Clinical signs, MRI features, and outcomes of two cats with thiamine deficiency secondary to diet change

Two cats were presented with vestibular signs and seizures. Both cats were diagnosed with thiamine deficiency. The transverse and dorsal T2-weighted magnetic resonance (MR) images revealed the presence of bilateral hyperintense lesions at specific nuclei of the midbrain, cerebellum, and brainstem. After thiamine supplementation, the clinical signs gradually improved. Repeated MR images taken 3 weeks after thiamine supplementation had started showed that the lesions were nearly resolved. This case report describes the clinical and MR findings associated with thiamine deficiency in two cats.

Vitamina B en paciente alcohólico: relato de un caso / Vitamine B in alcoholic patient: case report

Métodos: A partir del año 2007 se efectúan estudios en nuestro Instituto para precisar una dosis adecuada de complejo B a aplicar en el Síndrome de Deprivación Alcohólico (Ibáñez y Bustamante) Resultados: Después de tres semanas de tratamiento con benzodiacepina y complejo B (tiamina) según el nuevo protocolo se logra una recuperación motora y mental de un paciente con un Síndrome Korsakoiwideo alcohólico y un cuadro de paraparesia. Conclusión: Los resultados sugieren que la encefalopatía de Wernicke tratada con dosis superiores a 300 mg/diarios de tiamina puede tener un resultado altamente beneficioso para el paciente con síndrome de deprivación alcohólico.

Method: Since 2007, different studies have been made in our Institute, in order to find the right dose of Vitamin B Complex in cases of Alcohol Withdrawal Syndrome (Ibáñez y Bustamante). Results: After a 3 weeks treatment with Benzodiazepine and Vitamin B Complex (Thiamine), according to the new protocol, a patient with Alcoholic Korsakow Syndrome and Paraparesis, recovers his mental and motor functions. Conclusions: Wernicke’s encephalopathy can be treated with high doses of Thiamine (around 300 mg/a day), on patients with Alcohol Withdrawal Syndrome with highly good results.

Estudo retrospectivo de 19 casos de polioencefalomalácia, em bovinos, responsivos ao tratamento com tiamina / Retrospective study of 19 cases of polioencephalomalacia in cattle, responsive to the treatment with thiamine

Nineteen bovines of both sexes aging from 5 month-old to 5 year-old, were referred to a veterinary hospital. Clinical signs were observed from 6 hours to 10 days before. Thirteen animals were found in permanent lateral recumbency, five showed motor incoordination, 15 were exclusively fed on grass pasture, three showed partial loss of visual acuity, 14 were blindness, 16 showed presence of normal pupillary reflex, 16 decreased ruminal motility, 14 decreased sensorium (depression, semicoma or coma) and eight showed opisthotonos. Dehydration and dried feces were directly related to the time of evolution of the process. All the animals were administrated vitamin B1 and showed a marked improvement of the clinical status within 4 to 48 hours after treatment. The longer the time between the onset of the clinical signs and treatment, the greater the delay for the restoration of the vision. The treatment was very effective for a rapid response of the animal.

Potencialização do efeito antiinflamatório e antinociceptivo do diclofenaco e da nimesulida por vitaminas do complexo B / Potentiating effect of pretreatment with some B vitamins on the anti-inflammatory and antinociceptive properties of nimesulide and diclofenac

Investigou-se os efeitos de algumas vitaminas B associadas ao diclofenaco ou nimesulida, na contorção abdominal em camundongos e edema de pata em ratos apenas com a nimesulida ou sua associação com algumas vitaminas B.Verificou-se que o pré-tratamento com as vitaminas tiamina[B1], piridoxina[B6] e cianocobalamina [B12], isoladasou administradas conjuntamente, não inibiu o edema de pata produzido pela carragenina em ratos, nem as contorções abdominais produzidas pelo ácido acético em camundongos. Por outro lado, a nimesulida [5mg/kg]reduziu o edema de pata em ratos, e a associação das três vitaminas à este fármaco, mas não as vitaminas administradas isoladamente, potencializou seus efeitos nos tempos de duas, três e quatro horas após a carragenina. As contorções abdominais em camundongos foram inibidas pelas doses de 25 ou 50mg/kg de diclofenaco. A associação das três vitaminas ou apenas da cianocobalamina, potencializou as duas doses do diclofenaco utilizadas. As contorções abdominais foram reduzidas também pelo nimesulida [5mg/kg] e a associação das três vitaminas, oucada uma das vitaminas administradas isoladamente, foram capazes de potencializar os efeitos do nimesulida. É provável que a diferença no mecanismo de ação destes fármacos sejaresponsável pela diferença dos efeitos das vitaminas. O presente trabalho aponta para a realização de novos estudos com o uso destes antiinflamatórios, combinados com as vitaminas tiamina[B1], piridoxina[B6] e cianocobalamina [B12], em doenças inflamatórias crônicas, na tentativa dereduzir a dose destes fármacos e consequentemente diminuindo seus efeitos colaterais.

The effects of a combination of some B vitamins and diclofenac or nimesulide on chemical nociception in mice or paw edema in rats were investigated. While the vitamins alone had no effect, combination of thiamine (B1), pyridoxine (B6) and cyanocobalamin (B12), given i.p. in doses of 100mg and 5mg/kg, respectively, potentiated the inhibition by nimesulide (5mg/kg) of paw edema induced by carrageenin in rats. Antinociceptive effects of diclofenac and nimesulide (inhibition of abdominal writhing induced by acetic acid in mice) were also potentiated by the combination of the vitamins B1, B6 and B12. Thiamine, pyridoxine and cyanocobalamin given singly were effective in potentiating antinociceptive effects of nimesulide, but only cyanocobalamin potentiated these effects of diclofenac, probably reflecting the differing mechanisms of action of the two drugs. The results document the positive influence of B vitamins on the antinociceptive effects of diclofenac or nimesulide and support the use of B vitamins to shorten the treatment time and reduce the daily dose of anti-inflammatories.

Beribéri pós bypass gástrico: uma complicação não tão rara. Relato de dois casos e revisão da literatura / Beriberi after bariatric surgery: not an unusual complication. Report of two cases and literature review

É crescente o número de pacientes submetidos à cirurgia bariátrica para tratamento da obesidade mórbida; devido a isso, estão reaparecendo deficiências nutricionais com as quais muitos médicos já não estão familiarizados. No pós-operatório, podem ocorrer vários distúrbios nutricionais, sendo um deles a deficiência de tiamina (beribéri). A deficiência de tiamina e/ou vitamina B12 pode corresponder a 40 por cento dos casos de neuropatia após a cirurgia bariátrica. Serão descritos dois pacientes com a clínica de neuropatia periférica e síndrome de Wernicke-Korsakoff. Alguns meses após a cirurgia, eles apresentaram prostração, depressão, confusão mental e nistagmo, associados a dor e parestesia dos membros (principalmente inferiores). Com a hipótese diagnóstica de beribéri, foi iniciado o tratamento com tiamina. Um dos pacientes apresentou melhora completa do quadro neurológico, porém o outro permaneceu com déficit motor, sendo aquele em que decorreu o maior tempo entre o aparecimento dos sintomas e o início do tratamento. Estes casos servem para nos alertar sobre a importância da vigilância nutricional após a cirurgia bariátrica.

Adición de vitaminas y minerales a harinas de maíz y de trigo en México / Vitamin and mineral addition to corn and wheat flours in Mexico

En México la deficiencia marginal de algunas vitaminas y minerales afecta la salud y la funcionalidad de un número elevado de mexicanos, por lo que la Secretaría de Salud ha iniciado un programa para promover la adición de nutrimentosa a las harinas de trigo y de maíz que se procesan industrialmente. El presente documento expone las bases científicas y tecnológicas para dicha adición. El objetivo primordial es restaurar los nutrimentos que se pierden durante el proceso de obtención de las harinas y durante la fabricación de los alimentos a partir de las harinas; además, se adicionan aquellos nutrimentos cuya presencia es deficiente en una proporción importante de la población y cuya suplementación en la dieta ha demostrado ser benéficio de la fórmula para adicionar a las harinas de trigo de maíz se consideraron, además de los factores mencionados, los niveles de absorción de los diferentes nutrimentos, la interacción probable entre nutrimentos y un malgar muy amplio de seguridad, de manera que se eliminara cualquier riesgo de algún efecto adverso en la salud, aun en los niveles más altos de ingestión de los alimentos. Finalmente, se sugieren los compuestos más apropiados para la adición a las harinas considerando su reactividad y sus posibles efectos negativos en la estabilidad de las harinas, así como su biodisponibilidad, su disponibilidad en el mercado y su costo. Con lo anterior se recomienda la adición de 5 mg/kg de tiamina (mononitrato de tiamina), 3 mg/kg de riboflavina (hidroclorhidrato de riboflavina). 3 mg/kg de niacina (nicotinamida), 30 mg/kg de hierro (hierro reducido extrafino) y 20 mg/kg de zinc (óxido de zinc) para ambas harinas, así como 2 mg/kg y 0.5 mg/kg de ácido fólico para las harinas de trigo y maíz, respectivamente

Effects of dietary counseling on vitamin A, B-1, B-2 and zinc status of chronic hemodialysis patients.

Twenty-one chronic hemodialysis patients underwent nutritional evaluation and regular dietary counseling to improve the protein and energy intake for 8 weeks. As a result, the mean serum potassium and phosphorus concentrations were increased but were still within the normal ranges. After counseling, the frequency of abnormal TPPE and EGRAC were decreased (9.5 to 4.8 per cent and 19 to 14.3 per cent, respectively) while the frequency of hypervitaminosis A was increased from 67 to 81 per cent. Though the evidence of zinc deficiency was decreased from 81 to 62 per cent after counseling, mean serum zinc levels were low in both periods and inadequate vitamin B status cannot be totally eradicated due to the limitation of food selection. Therefore, regular supplementation of vitamin B complex is required, whereas, vitamin A supplementation must be prohibited in chronic HD patients. Small daily doses of potassium chelator and phosphate binder are mandatory if improvement of nutritional status is aimed to be one of the therapeutic goals.

Encefalopatía de Wernicke como complicación de hemodiálisis crónica: caso clínico / Wernicke's encephalopathy as an hemodialysis complication: clinical case

Wernicke encephalopathy, due to the depletion of thiamine, can be a complication of chronic hemodialysis. We report a 43 years old diabetic male in chronic hemodialysis, who two weeks after an infra-condyleal amputation of his left leg, was admited to the hospital due to an episode of vomiting and abdominal pain lasting 5 days, where confusion and ocular motor signs appeared. Parenteral thiamine administration was started and the confusional state abated. Dialysis can be a predisposing factor for Wernicke encaphalopathy and this diagnosis must be considered in confuse patients

Curative treatment of primary (spasmodic) dysmenorrhoea.

To prove the efficacy of oral vitamin B1 administration for the treatment of primary dysmenorrhoea, a randomised, double-blind, placebo-controlled study was carried out on 556 girls aged 12-21 yr, having moderate to very severe spasmodic dysmenorrhoea. Thiamine hydrochloride (vitamin B1) was given in a dose of 100 mg orally, daily for 90 days. The combined final results of both the 'active treatment first' group and the 'placebo first' group, after 90 days of vitamin B1 administration, were 87 per cent completely cured, 8 per cent relieved (pain almost nil to reduced) and 5 per cent showed no effect whatsoever. The results remained the same two months later as well when no drug was administered. Unlike all the current treatments which are suppression-oriented, this curative treatment directly treats the cause, is free from side effects, is inexpensive and easy to administer.

Efecto de la suplementación con tiamina, riboflavina y piridoxina en embarazadas del área norte de Santiago / Effect of thiamin, riboflavin and pyridoxin supplementation in pregnant women of the north area of Santiago

Con el propósito de evaluar la situación nutricional de tiamina, riboflavina y piridoxina de la embarazada y medir el impacto de una suplementación, se estudió la alimentación e indicadores bioquímicos en 40 embarazadas con índice de peso normal. En forma aleatoria fueron asignadas a un grupo control (n=21) y uno experimental (n=19) que recibió un suplemento con las vitaminas mencionadas y zinc. El consumo inicial de tiamina, piridoxina y riboflavina estuvo bajo el 75% de las recomendaciones en un porcentaje importante de las madres (22,4, 42,7 y 60,1% respectivamente) mejorando en ambos grupos en el control final. La presencia de signos que podrían atribuirse a deficiencia de vitaminas fue baja y sin diferencia entre los grupos. La deficiencia evaluada por métodos de función enzimática (transkelotasa, glutatión reductasa y glutáminico pirúvico transaminasa del glóbulo rojo) afectó en promedio al 12,5, 22,5 y 45,0% de las embarazadas para B1, B2 y B6 respectivamente. Al término del embarazo hubo una mejoría significativa sólo para B6 en el grupo suplementado (p<0,01). la baja respuesta hace recomendable utilizar un suplemento en mayor dosis y/o por períodos más prolongados

Erythrocyte transketolase activity as a function of vitamin B1 after prolonged oral contraceptive administration under different vitamin B1 nutritional status

The present investigation is concerned with studying the effect of feeding adult female rats, standard synthetic diet, diets [deprived, deficient and supplemented] with high dose of vitamin B1 on vitamin B1 functional activity during prolonged administration of an oral contraceptive [O.C] [Containing 0.035 mg ethinyl estradiol and 0.5 mg norethindrone]. The experiment lasted for 165 days. Blood samples were withdrawn after 15, 45, 75, 105, 135 and 165 days from O.C administration, for the determination of vitamin B1 level by a functional test, i.e. erythrocyte transketolase [ETK] basal activity and after in-vitro thiamin pyrophosphate addition [TPP]. Results were discussed. It is proved that a proper high dose of vitamin B1 should be given during prolonged oral contraceptive administration

Efeito da associaçäo das vitaminas B1 e B12 no tratamento da síndrome climatérica / Effect of vitamin B1 and B12 combination in the treatment of climateric syndrome

Foram avaliadas 87 pacientes climatéricas, em fase pós-menopáusica, com idade variando entre 42 a 68 anos (média etária 53,1 anos). A associaçäo das vitaminas B1 e B12 foi administrada por via intramuscular, na dosagem de 5.000 mcg de vitamina B1 por semana, por um período de 12 semanas. 1. Nítida melhora dos sintomas climatéricos avaliados pelo Indice Menopausal de Kupperman; 2. Ausência de modificaçäo no peso corpóreo e na pressäo arterial. 3. Ausência de efeitos colaterais