Earliest Porotic Hyperostosis on a 1.5-Million-year-old Hominin, olduvai gorge, Tanzania.

Meat-eating was an important factor affecting early hominin brain expansion, social organization and geographic movement. Stone tool butchery marks on ungulate fossils in several African archaeological assemblages demonstrate a significant level of carnivory by Pleistocene hominins, but the discovery at Olduvai Gorge of a child's pathological cranial fragments indicates that some hominins probably experienced scarcity of animal foods during various stages of their life histories. The child's parietal fragments, excavated from 1.5-million-year-old sediments, show porotic hyperostosis, a pathology associated with anemia. Nutritional deficiencies, including anemia, are most common at weaning, when children lose passive immunity received through their mothers' milk. Our results suggest, alternatively, that (1) the developmentally disruptive potential of weaning reached far beyond sedentary Holocene food-producing societies and into the early Pleistocene, or that (2) a hominin mother's meat-deficient diet negatively altered the nutritional content of her breast milk to the extent that her nursing child ultimately died from malnourishment. Either way, this discovery highlights that by at least 1.5 million years ago early human physiology was already adapted to a diet that included the regular consumption of meat

Megaloblastic anemia in Japan

Since 1903, 744 cases of megaloblastic anemia have been reported in Japan: 490 cases of pernicious anemia; 95 cases associated with pregnancy; 66 cases after gastrectomy; 22 cases of megaloblastic anemia of infants; 21 cases of folic acid deficiency other than pregnancy and 19 cases of vitamin B12 malabsorption after ileal resection. It is generally agreed among hematologists in Japan that pernicious anemia is relatively rare, as in other Asian countries. The diagnosis of pernicious anemia in Japan is usually made by stained marrow films, radioisotopic assay of serum vitamin B12, Schilling test and good response to vitamin B12 therapy. Serum folate level, intrinsic factor or its antibody, methylmalonic acid excretion, formiminoglutamic acid excretion and deoxyuridine suppression test are performed only at a small number of laboratories. The drugs of choice are hydroxocobalamin, deoxyadenosylcobalamin and methylcobalamin. Cyanocobalamin has nearly disappeared from commercial sources in Japan. Vitamin B12 administration is common in patients with neurological disorders. Megaloblastic anemia due to folic acid deficiency is extremely rare in Japan. Low serum folate levels are frequently observed among patients receiving anticonvulsants or in pregnant women, but in such samples megaloblastic anemia is almost never detected. The folic acid content of hospital diets indicates that satisfactory amounts of folate are taken in Japan. The intake of folic acid from rice is well over the minimum daily requirement of folate. Other factors in folic acid deficiency, such as food taboos, severe alcoholism and malabsorption syndrome are not frequently found in Japanese. The inadequate intake of folate was the critical factor in most reported cases.</p

Pathogenesis of Secondary Anemia

In patients with tissue damage of a malignant, infectious, inflammatory, ischemic or surgical nature, the plasma elimination (PE) of folates, iron, albumin, and cholesterol appears to be increased. Not all substances have been studied in diagnostic groups

Anaemia and cognitive function among Chinese elderly in Old Folks Homes

The relationship between anaemia and cognitive function was evaluated among 35 Chinese elderly (24 men and 11 women) aged 60 to 85 years (mean age 70.1 ± 6.7 years) from five old folks homes in Klang Valley. They were interviewed to obtain information on social and health status, habitual dietary intake and cognitive function. Hodkinson’s Abbreviated Mental Test was used to measure the cognitive function. Haematological indices which included Full Blood Count (FBC), serum iron, serum ferritin, Total Iron Binding Capacity (TIBC), serum folate and serum cobalamine (vitamin B12) weremeasured using an automated analyzer. Anthropometric measurements and clinical signs of anaemia were also examined. The findings indicated that the prevalence of anaemia as assessed using haemoglobin alone was 22.9%, while iron deficiency anaemia based on low serum iron, microcytic and hypochromic criterion was detected among 5.7% of the sample. Subclinical folate and vitamin B12 deficiencies were diagnosed among 34.3% and 8.6% of the subjects. However, there was no occurrence of megaloblastic anaemia. There was a positive correlation between cognitive score with mid upper arm circumference (MUAC) (r=0.547, p<0.01) and body mass index (BMI) (r=0.501, p < 0.01). All subjects with low haemoglobin and serum iron and approximately three quarter of subjects with folate and vitamin B12 deficiencies were classified as having cognitive impairment. In conclusion, subclinical malnutrition and anaemia may play a role in the deterioration of cognitive function in the elderl

Hematological studies on iron- and folate-requirements in pregnancy

Hematological changes and serum iron, vitamin B12 and folate levels after administration of iron plus folic acid were com· pared with changes and levels after supplement of iron alone in 100 pregnant women. No hematological benefits by adding folic acid was revealed. It is concluded that folic acid deficiency in pregnant women is mild and routine supplementation of folic acid is not necessary except for proved cases of folate deficiency. As to the reason why folic acid deficiency is so mild and megaloblastic anemia is so rare in Japan, uniformity of dietary habits, i. e. boiled rice as basic food, was discussed.</p

Acquired Elliptocytosis as a Manifestation of Myelodysplastic Syndrome with Ring Sideroblasts and Multilineage Dysplasia.

Acquired elliptocytosis is a known but rarely described abnormality in the myelodysplastic syndromes (MDS). Here we report the case of an elderly male who was admitted to the hospital with chest pain, dyspnea, and fatigue and was found to be anemic with an elliptocytosis that had only recently been noted on peripheral smears of his blood. After bone marrow biopsy he was diagnosed with MDS with ring sideroblasts and multilineage dysplasia and acquired elliptocytosis. Here we report a rare case of acquired elliptocytosis cooccurring with MDS with ring sideroblasts and multilineage dysplasia

Clinical and experimental studies on folic acid deficiency due to anticonvulsants. 2. Investigations on patients receiving anticonvulsants and experimental study on the effect of diphenylhydantoin on the absorption of folic acid in rats

A high incidence of subnormal serum folic acid levels was observed in 48 patients receiving anticonvulsants (75 %). In peripheral blood, macrocytosis was detected in 46 % and an increase of hypersegmented neutrophils was also seen in 24 % of the patients. Correlation existed between these signs and low serum folate levels. The growth response of Lactobacillus casei and L. leichmannii was not suppressed by the addition of various anticonvulsants to the medium of the bioassay systems. Administration of 5 mg of folic acid for a month corrected macrocytosis and an increase of hypersegmented neutrophils significantly. Folic acid supply also decreased mean diameters of the nuclei of oral epithelial cells significantly. It is concluded that subclinical folic acid deficiency is common among the patients receiving anticonvulsants. Absorption of 3H.folic acid from the small intestine of rats was inhibited by large dose of diphenylhydantoin (20 mg) not by 5 mg. This fact suggests that in patients on diphenylhydantoin, the quantity balance of folic acid and diphenylhydantoin in the intestine regulates the absorption of folic acid.</p