|
|
| (40 intermediate revisions by 5 users not shown) |
| Line 1: |
Line 1: |
| {{otheruses1|extreme [[malnutrition]]}}
| | __NOTOC__ |
| {{Infobox_Disease | | | {{Starvation}} |
| Name = {{PAGENAME}} |
| | '''For patient information, click [[Starvation (patient information)|here]]''' |
| Image = Starved girl.jpg |
| |
| Caption = A female child during the [[Nigerian-Biafran war]] of the late 1960s, shown suffering the effects of severe hunger and malnutrition. |
| |
| DiseasesDB = 12415 |
| |
| ICD10 = {{ICD10|T|73|0|t|66}} |
| |
| ICD9 = {{ICD9|994.2}} |
| |
| ICDO = |
| |
| OMIM = |
| |
| MedlinePlus = |
| |
| eMedicineSubj = |
| |
| eMedicineTopic = |
| |
| MeshID = D013217 |
| |
| }} | |
| [[Image:Starved Vietnamese man, 1966.JPEG|thumb|right|Starved [[Vietnam]]ese man, who was deprived of food in a [[Viet Cong]] prison camp.]]
| |
| '''Starvation''' is a severe reduction in [[vitamin]], [[nutrient]], and [[energy]] intake, and is the most extreme form of [[malnutrition]]. In [[human]]s, prolonged starvation (in excess of 1-2 months) causes permanent [[organ (anatomy)|organ]] damage and, eventually, death.
| |
|
| |
|
| According to the [[FAO|Food and Agriculture Organization]] of the [[United Nations]], more than 25,000 people died of starvation every day in [[2003]],<ref name="BBC_water_starvation">{{cite web|last = Kirby | first = Alex| title=UN warns of future water crisis| url = http://news.bbc.co.uk/2/hi/science/nature/2818615.stm | publisher = [[BBC]] | date=2003-03-05| accessdate=2007-09-01|}}</ref> and as of [[2001]] to [[2003]], about 800 million people were chronically undernourished.<ref name="FAO_malnutrition2001">{{cite web| last =| first =| authorlink =| coauthors =| title=The spectrum of malnutrition| work =| publisher =[[Food and Agricultural Organization]]| date =2001-10-05| url=http://www.fao.org/worldfoodsummit/english/fsheets/malnutrition.pdf |format =pdf| doi =| accessdate =2007-08-03}}</ref><ref name="BBC_water_starvation"/>
| | {{CMG}} |
|
| |
|
| == Symptoms == | | ==[[Starvation overview|Overview]]== |
| | ==[[Starvation historical perspective|Historical Perspective]]== |
|
| |
|
| Individuals experiencing starvation lose substantial [[fat]] and [[muscle]] mass as the body breaks down these tissues for [[energy]]. [[Catabolysis]] is the process (medical condition) of a body breaking down muscles and other tissues in order to keep vital systems -- such as the [[nervous system]] and [[heart]] muscle -- working. Catabolysis will not begin until there are no usable sources of energy coming into the body. [[Vitamin deficiency]] is also a common result of starvation, often resulting in [[anemia]], [[beriberi]], [[pellagra]], and [[scurvy]]. These diseases collectively may cause [[diarrhea]], [[skin rash]]es, [[edema]], and [[heart failure]]. Individuals are often [[irritable]], [[fatigue (physical)|fatigued]], and [[lethargy|lethargic]] as a result.
| | ==[[Starvation pathophysiology|Pathophysiology]]== |
|
| |
|
| == Psychological effects of starvation == | | ==[[Starvation causes|Causes]]== |
|
| |
|
| Through several reports and studies, scientists have discovered that starvation has many psychological effects on a person, in addition to its physiological effects.<ref name="Brozek">Brozek, Josef. "Psychology of Human Starvation and Nutritional Rehabilitation." ''The Scientific Monthly'' 70 (1950): 270-274. </ref> The most extensive and informative study on starvation's psychological effects is called The Minnesota Starvation-Rehabilitation Experiment, which was carried out from 1944-1946. The subjects of this experiment were thirty-two healthy conscientious objectors, ages twenty to thirty-three.<ref name="Brozek"/> Subjects experienced three phases of the experiment: twelve weeks of control period, twenty four weeks of semistarvation, and then twelve weeks of rehabilitation. During the control experiments, subjects were given 3,492 calories, during the period of semistarvation, calories were decreased to 1,570, and during the period of rehabilitation, they were re-increased to normal levels. During the period of semistarvation, subjects were fed foods most likely consumed in European famine areas.<ref name="Brozek"/> The results of the starvation experiment were tested in many ways. According to Josef Brozek, author of ''Psychology of Human Starvation and Nutritional Rehabilitation'', studies "ranged from intelligence and personality tests through ratings to purely descriptive material, provided by the experimenters' notes and diaries kept by the subjects".<ref name="Brozek"/> According to subjects of the semistarvation experiment, tiredness was the worst effect of the low calorie intake, followed by appetite, muscle soreness, irritability, apathy, sensitivity to noise, and hunger pain.<ref name="Brozek"/> Standard personality tests revealed that the starving individuals experienced a large rise in the "neurotic triad" -- hypochondriasis, depression, and hysteria. Also, the subjects of the experiment noticed a marked decrease in the drive for activity, and a remarkable decrease in sex drive.<ref name="Brozek"/> In peer evaluations, other experiment subjects noted great changes in subjects' personalities during the period of semistarvation. In interviews years later, subjects reported that they felt that they had not returned to normal by the end of the three month recovery period.<ref name="Kalm">Kalm LM, Semba RD (2005), [http://jn.nutrition.org/cgi/content/full/135/6/1347 They starved so that others be better fed: remembering Ancel Keys and the Minnesota experiment]. ''Journal of Nutrition'', Volume 135, Issue 6, Pages 1347-1352. Retrieved on [[September 13]], [[2007]].</ref> Subjects' own estimates of the time it took for recovery ranged from two months to two years.<ref name="Kalm"/> Many subjects reported that they grossly overate and put on fat after the experiment due to the urge to eat.<ref name="Kalm"/>
| | ==[[Starvation differential diagnosis|Differentiating Starvation from other Diseases]]== |
|
| |
|
| == Organizations Working to End Starvation == | | ==[[Starvation epidemiology and demographics|Epidemiology and Demographics]]== |
|
| |
|
| Many organizations have been highly effective at reducing starvation in different regions. Aid agencies give direct assistance to individuals, while political organizations pressure political leaders to enact policies that will reduce famine and provide aid.
| | ==[[Starvation risk factors|Risk Factors]]== |
|
| |
|
| ==Common causes of starvation== | | ==[[Starvation natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| [[Image:Holodomor.jpg|thumb|220px|Child victim of the [[Holodomor]].]] | |
| *[[Anorexia nervosa]]
| |
| *[[Bulimia nervosa]]
| |
| *[[Clinical Depression]]
| |
| *[[Coma]]
| |
| *[[Crash diet]]ing
| |
| *[[Diabetes mellitus]] (untreated)
| |
| *[[Digestive disease]]
| |
| *[[Famine]]
| |
| *[[Fasting]]
| |
| *[[Malnutrition]]
| |
| *[[Overpopulation]]
| |
| *[[Poverty]]
| |
|
| |
|
| == Capital punishment == | | ==Diagnosis== |
| | [[Starvation history and symptoms|History and Symptoms]] | [[Starvation physical examination|Physical Examination]] | [[Starvation laboratory findings|Laboratory Findings]] | [[Starvation electrocardiogram|Electrocardiogram]] | [[Starvation other imaging findings|Other Imaging Findings]] | [[Starvation other diagnostic studies|Other Diagnostic Studies]] |
|
| |
|
| [[Image:Starving-livilla.jpg|250px|right|thumb|The starving Livilla refusing food.<br>''From a drawing by André Castagne'']] | | ==Treatment== |
| Starvation has also historically been used as a death sentence. From the beginning of civilization through to the Middle Ages people were [[immurement|immured]], or starved to death. | | [[Starvation medical therapy|Medical Therapy]] | [[Starvation primary prevention|Primary Prevention]] | [[Starvation secondary prevention|Secondary Prevention]] | [[Starvation cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Starvation future or investigational therapies|Future or Investigational Therapies]] |
|
| |
|
| In ancient Greco-Roman societies, starvation was sometimes used to dispose of guilty upper class citizens, especially erring female members of patrician families. For instance, in the year [[31]], [[Livilla]], the niece and daughter-in-law of [[Tiberius]], was discreetly starved to death by her mother for her adulterous relationship with [[Sejanus]] and for her complicity in the murder of her own husband, [[Drusus the Younger]].
| | == Case Studies == |
| | [[Starvation case study one|Case #1]] |
|
| |
|
| Another daughter-in-law of Tiberius, named [[Agrippina the Elder]] (a granddaughter of [[Augustus]] and the mother of [[Caligula]]) also died of starvation, in [[33]] (however, it is not clear if she voluntary starved herself to death or if she was forced to).
| |
|
| |
|
| A son and a daughter of Agrippina were also executed by starvation for political reasons; [[Drusus Caesar]], her second son, was put in prison in 33 and starved to death on the orders of Tiberius (he managed to stay alive for nine days by chewing the stuffing of his bed); Agrippina's youngest daughter, called [[Julia Livilla]], was exiled on an island in [[41]] by her uncle, the emperor [[Claudius]], and not much later, her death by starvation was arranged by the empress [[Messalina]].
| |
|
| |
| Execution by starvation was also a possible punishment for [[Vestal Virgin]]s found guilty of breaking their vows.
| |
|
| |
| [[Maximilian Kolbe]], a Polish friar, offered his life to save another inmate sentenced to death in the [[Auschwitz concentration camp]]. He was starved along with another nine inmates. After two weeks of starvation he and three other inmates were still alive and executed with injections of [[phenol]].
| |
|
| |
| [[Ugolino della Gherardesca]], his sons and other members of his family were immured in the [[Muda (tower)|Muda]], a tower of [[Pisa]], and starved to death in the [[thirteenth century]]. [[Dante]], his contemporary, wrote about Gherardesca in his masterpiece ''[[The Divine Comedy]]''.
| |
|
| |
| In [[Sweden]] in [[1317]], the king [[Birger of Sweden]] had his two brothers locked up in the prison. They died a few weeks later because of starvation; their sentence was a punishment for a coup they staged several years earlier. This was called the [[Nyköping Banquet]].
| |
|
| |
| In [[Cornwall]] in [[1671]], there is a recorded case of a man by the name of [[John Trehenban]] from [[St Columb Major]] who was condemned to be starved to death in a cage at [[Castle An Dinas]] for the murder of two girls.
| |
|
| |
| == See also ==
| |
|
| |
| * [[Refeeding syndrome]]
| |
| * [[Anorexia (symptom)|Anorexia]]
| |
| * [[Anorexia nervosa]]
| |
| * [[Cachexia]]
| |
| * [[Dehydration]]
| |
| * [[Famine]]
| |
| * [[Famine response]]
| |
| * [[Famine scales]]
| |
| * [[Fasting]]
| |
| * [[Hunger]]
| |
| * [[Malnutrition]]
| |
| * [[Kwashiorkor]]
| |
| * [[Marasmus]]
| |
| * [[Muselmann]]
| |
| * [[Overpopulation]]
| |
| * [[Hunger strike]]
| |
| * [[List of famines]]
| |
| * [[List of countries by fertility rate]]
| |
|
| |
| == References ==
| |
| <references/>
| |
|
| |
| == External links ==
| |
| {{commonscat|Starvation}}
| |
| * [http://starvation.net The Three Top Sins Of The Universe by Mark R. Elsis]
| |
| * [http://www.merck.com/mrkshared/mmanual/section1/chapter2/2b.jsp Starvation - Merck Manual]
| |
| * [http://www.fao.org/newsroom/en/focus/2004/51786/index.html FAO - Understanding food insecurity]
| |
| * [http://www.fao.org/english/newsroom/news/2002/9703-en.html FAO - What the new figures on hunger mean]
| |
| * [http://www.thehungersite.com The Hunger Site - Help fight hunger world wide with just a click]
| |
| {{Consequences of external causes}} | | {{Consequences of external causes}} |
|
| |
|
| [[Category:Humanitarian aid]]
| |
| [[Category:Malnutrition]] | | [[Category:Malnutrition]] |
| [[Category:Poverty]] | | [[Category:Poverty]] |
| [[Category:Execution methods]]
| | |
| [[Category:Causes of death]] | | [[Category:Causes of death]] |
| [[Category:Emergency medicine]] | | [[Category:Emergency medicine]] |
| Line 121: |
Line 52: |
| [[simple:Starvation]] | | [[simple:Starvation]] |
| [[sv:Svält]] | | [[sv:Svält]] |
| | |
| | {{WH}} |
| | {{WS}} |