Outbreak of enzootic ataxia in goats and sheep in the state of Bahia / Surto de ataxia enzoótica em caprinos e ovinos no estado da Bahia

The objective of this study was to describe for the first time the clinical-epidemiological, laboratory and pathological aspects of different forms of enzootic ataxia in goats and lambs in the state of Bahia, as well as to propose an emergency oral treatment with copper sulfate in an individualized way for neonates. Three outbreaks of enzootic ataxia were studied. The history, clinical signs and epidemiological data were obtained from the owners and checked during the visits. The first outbreak (FO) occurred in 2013 in a property located in the municipality of Itaberaba and affected a herd composed of 90 goats and 130 sheep. The second outbreak (SO) occurred in 2014 in the municipality of Santa Luz and affected a herd of 90 goats and 110 sheep. The third outbreak (TO) occurred in 2018, in a property located in the same municipality of the SO, being the herd constituted by 80 sheep. Samples of blood were collected from all goats and sheep treated for serum copper dosage. Nine animals (five goats and four sheep) that presented a more severe clinical picture and unfavorable prognosis were necropsied for diagnostic confirmation. During the necropsy of the FO, SO and TO animals, liver samples were collected for copper dosage as well as fragments of several organs for histopathology. At the site where the SO occurred, samples of soil and the main forages where the animals were kept were collected to determine copper, iron, molybdenum, sulfur and zinc contents. The clinical and histopathological findings in the three outbreaks studied were characteristic of enzootic ataxia. In the outbreaks studied, the frequency of enzootic ataxia was higher in goats (52) than in lambs (39). In the goats the mean values of serum copper (0.05mg/kg) and hepatic (2.48mg/kg) of the FO and SO were well below their respective reference values, 12 times lower than serum levels and eight times lower in relation to liver contents. On the other hand, TO sheep presented mean values of serum copper (0.015mg/kg) reduced by 40 times. The levels of iron and sulfur were high in the fodder of the property where the SO occurred, already in the soil, iron levels were high and copper levels were reduced. The treatment tested in neonates and lambs with two doses of copper sulphate solution orally at a dose of 20mg/kg for sheep and 35mg/kg for goats during the first and second week of life was effective in prevention of enzootic ataxia in neonates and can be used for emergency control of the disease. The occurrence of enzootic ataxia (congenital and late form) in goats and sheep was first reported in Bahia. It is also worth noting that this disease caused by copper deficiency has caused great damage to the breeders of small ruminants, mainly due to the high mortality of the animals affected.(AU)

Objetivou-se com esse estudo descrever pela primeira vez os aspectos clínico-epidemiológicos, laboratoriais e patológicos de diferentes formas de ataxia enzoótica em cabritos e borregos no estado da Bahia, bem como propor um tratamento oral emergencial com sulfato de cobre de forma individualizada para neonatos. Foram estudados três surtos de ataxia enzoótica. O histórico, sinais clínicos e dados epidemiológicos foram obtidos com os proprietários e verificados durantes as visitas técnicas. O primeiro surto (PS) ocorreu em 2013 em uma propriedade localizada no município de Itaberaba e acometeu um rebanho composto por 90 caprinos e 130 ovinos. O segundo surto (SS) aconteceu em 2014 no município de Santa Luz e afetou um rebanho formado por 90 caprinos e 110 ovinos. O terceiro surto (TS) ocorreu 2018, em uma propriedade localizada no mesmo município do SS, sendo o rebanho constituído por 80 ovinos. Amostras de sangue foram colhidas de todos os caprinos e ovinos atendidos, para dosagem de cobre sérico. Nove animais (cinco caprinos e quatro ovinos) que apresentavam quadro clínico mais grave e prognóstico desfavorável foram necropsiados para confirmação diagnóstica. Durante a necropsia dos animais do PS, SS e TS amostras de fígado foram coletadas para dosagem de cobre, bem como amostras de diversos órgãos para exame histopatológico. Na propriedade onde ocorreu o SS, foram coletadas amostras de solo e das principais forragens onde os animais eram mantidos, a fim de se determinar os teores de cobre, ferro, molibdênio, enxofre e zinco. Os achados clínicos e histopatológicos verificados nos três surtos estudados foram característicos de ataxia enzoótica. Nos surtos estudados, a frequência da ataxia enzoótica foi maior em cabritos (52) do que em cordeiros (39). Nos caprinos os valores médios de cobre sérico (0,05mg/kg) e hepático (2,48mg/kg) do PS e SS encontravam-se muito abaixo dos respectivos valores de referência, sendo 12 vezes menor em relação aos níveis séricos e oito vezes menor em relação aos teores hepáticos. Já os ovinos do TS apresentavam valores médios de cobre sérico (0,015mg/kg) reduzidos cerca de 40 vezes. Os teores de ferro e enxofre encontravam-se elevados nas forragens da propriedade onde ocorreu o SS, já no solo, os níveis de ferro apresentavam-se elevados e os de cobre reduzidos. O tratamento testado nos cabritos e borregos neonatos, com duas administrações individualizadas com solução de sulfato de cobre, por via oral, na dose de 20mg/kg para ovinos e 35mg/kg para caprinos, na primeira e segunda semana de vida, foi eficaz na prevenção da ataxia enzoótica nos neonatos e pode ser utilizado para controle emergencial da doença. Comprovou-se pela primeira vez na Bahia a ocorrência da ataxia enzoótica (forma congênita e tardia) em caprinos e ovinos. Ressalta-se ainda que, esta doença causada por deficiência de cobre, tem cursado com grandes prejuízos aos criadores de pequenos ruminantes, sobretudo, devido à alta mortalidade dos animais acometidos.(AU)

Degenerative axonopathy associated with copper deficiency in pigs / Axonopatia degenerativa associada com deficiência de cobre em suínos

The epidemiological, clinic and morphological (pathological and ultrastructural) aspects of four outbreaks of copper deficiency affecting 21- to 90-day-old pigs in the Northeast region of Brazil are reported. Clinical signs began with paraparesis and ataxia and progressed to flaccid or spastic paralysis of the pelvic and thoracic limbs, followed by sternal and/or lateral recumbence. In addition, some animals showed dog-sitting position and intention tremors. The clinical manifestation period was 5-20 days. Significant gross lesions were not observed; however, microscopically, symmetrical degeneration of the white matter with ballooned myelin sheaths containing occasional macrophages was observed, mainly in the spinal cord. Two pigs presented with necrosis ad loss of Purkinje cells and ectopic Purkinje cells in the granular layer and cerebellar white matter. A ultrastructural analysis showed different degrees of damage of myelinated axons in the spinal segments, including an absence of the axoplasm structures with only axonal residues remaining. The myelin sheaths were degenerated and often collapsed into the space previously occupied by the axon. These results suggest that myelin degeneration is secondary to the axonal lesion. Finally, the concentration of copper in the liver was determined using atomic absorption spectrophotometry and was found to be low (ranging from 2.2 to 10.8 ppm). In conclusion, in the Brazilian semiarid region, Cu deficiency occurs in 21 to 90-day-old pigs that ingested different types of waste in their food.(AU)

São relatados os achados epidemiológicos, clínicos e morfológicos (patológicos e ultraestruturais) de quatro surtos de deficiência de cobre em suínos afetados entre 21 e 90 dias de idade na região Nordeste do Brasil. Os sinais clínicos iniciaram com paraparesia e ataxia, que progrediu a paralisia flácida ou espástica dos membros pélvicos e torácicos, seguido de decúbito esternal e/ou lateral. Além disso, alguns animais apresentaram posição de cão sentado e tremores de intenção. O período de manifestação clínica variou de 5-20 dias. Não foram observadas lesões macroscópicas significativas; no entanto, microscopicamente, foi observada degeneração simétrica da substância branca com fragmentação das bainhas de mielina, contendo ocasionais macrófagos, principalmente na medula espinal. Dois suínos apresentaram necrose e perda de células de Purkinje e células de Purkinje ectópicos na camada granular da substância branca cerebelar. A análise ultraestrutural mostrou diferentes graus de lesões em axônios mielinizados em segmentos da medula espinhal, incluindo o desaparecimento de estruturas do axoplasma, restando apenas restos axonais. A bainha de mielina encontrava-se degenerada e muitas vezes, colapsada dentro do espaço previamente ocupado pelo axônio. Esses resultados sugerem que a degeneração da mielina é secundária à lesão axonal. Finalmente, a concentração do cobre no fígado foi determinada usando espectrometria de absorção atômica e revelou baixos valores (variando de 2,2-10,8ppm). Conclui-se que na região semiárida do Brasil ocorre deficiência de cobre em suínos de 21 a 90 dias de idade alimentados com diferentes tipos de resíduos.(AU)

Magnesium, zinc and copper estimation in children with attention deficit hyperactivity disorder [ADHD]

Background: Attention deficit hyperactivity disorder [ADHD] is a common neuro developmental disorder. Evidence for dietary/nutritional treatments for [ADHD] varies widely, however recommended daily allowance of minerals and essential fatty acids is an ADHD-specific intervention

Aim of the work: To estimate magnesium, zinc and copper levels in the sera and hair of children with ADHD and compare them to normal children and also to correlate these levels with the disease symptoms

Methods: This case-control study was conducted on 20 patients with ADHD and 20 age and sex matched healthy controls. All subjects were subjected to psychiatric evaluation according to DSMIV-R, magnesium, zinc and copper estimation in serum and hair follicles. ADHD children were further assessed by the Stanford Binnet intelligence scale for children, Conners' parent rating scale, and Wisconsin's card sorting test

Results: Magnesium, zinc and copper deficiencies were found in 13 [65%], 14 [60%] and 12 [70%] of ADHD children respectively. Magnesium and zinc deficiencies were found to be correlated with hyperactivity, inattention and impulsivity. However, this correlation was not found in the copper deficient ADHD cases

Conclusion: Children with ADHD have lower levels of zinc, copper and magnesium compared to both laboratory reference ranges and to normal controls in both hair and serum. These deficiencies are correlated with the core symptoms of ADHD

Copper and magnssium deficiencies in patients wth short bowel syndrome receiviing parenteral nutrition or oral feedngg / Deficiência de cobre e magnésio em pacientes com Síndrome do Intestino Curto sob nutrição parenteral ou alimentação por via oral

Background Patients with short bowel syndrome have significant fluid and electrolytes loss. Objective Evaluate the mineral and electrolyte status in short bowel syndrome patients receiving intermittent parenteral nutrition or oral feeding. Methods Twenty two adults with short bowel syndrome, of whom 11 were parenteral nutrition dependent (PN group), and the 11 remaining had been weaned off parenteral nutrition for at least 1 year and received all nutrients by oral feeding (OF group). The study also included 14 healthy volunteers paired by age and gender (control group). Food ingestion, anthropometry, serum or plasma levels of sodium, potassium, phosphorus, magnesium, calcium, zinc, iron and copper were evaluated. PN group subjects were evaluated before starting a new parenteral nutrition cycle. Results The levels of sodium, potassium, phosphorus, calcium and zinc were similar between the groups. The magnesium value was lower in the PN group (1.0 ± 0.4 mEq /L) than other groups. Furthermore, this electrolyte was lower in the OF group (1.4 ± 0.3 mEq /L) when compared to the Control group (1.8 ± 0.1 mEq/L). Lower values of copper (69±24 vs 73±26 vs 109±16 µg/dL) were documented, respectively, for the PN and OF groups when compared to the control group. Conclusion Hypomagnesemia and hypocupremia are electrolyte disturbances commonly observed in short bowel syndrome. Patients with massive intestinal resection require monitoring and supplementation in order to prevent magnesium and copper deficiencies. .

Contexto Ressecções intestinais extensas resultam em perda de fluídos e eletrólitos. Objetivo Avaliar os níveis séricos de minerais e eletrólitos em pacientes com síndrome do intestino curto, dependentes ou não de nutrição parenteral. Métodos O estudo incluiu 22 adultos com síndrome de intestino curto, sendo 11 dependentes de nutrição parenteral (Grupo NP) e 11 sujeitos que recebiam todo aporte nutricional por via oral (Grupo VO). Foram incluídos 14 voluntários saudáveis, pareados para a idade e o gênero (Grupo Controle). A avaliação da ingestão alimentar, antropometria, níveis sanguíneos de sódio, potássio, fósforo, magnésio, cálcio, zinco, ferro e cobre foram documentados em todos os voluntários. Resultados Os níveis sanguíneos de sódio, potássio, fósforo, cálcio e zinco foram similares entre os grupos de estudo. Os níveis séricos de magnésio foram menores no Grupo NP (1,0±0,4 mEq/L) em relação aos demais grupos. Além disso, a concentração desse eletrólito foi menor no Grupo VO (1,4±0,3 mEq/L) em relação ao Grupo Controle (1,8±0,1 mEq/L). Foram documentados menores valores cobre (69±24 vs 73±26 vs 109±16 µg/dL) nos grupos NP e VO quando comparados com o Grupo Controle, respectivamente. Conclusão Hipomagnesemia e hipocupremia são distúrbios eletrolíticos comumente observados na síndrome de intestino curto. Os pacientes com ressecção intestinal extensa requerem monitorização e suplementação de magnésio e cobre a fim de prevenir deficiências. .

Prevalencia de deficiencia y consumo de hierro, zinc y cobre en mujeres chilenas en edad fértil / Prevalence of deficiency and dietary intake of iron, zinc and copper in Chilean childbearing age women

El objetivo del presente estudio es evaluar el estado nutricional e ingesta de hierro (Fe), zinc (Zn) y cobre (Cu) en mujeres chilenas en edad fértil. Se estudió una muestra de conveniencia de 86 mujeres entre 18 a 48 años de edad de la ciudad de Santiago, Chile. El estado nutricional de Fe se determinó a través de hemoglobina (Hb), volumen corpuscular medio, saturación de transferrina, zinc protoporfirina, ferritina sérica (FS), Zn y Cu séricos. La ingesta dietética fue evaluada con una encuesta de frecuencia de consumo. Un 4,7% de las mujeres presentó anemia por deficiencia de Fe, 21% deficiencia de Fe sin anemia, 26% depósitos depletados de Fe y un 48,3% estado nutricional normal de Fe. Las mujeres obesas presentaron mayores niveles de FS (p<0,01) al comparar con mujeres con peso normal. Además, presentaron niveles más altos de Hb (p<0,05) al comparar con mujeres con estado nutricional normal y sobrepeso. El 3,5% y 2,3% de las mujeres presentó deficiencia de Zn y Cu, respectivamente. El 95%, 94% y 99% cumplió el EAR para Fe, Zn y Cu, respectivamente. No se encontraron diferencias significativas en la ingesta de micronutrientes entre las mujeres al comparar por estado nutricional. En conclusión, un alto porcentaje de las mujeres presentó una ingesta adecuada de micronutrientes. Además existe una baja prevalencia de deficiencia de Zn, Cu y anemia. Sin embargo, un 47% presenta deficiencia de Fe en etapas anteriores a la de anemia.

The aim of the present study was to evaluate anemia, the biochemical status and dietary adequacy of iron (Fe), zinc (Zn) and copper (Cu), in Chilean childbearing age women. We studied a convenience sample of 86 women aged 18 to 48 years from Santiago, Chile. We determined anemia and the micronutrient status through hemoglobin (Hb) mean corpuscular volume, transferrin saturation, zinc protoporphyrin, serum ferritin (SF), serum Zn and Cu. Dietary adequacy was estimated using a food frequency questionnaire. Of all women, 4.7% had Fe deficiency (ID) anemia, 21 % ID without anemia, 26 % depleted Fe stores and 48.3% normal Fe status. Obese women had higher SF (p<0.01) compared with those classified as having normal BMI. Also, showed higher Hb (p<0.05) concentrations compared with overweight and normal weight women. Participants showed 3.5 % and 2.3 % of Zn and Cu deficiency, respectively. Also, 95 %, 94 % and 99 % had adequate intake of Fe, Zn and Cu respectively, according to EAR cut points. There were no significant differences in micronutrients intake across different nutritional status. There was a low prevalence of anemia, Fe, Zn and Cu deficiency. A high percentage of women reached micronutrient adequacy. However, 47% of women had ID without anemia and Fe depleted stores.

Deficiencia de oligoelementos durante el primer trimestre del embarazo en maracaibo, venezuela / Deficiencies of trace elements during the first trimester of pregnancy at maracaibo, venezuela

Las deficiencias de oligoelementos es un importante problema de salud pública, que pone en riesgo principalmente a las embarazadas y a sus productos; por tanto se propuso determinar las concentraciones séricas de Hierro (Fe), Zinc (Zn) y Cobre (Cu) durante el primer trimestre del embarazo e identificar las patologías asociadas con su deficiencia durante el primer trimestre del embarazo, en embarazadas que acudían a la consulta prenatal de la Maternidad Dr. Armando Castillo Plaza del Hospital Universitario de Maracaibo, Venezuela durante el año 2012. Investigación fue de tipo descriptiva y aplicada; con un diseño de tipo no experimental y prospectivo, que incluyo una muestra no probabilística e intencionada de 70 mujeres en el primer trimestre del embarazo, a las cuales se les determinaron las concentraciones séricas de Fe, Zn y Cu. Se encontró que la edad promedio fue de 20,5± 6 años; 42,85% eran adolescentes y 57,15% adultas. Se determinó una media de FE, Zn y Cu de 40,04 ± 1,212 μg/dL, 0,566 ± 0,130 μg/mL y 1,326 ± 0,878 μg/mL, respectivamente; siendo las concentraciones de Fe y Zn más bajos en las adolescentes (< 0,001). Asimismo, se demostró que el 67%, 57% y 14% de estas embarazadas presentaban deficiencia de Fe, Zn y Cu, respectivamente; sin diferencias significativas entre adolescentes o adultas (p >0,05). Se concluye que existe una alta prevalencia de deficiencias de oligoelementos (Zn, Cu y Fe) en gestantes sin patologías asociadas y aparentemente sanas al inicio de su embarazo(AU)

Deficiencies of trace elements is an important public health problem that threatens mainly pregnant women and their products; we propose to determine serum iron (Fe), Zinc (Zn) and copper (Cu) during the first trimester of pregnancy and identify the pathologies associated with a deficiency during the first trimester of pregnancy in pregnant women attending antenatal care at Maternity Dr. Armando Castillo Plaza, University Hospital of Maracaibo, Venezuela during 2012. A descriptive and applied type research, with a non-experimental and prospective design, which includes a non-probabilistic intentional sample of 70 women during the first trimester of pregnancy, which were measured in serum Fe, Zn and Cu. We found that the age mean was 20,5± 6 years; in terms of the concentrations of these trace elements was determined an average of Fe, Zn and Cu of 40,04 ± 1,212 μg/dL, 0,566 ± 0,130 μg/mL and 1,326 ± 0,878μg/mL, respectively; with concentrations of Fe and Zn lower in adolescents (<0,001). It also showed that 67%, 57% and 14% of these pregnant women were deficient in Fe, Zn and Cu, respectively; without not significant differences between adolescents and adults patients (p> 0,05). Its concluded that exist a high prevalence of deficiencies of trace elements (Zn, Cu and Fe) in patients without associated diseases and apparently healthy at the beginning of her pregnancy(AU)

Mielopatia por deficiência de cobre / Cupper deficiency myelopathy

A deficiência de cobre (CU) adquirida ganha reconhecimento como causa de anemia e neutropenia. Na última década, ela é reconhecida como produtora de mielopatia ou mieloneuropatia degenerativa, que mimetiza a deficiência de vitamina de B12, podendo apresentar-se em concomitância com essa última. Foram discutidos etiologias, fisiopatologia, diagnósticos diferenciais e tratamentos, assim como achados radiológicos caraterísticos na ressonância nuclear magnética (RNM), principalmente na imagem ponderada T2, da medula cervical e dorsal, confrontando-as com dados laboratoriais direcionados à patologia, conseguindo-se maior acurácia diagnóstica. Observou-se que o diagnóstico precoce pode reverter a doença do ponto de vista laboratorial, de imagem e neurológico ou estabilizar a progressão. Sendo assim, recomendamos incluir na pesquisa laboratorial das cirurgias bariátricas, gastrectomias, síndromes de má-absorção e na administração oral de zinco (Zn)...

Acquired copper (Cu) deficiency has been recognized to promote anemia and neutropenia. During the last decade degenerative myelopathy or myeloneuropathy diseases that can be mimicked by vitamin B12 deficiency or in another cases both of them (Cu and B12 deficiency) can coexist. We researched etiologies, physiopathology, differential diagnostic, treatment and radiologic findings in MRI, that showed high T2 signal in posterior cervical and thoracic cord and when assembled with laboratorial data we achieved accurate diagnostics. We observed that precocious diagnostic could revert the disease and improve neurologic deficit or stabilize its progression. However, we recommend laboratorial research in bariatric surgery, gastrectomy, malabsortion syndromes and high zinc levels administration...

Iron, zinc, copper and magnesium deficiencies in Mexican adults from the National Health and Nutrition Survey 2006 / Deficiencias de hierro, zinc, cobre y magnesio en adultos mexicanos. Encuesta Nacional de Salud y Nutrición 2006

OBJECTIVE: To describe the prevalence of serum iron and zinc deficiencies and low serum concentrations (LSC) of copper and magnesium in Mexican adults. MATERIALS AND METHODS: Blood samples from subjects (>20 years, both genders) participating in the 2006 National Health and Nutrition Survey were used to measure the serum concentrations of s-ferritin, soluble- transferrin-receptor (s-TfR), zinc, copper, and magnesium. RESULTS: The prevalence of s-ferritin<12ug/L was 18.1 and 3.6% while s-TfR>6mg/L was 9.5 and 4.4%, for females and males, respectively. The prevalence of zinc deficiency was 33.8% females and 42.6% males; LSC of copper were 16.8 and 18.2%, and 36.3 and 31.0% for magnesium, for females and males, respectively. CONCLUSIONS: The prevalence of deficiencies in iron (in females), and zinc are still high in the adult population. LSC of copper and magnesium are published for the first time and show significant prevalence of deficiencies. Corrective actions are necessary in order to diminish these nutritional deficits in the Mexican population.

OBJETIVO: Describir la prevalencia de deficiencias de hierro y zinc y valores bajos (VB) de cobre y magnesio en adultos mexicanos. MATERIAL Y MÉTODOS: Se utilizaron muestras de sangre de individuos (>20 años, ambos sexos) de la Encuesta Nacional de Salud y Nutrición 2006 para medir concentraciones séricas de s-ferritina, receptor soluble de transferrina (s-TfR), zinc, cobre y magnesio. RESULTADOS: La prevalencia de s-ferritina<12ug/L fue de 18.1 y 3.6%, s-TfR>6mg/L de 9.5 y 4.4% para mujeres y hombres, respectivamente. Para zinc fue de 33.8% mujeres y 42.6% hombres. Para VB de cobre fue 16.8 y 18.2%; y magnesio 36.3 y 31.0% en mujeres y hombres, respectivamente. CONCLUSIONES: Las prevalencias de deficiencia de hierro (mujeres) y zinc aún son altas en la población adulta. VB de cobre y magnesio se publican por primera vez en una muestra representativa de adultos y muestran prevalencias importantes. Son necesarias medidas correctivas para combatir estos problemas en la población mexicana.

Anemia and iron, zinc, copper and magnesium deficiency in Mexican adolescents: National Health and Nutrition Survey 2006 / Anemia y deficiencia de hierro, zinc, cobre y magnesio en adolescentes mexicanos: resultados de la ENSANUT 2006

OBJETIVE: To describe the frequency of anemia and iron, zinc, copper and magnesium deficiencies among Mexican adolescents in the probabilistic survey ENSANUT 2006. MATERIALS AND METHODS: The sample included 2447 adolescents aged 12 to 19 y. Capillary hemoglobin and venous blood samples were collected to measure the concentrations of ferritin, sTFR, CRP, zinc, iron, copper and magnesium. Logistic regression models were constructed to assess the risk for mineral deficiencies. RESULTS: The overall prevalence of anemia was 11.8 and 4.6%, body iron deficiency 18.2 and 7.9% for females and males, respectively. Overall prevalence of tissue iron deficiency was 6.9%, low serum copper were14.4 and 12.25%; zinc 28.4 and 24.5%, magnesium 40 and 35.3%; for females and males, respectively. CONCLUSIONS: There is a high prevalence of mineral deficiency in Mexican adolescents; females were more prone to have more mineral deficiencies. Nutritional interventions are necessaries in order to reduce and control them.

OBJETIVO: Describir la prevalencia de anemia y deficiencia de hierro, zinc, cobre y magnesio en adolescentes mexicanos en la encuesta probabilística ENSANUT 2006. MATERIAL Y MÉTODOS: La muestra incluyó 2447 adolescentes de 12 a 19 años de edad. Se tomó hemoglobina capilar y muestras de sangre venosa para medir las concentraciones séricas de ferritina, sTFR, CRP, zinc, hierro, cobre y magnesio. Se construyeron modelos de regresión logística para evaluar el riesgo de deficiencia de minerales. RESULTADOS: La prevalencia de anemia fue de 11.8% en mujeres y 4.6% en hombres. Las deficiencias de hierro fueron de 18.2 y 7.9% La deficiencia tisular de hierro fue 6.9%; la baja concentración de cobre fue de 14.4 y 12.25% la de zinc de 28.4 y 24.5%, la de magnesio fue 40 y 35.3% en mujeres y hombres, respectivamente. CONCLUSIONES: Existe una alta prevalencia de deficiencia de minerales en los adolescentes; las mujeres tuvieron mayor riesgo. Son necesarias intervenciones nutricionales para reducir o controlar estas deficiencias.

Prevalencia de las deficiencias de zinc y cobre en adultos mayores de la Región Metropolitana de Santiago / Prevalence of zinc and copper deficiencies in older subjects living in Metropolitan Santiago

Background: Older subjects have a high risk of developing zinc and copper deficiencies. Aim: To determine the prevalence of copper and zinc deficiencies in adults aged over 60 years, living in Metropolitan Santiago. Subjects and Methods: Analyses were performed using anonymous serum samplesfrom older subjects living in Santiago, Chile, who participated in the multicenter project SABE. Of the studied subjects, 49.3 percent had enough left over serum to measure serum zinc and copper concentrations by atomic absorption spectrometry. Results: A total of444 men and 198 women were studied. A positive correlation between serum zinc and copper was found in both women (r = 0.44, p < 0.001) and men (r = 0.48, p < 0.001). There were no differences in serum zinc concentration by sex and age. The prevalence of subnormal serum zinc valúes was 66.9 percent in women and 66.7 percent in men. Women had a significantly higher serum copper valúes than men (p < 0.02) and there were no differences by age. Prevalence of subnormal serum copper valúes was higher in women than in men (32.9 and 23.7 percent respectively, p < 0.05). Women had significantly higher copper I zinc serum ratio than men (p < 0.001). Conclusions: Older people living in Metropolitan Santiago have a high prevalence of copper and zinc deficiencies.

Efeitos da deficiência de cobre, zinco e magnésio sobre o sistema imune de crianças com desnutrição grave: [revisão] / Effects of copper, zinc and magnesium deficiency on the immune system of severely malnourished children: [review]

OBJETIVO: Esclarecer as repercussões da deficiência de cobre, zinco e magnésio sobre o sistema imune de crianças desnutridas graves. FONTES DE DADOS: Foi realizada revisão bibliográfica mediante consulta às bases de dados Pubmed Medline, Lilacs e SciELO, selecionando-se publicações científicas recentes, da última década, e representativas do tema por meio dos descritores: desnutrição infantil, cobre, zinco, magnésio e sistema imune. SÍNTESE DE DADOS: Os micronutrientes são compostos orgânicos essenciais. Além de sua função regulatória, atuam de maneira decisiva na modulação da resposta imune. Sua deficiência pode ocorrer devido à ingestão inadequada ou associada a doenças específicas. Quando associada à desnutrição, a multideficiência de minerais pode acarretar disfunções imunológicas e aumento na suscetibilidade a infecções, afetando gravemente a eficácia de intervenções terapêuticas. Cobre, zinco e magnésio atuam como cofatores de enzimas responsáveis tanto por diversas atividades metabólicas como na resposta imune inata e adquirida, além do papel importante na maturação dos tecidos e células linfoides. Sua deficiência acarreta neutropenia e linfopenia, comprometendo a imunocompetência. CONCLUSÕES: As alterações ocasionadas pelos déficits séricos dos minerais cobre, zinco e magnésio comprometem o funcionamento do sistema imune, levando à imunossupressão. A reposição desses elementos no manejo da desnutrição grave, como preconizada pela Organização Mundial da Saúde, é essencial, uma vez que tais alterações podem ser reversíveis.

OBJECTIVE: To report the effects of the deficiency of copper, zinc and magnesium on the immune system of severely malnourished children. DATA SOURCE: A literature review was performed by consulting the databases Pubmed Medline, Lilacs and SciELO, using the descriptors: child malnutrition, copper, zinc, magnesium and immune system. Representative studies published during the last decade were chosen. DATA SYNTHESIS: Micronutrients are essential organic compounds. Besides their regulatory function, the minerals act on the modulation of the immune response. Their deficiency may be due to inadequate intake or associated with specific diseases. When combined with malnutrition, a multimineral deficiency can cause immune dysfunction and increased susceptibility to infections, altering the effectiveness of therapeutic interventions. Copper, zinc and magnesium act as co-factors of both enzymes responsible for several metabolic activities and associated to the innate and acquired immune response. These minerals also play an important role in the maturation of lymphoid tissues and cells. Their deficiency causes neutropenia and lymphopenia, decreasing the immunocompetence. CONCLUSIONS: Deficits of serum copper, zinc and magnesium affect the function of the immune system, leading to immunosuppression. The replacement of these elements in the management of severe malnutrition, as recommended by the World Health Organization, is essential, since such changes may be reversible.

Elementos traço e complicações obstétricas na gestação na adolescência / Trace elements and obstetric complications in teenage pregnancy

Minerais estão relacionados com todas as etapas de crescimento e diferenciação celular. Quando a gestação coincide com a adolescência a demanda nutricional necessária para ótimo desenvolvimento e crescimento materno e fetal aumenta consideravelmente. Apesar de existirem muitos estudos sobre as funções destes micronutrientes, pouco se sabe sobre suas atuações no resultado da gestação. Este trabalho objetivou revisar na literatura o papel do cobre, ferro, e zinco no resultado da gestação, em especial de gestantes adolescentes, focando intercorrências como baixo peso ao nascer, partos pré-termo, pré-eclampsia, abortos, dentre outras complicações associadas à gestação na adolescência. Os estudos já realizados são limitados, há a necessidade de promovê-los em países em desenvolvimento, onde a deficiência de micronutrientes e intercorrências possuem altos índices. Os benefícios da suplementação de minerais na redução da prevalência de déficits e na melhora dos estoques maternos têm sido demonstrados, mas dados sobre os benefícios potenciais para o feto são pouco conclusivos.

Minerals are associated with all stages of growth and cellular differentiation. When gestation coincides with adolescence, the nutritional requirements for optimal development of the mother and fetus increase significantly. Although there are many studies on the function of micronutrients, little is known about their influence on pregnancy outcome. This work aimed to review studies that investigated the influence of copper, iron and zinc on pregnancy outcome, especially in teenagers, focusing on intercurrences such as low birth weight, preterm births, pre-eclampsia, miscarriages and other complications associated with teenage pregnancy. There are only a few studies on this topic and a need to promote them in developing countries, where high rates of micronutrient deficiencies and intercurrences are common. The efficacy of mineral supplementation in reducing deficiency rates and improving maternal reserves has been demonstrated but data on potential benefits for the fetus are not very conclusive.

Zinc y cobre séricos y la relación zinc/cobre en un grupo de niños del sur de Valencia, Venezuela / Zinc and copper in serum and zinc/copper ratio in a group of children from South Valencia, Venezuela

Se estudiaron las concentraciones séricas de zinc (Zn) y cobre (Cu), y la relación zinc/cobre (Zn/Cu) en 82 niños aparentemente sanos de 4 a 14 años de la ciudad de Valencia, Venezuela. Las concentraciones de Zn y Cu se determinaron por espectrofotometría de absorción atómica y el estado nutricional con los índices Peso/Talla, Talla/Edad e Índice de Masa Corporal. Los resultados de Zn (μg/dL), Cu (μg/dL) y la relación Zn/Cu fueron expresados en media±desviación estándar: (84,2±15,9), (125,4±24,8) y (0,69±0,18) respectivamente, sin diferencia significativa entre niños y niñas. La concentración de Cu correlacionó significativamente con la edad, siendo más baja en los niños mayores. La hipozincemia fue de 15,9% siendo las niñas (18,6%) más afectadas que los niños (13,2%) y por grupos de edad, los =11 años presentaron la mayor hipozincemia (22,2%). No se encontró hipocupremia. No hubo asociación entre las concentraciones de Zn, Cu y la relación Zn/Cu con el estado nutricional. Los resultados encontrados difieren de los hallados en otras investigaciones y la hipozincemia afectó más a las niñas y a los niños de mayor edad, mientras que no hubo hipocupremia en la muestra evaluada ni asociación entre las concentraciones de Zn, Cu y la relación Zn/Cu con el estado nutricional.

Sera levels of zinc (Zn), copper (Cu) and the ratlo zlnc/copper (Zn/Cu) were analyzed In 82 apparently healthy chlloren between 4 and 14 years of age from Valencia Clty Venezuela. The Zn (μg/dL) and Cu (μg/dL) were determlned by fíame atomic absorption spectrometry and the nutritional state was evaluated wlth Welght/Helght, Helght/Age and Body Mass index. Zn, Cu and the Zn/Cu were (Deflned by average±standard devlatlon): (84.2±15.9), (125.4 ± 24.8) and (0.69±0.18) respectlvely There was no significant diffference by gender. There was inverse and significant correlation between Cu and age. Zn deficiencies were 15.9%, and they were hígher in girls (18.6%) than in boys (13.2%). Children =11 years of age had 22.2% Zn deficiencies. There were no Cu deficiencies. No significant association was found between Zn, Cu, Zn/Cu and the nutrítíonai state. Zn, Cu ana Zn/Cu were different from those found in other investigations and hipozincemia in children affected mostiy femaies and those of oider age.

Efecto de la inflamación subclínica sobre el estado nutricional de hierro, cobre y zinc en adultos / Effects of subclinic inflammation on iron, copper and zinc nutrition status in adults

Chile is undergoing an epidemiological transition, where micronutrient deficiencies coexist with chronic diseases. The aim of this study was to determine the effect of mild infections on the prevalence of iron, copper and zinc deficiencies in apparently healthy adults. A venous blood sample was obtained from 377 apparently healthy adults, 20-55 years of age, from the south area of Peñalolén (Santiago, Chile), to measure white blood cell count, MCV and hemoglobin, free erythrocyte protoporphyrin, serum ferritin, serum copper and zinc, transaminases, and C reactive protein concentrations. The prevalence of anemia was 3.9 percent in women and 0.6 percent in men. All cases of anemia were due to iron deficiency and 20 percent of women presented depleted iron stores. Furthermore, 8.6 percent of men and 5.9 percent of women had low serum copper levels and 25.1 percent of women and 24.7 percent of men had low serum zinc concentrations. The presence of a subclinical inflammation neither modified the prevalence of anemia or the status of iron, zinc and copper in this population.

Chile se encuentra en la etapa de transición epidemiológica, en la que coexisten las deficiencias de micronutrientes con las enfermedades crónicas no transmisibles. El objetivo de este estudio fue medir el efecto de infecciones leves sobre la prevalencia de la deficiencia de hierro, cobre y zinc en adultos. Participaron 377 adultos aparentemente sanos (20-55 años), provenientes del área sur de la comuna de Peñalolén de Santiago de Chile. Se midió hemoglobina, VCM, protoporfirina libre eritrocitaria, ferritina sérica, niveles séricos de cobre y zinc, transaminasas, recuento de leucocitos y proteína C reactiva. Como resultado se obtuvo que solo el 3.9 por ciento de las mujeres y el 0,6 por ciento de los hombres presentaron anemia, todos los casos por déficit de hierro y un 20 por ciento de las mujeres mostraron depleción de depósitos de este mineral. El 8,6 por ciento de los hombres y el 5.9 por ciento de las mujeres tuvieron bajos niveles de cobre y en ambos grupos se encontraron altos porcentajes de deficiencia de zinc (25.1 por ciento en mujeres y 24,7 por ciento en hombres). El estado de inflamación sub-clínica no alteró la prevalencia de anemia o el estado nutricional de hierro, cobre y zinc en esta población.

Relation between some nutrients intake and nutritional anemia among physically handicapped children in Egypt

The most common cause of anemia is a deficiency of iron, although not necessarily a dietary deficiency of total iron intake. Deficiencies of folates [or folic acid], vitamin B[12] and protein may also cause anemia. Ascorbic acid, vitamin E, copper and pyridoxine are also needed for production of red blood cells [erythrocytes]. Vitamin A deficiency is also associated with anemia. The disability defined as a limitation of the variety of movement that can interfere with the acquisition of independence as well as hamper the child's ability to interact with the environment. The aim of the present study was to explore the prevalence of anemia and to evaluate the relation between some nutrients intake and nutritional anemia in physically handicapped children in Egypt. This study included 126 [62 boys and 64 girls] physically Handicapped aged from 6-

Prevalence of multiple micronutrient deficiencies amongst pregnant women in a rural area of Haryana.

Deficiencies of micronutrients (zinc, iron, folic acid and iodine) during pregnancy are known causes of Low Birth Weight (LBW). Studies have documented status of one or two micronutrients amongst pregnant women (PW). However, no attempt has been made to concurrently assess the prevalence of multiple micronutrient deficiencies and the factors associated with them amongst PW. OBJECTIVE: The present study was undertaken to assess the prevalence of multiple micronutrient deficiencies amongst PW in a rural area. METHODS: A community based cross sectional survey was conducted in six villages of a rural area of district Faridabad in Haryana state, India during November 2000 and October 2001. All PW aged 18 years or more, with pregnancy duration of more than 28 weeks were enrolled. Data were collected on socio-economic status and other demographic parameters. Serum zinc, copper and magnesium levels were estimated by utilizing the Atomic absorption spectrophotometry (AAS); serum ferritin and folate was estimated by Enzyme Linked Immuno Sorbent Assay (ELISA) method and the Radio-Immuno Assay (RIA) method, respectively and serum thyroid stimulating hormone (TSH) level was estimated by the Abbot AxSYM System. Serum zinc, copper, magnesium, ferritin, and folate levels less than 70.0 microg/dl, 80.0 microg/dl, 1.80 mg/dl, 15 ng/ml, and 3 ng/ml, respectively were considered as indicative of deficiency for respective micronutrients. The TSH levels of 4.670 and more indicated iodine deficiency status. Dietary intake of micronutrients was assessed utilizing 1-day 24-hour dietary recall methodology. Food consumption pattern was assessed utilizing the food frequency questionnaire methodology. RESULTS: Nearly 73.5, 2.7, 43.6, 73.4, 26.3, and 6.4 percent PW were deficient in zinc, copper, magnesium, iron, folic acid and iodine, respectively. The highest concurrent prevalence of two, three, four and five micronutrient deficiency was of zinc and iron (54.9%); zinc, magnesium and iron (25.6%); zinc, magnesium, iron and folic acid (9.3%) and zinc, magnesium, iron, folic acid and iodine (0.8%), respectively. No pregnant woman was found to have concomitant deficiencies of all the six micronutrients. Dietary intake data revealed an inadequate nutrient intake. Over 19% PW were consuming less than 50% of the recommended calories. Similarly, 99, 86.2, 75.4, 23.6, 3.9 percent of the PW were consuming less than 50% of the recommended folic acid, zinc, iron, copper, and magnesium. The consumption of food groups rich in micronutrients (pulses, vegetables, fruits, nuts and oil seeds, animal foods) was infrequent. Univariate and Multivariate logistic regression analysis revealed that low dietary intake of nutrients, low frequency of consumption of food groups rich in micronutrients and increased reproductive cycles with short interpregnancy intervals were important factors leading to micronutrient deficiencies. CONCLUSION: There was a high prevalence of micronutrient deficiencies amongst the PW of the area, possibly due to the poor dietary intake of food and low frequency of consumption of food groups rich in micronutrients. The concurrent prevalence of two, three, four and five micronutrient deficiencies were common.

Análise comparativa entre as imagens convencionais de ressonância magnética do encéfalo e a espectroscopia de prótons na doença de Wilson / The comparative analysis between magnetic resonance imaging of the brain and proton spectroscopy in Wilson's disease

A doença de Wilson (DW) é rara, causada por distúrbio no metabolismo do cobre. Avaliamos 36 pacientes com DW usando a espectroscopia de prótons por ressonância magnética em três locais do cérebro; comparamos com um grupo controle e observamos que os pacientes apresentaram: redução da relação NAA/Cr nos três locais, indicando perda neuronal; aumento da relação mI/Cr nos núcleos da base (NB), sugerindo gliose; e aumento da largura média dos picos nos NB, por deposição de ferro e cobre / Wilson’s disease (WD) is rare, caused by a disturbance in copper metabolism. We evaluated 36 WD patients using proton magnetic resonance spectroscopy in three areas of the brain; compared to a control group. We found that patients presented with: decrease in NAA/Cr ratio in the three studied areas...

Some biochemical and haematological alterations in hypocupremic ewes and a trial for treatment

A total number of 42 ewes [local breed], 2-5 years old, was selected from a flock containing 250 heads and used in this study. The animals were grazed in free pasture at El-Tall El-Kebir region, Ismailia Governorate. The pastures were improved using azotic urea and lime superphosphate as fertilizers. After the clinical and parasitological examination of the blood, feces and skin, the ewes were divided into two groups [20 healthy controls, group A, and 22 hypocupremic ewes manifested by alopecia and wool abnormalities, group B]. It was concluded that the biochemical analysis of the biological samples of sheep is a reliable tool for the early diagnosis of some nutritional deficiency disorders and cupric glycinate is an effective treatment for hypocupremic sheep

Modelo experimental para el estudio de la molibdenosis y de la deficiencia primaria de cobre en ratas / Experimental model for the study of molybdenosis in the primary copper deficiency in rats

Con el objetivo de diferenciar los efectos producidos por la deficiencia primaria cobre y los provocados por el excesso de molibdeno se evaluó un modelo experimental en ratas. Sesenta ratas de destete (30 machos y 30 hembras) recibieron una dieta compuesta por 70 por ciento de leche entera en polvo (1 ppm Cu) y 30 por ciento de harina de maíz (0.8 - 1.5 ppm Cu). Los animales se dividieron en tres grupos conforme a la suplementación mineral recibida: deficiencia primaria de cobre (40 ppm Fe), molibdenosis (40 ppm Fe + 40 ppm Cu + 500 ppm Mo) y controles (40 ppm Fe + 40 ppm Cu). Se pesaron cada 14 días. Al cabo de 70 días de tratamiento se obtuvieron muestras de sangre para determinación de hematocrito y actividad sérica de ceruloplasmina y se sacrificaron para medir concentraciones hepáticas de Cu y Mo. El grupo deficiente en Cu tuvo valores significativamente inferiores en la actividad de ceruloplasmina. Las concentraciones hepáticas de Cu y Mo fueron superiores significativamente en los animales con molibdenosis. Se concluye que con niveles de Cu por encima de los requerimientos mínimos, la alimentación con alto contenido de Mo, no afecta la actividad sérica de ceruloplasmina. Esto sumado a la concentración hepática de Mo lograda, permitirá identificar efectos "per se" de la molibdenosis.