Aleitamento materno e quimiocinas: diferenças entre esquizofrenia e controles / Breastfeeding and chemokines: differences in schizophrenia and controls

Introdução: Avaliar a associação entre níveis plasmáticos da quimiocina CCL11, coeficiente de inteligência e prática da amamentação em homens com esquizofrenia em condições psiquiátricas estáveis sob acompanhamento ambulatorial em um serviço de saúde pública. Métodos: Foi realizado estudo caso-controle com 60 indivíduos: 30 pacientes com esquizofrenia e 30 controles saudáveis, dos quais 15 de cada grupo foram expostos ao aleitamento materno e 15 não foram. Foi aplicado questionário abordando questões socioeconômicas, história ao nascer, dados clínicos e alimentação ao nascer. Foi dosada a quimiocina CCL11 e aplicados testes psicológicos para avaliar quociente de inteligência, funcionalidade, sintomas psiquiátricos, curso da doença e diagnóstico. Para os controles, foi utilizada uma escala para descartar doença psiquiátrica. Resultados: A quimiocina CCL11 apresentou valores significativamente mais altos (> 0,5) em pacientes com esquizofrenia quando comparados aos controles. No grupo de amamentados, os esquizofrênicos apresentaram valores significativamente mais altos a nível intermediário (entre 0.106 e 0.5). Não houve correlação da CCL11 com o número de hospitalizações, idade, tempo de diagnóstico e escolaridade. Não foi evidenciada correlação entre tempo de aleitamento materno em relação aos fatores do Brief Psychiatric Rating Scale. Houve uma tendência de correlação entre a idade de início da doença e o aleitamento materno. Foi encontrada correlação positiva do CCL11 com o tempo de aleitamento materno. Ao comparar os pacientes esquizofrênicos que foram aleitados com os que não foram, foi encontrada diferença estatisticamente significativa apenas para o quociente de inteligência. Conclusão: O aleitamento materno está associado a níveis mais baixos de CCL11, escores mais altos de quociente de inteligência e a esquizofrenia. A quimiocina CCL11 é mais alta em quem não amamentou, especialmente nos esquizofrênicos. (AU)

Introduction: To evaluate the association between plasma levels of chemokine CCL11, intelligence quotient, and exposure to breastfeeding in men with schizophrenia under stable psychiatric condition and monitored as outpatients in a public health care unit. Methods: A case-control study of 60 individuals, 30 patients with schizophrenia and 30 healthy controls; in each group, 15 were exposed to breastfeeding and 15 were not. A questionnaire addressing socioeconomic issues, history at birth, clinical data, and feeding at birth was administered. Chemokine CCL11 levels were measured, and psychological tests were applied to assess intelligence quotient, functional status, psychiatric symptoms, disease course, and diagnosis. A scale to rule psychiatric illness was used for the controls. Results: Chemokine CCL11 levels were significantly higher (> 0.5) in patients with schizophrenia than in controls. In the breastfed group, patients with schizophrenia also had significantly higher CCL11 levels, but at an intermediate level (between 0.106 and 0.5). There was no correlation between CCL11 and number of hospitalizations, age, time since diagnosis, or level of education, nor between duration of breastfeeding and the Brief Psychiatric Rating Scale factors. A trend toward a correlation was observed between age at disease onset and breastfeeding. There was a positive correlation between CCL11 and duration of breastfeeding. The comparison of patients with schizophrenia who were breastfed vs those who were not breastfed showed a statistically significant difference only in intelligence quotient. Conclusion: Breastfeeding is associated with lower CCL11 levels, higher intelligence quotient scores, and schizophrenia. Chemokine CCL11 levels are higher in those not exposed to breastfeeding, especially in patients with schizophrenia. (AU)

Trial using multiple micronutrient food supplement and its effect on cognition.

OBJECTIVE: To test the efficacy of a multiple micronutrient food supplement (MMFS) on the nutrition status of school children and its effect on cognition. METHODS: A MMFS was developed containing chelated ferrous sulphate and microencapsulated vitamin A, B2, B6, B12, folic acid, niacin, calcium pantothenate, vitamin C, vitamin E, lysine and calcium and the efficacy of the MMFS was assessed in 7-11 year old school children in Chennai, India by a pre-post test design. In the experimental group (N=51), the food in the school kitchen was cooked with the MMFS for the residential school children for a period of one year. The control group (N=72) consisted of day scholars who did not eat at the school. Hemoglobin, red blood cell count and hematocrit were measured at baseline and at the end of the study (after one year). A battery of 7 memory tests (The personal information test, the Mann-Suiter Visual memory screen for objects, The digit span forward test, The digit span backward test, The delayed response test, The Benton Visual Retention Test and The Cattells retentivity test), one test for attention and concentration (Letter cancellation test) and one test for intelligence (Ravens's coloured progressive matrices) were administered to all the children at baseline and endline. RESULTS: It was seen that there was a significant (P<0.05) improvement in the experimental group in hemoglobin, hematocrit and red cell count whereas in the control group there was a statistically significant decline(P<0.05) in hemoglobin and red cell count. In 5 tests out of the 7 memory tests and in the letter cancellation test for attention, the mean change in scores in the experimental group is significantly more (P<0.05) than the control group. There was no significant improvement in the overall intelligence as seen in the Ravens progressive matrices between the experimental and control groups at endline. CONCLUSION: The study shows that the MMFS is effective in improving the nutrition status and cognition in children.

Metabolism of inorganic arsenic and non-cancerous health hazards associated with chronic exposure in humans.

Humans can be exposed to arsenic from a variety of environmental, occupational and medicinal sources. Exposure from drinking water is the most common source nowadays. Inorganic arsenic is metabolized by two main biochemical reactions: reduction and oxidative methylation. Recent studies have confirmed a reactivation of the toxic effects of arsenic associated with such methylation process, because the methylated metabolites, especially the trivalent forms, are more toxic than the inorganic arsenicals. Chronic exposure to arsenic can cause a variety of cancerous and noncancerous health hazards in humans. The main non-cancerous health hazards include cardiovascular disease, skin lesions, neurological problems, diabetes mellitus and hypertension.

Decreased intelligence in children and exposure to fluoride and arsenic in drinking water

Recent evidence suggests that fluoride (F) and arsenic (As) may adversely affect intelligence quotient (IQ) scores. We explore the association between exposure to F and As in drinking water and intelligence in children. Three rural communities in Mexico with contrasting levels of F and As in drinking water were studied: Moctezuma (F 0.8±1.4mg/L; As 5.8±1.3µg/L); Salitral (F 5.3±0.9mg/L; As 169±0.9µg/L) and 5 de Febrero (F 9.4±0.9mg/L; As 194±1.3µg/L). The final study sample consisted of 132 children from 6 to 10 years old. After controlling for confounders, an inverse association was observed between F in urine and Performance, Verbal, and Full IQ scores (beta values = -13, -15.6, -16.9, respectively). Similar results were observed for F in drinking water (beta values = -6.7, -11.2, -10.2, respectively) and As in drinking water (beta values= -4.30, -6.40, -6.15, respectively). The p-values for all cases were < 0.001. A significant association was observed between As in urine and Full IQ scores (beta = -5.72, p = 0.003). These data suggest that children exposed to either F or As have increased risks of reduced IQ scores.

Estudios recientes sugieren que el flúor (F) y el arsénico (As) pueden tener efectos adversos sobre el coeficiente intelectual (CI). En este estudio exploramos la asociación entre el F y el As y la inteligencia en niños expuestos a estas sustancias a través del agua. Tres comunidades rurales de México con diferentes niveles de F y As fueron estudiadas: Moctezuma (F 0,8±1,4mg/L; As 5,8±1,3µg/L); Salitral (F 5,3±0,9mg/L; As 169±0,9µg/L) y 5 de Febrero (F 9,4±0,9mg/L; As 194±1,3µg/L). La muestra final fue de 132 niños de 6 a 10 años de edad. Después de controlar por confusores, se obtuvieron asociaciones inversas entre F en orina y las puntuaciones de los CI (Desempeño, Verbal y Total) (valores beta = -13, -15,6, -16,9, respectivamente) p < 0,001 en todos los casos. Resultados similares se obtuvieron con F en agua (valores beta = -6,7, -11,2, -10,2, respectivamente) y con As en agua (valores beta = -4,30, -6,40, -6,15, respectivamente). En todos los casos p < 0,001. Para As en orina, se obtuvo una asociación inversa con las puntuaciones del CI total (beta= -5,72; p = 0,003). Estos datos sugieren que los niños expuestos al F o al As tienen mayor riesgo de tener disminución en las puntuaciones del CI.

Lead levels and cognitive abilities in Peruvian children / Níveis de chumbo e funções cognitivas em crianças peruanas

OBJETIVE: To study the relationship between blood lead levels and cognitive abilities of children exposed to this metal. METHOD: This is a cross-sectional study that included 134 children aged 6 to 8.5 years old from 3 schools with different risks of lead exposure located in El Callao (Peru). Cognitive assessments were made by means of the Graphic Test of Reasoning (GTR) and the Kohs Block Design Test (KBDT). Blood lead levels and other laboratory tests were performed. RESULTS: Children with lead > 10 ug/dl presented greater prevalence of low scores in the Graphic Test of Reasoning (18.9 percent vs. 7.1 percent, p = 0.049) and in the Kohs Block Design Test (KBDT) (39.6 percent vs. 18.6 percent, p = 0.01) compared with those with lower lead blood levels. A deficit of 1 category in the Graphic Test of Reasoning was associated with an increase in lead blood level of 16.78 ug/dl (assuming a linear relationship) and from 1 to 5.19 ug/dl (logarithmic model). For each 10 ug/dl of increase in lead levels, the Kohs Block Design Test decreases in 6.24 units (12.91 in males and 0.216 in females) (linear model), and an increase from 1 to 10 ug/dl corresponds to a drop of 16.44 points in the Kohs Block Design Test (31.19 in males and 3.98 in females) (logarithmic model). Considering the Graphic Test of Reasoning subscales, lead levels correlated negatively with the areas of numerical problems (rho = -0.445, p < 0.001), numerical relationships (rho = -0.365, p < 0.001), inferences (rho = -0.281, p = 0.002) and similarities (rho = -0.250, p = 0.005). CONCLUSIONS: Lead levels were non-linearly associated with lower cognitive abilities, especially in males, being the numerical reasoning the most affected area.

OBJETIVO: Estudar a relação entre níveis séricos de chumbo e funções cognitivas em crianças expostas a esse metal. MÉTODO: Este é um estudo transversal que incluiu 134 crianças de 6 a 8,5 anos de idade, de três escolas localizadas em El Callao (Peru), e com riscos diferentes de exposição ao chumbo. As avaliações de suas funções cognitivas foram realizadas utilizando-se o Teste Gráfico de Raciocínio e o Teste dos Cubos de Kohs. Foram medidos os níveis séricos de chumbo RESULTADOS: As crianças com níveis séricos de chumbo > 10 ug/dl apresentaram maior prevalência de baixa pontuação no Teste Gráfico de Raciocínio (18,9 por cento vs. 7,1 por cento, p = 0,049) e também no Teste dos Cubos de Kohs (39,6 por cento vs. 18,6 por cento, p = 0,01), quando comparadas com aquelas com níveis séricos menores. Um déficit de uma categoria no Teste Gráfico de Raciocínio foi associado com um aumento no nível sérico de chumbo de 16,78 ug/dl (assumindo uma relação linear) e de 1 a 5,19 ug/dl (modelo logarítmico). Para cada 10 ug/dl de aumento no nível sérico de chumbo, o Teste dos Cubos de Kohs apresentou diminuição de 6,24 unidades (12,91 para os meninos e 0,216 para as meninas) (modelo linear) e um aumento de 1 a 10 ug/dl correspondeu a uma diminuição de 16,44 pontos no Teste dos Cubos de Kohs (31,19 para os meninos e 3,98 para as meninas) (modelo logarítmico). Considerando as subescalas do Teste Gráfico de Raciocínio, os níveis séricos de chumbo correlacionaram-se negativamente com as áreas de problemas numéricos (rho = -0,445, p < 0,001), relações numéricas (rho = -0,365, p < 0,001), inferências (rho = -0,281, p = 0,002) e semelhanças (rho = -0,250, p = 0,005). CONCLUSÕES: Níveis séricos de chumbo foram associados de uma maneira não-linear com déficits das habilidades cognitivas, especialmente entre os meninos, sendo o raciocínio numérico a área mais afetada.

Thyroid function and intellectual development in infant whose mothers receive methimazole

Recent studies have shown normal thyroid function in infants whose mothers receive methimazole [MMI] during breast-feeding. This study evaluates the long-term effect of MMI on thyroid function and intellectual development of such children.82 children aged 48-86 months were studied. 42 children had been breast-fed while their thyrotoxic lactating mothers received daily doses of MMI 20-30 mg in the first, 10 mg in the second and 5-10 mg for additional 10 months of therapy. Thyroid function of infants remained normal during the one year of MMI therapy of their mothers. 40 other infants served as controls. Serum T4, T3, and TSH concentrations, urinary iodine, thyroid antibodies, intelligent quotient [IQ], verbal and functional [performance] components [Wechsler and Goodenough tests] were measured in all children of case and control groups.Height, weight, serum T4, T3, TSH and antithyroid antibody titers were not differed between children of case and control groups. The mean IQ was 107 +/- 17 vs 106 +/- 16 [Goodenough test] and 103 +/- 10 vs 103 +/- 16 [Wechsler test] for children of thyrotoxic mothers and control children, respectively. There was no difference in verbal and functional IQ and their components between children of thyrotoxic MMI treated mothers and control children.Thyroid function and physical and intellectual development of breast-fed infants whose thyrotoxic lactating mothers were treated with MMI are normal at age 48 to 86 months

Effect of selegiline on cognitive functions in Parkinson's disease.

BACKGROUND: Selegiline hydrochloride, a selective MAO-B inhibitor is known to improve motor functions in Parkinson's disease (PD). The present study was undertaken to study the effect of selegiline on memory and intelligence of PD patients. MATERIAL AND METHOD: Thirty two patients of PD were divided in two groups: selegiline group (n = 17) received 10 mg selegiline per day and control group (n = 15) did not receive selegiline. Patients receiving trihexyphenidyl and selegiline were excluded. All other treatment remained unchanged. All patients were examined at baseline and after three months for change in UPDRS score, WAIS score, memory test and P300. RESULTS: Patients in selegiline group had less severe disease (UPDRS score 24.11 +/- 14.07) as compared to controls (UPDRS score 40.53 +/- 18.52). There was significant improvement in UPDRS score (p < 0.05), WAIS (p < 0.001) and memory (p < 0.001) in selegiline group. In the control group there was a significant prolongation of P300 latency (p < 0.05). CONCLUSION: The study suggests that selegiline improves memory functions and intelligence in PD patients in addition to motor functions. It also prevents prolongation of P300 latency which is a marker of cognitive function.

Secuelas neurológicas y psicológicas que deja la radioterapia o el metotresate intratecal en niños con leucemia linfoblástica aguda / Neurogical and psycological sequelae in children with acute lymphoblastic. leukemia who received central nervous system prophylaxis with radiotherapy or intrathecal methrotexate

Comparar las alteraciones neurológicas y psicológicas en niños con leucemia linfoblástica aguda (LLA), quienes habían estado con más de tres años sin tratamiento antineoplásico, y que recibieron profilaxis al sistema nervioso central (SNC) con base a radioterapia (RT), más quimioterapia intratecal (QTT) con metotrexate (Grupo 1) o sólo con QTIT (Grupo 2). En ambos grupos se realizó evaluación neurológica, electroencefalograma (EEG) y tomografía computada de cráneo (TACC). La evaluación psicológica consistió en la medición del coeficiente intelectual y de la función visomotora con la prueba de Bender. Las personas que realizaron cada una de las evaluaciones desconocían a que grupo de pacientes correspondía. Análisis estadístico: prueba exacta de Fisher y U de Mann-Whitnney. Catorce pacientes del grupo 1 y ocho pacientes del grupo 2. En el grupo 1 se encontró coeficiente intelectual significativamente inferior (mediana 83.5) al del segundo (90.5). En un paciente de cada grupo se encontraron alteraciones neurológicas, alteraciones en el EEG en 6 del grupo 1 y en 4 del grupo 2 y en la TACC, sólo en 2 pacientes del segundo grupo, sin tener diferencia estadística. Los niños con LLA quienes recibieron profilaxis al SNC con RT más QTIT, tuvieron mayor alteración en el rendimiento intelectual, en comparación con los tratados con metotrexate intratecal. En los dos grupos se presentaron anormalidades neurológicas, sin diferencia entre uno y otro grupo

The devastating consequence of iodine deficiency.

Endemic cretinism is the most striking consequence of iodine deficiency. Although cretinism is a serious condition, it usually involves only about 5% of the population even in serious endemic areas. There is a spectrum between cretinism and normality, many are able to perform simple work and look apparently normal, but it is difficult for them to perform skilled labor. Studies in China using the IQ distribution curve revealed that every person in an endemic area lost about 10-15 IQ points, so that the socio-economic development of the community was severely affected.

Intellectual functions in childhood malignant disorders.

Our study was designed to compare the intellectual functions in 35 children with lymphoreticular malignancies (ALL or NHL) who had received CNS directed therapy (Group A), with those in 21 patients with solid tumors (Group B). Intellectual assessment was done using the Malin's modification for Indian children of the Wechsler's intelligence scale. Using 5 verbal and performance subscales each, the verbal IQ, performance IQ and full scale IQ were derived. The mean VIQ, PIQ and FIQ were comparable in the two groups with the differences not being statistically significant. However, the dispersion of IQ scores was greater in Group A with a larger number of subjects having scores of < 80. Similarly, the scores obtained in the arithmetic, digit-span, picture completion and block design subscales were lower in Group A. Mean IQ scores were significantly lower in children over the age of 10 years at diagnosis. Sex duration since diagnosis, disease free survival and treatment variables did not affect IQ scores. In conclusion, a cross-sectional evaluation of intellectual functions has revealed only minimal differences in children treated with chemotherapy and CNS directed therapy (ITMTX and RT) in comparison to those treated with chemotherapy alone.

La historia toxicológica como predictora de déficit intelectual en politoxicómanos / Toxicological history as predictor of intellectual impairment in polydrug abusers

Estudiamos la influencia de las características de consumo de drogas en el funcionamiento intelectual de sujetos politotoxicómanos que utilizan la heroína como droga principal de abuso. Evaluamos a 62 sujetos (31 politoxicómanos y 31 no dependientes) mediante la aplicación del Test de Matrices Progresivas de Raven. Los resultados obtenidos revelan un rendimiento más pobre en los sujetos dependientes que el obtenido en grupo de sujetos no dependientes, de las mismas características personales, socioculturales y neuromédicas. La remisión del consumo, la duración de la dependencia, y el consumo de una segunda droga de abuso simultánea a la heroína no demostraron evidencia significativa de influir en los déficit intelectuales detectados

Intellectual functions of cancer patients treated by triple intrathecal therapy

Adverse intellectual effects have been noted in survivors of childhood lymphoblastic leukemia as a result of prophylactic radiation to the central nervous system. Triple intrathecal therapy [IT] was used as an effective and safe alternative to radiotherapy. In this study 16 children with cancer who received triple intrathecal therapy were tested. A group of 16 normal children matched for age, sex, socioeconomic,. and educational background served as controls. The tests administered were as follows : Wechsler Intelligence Scale for Children-Revised [Wisc-R], Kauffman achievement test [K-ABC] and Binet figure for the Stanford-Binet Scale. No significant differences were noted between the two groups in any of the tests

Síndrome alcohólico fetal y potencial intelectual normal / Fetal alcohol syndrome and normal potential intelectual

Se reporta el caso de un niño de 9 años de edad, con dificultades académicas e interpersonales, con historia de ingesta alcohólica materna excesiva durante la gestación, cuyo CI actual es de 7.5 con un potencial de 110. Paralelamente se describen algunas características de la familia del niño y el estudio del CI en algunos de ellos. Se destacan las dificultades asociadas al estudio de familias en donde uno de los progenitores es alcohólico y su correlación con la prevalencia de multiparidad, mortalidad infantil, fracaso escolar, marginalidad y psicopatología.