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    Scurvy as a mimicker of osteomyelitis in a child with autism spectrum disorder.
    Int J Infect Dis 2018 Feb 6. Epub 2018 Feb 6.
    Division of Infectious Diseases The Hospital for Sick Children 555 University Avenue Toronto, Ontario, Canada M5G 1X8. Electronic address:
    We describe a case of scurvy in a 10-year-old boy with autism spectrum disorder. His clinical presentation was initially thought to be due to osteomyelitis, for which empirical antimicrobial therapy was initiated. Further invasive and ultimately unnecessary investigations were avoided when scurvy was considered in the context of a restricted diet and classic signs of vitamin C deficiency. Read More

    Latent scurvy with tiredness and leg pain in alcoholics: An underestimated disease three case reports.
    Medicine (Baltimore) 2017 Nov;96(47):e8861
    Rationale: Scurvy is often diagnosed at the state of well-established signs as, for example, skin and visceral purpura, gums involvement, loss of healthy teeth, which derive mostly from disturbance of collagen metabolism. Little is known about the state of latent scurvy, which symptoms are nonspecific and may mimic more common conditions such as weakness, leg pain, and muscle aching.

    Patient Concerns: We report 3 cases of extreme lassitude and leg pain in alcoholics. Read More

    Do You C What I C: Emergency Department Evaluation and Diagnosis of Pediatric Scurvy in an Autistic Child With a Restricted Diet.
    Pediatr Emerg Care 2018 Jan 23. Epub 2018 Jan 23.
    From the Departments of Emergency Medicine and Pediatrics, Children's Hospital of the King's Daughters, Norfolk, VA.
    Scurvy in modern times may not be as rare as previously thought. The link between adequate intake of vitamin C and scurvy has been known since ancient times and is recorded in Ebers Papyrus. Recent reports indicate that, with restricted diets, vitamin C deficiency is being seen in infants exclusively fed plant-based formula and children with oral aversion, autism, restricted diets, and cerebral palsy. Read More

    The Medicinal Usage and Restriction of Ginseng in Britain and America, 1660-1900.
    Uisahak 2017 Dec;26(3):503-544
    This article demonstrates the medicinal usage of ginseng in the West from 1660 to 1914. Asian[Korea] ginseng was first introduced into England in the early 17th century, and North American ginseng was found in the early 18th century. Starting from the late 17th century doctors prescribed ginseng to cure many different kinds of ailments and disease such as: fatigue general lethargy, fever, torpidity, trembling in the joints, nervous disorder, laughing and crying hysteria, scurvy, spermatic vessel infection, jaundice, leprosy, dry gripes and constipation, strangury, yellow fever, dysentery, infertility and addictions of alcohol, opium and tobacco, etc. Read More

    Scurvy: When it is a Forgotten Illness the Surgery Makes the Diagnosis.
    Open Orthop J 2017 20;11:1314-1320. Epub 2017 Nov 20.
    Department of Orthopedic Surgery and Traumatology, Hbib Bourguiba University Hospital Sfax, Tunisia.
    Background: Unlike most of animal species, human beings lack the enzymatic process for the conversion of glucose to ascorbic acid (vitaminC), and therefore getting the vitamin from food sources is essential. The association of the various signs caused by a deficiency of vitamin C is called scurvy or Barlow's disease, an easily treatable disease but can be fatal. It is rare in the developed countries and even economically underdeveloped societies in which the basic diet is already rich in ascorbate. Read More

    Paleopathological rigor and differential diagnosis: Case studies involving terminology, description, and diagnostic frameworks for scurvy in skeletal remains.
    Int J Paleopathol 2017 Dec 25;19:96-110. Epub 2015 Nov 25.
    Department of Sociology and Anthropology, George Mason University, United States; Museo Nacional Sicán, Peru; Museo Nacional de Arqueología y Etnografía Hans Heinrich Brüning de Lambayeque, Peru. Electronic address:
    Diverse pathological processes can produce overlapping or even indistinguishable patterns of abnormal bone formation or destruction, representing a fundamental challenge in the understanding of ancient diseases. This paper discusses increasing rigor in differential diagnosis through the paleopathological study of scurvy. First, paleopathology's use of descriptive terminology can strive to more thoroughly incorporate international standards of anatomical terminology. Read More

    Introduction: Scientific rigor in paleopathology.
    Int J Paleopathol 2017 Dec 13;19:80-87. Epub 2017 Oct 13.
    Arizona State University, United States.
    This introductory chapter to the Special Issue on "Scientific Rigor in Paleopathology" serves to orient and introduce the chapters that follow through a detailed consideration of paleopathology as a 21century intellectual field. In this vein, we first make the significant point that paleopathology is a profoundly interdisciplinary endeavor, encompassing aspects of the biomedical science, the humanities, and the social sciences. Thus, we suggest that no one practitioner can personally command the range of skills necessary for a 21century paleopathologist. Read More

    Nutrition for oral health and oral manifestations of poor nutrition and unhealthy habits.
    Gen Dent 2017 Nov-Dec;65(6):36-43
    The availability of proper nutrients is critical for the growth, development, maintenance, and repair of healthy dentition and oral tissues. Deficiencies particularly relevant to the dental practice are those in folate and other B complex vitamins; vitamins A, C, and D; calcium; fluoride; and protein. A lack of these nutrients affects nearly every structure in the oral cavity, causing or contributing to scurvy, cleft palate, enamel hypoplasia, poor mineralization, caries, and other pathoses. Read More

    The role of vitamin C in epigenetic regulation.
    Postepy Hig Med Dosw (Online) 2017 Aug;71(1):747-760
    Katedra Biochemii Klinicznej, Collegium Medicum im. Ludwika Rydygiera w Bydgoszczy, Uniwersytet Mikołaja Kopernika w Toruniu.
    Vitamin C (L-ascorbic acid) is a micronutrient best known for its anti-scurvy activity in humans. Vitamin C is involved in many biological processes involving enzymatic reactions that are catalyzed by members of dioxygenases which use Fe(II) and 2-oxoglutarate as a co-substrate.The article reviews recent data that suggest the involvement of ascorbate in dioxygenases catalyzed chromatin and DNA modifications which thereby contribute to epigenetic regulation. Read More

    Basilar portion porosity: A pathological lesion possibly associated with infantile scurvy.
    Int J Paleopathol 2017 Sep 16;18:92-97. Epub 2017 Jun 16.
    Archaeological Sciences, University of Bradford, Bradford, West Yorkshire, BD7 1DP, UK. Electronic address:
    Recent analysis of the juvenile (≤12 years) human remains from a 19th century site in Wolverhampton, England revealed a relatively high level of nutritional deficiency diseases within the population. Indeed, 41.7% of the 48 juvenile skeletons analysed exhibited a combination of porous and proliferative bone lesions consistent with the pathological alterations associated with nutritional stress. Read More

    Scurvy at the agricultural transition in the Atacama desert (ca 3600-3200 BP): nutritional stress at the maternal-foetal interface?
    Int J Paleopathol 2017 Sep 23;18:108-120. Epub 2017 Jun 23.
    Universidad de Tarapacá, Instituto de Alta Investigación, Chile.
    Studies of contemporary populations have demonstrated an association between decreased dietary diversity due to resource scarcity or underutilization and an increase in diseases related to poor micronutrient intake. With a reduction of dietary diversity, it is often the women and children in a population who are the first to suffer the effects of poor micronutrient status. Scurvy, a disease of prolonged vitamin C deficiency, is a micronutrient malnutrition disorder associated with resource scarcity, low dietary diversity, and/or dependence on high carbohydrate staple-foods. Read More

    Development and implementation of an HPLC-ECD method for analysis of vitamin C in plasma using single column and automatic alternating dual column regeneration.
    Pract Lab Med 2016 Dec 4;6:25-37. Epub 2016 Sep 4.
    Department of Pathology, University of Utah Health Sciences Center, Salt Lake City, UT 84112, United States.
    Objectives: Vitamin C (l-ascorbic acid) is a water-soluble micronutrient necessary for human life. Inadequate intake can lead to the fatal disease scurvy. Measurement of vitamin C is used to assess nutritional status and to monitor supplementation. Read More

    Bateman purpura (dermatoporosis): a localized scurvy treated by topical vitamin C - double-blind randomized placebo-controlled clinical trial.
    J Eur Acad Dermatol Venereol 2018 Feb 5;32(2):323-328. Epub 2017 Sep 5.
    Laboratory of Skin Bioengineering and Imaging (LABIC), Department of Clinical Sciences, University of Liège, Liège, Belgium.
    Background: Bateman purpura is characterized by diffuse senile skin atrophy, senile purpura and spontaneous stellar pseudocicatrices. Cutaneous changes in the course of ageing have been related to lower levels of ascorbic acid into the dermis of elderly people.

    Objective: In this study, we postulate that senile purpura could be linked to dermal vitamin C deficiency and could be corrected by topical administration of this vitamin. Read More

    Plasma concentrations of ascorbic acid in a cross section of the German population.
    J Int Med Res 2018 Jan 31;46(1):168-174. Epub 2017 Jul 31.
    1 Department of Medicine 1, University of Erlangen - Nuremberg, Germany.
    Objectives Vitamin C deficiency is considered extremely rare in modern industrialized countries. This study was performed to assess vitamin C concentrations in the German population. Methods As part of a consultant-patient seminar on nutrition and food intolerances, patients were asked to participate in this study on a voluntary basis. Read More

    New evidence suggesting a dissociated etiology for cribra orbitalia and porotic hyperostosis.
    Am J Phys Anthropol 2017 09 8;164(1):76-96. Epub 2017 Jun 8.
    Department of Archaeology & Anthropology, Leverhulme Centre for Human Evolutionary Studies, University of Cambridge, United Kingdom.
    Objectives: Porotic hyperostosis (PH), characterized by porotic lesions on the cranial vault, and cribra orbitalia (CO), a localized appearance of porotic lesions on the roof of the orbits, are relatively common osteological conditions. Their etiology has been the focus of several studies, and an association with anemia has long been suggested. Anemia often causes bone marrow hypertrophy or hyperplasia, leading to the expansion in trabecular or cranial diploic bone as a result of increased hematopoiesis. Read More

    Health research and safeguards: The South African journey.
    S Afr Med J 2017 Apr 25;107(5):379-380. Epub 2017 Apr 25.
    Steve Biko Centre for Bioethics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
    Health research, as a social good, needs to be conducted in the interests of the common good. Because of the unfortunate exploitation of research participants globally, safeguards for protections are necessary. Most international codes and guidelines originated as responses to the abuse and mistreatment of research subjects. Read More

    The role of vitamin C in the treatment of pain: new insights.
    J Transl Med 2017 Apr 14;15(1):77. Epub 2017 Apr 14.
    Centre for Postgraduate Nursing Studies, University of Otago, Christchurch, PO Box 4345, Christchurch, 8140, New Zealand.
    The vitamin C deficiency disease scurvy is characterised by musculoskeletal pain and recent epidemiological evidence has indicated an association between suboptimal vitamin C status and spinal pain. Furthermore, accumulating evidence indicates that vitamin C administration can exhibit analgesic properties in some clinical conditions. The prevalence of hypovitaminosis C and vitamin C deficiency is high in various patient groups, such as surgical/trauma, infectious diseases and cancer patients. Read More

    Gingival bleeding in a patient with autism spectrum disorder: A key finding leading to a diagnosis of scurvy.
    Quintessence Int 2017 ;48(5):407-411
    Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder that can affect all aspects of life, including nutrition. This case reports a patient with ASD in which gingival bleeding was the key finding that led to a diagnosis of scurvy. The literature review discusses behavioral food aversions in patients with ASD that lead to significant nutritional deficiencies, such as scurvy. Read More

    Increasing ascorbate levels in crops to enhance human nutrition and plant abiotic stress tolerance.
    Curr Opin Biotechnol 2017 Apr 21;44:153-160. Epub 2017 Feb 21.
    Queensland University of Technology, Centre for Tropical Crops and Biocommodities, Institute for Future Environments, GPO Box 2434, Brisbane, QLD 4001, Australia.
    Ascorbate (or vitamin C) is an essential human micronutrient predominantly obtained from plants. In addition to preventing scurvy, it is now known to have broader roles in human health, for example as a cofactor for enzymes involved in epigenetic programming and as regulator of cellular iron uptake. Furthermore, ascorbate is the major antioxidant in plants and underpins many environmentally induced abiotic stress responses. Read More

    Headband sign on magnetic resonance imaging: An unusual finding of scurvy in a 5-year-old child described first time.
    J Pediatr Neurosci 2016 Oct-Dec;11(4):355-357
    Department of Pediatrics, Sir T Hospital, Bhavnagar, Gujarat, India.
    Scurvy usually presents with tender and painful limbs, swelling of joints, gum bleeding, poor wound healing, and muscle weakness. Here, we report a case of 5-year-old child with global developmental delay who presented with soft swelling of the head over scalp and protrusion of the left eye with extremely irritability. Neuroimaging was suggestive of diffuse extensive soft-tissue swelling involving the entire scalp with large necrotic collections with mild proptosis of the left orbit. Read More

    High Performance Liquid Chromatography-Diode Array Detector Method for the Simultaneous Determination of Five Compounds in the Pulp and Seed of Sea Buckthorn.
    Pharmacogn Mag 2017 Jan-Mar;13(49):136-140
    Central Laboratory of Xinjiang Medical University, Urumqi, Xinjiang, China.
    Context: Sea buckthorn (L.) as a traditional Chinese medicinal plant has various uses in Xinjiang.

    Objective: A reversed-phase rapid-resolution liquid-chromatography method with diode array detector was developed for simultaneous determination of protocatechuic acid, rutin, quercetin, kaempferol, and isorhamnetin in the pulp and seed of sea buckthorn, a widely used traditional Chinese medicine for promoting metabolism and treating scurvy and other diseases. Read More

    Crude extract and solvent fractions of Calystegia soldanella induce G1 and S phase arrest of the cell cycle in HepG2 cells.
    Int J Oncol 2017 Feb 2;50(2):414-420. Epub 2017 Jan 2.
    Institute of Fisheries Science, Pukyong National University, Ilgwang-myeon, Gijang-gun, Busan 619-911, Republic of Korea.
    The representative halophyte Calystegia soldanella (L) Roem. et Schult is a perennial vine herb that grows in coastal dunes throughout South Korea as well as in other regions around the world. This plant has long been used as an edible and medicinal herb to cure rheumatic arthritis, sore throat, dropsy, and scurvy. Read More

    Insights gained from ancient biomolecules into past and present tuberculosis-a personal perspective.
    Int J Infect Dis 2017 Mar 30;56:176-180. Epub 2016 Nov 30.
    Centre for Clinical Microbiology, Division of Infection and Immunity, Royal Free Campus, University College London, London NW3 2PF, UK. Electronic address:
    Ancient and historical tuberculosis (TB) can be recognized by its typical paleopathology in human remains. Using paleomicrobiology, it is possible to detect many more individuals infected with TB but with no visible lesions. Due to advances in molecular analysis over the past two decades, it is clear that TB was widespread in humans from the Neolithic period and has remained so until the present day. Read More

    Systematic reviews in context: highlighting systematic reviews relevant to Africa in the Pan African Medical Journal.
    Pan Afr Med J 2016 30;24:180. Epub 2016 Jun 30.
    The Pan African Medical Journal, Center for Public Health Research and Information, Nairobi, Kenya.
    Health research serves to answer questions concerning health and to accumulate facts (evidence) required to guide healthcare policy and practice. However, research designs vary and different types of healthcare questions are best answered by different study designs. For example, qualitative studies are best suited for answering questions about experiences and meaning; cross-sectional studies for questions concerning prevalence; cohort studies for questions regarding incidence and prognosis; and randomised controlled trials for questions on prevention and treatment. Read More

    Modern American scurvy - experience with vitamin C deficiency at a large children's hospital.
    Pediatr Radiol 2017 Feb 24;47(2):214-220. Epub 2016 Oct 24.
    Department of Radiology, Texas Children's Hospital, 6701 Fannin St., Suite 470, Houston, TX, 77030, USA.
    Background: Until recently scurvy has been viewed in developed countries as a disease of the past. More recently there have been reports of case series of children with scurvy who have had a delayed diagnosis after an extensive diagnostic workup that included imaging. Most of these children have had underlying neurologic conditions such as autism. Read More

    Gingival Bleeding and Bloody Dialysate: A Case Report of Scurvy in a Child With End-Stage Renal Disease Receiving Peritoneal Dialysis.
    J Ren Nutr 2016 Nov 23;26(6):407-411. Epub 2016 Apr 23.
    Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
    Patients with chronic kidney disease (CKD) or end-stage renal disease are at risk for vitamin C deficiency and scurvy due to diet restriction, increased urinary loss of the water-soluble vitamin C with diuretics, and in case of patients who are on dialysis, through dialysates. The condition may be overlooked as the clinical manifestation of scurvy may be subtle, and some presentations may mimic clinical signs in CKD. We reported a case of scurvy presenting with gingival bleeding and blood dialysate in a 6-year-old girl with end-stage renal disease who was on continuous ambulatory peritoneal dialysis. Read More

    Imaging Findings of Metabolic Bone Disease.
    Radiographics 2016 Oct;36(6):1871-1887
    From the Division of Musculoskeletal Imaging and Intervention, Department of Radiology (C.Y.C., D.I.R., S.V.K., A.J.H.), and the Pediatric Endocrine Division, Department of Pediatrics (D.M.M.), Massachusetts General Hospital, 55 Fruit St, Yawkey 6E, Boston, MA 02114; and the Department of Radiology, St. Luke's International Hospital, Tokyo, Japan (A.H.).
    Metabolic bone diseases are a diverse group of diseases that result in abnormalities of (a) bone mass, (b) structure mineral homeostasis, (c) bone turnover, or (d) growth. Osteoporosis, the most common metabolic bone disease, results in generalized loss of bone mass and deterioration in the bone microarchitecture. Impaired chondrocyte development and failure to mineralize growth plate cartilage in rickets lead to widened growth plates and frayed metaphyses at sites of greatest growth. Read More

    Poundbury Camp in Context-a new Perspective on the Lives of Children from urban and rural Roman England.
    Am J Phys Anthropol 2017 02 3;162(2):208-228. Epub 2016 Oct 3.
    Department of Archaeology, School of Archaeology, Geography and Environmental Science, University of Reading, Reading, Berkshire, RG6 6AB, UK.
    Objectives: The current understanding of child morbidity in Roman England is dominated by studies of single sites/regions. Much of the data are derived from third to fifth century AD Poundbury Camp, Dorchester, Dorset, considered an unusual site due to high levels of non-adult morbidity. There is little understanding of children in rural areas, and whether Poundbury Camp was representative of Romano-British childhood. Read More

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