Troxerutin protects the isolated perfused rat liver from a possible lipid peroxidation by coumarin.

For more than 40 years coumarin has been successfully used in the therapy of chronic venous insufficiency (CVI). The occurrence of liver injuries is rather rare and happens predominantly when doses are administered which are significantly higher than necessary for therapeutical use. Such effects caused by high coumarin concentrations are reproducible in in vivo experiments in mice or rats and HepG2-cells. In order to characterize the mechanism of liver injuries, the isolated perfused rat liver has been chosen as model. Since liver injuries are quite rare, if coumarin is used in co-medication with troxerutin, a possible protective influence of this flavonoid has been investigated. In concentrations higher than 4 mmol/l, coumarin alone is effective in the isolated perfused rat liver. Then the release of the enzymes alanine aminotransferase (ALT) and lactate dehydrogenase (LDH) increases and there is a measurable reduction of perfusion flow, oxygen consumption and rate of bile secretion. Additionally, the concentrations of hepatic adenosine triphosphate (ATP) and oxidized and total glutathione (GSSG/GSH) decrease. In the livers of fasting animals, coumarin doubles the concentration of hepatic malondialdehyde (MDA). This effect cannot be detected if troxerutin is added. In general, troxerutin reduces the concentration of all coumarin-metabolites in the perfusate and bile and changes the ratio of the main metabolites, coumarin: 3-hydroxycoumarin: 7-hydroxycoumarin. An analysis of the metabolic steps also shows that the amount of coumarin eliminated via faeces does not stem from absorbed coumarin, because the amount of orally applied coumarin detectable in the bile is less than 1%. The study demonstrates that troxerutin has hepatoprotective properties and thus protects the liver from a possible lipid peroxidation caused by coumarin. However, it is necessary to point out that these adverse effects caused by coumarin can be detected only in very high concentrations considerably above the regular therapeutical dosage. This allows the conclusion that troxerutin is a beneficial cofactor in coumarin preparations used for the therapy of chronic venous insufficiency.

Season of birth and neurodevelopmental disorders: summer birth is associated with dyslexia.

OBJECTIVE: Increased risk for certain psychiatric disorders has been associated with season of birth. This study was undertaken to look for hypothesized season-of-birth effects for dyslexia, schizophrenia spectrum disorders, and neurological soft signs in children and adolescents. METHOD: Month of birth and the diagnostic findings in question were examined based on charts from a clinic population of 585 boys. Odds ratios and etiological fractions were calculated. RESULTS: Neurological soft signs showed a sporadic peak for June births and schizophrenia spectrum showed a peak for August and November. A smooth curve suggesting true seasonality was evident in dyslexia for births in May, June, and July. For different 5-year birth cohorts, early summer birth accounts for 24 to 71% of cases of dyslexia. CONCLUSIONS: The authors suggest that viral infection, especially influenza, during the second trimester of pregnancy is the most attractive hypothesis to explain these findings. If this hypothesis is supported, immunization in women of child-bearing age could reduce the incidence of dyslexia. Secondary prevention could also be enhanced by early identification and treatment of children who were exposed in utero.

Sororicide in preteen girls. A case report and literature review.

All means of exploring the psychological and environmental antecedents of murder by a child should be used toward preventing lethal outcomes in future. The authors present the case of a ten year old girl who killed her sister with details of the sisters' relationship, the perpetrator's psychological characteristics and the family situation. Sibling-rivalry, family stressors, and the perpetrator's compulsive and narcissistic traits and preoccupation with a violent television fantasy are discussed. A literature review and suggestions for future research are provided.

PTSD in physically and sexually abused psychiatrically hospitalized children.

The history of sexual and physical abuse and the diagnosis of PTSD were examined in 98 psychiatrically hospitalized children. Relative to past studies, there was an increased incidence of abuse and of prevalence of PTSD. Specific instruments for assessing abuse and PTSD are suggested.

The classification of conduct disorders.

Empirical data comparing DSM-III and DSM-III-R criteria on conduct disorders were obtained from 100 adolescent juvenile justice center residents. The importance of an ongoing classification of childhood and adolescent psychiatric disorders, with primary emphasis on the diagnosis of conduct disorders, was stressed. Demographic and associated features were presented. DSM-III-R seemed superior to its predecessor in some respects and the severity index in particular may be useful. Direction for further classification modification was suggested.

Trichotillomania in children and adolescents: review of the literature and case report.

Hair pulling is an uncommon behavior for which a standard treatment modality has not yet been established; additionally its prognosis is generally guarded. This article reviews the literature and comments upon the demographic, dermatologic, clinical and psychodynamic features of trichotillomania. The various diagnostic association and the treatment approaches are discussed. A case of trichotillomania is presented and the possible relationship between trichotillomania and anxiety is explored.