14 µmol/L) at baseline compared with 45 % and 29 % at the end of the treatment period.. A mixed nutrient supplement containing physiological amounts of B vitamins significantly reduced plasma tHcy concentrations in older patients recovering from acute illness.

Topics: Acute Disease; Aged; Dietary Supplements; Double-Blind Method; Female; Folic Acid; Homocysteine; Hospitalization; Humans; Male; Placebos; Riboflavin; Treatment Outcome; Vitamin B 12; Vitamin B 6

The study tested whether nutritional support of older patients during acute illness leads to a clinical benefit.. In this randomized, double-blind, placebo-controlled study, we randomly assigned 445 hospitalized patients aged 65 to 92 years to receive either a normal hospital diet plus 400 mL oral nutritional supplements (223 subjects) or a normal hospital diet plus a placebo (222 subjects) daily for 6 weeks. The composition of the supplement was such as to provide 995 kcal of energy and 100% of the Reference Nutrient Intakes for vitamins and minerals for a healthy older person. Patients had three assessments: at baseline, at 6 weeks, and at 6 months post-randomization. Outcome measures were 6 months of disability, non-elective readmission and length of hospital stay, discharge destination, morbidity, and mortality.. Randomization to the supplement group led to a significant improvement in nutritional status. Over 6 months, 65 patients (29%) in the supplements group were readmitted to the hospital compared with 89 patients (40%) in the placebo group (adjusted hazard ratio 0.68 [95% confidence interval 0.49-0.94]). The mean length of hospital stay was 9.4 days in the supplements group compared with 10.1 days in the placebo group. Thirty-two people (14%) died in the supplement group compared with 19 people (9%) in the placebo group at 6 months (adjusted hazard ratio 1.65 [95% confidence interval, 0.93-2.92]).. Oral nutritional supplementation of acutely ill patients improved nutritional status and led to a statistically significant reduction in the number of non-elective readmissions.

Topics: Acute Disease; Aged; Aged, 80 and over; Aging; Diet; Dietary Supplements; Double-Blind Method; Erythrocytes; Female; Folic Acid; Humans; Male; Nutritional Physiological Phenomena; Nutritional Status; Placebos; Vitamin B 12

Homocysteine is a proposed causal risk factor for atherosclerosis, but this remains controversial. We measured fasting plasma homocysteine concentrations immediately after atherothrombotic stroke and in the convalescent period to investigate this controversy.. One hundred six patients (59 men and 47 women, mean age 57.2 [25 to 70] and 56.5 [26 to 69] years, respectively) were recruited within 24 hours of admission, and 82 patients were resampled at least 3 months later. Fasting total plasma homocysteine (tHcy) concentrations were measured by high-performance liquid chromatography.. Median tHcy in the acute phase of stroke was not significantly higher than in matched control subjects (men 9.2 [range 4.4 to 22.8] versus 8.7 [4.9 to 20] micromol/L, P:=0.09, Mann-Whitney U: test; women 8.1 [4.8 to 32.3] versus 7.6 [3.3 to 14.4] micromol/L, P:=0.58). Median plasma concentrations increased significantly in the convalescent period (from 8.5 [4.8 to 19.2] to 10.1 [4.3 to 31.5] micromol/L, P:<0.001, Wilcoxon signed rank test) and were then significantly higher than in control subjects in both men and women (P:=0.03 and 0.05, respectively, Mann-Whitney U: test). This did not appear to be explained by alteration in the known covariates red-cell folate, serum B(12), or creatinine concentrations.. Homocysteine concentrations are not elevated after recent atherothrombotic stroke but rise in the convalescent period. These data do not support the hypothesis that raised plasma homocysteine concentrations predate atherothrombotic stroke. Instead, they offer an explanation for the discrepancies between prospective and retrospective studies and suggest that elevated tHcy levels may be caused by the disease process itself.

Topics: Acute Disease; Adult; Aged; Arteriosclerosis; Brain; Case-Control Studies; Chromatography, High Pressure Liquid; Convalescence; Female; Folic Acid; Homocysteine; Humans; Hyperhomocysteinemia; Intracranial Thrombosis; Lipids; Male; Middle Aged; Regression Analysis; Risk Factors; Scotland; Stroke; Stroke Rehabilitation; Tomography, X-Ray Computed; Vitamin B 12

Topics: Acute Disease; Adolescent; Adult; Aged; Clinical Trials as Topic; Diamines; Dibucaine; Drug Combinations; Drug Evaluation; Female; Humans; Male; Middle Aged; Phenylbutazone; Prednisolone; Rheumatic Diseases; Vitamin B 12

Extra vitamins are needed to repair tissue damage and compensate for diminished hepatic storage during viral hepatitis. Coenzyme-B12 has recently been synthesized and ought to have a favourable effect on the damaged liver cell as has previously been reported for cyanocobalamin, since it is better absorbed by oral administration and to a greater extent accumulated in the liver. Two groups of patients from the same hepatitis A epidemic were treated with either coenzyme-B12 or cyanocobalamin. A more rapid return of serum aminotransferase (S-ALAT) levels to normal was observed in the group treated with coenzyme-B12.

Topics: Acute Disease; Cobamides; Hepatitis, Viral, Human; Humans; Vitamin B 12

Topics: Acute Disease; Adolescent; Adrenal Glands; Adult; Clinical Trials as Topic; Cobamides; Coenzymes; Drug Combinations; Female; Hepatitis A; Hepatitis B; Humans; Jaundice; Liver Extracts; Liver Function Tests; Male; Nucleosides; Tissue Extracts; Vitamin B 12

Topics: Acute Disease; Adrenocorticotropic Hormone; Adult; Chronic Disease; Evoked Potentials; Extremities; Female; Folic Acid; Humans; Male; Methods; Motor Activity; Multiple Sclerosis; Neural Conduction; Peripheral Nerves; Vitamin B 12

Irradiation of food at 50-55 kGy results in a profound, chronic demyelinating-remyelinating disease of the entire central nervous system (CNS) in cats, named Feline Irradiated Diet-Induced Demyelination (FIDID). This study examines the early stages of demyelination and long-term consequences of demyelination and remyelination on axon survival or loss. Myelin vacuolation is the primary defect leading to myelin breakdown, demyelination then prompt remyelination in the spinal cord and brain. There is no evidence of oligodendrocyte death. The spinal cord dorsal column is initially spared yet eventually becomes severely demyelinated with subsequent loss of axons in the core and then surface of the fasciculus gracilis. However remyelination of the sub-pial axons in the dorsal column results in their protection. While there was a lack of biochemical evidence of Vitamin B12 deficiency, the pathological similarities of FIDID with sub-acute combined degeneration (SCD) led us to explore treatment with Vitamin B12. Treatment led to recovery or improvement in some cats and neurologic relapse on cessation of B12 therapy. While the reason that irradiated food is myelinotoxic in the cat remains unresolved, nonetheless the neuropathological changes match exactly what is seen in SCD and its models and provide an ideal model to study the cellular and molecular basis of remyelination.

Topics: Acute Disease; Animals; Axons; Cats; Chronic Disease; Demyelinating Diseases; Diet; Disease Models, Animal; Female; Macrophages; Male; Metabolome; Microglia; Myelin Sheath; Nerve Degeneration; Neuropathology; Radiation; Remyelination; Spinal Cord; Time Factors; Vitamin B 12

A recent trial of vitamin B12 supplementation among Indian children 6-30 months found no effect on the incidence of diarrhea and respiratory infections. These results differ with studies in adults that showed improvement of the immune response following treatment with vitamin B12. We sought to determine how the adequacy of vitamin B12 concentrations in breast milk could act as immune modulator and protect against the incidence of diarrhea and respiratory infections of children up to 18 months in urban Tanzania.. A prospective cohort study was undertaken to determine the association of breast milk vitamin B12 concentration with the incidence of acute respiratory infection and diarrhea among infants in urban Tanzania. A random sample of 491 women enrolled in a trial of multivitamins provided milk for B12 analysis at or around 6 weeks postpartum. Of 491 women, 345 had breast milk vitamin B12 inadequacy (< 310 pmol/L). Using generalized estimating equations, we found no overall association of milk vitamin B12 concentration with incident diarrhea and acute respiratory infections in infants. Studies measuring longitudinal changes of breast milk B12 concentration over time are needed to clarify the role of breast milk vitamin B12 in childhood infections.

Topics: Acute Disease; Adolescent; Adult; Breast Feeding; Diarrhea; Female; Humans; Incidence; Infant; Lactation; Male; Milk, Human; Prospective Studies; Respiratory Tract Infections; Tanzania; Vitamin B 12; Young Adult

Topics: Acute Disease; Adult; Diagnosis, Differential; Disease Progression; Homocystinuria; Humans; Male; Polyneuropathies; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Abdomen; Abdominal Pain; Acute Disease; Adult; Analgesics, Opioid; Drug Therapy, Combination; Ecchymosis; Fluid Therapy; Humans; Male; Pancreatitis; Pantoprazole; Proton Pump Inhibitors; Thiamine; Tomography, X-Ray Computed; Tramadol; Treatment Outcome; Vitamin B 12; Vitamin B Complex

Neurodegenerative processes are effective in schizophrenia. However, the underlying causes of the symptoms and associated factors have not yet been fully elucidated. Recent research has focused on the relationship between neurodegeneration and vitamin D, Klotho and homocysteine levels. In this study, we aimed to investigate this relationship in schizophrenia.. This study included 30 schizophrenic inpatients, 30 schizophrenic outpatients in remission and 28 healthy volunteers as the control group. The psychiatric diagnoses of our patients were evaluated according to DSM-IV criteria. The Positive and Negative Syndrome Scale (PANSS), the Global Assessment of Functioning (GAF) scale and the Clinical Global Impression (CGI) scale were used for clinical measurements. Serum Klotho, homocysteine, vitamin D, vitamin B12 and folic acid levels were analyzed using ELISA and compared with clinical properties.. The PANSS scores and CGI scores were higher in schizophrenic inpatients than outpatients, and the GAF scores were lower (p < 0.05). Three groups were compared for Klotho, homocysteine and vitamin D serum levels; Klotho levels were elevated but the difference was not statistically significant (p > 0.05). However, vitamin B12, folic acid and homocysteine levels were higher in schizophrenic patients than the control group (p < 0.05).. Higher levels of homocysteine with concomitant higher levels of vitamin B12 and folic acid suggest a relationship of this pathway with schizophrenia. Differences in Klotho levels were elevated but it was not significant. Replication studies to investigate probable associations with larger samples are needed.

Topics: Acute Disease; Adult; Aged; Case-Control Studies; Enzyme-Linked Immunosorbent Assay; Female; Folic Acid; Glucuronidase; Homocysteine; Humans; Klotho Proteins; Male; Middle Aged; Psychiatric Status Rating Scales; Schizophrenia; Vitamin B 12; Vitamin D; Young Adult

Topics: Acute Disease; Aged; Aged, 80 and over; Comorbidity; Cross-Sectional Studies; Female; France; Health Services for the Aged; Hematologic Diseases; Humans; Male; Middle Aged; Neoplasms; Vitamin B 12

Premacular retrohyaloid hemorrhage is a rare complication of acute severe anemia. The authors report two cases of premacular hemorrhage in which no treatment other than clinical and spectral-domain optical coherence tomography observation was performed. The natural history of this condition reveals that complete clinical resolution is not accompanied by full anatomical restoration. [Ophthalmic Surg Lasers Imaging Retina. 2014;45:E5-E7.].

Topics: Acute Disease; Adult; Anemia, Hemolytic, Autoimmune; Anemia, Megaloblastic; Blood Transfusion; Fluorescein Angiography; Folic Acid; Folic Acid Deficiency; Glucocorticoids; Humans; Male; Retinal Hemorrhage; Thrombocytopenia; Tomography, Optical Coherence; Vision Disorders; Visual Acuity; Vitamin B 12; Vitamin B 12 Deficiency

Cobalamin and folate are essential micronutrients and are important in DNA and RNA synthesis, cell proliferation, growth, hematopoiesis, and cognitive function. However, data on cobalamin and folate status are lacking particularly from young children residing in low and middle income countries.. To measure cobalamin and folate status and identifies their predictors among 6 to 35 months old children presenting with acute diarrhea.. This was a cross-sectional study in 823 children presenting with acute diarrhea. We measured plasma cobalamin, folate, methylmalonic acid and total homocysteine who sought treatment for acute diarrhea between June 1998 and August 2000.. The mean (SD) plasma concentrations of cobalamin, folate, total homocysteine and methylmalonic acid were 206 (124) pmol/L, 55 (32) nmol/L, 11.4 (5.6) µmol/L and 0.79 (1.2) µmol/L, respectively. The prevalence of low plasma cobalamin (<150 pmol/L) was 41% but less than 2% (15) children had low folate concentration (<10 nmol/L). Plasma homocysteine and methylmalonic acid concentrations were negatively associated with cobalamin concentration but not associated with folate status. The prevalence of cobalamin deficiency was higher in breastfed than non-breastfed children (44% vs 24%; p = <0.001). The prevalence of hyperhomocysteinemia (>10 µmol/L) and elevated methylmalonic acid (>0.28 µmol/L) were 73% and 52%, respectively. In the regression analyses, the plasma cobalamin concentration was positively associated with age, and introduction of animal or formula milk.. Our study indicated that poor cobalamin status was common particularly among breastfed children. Folate deficiency was virtually none existent. Possible consequences of cobalamin deficiency in young children need to be explored.

Topics: Acute Disease; Child, Preschool; Cross-Sectional Studies; Diarrhea; Female; Folic Acid; Humans; Infant; Male; Nepal; Vitamin B 12

To explore the relationship between total plasma homocysteine (tHcy) concentration and central retinal vein occlusion (CRVO) in the acute phase in a Chinese population.. This was a matched case-control study, and participants were recruited between January 2008 and April 2012. The cohort included 68 consecutive patients with CRVO and 68 controls, matched for age and gender, aged 50 years and over. The total plasma homocysteine, vitamin B12 and folate levels and the presence of C677T MTHFR polymorphisms were analyzed in all patients and controls. Fasting venous blood samples were collected within three days after CRVO.. There were no significant differences (p = 0.134) in mean plasma tHcy between CRVO patients (10.73 ± 3.21 µmol/l) and controls (9.99 ± 2.57 µmol/l), nor were there any statistically significant differences when subjects were categorized by ischemic and nonischemic CRVO. However, six patients (27.3%) in the ischemic group and three patients (6.5%) in the nonischemic group were found to have hyperhomocysteinemia (p = 0.018). There were no statistically significant differences in serum folate (p = 0.503) or vitamin B12 levels (p = 0.419) between CRVO patients (folate, 5.97 ± 2.06 ng/ml; vitamin B12, 411 ± 122 pg/ml) and controls (folate, 6.18 ± 1.42 ng/ml; vitamin B12, 427 ± 115 pg/ml). The prevalence of the homozygous genotype of the MTHFR C677T mutation was not significantly different in patients than in controls.. We found no association between tHcy in the acute phase after CRVO and CRVO occurrence in a Chinese population, but hyperhomocysteinemia were associated with the development of CRVO.

Topics: Acute Disease; Aged; Asian People; Cardiovascular Diseases; Female; Folic Acid; Genotype; Homocysteine; Humans; Hyperhomocysteinemia; Hyperlipidemias; Male; Methylenetetrahydrofolate Reductase (NADPH2); Middle Aged; Retinal Vein Occlusion; Risk Factors; Vitamin B 12

The study was designed to investigate the association between vitamin B12 levels and patients with acute-on-chronic liver failure (AoCLF). In addition, we analyzed whether B12 is associated with mortality in the AoCLF patients.. One hundred five patients with AoCLF and 44 healthy controls (HCs) were prospectively studied. In all subjects, a blood sample was collected at admission to examine liver function, renal function, international normalized ratio and B12 levels. A total of 9 clinical chemistry and biochemical variables were analyzed for possible association with outcomes by using Cox proportional hazards and multiple regression models.. AoCLF patients had significantly higher B12 levels at admission compared with HCs (AoCLF patients vs HCs, median 1218 pg/ml, mean 1736.2 pg/ml, SD, 1294.6 vs 504 pg/ml, 529.8 ± 149.8 pg/ml, P<0.001). Elevated B12 levels were associated with increased severity of liver disease and 3-month mortality rate. Multivariate analysis demonstrated that B12 levels and the model for end-stage liver disease score were independent predictors for mortality (both P<0.001).. B12 levels were significantly higher in AoCLF patients than in HCs and elevated B12 were associated with increased severity of disease. Moreover, B12 levels are an independent predicting factor for the 3-month mortality rate in AoCLF patients.

Topics: Acute Disease; Adult; Aged; Biomarkers; Case-Control Studies; End Stage Liver Disease; Female; Humans; Male; Middle Aged; Prognosis; Prospective Studies; Vitamin B 12

Our aim was to address the hypothesis that maternal dietary intake of folate during pregnancy is inversely associated with risk of acute lymphoblastic leukemia (ALL) in the offspring. Dietary intake of folate, vitamins B6 and B12 in the last 6 mo of pregnancy from 333 cases and 695 frequency-matched controls were assessed using a food frequency questionnaire. Data were analyzed using unconditional logistic regression, adjusting for study matching variables, total energy, and potentially confounding variables. Higher levels of dietary folate and B12 appeared to be associated with a decreased risk of ALL. Higher levels of vitamin B6 were associated with an increased risk. The strongest associations of ALL with these variables were seen when mothers consumed alcohol in pregnancy. Our findings are consistent with a modest protective effect of higher dietary intake of folate and vitamin B12 against ALL in the offspring, more particularly among women who drank alcohol during pregnancy. These findings are consistent with previous reports of the protective effects of a maternal diet high in fruit, vegetables, and nondairy protein sources. The vitamin B6 findings are not consistent with evidence that it is a protective factor against other cancers, and may be a chance finding.

Topics: Acute Disease; Adolescent; Adult; Case-Control Studies; Child; Child, Preschool; Diet; Female; Folic Acid; Humans; Infant; Logistic Models; Maternal Nutritional Physiological Phenomena; Nutrition Assessment; Odds Ratio; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Pregnancy; Prospective Studies; Risk Factors; Surveys and Questionnaires; Vitamin B 12; Vitamin B 6

The aim of this study was to investigate blood folic acid and vitamin B12 levels in patients with ischemic and hemorrhagic stroke patients and correlate these levels with prognosis.. Patients presenting within 3 hours of onset of ischemic or hemorrhagic strokes were approached for participation in the study. Diagnosis was made by clinical examination and head computed tomography scan. Venous blood samples were taken for determination of blood folic acid and vitamin B12 levels. Parameters were evaluated with respect to stroke type and according to Glasgow coma scale (< or =8 or > or =9).. Eighty-seven patients with ischemic stroke (mean age: 65 +/- 10 years, 53% male) and 27 patients with hemorrhagic stroke (mean age: 60 +/- 10 years, 56% male) were included in the study. A significant direct correlation was found between Glasgow coma scale and mean plasma B12 levels in ischemic, but not hemorrhagic, stroke (r=112.75 and p=0.007, respectively). A significant direct correlation was found between Glasgow coma scale and mean plasma folic acid levels in hemorrhagic, but not ischemic, stroke (r=1.03 and p=0.017, respectively). In patients with Glasgow coma scale < or =8 (either hemorrhagic or ischemic stroke), a significant direct correlation was found between Glasgow coma scale and blood vitamin B12 levels. Vitamin B12 levels were significantly lower in patients with Glasgow coma scale < or =8 than in patients with Glasgow coma score > or =9 (p=0.04).. In patients with ischemic stroke, low vitamin B12 levels, and in patients with hemorrhagic stroke, low blood folic acid levels, are associated with lower Glasgow coma scale values and higher hospital mortality.

Topics: Acute Disease; Aged; Biomarkers; Brain Ischemia; Female; Folic Acid; Glasgow Coma Scale; Humans; Intracranial Hemorrhages; Male; Middle Aged; Prognosis; Stroke; Time Factors; Vitamin B 12

Acute mesenteric venous thrombosis (AMVT) was first reported by Fagge and was recognised as a distinct clinical entity by Warreen in 1935. However, its pathogenesis is still unclear. Elevated plasma levels of homocysteine (Hcy) are associated with an increased risk of deep vein thrombosis. This case-control study examines the potential association among hyperhomocysteinaemia (hyper-Hcy), low serum folate and vitamin B(12) levels and the common C677T mutation of the MTHFR gene in patients with AMVT.. Sixty-three patients with AMVT and 75 sex- and age-matched healthy controls were recruited, and their plasma Hcy, folate and vitamin B(12) levels were measured by high performance liquid chromatography (HPLC) and immunological assays. The polymorphism of MTHFR C677T was detected by PCR-RFLP.. The mean plasma Hcy levels were significantly higher in patients with AVMT compared with controls (23.5 standard deviation (S.D.) 8.8 vs. 12.6+/-6.6micromoll(-1), P<0.01). The fasting Hcy correlated negatively with folate (AMVT: r=-0.42, P<0.01;. r=-0.40, P<0.01). The frequency of homozygous (TT) genotype in MTHFR C677T mutation was significantly higher in patients with AMVT than that in control subjects (33% vs. 17%; chi square (chi(2))=6.31, P<0.05; odds ratio (OR)=2.80; 95% confidence interval (CI): 1.25-6.25). Compared with the control subjects, the mean serum vitamin B(12) levels were lower in patients, but it was not statistically significant (365+/-88pmoll(-1) vs. 408+/-108pmoll(-1), P>0.05).. Hyper-Hcy and low serum folate levels were associated with an increased risk of AMVT. The homozygous (TT) genotype of MTHFR gene mutation may be a crucial hereditary risk factor in the development of AMVT for a Chinese population.

Topics: Acute Disease; Adult; Aged; Asian People; Biomarkers; Case-Control Studies; Chi-Square Distribution; China; Chromatography, High Pressure Liquid; Down-Regulation; Female; Folic Acid; Genetic Predisposition to Disease; Homocysteine; Homozygote; Humans; Hyperhomocysteinemia; Immunoassay; Male; Mesenteric Vascular Occlusion; Mesenteric Veins; Methylenetetrahydrofolate Reductase (NADPH2); Middle Aged; Mutation; Odds Ratio; Phenotype; Polymerase Chain Reaction; Polymorphism, Restriction Fragment Length; Risk Assessment; Risk Factors; Venous Thrombosis; Vitamin B 12; Young Adult

Blood levels of total homocysteine (tHcy), cysteine (Cys), total and reduced glutathione (tGSH and rGSH), folic acid (FA), and vitamin B12 (B12) change during ischemic stroke as accompaniment of the tissue damage. The relationship between these changes remains scantly investigated. We evaluated the variation of these molecules in the 48 h after acute large artery atherothrombotic stroke (LAAS) and searched for the presence of matched variation of them. The study involved 50 subjects affected by acute LAAS and 49 healthy controls. Plasma levels of tHcy and Cys were significantly higher and serum levels of FA and B12 and plasma levels of rGSH were significantly lower in the patients than in the control group. Acute LAAS was associated with increased Hcy-decreased tGSH and decreased FA/tGSH. Pathways involved in cellular stress and in tissue repair are activated during acute LAAS.

Topics: Acute Disease; Aged; Aged, 80 and over; Brain Ischemia; Cysteine; Female; Folic Acid; Glutathione; Homocysteine; Humans; Hyperhomocysteinemia; Intracranial Thrombosis; Male; Middle Aged; Risk Factors; Stroke; Vitamin B 12; Vitamins

To evaluate whether low levels of holotranscobalamin (holoTC) or elevated levels of methylmalonic acid (MMA), both indicators of vitamin B(12) deficiency, might predispose to new cardiovascular events following an acute myocardial infarction (MI).. A prospective prognostic study.. One hospital center in Stavanger, Norway.. A total of 300 patients admitted with an acute MI.. Registration of new TnT positive coronary events (defined as TnT>0.05 microg/l and a typical MI pattern) and/or cardiac death during a median follow-up time of 45 months.. We compared the recurrence of events in the lowest quartile of holoTC (Q1<73.9 pmol/l) to the event rate above the 25% percentile (Q2-4). For methylmalonic acid (MMA) the same comparison was carried out for the upper quartile (Q4 > or =0.24 micromol/l) as compared with the event rate below the 75% percentile (Q1-3). After 18 and 45 months of follow-up, the odds ratio (OR) for Q1 vs Q2-4 for holoTC was 1.15 (95% confidence interval (CI) 0.91-1.46, P=0.25) and 1.05 (95% CI 0.86-1.29, P=0.64), respectively. For MMA the OR for Q4 vs Q1-3 was 0.95 (95% CI 0.76-1.19, P=0.67) after 18 months and 1.01 (95% CI 0.83-1.23, P=0.90) after 45 months.. This study showed no increased risk of future cardiovascular events associated with low levels of holoTC or high levels of MMA following an acute MI.

Topics: Acute Disease; Aged; Aged, 80 and over; Biomarkers; Female; Follow-Up Studies; Homocysteine; Humans; Male; Methylmalonic Acid; Myocardial Infarction; Odds Ratio; Prognosis; Recurrence; Time Factors; Transcobalamins; Vitamin B 12; Vitamin B 12 Deficiency

Although increased plasma total homocysteine (tHcy) concentrations were reported in psychiatric diseases, currently the reasons of elevated tHcy levels were not clearly understood. In this study we aimed to investigate the contribution of renal clearance of homocysteine on plasma tHcy load in patients with depression and first episode psychosis.. Thirty depression, 14 first episode psychosis patients and 34 healthy individuals (control group) were involved in the study. In patients and control groups, plasma and urine tHcy levels, urine methylmalonic acid (uMMA), serum vitamin B12 and folate concentrations were measured.. Although there was not any difference between depression, psychosis and control groups with respect to mean (SD) values of vitamin B12 (289(131), 230 (72) and 249(79) pg/mL, respectively) and folate (6.4(4.0), 5.3(2.3) and 5.7(2.3) ng/mL, respectively), plasma tHcy levels of depression and psychosis group were higher than the control values (16.3(6.2), 15.5(4.3) and 9.9(2.1) micromol/L, respectively). Urine tHcy values of patient groups were significantly lower than those in the control group (14.5(7.6), 15.8(6.8) and 29.6(16.9) micromol/g creatinine, respectively). There were elevated uMMA levels in depression and psychosis groups compared with control group (4.9(2.4), 6.6(3.2) and 2.8(1.2) mmol/mol creatinine, respectively). There were a significant and negative correlation between urinary tHcy and plasma tHcy levels (r=-0.258 and p=0.011).. In conclusion, reduced urinary tHcy levels in psychiatric patients could be one of the reasons of plasma tHcy elevations with normal folate and vitamin B12 levels. Altered renal handling mechanisms of homocysteine may lead to elevated plasma tHcy levels by reduced clearance of homocysteine via glomerular filtration.

Topics: Acute Disease; Adult; Biomarkers; Chronic Disease; Female; Folic Acid; Homocysteine; Humans; Male; Meta-Analysis as Topic; Middle Aged; Psychotic Disorders; Vitamin B 12

Vitamin deficiencies are often part of malnutrition, which predisposes to acute lower respiratory tract infections.. The objective was to measure the association between cobalamin and folate status and subsequent respiratory morbidity.. A prospective cohort study was conducted in 2482 children aged 6-30 mo nested in a zinc supplementation trial. We measured plasma concentrations of folate, cobalamin, methylmalonic acid, and total homocysteine (tHcy) and followed the children for 4 mo.. We observed 1176 episodes of acute lower respiratory tract infections. Children with folate concentrations in the lowest quartile (interquartile range: 6.4-20.0 nmol/L) had a 44% higher incidence [adjusted incidence rate ratio (IRR): 1.44; 95% CI: 1.23, 1.70] of acute lower respiratory tract infections than did children in the other 3 quartiles. For tHcy, the IRR was 1.24 (1.07, 1.40) in a comparison of those in the highest quartile with those in the other quartiles. Breastfeeding was associated with high folate concentrations and protection against subsequent respiratory tract infections. This protection was significantly and substantially reduced after adjustment for plasma folate concentrations at baseline. Compared with the children in the other 3 quartiles, the IRR for being in the lowest quartile of cobalamin was 1.13 (0.76, 1.03) and for being in the highest quartile of methylmalonic acid was 1.12 (0.96, 1.31).. Poor folate status appears to be an independent risk factor for lower respiratory tract infections in young children. This study also suggests that the protective effect of breastfeeding is partly mediated by folate provided through breast milk.

Topics: Acute Disease; Child, Preschool; Cohort Studies; Female; Folic Acid; Homocysteine; Humans; Incidence; India; Infant; Male; Methylmalonic Acid; Multivariate Analysis; Prospective Studies; Regression Analysis; Respiratory Tract Infections; Risk Factors; Vitamin B 12

Topics: Acute Disease; Adult; Female; Folic Acid; Humans; Lactation; Pancytopenia; Postpartum Period; Time Factors; Vitamin B 12

Interferon-beta is a mainstay therapy of demyelinating diseases, but its effects are incomplete in human multiple sclerosis and several of its animal models. In this study, we demonstrate dramatic improvements of clinical, histological, and laboratory parameters in in vivo mouse models of demyelinating disease through combination therapy with IFN-beta plus vitamin B(12) cyanocobalamin (B(12)CN) in nonautoimmune primary demyelinating ND4 (DM20) transgenics, and in acute and chronic experimental autoimmune encephalomyelitis in SJL mice. Clinical improvement (p values <0.0001) was paralleled by near normal motor function, reduced astrocytosis, and reduced demyelination. IFN-beta plus B(12)CN enhanced in vivo and in vitro oligodendrocyte maturation. In vivo and in vitro altered expression patterns of reduced Notch-1 and enhanced expression of sonic hedgehog and its receptor were consistent with oligodendrocyte maturation and remyelination. IFN-beta-B(12)CN combination therapy may be promising for the treatment of multiple sclerosis.

Topics: Acute Disease; Animals; Brain; Cell Line; Chronic Disease; Demyelinating Diseases; Drug Synergism; Drug Therapy, Combination; Encephalomyelitis, Autoimmune, Experimental; Female; Hedgehog Proteins; Humans; Interferon-beta; Mice; Mice, Inbred Strains; Mice, Transgenic; Oligodendroglia; Peptide Fragments; Receptor, Notch1; Receptors, Cell Surface; Stem Cells; Trans-Activators; Transcription Factors; Vitamin B 12

Hyperhomocysteinemia is an independent risk factor for atherothrombotic cerebral stroke. Vitamin B12 and folic acid are important determinants of homocysteine metabolism. We aimed to evaluate the relationship, if present, between vitamin B12 and folic acid levels and acute cerebral stroke in this study. Blood aliquots drawn within 24 hours after the stroke from hospitalized patients (n=66) with the diagnosis of acute ischemic cerebrovascular episode and also blood samples from 38 healthy controls without any vascular risk factor were analyzed. With a competitive, chemoluminescence assay, serum levels of vitamin B12 and folic acid were measured in blood samples taken within 24 hours after the stroke. The differences and correlations were tested using frequency test, student-t test and multivariate analysis. Mean serum vitamin B12 levels were significantly lower in the patients than in the control subjects, 245.40 (S.D.: 72.9) and 343.2 (S.D.: 113.0) pg/ml respectively (p=0.0001). This difference was independent from other risk factors. Likewise, mean serum folic acid levels were lower in the patients than in the control subjects, 4.62 (S.D.: 1.94) and 5.97 (S.D.: 1.19) ng/ml, respectively (p=0.003). Mean serum levels of vitamin B12 and folate at the convalescence phase were 253.05 (S.D.: 68.78) pg/ml and 4.48 (S.D.: 2.08) ng/ml, respectively; the values obtained at the acute phase were not significantly different from the values obtained at the convalescence phase. We conclude that low vitamin B12 and folic acid concentrations are associated with an increased risk of stroke, and the relationship for vitamin B12 is independent from the other known modifiable stroke risk factors. For understanding the effects of B12 and folate in stroke patients, more detailed follow-up studies with long period are needed.

Topics: Acute Disease; Aged; Female; Folic Acid; Humans; Hyperhomocysteinemia; Intracranial Thrombosis; Male; Middle Aged; Reference Values; Risk Factors; Vitamin B 12

Topics: Acute Disease; Folic Acid; Gastrectomy; Humans; Male; Middle Aged; Peripheral Nervous System Diseases; Stomach Neoplasms; Treatment Outcome; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B 6 Deficiency; Vitamin B Complex

Although several prospective studies have shown that low folate intake and low circulating folate are associated with increased risk of coronary heart disease (CHD), the findings are inconsistent.. We studied the associations of dietary intake of folate, vitamin B(6), and vitamin B(12) with the risk of acute coronary events in a prospective cohort study of 1980 Finnish men 42 to 60 years old examined in 1984 to 1989 in the Kuopio Ischemic Heart Disease Risk Factor Study. Nutrient intakes were assessed by 4-day food record. During an average follow-up time of 10 years, 199 acute coronary events occurred. In a Cox proportional hazards model adjusted for 21 conventional and nutritional CHD risk factors, men in the highest fifth of folate intake had a relative risk of acute coronary events of 0.45 (95% CI 0.25 to 0.81, P=0.008) compared with men in the lowest fifth. This association was stronger in nonsmokers and light alcohol users than in smokers and alcohol users. A high dietary intake of vitamin B(6) had no significant association and that of vitamin B(12) a weak association with a reduced risk of acute coronary events.. The present work in CHD-free middle-aged men is the first prospective cohort study to observe a significant inverse association between quantitatively assessed moderate-to-high folate intakes and incidence of acute coronary events in men. Our findings provide further support in favor of a role of folate in the promotion of good cardiovascular health.

Topics: Acute Disease; Adult; Analysis of Variance; Clinical Trials as Topic; Cohort Studies; Coronary Disease; Diet; Dose-Response Relationship, Drug; Finland; Folic Acid; Follow-Up Studies; Humans; Incidence; Male; Middle Aged; Prospective Studies; Pyridoxine; Risk Factors; Vitamin B 12

Low folate levels are related to increased risk for coronary artery disease in humans, while experimental work has shown that folate deficiency is thrombogenic. We hypothesized that relatively low folate levels are related to the development of acute coronary syndromes in patients with previously stable coronary artery disease.. One hundred and forty-one men were studied: 53 consecutive patients with acute coronary syndromes, 41 with stable coronary artery disease and 47 control participants. Known clinical and lipid risk factors were identified in all subjects and in addition plasma B12, plasma and red cell folate levels were measured.. Red cell folate levels were significantly lower in patients with acute coronary syndromes (510+/-178 nmol/l) than in both stable coronary artery disease patients (638+/-264 nmol/l, P< 0.005) and controls (615+/-193 nmol/l, P< 0.05 respectively). Plasma folate and B12 levels were similar in all three groups. Multiple logistic regression analysis identified red cell folate levels as the only independent predictor of acute coronary events in the whole population of patients with known coronary artery disease and in the subgroup of non-smokers (P=0.010 and P=0.031).. The present study suggests that relatively low red cell folate levels are associated with acute coronary syndromes and are an independent predictor of acute coronary events.

Topics: Acute Disease; Cholesterol, HDL; Coronary Artery Disease; Erythrocytes; Folic Acid; Humans; Male; Predictive Value of Tests; Regression Analysis; Smoking; Syndrome; Vitamin B 12

Deficiency of vitamin B12 may produce neuropsychiatric disturbances. In the CNS the disease affects mainly myelin sheaths, and the spongy degeneration and diffuse demyelination of the posterior and lateral columns of the spinal cord are the classical pathological changes in patients with subacute combined degeneration. Similar changes also occur in cerebral hemispheres and MRI abnormalities in brain of such patients could be expected, but have received little attention. We report a case of pernicious anemia with neurological manifestations and brain MRI abnormalities. We discuss the neuropathological aspects and we suggest that pernicious anemia is a differential diagnosis to consider in central demyelinating lesions at MRI.

Topics: Acute Disease; Anemia, Pernicious; Brain Diseases; Demyelinating Diseases; Female; Follow-Up Studies; Humans; Magnetic Resonance Imaging; Middle Aged; Spinal Cord Diseases; Vitamin B 12

Vitamin B12 deficiency is a systemic disease that often affects the nervous system. One of the most prevalent manifestations is subacute combined degeneration (SCD) of the spinal cord. To access the clinical, electrophysiological, and structural abnormalities associated with SCD, a study was conducted in nine patients.. Clinical, electrophysiological (electroneurography, somatosensory and motor evoked potentials), and MRI evaluations were performed in patients before and after treatment.. The most prominent clinical and electrophysiological findings in all patients were dysfunctions of the posterior column. Corresponding hyperintense lesions in the posterior column of the spinal cord were found in two patients by T2 weighted MRI. Damage to the central motor pathway was identified in four patients. Demyelinating neuropathy was present in one patient and axonal neuropathy in four. All patients showed improvement of their symptoms after treatment with cobalamin. Abnormalities of the spinal cord on MRI disappeared early in recovery. Motor evoked potentials and median somatosensory evoked potentials typically normalised after treatment, whereas tibial somatosensory evoked potentials remained abnormal in most patients.. Clinical, electrophysiological, and MRI findings associated with SCD in vitamin B12 deficiency are diverse. Thus vitamin B12 deficiency should be considered in the differential diagnosis of all spinal cord, peripheral nerve, and neuropsychiatric disorders.

Topics: Acute Disease; Aged; Aged, 80 and over; Axons; Diagnosis, Differential; Evoked Potentials, Motor; Evoked Potentials, Somatosensory; Female; Humans; Magnetic Resonance Imaging; Male; Nerve Degeneration; Retrospective Studies; Spinal Cord Diseases; Tibial Nerve; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Acute Disease; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Nerve Degeneration; Spinal Cord Diseases; Spinal Nerves; Vitamin B 12

Measurements of tissue content of myeloperoxidase, a constituent of neutrophil azurophil granules and of unsaturated vitamin B12-binding protein from neutrophil-specific granules, have been used to assess intestinal inflammation. This paper reports results of a prospective evaluation of such measurements in serial colonoscopy biopsy specimens from patients with inflammatory bowel disease. Histologic grading of acute inflammation was based on perceived numbers of neutrophil polymorphs in sections from an immediately adjacent biopsy specimen. The mean + 2 SD range for unsaturated vitamin B12-binding protein activity in homogenates of histologically normal specimens was 62 pg mg protein-1. Values increased progressively up to 900 pg mg-1 protein in the most severely inflamed specimens. Unsaturated vitamin B12-binding protein measurements generally distinguished among histologic grades of inflammation, whereas myeloperoxidase activities failed to do this, probably because substantial myeloperoxidase activity was found in uninflamed colonic mucosa, suggesting a non-neutrophil source for this enzyme.

Topics: Acute Disease; Biopsy; Colonoscopy; Humans; Inflammation; Inflammatory Bowel Diseases; Intestinal Mucosa; Peroxidase; Prospective Studies; Vitamin B 12

Acute nonlymphocytic leukemia developed in a 57-year-old woman following adjuvant therapy with melphalan for ovarian carcinoma. Maturation of differentiating marrow myeloid and erythroid precursors was megaloblastic. The serum vitamin B12 level was low, and Schilling test revealed vitamin B12 malabsorption correctable with intrinsic factor. Megaloblastic maturation of the marrow cells was converted to normoblastic following treatment with vitamin B12 and folic acid. However, blast cells persisted in the marrow, and cytogenetic analysis revealed aneuploidy and trisomy 18. In contrast to the marrow blast cells, there was a decline in circulating blast cells following vitamin replacement, suggesting that these cells were capable of maturation but required vitamin B12 for this purpose.

Topics: Acute Disease; Anemia, Pernicious; Bone Marrow; Cell Division; Cystadenocarcinoma; Female; Folic Acid; Hemoglobins; Humans; Leukemia; Melphalan; Middle Aged; Ovarian Neoplasms; Vitamin B 12; Vitamin B 12 Deficiency

The brain oedema, distribution space (DS) and brain uptake index (BUI), of L-glucose, inulin, B12 vitamin and of three polypeptidic hormones of increasing molecular weight (angiotensin-I, gastrin and insulin) were measured in the rat after sham operation, porto-caval shunt (PCS) or liver ischaemia. At an early stage following PCS or liver ischaemia brain oedema was not constant, and was only demonstrable after liver ischaemia in a large number of animals. Substances without an active transport and with a low diffusion coefficient such as L-glucose and inulin had a very low BUI, unchanged even if the 3H2O brain content or the DS were modified. B12 vitamin, DS and BUI were very high and did not change after liver ischaemia or PCS. Insulin DS and BUI were low in the three groups of animals, whereas it decreased after PCS for gastrin. A significant increase of BUI and DS (without any cerebral oedema) was demonstrated for angiotensin-I, a polypeptidic hormone of molecular weight 1300. This polypeptidic marker is in the same range of MW as the preliminary recently recognized medium-sized molecules which may be involved in the pathogenesis of encephalopathy during experimental acute liver failure. However, not only the MW, but the nature of such polypeptides may be of importance in the genesis of this limited impairment of BBB permeability.

Topics: Acute Disease; Angiotensin I; Animals; Blood-Brain Barrier; Brain Edema; Ischemia; Liver; Male; Molecular Weight; Permeability; Portacaval Shunt, Surgical; Rats; Rats, Inbred Strains; Vitamin B 12

In acute poisoning the main purpose of any therapeutic approach is a rapid removal of the drug or poison from body tissues. This approach suggested to undertake a study for the development of an uncoated activated carbon hemoperfusion column suitable for acute poisoning. Th clearances were significantly superior compared with a similar device manufactured using coated carbon. The microparticle generation, utilizing a spherical type of activated carbon, was undetectable with the adopted measuring method, well below the US and British Pharmacopeas limits and practically equal to a coated carbon column with identical geometry.

Topics: Acute Disease; Adsorption; Animals; Blood Glucose; Blood Urea Nitrogen; Carbon; Creatinine; Hemoperfusion; Humans; Inulin; Particle Size; Phenobarbital; Poisoning; Rabbits; Salicylates; Salicylic Acid; Uric Acid; Vitamin B 12

By means of a test set of the Isocommerz (GDR) determinations of vitamin B12 in the serum were carried out according to the principle of the competitive protein binding. The normal values lie between 200 and 1,000 pg/ml serum. Clearly decreased levels of vitamin B12 are found in the pernicious anaemia, in other megaloblastic anaemias and in disturbances of the resorption after resection of the stomach. Increased values can be stated in the untreated chronic myelosis and in the blast episode. Under Busulphan-therapy a significant decrease of the values of vitamin B12 develops. The method seems to be practically important for the well-timed recognition of deficiency conditions of vitamin B12 in beginning pernicious anaemia, in disturbances of intestinal resorption after resection of the stomach and for the observation of the course of the chronic myelosis.

Topics: Acute Disease; Anemia, Pernicious; Busulfan; Hematologic Diseases; Humans; Leukemia; Leukemia, Myeloid; Polycythemia; Postgastrectomy Syndromes; Vitamin B 12

Thirteen patients with significant hemorrhage, severe thrombocytopenia, and megaloblastic bone marrows are described. Unusual features of this problem included its acute onset, frequent absence of the typical peripheral blood changes of megaloblastic anemia, normal serum B12 levels, and serum folates which were often not clearly abnormal. Most patients were critically ill and common clinical features included reduced dietary intake, renal failure, renal dialysis, the postoperative state, and sepsis. These clinical features, the laboratory findings, and a platelet increase in most patients after folate therapy lead to the conclusion that this problem is probably due to acute folic acid deficiency. Possible explanations for the atypical laboratory findings include the acuteness of onset, recent blood transfusion therapy, and impaired folate utilization. This problem may be relatively common. Because of its potential clinical importance, rapid onset, and attendent diagnostic difficulties, prophylactic folic acid is recommended in the clinical setting described.

Topics: Acute Disease; Anemia, Megaloblastic; Bone Marrow Examination; Folic Acid; Folic Acid Deficiency; Hemorrhage; Humans; Thrombocytopenia; Vitamin B 12

Topics: Acute Disease; Adolescent; Age Factors; Child; Child, Preschool; Glutamate Dehydrogenase; Hepatitis, Viral, Human; Humans; Vitamin B 12

Topics: Acute Disease; Benzopyrans; Catechin; Drug Evaluation; Drug Therapy, Combination; Fructose; Hepatitis, Viral, Human; Humans; Vitamin B 12

Nine patients were selected according to the following criteria: 1. Hematological findings consistent with the diagnosis of myelofibrosis with myeloid metaplasia (MMM), except for an excess of blasts in the blood and bone marrow; 2. No previous (silent) phase of MMM. 3. No PH1 chromosome, and 4. No identifiable cause of secondary myelofibrosis. These patients had either an acute or subacute myelofibrosis. The onset of such symptoms as fever, bone pain, hemorrhage and mild splenomegaly was rapid. Terminal acute leukemia or more often progressive bone marrow biopsy showing myelofibrosis with persistence of differentiated myeloid tissue, particularly megacaryocytes. Isotopic studies (59Fe and 51Cr) showed splenic erythroid metaplasia, poor bone marrow 59Fe uptake and increased peripheral red blood cell destruction. This study confirms that malignant myelosclerosis is a well-defined syndrome which must be distinguished from: a) Acute transformation of typical agnogenic myeloid metaplasia even though it was previously undiagnosed (4 cases of MMM illustrating this possibility have been reported); b) Acute myeloblastic leukemia with myelofibrosis; and c) Myelofibrosis secondary to lymphomatous or carcinomatous bone-marrow invasion (2 cases with acute myelofibrosis appearing long after appropriate treatment have been reported).

Topics: Acute Disease; Adult; Aged; Alkaline Phosphatase; Bone Marrow Examination; Cell Survival; Erythrocytes; Erythropoiesis; Female; Folic Acid; Humans; Leukemia; Leukocytes; Male; Middle Aged; Primary Myelofibrosis; Uric Acid; Vitamin B 12

Topics: Acute Disease; Chronic Disease; Female; Humans; Male; Pancreatitis; Vitamin B 12

Topics: Acute Disease; Adolescent; Adult; Aged; Chronic Disease; Female; Humans; Male; Middle Aged; Pancreatitis; Vitamin B 12

446 patients with acute rheumatic diseases were treated intensively for an extremely short peroid with Ambene ampoules and Ambene coated tablets. Physical measures were used from the first day of treatment. Bed rest was dispensed with. Under this plan of treatment, 55.3% of the patients were free of complaints within 3 days and 33.4% within 6 days. In spite of extremely high doses of phenylbutazone, no noteworthy side effects appeared.

Topics: Acute Disease; Administration, Oral; Adolescent; Adult; Aged; Aluminum; Aminopyrine; Anti-Inflammatory Agents; Drug Combinations; Female; Glycine; Humans; Injections, Intramuscular; Lidocaine; Male; Middle Aged; Patient Care Planning; Phenylbutazone; Physical Therapy Modalities; Rheumatic Diseases; Vitamin B 12

This paper describes the clinical history of an adult male who was found to be suffering from subacute combined degeneration of the spinal cord. It is believed that this is the first report of this condition in Papua New Guinea.

Topics: Acute Disease; Humans; Male; Middle Aged; Nerve Degeneration; Neurologic Examination; Spinal Cord Diseases; Vitamin B 12

New tests and test methods aid in the diagnosis of pancreatic disorders. Pancreatic carcinoma, especially, may have an improved prognosis with earlier detection as a result of refinements in arteriography, cytology, pancreatic radioisotopic scanning, and endoscopic retrograde cholangiopancreatography. Acute pancreatitis results most commonly from alcoholism, biliary tract disease, and trauma. Management is directed primarily at decreasing pancreatic exocrine secretion. Surgery is usually best avoided in the acute phase. Chronic pancreatitis is most often a result of recurrent attacks of acute pancreatitis. Diabetes and malassimilation become manifest as pancreatic destruction progresses. Management consists of replacement of pancreatic enzymes and diet supplements. Once chronic pancreatitis is established, surgery can only be directed at complications of the disease. Pancreatic ascites is usually associated with a break in the pancreatic ductal system. Ascites caused by trauma responds well to surgical intervention, but the alcoholic type is less amenable to treatment.

Topics: Acute Disease; Alcoholism; Antacids; Ascites; Carcinoembryonic Antigen; Cholangiography; Chronic Disease; Cysts; Diabetes Mellitus; Diet Therapy; Endoscopy; Gastrointestinal Hemorrhage; Humans; Metabolic Diseases; Methionine; Pancreatic Diseases; Pancreatic Juice; Pancreatic Neoplasms; Pancreatin; Pancreatitis; Prognosis; Selenium; Ultrasonics; Vitamin B 12

Topics: Acute Disease; Adolescent; Age Factors; Child; Child, Preschool; Cobalt Radioisotopes; Hepatitis A; Humans; Infant; Liver; Vitamin B 12

Topics: Acute Disease; Chronic Disease; Diagnosis, Differential; Female; Galactose; Hepatitis; Humans; Liver Cirrhosis; Male; Prognosis; Vitamin B 12

Rats were rendered iron deficient by a combination of diet and bleeding to study its effects on vitamin B(12) absorption. Small intestinal loops were isolated in vivo and the absorption of -57Co-vitamin B(12) bound to a known quantity of intrinsic factor was measured. Iron deficiency resulted in the impairment of both uptake and transport of B(12). This malabsorption was corrected within 5 days by parenteral iron repletion. The findings were not due to a non-specific effect of anaemia since no correlation existed between haemoglobin levels and B(12) absorption in rats anaemic as a result of acute blood loss. No evidence was found for an altered small-intestinal microflora, bacterial counts being similar in iron-deficient and control rats. It is concluded that iron deficiency in the rat results in impaired absorption of B(12) by the small intestine, probably as a result of some defect produced in the enterocyte.

Topics: Acute Disease; Anemia, Hypochromic; Animals; Bacteria; Cobalt Radioisotopes; Female; Intestinal Absorption; Intestine, Small; Intrinsic Factor; Kidney; Liver; Rats; Vitamin B 12

Topics: Acute Disease; Aminopyrine; Arthritis, Rheumatoid; Dexamethasone; Drug Combinations; Female; Humans; Lidocaine; Male; Pain; Phenylbutazone; Prednisolone; Riboflavin; Thiamine; Vitamin B 12

Topics: Acute Disease; Animals; Cardiomegaly; Folic Acid; Leucine; Male; Myocardial Contraction; Myocardium; Orotic Acid; Protein Biosynthesis; Rats; Stimulation, Chemical; Uridine; Vitamin B 12

Topics: Acute Disease; Adolescent; Adult; Afibrinogenemia; Autopsy; Biopsy; Blood Proteins; Bone Marrow; Child; Disseminated Intravascular Coagulation; Female; Hemorrhage; Humans; Leukemia, Myeloid, Acute; Leukopenia; Liver; Male; Middle Aged; Protein Binding; Vitamin B 12

Topics: Acute Disease; Amino Acids; Aprotinin; Calcium; Chronic Disease; Humans; Pancreatitis; Vitamin B 12

Topics: Acute Disease; Adolescent; Child; Child, Preschool; Cobalt Isotopes; Giardiasis; Growth; Helminthiasis; Hepatitis A; Humans; Infant; Radioisotope Dilution Technique; Trichuriasis; Vitamin B 12

Topics: Acute Disease; Adult; Aged; Alanine Transaminase; Alkaline Phosphatase; Amino Acids; Aspartate Aminotransferases; Bilirubin; Body Weight; Chronic Disease; Citric Acid Cycle; Drug Combinations; Evaluation Studies as Topic; Female; Humans; Liver Diseases; Liver Extracts; Male; Middle Aged; Vitamin B 12

Topics: Acute Disease; Adrenocorticotropic Hormone; Adult; Biopsy; Chlorpromazine; Cytochromes; Dimercaprol; Edetic Acid; Female; Folic Acid; Humans; Male; Middle Aged; Neostigmine; Niacinamide; Porphyrias; Reserpine; Riboflavin; Vitamin B 12

Intestinal function was studied in 26 patients with seven types of acute and chronic liver disease, documented by liver biopsy. Steatorrhea, defined by a stool fat higher than 6 g. per day, was present in 18 of 23 consecutive patients studied, an incidence of 78.3%. Two patients with infectious hepatitis associated with steatorrhea studied previously were added and the 20 cases were analyzed. The malabsorption found was confined to fat and fat-soluble vitamins; stool excretion varied from 6.1 to 22 g. per day in the seven groups studied. No histological abnormality was seen on jejunal biopsy, serum vitamin B(12), D-xylose and Schilling tests were normal, and no radiological findings associated with malabsorption were detected in the small bowel. It is concluded that steatorrhea is a common finding in a wide variety of acute and chronic liver diseases and cannot be attributed to a primary defect of the small bowel.

Topics: Acute Disease; Adolescent; Adult; Alkaline Phosphatase; Aspartate Aminotransferases; Bilirubin; Celiac Disease; Chromatography, Thin Layer; Chronic Disease; Diagnosis, Differential; Female; Hepatitis A; Humans; Intestinal Absorption; Intestine, Small; Liver Diseases; Liver Function Tests; Malabsorption Syndromes; Male; Middle Aged; Pancreatitis; Vitamin B 12

Topics: Acute Disease; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Prognosis; Vitamin B 12

Topics: Acute Disease; Chronic Disease; Coenzymes; Folic Acid; Hepatitis; Histidine; Humans; Liver Cirrhosis; Liver Diseases; Liver Function Tests; Liver Neoplasms; Male; Middle Aged; Vitamin B 12

Topics: Acute Disease; Animals; Coenzymes; Female; Hypoproteinemia; Male; Plasmapheresis; Rabbits; Serum Albumin; Time Factors; Vitamin B 12

Topics: Acute Disease; Chronic Disease; Female; Hepatitis; Hepatitis A; Humans; Male; Vitamin B 12

Topics: Acute Disease; Adult; Bromides; Cytochromes; Female; Humans; Porphyrias; Vitamin B 12

Topics: Acute Disease; Adrenal Cortex Hormones; Cholestyramine Resin; Chronic Disease; Diet Therapy; Hepatitis; Humans; Liver; Liver Cirrhosis; Long-Term Care; Organotherapy; Tissue Extracts; Vitamin B 12

Topics: Acute Disease; Animals; Blood Urea Nitrogen; Body Weight; Chlortetracycline; Cholesterol; Choline Deficiency; Cystine; Diet; Feces; Germ-Free Life; Hematocrit; Kidney Diseases; Lipid Metabolism; Liver; Male; Neomycin; Rats; Stimulation, Chemical; Vitamin B 12

Topics: Acute Disease; Adolescent; Adult; Anti-Bacterial Agents; Asia, Southeastern; Female; Folic Acid; Folic Acid Deficiency; Helminthiasis; Humans; Ileum; Indican; Jejunum; Male; Middle Aged; Military Medicine; Sprue, Tropical; Vitamin B 12

Topics: Acute Disease; Adult; Blood Transfusion; Bone Diseases; Bone Marrow Diseases; Bone Marrow Examination; Chloramphenicol; Female; Folic Acid; Hepatitis A; Hip Joint; Humans; Myeloproliferative Disorders; Prednisone; Testosterone; Vitamin B 12

Topics: Acute Disease; Humans; Pharyngitis; Tonsillitis; Vitamin B 12

Topics: Acute Disease; Cerebellar Ataxia; Child; Child, Preschool; Female; Gait; Humans; Male; Posture; Prednisone; Speech Disorders; Vitamin B 12

Topics: Acute Disease; Aged; Anti-Bacterial Agents; Diathermy; Electrophoresis; Encephalitis; gamma-Globulins; Ganglia; Herpes Zoster; Humans; Male; Massage; Meningism; Meningitis, Viral; Middle Aged; Neuralgia; Neuritis; Pantothenic Acid; Physical Therapy Modalities; Procaine; Radiography; Vitamin B 12; Vitamin B Complex

Topics: Acute Disease; Adolescent; Adult; Aged; Eosinophils; Feces; Female; Hepatitis A; Humans; Liver; Liver Function Tests; Male; Middle Aged; Organotherapy; Pruritus; Spleen; Tissue Extracts; Vitamin B 12

From 25 patients with acute leukemia 116 specimens of leukocytes were assayed microbiologically for total vitamin B(12) to determine if variation in vitamin B(12) content would help in differentiating the acute leukemias. The mean cell vitamin B(12) levels (mumug./10(8) cells) in the different types of leukemia were: lymphoblastic 464, myeloblastic 1058 and monocytic 200. Cell vitamin B(12) levels above the normal range (100-800 mumug./10(8) cells) are suggestive of myeloblastic leukemia. The only elevated cell vitamin B(12) levels comparable to those found in myeloblastic leukemia were in reticulum cell leukemia, and this type of leukemia was not difficult to diagnose morphologically. Blast cells contained more vitamin B(12) than mature cells of the same series; there was a significant positive correlation between the percentage of blast cells and cell levels of total vitamin B(12) in both lymphoblastic and myeloblastic leukemia.

Topics: Acute Disease; Animals; Diagnosis, Differential; Humans; Leukemia; Leukemia, Myeloid; Leukocytes; Lymphocytes; Monocytes; Vitamin B 12

Topics: Acute Disease; Adolescent; Dexamethasone; Drug Therapy, Combination; Exophthalmos; Fascia; Humans; Male; Oleandomycin; Orbital Myositis; Scleritis; Tetracycline; Thiamine; Vitamin B 12

Topics: Acute Disease; Cholesterol; Communicable Diseases; Corrinoids; Hematinics; Humans; Infections; Smoking; Students, Medical; Vitamin B 12

Topics: Acute Disease; Blood; Hematinics; Humans; Leukemia; Vitamin B 12

Topics: Acute Disease; Corrinoids; Hematinics; Leukemia; Vitamin B 12