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Journal of Cardiology Cases Sep 2020A 69-year-old woman with previous pancreaticoduodenectomy was admitted for evaluation of chest discomfort on effort and leg edema for a few months. Oral flosemide before...
A 69-year-old woman with previous pancreaticoduodenectomy was admitted for evaluation of chest discomfort on effort and leg edema for a few months. Oral flosemide before admission for 1 week failed to relieve her symptoms. Her blood pressure was 105/51 mmHg and heart rate was 76 beats/min. Chest X-ray revealed an enlarged heart and mild pulmonary congestion. Echocardiography demonstrated normal left ventricular ejection fraction and diastolic dysfunction with no left ventricular hypertrophy. Cardiac catheterization showed normal coronary arteries, high cardiac index, and elevated intracardial pressures. Myocardial biopsy from the right ventricular septum revealed nearly normal findings. Cardiac magnetic resonance imaging (CMRI) showed both ventricles enlarged and increased global extracellular volume fraction (ECV) of 37%, but normal native T1 and T2 values. As she had pancreaticoduodenectomy, beriberi was suspected. Vitamin B1 significantly increased urine output and lowered intracardiac pressures and cardiac index. After 3 months of vitamin B1, CMRI exhibited that the right ventricle had decreased in size and the global ECV value had been lowered. Our case highlights that chronic beriberi may be associated with little myocardial damage. The increased ECV suggests that the diffuse expansion of extracellular space unrelated to myocardial edema might have been reversed by vitamin B1treatment. Morphological changes in the ventricles and myocardial damage by wet beriberi can be demonstrated by CMRI. < Chronic wet beriberi can occur in patients with previous pancreaticoduodenectomy although they eat regularly and never drink alcohol. Morphological changes in the ventricles and myocardial damage by wet beriberi can be demonstrated by cardiac magnetic resonance imaging.>.
PubMed: 32884587
DOI: 10.1016/j.jccase.2020.05.010 -
Children (Basel, Switzerland) Oct 2020Persistent pulmonary hypertension of the newborn (PPHN) is a syndrome of high pulmonary vascular resistance (PVR) commonly seen all over the world in the immediate... (Review)
Review
Persistent pulmonary hypertension of the newborn (PPHN) is a syndrome of high pulmonary vascular resistance (PVR) commonly seen all over the world in the immediate newborn period. Several case reports from India have recently described severe pulmonary hypertension among infants in the postneonatal period. These cases typically present with respiratory distress in 1-6-month-old infants, breastfed by mothers on a polished rice-based diet. Predisposing factors include respiratory tract infection such as acute laryngotracheobronchitis with change in voice, leading to pulmonary hypertension, right atrial and ventricular dilation, pulmonary edema and hepatomegaly. Mortality is high without specific therapy. Respiratory support, pulmonary vasodilator therapy, inotropes, diuretics and thiamine infusion have improved the outcome of these infants. This review outlines four typical patients with thiamine-responsive acute pulmonary hypertension of early infancy (TRAPHEI) due to thiamine deficiency and discusses pathophysiology, clinical features, diagnostic criteria and therapeutic options.
PubMed: 33126440
DOI: 10.3390/children7110199 -
Journal of Community Hospital Internal... 2023Bariatric surgery is an effective strategy for achieving substantial weight loss, prolonging survival, and improving the comorbidities associated with obesity....
Bariatric surgery is an effective strategy for achieving substantial weight loss, prolonging survival, and improving the comorbidities associated with obesity. Nutritional deficiency is a commonly recognized post-procedural complication. Here, we present a case of a patient with paresthesia, lower extremity weakness, and altered mental status one year following Roux-en-Y gastric bypass, who was found to have multiple vitamin and micronutrient deficiencies and was diagnosed with beriberi in the setting of profound thiamine deficiency.
PubMed: 37868250
DOI: 10.55729/2000-9666.1210 -
Frontiers in Psychology 2021Consumers often feel embarrassed when buying products like condoms, hemorrhoid cream, and beriberi cream in crowded pharmacies. There is an interesting phenomenon in...
Consumers often feel embarrassed when buying products like condoms, hemorrhoid cream, and beriberi cream in crowded pharmacies. There is an interesting phenomenon in life: Some beriberi creams use the images of a "real foot", while others use the images of a "cartoon foot." Imagine if a young woman needed to go to a retail store for beriberi cream that would embarrass her, she would choose a "real foot image" or a "cartoon foot image" beriberi cream? It has been shown that the embarrassment of these products has a strong negative impact on consumer buying behavior. Previous researches have explored how changing packaging elements of embarrassing products (e.g., color/design/image placement) can effectively reduce consumer embarrassment. However, few have examined the impact of different image types of embarrassing product packaging (artificial vs. natural) with embarrassment. Therefore, this research explores the effect of image types (artificial vs. natural) on consumers' willingness to purchase embarrassing products and reveals the mechanisms of the underlying effects. The results show that natural images can lead to lower purchase intention of embarrassing products when the advertisement uses first-person pronouns due to the mediating role played by negative body imagery. However, there is no significant difference in purchase intention between different image types in the third-person pronouns. Finally, this paper discusses its contributions and limitations.
PubMed: 35126246
DOI: 10.3389/fpsyg.2021.796998 -
Annals of the New York Academy of... Aug 2021Severe thiamine (vitamin B ) deficiency is generally regarded as a problem affecting mostly infants in low-income communities of Southeast Asia and adult alcoholics... (Review)
Review
Severe thiamine (vitamin B ) deficiency is generally regarded as a problem affecting mostly infants in low-income communities of Southeast Asia and adult alcoholics regardless of their location. However, recent scholarship shows that the disorders associated with thiamine deficiency may also affect heretofore unsuspected populations, and that the scope of disorders, including some long-lasting neurocognitive consequences, is broader than previously thought.
Topics: Beriberi; Biomarkers; Disease Management; Disease Susceptibility; Global Health; Humans; Population Surveillance; Risk Factors; Thiamine Deficiency
PubMed: 33939178
DOI: 10.1111/nyas.14594 -
Therapeutic Advances in... 2020Wernicke's encephalopathy (WE) is an acute neuropsychiatric state. Untreated, WE can lead to coma or death, or progress to Korsakoff syndrome (KS) - a dementia... (Review)
Review
Wernicke's encephalopathy (WE) is an acute neuropsychiatric state. Untreated, WE can lead to coma or death, or progress to Korsakoff syndrome (KS) - a dementia characterized by irreversible loss of anterograde memory. Thiamine (vitamin B1) deficiency lies at the heart of this condition. Yet, our understanding of thiamine regarding prophylaxis and treatment of WE remains limited. This may contribute to the current undertreatment of WE in clinical practice. The overall aim of this review is to identify the best strategies for prophylaxis and treatment of WE in regard to (a) dose of thiamine, (b) mode of administration, (c) timing of switch from one mode of administration to another, (d) duration of administration, and (e) use of magnesium along thiamine as an essential cofactor. Evidence from randomized controlled trials and other intervention studies is virtually absent. Therefore, we have to resort to basic science for proof of principle instead. Here, we present the first part of our clinical review, in which we explore the physiology of thiamine and the pathophysiology of thiamine deficiency. We first explore both of these in their historical context. We then review the pharmacodynamics and pharmacokinetics of thiamine, exploring the roles of the six currently known thiamine compounds, their transporters, and target enzymes. We also explore the significance of magnesium as a cofactor in thiamine-facilitated enzymatic reactions and thiamine transport. In the second (forthcoming) part of this review, we will use the findings of the current review to make evidence-based inferences about strategies for prophylaxis and treatment of WE.
PubMed: 33447357
DOI: 10.1177/2045125320978106 -
Monaldi Archives For Chest Disease =... Feb 2023Thiamine deficiency is commonly associated with malnutrition, alcoholism and bariatric surgery. Thiamine deficiency can manifest in different ways, especially in...
Thiamine deficiency is commonly associated with malnutrition, alcoholism and bariatric surgery. Thiamine deficiency can manifest in different ways, especially in developing countries: as peripheric neuropathy, as Wernicke encephalopathy or as beriberi disease. The authors present the case of a 72-year-old male, with a hiatal hernia that led to thiamine deficiency due to malnutrition. The initial clinical manifestation was an ST-elevation myocardial infarct equivalent, an ECG with a shark-fin pattern that evolved to a Wellens type B pattern. The patient evolved with severe altered mental status. A Wernicke encephalopathy diagnosis was confirmed by MRI; the patient was medicated with high-dose thiamine, with quick recovery, both neurologic and cardiac. The clinical history and response to treatment confirm the diagnosis of Wernicke encephalopathy and beriberi disease.
Topics: Aged; Humans; Male; Beriberi; Korsakoff Syndrome; ST Elevation Myocardial Infarction; Thiamine Deficiency; Wernicke Encephalopathy
PubMed: 36806824
DOI: 10.4081/monaldi.2023.2513 -
BMJ Case Reports Jul 2021A 74-year-old man with a history of chronic alcohol use presented with progressive exertional dyspnoea and weight gain. On physical examination, he was noted to have...
A 74-year-old man with a history of chronic alcohol use presented with progressive exertional dyspnoea and weight gain. On physical examination, he was noted to have wide pulse pressure, elevated jugular venous pressure, and alternating flushing and blanching of the nail beds in concert with the cardiac cycle, known as Quincke's pulse. Transthoracic echocardiography demonstrated normal biventricular systolic function and valvular function, but noted a dilated inferior vena cava. Right heart catheterisation revealed elevated filling pressures, high cardiac output and low systemic vascular resistance, consistent with high-output heart failure. Whole blood concentration of thiamine was low, confirming the diagnosis of wet beriberi. The patient abstained from alcohol use and was started on thiamine replacement therapy, resulting in narrowing of the pulse pressure over time and complete resolution of symptoms without the need for diuretic therapy.
Topics: Aged; Beriberi; Blood Pressure; Echocardiography; Heart Failure; Humans; Male; Thiamine
PubMed: 34301700
DOI: 10.1136/bcr-2021-241654 -
Annals of Cardiac Anaesthesia 2023Thiamine deficiency presents as dry and wet beriberi. Wet beriberi is a complication of the cardiovascular system. Acute form of wet beriberi known as Shoshin beriberi...
Thiamine deficiency presents as dry and wet beriberi. Wet beriberi is a complication of the cardiovascular system. Acute form of wet beriberi known as Shoshin beriberi is an acute presentation of cardiogenic shock which is rapidly reversed with thiamine administration. Here we present successful management of intraoperative acute decompensated heart failure, probably due to thiamine deficiency.
Topics: Humans; Young Adult; Beriberi; Thiamine Deficiency; Heart Failure; Anesthesia; Perioperative Period
PubMed: 37470531
DOI: 10.4103/aca.aca_133_22 -
Pediatric Nephrology (Berlin, Germany) Jul 2021
PubMed: 33474685
DOI: 10.1007/s00467-021-04931-1