Vitamin DEFICIENCY AND HYPOVITAMINOSIS B1 (BERIBERI, NUTRITIONAL POLYNEURITIS)

Vitamin DEFICIENCY AND HYPOVITAMINOSIS B1 (BERIBERI, NUTRITIONAL POLYNEURITIS)- QR

HYPOVITAMINOSIS AND AVITAMINOSIS : - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention

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What is the Vitamin DEFICIENCY AND HYPOVITAMINOSIS B1 (BERIBERI, NUTRITIONAL POLYNEURITIS) and how it is treated?

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Etiology and pathogenesis Vitamin DEFICIENCY AND HYPOVITAMINOSIS B1 (BERIBERI, NUTRITIONAL POLYNEURITIS)

Etiology. The absence or low content in food protevorevmaticescoe vitamin (thiamine, aneurine).

The pathogenesis. In the absence of the vitamin in the diet or insufficient intake or absorption is disturbed mainly carbohydrate metabolism in the body.

There are several forms of the disease:

1) rice beriberi;

2) narisawa beriberi;

3) secondary beriberi with the full power on the basis of malabsorption protevorevmaticescoe vitamin in the gastrointestinal tract. In this form, it seems, is alcoholic, metabolic, diabetic polyneuritis and polyneuritis pregnant. The special place occupies the deficiency and hypovitaminosis B1 newborns and older children, the main power which is the parent and cow's milk contains little protevorevmaticescoe vitamin B1 (thiamine).

Symptoms and course Vitamin DEFICIENCY AND HYPOVITAMINOSIS B1 (BERIBERI, NUTRITIONAL POLYNEURITIS)

Symptoms. The characteristic triad: cardiovascular disorders, swelling and polyneuritis. Cardiovascular system: shortness of breath, tightness in the chest and cyanosis, especially pronounced in malignant form "chosen". Boundaries extended to the left behind the nipple line, right behind the right parasternal line. Epigastric pulsation, shaking, chest, systolic murmur at the apex, sharp smexiest heart. On the radiograph heart is shaped like a ball. Pulse frequent, sometimes over 100 beats alone, labile. Distinct changes in the electrocardiogram: low voltage, some perversion or flattening of the T wave in the first, second and third abstraction, shortening of the interval R - R and the interval extension of Q, the Maximum blood pressure is not changed, the minimum is reduced. With the introduction of epinephrine diastolic blood pressure did not increase, but decrease. Swelling of the legs and rear brake. In acute cases, the amount of urine is reduced to 500 - 700 ml, the high proportion of it, no protein, and cylinders. Lowering of appetite, heaviness and pressure in the stomach, nausea and vomiting (with the malignant form "chosen"). Constipation, General weakness. Central nervous system: disorders is not understood, but certainly has a place. Peripheral nervous system: a decrease in the sensitivity of legs, feet (paper base). The crawling. The decrease in the sensitivity of the toes, lower abdomen, forearms, and the circumference of the mouth. Severe pain when pressure and this calf muscles, testoviny swelling of the calf muscles, heaviness and weakness in the legs, fatigue when walking, lameness, seizures, swelling of the ankles, rising up on hip and thigh. Solasia pain along the nerves. Sometimes imbalance, reminiscent of Meniere's disease. Typical gait: the patient initially admitted to the fingers and the outer edge of the foot, sparing the heel, then the weak pateticheskaja gait with crutches; socks feet hanging down (pes equinus and equino-varus). At first increase, then decrease and extinction patello and Achilles tendon reflexes.

Symptoms of vitamin B1 in children: pallor, lack of growth or weight loss, constipation, motor restlessness, rigidity of the neck, spastic condition of the muscles of the limbs, then cardiovascular effects, swelling, paralysis n. recurrens and n. oculomotorius and meningeal phenomena.

Course and complications. The disease begins gradually with a long lasting hypovitaminoses state, then attack with the prevalence of cardiovascular symptoms, followed in rice beriberi usually occurs paralytic stage. When narisovat beriberi nervous phenomena are usually expressed less sharply. Disease duration from 1 year to several years.

Recognition Vitamin DEFICIENCY AND HYPOVITAMINOSIS B1 (BERIBERI, NUTRITIONAL POLYNEURITIS)

To differentsirovat have from malnutrition, infectious disease and graves ' disease, from heart disease (mitral insufficiency), polyneuritis neovitalism origin, pellagra, elementarnoi intoxication reason (Lathyrus sativa).

For early detection it is important to increase the content of pyruvic acid in the blood (normal: 0.5 - 1 mg%) and a decrease in the secretion of vitamin B1 in the daily amount of urine (normal 250 - 500).

Predictions Vitamin DEFICIENCY AND HYPOVITAMINOSIS B1 (BERIBERI, NUTRITIONAL POLYNEURITIS)

The prediction is usually favorable.

Acute malignant form "chosen" ends in death after 1 to 3 days.

 

Prevention Vitamin DEFICIENCY AND HYPOVITAMINOSIS B1 (BERIBERI, NUTRITIONAL POLYNEURITIS)

A diet with sufficient levels of vitamin B1. The average daily requirement of an adult with average physical activity of approximately 2 mg of vitamin B1 (thiamine). The need for vitamin B1 is determined by the correct ratio of nutrients. The more carbohydrates require more vitamin B1; the more fat, the less the need for vitamin B1. The need for vitamin B1 increases with decreasing and increasing ambient temperature and with febrile illnesses. Mass prevention among the population - inclusion in the diet of rye bread (0.15 mg% of vitamin e,1) and bread from whole wheat (0.30 mg%), and buckwheat (0.50 mg%), barley (0,40 mg%), oatmeal (0.30 mg%) Mr. bean: soybeans (0,60 mg%), beans and peas (0,40 mg%). From meat and dairy products are good source of vitamin B1 - liver (0,40 mg%), heart (0,60 mg%) and kidney (0,40 - 0,70 mg%) large cattle and pigs, as well as lean pork (0,40 mg%) and ham (0,70 mg%). Milk, dairy products and eggs are deficient in vitamin B1. Rich in vitamin B1, yeast - dry beer (5 mg%), dried Baker (2 mg%). Other products - wheat germ (2 mg%), nuts, peanuts (0,80 mg%), forest (0,60 mg%) and walnut (0.30 mg%).

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