Scurvy in a man with schizophrenia.
Ontology highlight
ABSTRACT:
SUBMITTER: Dube M
PROVIDER: S-EPMC3153552 | biostudies-literature | 2011 Aug
REPOSITORIES: biostudies-literature
Publications
Scurvy in a man with schizophrenia.
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne 20110509 11
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Project description:Scurvy is a well-known clinical condition caused by vitamin C deficiency. Although considered a rare disease in high-income countries, it has been recently increasingly reported in children, especially in those with abnormal dietary habits, mental or physical disabilities. We performed an extensive review of the literature analyzing studies published in the last 20 years focusing on clinical features, differential diagnosis and diagnostic delay. Fifteen articles were selected, collectively reporting a total of 166 children. Because of the wide clinical spectrum (musculoskeletal complaints and/or mucocutaneous lesions or systemic symptoms), scurvy can mimic several conditions, including autoimmune diseases, infections, and neoplasia. In addition, frequent findings such as normal nutritional status, anemia or elevated inflammatory markers may guide clinicians towards the abovementioned misdiagnoses. Scurvy should be considered in patients presenting with musculoskeletal complaints, not only in those with risk factors but also in healthy children. A focused dietary history and a careful physical examination, assessing other signs of vitamin C deficiency, are mandatory in these patients. When suspected, the dosage of serum vitamin C is the diagnostic gold standard; furthermore, imaging studies, performed by an expert radiologist, can reveal the typical features of scurvy. Only early diagnosis can avoid unnecessary investigations and potentially fatal complications of the disease.
| S-EPMC8840722 | biostudies-literature
Project description:We report a case of a six-year-old boy who presented after a cardiac arrest, likely due to a pulmonary hypertensive crisis in the setting of vitamin C deficiency. After initially presenting with subacute multifocal bone lesions of unknown etiology, he experienced a pulseless electrical activity cardiac arrest while undergoing a diagnostic procedure under sedation. During his post-arrest convalescence, he developed persistent tachycardia and peripheral edema. An echocardiogram revealed findings consistent with significant pulmonary arterial hypertension, which was found to be responsive to inhaled nitric oxide. Laboratory investigation revealed undetectable levels of vitamin C, resulting in disclosure of a history of severe restrictive eating behavior. With ascorbate supplementation, the patient's pulmonary vasodilators were weaned and discontinued. Given his complete recovery, we suspect that the cardiac arrest and pulmonary hypertension were the consequence of a rare, but reversible, complication of scurvy.
| S-EPMC6457075 | biostudies-literature
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| S-EPMC5802474 | biostudies-literature
Project description:INTRODUCTION: Scurvy, while uncommon, still occurs in developed countries despite the widespread availability of vitamins and fortified foods. A vitamin C deficiency prevalence of 10 to 14% in adults was reported in the National Health and Nutrition Examination Survey (NHANES) in 1994. OBJECTIVE: We report the case of a 57-year-old male who presented with a combined vitamin C deficiency (scurvy) and a Zinc deficiency. INTERVENTIONS: He came to the emergency department complaining of a painful swollen ecchymotic leg and dyspnea. Prescriptions for narcotics did not relieve his symptoms. When a detailed dietary history was obtained, we added scurvy to the differential diagnosis. An extensive evaluation excluded trauma, coagulopathies, neoplasia, and vasculitides. MAIN RESULT: The combination of a classic skin biopsy and a low vitamin C level confirmed the diagnosis. CONCLUSION: This presentation illustrates the necessity of including scurvy in the differential diagnosis of ecchymoses and demonstrates specific populations at risk: single adults and the elderly with deficient diets.
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Project description:Later Stone Age human hair from Vaalkrans Shelter, Cape Floristic Region of South Africa, reveals genetic affinity to Khoe groups
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Project description:While rare, scurvy is a disease the emergency physician should continue to consider in the differential of bruising and joint pain. Although these symptoms are nonspecific, the astute physician should remain open-minded even when scurvy is not likely to be seen in an economically stable country. Contrary to this, we report a case of a young boy in the United States with scurvy who presented with a rash and limp. The diagnosis of scurvy can be made alone by a thorough history, but radiologic studies and pertinent labs also helped. Early diagnosis resulted in adequate vitamin supplementation and quick recovery of symptoms thereby avoiding unnecessary testing and lowering the cost of care.TopicsScurvy, pediatric, vitamin C deficiency, nutritional deficiencies.
| S-EPMC10332736 | biostudies-literature
Project description:The past two decades have seen a proliferation in bioarchaeological literature on the identification of scurvy, a disease caused by chronic vitamin C deficiency, in ancient human remains. This condition is one of the few nutritional deficiencies that can result in diagnostic osseous lesions. Scurvy is associated with low dietary diversity and its identification in human skeletal remains can provide important contextual information on subsistence strategy, resource allocation, and human-environmental interactions in past populations. A large and robust methodological body of work on the paleopathology of scurvy exists. However, the diagnostic criteria for this disease employed by bioarchaeologists have not always been uniform. Here we draw from previous research on the skeletal manifestations of scurvy in adult and juvenile human skeletal remains and propose a weighted diagnostic system for its identification that takes into account the pathophysiology of the disease, soft tissue anatomy, and clinical research. Using a sample of individuals from the prehistoric Atacama Desert in Northern Chile, we also provide a practical example of how diagnostic value might be assigned to skeletal lesions of the disease that have not been previously described in the literature.
| S-EPMC6282809 | biostudies-literature
Project description:Background and hypothesisRacial discrimination and public stigma toward Black individuals living with schizophrenia create disparities in treatment-seeking and engagement. Brief, social-contact-based video interventions efficaciously reduce stigma. It remains unclear whether including racial identity experiences in video narrative yields greater stigma reduction. We hypothesized that we would replicate findings showing sustained stigma reduction in video-intervention groups vs control and that Black participants would show greater stigma reduction and emotional engagement than non-Black participants only for a racial-insights video presenting a Black protagonist.Study designRecruiting using a crowdsourcing platform, we randomized 1351 participants ages 18-30 to (a) brief video-based intervention, (b) racial-insights-focused brief video, or (c) non-intervention control, with baseline, post-intervention, and 30-day follow-up assessments. In 2-minute videos, a young Black protagonist described symptoms, personal struggles, and recovery from schizophrenia, with or without mentioning race-related experiences.Study resultsA 3 × 3 ANOVA showed a significant group-by-time interaction for total scores of each of five stigma-related domains: social distance, stereotyping, separateness, social restriction, and perceived recovery (all P < .001). Linear mixed modeling showed a greater reduction in stigma from baseline to post-intervention among Black than non-Black participants in the racial insights video group for the social distance and social restriction domains.ConclusionsThis randomized controlled trial replicated and expanded previous findings, showing the anti-stigma effects of a brief video tailored to race-related experiences. This underscores the importance of personalized, culturally relevant narratives, especially for marginalized groups who, more attuned to prejudice and discrimination, may particularly value identification and solidarity. Future studies should explore mediators/moderators to improve intervention efficacy.
| S-EPMC11059800 | biostudies-literature