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Query: UMLS:C0038187 (starvation)
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Body composition and aerobic work performance have been studied in 5 boys and 10 girls suffering from anorexia nervosa. The average ages of the two groups of children were 15.4 (boys) and 15.2 (girls) years respectively. Measurements of body composition included height, weight (W), body potassium (40K), skinfold thickness (SFT) at triceps and subscapularis, blood volume (BV) and femoral condylar and radioulnar breadths. From these measurements estimates of fat free weight (FFW), skeletal weight (S) and lean body mass (LBM) were made. Work performance was assessed by measurement of the maximal aerobic power (VO2 max). The patients had lost on average 26% of their former body weight. The boys had on average greater than 7% of their body weight as fat compared with greater than 9% in the girls. However, the loss of weight was not solely due to loss of body fat, but could also be ascribed to a decrease in soft fatfree tissue. LBM or FFW could be estimated as well from SFT as from 40k. vo2 max averaged 1.43 1/min (35.1 ml/kg/min) in the anorexic boys and 1.24 l/min (33.2 ml/kg/min) in the girls and was associated with FFW and LBM. However, VO2 max was lower in relation to LBM than in healthy children of the same age. Thus it was suggested that the emaciation in anorexia is directly attributable to loss of both fat and muscle and accounts in part for the reduction of aerobic power observed. However, an important factor may be the debilitating effect of starvation on the patient, particularly in its advanced and later stages, which reduces his/her level of habitual physical activity.
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PMID:Total body potassium fat free weight and maximal aerobic power in children with anorexia nervosa. 62 81

1. Clinical and necropsy observations in lepromatous leprosy associated with severe emaciation and accompanying hypoproteinemia suggest that protein deprivation may be of pathogenic significance in the ulcerative phenomenon that is designated "Lazarine leprosy". 2. An experimental utilizing Wiersung rats infected with Mycobacterium lepraemurium and maintained on a protein-free diet was developed for the purpose of studying the effect of protein starvation on the course of chronic mycobacterial disease similar to lepromatous leprosy with respect to pathogen and host inflammatory response. 3. It was possible to maintain the experimental animals on a protein-free diet for up to 18 weeks of concomitant M. lepraemurium infection. This was long enough for the infection to disseminate to a degree that was evident in control animals only several weeks later. 4. The protein-deprived animals showed decreased inflammatory response to the pathogen, presented more rapid dissemination of the infection and harbored more bacilli per macrophage than did animals similarly infected but maintained on a protein adequate diet. This indicates impairment of native cellular immunity by protein deprivation through decrease in ability of macrophages to inhibit bacillary multiplication. 5. There was no evidence of impairment of macrophage ability to phagocytose the pathogens. 6. Morphologically the increased dissemination of pathogens and decrease in inflammatory response was similar to the increase in number and extent of visceral lesions seen in Lazarine leprosy. Decreased ability to dispose of the infecting bacilli was similar in the two models, human and animal. The animal model does not, as does lepromatous leprosy, involve the skin in the infection. Hence comparable ulcerative phenomena were not replicated in the animals. 7. It is suggested that Lazarine leprosy may result from enhanced lepromatous leprous infection occurring as a result of protein malnutrition. The pathogenic mechanism appears to be impairment of cellular immunity probably enhanced by concomitant impairment of humoral antibody immunity resulting also in decreased resistance to pyogenic and other secondary pathogens. The tissue edema attendant on decreased serum osmotic pressure due to lowering of the serum protein fractions enhances the probability of ulceration.
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PMID:The role of protein malnutrition in the pathogenesis of ulcerative "Lazarine" leprosy. 82 11

As part of an investigation of the effect of plastic ingestion on seabirds in Hawaii, we necropsied the carcasses of 137 Laysan albatross (Diomedea immutabilis) chicks from Midway Atoll in the Pacific Ocean during the summer of 1987. Selected tissues were collected for microbiological, parasitological, toxicological or histopathological examinations. Dehydration was the most common cause of death. Lead poisoning, trauma, emaciation (starvation) and trombidiosis were other causes of death; nonfatal nocardiosis and avian pox also were present. There was no evidence that ingested plastic caused mechanical lesions or mortality in 1987, but most of the chicks had considerably less plastic in them than chicks from earlier years. Human activity (lead poisoning and vehicular trauma) caused mortality at Midway Atoll and represented additive mortality for pre-fledgling albatrosses.
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PMID:Causes of mortality of albatross chicks at Midway Atoll. 216 93

Patients with anorexia nervosa (AN) exhibit neuroendocrine abnormalities that may result solely from emaciation or may reflect defective endocrine mechanisms which are intrinsic to disordered eating even in the absence of starvation. To distinguish these possibilities, we have studied indices of hypothalamic-pituitary-gonadal (HPG) function in 9 patients with AN, 12 normal weight patients with bulimia and recent or current oligomenorrhea, and 8 normal weight controls. Measurement of 24-hour luteinizing hormone (LH) secretion with 30-min sampling revealed significantly fewer LH secretory spikes and a trend toward lower mean 24-hour LH levels in both bulimic and anorectic patients than in controls. Stimulation with gonadotropin releasing hormone produced elevated LH responses in the bulimic group and blunted LH responses in the anorectic group. Stimulation with estradiol revealed diminished LH augmentative responses and a trend toward diminished follicle stimulating hormone augmentative responses among bulimic as well as AN patients compared to controls. In each instance, the bulimic group tended to show within-group heterogeneity, with some individuals falling within the AN range. These findings suggest that HPG axis abnormalities in eating disordered patients cannot entirely be attributed to emaciation and that factors other than subnormal weight contribute to disturbed hypothalamic-pituitary functioning in these patients.
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PMID:Hypothalamic-pituitary-gonadal function in anorexia nervosa and bulimia. 250 Jun 76

Computed tomographic (CT) brain scans were performed in 50 inpatients with bulimia nervosa, 50 anorectic inpatients, and 50 age-matched control subjects. A number of patients with bulimia nervosa had enlarged ventricles and/or sulcal widening, but the degree and frequency of ventricular dilatation and sulcal widening were not so pronounced as in patients with anorexia nervosa. As the bulimic patients were of normal body weight, the CT abnormalities cannot be attributed to emaciation, which has often been suggested as the cause of abnormalities found in anorectic patients. Since many bulimic patients repeatedly attempt to lose weight by going on restrictive diets, the morphological brain alterations may reflect the endocrine and metabolic reactions to starvation--regardless of whether starvation has led to emaciation, as in the case of anorexia nervosa, or only counterbalanced the binges of high-caloric food. This assumption is supported by the finding that in both bulimic and anorectic patients ventricular size is inversely correlated with the plasma levels of triiodothyronine, a low concentration of which is an indicator for starvation.
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PMID:Structural brain abnormalities in patients with bulimia nervosa. 292 42

The cases of 13 men with anorexia nervosa are reported. While the disorder as seen in the clinic is much less common in males than females this may not be a true reflection of the differential sex or overall prevalence rates. The disorder is found to have the same basic characteristics in the male as in the female: namely, a phobic avoidance of normal weight associated with elective carbohydrate starvation and emaciation. As in the female the mechanism appears to develop out of normal adolescent dieting behaviour and to arise as a means of avoiding overwhelming psychosocial maturational demands of adolescence. Premorbid and family features include a state of overnutrition and a high degree of family psychopathology reflected in high rates of parental psychiatric morbidity and marital difficulty.
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PMID:Primary anorexia nervosa or weight phobia in the male: report on 13 cases. 500 58

During the height of the 1992-93 famine in Somalia, data were collected from 573 inpatients at the Concern Worldwide Adult Therapeutic Centre in Baidoa, the town at the epicentre of the disaster. These data indicate that a body mass index (BMI, body weight in kilograms divided by height in metres squared) of less than 10 kg m-2 can be compatible with life, so long as specialized care is provided. Such low levels of BMI may be explained, in part, by the high ambient temperature, the tall phenotype of the Somalis, the gradual reduction in food intake and previous exposure to chronic energy deficiency. Famine oedema occurred with the same prevalence in male and female patients, but male patients had more severe oedema and a poorer prognosis at any given degree of severity. Survival from these extremes of emaciation has never before been recorded, and many of the BMI values documented here are below the level of 12, previously thought to mark the limit of human adaptation to starvation.
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PMID:The limit of human adaptation to starvation. 758 85

A mixed retrospective-prospective study of 70 Chinese anorexic patients in Hong Kong shows that although they were similar to Western anorexics in most other ways, 41 (58.6%) of them did not exhibit any fear of fatness throughout their course of illness. Instead, these non-fat phobic patients used epigastric bloating (31.4%), no appetite/hunger (15.7%) or simply eating less (12.9%) as legitimating rationales for food refusal and emaciation. Compared to fat phobic anorexics, they were significantly slimmer pre-morbidly (P < 0.0001) and were less likely to exhibit bulimia (P = 0.001). The possible explanations for the absence of fat phobia and the interpretive dilemma this provokes are discussed from historical, pathoplastic and cultural anthropological perspectives. It is argued that anorexia nervosa may display phenomenological plurality in a Westernizing society, and its identity may be conceptualized without invoking the explanatory construct of fat phobia exclusively. As non-fat phobic anorexia nervosa displays no culturally peculiar features, it is not strictly speaking a Western culture-bound syndrome, but may evolve into its contemporary fat phobic vogue under the permeative impact of Westernization. Its careful evaluation may help clarify the aetiology and historical transformation of eating disorder, foster the development of a cross-culturally valid taxonomy of morbid states of self-starvation, and exemplify some of the crucial issues that need to be tackled in the cross-cultural study of mental disorders.
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PMID:Fat phobic and non-fat phobic anorexia nervosa: a comparative study of 70 Chinese patients in Hong Kong. 813 23

Although anorexia nervosa emerged as a new syndrome in the second half of the 19th century, this clinical picture seemed to be unknown in the psychiatric hospitals or asylums. In asylum medicine, the commonly used concept of sitophobia to designate food refusal in the insane covered a wide variety of mental disturbances and cannot be plainly equated with anorexia nervosa. A major difference is the occurrence of hallucinations and delusions specifically centered around religion and digestion. Most probably, anorectic patients were not treated in asylums, but at home, in the doctor's office, or in general hospitals. This pattern may be partly attributed to the fact that both patients and doctors were focusing on symptoms of self-starvation like emaciation, constipation, and amenorrhea, which were primarily interpreted as referring to somatic diseases. Additionally, wealthy families probably preferred private care in water-cure establishments, sanatoria, and rest homes to the stigmatizing referral of their anorectic daughter to an asylum. Hence, the fact that late 19th-century institutionalized psychiatry was only incidentally confronted with anorexia nervosa may explain its lack of interest in the emerging syndrome.
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PMID:Food refusal and insanity: sitophobia and anorexia nervosa in Victorian asylums. 1074 45

Mortalities and abortions associated with starvation occurred at Cape Cross, Namibia, in Cape fur seals (Arctocephalus pusillus pusillus). Affected seals showed lethargy and emaciation, and the most common pathological signs were those of a respiratory infection, both in adults and offspring. Streptococcus phocae was isolated from adult seals, a cub and aborted foetuses.
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PMID:Streptococcus phocae infections associated with starvation in Cape fur seals. 1085 31


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