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Query: UMLS:C0038187 (starvation)
 24,951 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Five hundred million attacks of diarrhoea occur each year in children under 5 years of age, throughout the world, and acute gastroenteritis remains a frequent cause of admission to hospital in the United Kingdom. Current practice in the treatment of diarrhoeal dehydration in the UK is focused upon intravenous rehydration. Drugs (eg antibiotics, anti-emetics, anti-diarrhoeal agents and absorbents) are commonly prescribed, and 'therapeutic' starvation, followed by cautious reintroduction of diet, is recommended. Studies conducted by health workers in developing countries have challenged these dogma. Whilst intravenous rehydration is occasionally required (eg. in shock, ileus or coma) the majority of episodes of dehydration can be treated orally. Oral rehydration is less unpleasant than intravenous infusion, safer, quicker, cheaper and readily administered by parents with nursing supervision. Recovery may be hastened by continuing to breast feed and offer normal diet, and weight loss is minimized. These principles are being applied in pilot studies at The Children's Hospital, Birmingham. Outpatient treatment is largely supervised by trained paediatric nurses, after initial medical assessment of the child. Nurses are becoming more confident in the technique of oral rehydration, coupled with early reintroduction of food. This is reflected in less discomfort and weight loss for the child, less parental anxiety, decreased length of hospital stay, and financial savings.
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PMID:Recent advances in the care of children with acute diarrhoea: giving responsibility to the nurse and parents. 364 45

The case history is presented of a man with an atypical psychosis and classical clinical features of alexithymia. On his last admission, the patient presented with starvation and hypernatremic coma. A CT scan, which was done because of the coma, revealed a large left fronto-temporal arachnoid cyst. The significance of this finding is reviewed in the light of previously suggested organic bases for alexithymia and related syndromes. Although the symptom of alexithymia is present, the patient's other symptoms do not fit readily into existing diagnostic categories and the resulting diagnostic dilemma is discussed.
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PMID:A case of atypical psychosis associated with alexithymia and a left fronto-temporal lesion: possible correlations. 369 Apr 85

Magnesium deficiency may complicate many diseases. The causes include the following: inadequate intake during starvation or increased requirement during early childhood, pregnancy, or lactation; excessive losses of magnesium as a result of malabsorption from the gastrointestinal tract or from the kidneys during use of diuretics; and to a combination of the two, as in alcoholism. Most often the etiological factors have been operative for a month or more. Acute hypomagnesemia can occur without previous Mg deficiency after epinephrine, cold stress and stress of serious injury or extensive surgery. The clinical manifestations depend on the age of the patient and may begin insidiously or with dramatic suddenness, or there may be no overt symptoms or signs. The manifestations can be divided into the following categories: totally non-specific symptoms and signs ascribable to the primary disease; neuromuscular hyperactivity including tremor, myoclonic jerks, convulsions, Chvostek sign, Trousseau sign (rarely), spontaneous carpopedal spasm (rarely), ataxia, nystagmus and dysphagia; psychiatric disturbances from apathy and coma to some of all facets of delirium; cardiac arrhythmias including ventricular fibrillation and sudden death; hypocalcemia which is responsive only to Mg therapy; and hypokalemia which is not easily nor completely corrected without Mg therapy. The diversity of etiologies and the multiplicity of manifestations result in confusion and controversy. The documentation of normal renal function is absolutely necessary for maximum doses. The order of magnitude of dose is 1.0 meq Mg/kg on day 1, and 0.3 to 0.5 mEq/kg per day for 3 to 5 days. In emergencies such as convulsions or ventricular arrhythmias, a bolus injection of 1.0 gm (8.1 meq) of MgSO4 is indicated. Therapy of Mg deficiency in the presence of renal insufficiency requires smaller doses and frequent monitoring. Complete repletion occurs slowly.
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PMID:Magnesium deficiency. Etiology and clinical spectrum. 702 Mar 47

Paractora dreuxi displays distinct ontogenetic differences in thermal tolerance and water balance. Larvae are moderately freeze tolerant. Mean larval onset of chill coma was -5.1 degrees C, and onset of heat stupor was 35.5 degrees C. Larval supercooling point (SCP) was -3.3 degrees C with 100% recovery, although mortality was high below -4 degrees C. Starvation caused SCP depression in the larvae. Adults were significantly less tolerant, with critical thermal limits of -2.7 and 30.2 degrees C, no survival below the SCP (-9.6 degrees C), and no change in SCP with starvation. Moderate freeze tolerance in the larvae supports the contention that this strategy is common in insects from southern, oceanic islands. Fly larvae survived desiccation in dry air for 30 h, and are thus less desiccation tolerant than most other sub-Antarctic insect larvae. Water loss rates of the adults were significantly lower than those of the larvae. Lipid metabolism did not contribute significantly to water replacement in larvae, which replaced lost body water by drinking fresh water, but not sea water. Kelp fly larvae had excellent haemolymph osmoregulatory abilities. Current climate change has led to increased temperatures and decreased rainfall on Marion Island. These changes are likely to have significant effects on P. dreuxi, and pronounced physiological regulation in larvae suggests that they will be most susceptible to such change.
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PMID:Critical thermal limits, temperature tolerance and water balance of a sub-Antarctic kelp fly, Paractora dreuxi (Diptera: Helcomyzidae). 1103 71

Appellate courts in California and New Jersey have reached conflicting conclusions in the first legal tests of whether artificial feeding is a "medical treatment," and whether it is ever legally permissible to allow a patient to die from dehydration or starvation. In a criminal prosecution of physicians Robert Nejdl and Neil Barber, the California court ruled that there was no significant difference between a respirator and intravenous feeding, and that the two doctors had no legal duty to continue "futile" treatment of their irreversibly comatose patient. The New Jersey court rejected as purposeful killing a request to remove the nasogastric tube from elderly nursing home patient Claire Conroy, who was incompetent but not comatose. Annas considers the issue of pain or suffering to be central to decision making in such cases.
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PMID:Nonfeeding: lawful killing in CA, homicide in NJ. 1164 94

The Superior Court of New Jersey found that appointment of a guardian to consent to a proposed enterostomy was warranted for a 45-year-old patient with partial paralysis and organic brain damage who was likely to die of starvation and dehydration unless the procedure was performed. The court also found that an enterostomy was in the best interests of the patient. The patient was judged incompetent even though he was not in a coma or vegetative state because it was determined that he could not reasonably understand the nature and attendant risks of the proposed surgery.
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PMID:In re Clark. 1164 72

Clines for size and stress resistance traits have been described for several Drosophila species and replicable clines across different species may indicate climatic selection. Here we consider clines in stress resistance traits in an Australian endemic species, D. serrata, by comparing levels of variation within and among isofemale lines initiated with flies collected from the eastern coast of Australia. We also consider clinical variation in chill coma recovery, a trait that has recently been shown to exhibit high levels of variation among Drosophila species. Patterns were compared with those in the cosmopolitan species D. melanogaster from the same area. Both desiccation and starvation resistance showed no clinical pattern despite heritable variation among isofemale lines. In contrast chill coma resistance exhibited a linear cline in the anticipated direction, resistance increasing with latitude. Body size was measured as wing length and body weight. Both traits showed geographic variation and strong non-linear clines with a sharp reduction in size in the tropics. These results are discussed in the context of climatic selection and evolutionary processes limiting species borders.
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PMID:Clinal variation in Drosophila serrata for stress resistance and body size. 1207 52

Court Decision: 512 New York Supplement, 2d Series 622; 1986 Oct 27 (date of decision). The wife of a comatose stroke patient petitioned the New York Supreme Court, Nassau County, for an order authorizing removal of the nasogastric tube which was the patient's only source of nourishment. The Court appointed a guardian ad litem who opposed the petition because the patient, though in a vegetative state, was neither terminally ill nor brain dead. The Court heard testimony by relatives and a family friend that, prior to his illness, the patient had expressed a wish not to be kept alive solely by artificial means. The Court denied the petition on the grounds that the patient was not being kept alive by extraordinary means but was simply unable to care for himself due to his infirmities. In view of this distinction, the Court held that society's duty was to care for the patient rather than to induce his death by starvation.
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PMID:Vogel v. Forman. 1708 48

Medium-chain acyl-CoA dehydrogenase (MCAD) deficiency is the commonest disorder of fatty acid metabolism, with a high incidence of morbidity and mortality at presentation. We report a 16 year old girl with first presentation of MCAD deficiency following an alcoholic binge and subsequent period of starvation. Presentation was as acute encephalopathy progressing to coma. Renal, cardiac and hepatic failures were managed with intensive supportive care including mechanical ventilation, inotropic support, blood products and renal replacement therapy. Diagnosis of MCAD deficiency was confirmed on day 6. The patient was discharged from hospital on day 20 with a mild proximal myopathy, which subsequently resolved. The diagnosis of MCAD deficiency requires a high index of suspicion at all ages. Precipitating factors in later life may include alcohol.
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PMID:Late presentation of medium-chain acyl-CoA dehydrogenase deficiency. 1714 76

Recent studies have used a variety of theoretical arguments to show that mitochondrial (mt) DNA rarely evolves as a strictly neutral marker and that selection operates on the mtDNA of many species. However, the vast majority of researchers are not convinced by these arguments because data linking mtDNA variation with phenotypic differences are limited. We investigated sequence variation in the three mtDNA and nine nuclear genes (including all isoforms) that encode the 12 subunits of cytochrome c oxidase of the electron transport chain in Drosophila. We then studied cytochrome c oxidase activity as a key aspect of mitochondrial bioenergetics and four life-history traits. In Drosophila simulans, sequence data from the three mtDNA encoded cytochrome c oxidase genes show that there are 76 synonymous and two nonsynonymous fixed differences among flies harboring siII compared with siIII mtDNA. In contrast, 13 nuclear encoded genes show no evidence of genetic subdivision associated with the mtDNA. Flies with siIII mtDNA had higher cytochrome c oxidase activity and were more starvation resistant. Flies harboring siII mtDNA had greater egg size and fecundity, and recovered faster from cold coma. These data are consistent with a causative role for mtDNA variation in these phenotypic differences, but we cannot completely rule out the involvement of nuclear genes. The results of this study have significant implications for the use of mtDNA as an assumed neutral marker and show that evolutionary shifts can involve changes in mtDNA despite the small number of genes encoded in the organelle genome.
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PMID:Mitochondrial DNA variation is associated with measurable differences in life-history traits and mitochondrial metabolism in Drosophila simulans. 1759 52


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