Sample records for pellagra

  1. Pellagra (United States)

    ... Images Vitamin B3 deficit References Crook MA. The importance of recognizing pellagra (niacin deficiency) as it still ... team. Alcoholism and Alcohol Abuse Read more B Vitamins Read more Malnutrition Read more A.D.A.M., Inc. is accredited by URAC, also ...

  2. Pellagra Associated with Psychosis

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    B B Lal


    Full Text Available A case of pellagra who had psychosis, dermatitis and gastrointestinal system involvement in the form of constipation has been described. In this case mental symptoms in the form of insomnia appeared prior to dermal lesions. The case was successfully treated both for the mental and skin condition with nicotinamide and other ancillary treatment.

  3. Politics and pellagra: the epidemic of pellagra in the U.S. in the early twentieth century. (United States)

    Bollet, A. J.


    The epidemic of pellagra in the first half of this century at its peak produced at least 250,000 cases and caused 7,000 deaths a year for several decades in 15 southern states. It also filled hospital wards in other states, which had a similar incidence but refused to report their cases. Political influences interfered, not only with surveillance of the disease, but also in its study, recognition of its cause, and the institution of preventive measures when they became known. Politicians and the general public felt that it was more acceptable for pellagra to be infectious than for it to be a form of malnutrition, a result of poverty and thus an embarrassing social problem. Retrospectively, a change in the method of milling cornmeal, degermination, which began shortly after 1900, probably accounted for the appearance of the epidemic; such a process was suggested at the time, but the suggestion was ignored. PMID:1285449

  4. Pellagra-like condition is xeroderma pigmentosum/Cockayne syndrome complex and niacin confers clinical benefit. (United States)

    Hijazi, H; Salih, M A; Hamad, M H A; Hassan, H H; Salih, S B M; Mohamed, K A; Mukhtar, M M; Karrar, Z A; Ansari, S; Ibrahim, N; Alkuraya, F S


    An extremely rare pellagra-like condition has been described, which was partially responsive to niacin and associated with a multisystem involvement. The condition was proposed to represent a novel autosomal recessive entity but the underlying mutation remained unknown for almost three decades. The objective of this study was to identify the causal mutation in the pellagra-like condition and investigate the mechanism by which niacin confers clinical benefit. Autozygosity mapping and exome sequencing were used to identify the causal mutation, and comet assay on patient fibroblasts before and after niacin treatment to assess its effect on DNA damage. We identified a single disease locus that harbors a novel mutation in ERCC5, thus confirming that the condition is in fact xeroderma pigmentosum/Cockayne syndrome (XP/CS) complex. Importantly, we also show that the previously described dermatological response to niacin is consistent with a dramatic protective effect against ultraviolet-induced DNA damage in patient fibroblasts conferred by niacin treatment. Our findings show the power of exome sequencing in reassigning previously described novel clinical entities, and suggest a mechanism for the dermatological response to niacin in patients with XP/CS complex. This raises interesting possibilities about the potential therapeutic use of niacin in XP. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Livedo reticularis due to pellagra in a two year old child

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    Biju Vasudevan


    Full Text Available A two-year-old girl child was admitted with complaints of diarrhoea of one week duration in the paediatric ward. She was referred to the skin OPD for gradually progressive skin rashes on both lower limbs noticed since two days. Dermatological examination revealed finding of livedo reticularis. Dietary history revealed maize forming a significant portion of the child′s diet since the age of nine months. The child was treated with a course of Niacin in the form of Nicotinamide 50 mg twice a day for 4 weeks and the parents were advised not to give her maize in the diet. The skin lesions and diarrhoea regressed in duration of two weeks. This is probably the first time that a case of pellagra causing livedo is being reported, that too in a child.

  6. 'Shrouded in a dark fog': comparison of the diagnosis of pellagra in Venice and general paralysis of the insane in the United Kingdom, 1840-1900. (United States)

    Priani, Egidio


    The debate on the causes and the nature of pellagra in Italy during the nineteenth century resembles and evokes the similar debate on General Paralysis of the Insane (GPI) that was growing at the same time in the United Kingdom. Pellagra and GPI had a massive and virulent impact on the populations of Italy and the UK, respectively, and contributed to a great extent to the increase and overcrowding of the asylum populations in these countries. This article compares the two illnesses by examining the features of their nosographic positioning, aetiology and pathogenesis. It also documents how doctors arrived at the diagnoses of the two diseases and how this affected their treatment.

  7. Functional abdominal pain causing Scurvy, Pellagra, and Hypovitaminosis A [v1; ref status: indexed,

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    Edith Y. Ho


    Full Text Available Severe vitamin deficiency disease is rarely seen in developed countries. We present an atypical case of a young man with scurvy, pellagra, and hypovitaminosis A, caused by longstanding functional abdominal pain that severely limited his ability to eat.

  8. Niacin (United States)

    ... niacin along with combinations of antioxidants, including vitamin C, seems to blunt this rise in HDL. It ... Acid, Pellagra Preventing Factor, Vitamin B3, Vitamin PP, Vitamina B3, Vitamine B3, Vitamine PP.

  9. Acquired ichthyosis with hoffman's syndrome

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    Sathyanarayana B


    Full Text Available A middle aged man presented with features of acquired ichthyosis with Hoffman's syndrome. Laboratory tests support hypothyodism. Myoedema and hypertrophy of muscles were present. Patient was previously treated for Pellagra.

  10. 21 CFR 101.93 - Certain types of statements for dietary supplements. (United States)


    ... leading to such dysfunctioning (e.g., hypertension); except that diseases resulting from essential nutrient deficiencies (e.g., scurvy, pellagra) are not included in this definition. (2) FDA will find that... an ingredient that is an article included in the definition of “dietary supplement” under 21 U.S.C...


    African Journals Online (AJOL)

    :s of the pellagra and kwashior- kor groups. on admission as well as after recovery, were compared with each other for significant differences at the 5°~ level of significance using variance analyses." The same tests were done in both groups to ...


    African Journals Online (AJOL)

    (TW) or adjacent cytoplasm, in round or bizarre-shaped dense bodies. (double arrows), and in the Golgi complex (G) microvilli (MV). (x 120000). these haemosiderin-containing structures were acid- phosphatase-positive and were therefore secondary lysosomes. Although the Golgi complex in pellagra patients occasionally.

  13. Malnutrition and skin disease in Far East prisoners-of-war in World War II. (United States)

    Creamer, D


    During the Second World War, thousands of captured British and Commonwealth troops were interned in prisoner-of-war (POW) camps in the Far East. Imprisonment was extremely harsh, and prisoners developed multiple pathologies induced by physical hardship, tropical infections and starvation. Immediately after the war, several POW doctors published their clinical experiences, including reports of skin disease caused by malnutrition. The most notable deficiency dermatoses seen in Far East POWs were ariboflavinosis (vitamin B2 or riboflavin deficiency) and pellagra (vitamin B3 or niacin deficiency). A lack of vitamin B2 produces a striking inflammatory disorder of scrotal skin. Reports of pellagra in POWs documented a novel widespread eruption, developing into exfoliative dermatitis, in addition to the usual photosensitive dermatosis. A review of the literature from 70 years ago provides a reminder of the skin's response to malnutrition. © 2018 British Association of Dermatologists.

  14. Niacin metabolism and indoleamine 2,3-dioxygenase activation in malnourished patients with flaky paint dermatosis. (United States)

    Maltos, André Luiz; Portari, Guilherme Vannucchi; Moraes, Giselle Vanessa; Monteiro, Marina Casteli Rodrigues; Vannucchi, Helio; da Cunha, Daniel Ferreira


    Flaky paint dermatosis, characterized by extensive, often bilateral areas of flaking and pigmentation, mostly in sun unexposed areas is considered a feature of kwashiorkor in both children and adults, and must be differentiated from other dermatosis, including chapped and xerotica skin, and pellagra. In this case series we provide evidence that malnourished patients with flaky paint dermatosis and infection/inflammation shown laboratory data suggestive of indoleamine 2,3-dioxygenase (IDO) activation, besides decreased urinary excretion of N1-methylnicotinamide (N1 MN), a marker of pellagra. We study nine adult patients showing flaky paint dermatosis and clinical features of infection or inflammation, and increased serum C-reactive protein, characteristic of the presence of acute phase response syndrome. As a group, they had low or deficient urinary N1 MN excretion (0.52 ± 0.39 mg/g creatinine) compatible with pellagra. They also showed low serum tryptophan levels (dermatosis showed laboratory data suggestive of IDO activation, besides decreased N1 MN urinary excretion. Taken together, the data support the idea that flaky paint dermatosis could be a skin manifestation of niacin deficiency. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. A Brief Historic Overview of Clinical Disorders Associated with Tryptophan: The Relevance to Chronic Fatigue Syndrome (CFS and Fibromyalgia (FM.

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    Adele Blankfield


    Full Text Available Last century there was a short burst of interest in the tryptophan related disorders of pellagra and related abnormalities that are usually presented in infancy. 1 , 2 Nutritional physiologists recognized that a severe human dietary deficiency of either tryptophan or the B group vitamins could result in central nervous system (CNS sequelae such as ataxia, cognitive dysfunction and dysphoria, accompanied by skin hyperpigmentation. 3 , 4 The current paper will focus on the emerging role of tryptophan in chronic fatigue syndrome (CFS and fibromyalgia (FM.

  16. Chapter 30: historical aspects of the major neurological vitamin deficiency disorders: the water-soluble B vitamins. (United States)

    Lanska, Douglas J


    This historical review addresses major neurological disorders associated with deficiencies of water-soluble B vitamins: beriberi, Wernicke-Korsakoff syndrome, pellagra, neural tube defects, and subacute combined degeneration of the spinal cord. Beriberi: Beriberi was known for millennia in Asia, but was not described by a European until the 17th century when Brontius in the Dutch East Indies reported the progressive sensorimotor polyneuropathy. The prevalence of beriberi increased greatly in Asia with a change in the milling process for rice in the late 19th century. In the 1880s, Takaki demonstrated the benefits of dietary modification in sailors, and later instituted dietary reforms in the Japanese Navy, which largely eradicated beriberi from the Japanese Navy by 1887. In 1889 Eijkman in Java serendipitously identified dietary factors as a major contributor to "chicken polyneuritis," which he took to be an animal model for beriberi; the polyneuritis could be cured or prevented by feeding the chickens either unpolished rice or rice polishings. By 1901, Grijns, while continuing studies of beriberi in Java, suggested a dietary deficiency explanation for beriberi after systematically eliminating deficiencies of known dietary components and excluding a toxic effect. Wernicke-Korsakoff syndrome: In the late 1870s, Wernicke identified a clinicopathological condition with ophthalmoparesis, nystagmus, ataxia, and encephalopathy, associated with punctate hemorrhages symmetrically arranged in the grey matter around the third and fourth ventricles and the aqueduct of Sylvius. In the late 1880s, Korsakoff described a spectrum of cognitive disorders, including a confabulatory amnestic state following an agitated delirium, occurring in conjunction with peripheral polyneuropathy. Beginning around 1900, investigators recognized the close relationship between Korsakoff's psychosis, delirium tremens, and Wernicke's encephalopathy, but not until several decades later were Wernicke

  17. [Neurological changes related to malnutrition during the spanish civil war (1936-1939)]. (United States)

    Culebras, Jesús M


    In this lecture, given at the International Conferences on Neuroscience, in Quito, May 31st-June 1st of 2013, the topic of famine situations during the Spanish Civil War, 1936-1939, was approached. Madrid, the capital of Spain, was under food, water and milk rationing during that period. This situation led to conditions that showed the relationships between the nervous system and nutrition. The Madrilenian population was submitted to a real experiment of hyponutrition, similar to the one that may be reproduced at the laboratory. At the end of the war, the National Direction on Health and the Institute of Medical Investigations, with the collaboration of the Rockefeller Foundation, carried out a series of clinical and food consumption surveys among the Madrilenian population. There were three medical situations that were of particular relevance during the Civil War and after it: the pellagra epidemics, the onset of lathyrism, and the socalled Vallecas syndrome. The occurrence of pellagra cases was paramount because it allowed reconsidering all the unspecific symptoms observed from an already known vitamin deficiency. Pellagra became the most prevalent deficitrelated disease, and most clearly related to nutrition. Lathyrism is a chronic intoxication produced by the accumulation of neurotoxins. It is due to common intake of chickling peas (Lathyrus sativus). Chickling peas are toxic only if they represent more than 30% of the daily calories consumed for a prolonged period greater than two to three months. Lathyrism would reoccur in the Spanish population after the war, in 1941 and 1942, the so called "famine years", when due to the scarcity of foods chickling pea flour was again consumed in high amounts. Deficiency-related neuropathies observed in Madrid during the Civil War led to new and original clinical descriptions. In children from schools of the Vallecas neighborhood, a deficiency syndrome, likely related to vitamin B complex deficiency, was described, which

  18. Tissue vitamin concentrations are maintained constant by changing the urinary excretion rate of vitamins in rats' restricted food intake. (United States)

    Shibata, Katsumi; Fukuwatari, Tsutomu


    We previously reported that mild food restriction induces a reduction in tryptophan-nicotinamide conversion, which helps to explain why death secondary to pellagra is pandemic during the hungry season. In this study, we investigated the levels of B-group vitamins in the liver, kidney, blood, and urine in rats that underwent gradual restriction of food intake (80, 60, 40, and 20% restriction vs. ad libitum food intake). No significant differences in the B-group vitamin concentrations (mol/g tissue) in the liver and kidney were observed at any level of food restriction. However, the urine excretion rates exhibited some characteristic phenomena that differed by vitamin. These results show that the tissue concentrations of B-group vitamins were kept constant by changing the urinary elimination rates of vitamins under various levels of food restriction. Only vitamin B12 was the only (exception).

  19. Die Voedingstand van die Suid-Afrikaanse Bevolking

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    J.P. Kotzé


    Full Text Available During the period 1970 to 1975 the world population grew at an average annual rate of 1,98%. At presentthe estimated world population is 4,2 milliard (4,2 x 109. Food production has the formidable task of feeding85 million extra mouths per year.A recent United Nations document stated that during 1974 already about 500 million people suffered fromsome form of malnutrition. Of these about 100 million children under the age of 5 years were malnourished.According to the Gomez classification, which is accepted by the World Health Organization, first degreeprotein-energy-malnutrition (PEM is present in children who have body weights between 75 and 90% of theexpected weight for age and sex. Children with body weights between 60 and 75% of the expected weight forage and sex suffer from second degree PEM (moderate. Third degree PEM (severely malnourished is foundin children who reached 60% or less of the expected body weight for age and sex or suffer from oedema.Data are presented for the incidence of malnutrition in Africa and other parts of the world.South Africa and its newly independent territories have a total population of 27,2 million for whom 122,111million hectares of land is available. A hundred million hectares can be used for agricultural purposes andonly 15% of this land is arable.South African food production managed to remain comfortably ahead of population growth over the pastfew decades. At present at least 25 210 kilojoules/capita/day and 146,9g protein/capita/day are available forevery citizen. Despite such an enviable food position we have a considerable problem of malnutrition in SouthAfrica. Firstly, obesity is endangering the health of a fair portion of all ethnic groups. Secondly PEM andvitamin deficiency diseases are frequently diagnosed in the lower socio-economic groups. During 1976 286district surgeons reported 48 783 cases of kwashiorkor, 37 855 cases of pellagra and 1 008 cases of beri-beri.Although some of these diagnoses


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    Full Text Available

    ABSTRACT: Using a defined laboratory diet composed by gelatin (6% and casein (10% as protein sources, without tryptophan and nicotinic acid supplementation, it should be possible to reproduce, in young rats, after 28 dais feeding with this deficient diet, a clinical and laboratory model of niacin deficiency. The deficient group, when compared against control, showed poor growth (63.3 g x 163.3 g; p<0.05, lower urinary excretion of N’-methylnicotinamide (0.005 mg/24 h x 0.259 mg/24 h; p<0.05, lower plasma free-tryptophan (2.1 uM/dl x 5.4 uM/dl; p<0.05, lower plasma albumin level (1.8 g/dl; p<0.05, smaller erythrocytes (48.9 u3 x 54.8 u3; p<0.05 and lower corpuscular hemoglobin (23.2 pg x 26.6 pg; p<0.05. All these changes were normalized by niacin replacement. We conclude that this dietetics model is easy and practical to be used for niacin deficiency purposes. KEYWORDS: Niacin; nicotinicacid; tryptophan; N’-methylnicotinamide; Pellagra.

  1. The management of psoriasis through diet

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    Duarte G


    Full Text Available Gleison Duarte,1 Luan Oliveira Barbosa,2 Maria Elisa A Rosa11Dermatology Division, Alergodermoclin, Salvador, Bahia, Brazil; 2Escola Bahiana de Medicina e Saúde Pública Salvador, Bahia, BrazilAbstract: Diet is an important factor in the management of several dermatological diseases, such as dermatitis herpetiformis, acne vulgaris, gout, phrynoderma, pellagra, psoriasis, and acrodermatitis enteropathica. New concepts have emerged concerning the influence of diet on psoriasis. For example, diet has an adjuvant role in the management of several cardiovascular comorbidities that exhibit a higher-than-expected prevalence in psoriatic patients. Functional foods, such as yellow saffron and fish oil, may exert favorable effects on immune and cardiovascular functions. A gluten-free diet may promote significant clinical and histologic improvement. Folate supplementation may induce clinical improvement of psoriasis, but side effects may also occur. Diets rich in fresh fruits and vegetables are associated with a lower prevalence of psoriasis, and vegetarian diets were associated with clinical improvement. Additionally, many drug-diet interactions (retinoids, methotrexate, cyclosporine must be considered in patients with psoriasis. Therefore, in addition to current nutritional advice given to psoriasis patients, further studies are necessary in the role of diet in psoriasis therapy.Keywords: diet, lifestyle, psoriasis, recommendations, supplementation

  2. Rare and unusual ... or are they? Less commonly diagnosed encephalopathies associated with systemic disease. (United States)

    Weathers, Allison L; Lewis, Steven L


    Encephalopathy due to hepatic or renal failure, electrolyte disturbances, or the administration of benzodiazepines and narcotics is commonly encountered, well reviewed in the literature, and, therefore, not usually missed. This article focuses on encephalopathies that were previously well described but may be overlooked by modern clinicians, as well as those that are still taught in the classroom but seldom thought of in practice. Due to the presumed relative rarity of these cases and emphasis on the well-memorized "classic" clinical presentations, these often treatable, and perhaps not so rare, encephalopathies due to systemic medical illness may go undiagnosed and untreated. Pancreatic encephalopathy, Wernicke's encephalopathy, and pellagra encephalopathy are reviewed in detail; cefepime and ifosfamide encephalopathies are discussed as examples of specific medication-induced encephalopathies. Septic encephalopathy, central pontine myelinolysis, and fat embolism syndrome are briefly reviewed. The encephalopathies reviewed have the potential for devastating neurological consequences if recognition and, therefore, treatment are delayed. Clinical improvement for many of these syndromes depends on prompt intervention. This article highlights some representative examples of less-commonly diagnosed metabolic and toxic encephalopathies.

  3. Diet in dermatology: Revisited

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    Kaimal Sowmya


    Full Text Available Diet has an important role to play in many skin disorders, and dermatologists are frequently faced with the difficulty of separating myth from fact when it comes to dietary advice for their patients. Patients in India are often anxious about what foods to consume, and what to avoid, in the hope that, no matter how impractical or difficult this may be, following this dictum will cure their disease. There are certain disorders where one or more components in food are central to the pathogenesis, e.g. dermatitis herpetiformis, wherein dietary restrictions constitute the cornerstone of treatment. A brief list, although not comprehensive, of other disorders where diet may have a role to play includes atopic dermatitis, acne vulgaris, psoriasis vulgaris, pemphigus, urticaria, pruritus, allergic contact dermatitis, fish odor syndrome, toxic oil syndrome, fixed drug eruption, genetic and metabolic disorders (phenylketonuria, tyrosinemia, homocystinuria, galactosemia, Refsum′s disease, G6PD deficiency, xanthomas, gout and porphyria, nutritional deficiency disorders (kwashiorkar, marasmus, phrynoderma, pellagra, scurvy, acrodermatitis enteropathica, carotenemia and lycopenemia and miscellaneous disorders such as vitiligo, aphthous ulcers, cutaneous vasculitis and telogen effluvium. From a practical point of view, it will be useful for the dermatologist to keep some dietary information handy to deal with the occasional patient who does not seem to respond in spite of the best, scientific and evidence-based therapy.

  4. [Emigration and immigration in Italy. (1861-2011)]. (United States)

    Pasini, Walter


    The creation of the Italian Kingdom was characterized by the mass emigration of Italian people, mainly peasants towards European and American destinations. Poverty, unemployment, diseases, like pellagra, malaria and tubercolosis forced millions of Italians to leave the Country. The phenomenon of emigration is usually divided in three periods: the mass emigration from 1976 to 1914, the second one between the two world wars, the third one from 1946 to 1976. In the last quarter of the 20th century the number of repatriations overcome expatriations and the number of immigrants from Albania, Romania, Senegal, Tunisia, China, Philippines grew up becoming more and more important. Italy was a country of emigrants, now is a country of immigrants. It is difficult to compare the work conditions of the Italian emigrants with the new immigrants. At the end of the 19th Century or in the first decades of the 20th Century there were no consideration for human rights, no legislations to protect workers. Immigration from North Africa and from all the low and middle income countries should be studied in all its aspects because it will characterize our future. In the new era of economical globalization, Universities should prepare the new medical doctors to extend their professional culture to a international dimension to be able to cope with the new challenges of our time.

  5. The historical evolution of thought regarding multiple micronutrient nutrition. (United States)

    Semba, Richard D


    Multiple micronutrient nutrition is an idea that originated in the 1940s and exemplifies the iterative nutritional paradigm. In the first four decades of the 20th century, scientists sought to separate and characterize the vitamins that were responsible for xerophthalmia, rickets, pellagra, scurvy, and beriberi. The dietary requirements of the different micronutrients began to be established in the early 1940s. Surveys showed that multiple micronutrient deficiencies were widespread in industrialized countries, and the problem was addressed by use of cod-liver oil, iodized salt, fortified margarine, and flour fortification with multiple micronutrients, and, with rising living standards, the increased availability and consumption of animal source foods. After World War II, surveys showed that multiple micronutrient deficiencies were widespread in developing countries. Approaches to the elimination of multiple micronutrient deficiencies include periodic vitamin A supplementation, iodized salt, targeted iron/folate supplementation, fortified flour, other fortified foods, home fortification with micronutrient powders, and homestead food production. The prevention of multiple micronutrient malnutrition is a key factor in achieving the Millennium Development Goals, given the important effects of micronutrients on health and survival.

  6. A Nampt inhibitor FK866 mimics vitamin B3 deficiency by causing senescence of human fibroblastic Hs68 cells via attenuation of NAD(+)-SIRT1 signaling. (United States)

    Song, Tuzz-Ying; Yeh, Shu-Lan; Hu, Miao-Lin; Chen, Mei-Yau; Yang, Nae-Cherng


    Vitamin B3 (niacin) deficiency can cause pellagra with symptoms of dermatitis, diarrhea and dementia. However, it is unclear whether the vitamin B3 deficiency causes human aging. FK866 (a Nampt inhibitor) can reduce intracellular NAD(+) level and induce senescence of human Hs68 cells. However, the mechanisms underlying FK866-induced senescence of Hs68 cells are unclear. In this study, we used FK866 to mimic the effects of vitamin B3 deficiency to reduce the NAD(+) level and investigated the mechanisms of FK866-induced senescence of Hs68 cells. We hypothesized that FK866 induced the senescence of Hs68 cells via an attenuation of NAD(+)-silent information regulator T1 (SIRT1) signaling. We found that FK866 induced cell senescence and diminished cellular NAD(+) levels and SIRT1 activity (detected by acetylation of p53), and these effects were dramatically antagonized by co-treatment with nicotinic acid, nicotinamide, or NAD(+). In contrast, the protein expression of SIRT1, AMP-activated protein kinase, mammalian target of rapamycin, and nicotinamide phosphoribosyltransferase (Nampt) was not affected by FK866. In addition, the role of GSH in the FK866-induced cells senescence may be limited, as N-acetylcysteine did not antagonize FK866-induced cell senescence. These results suggest that FK866 induces cell senescence via attenuation of NAD(+)-SIRT1 signaling. The effects of vitamin B3 deficiency on human aging warrant further investigation.

  7. Scratch and sniff. The dynamic duo. (United States)

    Stitt, W Z; Goldsmith, A


    Are odors diagnostic? In this age of polymerase chain reactions, in situ hybridization, and immunohistochemical staining, is there any room left for the nose in diagnosing disease? Long ago, and perhaps far away, smell was crucial to describing an illness. Infectious diseases were known by their characteristics odors--scrofula as smelling like stale beer; typhoid, like freshly baked brown bread; rubella, like plucked feathers; and diphtheria, as "sweetish." Anosmics might be banned from medical school. Perhaps we have left the descriptions behind along with these illnesses we rarely encounter today. After all, how many young physicians, residents, or medical students have ever seen a case of diphtheria or even rubella, and how many fewer have ever plucked a chicken? We have learned that pellagra (that "must appear" diagnosis in our differential by rote, but not by example, for photosensitive dermatoses) should smell like sour bread and that the exotic favus should smell "mousy" (Table 1). What does Candida smell like--a "heavy sweetness"? Darier's disease in poor control--"organic"? Pseudomonal infections--"foul and biting"? And are not our patients with noninfected eczematous dermatitis distinct for lacking any peculiar odor, do they not actually smell "dry"? We cannot blame the abandonment of our olfactory skills on the younger generation, for how many of us could describe those odors we smell every day? Would we be able to detect a subtle change in the odor of our patient with psoriasis, a change perhaps signifying superinfection?

  8. Big Brains, Meat, Tuberculosis, and the Nicotinamide Switches: Co-Evolutionary Relationships with Modern Repercussions?

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    Adrian C. Williams


    Full Text Available Meat-eating was a game changer for human evolution. We suggest that the limiting factors for expanding brains earlier were scarcities of nicotinamide and tryptophan. In humans and some other omnivores, lack of meat causes these deficiencies. Nicotinamide adenine dinucleotide (NADH is necessary to synthesize adenosine triphosphate (ATP via either glycolysis or via the mitochondrial respiratory chain. NAD consumption is also necessary for developmental and repair circuits. Inadequate supplies result in “de-evolutionary” brain atrophy, as seen with pellagra. If trophic nicotinamide/tryptophan was a “prime mover” in building bigger brains, back-up mechanisms should have evolved. One strategy may be to recruit extra gut symbionts that produce NADH precursors or export nicotinamide (though this may cause diarrhea. We propose a novel supplier TB that co-evolved early, which did not originally and does not now inevitably cause disease. TB has highly paradoxical immunology for a pathogen, and secretes and is inhibited by nicotinamide and its analogue, isoniazid. Sharp declines in TB and diarrhea correlated with increased meat intake in the past, suggesting that dietary vitamin B 3 and tryptophan deficiencies (also associated with poor cognition and decreased lifespans are still common where meat is unaffordable.

  9. Et dansk planteforskningsnetværk for afhjælpning af mikronæringsstofmangel i human ernæring

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    Holm, Preben Bach; Schjørring, Jan Kofod; Rasmussen, Søren K.


    Mennesker og husdyr skal gennem føden have tilført 49 unikke eræringselementer. Disse omfatter vand, kulhydrat, de ti essentielle aminosyre, linolen- og linoleinsyre, syv mineralske makroelementer, sekten mineralske mikroelementer og tretten vitaminer (se Tabel 1). Indenfor den humane ernæring sa...... A), engelsk syge (vitamin D) og perniciøs anemi (vitamin B12) (se en historisk gennemgang i McDowell 2006).......Mennesker og husdyr skal gennem føden have tilført 49 unikke eræringselementer. Disse omfatter vand, kulhydrat, de ti essentielle aminosyre, linolen- og linoleinsyre, syv mineralske makroelementer, sekten mineralske mikroelementer og tretten vitaminer (se Tabel 1). Indenfor den humane ernæring...... samles mikroelementer og vitaminer under fællesbetegnelsen mikornæringsstoffer. Mangel på disse har påvirket menneskets sundhed gennem hele historien. Klassiske eksempler på vitaminmangel er skørbug (vitamin C), beriberi (vitamin B1), pellagra (vitamin B3 (niacin)), natteblindhed og xeropthalmia (vitamin...

  10. Exploiting Nutritional Value of Staple Foods in the World’s Semi-Arid Areas: Risks, Benefits, Challenges and Opportunities of Sorghum

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    Ilaria Proietti


    Full Text Available Sorghum (Sorghum bicolor (L. Moench is a drought-resistant crop and an important food resource in terms of nutritional as well as social-economic values, especially in semi-arid environments. Cultivar selection and processing methods have been observed to impact on composition and functional and nutritional value of sorghum. Amino acid imbalance, cyanogenic glycosides, endogenous anti-nutrients, mycotoxins and toxic elements are among factors impairing its nutritional value. This paper reviews possible approaches (varieties selection, production practices, cooking processes to improve the benefits-to-risks balance of sorghum meal, to mitigate the risk of deficiencies and/or imbalances and to improve effects on human nutrition. Opportunity for avoiding dietary diversification in high sorghum consumers is also discussed, e.g., tryptophan and niacin deficits potentially related to pellagra, or unavailability of proteins and divalent cations (e.g., Fe, Zn due to the antinutrient activity of phytic acid and tannins. As potential candidate for production investments, the role of sorghum in preserving biological diversity is also considered.

  11. Study on dermatoses and their prevalence in groups of confirmed alcoholic individuals in comparison to a non-alcoholic group of individuals Estudo das dermatoses e sua prevalencia em individuos comprovadamente alcoolistas comparativamente a um grupo de individuos não alcoolistas

    Directory of Open Access Journals (Sweden)

    Maria Cecilia Teixeira de Carvalho Bruno


    Full Text Available BACKGROUND: The direct relationship between alcoholism and dermatoses has been evaluated in recent researches. However, there are few objective surveys that demonstrate and prove a direct relationship between alcohol and a specific dermatosis. OBJECTIVES: to verify the prevalence of dermatoses in alcoholics, analize the dermatological changes found in these patients and their evolution during alcoholic abstinence. Also, to compare the results obtained with a non-alcoholic control group and with the data found in medical literature. METHODS: the dermatologic conditions of 278 alcoholic patients (250 men, 28 women were studied over a period of 4 years, and compared to those of a control group of 271 non-alcoholic individuals (249 men, 22 women, members of the Military Police Force. The individuals in both groups were between 20 and 60 years old. RESULTS: Pellagra, nummular eczema, purpura pigmentosa chronica (also known as pigmented purpuric dermatosis and psoriasis were more frequent in the group of alcoholics and, apparently, occurred in parallel with alcoholism that seems to play a role in the evolution of these dermatoses. The dermatopathies were more frequent before the age of forty, regardless of factors such as profession, race or gender. CONCLUSION: the association of dermatoses and alcoholism was extremely significant according to the statistical data. Alcoholism can be considered a risk factor for pellagra, psoriasis, nummular eczema and purpura pigmentosa chronica dermatoses, which can, as well, be considered alcoholism indicators. FUNDAMENTOS: A relação direta entre o alcoolismo e as dermatoses vem sendo avaliada em recentes pesquisas. No entanto são poucos os estudos objetivos que demonstram e comprovam uma relação direta entre o álcool e uma determinada dermatose. OBJETIVOS: Verificar a prevalência de dermatoses em alcoolistas, avaliar as alterações dermatológicas encontradas nesses doentes e sua evolução frente abstin

  12. The changing nutrition scenario. (United States)

    Gopalan, C


    The past seven decades have seen remarkable shifts in the nutritional scenario in India. Even up to the 1950s severe forms of malnutrition such as kwashiorkar and pellagra were endemic. As nutritionists were finding home-grown and common-sense solutions for these widespread problems, the population was burgeoning and food was scarce. The threat of widespread household food insecurity and chronic undernutrition was very real. Then came the Green Revolution. Shortages of food grains disappeared within less than a decade and India became self-sufficient in food grain production. But more insidious problems arising from this revolution were looming, and cropping patterns giving low priority to coarse grains and pulses, and monocropping led to depletion of soil nutrients and 'Green Revolution fatigue'. With improved household food security and better access to health care, clinical manifestations of severe malnutrition virtually disappeared. But the decline in chronic undernutrition and "hidden hunger" from micronutrient deficiencies was slow. On the cusp of the new century, an added factor appeared on the nutritional scene in India. With steady urban migration, upward mobility out of poverty, and an increasingly sedentary lifestyle because of improvements in technology and transport, obesity rates began to increase, resulting in a dual burden. Measured in terms of its performance in meeting its Millennium Development Goals, India has fallen short. Despite its continuing high levels of poverty and illiteracy, India has a huge demographic potential in the form of a young population. This advantage must be leveraged by investing in nutrition education, household access to nutritious diets, sanitary environment and a health-promoting lifestyle. This requires co-operation from all the stakeholders, including governments, non government organizations, scientists and the people at large.

  13. The changing nutrition scenario

    Directory of Open Access Journals (Sweden)

    C Gopalan


    Full Text Available The past seven decades have seen remarkable shifts in the nutritional scenario in India. Even up to the 1950s severe forms of malnutrition such as kwashiorkar and pellagra were endemic. As nutritionists were finding home-grown and common-sense solutions for these widespread problems, the population was burgeoning and food was scarce. The threat of widespread household food insecurity and chronic undernutrition was very real. Then came the Green Revolution. Shortages of food grains disappeared within less than a decade and India became self-sufficient in food grain production. But more insidious problems arising from this revolution were looming, and cropping patterns giving low priority to coarse grains and pulses, and monocropping led to depletion of soil nutrients and ′Green Revolution fatigue′. With improved household food security and better access to health care, clinical manifestations of severe malnutrition virtually disappeared. But the decline in chronic undernutrition and "hidden hunger" from micronutrient deficiencies was slow. On the cusp of the new century, an added factor appeared on the nutritional scene in India. With steady urban migration, upward mobility out of poverty, and an increasingly sedentary lifestyle because of improvements in technology and transport, obesity rates began to increase, resulting in a dual burden. Measured in terms of its performance in meeting its Millennium Development Goals, India has fallen short. Despite its continuing high levels of poverty and illiteracy, India has a huge demographic potential in the form of a young population. This advantage must be leveraged by investing in nutrition education, household access to nutritious diets, sanitary environment and a health-promoting lifestyle. This requires co-operation from all the stakeholders, including governments, non government organizations, scientists and the people at large.

  14. Fortification and health: challenges and opportunities. (United States)

    Dwyer, Johanna T; Wiemer, Kathryn L; Dary, Omar; Keen, Carl L; King, Janet C; Miller, Kevin B; Philbert, Martin A; Tarasuk, Valerie; Taylor, Christine L; Gaine, P Courtney; Jarvis, Ashley B; Bailey, Regan L


    Fortification is the process of adding nutrients or non-nutrient bioactive components to edible products (e.g., food, food constituents, or supplements). Fortification can be used to correct or prevent widespread nutrient intake shortfalls and associated deficiencies, to balance the total nutrient profile of a diet, to restore nutrients lost in processing, or to appeal to consumers looking to supplement their diet. Food fortification could be considered as a public health strategy to enhance nutrient intakes of a population. Over the past century, fortification has been effective at reducing the risk of nutrient deficiency diseases such as beriberi, goiter, pellagra, and rickets. However, the world today is very different from when fortification emerged in the 1920s. Although early fortification programs were designed to eliminate deficiency diseases, current fortification programs are based on low dietary intakes rather than a diagnosable condition. Moving forward, we must be diligent in our approach to achieving effective and responsible fortification practices and policies, including responsible marketing of fortified products. Fortification must be applied prudently, its effects monitored diligently, and the public informed effectively about its benefits through consumer education efforts. Clear lines of authority for establishing fortification guidelines should be developed and should take into account changing population demographics, changes in the food supply, and advances in technology. This article is a summary of a symposium presented at the ASN Scientific Sessions and Annual Meeting at Experimental Biology 2014 on current issues involving fortification focusing primarily on the United States and Canada and recommendations for the development of responsible fortification practices to ensure their safety and effectiveness. © 2015 American Society for Nutrition.

  15. Chapter 29: historical aspects of the major neurological vitamin deficiency disorders: overview and fat-soluble vitamin A. (United States)

    Lanska, Douglas J


    The vitamine doctrine: Although diseases resulting from vitamin deficiencies have been known for millennia, such disorders were generally attributed to toxic or infectious causes until the "vitamin doctrine" was developed in the early 20th century. In the late-19th century, a physiologically complete diet was believed to require only sufficient proteins, carbohydrates, fats, inorganic salts, and water. From 1880-1912, Lunin, Pekelharing, and Hopkins found that animals fed purified mixtures of known food components failed to grow or even lost weight and died, unless the diet was supplemented with small amounts of milk, suggesting that "accessory food factors" are required in trace amounts for normal growth. By this time, Funk suggested that deficiencies of trace dietary factors, which he labeled "vitamines" on the mistaken notion that they were "vital amines," were responsible for such diseases as beriberi, scurvy, rickets, and pellagra. Vitamin A deficiency eye disease: Night blindness was recognized by the ancient Egyptians and Greeks, and many authorities from Galen onward advocated liver as a curative. Outbreaks of night blindness were linked to nutritional causes in the 18th and 19th centuries by von Bergen, Schwarz, and others. Corneal ulceration was reported in 1817 by Magendie among vitamin A-deficient dogs fed for several weeks on a diet limited to sugar and water, although he erroneously attributed this to a deficiency of dietary nitrogen (i.e. protein). Subsequently, corneal epithelial defects, often in association with night blindness, were recognized in malnourished individuals subsisting on diets now recognizable as deficient in vitamin A by Budd, Livingstone, von Hubbenet, Bitot, Mori, Ishihari, and others. During World War I, Bloch conducted a controlled clinical trial of different diets among malnourished Danish children with night blindness and keratomalacia and concluded that whole milk, butter, and cod-liver oil contain a fat-soluble substance