Vitaminas B neurotrópicas y neuropatía periférica: estado del arte y acuerdo de expertos / Neurotropic B vitamins and peripheral neuropathy: State of the art and agreement of experts

Propósito: La neuropatía periférica tiene un espectro clínico inespecífico y multifactorial, con frecuente subdiagnóstico y terapéutica de eficacia variable. Existe una heterogénea prescripción de vitaminas B, las cuales pueden desempeñar un rol importante en el manejo de diferentes neuropatías; sin embargo, en Colombia no existen guías clínicas al respecto. El propósito de este trabajo es orientar en el reconocimiento temprano de las neuropatías periféricas y generar recomendaciones sobre el uso adecuado de vitaminas B neurotrópicas. Descripción de la metodología: Acuerdo de expertos sobre la neuropatía periférica y el rol terapéutico de las vitaminas B con énfasis en la epidemiología en Colombia, diagnóstico y tratamiento. Contenidos: En Colombia, la prevalencia de neuropatía periférica se estima cercana al 10 %, sin embargo, no hay datos recientes. Dentro de las etiologías más frecuentes se encuentran la neuropatía diabética, infecciosa, inflamatoria, carenciales, toxica y farmacológica. Se recomiendan las siguientes herramientas de tamizaje en población de riesgo: DN4, MNSI, test de monofilamento, test de vibración y valoración de reflejos. Las vitaminas B1, B6 y B12 son seguras, accesibles y pueden ser eficaces en neuropatía periférica, incluso cuando el déficit no ha sido demostrado, pero con requerimientos particulares en su administración conjunta. Conclusiones: Las neuropatías periféricas son un reto diagnóstico y terapéutico que requiere la identificación oportuna para el tratamiento de la etiología subyacente y el control de síntomas. El uso de vitaminas B neurotrópicas es efectivo y seguro en neuropatía periférica carencial, y también parece ser eficaz en el manejo de neuropatías periféricas de diferentes etiologías.

Purpose: Peripheral neuropathy has a nonspecific and multifactorial clinical spectrum, with frequent underdiagnosis and therapeutics of variable efficacy. There is a high but heterogeneous prescription of B vitamins, which can play an important role in the management of different neuropathies; however, in Colombia there are no clinical guidelines in this regard. The purpose of this article is to guide the early recognition of peripheral neuropathy and generate recommendations on the proper use of neurotropic B vitamins. Description of the methodology: Expert agreement on peripheral neuropathy and the therapeutic role of B vitamins with emphasis on epidemiology in Colombia, diagnosis and treatment. Contents: In Colombia, there are no recent data to estimate the prevalence of peripheral neuropathy; the main etiologies are: diabetes mellitus, nutritional deficiencies, herpes zoster and neuropathies due to chemotherapy. Given risk factors in the anamnesis, the use of DN4, MNSI, monofilament test, vibration test and assessment of reflexes is recommended. Vitamins B1, B6, and B12 are safe and can be effective in peripheral neuropathy, even when the deficit has not been demonstrated, but with special requirements in their joint administration. Conclusions: peripheral neuropathies are a diagnostic and therapeutic challenge, and require timely identification, for the treatment of the underlying etiology and symptom control. The use of neurotropic B vitamins is effective and safe in deficient peripheral neuropathy, and also appears to be effective in the management of peripheral neuropathies of different etiologies.

O uso do cloridrato de piridoxina para induzir estro em cadelas / The use of pyridoxine chloridrate to induce estrus in female dogs

Os agonistas dopaminérgicos são utilizados para induzir estro em cadelas, pois atuam na síntese e liberação de prolactina. Objetivou-se avaliar o efeito da piridoxina como indutor de estro em cadelas por agir na neurotransmissão dopaminérgica. Foram selecionadas 40 cadelas em anestro, divididas em quatro grupos experimentais, tratadas com 10mg/kg/dia (G1) e 50mg/kg/dia (G2) de cloridrato de piridoxina, 5µg/kg/dia (G3) de cabergolina e grupo controle/placebo (G4) por até 20 dias. Foram realizadas citologias vaginais a cada 24h para acompanhamento do ciclo estral e análises hormonais (FSH, LH e PRL) no dia zero e 120h do início do tratamento. As cadelas do G3 (100%) manifestaram proestro após 12 dias de tratamento aproximadamente, tempo inferior aos demais grupos (P<0,05). Apenas uma cadela do G1 e uma do G2 ficaram gestantes contra oito fêmeas do G3 e nenhuma do G4 (P<0,05). As concentrações plasmáticas de prolactina foram reduzidas nas fêmeas do G2 e G3 (P<0,05). As demais avaliações hormonais não sofreram influência do tratamento (P>0,05). O cloridrato de piridoxina foi ineficiente para induzir estro em cadelas, mas foi capaz de suprimir a prolactina, de forma semelhante à cabergolina, quando utilizado na dose de 50mg/kg/dia.(AU)

Dopaminergic agonists are used to induce estrus in female dogs as they act in the synthesis and release of prolactin. The objective of this study was to evaluate the effect of pyridoxine as an inducer of estrus by acting on dopaminergic neurotransmission. A total of 40 female dogs in anestrous were divided into four experimental groups treated with 10mg/kg/day (G1) and 50mg/kg/day (G2) of pyridoxine hydrochloride, 5µg/kg/day (G3) of cabergoline and control group/placebo (G4) for up to 20 days. Vaginal cytologies were performed every 24h for follow-up of the estrous cycle and hormonal analyzes (FSH, LH and PRL) on day zero and 120 hours after the start of treatment. The female dogs from G3 (100%) showed proestrus after 12 days of treatment, less time than the other groups (P< 0.05). Only one female from G1 and one from G2 were pregnant against eight from G3 and none from G4 (P< 0.05). Plasma concentrations of prolactin were reduced by treatment in females from G2 and G3 (P< 0.05). The other hormonal evaluations were not influenced by the treatment (P> 0.05). Pyridoxine chloridrate was inefficient to induce estrus in female dogs but was able to suppress prolactin when used at a dose of 50mg/kg/day.(AU)

Screening Moringa species focused on development of locally available sustainable nutritional supplements

BACKGROUND/OBJECTIVES: The leaves of Moringa oleifera (MO) and Moringa stenopetala (MS) commonly grown in Ethiopia possess potential nutritional and medicinal value. The aim of this study was to evaluate the nutritional and functional characteristics of the dried leaf powder from two Moringa species to develop sustainable nutritional supplements for Ethiopians from locally grown plant sources. SUBJECTS/METHODS: Freshly harvested and air-dried MO and MS leaves were authenticated and the nutritional contents, such as protein, ash, lipids, and selected vitamins and minerals, were analyzed using standard analytical procedures. Amino acid compositions were also determined by an amino acid analyzer. Nine-week-old mice were randomly divided into four groups to investigate the anti-obesity effects of Moringa. The first group was fed a basal diet, the second group a high-fat diet, and the others were fed a high-fat diet containing 0.1% Moringa leaf powder from each species. After seven weeks, serum indices related to lipid profiles from each mouse were analyzed. RESULTS: The present study revealed high protein (28–29%) and ash (7–11%) contents. Glutamic acid, aspartic acid, proline, and leucine were the most abundantly found amino acids in both species. The predominant minerals in the leaf powder were calcium (826–1,530 mg/100 g), potassium (794–904 mg/100 g), and magnesium (286-431 mg/100 g). Pyridoxine (475.06 mg/100 g) and vitamin E (34.2 mg/100 g) were found only in MS. Niacin was found only in MO at 32.21 mg/100 g, whereas ascorbic acid was found in both species (3.89 and 6.19 mg/100 g dry weight for MO and MS, respectively). The results of the animal study showed that mice on a high-fat diet containing 0.1% MO leaf powder alleviated the elevation of cholesterol, triglycerides, and low-density lipoprotein cholesterol induced by the high fat diet. MO was more effective than MS in preventing hypercholesterolemia and fat deposition. CONCLUSIONS: The findings in this work confirmed that Moringa leaves of both MO and MS possessed high nutritional value but MO was better at preventing the harmful effects of the high-fat diet than MS.

Sensory Polyneuropathy Associated with Pyridoxine Overdose

Pyridoxine deficiency and excess have both been implicated as causes of peripheral neuropathy. A 74-year-old man presented with paresthesia in both legs that first appeared 2 months previously. A nerve conduction study revealed axonal sensory polyneuropathy. He had consumed 100 milligrams of pyridoxine every day for 1 year, in the form of vitamin tablets. His blood levels of vitamin B6 were markedly elevated to above 250 nmol/L. This case indicates that the consumption of high-dose pyridoxine can cause sensory polyneuropathy.

Two Cases of External Ophthalmoplegia after Vincristine Treatment in Childhood

PURPOSE: To report 2 cases of extraocular muscle paresis with ptosis after vincristine treatment in childhood with acute leukemia. CASE SUMMARY: A 4-year-old girl with acute lymphoblastic leukemia experienced diplopia, esotropia and bilateral ptosis after intravenous vincristine treatment. Ptosis improved after two weeks of pyridoxine treatment with vincristine reduction. After 2 months, left abduction defect and ptosis completely disappeared with pyridoxine treatment. A 23-month-old boy with acute lymphoblastic leukemia had bilateral ptosis with worsening pre-existing infantile esotropia after intravenous vincristine treatment. Bilateral ptosis resolved and esotropia improved after vincristine reduction with pyridoxine treatment for 2 months. CONCLUSIONS: We observed extraocular muscle paresis and ptosis after vincristine treatment for acute leukemia in pediatric patients. Physicians should be suspicious of toxic neuropathy related to vincristine treatment when patients have extraocular ophthalmoplegia, and physicians should know that vincristine reduction with pyridoxine supplement may be helpful.

Convulsiones por isoniazida: una causa toxicológica a considerar / Isoniazid seizures: A toxicological cause to consider

La neurotoxicidad de la isoniazida (INH) frecuentemente no es tenida en cuenta por el pediatra ante un paciente con un cuadro convulsivo agudo. La INH es uno de los fármacos más indicados en el tratamiento y quimioprofilaxis de la tuberculosis. Habitualmente se la indica al grupo familiar, debido a las características epidemiológicas de esta enfermedad, lo cual permite una amplia disponibilidad en los hogares, pudiendo originar intoxicaciones accidentales o intencionales. La intoxicación severa se caracteriza por un cuadro neurotóxico agudo, expresado en un síndrome convulsivo o coma, que no cede con el tratamiento habitual. Se presenta un caso clínico de una paciente intoxicada grave con isoniazida, habiendo sido la anamnesis dirigida ampliada junto con un diagnóstico precoz y el tratamiento específico con el antídoto, la base fundamental para la evolución favorable de la paciente.

Pediatricians do not usually considered isoniazid (INH) neurotoxicity in cases of patients with severe seizure disorders. INH is one of the most suitable drugs in the treatment and chemoprophylaxis of tuberculosis. It is usually indicated to the family group, due to the epidemiological characteristics of this disease, allowing a wide availability in homes and being able to cause accidental or intentional poisoning. An acute neurotoxic picture, expressed as a convulsive syndrome or coma, which does not improve with the usual treatments, characterized severe intoxication. A case of a patient with severe intoxication with isoniazid is presented. The extended anamnesis, along with an early diagnosis and the specific antidote treatment, set the fundamental basis for the favorable evolution of the patient.

Screening Molecular Chaperones Similar to Small Heat Shock Proteins in Schizosaccharomyces pombe

To screen molecular chaperones similar to small heat shock proteins (sHsps), but without alpha-crystalline domain, heat-stable proteins from Schizosaccharomyces pombe were analyzed by 2-dimensional electrophoresis and matrix assisted laser desorption/ionization time-of-flight mass spectrometry. Sixteen proteins were identified, and four recombinant proteins, including cofilin, NTF2, pyridoxin biosynthesis protein (Snz1) and Wos2 that has an alpha-crystalline domain, were purified. Among these proteins, only Snz1 showed the anti-aggregation activity against thermal denaturation of citrate synthase. However, pre-heating of NTF2 and Wos2 at 70degrees C for 30 min, efficiently prevented thermal aggregation of citrate synthase. These results indicate that Snz1 and NTF2 possess molecular chaperone activity similar to sHsps, even though there is no alpha-crystalline domain in their sequences.

Suplementação mineral e vitamínica em doenças crônicas e de convalescença / Mineral and vitamin supplementation in chronic diseases and convalescence

A síndrome de fadiga crônica (SFC) é uma condição clínica que, apesar de muito prevalente, tem tratamento controverso. A suplementação com substratos como glutamina e vitaminas pode atuar como adjuvante terapêutico. Os autores descrevem um medicamento que pode atender essa finalidade, composto por glutamina 200mg, glutamato de cálcio 250mg, cloridrato de piridoxina 20mg e fosfato de ditetraetilamônio 6mg. São descritas também as ações de cada um dos componentes, e como podem auxiliar na terapêutica da SFC e em períodos de convalescença em diversas condições.

The chronic fatigue syndrome (CFS) is a clinical condition which, although highly prevalent, treatment is controversial and supplementation of substrates such as glutamine and vitamins can act as therapeutic adjuvant. A drug composition that can serve this purpose, the composition is glutamine 200mg, 250mg calcium glutamate, 20mg pyridoxine hydrochloride and phosphate ditetraetilammonium 6mg is described. Also described the actions of each component and how they can assist in the treatment of CFS and in periods of convalescence from various other conditions described.

Effects of nutrition education on nutrition-related knowledge, dietary habits, and nutrient intakes of alcoholic patients / 한국영양학회지

PURPOSE: The aim of this study was to examine the characteristics of nutrition-related knowledge, dietary habits, and nutrient intakes of alcoholic patients and how nutrition education affects these nutritional behaviors. METHODS: Subjects included 37 adult male alcoholic patients who were hospitalized. The nutrition education program consisted of five lessons over a five-week period. An each 80-minute nutrition education program per week was implemented for the alcoholic patients over a five-week period. Both before and after the implementation of nutrition education, their nutrition-related knowledge and dietary habits were assessed and nutrient intakes were investigated. RESULTS: The subjects showed drinking habits of considerably high frequency, a large quantity of alcohol consumption, and preference for soju (a liquor) over beer. They had proper weight, height, and BMI, and came from relatively poor socioeconomic backgrounds with a low-level of self-rated health status and a comparatively high rate of suffering from disease. Mean score of their nutrition-related knowledge and dietary habits was quite low. They consumed less energy, dietary fiber, vitamin C, thiamin, riboflavin, folic acid, Ca, and K, but more Na compared to each Dietary Reference Intake (DRI). After implementing the nutrition education, mean score of nutrition-related knowledge and dietary habits showed significant improvement. In addition, the meeting rate of each DRI of several nutrients was increased significantly, including energy, carbohydrate, dietary fiber, vitamins A, C, and B6, thiamin, riboflavin, niacin, pyridoxine, folic acid, Ca, P, K, Fe, and Zn, while that of Na decreased. CONCLUSION: The findings of this study indicate that alcoholic patients had various nutritional problems, such as lack of nutrition-related knowledge, bad dietary habits, and insufficient nutrient intakes, however, these problems can be positively modified by implementation of a relatively short-term nutrition education program.

A Case of Seizure and Metabolic Acidosis Due to Renal Adjustment Dosage of Isoniazid in an Elderly Woman / 고신대학교의과대학학술지

Isoniazid is one of the most commonly used antituberculosis drug. Acute into xication is characterized by repetitious convulsions, high anion gap metabolic a cidosis and coma. The basis of theraphy consists of parental pyridoxine admi nistration in a dose equivalent to that of isoniazid ingested. Here we present a case of seizure and metabolic acidosis due to only renal adjustment dosage of Isoniazid in an elderly woman.

Effect of Potassium Magnesium Citrate and Vitamin B-6 Prophylaxis for Recurrent and Multiple Calcium Oxalate and Phosphate Urolithiasis

PURPOSE: To study the effects of long-term treatment with potassium magnesium citrate and vitamin B-6 prophylaxis (Urikind-KM6; 1,100-mg potassium citrate, 375-mg magnesium citrate, and 20-mg pyridoxine hydrochloride/5 mL) every 8 hours over 3 years. MATERIALS AND METHODS: A total of 247 patients with recurrent idiopathic hypocitraturia with or without hyperuricosuria and randomized controls were studied prospectively for 3 years. The total patients were divided into three groups. Control group 1 consisted of 61 patients (24.7%) who had moderate to severe hypocitraturia with or without hyperuricosuria and were recurrent stone formers but discontinued prophylaxis because of drug intolerance within 1 month of therapy. Control group 2 constituted 53 patients (21.5%) who were first-time stone formers and who had mild hypocitraturia with or without hyperuricosuria and were not put on prophylactic therapy and were followed for 3.16+/-0.08 years. Control group 3 constituted 133 patients (54.8%) who were recurrent stone formers who had moderate to severe hypocitraturia with or without hyperuricosuria and were put on prophylaxis therapy and were followed for 3.16+/-0.08 years. All patients were followed up at 6-month intervals. RESULTS: Potassium magnesium citrate prophylaxis produced a sustained increase in 24-hour urinary citrate excretion from initially low values (221.79+/-13.39 mg/dL) to within normal to high limits (604.04+/-5.00 mg/dL) at the 6-month follow-up. Urinary pH rose significantly from 5.62+/-0.2 to 6.87+/-0.01 and was maintained at 6.87+/-0.01. The stone recurrence rate declined from 3.23+/-1.04 per patient per year to 0.35+/-0.47 per patient per year. CONCLUSIONS: Potassium magnesium citrate prophylaxis was effective in reducing the recurrence of calcium oxalate and phosphate urolithiasis.

Medicamentos antieméticos no tratamento da náusea e vômitos associados à gestação / Antiemetic medications in the treatment of nausea and vomiting associated with pregnancy

Náusea e vômitos (NV) são os sintomas mais comuns durante a gravidez, geralmente iniciando-se entre a 6ª e a 8ª semana, atingindo a intensidade máxima em torno da 9ª semana e resolvendo-se até a 12ª semana. Embora sua etiologia seja, provavelmente, multifatorial, seu curso clínico se correlaciona com as concentrações plasmáticas da gonadotrofina coriônica humana. Por comprometerem a qualidade de vida, NV devem ser abordados com modificações dietéticas que incluem dieta fracionada e redução do consumo de alimentos gordurosos, entre outras. O uso de piridoxina pode melhorar a náusea de intensidade leve, embora não diminua significantemente os episódios de vômitos. Os anti-histamínicos são os medicamentos mais utilizados como terapia medicamentosa de primeira linha e têm sua segurança comprovada; dentre eles, o dimenidrinato determina início de ação mais rápido e menor sedação que a meclizina. Entre os antagonistas dopaminérgicos, a prometazina e a metoclopramida podem ser utilizadas, mas apresentam como desvantagem o potencial de eventos adversos maternos. O antagonista dos receptores 5-HT3, ondansetrona, pode ser considerado quando outros medicamentos não foram efetivos no tratamento de NV de intensidade grave. Do mesmo modo, os corticosteroides devem ter seu uso reservado para casos não responsivos a outros medicamentos e preferencialmente após a 10ª semana de gestação...

Vitamin B[6]: Deficiency diseases and methods of analysis

Vitamin B[6] [pyridoxine] is closely associated with the functions of the nervous, immune and endocrine systems. It also participates in the metabolic processes of proteins, lipids and carbohydrates. Pyridoxine deficiency may result in neurological disorders including convulsions and epileptic encephalopathy and may lead to infant abnormalities. The Intravenous administration of pyridoxine to patients results in a dramatic cessation of seizures. A number of analytical methods were developed for the determination of pyridoxine in different dosage forms, food materials and biological fluids. These include UV spectrometric, spectrofluorimetric, mass spectrometric, thin-layer and highperformance liquid chromatographic, electrophoretic, electrochemical and enzymatic methods. Most of these methods are capable of determining pyridoxine in the presence of other vitamins and complex systems in micro g quantities. The development and applications of these methods in pharmaceutical and clinical analysis mostly during the last decade have been reviewed

The Experiences of the Emergency Antidote Stock and Delivery Service by the Korean Poison Information Center

PURPOSE: Antidotes for toxicological emergencies can be life-saving. However, there is no nationwide stocking and delivery system for emergency antidotes in Korea. We report on a two-year experience of a nationwide stocking and delivery trial for emergency antidotes at emergency departments in Korea. METHODS: An expert panel of clinical toxicologists reviewed and made a list of 15 stocked antidote. These antidotes were purchased or imported from other countries and delivered from 14 antidote stocking hospitals nationwide 24 hours per day, seven days per week. RESULTS: From August 1, 2011 to April 30, 2013, 177 patients with acute poisoning, with a median age of 48.5 years, were administered emergency antidotes. The causes of poisoning were intentional in 52.0% and 88.0% were intentional as a suicide attempt. Regarding clinical severity, using the poisoning severity score, 40.7% of patients had severe to fatal poisoning and 39.0% had moderate poisoning according to clinical severity. The most frequent presenting symptom was neurologic deficit, such as altered mentality (62.7%). alerted mentality (62.7%). Emergency antidotes were administered as follows: methylene blue (49 cases), flumazenil (31), N-acetylcysteine (25), glucagon (17), 100% ethanol (15), cyanide antidote kit (12), anti-venin immunoglobulin (5), pyridoxine (4), hydroxocobalamine (2), and deferoxamine (1). The median time interval from antidote request to delivery at the patient's bedside was 95 minutes (interquartile range 58.8-125.8). CONCLUSION: Findings of this study demonstrated the possibility of successful operation of the nationwide system of emergency antidotes stocking and delivery in Korea.

Factors Related to Calceneal Broadband Ultrasound Attenuation, Anthropometric Indexes and Nutrient Intakes among Elementary School Children in Chungnam / 대한지역사회영양학회지

Variables affecting bone heath of growing children were analyzed among forty nine 10-12 year old elementary students in three rural regions of north west Chungnam area. Information on age of the parents, duration of breast feeding and birth weight were collected from the guardians of the participants and nutrient intake and diet quality were assessed by average of three-day food records of participants with the help of dietitians. Bone health status was measured by calceneal broadband ultrasound attenuation (BUA) using quantitative ultrasound (QUS). Results showed that anthropometic indexes and nutrient intake levels were not different between boys and girls. However, iron intake was significantly lower in girls than in boys. Girls after menarche showed lower intake levels for thiamin, riboflavin, pyridoxine and niacin than girls before menarche. z-scores of BMI were lower than -1 and higher than +1 showed shorter breast feeding period than others but the difference was statistically non-significant. Overall, the subjects did not consume enough s of calcium, vitamin C and folic acid. Zinc intake and BMI were the most significant factors affecting BUA by the results of backward elimination in multiple regression models. Phosphorous and beta-carotene intakes showed significant negative relation with BUA. This study showed that children living in the rural area of Chungnam need extra care to keep their health and nutrient intakes especially for the nutrients known to affect growth. Tailored nutrition education needs to be more focused on the improvement of bone health status of children.

Measuring Differences in Food Iintakes and Dietary Habits of Preschool Children by the Weight-Length Index

This study was conducted to obtain data and offer advice regarding dietary intake at kindergarten and to recommend dietary habits to prevent childhood obesity. The study was conducted in 85 children aged 4 to 5 years. Body weight and height, dietary intakes of lunch served at Kindergarten and questionnaires for dietary behaviors in Kyeongnam area were studied. All subjects were classified by their weight-length index (WLI). According to the standard WLI values, 41.2% of the children were within the normal value (90 or =120). The mean energy intake at lunch for kindergarteners was 287.1+/-13.4 kcal in the normal group, 307.6+/-10.2 kcal in the overweight group and 323.7+/-8.6 kcal in the obese group. The percent energy of estimated energy requirement (EER) was 21.8%. The intake of protein, iron, zinc, vitamin A, and pyridoxine were significantly different by WLI (P<0.05). A comparison of nutrients in the lunch menu provided with those of 1/3 recommended intake (RI) showed that preschoolers took in fewer calories, calcium, and vitamin B2, and that their deficiency rates were high (81.2%, 76.5% and 70.6% of recommended levels, respectively). There was a significant difference in the preference of fruits and milk and dairy products by WLI. Therefore, a nutritional education program and new guidance in the proper nutrition management for kindergarteners should be developed to enhance nutritional status during childhood.

Clinical Characteristics and Outcomes of Neonatal Seizures

PURPOSE: Neonatal seizures are one of the most common neurologic manifestations in neonates and could be the important clinical sign of underlying brain disorders. The aim of this study is to review the clinical characteristics and to find the prognostic factors related to the outcomes of neonatal seizures. METHODS: We reviewed medical records retrospectively in 23 patients with neonatal seizures who admitted to Dankook University Hospital from July 2007 to June 2009. RESULTS: During the study period, neonatal seizures were diagnosed in 23/1,474 (1.56%) neonates. Nineteen of them (82.6%) were term and 4 were preterm. The main cause of neonatal seizures was hypoxic ischemic encephalopathy (n=8, 35%). Other various causes included metabolic disorders (n=4, 17%, carnitine palmitoyl transferase 1 deficiency, severe hypernatremic dehydration, prolonged severe hypoglycemia, and pyridoxine dependent seizure), intracranial hemorrhages (n=2, 9%), congenital brain anomaly (callosal dysgenesis, hemimegalencephaly) (n=2, 9%), and infection (congenital syphilis, early neonatal sepsis, n=2, 9%). Among nineteen neonates (82.6%) who were treated with anticonvulsants, we could not stop the anticonvulsants in six of them (32%). They had severe HIE, prolonged severe hypoglycemia with residual encephalomalatic changes, sinovenous thrombotic hemorrhages due to antithrombin III deficiency, congenital brain anomaly, and septic shock, respectively. CONCLUSION: Approximately one third of neonatal seizures were caused by HIE, and moderate to severe HIE had more serious outcomes. Neonatal seizure could be a significant clinical sign indicating specific underlying etiologies such as stroke, metabolic disturbances or congenital brain anomalies. Therefore, intensive workup and prompt management for neonatal seizures should be considered for better outcomes.

Pyridoxine in the Treatment of Peripheral Nerve Related Foot Pain / 대한족부족관절학회지

PURPOSE: We analyzed retrospectively the effect of pyridoxine in the treatment of peripheral nerve related foot pain because we have seen favorable clinical results from it as a monotherapy. MATERIALS AND METHODS: We analyzed the clinical results of 200 cases of peripheral nerve related foot pain, treated with pyridoxine from March 2009 to February 2012. We devided them into three groups, peripheral neuritis, Morton's neuroma and posttraumatic neuralgia and recorded percentage of improvement of pain, compared to initial pain level at 2 weeks and 6 weeks. RESULTS: There were 127 peripheral neuritis cases, 22 Morton's neuroma and 51 posttraumatic neuralgia. At 2 weeks after treatment, 135 cases(67.5%) showed pain relief. At 6 weeks, 36 cases(21%) showed complete improvement of pain, 81 cases(47%) showed more than 50% of improvement, 22 cases(13%) showed less than 50% of improvement and 33 cases(19%) showed no improvement. There are 4 cases of gastrointestinal discomfort and 2 cases of aggravation of nervy pain. CONCLUSION: Pyridoxine was effective drug in the treatment of peripheral neuropathic pain in terms of pain relief, safety and cost effectiveness. So it can be an available first line drug before adding other drugs.

Lipid profiles of rats fed with diets supplemented with vitamins niacin and pyridoxine

Hypercholesterolemia is a major risk factor for cardiovascular disease. Supplements containing the vitamins niacin (B3) and pyridoxine (B6) can promote the reduction of total cholesterol and an increase in HDL cholesterol. In this study, the effects of diets supplemented with niacin (B3) and pyridoxine (B6) on the hepatic and serum lipid profiles of Wistar rats were assessed. The diets were prepared with combinations of three concentrations of niacin (3, 4 and 5 g/kg) and pyridoxine (6, 12 and 18 mg/kg) and one with neither vitamin. The animals were divided into eleven experimental groups of six animals per group, and nine groups were fed on a standard diet with 7.5% fat and vitamin supplementation. Another group was fed with 7.5% fat without vitamin supplements. A control group received the standard diet (AIN-93M) without modifications (4% fat). The weight gain, food intake, serum and hepatic total cholesterol, serum cholesterol fractions (HDL, LDL, and VLDL), serum and hepatic triacylglycerols and hepatic and fecal lipid contents were measured after 30 days. The diet with the highest concentration of niacin and lowest concentration of pyridoxine had the lowest level of total hepatic cholesterol. Hepatic triacylglycerols were reduced by the highest concentration of niacin (5 g/kg), and this reduction was enhanced by increasing the pyridoxine concentration. The diets supplemented with niacin and pyridoxine reduced the levels of serum total cholesterol, LDL, VLDL, triacylglycerols and hepatic lipids. These effects on the lipid profile varied with the concentrations of the two vitamins and the interactions between them.