vitamin-k-semiquinone-radical and Nutrition-Disorders

Chronic alcoholics frequently have evidence of nutritional deficiency due to decreased intake, reduced uptake and impaired utilisation of nutrients. The alcoholic has increased nutrient requirements due to greater metabolic demands and the need for tissue repair. Chronic alcohol-related brain damage can often be a direct result of nutrient depletion, particularly of the vitamins thiamine, B12, nicotinamide and pyridoxine. Lesser degrees of brain damage are frequently unrecognised, and by the time a vitamin deficiency syndrome has developed and been diagnosed, irreversible damage has often occurred. The development of suitable computerised psychometric tests may allow earlier detection of brain malfunction associated with malnutrition, which can be reversed by nutrient repletion before permanent damage occurs. Circulating levels of vitamins can be a valuable guide to nutritional status, although care is needed when interpreting the results of such tests in the alcoholic. Sensitive microbiological and biochemical tests for assessing vitamin status in man have been available for some years, and in addition, new biochemical methods are constantly being developed. It is important that such methods are evaluated, and possibly adapted for clinical use where appropriate. Newer methods may have significant advantages over older, more established techniques. For thiamine and pyridoxine, for example, methods now exist to determine accurately circulating levels of the active forms of these vitamins, which could give more direct assessment of vitamin status than earlier methodology that uses indirect measurements, such as red cell enzyme activities. On the other hand, in the case of folate and B12, there has been a tendency to opt for the easy-to-perform radioassay techniques, when in fact the earlier microbiological methods offer greater sensitivity and probably also better accuracy. Technically difficult assays should not be disregarded if they can give information which is of greater clinical use than a simpler assay technique. Clinical laboratories should always bear in mind what their vitamin methods are actually measuring, particular consideration being given to whether metabolically inactive forms or analogues are determined in the assay. This can be of importance to the interpretation of vitamin data in the alcoholic, who often has problems forming active vitamins from their precursors.(ABSTRACT TRUNCATED AT 400 WORDS)

Topics: Alcoholism; Ascorbic Acid; Avitaminosis; Ethanol; Humans; Intestinal Absorption; Nutrition Disorders; Nutritional Requirements; Vitamin A; Vitamin B Complex; Vitamin D; Vitamin E; Vitamin K; Vitamins

Topics: Copper; Fluoride Poisoning; Folic Acid; Humans; Hypervitaminosis A; Iron; Nicotinic Acids; Nutrition Disorders; Obesity; Sodium; Vitamin D; Vitamin K

To report a case of hypoprothrombinemia associated with the use of cefmetazole sodium, define patients at risk for this adverse effect, and identify options to prevent this problem.. A malnourished patient with endstage renal disease received cefmetazole following a below-the-knee amputation of the right leg. Three days later, a prothrombin time (PT) and an international normalized ratio (INR) were obtained and were markedly elevated from baseline; however, the patient had no clinical symptoms of bleeding. Cefmetazole was discontinued. Vitamin K and fresh frozen plasma were administered. The PT and INR normalized within 24 hours and remained normal throughout the remainder of hospitalization.. The incidence of hypoprothrombinemia associated with cefmetazole reported in the literature is conflicting and not consistent. There are three proposed mechanisms of cephalosporin-associated hypoprothrombinemia, two of which involve the N-methylthiotetrazole (NMTT) chain. The most plausible mechanism is NMTT inhibition of vitamin K epoxide reductase in the liver. Patients at an increased risk for this adverse event include those with low vitamin K stores, specifically patients who are malnourished, with low albumin concentrations and poor food intake. The elderly and patients with liver or renal dysfunction are examples of populations at risk.. Hypoprothrombinemia may occur with cephalosporins and is especially problematic with those containing an NMTT side chain. Clinicians need to identify patients at risk for developing antibiotic-associated hypoprothrombinemia, monitor them closely, and give vitamin K as prophylaxis accordingly.

Topics: Anti-Bacterial Agents; Cefmetazole; Cephalosporins; Humans; Hypoprothrombinemias; Male; Middle Aged; Nutrition Disorders; Vitamin K

Topics: Cephalosporins; Colon; Humans; Hypoprothrombinemias; Liver; Nutrition Disorders; Vitamin K; Vitamin K Deficiency

The alcohol withdrawal syndromes are generally self-limited processes from which spontaneous recovery can be anticipated. To achieve this outcome, the various types of withdrawal must be managed in such a way as to prevent the occurrence of life-threatening situations. This begins with a good initial evaluation, followed by the appropriate pharmacologic and behavioral steps to control the severity of withdrawal symptoms and to manage complications. Once the withdrawal process is completed, the patient can then be entered into a long-term treatment program.

Topics: Acute Disease; Alcohol Withdrawal Delirium; Alcoholism; Benzodiazepines; Chloral Hydrate; Ethanol; Folic Acid; Gastrointestinal Hemorrhage; Hallucinations; Humans; Nutrition Disorders; Seizures; Social Support; Substance Withdrawal Syndrome; Thiamine; Vitamin K; Water-Electrolyte Imbalance

The coagulopathy induced by vitamin K deficiency commonly results from our lack of awareness of the clinical setting associated with vitamin K deficiency. Thirteen cases are reviewed to illustrate the clinical correlates most frequently observed. Dietary deficiency was always present, but concomitant antibiotic therapy was not an absolute requirement. The postoperative patient is at high risk, as is the patient with cancer or renal failure. Abnormal bleeding was common, but significant hemorrhage occurred only in postoperative patients. Factor assays were helpful and occasionally necessary to make the diagnosis, but a therapeutic trial with parenteral vitamin K was often enough to provide the right diagnosis. Greater awareness of this deficiency syndrome is necessary to avoid the serious morbidity that often results.

Topics: Adult; Aged; Anti-Bacterial Agents; Blood Coagulation Disorders; Humans; Kidney Failure, Chronic; Male; Middle Aged; Neoplasms; Nutrition Disorders; Preoperative Care; Risk; Surgical Procedures, Operative; Vitamin K; Vitamin K Deficiency

Fourteen cases of ASA induced hypoprothrombinemic bleeding, including three patients reported by the authors, are reviewed. Predisposing factors toward bleeding include malnutrition and malabsorption syndrome. Although the bleeding is usually benign, it may be serious on occasion. The importance of this rarely considered cause of ASA associated bleeding lies in the fact that it is readily corrected with Vitamin K.

Topics: Adult; Aged; Arthritis, Rheumatoid; Aspirin; Epistaxis; Female; Humans; Hypoprothrombinemias; Malabsorption Syndromes; Male; Middle Aged; Nutrition Disorders; Vitamin K

Topics: Blood Coagulation Disorders; Blood Coagulation Factors; Blood Coagulation Tests; Blood Proteins; Child, Preschool; Dehydration; Dietary Proteins; Emaciation; Factor V Deficiency; Humans; Infant; Kwashiorkor; Liver Function Tests; Nutrition Disorders; Protein-Energy Malnutrition; Prothrombin Time; Vitamin K

Topics: Humans; Nutrition Disorders; Nutritional Physiological Phenomena; Nutritional Sciences; Nutritional Status; Vitamin A; Vitamin K; Vitamins

Topics: Coronary Disease; Diet; Humans; Lipid Metabolism; Lipids; Nutrition Assessment; Nutrition Disorders; Vitamin K; Vitamins

Topics: Amino Acids; Humans; Nutrition Disorders; Vitamin A; Vitamin K; Vitamins

Topics: Aged; Geriatrics; Glutamates; Humans; Mental Disorders; Nutrition Disorders; Vitamin A; Vitamin K; Vitamins

Topics: Androgens; Child; Feeding and Eating Disorders; Humans; Infant; Nutrition Disorders; Pediatrics; Vitamin A; Vitamin K; Vitamins

Topics: Avitaminosis; Dermatology; Humans; Nutrition Disorders; Skin Diseases; Vitamin A; Vitamin K; Vitamins

Topics: Hormones; Humans; Nutrition Disorders; Nutritional Sciences; Nutritional Status; Stress, Psychological; Vitamin A; Vitamin K; Vitamins

Topics: Humans; Infant; Infant Nutritional Physiological Phenomena; Nutrition Disorders; Vitamin A; Vitamin K; Vitamins

Topics: Hormones; Humans; Infections; Nutrition Disorders; Nutritional Status; Vitamin A; Vitamin K; Vitamins