DOCSLIB.ORG

Essentials of Medical Chemistry and Biochemistry

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Essentials of Medical Chemistry and Biochemistry MASARYK UNIVERSITY Faculty of Medicine ESSENTIALS OF MEDICAL CHEMISTRY AND BIOCHEMISTRY Jiří Dostál, Editor Brno 2014 Editor: Doc. RNDr. Jiří Dostál, CSc. Authors: Doc. RNDr. Jiří Dostál, CSc. RNDr. Hana Paulová, CSc. Prof. RNDr. Eva Táborská, CSc. Doc. RNDr. Josef Tomandl, Ph.D. Reviewers: Prof. RNDr. Zdeněk Glatz, CSc. (Department of Biochemistry, Faculty of Science, Masaryk University, Brno) Doc. RNDr. Jitka Vostálová, Ph.D. (Department of Medical Chemistry and Biochemistry, Faculty of Medicine, Palacký University, Olomouc) Content 1 Basic Chemical Definitions ..…………………………………………………………...… 5 2 Chemical Bonds …………………………………………………………………………... 8 3 Energetics of Chemical Reactions ……………………………………………………….. 12 4 Chemical Kinetics ………………………………………………………………………… 17 5 Chemical Equilibrium …………………………………………………………………….. 23 6 Liquid Dispersions ………………………………………………………………………... 26 7 Solubility of Substances ………………………………………………………………….. 27 8 Quantitative Composition of Solutions …………………………………………………… 28 9 Colloidal Solutions …………………………………………….…………………………. 30 10 Osmotic Pressure …………………………………………………………………………. 34 11 Coarse Dispersions ……………………………………………………………………….. 37 12 Adsorption and Adsorbents ………………………………………………………………. 38 13 Surfactants ………………………………………………………………………………... 39 14 Electrolytes ……………………………………………………………………………….. 42 15 Acid-Base Reactions ……………………………………………………………………… 44 16 Buffers ……………………………………………………………………………………. 51 17 Precipitation Reactions. Solubility Product……………………………………………….. 57 18 Complex-Forming Reactions ……………………………………………………………... 60 19 Redox Reactions ………………………………………………………………………….. 62 20 Latin Names ………………………………………………………………………………. 68 21 Essential Macroelements …………………………………………………………………. 70 22 Essential Microelements ………………………………………………………………….. 87 23 Introduction to Organic Compounds ……………………………………………………... 93 24 Alcohols and Phenols …………………………………………………………………….. 96 25 Esters of Inorganic Acids …………………………………………………………………. 101 26 Organic Sulfur Compounds ………………………………………………………………. 104 27 Aldehydes and Ketones …………………………………………………………………... 107 28 Carboxylic Acids and Their Derivatives …………………………………………………. 111 29 Derivatives of Carbonic Acid …………………………………………………………….. 118 30 Hydroxy Acids and Oxo Acids …………………………………………………………… 120 31 Amines ……………………………………………………………………………………. 124 32 Biochemically Important Heterocycles …………………………………………………... 128 33 Toxicologically Important Substances …………………………………………………… 134 34 Monosaccharides …………………………………………………………………………. 140 35 Disaccharides ……………………………………….…………………………………….. 148 36 Polysaccharides …………………………………………………………………………… 150 37 Nucleosides and Nucleotides ……………………………………………………………... 155 38 Nucleic Acids …………………………………………………………………………….. 161 39 Lipids ……………………………………………….…………………………………….. 165 40 Terpenes ………………………………………………….……………………………….. 177 41 Steroids …………………………………………………………………………………… 179 42 Amino Acids …………………………………………………………………………….... 183 43 Peptides …………………………………………………………………………………… 190 44 Proteins …………………………………………………………………………………… 193 45 Glycoproteins ……………………………………………………………………………... 200 46 Vitamins …………………………………………………………………………………... 203 Index ……………………………………………………………………………………… 209 The text has been created and designed for one-semester English program of General medicine and Dentistry studies in the Faculty of Medicine, Masaryk University, Brno. The selection of topics emphasizes the biochemical processes and the metabolic conversions of compounds occurring in the human body. The text describes the most important biomolecules in the human tissues (saccharides, lipids, amino acids, proteins, nucleic acids), however, it also comprises essential facts from general chemistry (energy, equilibrium, kinetics, acids and bases, redox reactions, solutions, etc.), summarizes biologically important elements (macroelements, microelements), and treats main groups of organic compounds (alcohols, aldehydes, amines, carboxylic acids, heterocycles, etc.). Some special topics are also included like colloidal solutions, dispersions, osmotic pressure, Latin nomenclature, steroids, terpenes, glycoproteins, vitamins, selected toxic substances. Some structural formulas, indicated by a side dotted line, are presented just to illustrate the issue; they are not demanded in testing. The authors believe that Essentials of Medical Chemistry and Biochemistry will become a very useful and friendly tool for students to acquire primary knowledge for the following study of Biochemistry I and Biochemistry II. Brno, May 2014 1 Basic Chemical Definitions Elementary Particles of Matter, Substances, Elements, Compounds A substance is a specific kind of matter that exhibits stable physical characteristics at definite condi- tions. All substances contain atoms. An atom is the smallest electrically neutral particle that still keeps the chemical characteristics (quali- ty) of the corresponding element. It consists of a positively charged nucleus and negatively charged electron shell. The arrangement of electrons in the shell influences the chemical characteristics of an atom. A molecule is the smallest part of a pure substance that still keeps the chemical characteristics of this substance. It is electroneutral, characterised by a specific composition (nature and number of the pre- sent atoms) and structure (their mutual arrangement in space, kind of bonds). Di- or polyatomic mole- cules of one type of chemical element have isoatomic composition (they contain one kind of atom e.g. H2, O2, N2, Cl2). Molecules of compounds have heteroatomic composition, e.g. HCl, H2O, etc. In some substances (e.g. solid substances with crystal structure), the individual molecules are not identifiable. In this case, we formally appoint the smallest part of the substance (the smallest numerical ratio of atoms), the composition of which still describes the composition of the whole substance, and we call it formula unit (e.g. a pair of ions Na+ and F− in sodium fluoride, carbon atom in diamond, Si atom and two O atoms in silicon dioxide, etc.). From this formula unit (the repeating part) the name of the sub- stance is derived. According to the composition, chemically pure substances and mixtures (homogeneous, colloid, and heterogeneous) are distinguished. In nature, substances usually occur in the form of mixtures. A chemically pure substance (chemical individual) consists of the same particles with stable charac- teristic properties (boiling point and melting point, density, refractive index, specific rotation). We distinguish two groups of chemically pure substances – elements and compounds. An element is a chemically pure substance consisting of atoms with the same proton/atomic number. If the element is formed by atoms with the same mass number, it is called a nuclide. Atoms of the given element can be non-combined (noble gases), form molecules (gaseous dioxygen O2), or they are combined altogether to form more complex structures (e.g. covalent bonds – diamond, metal bonds in metals, covalent bonds and van der Waals forces – graphite). A compound is a chemically pure substance consisting of two or more different atoms. The atoms can be arranged in isolated molecules (gaseous carbon dioxide) or they can form more complex structures (crystalline structures – sodium chloride). A mixture (dispersion system) consists of several different, chemically pure substances. The proper- ties of mixtures are not stable; they depend on the composition of the mixture. A mixture can be ho- mogeneous (formed by only one phase – air, solutions), colloid (e.g. egg white in water) or heteroge- neous (more phases physically separated from each other – water with sand). 5 Expressing the Amount of Substance and Their Structural Elements The amount of any substance (chemical element, compound, mixture) can be expressed in several ways: mass (m), volume (V) or the number of basic structural particles, atoms, ions, molecules (N). Atomic and Molar Mass Mass (m) is an additive quantity that does not depend on temperature and pressure. The mass of the structural particles can be expressed in common mass units (kg, g). The absolute mass of an atom (the value of its resting mass) is very small, about 10−27–10−25 kg. Thus, the absolute quantities are impractical for everyday use. Mass can be more conveniently expressed by the comparative standard (object with a mass similar to the mass of these particles). This standard was stated during the last correction in 1961 to be the atom of a carbon nuclide 12C. Exactly 1/12 of the rest mass of this atom 12 m0( C) was determined as an accessory unit. It is the unified atomic mass unit (symbol u); in bio- chemistry and molecular biology, it is more often called dalton (symbol Da). The value of its mass is called the atomic mass constant (symbol mu). 12 −27 mu = 1/12 m0( C) = 1.660 54 · 10 kg = 1 u = 1 Da The absolute atomic masses are not as important from the chemical point of view as the ratio (the rela- tive amount), under which the atoms react with each other. Therefore, we most frequently use the rela- tive (proportional) expression of mass (related to 1/12 of the mass of the carbon nuclide 12C). The relative atomic mass (Ar) is a dimensionless number representing how many times the mass of a given atom (X) is higher than the atomic mass constant mu. It is given by the ratio between the (abso- lute) mass of one atom m(X) in kg to the atomic mass constant mu in kg. For the given element X it is accepted that: m(X) Ar (X) mu The relative molecular mass (Mr) is the sum of the relative atomic masses of all atoms present in the mol- ecule. It is
Load more

Recommended publications
  • Micronutrient Status and Dietary Intake of Iron, Vitamin A, Iodine
    nutrients Review Micronutrient Status and Dietary Intake of Iron, Vitamin A, Iodine, Folate and Zinc in Women of Reproductive Age and Pregnant Women in Ethiopia, Kenya, Nigeria and South Africa: A Systematic Review of Data from 2005 to 2015 Rajwinder Harika 1,*, Mieke Faber 2 ID , Folake Samuel 3, Judith Kimiywe 4, Afework Mulugeta 5 and Ans Eilander 1 1 Unilever Research & Development, Vlaardingen, 3130 AC, The Netherlands; [email protected] 2 Non-communicable Diseases Research Unit, South African Medical Research Council, Cape Town 19070, South Africa; [email protected] 3 Department of Human Nutrition, University of Ibadan, Ibadan 200284, Nigeria; [email protected] 4 School of Applied Human Sciences, Kenyatta University, Nairobi 43844-00100, Kenya; [email protected] 5 Department of Nutrition and Dietetics, Mekelle University, Mekelle 1871, Ethiopia; [email protected] * Correspondence: [email protected]; Tel.: +31-101-460-5190 Received: 10 August 2017; Accepted: 28 September 2017; Published: 5 October 2017 Abstract: A systematic review was conducted to evaluate the status and intake of iron, vitamin A, iodine, folate and zinc in women of reproductive age (WRA) (≥15–49 years) and pregnant women (PW) in Ethiopia, Kenya, Nigeria and South Africa. National and subnational data published between 2005 and 2015 were searched via Medline, Scopus and national public health websites. Per micronutrient, relevant data were pooled into an average prevalence of deficiency, weighted by sample size (WAVG). Inadequate intakes were estimated from mean (SD) intakes. This review included 65 surveys and studies from Ethiopia (21), Kenya (11), Nigeria (21) and South Africa (12).
    [Show full text]
  • Is There an Ideal Diet to Protect Against Iodine Deficiency?
    nutrients Review Is There an Ideal Diet to Protect against Iodine Deficiency? Iwona Krela-Ka´zmierczak 1,† , Agata Czarnywojtek 2,3,†, Kinga Skoracka 1,* , Anna Maria Rychter 1 , Alicja Ewa Ratajczak 1 , Aleksandra Szymczak-Tomczak 1, Marek Ruchała 2 and Agnieszka Dobrowolska 1 1 Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Hospital, 60-355 Poznan, Poland; [email protected] (I.K.-K.); [email protected] (A.M.R.); [email protected] (A.E.R.); [email protected] (A.S.-T.); [email protected] (A.D.) 2 Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 60-355 Poznan, Poland; [email protected] (A.C.); [email protected] (M.R.) 3 Department of Pharmacology, Poznan University of Medical Sciences, 60-806 Poznan, Poland * Correspondence: [email protected]; Tel.: +48-665-557-356 or +48-8691-343; Fax: +48-8691-686 † These authors contributed equally to this work. Abstract: Iodine deficiency is a global issue and affects around 2 billion people worldwide, with preg- nant women as a high-risk group. Iodine-deficiency prevention began in the 20th century and started with global salt iodination programmes, which aimed to improve the iodine intake status globally. Although it resulted in the effective eradication of the endemic goitre, it seems that salt iodination did not resolve all the issues. Currently, it is recommended to limit the consumption of salt, which is the main source of iodine, as a preventive measure of non-communicable diseases, such as hypertension or cancer the prevalence of which is increasing.
    [Show full text]
  • Page Numbers in Bold Indicate Main Discus- Sion of Topic. Page Numbers
    168397_P489-520.qxd7.0:34 Index 6-2-04 26p 2010.4.5 10:03 AM Page 489 source of, 109, 109f pairing with thymine, 396f, 397, 398f in tricarboxylic acid cycle, 109–111, 109f Adenine arabinoside (vidarabine, araA), 409 Acetyl CoA-ACP acetyltransferase, 184 Adenine phosphoribosyltransferase (APRT), Index Acetyl CoA carboxylase, 183, 185f, 190 296, 296f in absorptive/fed state, 324 Adenosine deaminase (ADA), 299 allosteric activation of, 183–184, 184f deficiency of, 298, 300f, 301–302 allosteric inactivation of, 183, 184f gene therapy for, 485, 486f dephosphorylation of, 184 Adenosine diphosphate (ADP) in fasting, 330 in ATP synthesis, 73, 77–78, 78f Page numbers in bold indicate main discus- hormonal regulation of, 184, 184f isocitrate dehydrogenase activation by, sion of topic. Page numbers followed by f long-term regulation of, 184 112 denote figures. “See” cross-references direct phosphorylation of, 183–184 transport of, to inner mitochondrial short-term regulation of, 183–184, 184f membrane, 79 the reader to the synonymous term. “See Acetyl CoA carboxylase-2 (ACC2), 191 in tricarboxylic acid cycle regulation, 114, also” cross-references direct the reader to N4-Acetylcytosine, 292f 114f related topics. [Note: Positional and configura- N-Acetyl-D-glucosamine, 142 in urea cycle, 255–256 N-Acetylgalactosamine (GalNAc), 160, 168 ribosylation, 95 tional designations in chemical names (for N-Acetylglucosamindase deficiency, 164f Adenosine monophosphate (AMP; also called example, “3-“, “α”, “N-“, “D-“) are ignored in N-Acetylglucosamine (GlcNAc),
    [Show full text]
  • Review Article
    REVIEW ARTICLE COLLAGEN METABOLISM COLLAGEN METABOLISM Types of Collagen 228 Structure of Collagen Molecules 230 Synthesis and Processing of Procollagen Polypeptides 232 Transcription and Translation 233 Posttranslational Modifications 233 Extracellular Processing of Procollagen and Collagen Fibrillogenesis 240 Functions of Collagen in Connective rissue 243 Collagen Degradation 245 Regulation of the Metabolism of Collagen 246 Heritable Diseases of Collagen 247 Recessive Dermatosparaxis 248 Recessive Forms of EDS 251 EDS VI 251 EDS VII 252 EDS V 252 Lysyl Oxidase Deficiency in the Mouse 253 X-Linked Cutis Laxa 253 Menke's Kinky Hair Syndrome 253 Homocystinuria 254 EDS IV 254 Dominant Forms of EDS 254 Dominant Collagen Packing Defect I 255 Dominant and Recessive Forms of Osteogenesis Imperfecta 258 Dominant and Recessive Forms of Cutis Laxa 258 The Marfan Syndrome 259 Acquired Diseases and Repair Processes Affecting Collagen 259 Acquired Changes in the Types of Collagen Synthesis 260 Acquired Changes in Amounts of Collagen Synthesized 263 Acquired Changes in Hydroxylation of Proline and Lysine 264 Acquired Changes in Collagen Cross-Links 265 Acquired Defects in Collagen Degradation 267 Conclusion 267 Bibliography 267 Collagen Metabolism A Comparison of Diseases of Collagen and Diseases Affecting Collagen Ronald R. Minor, VMD, PhD COLLAGEN CONSTITUTES approximately one third of the body's total protein, and changes in synthesis and/or degradation of colla- gen occur in nearly every disease process. There are also a number of newly described specific diseases of collagen in both man and domestic animals. Thus, an understanding of the synthesis, deposition, and turnover of collagen is important for the pathologist, the clinician, and the basic scientist alike.
    [Show full text]
  • Guidelines on Food Fortification with Micronutrients
    GUIDELINES ON FOOD FORTIFICATION FORTIFICATION FOOD ON GUIDELINES Interest in micronutrient malnutrition has increased greatly over the last few MICRONUTRIENTS WITH years. One of the main reasons is the realization that micronutrient malnutrition contributes substantially to the global burden of disease. Furthermore, although micronutrient malnutrition is more frequent and severe in the developing world and among disadvantaged populations, it also represents a public health problem in some industrialized countries. Measures to correct micronutrient deficiencies aim at ensuring consumption of a balanced diet that is adequate in every nutrient. Unfortunately, this is far from being achieved everywhere since it requires universal access to adequate food and appropriate dietary habits. Food fortification has the dual advantage of being able to deliver nutrients to large segments of the population without requiring radical changes in food consumption patterns. Drawing on several recent high quality publications and programme experience on the subject, information on food fortification has been critically analysed and then translated into scientifically sound guidelines for application in the field. The main purpose of these guidelines is to assist countries in the design and implementation of appropriate food fortification programmes. They are intended to be a resource for governments and agencies that are currently implementing or considering food fortification, and a source of information for scientists, technologists and the food industry. The guidelines are written from a nutrition and public health perspective, to provide practical guidance on how food fortification should be implemented, monitored and evaluated. They are primarily intended for nutrition-related public health programme managers, but should also be useful to all those working to control micronutrient malnutrition, including the food industry.
    [Show full text]
  • Nl Nov14 Web.Indd
    IDD NEWSLETTER NOVEMBER 2014 ID IN CANADA 15 Severe iodine deficiency in a Canadian boy with food allergies Excerpted from: Pacaud D et al. A third world endocrine disease in a 6-year-old North American boy. Journal of Clinical Endocrinology and Metabolism. 1995; 80(9): 2574–2576 A 6-year-old French-Canadian boy was seen for symptoms of goiter and hypothyroidism of acute onset. He was referred to the endo- crinology clinic with a 3-month history of fatigue. Severe asthma and atopic dermatitis had started during infancy. The boy had multiple food allergies. His diet was very restricted and consisted of oat cereal, horse meat, broccoli, sweet potatoes, cauliflower, grapes, apples, and water. His thyroid was diffusely increased in size. Thyroid function tests revealed severe primary hypothyroidism with undetectable antibodies. Physical exam showed several classic signs of hypothyroi- dism: facial edema was noticeable, and the skin felt very dry and was eczematous. Investigations and treatment liz west/flickr, 2012; CC BY 2.0 Normal bone age and growth rate suggested Cruciferous vegetables contain thiocyanate which together with iodine deficiency may lead to goiter that the hypothyroidism was of acute onset. A nutritional investigation showed low Discussion In conclusion, this boy suffered from caloric intake and low urinary iodine levels Since the introduction of iodized table salt goitrous hypothyroidism secondary to severe indicative of severe iodine deficiency. Initial in North America, severe iodine deficiency iodine deficiency and compounded by thi- treatment with levothyroxine resulted in has been practically eradicated. The boy’s ocyanate overload. Thus, even in our envi- the resolution of clinical hypothyroidism, a severe goitrous hypothyroidism was the ronment of relative iodine abundance, IDD reduction of thyroid volume, and normali- result of an extremely restricted diet used and possibly other nutritional deficiencies zation of thyroid function tests, but urinary to control severe atopy.
    [Show full text]
  • Assessment of Dietary Iodine Intake in School Age Children: the Cross-Sectional ANIVA Study
    nutrients Article Assessment of Dietary Iodine Intake in School Age Children: The Cross-Sectional ANIVA Study María Morales-Suárez-Varela 1,2,* , Isabel Peraita-Costa 1,2, Agustín Llopis-Morales 1 and Agustín Llopis-Gonzalez 1,2 1 Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Legal Medicine, School of Pharmacy, University of Valencia, Vicent Andres Estelles Avenue, Burjassot, 46100 Valencia, Spain; [email protected] (I.P.-C.); [email protected] (A.L.-M.); [email protected] (A.L.-G.) 2 Biomedical Research Consortium in Epidemiology and Public Health Network (CIBERESP), Monforte de Lemos Avenue, 3-5, Pavillion 11 Floor 0, 28029 Madrid, Spain * Correspondence: [email protected]; Tel.: +34-96-354-4951 Received: 19 October 2018; Accepted: 23 November 2018; Published: 3 December 2018 Abstract: Iodine deficiency is one of the most important health problems in the world. It intervenes in the synthesis of thyroid hormones, which carry out important functions, so that a deficit of this mineral causes alterations of different kinds such as those related to growth. The objective of the present study was to know the prevalence of iodine deficit in the diet of Valencian children from 6 to 8 years old and their relationship with anthropometry. The analysis of the dietary intake was carried out through questionnaires. Thirteen schools participated in the study. The sample studied consists of 661 school children belonging to the Valencian Community, between 6 and 8 years of age: 298 boys and 363 girls. 79.12% of the children did not meet recommended daily iodine intakes.
    [Show full text]
  • Iodine Fact Sheet & References
    Iodine Fact Sheet and References What is iodine? • Essential trace mineral • Critical in the synthesis of thyroid hormones. The thyroid gland converts iodine into T3 (triiodothyronine) and T4 (thyrodine) hormones, which control metabolism throughout the body. • Excreted through urine Where do we find iodine? • Table salt (iodized salt) – Beginning in the 1920s, iodine was added to table salt and to other foods to prevent iodine deficiency. • Seafood and seaweed • Dairy and grains (amounts vary depending on source) Who’s impacted? • 2.2 billion people worldwide are at risk for Iodine Deficiency Disorders (IDDs). Of these, 30-70% have goiter and 1-10% have cretinism. • People living in the Great Lakes region (including Minnesota) may have inadequate intake due to low levels of iodine in the soil in which crops are grown. • Iodine deficiency virtually eliminated in the U.S. and many Western nations, due to iodization of salt. However: o 1970s-1990s: median U.S. urinary iodine (UI) excretion fell 50%, indicating indicate intake, and possible increased risk for moderate IDD. Experts thought this might be attributable to a decreased intake of salt; removal of iodate conditioners in store-bought breads; and an increased use of non-iodized salt in manufactured or premade convenience foods o 2001-2002 NHANES data indicated that levels had stabilized. Even so, women of reproductive age consistently had the lowest UI levels. • Women of reproductive age are an important group to monitor: o Pregnant women are vulnerable to iodine deficiency due to an increased renal clearance of iodine and transfer of iodine to fetus. o Iodine supplementation during pregnancy is often delayed, because women are unaware they are pregnant during early weeks of gestation.
    [Show full text]
  • Limited Knowledge About Folic Acid and Iodine Nutrition in Pregnant Women Reflected in Supplementation Practices
    University of Wollongong Research Online Faculty of Science, Medicine and Health - Papers: part A Faculty of Science, Medicine and Health 1-1-2014 Limited knowledge about folic acid and iodine nutrition in pregnant women reflected in supplementation practices Souad Elmani University of Wollongong, [email protected] Karen E. Charlton University of Wollongong, [email protected] Victoria M. Flood University of Wollongong, [email protected] Judy Mullan University of Wollongong, [email protected] Follow this and additional works at: https://ro.uow.edu.au/smhpapers Part of the Medicine and Health Sciences Commons, and the Social and Behavioral Sciences Commons Recommended Citation Elmani, Souad; Charlton, Karen E.; Flood, Victoria M.; and Mullan, Judy, "Limited knowledge about folic acid and iodine nutrition in pregnant women reflected in supplementation practices" (2014). Faculty of Science, Medicine and Health - Papers: part A. 2132. https://ro.uow.edu.au/smhpapers/2132 Research Online is the open access institutional repository for the University of Wollongong. For further information contact the UOW Library: [email protected] Limited knowledge about folic acid and iodine nutrition in pregnant women reflected in supplementation practices Abstract Aim In order to reduce the risk of neural tube defects (NTDs) and iodine deficiency in pregnancy, the National Health and Medical Research Council recommends that pregnant women supplement their diet with folic acid and iodine. This study aimed to identify the knowledge, attitudes and practices of pregnant women regarding intake of these nutrients in order to assess whether women are adequately exposed to this health message. Methods One hundred and fifty-two conveniently sampled pregnant women residing in a regional area of New South Wales, Australia, completed a pretested questionnaire on knowledge and practices regarding nutritional supplement use during pregnancy and dietary sources of folic acid and iodine.
    [Show full text]
  • 243 Public Health Reviews, Vol
    243 Public Health Reviews, Vol. 32, No 1, 243-255 Micronutrient Defi ciency Conditions: Global Health Issues Theodore H Tulchinsky, MD, MPH1 ABSTRACT Micronutrient defi ciency conditions are widespread among 2 billion people in developing and in developed countries. These are silent epidemics of vitamin and mineral defi ciencies affecting people of all genders and ages, as well as certain risk groups. They not only cause specifi c diseases, but they act as exacerbating factors in infectious and chronic diseases, greatly impacting morbidity, mortality, and quality of life. Defi ciencies in some groups of people at special risk require supplementation, but the most effective way to meet community health needs safely is by population based approaches involving food fortifi cation. These complementary methods, along with food security, education, and monitoring, are challenges for public health and for clinical medicine. Micronutrient defi ciency conditions relate to many chronic diseases, such as osteoporosis osteomalacia, thyroid defi ciency colorectal cancer and cardiovascular diseases. Fortifi cation has a nearly century long record of success and safety, proven effective for prevention of specifi c diseases, including birth defects. They increase the severity of infectious diseases, such as measles, HIV/AIDS and tuberculosis. Understanding the pathophysiology and epidemiology of micronutrient defi ciencies, and implementing successful methods of prevention, both play a key part in the New Public Health as discussed in this section, citing the examples of folic acid, vitamin B12, and vitamin D. Key Words: micronutrient defi ciency conditions, global health, folic acid, vitamin D, vitamin B12, defi ciency INTRODUCTION Micronutrient Defi ciencies (MNDs) are of great public health and socio- economic importance worldwide.
    [Show full text]
  • Vitamins and Minerals in Pregnancy and Lactation, Edited by Heribert Berger
    Vitamins and Minerals in Pregnancy and Lactation, edited by Heribert Berger. NestU Nutrition Workshop Series, Vol. 16. Nestec Ltd., Vevey/Raven Press, Ltd., New York © 1988. Vitamins and Minerals in Pregnancy and Lactation: An Introduction Angel Ballabriga Children's Hospital Vail D'Hebron, Autonomous University, Barcelona, Spain The determination of the nutritional requirements of the developing fetus and the newborn is a very complex problem, given that the optimum rate of growth has not been established with certainty. The model of fetal growth is growth in the intrauterine environment; the problem is more complex during extrauterine life. Maternal nutritional status at the time of conception, qualitative and quantitative intakes during pregnancy, and possible inter- vention programs during its course will influence intrauterine growth. Preg- nancy itself and its far-reaching consequences, as well as interactions among nutrients, will also play a role. A great number of enzymes regulating key metabolic pathways depend on the presence of trace elements and vitamins, and due to this, the effects of maternal nutritional deprivation could affect development of enzymes in fetal tissues. Through the studies of Widdowson and Spray (1) on 38 human fetuses and those of Apte and Iyengar (2) on the body composition of 41 fetuses of mothers from lower socioeconomic classes in India, we have some knowledge about the quantities of minerals in fetal tissues in the different stages of pregnancy. The rate of incorporation of different trace elements into fetal organs during pregnancy is very different for each organ, and in some aspects it follows a general law similar to that regulating the accretion of different compounds during specific periods of pregnancy.
    [Show full text]
  • Integrative Treatment of Hypothyroidism
    Integrative Treatment of Hypothyroidism As a major regulator of cellular metabolism, the thyroid gland influences an astonishing number of physiologic processes with include development and growth, thermogenesis, lipid and carbohydrate metabolism, cardiac myocyte activity, reproduction and cognitive functioning. This important gland is characteristic of vertebrates, and its secretions presumably affect every cell in the body, generally increasing metabolic rate. Accordingly, dysfunctional states of the thyroid gland are associated with numerous and fairly non-specific symptoms. Given the non-specific expressions and common occurrence of thyroid disease, concerns about thyroid function are frequently raised by clinicians and patients alike. SIGNS AND SYMPTOMS OF HYPOTHYROIDISM1 Fatigue Constipation Weight gain from fluid retention Memory and mental impairment Dry skin and cold intolerance Decreased concentration Yellow skin Depression Coarse hair or loss of hair Irregular or heavy menses and infertility Hoarseness Myalgias Goiter Hyperlipidemia Reflex delay, relaxation phase Bradycardia and hypothermia Ataxia Myxedema fluid infiltration of tissues The array of thyroid disorders focuses on the outliers along the continuum of thyroid function (namely hypothyroidism and hyperthyroidism) based upon the production of T3 (triiodothyronine) and T4 (thyroxine). Hypothyroidism is the most common thyroid disease and is estimated to affect between 0.1 and 2% of the population,2 with rates in women as much as 10 times higher than in men.3 The elderly and pregnant also experience higher rates of hypothyroidism. Worldwide, iodine deficiency remains the most common cause of hypothyroidism,4 whereas in industrially developed parts of the world autoimmune hypothyroidism (Hashimoto’s disease) is the most common thyroid disease. In the United States many cases of hyperthyroidism eventually lead to hypothyroidism either due to autoimmune “burnout” of the thyroid gland or medical interventions.
    [Show full text]