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Query: UMLS:C0038187 (starvation)
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Clinical observations suggest that overt rhabdomyolysis may occur if severe hypophosphatemia is superimposed upon a pre-existing subclinical myopathy. To examine this possibility, a subclinical muscle cell injury was induced in 23 dogs by feeding them a phosphorus- and calorie-deficient diet until they lost 30% of their original weight. To induce acute, severe hypophosphatemia in the animals after partial starvation, 17 of the dogs were given large quantities of the same phosphorus-deficient diet in conjunction with an oral carbohydrate supplement, which together provided 140 kcal/kg per day. After phosphorus and caloric deprivation, serum phosphorus and creatine phosphokinase (CPK) activity were normal. Total muscle phosphorus content fell from 28.0+/-1.3 to 26.1+/-2.5 mmol/dg fat-free dry solids. Sodium, chloride, and water contents rose. These changes resembled those observed in patients with subclinical alcoholic myopathy. When studied after 3 days of hyperalimentation, the animals not receiving phosphorus showed weakness, tremulousness, and in some cases, seizures. Serum phosphorus fell, the average lowest value was 0.8 mg/dl (P <0.001). CPK activity rose from 66+/-357 to 695+/-1,288 IU/liter (P <0.001). Muscle phosphorus content fell further to 21.1+/-7.7 mmol/dg fat-free dry solids (P <0.001). Muscle Na and Cl contents became higher (P <0.01). Sections of gracilis muscle showed frank rhabdomyolysis.6 of the 23 phosphorus- and calorie-deprived dogs were also given 140 kal/kg per day but in addition, each received 147 mmol of elemental phosphorus. These dogs consumed their diet avidly and displayed no symptoms. They did not become hypophosphatemic, their CPK remained normal, and derangements of cellular Na, Cl, and H(2)O were rapidly corrected. The gracilis muscle appeared normal histologically in these animals. These data suggest that a subclinical myopathy may set the stage for rhabdomyolysis if acute, severe hypophosphatemia is superimposed. Neither acute hypophosphatemia nor rhabdomyolysis occur if abundant phosphorus is provided during hyperalimentation.
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PMID:Hypophosphatemia and rhabdomyolysis. 74 77

Malnutrition has a direct relationship to complications associated with ineffective wound and fracture healing, inadequate immune responses, decreased tolerance to cancer therapy, muscle weakness, and certain organ dysfunctions (heart and liver). Malnutrition combined with disease, injury, or stress increases the metabolic rate in patients above that of resting. These patients are undergoing an accelerated form of starvation, which is more common than presently recognized in veterinary medicine and may be responsible for the less than optimal responses to proper therapies. Diseased or injured patients unable to digest or absorb nutrients from the gastrointestinal tract require additional medical support in the form of parenteral nutrition. Advances in parenteral solutions, products, and delivery systems make parenteral nutritional support possible in veterinary medicine, although not possible in all small animal practices. Proper patient selection, well-informed clients, dedicated technicians, and knowledgeable veterinarians are all essential in the successful implementation of parenteral nutritional support.
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PMID:Parenteral nutritional support in the small animal patient. 251 12

Starvation, primarily during the first week postpartum, is the direct or indirect cause of at least one-half of preweaning mortalities in healthy herds. Causes of starvation originate from characteristics of the dam, of the litter and of individual piglets. A major cause of starvation is congenital weakness associated with birth weights less than 1000 g. Increasing energy during late gestation shows inconsistent effects on birth weight; some dietary component energy sources appear to improve stamina of newborn and(or) energy content of sow's milk with favorable effects on survival. Total or partial supplemental nutrient intake supplied by caretakers, automated feeding devices or transfer of piglets to foster dams are the primary means of providing enhanced nutrient intake opportunity. Nutrient intake from non-dam sources ranges from temporary tube-feeding, administered by caretakers to excessively small or weak pigs, to self-feeding by pigs from simple or sophisticated dispensers of sow milk substitutes. Transfer of piglets to foster dams as a nutrient intake source is most successful when characteristics such as size of dam, size of teats, stage of lactation and temperament are in harmony with characteristics affecting pigs' needs. If other dams are not available, sows 2 to 3 wk into lactation can serve as foster dams for large and strong newborn piglets after resident litters are removed. Planning for availability of appropriate foster dams, based on prior or projected prolificacy and other sow and litter traits, should be done at time of assembling each mating group. Research results show that, on a weight-to-weight basis, pigs requiring artificial or foster dam rearing perform similarly to other pigs and thus justify management to secure their survival.
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PMID:Improving sow efficiency by management to enhance opportunity for nutritional intake by neonatal piglets. 377 8

The metabolic response to human growth hormone (HGH) was studied in five obese subjects in the fed state and during prolonged (5-6 wk) starvation. In the fed state (three subjects), HGH induced an elevation in basal serum insulin concentration, a minimal increase in blood and urine ketone levels, and a marked reduction in urinary nitrogen and potassium excretion resulting in positive nitrogen and potassium balance. In prolonged fasting (four subjects), HGH administration resulted in a 2- to 3-fold increase in serum insulin which preceded a 50% elevation in blood glucose. Persistence of the lipolytic effects of HGH was indicated by a rise in free fatty acids and glycerol. The response differed markedly from the fed state in that blood beta-hydroxybutyrate and acetoacetate levels rose by 20-40%, resulting in total blood ketone acid concentrations of 10-12 mmoles/liter, ketonuria of 150-320 mmoles/day, and increased urinary potassium loss. The subjects complained of nausea, vomiting, weakness, and myalgias. Despite a 50% reduction in urea excretion during HGH administration, total nitrogen loss remained unchanged as urinary ammonia excretion rose by 50% and correlated directly with the degree of ketonuria. It is concluded that in prolonged starvation (a) HGH may have a direct insulinotropic effect on the beta cell independent of alterations in blood glucose concentration, (b) persistence of the lipolytic action of HGH results in severe exaggeration of starvation ketosis and interferes with its anticatabolic action by necessitating increased urinary ammonia loss, and (c) failure of HGH to reduce net protein catabolism in starvation suggests that this hormone does not have a prime regulatory role in conserving body protein stores during prolonged fasting.
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PMID:Metabolic response to human growth hormone during prolonged starvation. 554 Jan 76

A patient with acute myelogenous leukemia developed severe hypophosphatemia manifesting by extreme weakness, confusion, loss of sphincter control, nuchal rigidity, hyperesthesia, hemolysis, congestive heart failure and liver dysfunction. The possible causes for this condition were starvation, parenteral glucose and saline administration, sepsis, hypokalemia and treatment with acetazolamide. A dramatic improvement was noted following phosphate administration.
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PMID:Life-threatening hypophosphatemia in a patient with acute myelogenous leukemia. 677 68

Twenty patients with anorexia nervosa and a body weight below 60% of the standard weight were studied. One died of starvation; the others survived. Four patients, including the deceased, had such severe weakness that they could not sit up without support, and another five could sit up only from a lateral position. Serum albumin or hemoglobin levels at the beginning of therapy could not be used for nutritional assessment because of dehydration, while increased blood urea nitrogen was associated with acute illness. The present results together with data from previous studies of fatal anorexia indicate that the risk of mortality may be quite low when body weight is above 60% of the standard. We suggest that gross muscle weakness in addition to body weight for height can be a valuable indicator to assess the criticalness in anorexia nervosa.
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PMID:Assessment of emaciation in relation to threat to life in anorexia nervosa. 801 84

The peak time period for the average beef producer to experience the majority of calf losses has consistently been from the time of birth through the first seven days of life. Weakness is a principal clinical sign of diseases or conditions responsible for mortality including birth trauma, prematurity or dysmaturity, congenital malformations, metabolic defects, intrauterine infection, anoxia or hypoxia, hypothermia, starvation, extremes in birth weight, and post-natal infection. This article discusses anoxia/hypoxia and septicemia in greater detail because of their involvement as a common cause of weakness in the newborn calf.
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PMID:Weakness in the newborn calf. 819 20

A weakness of many animal models of diabetes mellitus is the failure to use insulin therapy, which typically results in severe body wasting. Data collected from such studies must be interpreted cautiously to separate the effects of hyperglycemia from those of starvation. We provide several algorithms that were used by us in two long-term (20-week) experiments in which hyperglycemia (300 to 400 mg/dl), dyslipidemia (cholesterol [280 to 405 mg/dl] and triglycerides [55 to 106 mg/dl] concentrations), and positive energy balance were maintained in swine. Yucatan miniature swine groups included control, alloxan-induced diabetes mellitus, diabetes mellitus plus diet-induced dyslipidemia, and exercise-trained diabetic dyslipidemic pigs. The algorithms were developed for the porcine model because of several similarities to humans, including: cardiac anatomy and physiology, propensity for sedentary behavior, and metabolism of dietary carbohydrates and lipids. Acute toxic effects of alloxan (hypoglycemia, hyperglycemia, nephrotoxicosis) were minimized by preventive fluid loading and by use of algorithms in which insulin, food, and fluid therapy were administered. Long-term insulin and food maintenance algorithms elicited normal body weight gain in all three diabetic groups (lean experiment) and threefold greater body weight gain in pigs of an obesity experiment. Exercise-trained pigs of both experiments manifested significantly increased work performance and did not experience medical complications. We conclude that these algorithms can be used in swine, or similar algorithms can be developed for other animal species to maintain hyperglycemia and/or dyslipidemia, while avoiding diabetes-induced wasting. Importantly, animal models of diabetes mellitus that maintain positive energy balance and poor glycemic control provide a marked improvement over other models by more closely mimicking the human presentation of diabetes mellitus.
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PMID:Porcine model of diabetic dyslipidemia: insulin and feed algorithms for mimicking diabetes mellitus in humans. 1262 6

The aims of this project were to determine mortality rate and aetiology of losses in suckling rabbits during the first 14 days of life. Post-mortem examinations were done on 1096 siblings from 8 conventional farms. Mortality rates varied from 0 to 17.0%. Main death causes were non-infectious and included stillbirth (13.9%), weakness due to reduced birth weight (3.0%), starvation (11.6%), runting (11.6%), cannibalism (0.5%) and scattering (7.9%). The last four causes mainly attributed to insufficient nursing by the doe. Only 21.8% of the losses were of infectious aetiology.
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PMID:[Suckling mortality in fattening rabbits in Switzerland]. 1289 6

During World War II, 36 conscientious objectors participated in a study of human starvation conducted by Ancel Keys and his colleagues at the University of Minnesota. The Minnesota Starvation Experiment, as it was later known, was a grueling study meant to gain insight into the physical and psychologic effects of semistarvation and the problem of refeeding civilians who had been starved during the war. During the experiment, the participants were subjected to semistarvation in which most lost >25% of their weight, and many experienced anemia, fatigue, apathy, extreme weakness, irritability, neurological deficits, and lower extremity edema. In 2003-2004, 18 of the original 36 participants were still alive and were interviewed. Many came from the Historic Peace Churches (Mennonite, Brethren, and Quaker), and all expressed strong convictions about nonviolence and wanting to make a meaningful contribution during the war. Despite ethical issues about subjecting healthy humans to starvation, the men interviewed were unanimous in saying that they would do it all over again, even after knowing the suffering that they had experienced. After the experiment ended, many of the participants went on to rebuilding war-torn Europe, working in the ministries, diplomatic careers, and other activities related to nonviolence.
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PMID:They starved so that others be better fed: remembering Ancel Keys and the Minnesota experiment. 1593 Apr 36


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