Efeito do ômega 3 e da vitamina B12 no espermograma, na histomorfometria dos órgãos reprodutivos e nas temperaturas do corpo com termografia infravermelha em ratos Wistar / Effect of Omega 3 and Vitamin B12 on the spermogram, histomorphometry of the reproductive organs and body temperatures with infrared thermography in Wistar rats

Objetivou-se estudar o efeito do ômega 3 e da vitamina B12 no espermograma, na histomorfometria dos órgãos reprodutivos e na temperaturas do corpo com termografia infravermelha em ratos Wistar. Utilizaram-se 16 ratos, em quatro grupos (n=4), que receberam injeções diárias por 30 dias, sendo: grupo controle - solução salina; grupo ômega 3 - óleo de peixe 1g/kg; grupo B12 - vitamina B12 3µg; e grupo ômega 3 + B12 - óleo de peixe 1g/kg e vitamina B12 3µg. Imagens termográficas de áreas do corpo foram obtidas. No 30º dia, os ratos foram sacrificados e realizaram-se as análises de morfologia espermática e histomorfometria. Os dados foram submetidos à análise de variância e ao teste de Tukey a 5%. A temperatura da superfície do escroto foi superior no grupo B12 (P<0,05). Não houve diferenças entre grupos (P>0,05) para temperaturas do globo ocular. Houve correlação entre temperatura da superfície do escroto e porcentagem de gota citoplasmática distal (P=0,678). A elevação da temperatura do escroto resulta no aumento da porcentagem de gotas citoplasmáticas distais. A temperatura do globo ocular não sofre influência significativa do ômega 3 e da vitamina B12. O ômega 3 reduz o epitélio seminífero, e a vitamina B12 minimiza esse efeito.(AU)

The objective of this study was to study the effect of Omega 3 and vitamin B12 on spermogram, histomorphometry of reproductive organs and body temperature with infrared thermography in Wistar rats. Sixteen rats were used in four groups (n= 4) who received daily injections for 30 days. Control Group - saline solution; Group Omega 3 - fish oil 1g/kg; Group B12 - vitamin B12 3μg and Group Omega 3 + B12 - fish oil 1g/kg and vitamin B12 3μg. Thermographic images of body were obtained. On the 30th day the rats were sacrificed and analyzes of sperm morphology and histomorphometry were performed. Data were submitted to analysis of variance and Tukey's test at 5%. The surface temperature of the scrotum was higher in group B12 (P< 0.05). There were no differences between groups (P> 0.05) for eyeball temperatures. There was a correlation between scrotal temperature and distal cytoplasmic droplet (P= 0.678). Elevation of scrotum temperature results in an increase in the percentage of distal cytoplasmic droplets. The temperature of the eyeball is not significantly influenced by Omega 3 and vitamin B12. Omega 3 reduces the seminiferous epithelium and vitamin B12 minimizes this effect.(AU)

Déficit de vitamina B12 en la práctica psiquiátrica / Vitamin B12 deficiency in psychiatric practice / Déficit de Vitamina B12 na prática psiquiátrica

RESUMEN Es común la solicitud de los niveles de vitamina B12 en pacientes evaluados por psiquiatría y específicamente en las unidades de pacientes agudos, pero, a pesar de la creciente literatura disponible sobre la correlación entre esta hipovitaminosis y los síntomas neuropsiquiátricos, aún existen muchas dudas sobre los grupos poblacionales de riesgo que se deben tamizar, el tipo de examen que se debe solicitar, la forma de hacer el tratamiento y la utilidad real de la reposición vitamínica en la resolución de los síntomas afectivos, cognitivos o psicóticos. Este artículo es una revisión narrativa de la literatura disponible con el objetivo de poder evaluar de forma crítica los interrogantes teóricos y prácticos más relevantes para el psiquiatra actual, con énfasis en la evidencia sobre la correlación entre niveles bajos de vitamina B12 y déficit cognitivo, depresión y algunos trastornos psicóticos.

SUMMARY Levels of vitamin B12 are commonly requested in psychiatric patients, specifically in units for acute patients. Despite the abundant literature available about the correlation between this hypovitaminosis and neuro-psychiatric symptoms, there are still many doubts about the risk groups that should be screened, the tests that should be applied, how to treat, and the real usefulness of vitamin supplementation in the resolution of affective, cognitive or psychotic symptoms. This article presents a narrative review of the available literature, and summarizes the main recommendations about theoretical and practical questions concerning this subject matter, with emphasis on the correlation between low levels of vitamin B12 and cognitive impairment, depression and psychotic disorders.

RESUMO É comum a solicitação de níveis de vitamina B12 em pacientes avaliados por psiquiatria e especificamente nas unidades de pacientes agudos, mas apesar da crescente literatura disponível sobre a correlação entre esta hipovitaminose e os sintomas neuropsiquiá- tricos, ainda existem muitas dúvidas sobre os grupos populacionais de risco que devem tamisar, o tipo de exame que se deve solicitar, a forma de fazer o tratamento e a real utilidade da reposição vitamínica na resolução dos sintomas afetivos, cognitivos ou psicóticos. Este artigo pretende fazer uma revisão narrativa da literatura disponível com o objetivo de poder avaliar de forma crítica os interrogantes teóricos e práticos mais relevantes para o psiquiatra atual, fazendo ênfase na evidência sobre a correlação entre níveis baixos de vitamina B12 e déficit cognitivo, depressão e alguns transtornos psicóticos.

Acidemia metilmalónica: presentación de un caso y revisión de literatura científica / Methylmalonic acidemia: report of a case and review of scientific literature / Acidemia orgânica metilmalônica: apresentação de caso e revisão de literatura cientifica

La acidemia metilmalónica es un desorden causado por anormalidad en la enzima metil malonil CoA mutasa o su cofactor Adenosilcobalamina. Esta holoenzima se encuentra implicada en el catabolismo de varios aminoácidos entre los que se incluyen dos de cadena ramificada (isoleucina y valina). Puede presentarse como una forma severa de inicio neonatal hasta formas con síntomas lentamente progresivos como hipotonía y retardo en el desarrollo. El diagnóstico y tratamiento oportuno, pueden modificar el curso y desenlace de la enfermedad, mejorando la calidad de vida del paciente. Reportamos el caso de un lactante de 3 meses, con pancitopenia, hipotonía, retardo en desarrollo y convulsiones. Se diagnosticó acidemia metilmalónica mediante cromatografía de ácidos orgánicos en orina. El paciente fue tratado con Cianocobalamina, restricción dietaria y levetiracetam con respuesta clínica favorable. Actualmente permanece libre de crisis, los índices de desarrollo son normales y la pancitopenia resolvió. Este caso muestra como el diagnóstico y tratamiento temprano en un paciente con acidemia metilmalónica, aun cuando se origine por déficit de cofactor, puede favorecer el pronóstico neurológico y funcional.

Methylmalonic Acidemia is a disorder caused by an abnormality of methylmalonyl-CoA mutase or a deficiency of adenosylcobalamin as cofactor. This holoenzyme is involved in the catabolism of branched chain amino acids. It can present clinically either as a severe neonatal-onset form, or some progressive symptoms as hypotonia and developmental delay. Early diagnosis and treatment can alter the course and outcome. We report the case of a 3- month- old boy, with pancytopenia, hypotonia, developmental delay and seizures. Methylmalonic Acidemia was diagnosed by urinary organic acid chromatography. Patient was treated with Cyanocobalamin, dietary restriction and levetiracetam with favorable response. He is currently seizure free, development indexes are normal and pancytopenia has resolved. This case shows how early diagnosis and treatment in a patient with Methylmalonic Acidemia caused by cofactor deficiency may favor functional and neurologic outcomes.

A acidémia metilmalónica é uma desordem causada pela anormalidade na enzima l-metil malonil- coa mutase o no seu cofator adenosilcobalamina. Esta holoenzima está envolvida no catabolismo de vários aminoácidos, entre os quais encontrasse os de cadeia ramificada (isoleucina e valina). Sua apresentação clínica pode ser uma forma grave em neonatos com sintomas lentamente progressivos, como hipotonia e atraso no desenvolvimento. O diagnóstico e tratamento precoce podem alterar a história natural da doença, melhorando a qualidade de vida dos pacientes. Relata-se o caso de uma criança de colo de três meses, com pancitopenia, hipotonia, atraso no desenvolvimento e convulsões. O diagnóstico de acidémia metilmalónica foi feito com cromatografia. O paciente foi tratado com Cianocobalamina, regime de dieta e levetiracetam, com resposta clínica favorável. Atualmente o paciente está sem crises, o desenvolvimento é normal para idade e a pancitopenia foi resolvida. Na acidémica metilmalónica, a despeito, da sua origem por déficit de cofator com diagnóstico e tratamento precoce, pode ter uma evolução neurológica e funcional.

Validación de método analítico para el control de la calidad de vitamina B12 10 000 inyección / Validation of analytical method for quality control of B12 Vitamin-10 000 injection

Se validó el método analítico reportado en la Farmacopea de los Estados Unidos, para el control de la calidad de vitamina B12 10 000 U (cianocobalamina) inyectable, por espectrofotometría ultravioleta, por ser este un método más sencillo, económico y que permite controlar la calidad del producto terminado. La curva de calibración se realizó en el intervalo de 60 al 140 %, donde fue lineal con un coeficiente de correlación igual a 0,9999; la prueba estadística para el intercepto y la pendiente se consideró no significativa. Se obtuvo un recobrado del 99,97 % en el intervalo de concentraciones estudiado, y las pruebas de Cochran (G) y Student (t) resultaron no significativas. El coeficiente de variación en el estudio de la repetibilidad fue igual a 0,59 % para las 6 réplicas ensayadas, mientras que en los análisis de la precisión intermedia las pruebas de Fischer y Student no significativas. El método analítico resultó lineal, preciso, específico y exacto en el intervalo de concentraciones estudiadas.

Analytical method reported by USA Pharmacopeia was validated for quality control of injectable B12 Vitamin (10 000 U) by UV spectrophotometry because this is a simpler and low-cost method allowing quality control of finished product. Calibration curve was graphed at 60 to 140 % interval, where it was linear with a correlation coefficient similar to 0, 9999; statistical test for interception and slope was considered non-significant. There was a recovery of 99.7 % in study concentrations interval where the Cochran (G) and Student(t) test were not significant too. Variation coefficient in repetition study was similar to 0.59 % for the 6 assayed replies, whereas in intermediate precision analysis, the Fisher and Student tests were not significant. Analytical method was linear, precise, specific and exact in study concentrations interval.

Osteoarthritis: clinical evaluation of diclofenac combined with the B complex vitamins / Osteoartrite: avaliação clínica da ação do diclofenaco com as vitaminas do complexo B

A double-blind, placebo controlled evaluation was performed on parallel groups of patients presenting osteoarthritis of the knee, hip or hand. The study aimed to evaluate the use of a combination of sustained-release diclofenac and vitamins B1, B6 and B12 in the treatment of the signs and symptoms of osteoarthritis. After screening and informed consent, randomized subjects underwent a 7-day treatment period with twice-daily oral therapy. Osteoarthritis pain, mobility and satisfaction assessments by both the subjects and the investigating physician were performed at each of the three visits to the study center before, during and at the end of the treatment period, along with physical examinations, laboratory evaluations and monitoring of adverse events and concomitant medications. Results were compared between the active and placebo treated groups (Group A and Group B, respectively).The active treatment was found to be superior to placebo in all of the pain, mobility and satisfaction assessments. Patients treated with the active substance were more willing to continue treatment at the end of the study. No significant difference was observed between the treatment groups in the physical examinations and laboratory evaluations performed.Based on the results observed in this double-blind clinical evaluation, we conclude that the combination of sustained-release diclofenac and vitamins B1, B6 and B12 is both well-tolerated and superior to placebo in the treatment of the signs and symptoms of OA in the study population evaluated.

Treatment of inflammatory neuropathy with dexamethasone plus B-vitamins: a clinical evaluation / Tratamento de neuropatia inflamatória com a associação de dexametasona e vitaminas B: uma avaliação clínica

We evaluated the use of a combination of vitamins B1, B6, and B12 with dexamethasone in the treatment of the signs and symptoms of inflammatory neuropathy of the upper and lower limbs, in an open-label clinical trial. Patients were submitted to a 9-day treatment period with three doses of study medication at three day intervals, and a series of clinical and laboratory assessments, prior to the first dose of study medication and at each of the following three visits to the study center. Efficacy evaluations at each study visit included a 100mm VAS pain scale and global and satisfaction surveys completed by the patient and the investigating physician. Safety evaluations included a comparison of changes in laboratory evaluations at each visit and the incidence, severity, duration, and outcome of adverse events. A total of sixty-one patients were enrolled in the trial. A clinically significant improvement in all of the efficacy measures was observed from the pre-treatment to end-of-study evaluations. No clinically significant alterations in clinical assessments were observed during the treatment period. Based on the results of this clinical study, we conclude that the combination of dexamethasone with the B-vitamins is safe and effective in the treatment of the signs and symptoms of inflammatory neuropathy.

Safety and efficacy of a B-vitamin combination in the treatment of osteoarthritis-related pain / Segurança e eficácia da associação das vitaminas B1, B6, B12 na analgesia da osteoartrite

We evaluated the safety and efficacy of the use of an oral combination of vitamins B1, B6, and B12 in the treatment of osteoarthritis-related pain and loss of mobility. A 14-day, open-label treatment period was adopted for patients presenting osteoarthritis of the knee or hip. Patients underwent a series of clinical and laboratory evaluations prior to the first treatment dose, following 7 days of treatment, and at the end of the 14-day drug administration period. The incidence of adverse events and use of concomitant medication was also monitored at each study visit. At each study visit, osteoarthritis evaluations were performed, including a 100mm VAS pain assessment, and global and satisfaction surveys completed by both patients and investigating physician. At the conclusion of the study, an additional assessment was performed to evaluate the patient's willingness to continue treatment with the B-vitamin combination.Clinical safety was evaluated by comparing the differences between the pretreatment, mid-study, and end-of-study clinical and laboratory evaluations as well as the incidence and severity of any adverse events. A comparison between the patient and physician assessments at each study visit was used to evaluate efficacy.A total of 54 patients were treated with the study medication. A clinically significant change was observed from pretreatment to end-of-study efficacy evaluations, including those for pain, mobility, and global osteoarthritis condition. The physician's evaluation of global patient condition and treatment satisfaction evaluation also presented a clinically significant change from pretreatment to the final study evaluation. No clinically significant changes in the patients clinical and laboratory evaluations were observed during the study.Based on the results of this clinical study, we conclude that the combination of cyanocobalamin, thiamine mononitrate and pyridoxine chlorihydrate at the concentrations employed is safe and effective in the treatment of the pain and loss of mobility associated with osteoarthritis.