Possible interplay between vitamin C deficiency and prolactin in pregnant women with premature rupture of membranes: facts and hypothesis.

The precise etiologic mechanisms involved in the premature rupture of membranes (PROM) during pregnancy, the main cause of preterm delivery worldwide, are unknown. Previous studies have shown that: (a) the rupture of chorioamniotic membranes is related to an imbalance between synthesis and degradation of collagen induced by the overexpression/activity of various matrix metalloproteinases (MMP); (b) during human labor and delivery the expression of prolactin receptors (PRL-R) increases in chorioamniotic membranes, decidua and placenta; (c) prolactin (PRL) can influence the synthesis of prostaglandins, the expression of some MMP (MMP-2, MMP-9 and decysin) and tissue inhibitors of MMP in general; (d) vitamin C deficiency induces the expression/activity of extracellular MMP and is considered a risk factor for PROM; and (e) vitamin C potentiates the dopamine-mediated inhibition of PRL in rats. The present hypothesis proposes that a decreased hypothalamic dopaminergic tone-and thus an increased synthesis/release of pituitary PRL - is induced by vitamin C deficiency below a critical threshold (<18 microg/10(8) leukocytes) and that both factors, in turn, would cause upregulation of the expression/activity of several MMP. The increased PRL concentrations (acting like a Th1-type cytokine) along with the overexpression of other proinflammatory cytokines would induce a premature switch from a favorable Th2-type immune response to a noxious Th1-type immune response in the intrauterine environment. This change, in conjunction with the upregulation of MMP-2 and MMP-9, would cause a premature imbalance between synthesis/degradation of collagen in chorioamniotic membranes (an "anticipation" of the normal parturition cascade?), which favors extracellular matrix degradation, proposed as the most relevant event in the genesis of PROM. This hypothesis represents a new dimension in the study of the etiology of PROM.

Prevalence of nutritional deficiencies in Mexican adolescent women with early and late prenatal care

The objective was to evaluate the prevalence of specific nutritional deficiencies in a group of pregnant adolescents according to the gestational age when they started to receive prenatal care. A group of 163 pregnant adolescents that attended the Instituto Nacional de Perinatología (Mexico City) for the first time to receive prenatal care was evaluated. An anthropometrical evaluation was performed and a blood sample taken to determine hemoglobin, ferritin, erythrocyte folate and plasma zinc to all cases. The mean age was 15 years (11 to 17 years). The mean gestational age when starting prenatal care was 27 +/- 7 gestation weeks and most of them tended to have low weight (97 +/- 12 per cent expected weight for height and gestational age). Eight of every ten adolescents had anemia and iron deficiency. Late prenatal care (> or = 25 weeks) was associated with the risk of presenting anemia OR 5.11 (CI 95 per cent 2.4-10.7) iron deficiency (OR 3.5; CI 95 per cent 1.7 to 7.1) and zinc deficiency (OR 2.9; CI 95 per cent 1.1 a 7.6). In relation to folate deficiency, the opposite effect was observed (OR 0.10; CI 95 per cent 0.02 a 0.48). Lack of opportune prenatal care was associated with the presence of iron and zinc depletion. Probably iron deficiency contributes to an erythrocyte folate accumulation.

[Glazed pottery as a risk factor in lead exposure]. / La cerámica vidriada como factor de riesgo de exposición al plomo.

The purpose of this study was to determine if the use of "earthenware dishes" is associated with high blood lead levels in children. Measurements of lead in blood were done in 169 school-children. Of this sample 100 children were selected: 50 of them with the lowest concentration of lead in blood and 50 with the highest. A questionnaire was applied to 39 mothers of the children with low blood lead levels (< 20.2 micrograms/dl) and 48 mothers of the children with high blood lead levels (> 28.0 micrograms/dl). Results show that the use, frequency and time of utilization of this type of dishes is statistically associated with high levels of lead in blood.

[Manganese determination in blood from malnourished children]. / Determinación de manganeso en suero en niños desnutridos.

We investigated the serum manganese (Mn) concentration of 52 children less than two years old. 22 of them were healthy controls (C), 13 had marasmatic (M) malnutrition and 17 kwashiorkor (K). The measurements of Mn were done in an atomic absorption spectrophotometer with a graft furnace oven. The serum was diluted with 1% triton X-100. For the quantification of Mn we used the addition method. There was a significant difference between the levels of Mn measured in the M group (1,582 +/- 0.673 micrograms/L), and the K group (1,811 +/- 0.700 micrograms/L) and levels obtained in the controls (3,212 +/- 1,247 micrograms/L). When we compared the concentration of Mn by sex or age in each group, we didn't find any significant difference. We conclude that the severe malnourished children in our study present lower concentrations of Mn as compared with controls.

[Behavioral development and nerve conduction velocity during recovery from malnutrition]. / Evolución conductual y velocidad de la conducción nerviosa durante la recuperación de la desnutrición.

OBJECTIVES: To research if the improvement in psychomotor development observed during the treatment of malnutrition, is related to favorable changes in the speed of nerve conduction and in the excretion of hydroxy-indole acetic acid (indole). DESIGNED OF THE STUDY: Prospective, of a descriptive type, includes the follow-up of children during the first month of treatment. APPLICATION: To better know the impact which malnutrition has on mental development. PATIENTS: Nine children, ranging from three to 15 months of age, gravely undernourished. INTERVENTION: The neurological development, the speed of nerve conduction and the excretion of indole were evaluated at 10 day intervals. MEASUREMENTS AND RESULTS: Using the Gesell technique in order to evaluate the development, the measurement of conduction through the medial and external popliteal sciatic nerves and indole excreted in 24 hours, a quantitative increase of all of these variables was seen in 24 hours. At the beginning the conduction speed was slow (less than 30 m/s) and the excretion of indole was very low (0.28 mg/24 h). After the tenth day these measurements returned to normal, although the development coefficient was found to still below at the end of the study (63.9 +/- 21.0). CONCLUSIONS: Simultaneous to the neurological deficit, there is a reduced speed of conduction, which returns to normal after the tenth day without a positive correlation with motor functions and development. Neither does the disponibility of serotonin (judged by the excretion of indole) correlate with the speed of conduction.

[Vitamin E concentration in children with proteino-energetic malnutrition]. / Concentración de vitamina E en niños con desnutrición proteino-energética.

Fourty eight malnourished infants were studied in regard to plasma vitamin E levels. The mean plasma vitamin E concentration was 0.41 mg/dL (+/- 0.20); the values ranged from less than 0.10 to 0.96. Only 4 children had an acceptable level of this vitamin (greater than 0.70 mg/dL). The possible interrelationship of vitamin E and red cell fragments in blood was investigated in 24 of the children. The data obtained do not suggest that a low plasmatic vitamin E level is not related to either, red cell fragmented or hemoglobin level.

[Pancreatitis in infants with a clinical diagnosis of septicemia]. / Pancreatitis en niños lactantes con diagnóstico clínico de septicemia.

Considering the possibility that during septicemic processes, pancreatitis could develop, 10 infants were studied when the clinical diagnosis of septicemia was established. With this purpose, the clinical manifestations present in the patients were recorded and the activities of serum amilase and lipase were determined at 24 hour intervals during the first three days and these studies were repeated on the 5th and 7th days. The results showed an abnormally high serum lipase activity, especially in 6 of the 10 infants. The amilase was found within normal limits with a tendency to drop in certain cases. This information suggest the presence of acute pancreatitis in some of the subjects studied.

Pancreatitis en ninos lactantes con diagnostico clinico de septicemia. / Pancreatitis in infants with clinical diagnosis of septicemia

Teniendo en cuenta la posibilidad de que durante los procesos septicemicos pudiese desarrolarse una pancreatitis aguda, se estudiaron 10 ninos lactantes a partir del momento en que se establecio el diagnostico clinico de septicemia. Con este proposito, se registraron las manifestaciones clinicas presentes en los ninos y se estimo la actividad de la amilasa y la lipasa sericas a intervalos de 24 horas durante los 3 primeros dias, repitiendo estos estudios al 5o. y 7o. dias. Los resultados mostraron una actividad anormalmente elevada de lipasa serica, particularmente en 6 de los 10 lactantes. La amilasa se encontro dentro de limites normales, con tendencia al descenso en ciertos casos. Esta informacion sugiere la presencia de pancreatitis aguda en algunos de los ninos investigados

[Tolerance to vitamin C in malnourished children]. / Tolerancia a la vitamina C en niños desnutridos.

Although the concentration of ascorbic acid in the serum of malnourished children is usually low, the state in which organic reserves of this vitamin were found, were unknown. Based on this information, a tolerance study, before and after a saturation period, was planned. The main idea of the investigation was to find out the organic reserves of this nutriment in infants complaining of severe malnutrition. The study was carried out in 12 malnourished children with ages between 3 to 30 months. After a fasting period of 8 hours, a blood sample was taken and each patient was given 200 mgs. ascorbic acid by intramuscular route; following this, blood samples were obtained every hour on 4 occasions. During the next 5 days they were given 1 g. daily of vitamin C and on the 6th day, the tolerance test was repeated. With the purpose of determining excretion of vitamin C, urine was collected 12 hours previously and 12 hours after each study. The results showed a significant statistical difference in responses obtained with the load of vitamin C before and after the course of the saturation period; this finding allows the statement that the organic tissues of the malnourished child keep a short reserve of this vitamin, although it does not reach the critical levels of 0.3 mg/100 ml when the clinical signs of the specific deficiency to this nutriment appear.

[Seasonal variations in ascorbic acid concentration in children from Mexico City]. / Variación estacional en la concentración de ácido ascórbico en niños de la Ciudad de México.

With the purpose of finding out whether the concentration of ascorbic acid in the serum in children suffered significant variations through the different months of the year, 301 blood samples were studied; 108 were studied in the month of January; 92 in the month of May and 101 in September. No statistically important difference was found after comparing the averages corresponding to the 3 samples studied. However, the analysis of the concentration of ascorbic acid in terms of the ages of the patients showed an unquestionable seasonal variation in the sera corresponding to children under 3 years of age. This same age group showed the most significantly low averages through the different stages of the calendar year.

[Lead content of evaporated milk]. / Contenido de plomo en la leche evaporada.

In order to determine the concentration of lead in evaporated type of commercially available milks, a study was carried out in 40 cans. Out of them, 20 were of the "vitamin" brand and the other 20 were of "protein" quality. The lead content in either type of milk was not significantly different; "protein" milk showed 38.4 mug/100 ml, while the figure for the "vitamin" grade was 35.0 mug/100 ml. Considering the use of evapored milks in infant feeding, it was deemed wise to carry out an estimation of the amount of lead ingested in case the volume consumed reached from 500 to 1000 ml. As a result of this study, it is stated that somewhat between 150 to 200 mug of lead are ingested daily in the consumption of evapored milk at normal dilution. Based on the tolerance levels, the findings are discussed.

[D-xylose absorption and weight increase during treatment of celiac disease]. / Absorción de la d-xilosa y recuperación del peso en el tratamiento de la enfermedad celíaca

Four patients were studied during the early phase of celiac disease treatment, observing a close correlation between weight increase and the ability to absorb d-xylose.