Neurocognitive function in adult residents of a mining district in Mexico after reducing manganese exposure: Follow-up after 11 years

BACKGROUND

Little is known about the neurotoxic effects of chronic exposure to airborne Mn once exposure has been reduced. The environmentally exposed and the reference adult populations evaluated in 2002 were followed, after an environmental management program (EMP) was implemented to reduce the exposure in a mining district in Mexico.

OBJECTIVE

The aim of this study was to compare the association between exposure to Mn and neurocognitive performance in environmentally exposed and reference groups of adults before and after EMP implementation.

METHODS

In 2013, the same battery of neurocognitive tests used in the initial study (2002) was applied to 58 adults exposed to airborne Mn and 30 adults from the reference community. A cumulative exposure index (CEI) was estimated for the study population before and after the EMP. Categorical outcomes were analyzed using logistic regression, and the resulting ORs were compared between studies. Continuous outcomes were analyzed using linear regression. All models were adjusted for age, years of education, socioeconomic status and blood lead levels.

RESULTS

Exposed adults from the post-EMP study showed an improvement in fine motor and verbal regulation of motor skills (OR < 1) compared to the exposed adults from the pre-EMP study (OR > 1). In both pre- and post-studies, the exposed adults showed a deterioration in their dynamic organization of motor activity compared to the reference group (p < 0.05); however, they showed no significant change in attention and working-memory performance.

DISCUSSION

After four years of a significant reduction in airborne Mn levels resulting from EMP implementation, chronically exposed adults showed an improvement in fine motor and verbal regulation of motor skills; however, the remaining areas of their motor and cognitive functions remained impaired.

A phase 2, double-blind, placebo-controlled trial of a valproate/lithium combination in ALS patients

BACKGROUND

Few treatments are currently available for amyotrophic lateral sclerosis (ALS). A combination of lithium carbonate and valproic acid (VPA-Li) was shown to inhibit motor neuron death and delay disease progression.

METHODS

Outpatients with a typical ALS presentation were enrolled in a randomized, placebo-controlled trial to assess the efficacy of orally administered VPA-Li. Changes in a functional scale score (ALSFRS-R) and survival rate were chosen as primary outcome variables. Secondary outcome variables included BMI, respiratory monitoring, quality of life, and a global impression of the treatment.

RESULTS

Out of 42 patients enrolled, 20 individuals receiving VPA-Li and 18 on placebo treatment were included in the final analysis. Forty-five percent of patients receiving VPA-Li completed the trial, whereas only 22.22% of patients in the placebo group attended the final visit 18 months later (P = 0.09). Major changes in the ALSFRS-R score were observed, including a decrease of 1.195 points/month in the placebo group (95% CI: 0.7869-1.6031) and of 0.5085 under VPA-Li treatment (95% CI: 0.2288-0.7882) between months 6 and 14. Adverse events included bad mouth taste, constipation, and anorexia. Survival rate, body weight, and quality of life were positive outcomes by the end of the trial despite a high sample reduction, especially in the placebo group. The inclusion of 212 subjects in each group would confirm these differences.

CONCLUSIONS

Combined VPA-Li treatment associated with slower ALS progression and better secondary outcomes. This dual treatment overcame the futility threshold and merits further investigation in ALS.

POS0302 BURNOUT IN RHEUMATOLOGISTS IN LATIN AMERICA

Background:

Rheumatology is considered a low-risk specialty, but studies have shown a prevalence of burnout between 42% to 51%1,2. Factors associated with it include the use of electronic medical records, administrative tasks and prolonged working hours. This has several repercussions such as higher prevalence of depression/anxiety and less productivity.

Objectives:

To determine the prevalence of burnout in rheumatologists in Latin America and the factors associated with it.

Methods:

Cross-sectional study based on a survey completed through Google Forms platform that was sent by the national rheumatology associations of Latin America. Burnout was assessed with the Maslach Burnout Inventory (MBI) with cut off values of ≥27 for emotional exhaustion (EE), ≥10 for depersonalization (DP), and ≤33 for personal accomplishment (PA). Other variables were studied such as demographics, working conditions, satisfaction, comorbidities, depression using PHQ-9 and happiness using the Subjective Happiness Scale. Data was analyzed using the statistical program SPSS v.22.

Results:

297 rheumatologists from 15 countries were included, mainly Argentina (28.3%), Brazil (26.3%) and Mexico (12.8%). The majority were women 62%, 42.4% worked in public hospitals with an average of 40.1 ± 14.2 hours per week. 31.3% did research, 13.1% clinical trials, 56.6% teaching, and 42.8% administrative work. 36% received an annual income less than 25K.

56.6% had burnout in at least 1 dimension. According to the dimensions, 35.7% had burnout in EE, 25.6% in PA and 26.6% in DP. 32.3% had burnout in only 1 dimension, 17.2% in two and 7.1% in all three dimensions. Only 20.2% thought they had burnout, 9.1% were currently with professional help and 15.8% had sought help in the past. 72.1% said they were willing to participate in a program to reduce burnout.

The rheumatologists with burnout were younger than those without burnout (46.5 vs 49.9 years, p = 0.015), mentioned more frequently that they would like to decrease the number of working hours (56.5% vs 36.4%, p = 0.002) and had lower practice satisfaction (5.2 vs 6.2, p <0.001) and income satisfaction (3.4 vs 4.6, p <0.001). Those with burnout were less happy than those without burnout (5.1 vs 5.9, p <0.001) and had higher PHQ-9 (7.7 vs 2.5, p <0.001). In the burnout group, there was a higher percentage with an income less than $ 25K/year (45.7% vs 25.4%, p=0.008), presence of comorbidities (53.6% vs 40.3%, p=0.023), anxiety (11.9 % vs. 2.3%, p=0.002), use of SSRIs/SNRIs (19% vs 8.5%, p=0.011), suicidal thoughts (13.6% vs 1.6%, p <0.001) and low self-esteem (12.5% vs 3.1%, p <0.001). There was a higher percentage of rheumatologists involved in teaching in the group without burnout (66.7% vs 48.8%, p = 0.002). No statistically significant associations were found between burnout and sex, exercise, alcohol consumption, duration of career, main workplace, type of clinical practice, duration of vacation, clinical research, clinical trials and administrative work.

Conclusion:

Burnout affects near half of rheumatologists in Latin America and was associated to younger age, long working hours, low satisfaction, less happiness, higher PHQ-9, suicidal thoughts, anxiety, income, presence of comorbidities and low self-esteem. Most of the rheumatologists were willing to participate in programs to reduce burnout which represents an opportunity for interventions to reduce this syndrome.

References:

[1]Martin K. Medscape Rheumatologist Lifestyle, Happiness & Burnout Report 2020. 2020; Available at: https://www.medscape.com/slideshow/2020-lifestyle-rheumatologist-6012480#4. Accessed July 10, 2020.

[2]Tiwari V, Kavanaugh A, Martin G, Bergman M. High impact of burnout on rheumatology practitioners. Journal of rheumatology 2020:jrheum.191110.

Disclosure of Interests:

None declared

Acute Polychlorinated Biphenyl Benthic Invertebrate Toxicity Testing to Support the 2017 Chronic Dose-Response Sediment Injury Model

As managers and decision makers evaluate pollutant risk, it is critical that we are able to measure an assessment of the injury. Often, these estimates are difficult to determine for benthic organisms, so in 2017 a chronic polychlorinated biphenyl (PCB) sediment dose-response model to predict benthic invertebrate injury was proposed. Given both natural resource trustee and consultant questions following publication concerning that the aqueous chronic toxicity testing data used in the 2017 model development were primarily from the 1970s and 1980s, this follow-up short communication is meant to provide the user some additional data that are more recent. With the advances in analytical and quantitative environmental chemistry (i.e., better detection limits and congener separation), we chose to complete acute aquatic toxicity testing using 3 estuarine invertebrates and lethal endpoints (20 and 50% lethal concentrations). This acute testing was selected because chronic aquatic testing for PCBs outside of the data used in the 2017 study was not available to us. The aquatic results used in the present study were changed to sediment using equilibrium partitioning, as done in the 2017 chronic model, after using the same organic-carbon partition coefficient and total organic carbon for our equilibrium partitioning (EqP)-measured calculations. Based on these acute aquatic toxicity results and a general acute-to-chronic injury concentration ratio of approximately 10, we found that the 2017 model was valid and, hence, that a 1.0 µg/g chronic PCB sediment criterion is a reasonable estimation of potential benthic invertebrate injury. This was followed by spiked sediment tests where percent acute sediment injury was compared to the EqP-derived chronic value and the results from 2017; modest agreement is shown. Environ Toxicol Chem 2021;40:1188-1193. Published 2020. This article is a U.S. Government work and is in the public domain in the USA.

Effects of a Reserve Protein on Spodoptera frugiperda Development: A Biochemical and Molecular Approach to the Entomotoxic Mechanism

Talisin is a storage protein from Talisia esculenta seeds that presents lectin-like and peptidase inhibitor properties. These characteristics suggest that talisin plays a role in the plant defense process, making it a multifunctional protein. This work aimed to investigate the effects of chronic intake of talisin on fifth instar larvae of Spodoptera frugiperda, considered the main insect pest of maize and the cause of substantial economic losses in several other crops. The chronic intake of talisin presented antinutritional effects on the larvae, reducing their weight and prolonging the total development time of the insects. In addition, talisin-fed larvae also showed a significant reduction in the activity of trypsin-like enzymes. Midgut histology analysis of talisin-fed larvae showed alterations in the intestinal epithelium and rupture of the peritrophic membrane, possibly causing an increase of aminopeptidase activity in the midgut lumen. Talisin also proved to be resistant to degradation by the digestive enzymes of S. frugiperda. The transcription profile of trypsin, chymotrypsin and aminopeptidase genes was also analyzed through qPCR technique. Talisin intake resulted in differential expression of at least two genes from each of these classes of enzymes. Molecular docking studies indicated a higher affinity of talisin for the less expressed enzymes.

Bone Mass Loss and Sarcopenia in Ecuadorian Patients

OBJECTIVE

To study the association between osteoporosis and sarcopenia and determine the prevalence of osteosarcopenia in patients who attended a rheumatology center in Ecuador.

METHODS

A cross-sectional study was conducted in a population of patients who had a densitometric study. The diagnosis of sarcopenia was determined by the DXA standard gold test, screening, and conventional methods (bioimpedance, anthropometric measurements, SARC-F, muscle function, and gait test).

RESULTS

A total of 92 patients were studied. The median age was 66 ± 10, 90% females. Using the criteria of SMI, 65% had sarcopenia of which 9% had only sarcopenia and 56% had osteosarcopenia; 22% had only osteopenia/osteoporosis; and 13% none of these conditions. The prevalence of sarcopenia according to handgrip strength was 60%, gait speed 45%, and SARC-F score 40%. The prevalence of osteosarcopenia according to handgrip strength was 51%, gait speed 34%, and SARC-F score 32%. Osteoporosis was associated with a higher prevalence of sarcopenia using the criteria of SMI since 40% had sarcopenia in the normal DXA group, 64% in the osteopenia group, and 76% in the osteoporosis group (p=0.017). Of the women, 69% had sarcopenia compared to 33% of the men (p=0.034). The BMI was lower in the group with sarcopenia (25.1 ± 4.1 kg/m2) compared to the group without sarcopenia (29.4 ± 4.1 kg/m2, p < 0.001). Patients with osteosarcopenia and sarcopenia had lower BMI, handgrip strength, ASM, SMI, and total-body skeletal muscle mass than those with osteopenia/osteoporosis or normal patients.

CONCLUSION

65% of the studied population had sarcopenia. It is clear that the prevalence of sarcopenia is higher in patients with greater loss of bone mass. Identifying pathways that affect both bone and muscle could facilitate the development of treatments that simultaneously improve osteoporosis and sarcopenia.

Seroprevalence of leptospirosis in human groups at risk due to environmental, labor or social conditions

Leptospirosis is important in Uruguay due to the economic loss caused by the diseases of production animals, mainly bovines, and also due to frequent human infection. We decided to study anti-Leptospira antibodies in the sera of dairy workers, rice laborers, veterinarians, suburban slum dwellers and garbage recyclers. Our aims were to estimate the seroprevalence of infection by Leptospira spp. in these people at risk, the relative importance of the known risk factors associated with infection, and the impact of human infections in each setting. Groups at risk were identified and 35 visits to their locations were made, conducting field surveys and exchange talks for information and education. Simple epidemiological questionnaires were administered and sera samples were taken from 308 persons. The microagglutination Technique (MAT) and the IgM Indirect Immunofluorescence (IIF) assay were employed to detect antibodies. Environmental water samples, canine and equine sera were also examined. More than 45% of human sera were reactive and the studied groups were confirmed to be widely exposed to infection. Female sera were frequently reactive, though most illnesses occur in men, and the most severe cases in elderly males; the emergence and evolution of the disease may strongly depend on the host condition and functions. Animal contact and unsafe water usage were the main identified risk factors to be considered in prevention. Fifty per cent of the studied horses showed a positive MAT reaction. The underdiagnosis of the illness and its long-term symptoms require further study, as well as greater health and social attention efforts.

Biodistribution and radiation dosimetry of [64Cu]copper dichloride: first-in-human study in healthy volunteers

Background

In recent years, Copper-64 (T_1/2 = 12.7 h) in the chemical form of copper dichloride ([⁶⁴Cu]CuCl₂) has been identified as a potential agent for PET imaging and radionuclide therapy targeting the human copper transporter 1, which is overexpressed in a variety of cancer cells. Limited human biodistribution and radiation dosimetry data is available for this tracer. The aim of this research was to determine the biodistribution and estimate the radiation dosimetry of [⁶⁴Cu]CuCl₂, using whole-body (WB) PET scans in healthy volunteers. Six healthy volunteers were included in this study (3 women and 3 men, mean age ± SD, 54.3 ± 8.6 years; mean weight ± SD, 77.2 ± 12.4 kg). After intravenous injection of the tracer (4.0 MBq/kg), three consecutive WB emission scans were acquired at 5, 30, and 60 min after injection. Additional scans were acquired at 5, 9, and 24 h post-injection. Low-dose CT scan without contrast was used for anatomic localization and attenuation correction. OLINDA/EXM software was used to calculate human radiation doses using the reference adult model.

Results

The highest uptake was in the liver, followed by lower and upper large intestine walls, and pancreas, in descending order. Urinary excretion was negligible. The critical organ was liver with a mean absorbed dose of 310 ± 67 μGy/MBq for men and 421 ± 56 μGy/MBq for women, while the mean WB effective doses were 51.2 ± 3.0 and 61.8 ± 5.2 μSv/MBq for men and women, respectively.

Conclusions

To the best of our knowledge, this is the first report on biodistribution and radiation dosimetry of [⁶⁴Cu]CuCl₂ in healthy volunteers. Measured absorbed doses and effective doses are higher than previously reported doses estimated with biodistribution data from patients with prostate cancer, a difference that could be explained not just due to altered biodistribution in cancer patients compared to healthy volunteers but most likely due to the differences in the analysis technique and assumptions in the dose calculation.

Historical epidemiology of hepatitis C virus in select countries-volume 4

Due to the introduction of newer, more efficacious treatment options, there is a pressing need for policy makers and public health officials to develop or adapt national hepatitis C virus (HCV) control strategies to the changing epidemiological landscape. To do so, detailed, country-specific data are needed to characterize the burden of chronic HCV infection. In this study of 17 countries, a literature review of published and unpublished data on HCV prevalence, viraemia, genotype, age and gender distribution, liver transplants and diagnosis and treatment rates was conducted, and inputs were validated by expert consensus in each country. Viraemic prevalence in this study ranged from 0.2% in Hong Kong to 2.4% in Taiwan, while the largest viraemic populations were in Nigeria (2 597 000 cases) and Taiwan (569 000 cases). Diagnosis, treatment and liver transplant rates varied widely across the countries included in this analysis, as did the availability of reliable data. Addressing data gaps will be critical for the development of future strategies to manage and minimize the disease burden of hepatitis C.

The present and future disease burden of hepatitis C virus infections with today's treatment paradigm: Volume 4

Factors influencing the morbidity and mortality associated with viremic hepatitis C virus (HCV) infection change over time and place, making it difficult to compare reported estimates. Models were developed for 17 countries (Bahrain, Bulgaria, Cameroon, Colombia, Croatia, Dominican Republic, Ethiopia, Ghana, Hong Kong, Jordan, Kazakhstan, Malaysia, Morocco, Nigeria, Qatar and Taiwan) to quantify and characterize the viremic population as well as forecast the changes in the infected population and the corresponding disease burden from 2015 to 2030. Model inputs were agreed upon through expert consensus, and a standardized methodology was followed to allow for comparison across countries. The viremic prevalence is expected to remain constant or decline in all but four countries (Ethiopia, Ghana, Jordan and Oman); however, HCV-related morbidity and mortality will increase in all countries except Qatar and Taiwan. In Qatar, the high-treatment rate will contribute to a reduction in total cases and HCV-related morbidity by 2030. In the remaining countries, however, the current treatment paradigm will be insufficient to achieve large reductions in HCV-related morbidity and mortality.

Strategies to manage hepatitis C virus infection disease burden-Volume 4

The hepatitis C virus (HCV) epidemic was forecasted through 2030 for 17 countries in Africa, Asia, Europe, Latin America and the Middle East, and interventions for achieving the Global Health Sector Strategy on viral hepatitis targets-"WHO Targets" (65% reduction in HCV-related deaths, 90% reduction in new infections and 90% of infections diagnosed by 2030) were considered. Scaling up treatment and diagnosis rates over time would be required to achieve these targets in all but one country, even with the introduction of high SVR therapies. The scenarios developed to achieve the WHO Targets in all countries studied assumed the implementation of national policies to prevent new infections and to diagnose current infections through screening.

A rare case of racemose neurocysticercosis and its complications. Case report

Neurocysticercosis is a central nervous system infection caused by the pork tapeworm Taenia solium. The disease is endemic in Central and South America, Asia and Africa. Racemose neurocysticercosis refers to cysts in the subarachnoid space and is characterized by proliferative lobulated cysts without a scolex. We report a case of a 43-year-old woman with an eight-month history of headaches, ataxia and loss of vision. CT and MRI showed an intraventricular cyst, causing entrapment of Monro foramina and hydrocephalus, smaller cysts at subarachnoid space in temporal lobes, Sylvian fissures, supra-selar and perimesencephalic cisterns, and an intra-orbital cyst. Additionally, there were acute ischemic vascular lesions on the left thalamus and corpus callosum splenium and subacute ischemic lesions of both occipital lobes. The diagnosis of racemose cysticercosis was made after biopsy and drainage of the intraventricular cyst. It is important to recognize neurocysticercosis as a differential diagnosis in intra-cranial cysts, not only intraparenchymal cysts.

Magnetic Resonance Imaging Study on Blebs Morphology of Ahmed Valves

PURPOSE

To determine the morphometric parameters of filtration blebs of a valved aqueous humor drainage device.

MATERIALS AND METHODS

Orbital magnetic resonances imaging (MRI) was taken after implantation of an Ahmed valve (FP7 model). Outcomes of the analysis were intraocular pressure (IOP) and the bleb's morphometric analysis (volume, height, major and minor axis). Associations between IOP and the imaging-related study variables were explored by Spearman's correlation test.

RESULTS

Eleven patients underwent orbital MRI examination. Recordings were taken after a mean of 2.7 months (1-6 months) after surgery. IOP was significantly lower than its preoperative values (17.6 ± 6.4 mm Hg vs 36.1 ± 6.4 mm Hg, p < 0.01). Mean bleb volume was 856.9 ± 261 mm(3) and its height, major and minor axis were 5.77 ± 1.9, 14.8 ± 2.9 and 8.14 ± 3.6 mm, respectively. A positive correlation was detected between IOP and mean height (r = 0.77, p = 0.048) and major axis (r = 0.83, p = 0.03). Interestingly, the overall bleb volume was related to IOP levels immediately prior to surgery (r = 0.75, p < 0.01). Additionally, the posterior part of the plate was found to be displaced from the scleral surface in five cases (45%).

CONCLUSION

Ahmed valve's bleb morphology seems to correlate with both the pre- and postoperative IOP, which might suggest a clinical benefit of administering aqueous suppressants pre- as well as postoperatively. The plate of the device may show a significant dislocation from its initial surgical implantation site. How to cite this article: Ferreira J, Fernandes F, Patricio M, Brás A, Rios C, Stalmans I, Pinto LA. Magnetic Resonance Imaging Study on Blebs Morphology of Ahmed Valves. J Curr Glaucoma Pract 2015;9(1):1-5.

[Does medication abuse in patients with chronic migraine influence the effectiveness of preventive treatment with topiramate?]

INTRODUCTION

Patients with chronic migraine (CM) and medication abuse are difficult to treat, and have a greater tendency towards chronification and a poorer quality of life than those with other types of headache.

AIM

To evaluate whether the presence of medication abuse lowers the effectiveness of topiramate.

PATIENTS AND METHODS

A series of patients with CM were grouped according to whether they met abuse criteria or not. They were advised to stop taking the drug that they were abusing. Treatment was adjusted to match their crises and preventive treatment with topiramate was established from the beginning. The number of days with headache and intense migraine in the previous month and at four months of treatment was evaluated.

RESULTS

In all, 262 patients with CM criteria were selected and 167 (63.7%) of them fulfilled abuse criteria. In both groups there was a significant reduction in the number of days with headache/month and number of migraine attacks/month at the fourth month of treatment with topiramate. The percentage of reduction in the number of days with headache/month in CM without abuse was 59.3 ± 36.1%, and with abuse, 48.7 ± 41.7% (p = 0.0574). The percentage of reduction in the number of days with intense migraine/month in CM without abuse was 61.2%, and with abuse, 50% (p = 0.0224). Response rate according to the number of days with headache/month in CM without abuse was 69%, and with abuse, 57%. Response rate according to the number of intense migraines/month in CM without abuse was 76.8%, and in CM with abuse, 61% (p = 0.0097).

CONCLUSIONS

Topiramate was effective in patients with CM with and without medication abuse, although effectiveness is lower in the latter case.

[A study to compare independent groups of patients with episodic migraine who were treated preventively with flunarizine or nadolol]

INTRODUCTION. Flunarizine, with level of evidence A, and nadolol, with evidence level C, would be indicated as preventive treatment of migraine. Yet, no previous studies have been conducted to compare the effectiveness of the two drugs. AIM. To compare the effectiveness parameters in independent groups of patients treated preventively with one of the pharmaceuticals from the study, the same protocol being applied in both cases. PATIENTS AND METHODS. The subjects selected for the study were patients with episodic migraine (according to 2004 International Headache Society criteria) who had undergone preventive treatment for the first time, with flunarizine (5 mg/day) or nadolol (20-40 mg/day). The main effectiveness variables (reduction in the number of seizures at four months of treatment and responder rates) were analysed. RESULTS. The study included 227 patients who intended to receive treatment: 155 with flunarizine (80.5% females; mean age: 38.3 ± 12.1 years) and 72 with nadolol (63.8% females; mean age: 37.1 ± 12.0 years). The mean number of seizures prior to treatment was 6.09 ± 2.6 in the flunarizine group and 5.1 ± 1.7 in the nadolol group (p = 0.0079); at four months of treatment it was 2.61 ± 2.4 in the flunarizine group and 2.77 ± 2.4 in the nadolol group (p = NS). Percentage of reduction of migraines: 55.2% with flunarizine and 50.4% with nadolol (p = NS). The responder rate was 69% with flunarizine and 67% with nadolol (p = NS). The excellent response rate (reduction in the number of seizures by 75% or more) was 52.2% with flunarizine and 36.1% with nadolol (p = 0.0077). Percentage of adverse side effects: 48.3% with flunarizine and 25% with nadolol (p = 0.0009). The satisfaction rate was similar in both groups, 68%. CONCLUSIONS. Both flunarizine and nadolol proved to be effective in the preventive treatment of episodic migraine. Flunarizine is used more often in our milieu and was less well tolerated.

Serum prolactin rises in Mexican school children exposed to airborne manganese

Early studies on manganese (Mn) exposure have shown that this transition metal affects dopamine neurotransmission. Dopamine serves as a tonic inhibitor of prolactin release in the anterior hypophysis, thus the serum prolactin levels in occupationally Mn exposed workers has been found increased. However, little is known about environmental Mn exposure effect on this hormone. In the present study we assessed serum prolactin in environmentally (mainly through air) exposed children living in the proximity of a rich Mn zone in Mexico and a control group with similar socioeconomic and ethnic characteristics. We also determined Mn levels in blood and hair, hemoglobin and anthropometric variables. Children between 7 and 11 years old were included (77 from Mn exposed and 93 from control communities). Blood Mn was higher in exposed children (median 9.5 μg/L, rank [5.5, 18]) as compared to the control group (median 8 μg/L, rank [5, 14]) (p<0.05, Mann-Whitney). Hair Mn was also increased in the exposed group (median 13.2 μg/g, rank [4.2, 48]) in comparison to the control group (median 0.6 μg/g rank [0.06, 3.6]). Prolactin was found increased in the exposed children (median 12.35 ng/ml, rank [2.90, 33.70]) versus controls (median 7.77 ng/ml, rank [2.7, 23.6]). Positive correlations were found between prolactin and both blood Mn and hair Mn (Rho=0.217 and 0.250, respectively, p<0.05). A linear regression, with prolactin as the dependent variable, showed hair Mn as the determinant variable after adjusting by age, hemoglobin and sex. After a stratification of hair and blood Mn into low, medium and high content, significant associations were also found, confirming the relationship between prolactin and hair Mn. Results suggest that children from these Mn environmentally exposed communities could be at risk of endocrine alterations.

Histochemical changes in muscle of rats exposed subchronically to low doses of heavy metals

Heavy metals are ubiquitous in the environment and exposure through food and water as well as occupational sources can constitute a potential threat to human health. The mechanisms of heavy metal damage include the production of free radicals that alter mitochondrial activity, affecting cellular types like neurons and muscular fibres. We examined whether rats exposed subchronically via drinking water to low doses of heavy metals can produce alterations in muscle. Results showed that the proportion of ragged red fibres increased in muscle of rats exposed to lead and thallium, likewise slight changes in enzymatic activity of muscular fibres were also observed.

Mother-fetus transference of lead and cadmium in rats: involvement of metallothionein

This study was designed to assess the effect of Cadmium (Cd) and lead (Pb) exposure during pregnancy in rats and their correlation with metallothionein (MT). Rats were exposed to either 10 ppm Cd or 300 ppm Pb through drinking water during pregnancy. Both metals were measured in placenta, fetus brain and fetal and maternal blood. MT was quantified in placenta and fetus brain and it was also observed in placenta by immunohistochemical technique. Offspring weight was found to be significantly lower for the Cd exposure group than for the control group. A Cd increase in the placenta of the exposed group was accompanied by MT induction; these effects were related to a limited accumulation of Cd in fetus brain. In contrast, dam Pb exposure caused an accumulation of Pb in the fetus brain and induced damage to placenta. The results account for differences in the transference of these metals during pregnancy that could be related to their toxicity.

Memantine versus donepezil in mild to moderate Alzheimer's disease: a randomized trial with magnetic resonance spectroscopy

BACKGROUND AND PURPOSE

To compare memantine with the most prescribed cholinesterase inhibitor (donepezil) from a clinical viewpoint when administered in early phases of Alzheimer disease (AD), and to find out whether memantine may produce changes in brain metabolite concentrations in comparison with donepezil.

METHODS

In this comparative rater-blinded parallel group randomized trial we recruited a consecutive sample of patients with probable mild to moderate AD. At baseline we carried out neuropsychological assessment with mini-mental, Clinical Dementia Rating Scale (CDR), Blessed Dementia Rating Scale, Alzheimer's Disease Assessment Scale, cognitive part (ADAS-cog), neuropsychiatric inventory (NPI), and disability assessment for dementia (DAD), as well as (1)H magnetic resonance spectroscopy (MRS) in several areas of the brain. Patients were randomized to receive either donepezil or memantine for 6 months. After this elapse of time we repeated the same procedures and observed the changes in clinical scales (ADAS-cog, NPI, DAD), as well as the changes in metabolite levels in every area of exploration (temporal, pre-frontal, posterior cingulated (PCG), and occipital), especially those of N-acetyl-aspartate (NAA) which is regarded as a surrogate marker of neuronal density.

RESULTS

A total of sixty-three patients completed the trial. We did not see significant differences in clinical scales and metabolite levels between those on donepezil (n = 32) and those on memantine (n = 31). In general, more patients worsened than improved on either of the drugs. The changes in the NAA/creatine ratio in the PCG correlated significantly with the changes in the ADAS-cog (P = 0.004).

CONCLUSIONS

Donepezil and memantine have similar modest clinical and spectroscopic effect on mild to moderate AD. MRS could be useful to monitor progression of the disease.

Negative covariation between task-related responses in alpha/beta-band activity and BOLD in human sensorimotor cortex: an EEG and fMRI study of motor imagery and movements

Similar to the occipital alpha rhythm, electroencephalographic (EEG) signals in the alpha- and beta-frequency bands can be suppressed by movement or motor imagery and have thus been thought to represent the "idling state" of the sensorimotor cortex. A negative correlation between spontaneous alpha EEG and blood-oxygen-level-dependent (BOLD) signals has been reported in combined EEG and fMRI (functional Magnetic Resonance Imaging) experiments when subjects stayed at the resting state or alternated between the resting state and a task. However, the precise nature of the task-induced alpha modulation remains elusive. It was not clear whether alpha/beta rhythm suppressions may co-vary with BOLD when conducting tasks involving varying activations of the cortex. Here, we quantified the task-evoked responses of BOLD and alpha/beta-band power of EEG directly in the cortical source domain, by using source imaging technology, and examined their covariation across task conditions in a mixed block and event-related design. In this study, 13 subjects performed tasks of right-hand, right-foot or left-hand movement and motor imagery when EEG and fMRI data were separately collected. Task-induced increase of BOLD signal and decrease of EEG amplitudes in alpha and beta bands were shown to be co-localized at the somatotopic sensorimotor cortex. At the corresponding regions, the reciprocal changes of the two signals co-varied in the magnitudes across imagination and movement conditions. The spatial correspondence and negative covariation between the two measurements were further shown to exist at somatotopic brain regions associated with different body parts. These results suggest an inverse functional coupling relationship between task-induced changes of BOLD and low-frequency EEG signals.

Relationship between serum nonesterified fatty acids at calving and the incidence of periparturient diseases in Holstein dairy cows

The objective was to describe the relationship between concentration of serum nonesterified fatty acids (NEFAs) at calving and the incidence of periparturient disorders in Chilean Holstein dairy cows (Bos taurus). The study was conducted at two dairies (central Chile) with 700 milking cows each and similar management. Between July 2006 and March 2007, 350 cows were selected, and concentrations of serum NEFAs were determined at calving. The incidence of milk fever (MF), retained fetal membranes (RFMs), metritis, and clinical mastitis from calving to 100 d in lactation were consistently recorded. The relationship between concentration of serum NEFAs at calving and the incidence of periparturient diseases was determined using logistic regression. The main explanatory variable was concentration of serum NEFAs at calving. The incidence of MF, RFM, metritis, and mastitis was 5.4%, 15.6%, 10.8%, and 14.4%, respectively. There was no association between concentration of NEFAs at calving and the incidence of these conditions when the median value of NEFAs (0.9 mEq/L) was used as a cutoff. However, when the 75th percentile (1.2 mEq/L) was used as the cutoff, cows with values <1.2 mEq/L were 0.45 and 0.32 times as likely to develop clinical mastitis and MF, respectively, compared with cows with values >or=1.2 mEq/L. When the 90th percentile (1.6 mEq/L) was used as a cutoff, cows with values <1.6 mEq/L were 0.25 times as likely to develop clinical mastitis compared with cows with values >or=1.6 mEq/L. As a continuous variable, for every 0.1 mEq/L increment in NEFAs at calving, cows were 1.11 times more likely to experience clinical mastitis. In conclusion, cows with NEFA concentrations >or=1.2 mEq/L had a higher incidence of clinical mastitis and MF than that of cows with values <1.2 mEq/L.

Electrophysiological neuroimaging: cortical correlates of alpha rhythm modulation

Eyes-open and eyes-closed are two widely accepted resting conditions in neuroimaging study. When alternating between the two conditions, electroencephalogram (EEG) studies have reported the modulation of alpha band (8-12 Hz) oscillation. Functional magnetic resonance imaging (fMRI) studies have found modulation of blood-oxygen-level dependent (BOLD) response. The neuronal correlates of the two modulations are not well understood. In the present study, we conducted an eyes-open-eyes-closed human experiment with simultaneous EEG and fMRI recordings. We investigated the spatial and temporal correlations between the alpha modulation and BOLD response. Besides the neural network generating the eyes-open-eyes-closed-task-induced modulation, we further examined other neural networks involved in the task. Their spatial and temporal relationship with the alpha modulation was investigated.

Morphometric analysis of brain lesions in rat fetuses prenatally exposed to low-level lead acetate: correlation with lipid peroxidation

The effect of prenatal lead acetate exposure was studied microscopically together with the concentration of lead and lipid fluorescent products (LFP) in the brain of rat fetuses. Wistar rats were intoxicated with a lead solution containing either 160 or 320 ppm of lead acetate solution during 21 days through drinking water. The control group (ten rats) received deionized water for the same period. The rats were killed on gestation day 21 and fetuses were obtained; the placenta, umbilical cord and parietal cortex (Cx), striatum (St), thalamus (Th) and cerebellum (Ce) were collected for measuring tissue lead concentration, LFP as an index of lipid peroxidation and histopathologic examination. Lead contents were increased in placenta, umbilical cord, St, Th and Cx in both lead-exposed groups. Lead exposure increased (LFP) in placenta and umbilical cord, St, Th and Ce as compared to the control group. Histopathological examination showed severe vascular congestion in placenta, the Cx, St, Th and Ce with hyperchromatic and shrunken cells. Interstitial oedema was found in all regions studied of both lead exposed groups. The morphometric evaluation of the studied brain regions showed an absolute decrease in total cell number and increased number of damaged cells and interstitial oedema. Our results show that morphological changes in rat brain are correlated with increased lipid peroxidation, and the lead levels of the umbilical cord, however it is not clear whether oxidative stress is the cause or the consequence of these neurotoxic effects of lead.

Functional interactions between mu opioid and alpha 2A-adrenergic receptors

Adrenergic and opioid receptors belong to the rhodopsin family of G-protein coupled receptors, couple to analogous signal transduction pathways, and affect the nociceptive system. Although a number of previous studies have reported functional interactions between these two receptors, the basis for this has not been well explored. We propose that direct receptor-receptor interactions could account, in part, for opioid-adrenergic cross-talk. In this report, we have addressed this using biophysical, biochemical, and pharmacological studies. We show that mu opioid and alpha2A adrenergic receptors reside in close proximity in live cells using the bioluminescence resonance energy transfer assay. These receptors colocalize to proximal dendrites in primary hippocampal neurons. mu-alpha2A Receptor complexes can be isolated from heterologous cells or primary neurons coexpressing these receptors. In these cells, the activation of either mu or alpha2A receptor leads to a significant increase in the level of immunoprecipitable mu-alpha2A complexes, whereas activation of both receptors leads to a significant decrease. The implications of these effects on signaling were examined using the agonist-mediated increase in G-protein activity and mitogen-activated protein kinase activity. We find that activation of either mu or alpha2A receptors leads to an increase in the extent of signaling, whereas activation of both receptors leads to a decrease. The increase in signaling by individual ligands and decrease by a combination of ligands is also seen in primary spinal cord neurons endogenously expressing these receptors. Taken together, these results suggest that physical associations between mu and alpha2A receptors could play a role in the functional interactions between these receptors.

Personal exposure to benzene, toluene and xylene in different microenvironments at the Mexico City metropolitan zone

The Mexico City Metropolitan Zone (ZMCM) population's exposure to benzene, toluene and xylene was measured at different microenvironments to establish basic indicators of the presence and effects of these characteristic volatile organic compounds (VOC). In particular, VOC personal exposures were measured in different microenvironments during a 5-day working week, with 12-h daily periods. We have found a good agreement of our results with the registered VOC levels of the Metropolitan Automated Monitor System (RAMA) for the corresponding period. From our results, we expect to generate useful information to evaluate the health effects of these VOCs on exposed people.

Varicella, ephemeral breastfeeding and eczema as risk factors for multiple sclerosis in Mexicans

OBJECTIVE

It has been suggested that the incidence of multiple sclerosis (MS) in Mexico and other countries of Latin America has increased steadily for the last two decades. We made a thorough search of antecedents on MS patients that could be potential risk factors.

METHODS

A case-control study was conducted using a questionnaire that included demographic, nutritional, infectious and personal antecedents previously identified in other reports as possible risk factors for MS.

RESULTS

The frequency of varicella, ephemeral breastfeeding and eczema in the medical history of MS patients were significant when compared with controls; all appeared to be mutually additive. However, they were unrelated with clinical characteristics or disease severity.

CONCLUSION

During the last decades, breastfeeding has been abandoned in large segments of society and the incidence of varicella and childhood eczema keeps a north-south gradient similar to that described for MS. These factors may participate in the sharp increase of MS in countries like Mexico traditionally considered as an area of very low incidence.

EGb761 blocks MPP+-induced lipid peroxidation in mouse corpus striatum

EGb761 has been suggested to be an antioxidant and free radical scavenger. Excess generation of free radicals, leading to lipid peroxidation (LP), has been proposed to play a role in the damage to striatal neurons induced by 1-methyl-4-phenylpyridinium (MPP+). We investigated the effects of EGb761 pretreatment on MPP+ neurotoxicity. C-57 black mice were pretreated with EGb761 for 17 days at different doses (0.63, 1.25, 2.5, 5 or 10 mg/kg) followed by administration of MPP+, (0.18, 0.36 or 0.72 mg/kg). LP was analyzed in corpus striatum at 30 min, 1 h, 2 h and 24 h after MPP+ administration. Striatal dopamine content was analyzed by HPLC at the highest EGb761 dose at 2 h and 24 h after MPP+ administration. MPP+-induced LP was blocked (100%) by EGb761 (10 mg/kg). Pretreatment with EGb761 partially prevented (32%) the dopamine-depleting effect of MPP+ at 24 h. These results suggest that supplements of EGb761 may be effective at preventing MPP+-induced oxidative stress.

Clomipramine increases the striatal concentrations of dopamine and homovanillic acid in rats chronically consuming alcohol

OBJECTIVE

There have been many studies on the relationships between the dopaminergic system, alcoholism and antidepressant drugs; the information, however, is controversial. The purpose of this study was to examine the effect of clomipramine (CMI), a tricyclic antidepressant, on the striatal concentration of dopamine (DA) and homovanillic acid (HVA), and their turnover, in a rat model of chronic alcohol ingestion.

METHOD

After 10 months of exposure to either water (expW) or alcohol (expA), female Wistar rats (N = 60) were randomly assigned to one of the following six groups: (1) (expW) control group (C), normal diet; (2) (expA) alcohol administration group (A), drinking water was replaced by commercial brandy that was 38% ethanol; (3) (expW) clomipramine group (CMI), received intraperitoneal injections over 4 months; (4) (expA) alcohol administration + clomipramine group (ACMI); (5) (expA) alcohol abstinence group (AA); and (6) (expA) alcohol abstinence + clomipramine group (AACMI). Each group consisted of 10 animals.

RESULTS

Chronic alcohol intake decreased striatal dopamine concentration (p < .001), whereas clomipramine administration produced a significant increase (p < .001) when administered in both control rats and rats exposed to long-term alcohol administration. The increase in the ACMI group was significantly different (p < .001) when it was compared with the CMI group. In the AA and AACMI groups, a significant decrease of striatal dopamine was observed (p < .001). During long-term alcohol administration, homovanillic acid decreased (p < .005). HVA/DA ratio increased in AA and AACMI groups (p < .001).

CONCLUSIONS

These findings show that clomipramine produces favorable changes in dopaminergic systems altered by chronic alcohol administration. Results also provide evidence to support further prospective studies of potential therapeutic effects of antidepressant drugs in alcoholism.

Neuroprotective effect of acute and chronic administration of copper (II) sulfate against MPP+ neurotoxicity in mice

Neurodegenerative effects of MPP+, the main metabolite of MPTP include dopamine (DA) depletion and enhanced lipid peroxidation (LPO) in mice striata, both associated to free radicals overproduction. Since copper is related to several antioxidant enzymes, we tested its neuroprotective effect against MPP+-induced neurotoxicity (20 microg/3 microl). CuSO4 pretreatment was administrated by either acute (2.5 mg/kg, i.p.) or chronic (350 or 700 mg/l doses through drinking water, for 30 days) schemes. Acute administration blocked MPP+-induced striatal LPO only when administered 16 or 24 hours before MPP+, and prevented the DA-depleting effect only at 24 hours. Chronic CuSO4 prevented the LPO increase, and blocked the DA depletion only at the higher dose used (700 mg/l). Neuroprotective effect of CuSO4 was dependent on the dose and the time of pretreatment, which suggest that this lag could be related with mechanisms of activation or synthesis of copper-dependent proteins responsible of cellular defense against MPP+.

G protein coupled receptor dimerization: implications in modulating receptor function

Protein-protein interactions are involved in the regulation of a large number of biological processes. It is well established that a variety of cell surface receptors interact with each other to form dimers, and that this is essential for their activation. Although the existence of G protein coupled receptor dimers was predicted from early pharmacological and biochemical analysis, solid evidence supporting dimerization has come within the past few years following the cloning of G protein coupled receptor cDNAs. Using differential epitope tagging and selective immunoisolation of receptor complexes, dimerization of a number of G protein coupled receptors including members of the rhodopsin, secretin, and metabotropic glutamate receptor families have been reported. More recently fluorescence or bioluminescence resonance energy transfer techniques have been used to examine dimerization of these receptors in live cells. These studies have found that whereas in some cases there is an agonist induced increase in the level of dimers, in others there is a decrease or no change in dimer levels. Several recent studies have also reported the ability of related members of G protein coupled receptors to heterodimerize. These heterodimers exhibit distinct physical and functional properties. Examination of possible sites of interactions between receptors has implicated a role for extracellular, transmembrane and/or C-terminal region in dimerization. The functional consequences of dimerization, explored mainly using mutant receptors, have demonstrated a role in modulating agonist affinity, efficacy, and/or trafficking properties. Thus dimerization appears to be a universal phenomenon that provides an additional mechanism for modulation of receptor function as well as cross-talk between G protein coupled receptors.

Exposure to manganese: health effects on the general population, a pilot study in central Mexico

To support a risk assessment of manganese exposure in two communities living within a manganese mining district a cross-sectional study was performed on a sample of the adult population of long-term residents. One community was exposed to a point source from an ore primary refining plant. Manganese is an essential mineral for human life. It is also the fourth in importance for industrial metal making. Data were collected on socioeconomic living conditions, emission sources, environmental media concentrations (air, water, soil, dust, food), respiratory symptomatology, and a neuropsychological examination (Mini-Mental Screening test, the Hooper Visual Organization test, the Ardila-Ostroski, and others). We examined 73 subjects (52 women), most of low socioeconomic status. Environmental air concentrations were 2 to 3 times higher than those in other urban concentrations. Manganese blood concentrations ranged from 7.5 to 88 microg/L, with a median concentration of 15, the upper quartile starting at 20 microg/L; the upper 10% was above 25 microg/L. Lead and manganese were highly correlated; there was an inverse relation to hemoglobin. Reduced levels of plasma lipid peroxidation were associated with blood manganese. Using multivariate logistic regression, we identified B-Mn as increasing the risk of deficient cognitive performance 12 times (Mini-Mental score of less than 17).

Lipid peroxidation inhibition in spinal cord injury: cyclosporin-A vs methylprednisolone

To compare the effectiveness of cyclosporin-A (CsA) with methylprednisolone (MP) or a combination of both upon inhibition of lipid peroxidation (LP) after spinal cord (SC) injury, rats were treated with either CsA, MP, CSA+MP or vehicle starting 1 h after SC contusion at T9 level. LP was assessed 24h after injury by the lipid fluorescent product formation method. The survival rate was also evaluated in other series of rats by the Kaplan-Meier curves. Lipid peroxidation was similarly inhibited in rats treated with CsA, MP, or CSA+MP (p>0.05). Animals receiving MP (alone or combined with CsA) showed the poorest surviving rate. LP was inhibited by CsA to the same extent as by MP but without the lethal effect of the latter.

Changes of metallothionein I + II proteins in the brain after 1-methyl-4-phenylpyridinium administration in mice

1-methyl-4-phenylpyridinium (MPP+) is a drug that induces a Parkinson's-like syndrome in several species. Oxidative stress resulting from either excess generation or reduced scavenging of free radicals has been proposed to play a role in its neurotoxicity. It has been suggested that metallothionein (MT) protects against oxidative damage of the central nervous system produced by overproduction of free radicals. This study examined the effect of MPP+ on metallothionein I+II protein content in different brain regions. NIH mice were injected with MPP+ (4.5, 9.0 or 18 microg/3 microl) into their right lateral ventricle. Corpus striatum, cerebellum, midbrain, frontal cortex and hippocampus were dissected out and their metallothionein concentrations were analyzed by radioimmunoassay. MPP+ reduced the concentration of MT I+II proteins (38%) only in the striatum. The results suggest that changes in MT I+II content may be associated with MPP+ neurotoxicity.

Blood lead levels measured prospectively and risk of spontaneous abortion

Studies of low to moderate level lead exposures have reported mixed findings regarding the risk of spontaneous abortion, despite lead's abortifacient properties at very high doses. To evaluate the risk of spontaneous abortion from low or moderate lead exposures, a nested case-control study was conducted within a cohort of pregnant women in Mexico City, 1994-1996. During their first trimester, 668 women enrolled, were interviewed, and contributed blood specimens. Pregnancies were followed by home visits or telephone calls. Spontaneous abortions before week 21 (n = 35) were matched with pregnancies that survived beyond week 20 (n = 60) on maternal age, hospital, date of enrollment, and gestational age at enrollment. Mean blood lead levels were 12.03 microg/dL for cases and 10.09 microg/dL for controls (p = 0.02). Odds ratios for spontaneous abortion comparing 5-9, 10-14, and > or =15 microg/dL with the referent category of <5 microg/dL of blood lead were 2.3, 5.4, and 12.2, respectively, demonstrating a significant trend (p = 0.03). After multivariate adjustment, the odds ratio for spontaneous abortion was 1.8 (95% confidence interval = 1.1, 3.1) for every 5 microg/dL increase in blood lead. Low to moderate lead exposures may increase the risk for spontaneous abortion at exposures comparable to US general population levels during the 1970s and to many populations worldwide today; these are far lower than exposures encountered in some occupations.

Lead acetate exposure inhibits nitric oxide synthase activity in capillary and synaptosomal fractions of mouse brain

The toxicity of lead (Pb) is of concern to public health due to its persistence in the environment. Brain is one of the major target organs where severe neurologic alterations may be triggered after exposure. The primary effects of lead on brain functions are thought to be a damage to the nervous system microvasculature. However, the mechanism of this toxicity is poorly understood. Nitric oxide synthase (NOS) may be a target for lead and changes in its function can result in a cascade of pathophysiological effects that may be observed in isolated capillaries and synaptosomes. We have determined the concentration of lead in blood, capillaries and synaptosomes in brain from mice receiving 0, 250, 500, and 1000 ppm of lead for 14 days, through the drinking water. NOS activity was determined in the capillaries and synaptosomes by following the conversion of 3H-L-arginine to 3H-L-citrulline. The results show that blood lead levels were dose-dependent. Brain capillaries showed a preferential accumulation of lead as compared to synaptosomes. With all Pb treatments, synaptosomal constitutive NOS was inhibited (about 50% of control) while the inducible NOS activity in capillaries was enhanced. These data suggest that inhibition of cNOS activity and increase in iNOS may contribute to the Pb effects on the CNS.

Cyclosporin-A inhibits lipid peroxidation after spinal cord injury in rats

Besides its immunosuppressive/anti-inflammatory activity, cyclosporin-A (CsA) may protect damaged tissues from lipid peroxidation (LP) by free radicals. To determine the effect of CsA on LP spinal cord (SC) injury, Wistar rats were treated with either vehicle or CsA (2.5 mg/kg per 12 h i.p.) 1, 2, 6 or 12 h after SC trauma by T8-T9 spinal cord contusion, analyzing LP 24 h after injury at the lesion site by the lipid fluorescent products formation method. CsA significantly diminished LP to levels below control values after contusion (P < 0.05). The greater inhibition was observed when CsA was given during the first 6 h after injury, furthermore, animals showed a significant clinical improvement. Results show that CsA may be beneficial to injured tissue by inhibiting the levels of LP.

Reduced ferroxidase activity in the cerebrospinal fluid from patients with Parkinson's disease

Recent evidence suggest the implication of transition metals leading to overproduction of free radicals as a possible causal factor in the death of nigral cells associated to Parkinson's disease (PD). Iron depots in the basal ganglia of PD patients have been described; in addition, contents of nigral copper have been found decreased, while its concentration in cerebrospinal fluid (CSF) is raised, particularly the free form of the metal. To search for a possible link between altered copper concentrations and PD, we advanced the hypothesis that ferroxidase activity of ceruloplasmin is decreased in the CSF of PD patients. We studied 35 untreated PD patients, 14 L-3,4-dihydroxyphenylalanine (L-DOPA)-treated PD patients and 26 controls. Both CSF ferroxidase activity and CSF copper content were measured and correlated with the clinical stage of the disease. We found that untreated PD patients had a significant reduction of 40% in CSF ferroxidase while CSF copper was slightly increased as compared with both the values in L-DOPA-treated PD patients and controls. We also found that the fraction of copper linked to ferroxidase in untreated PD is inversely related to the clinical stage of the disease.

Relationship between peripheral estrogen concentrations at insemination and subsequent fetal loss in cattle

In a survey on pregnancy rate and embryonic losses in dairy cattle on 6 Israeli farms, cows (n = 78) were divided into 3 groups on the basis of ultrasonography at 21 d post insemination; pregnancy diagnosis at 40 to 50 d post insemination and blood progesterone (P4) levels at 21 d. The groups were either pregnant (P4 level > 1.0 ng/ mL); not pregnant (P4 < 0.5 ng/mL), or showed early embryo loss (P4 > 1.0 ng/mL and the presence of an embryonic vesicle on D 21 but later returned to estrus or were found not pregnant on D 40 to 50). On the day of insemination, peripheral estrogen was significantly higher (P < 0.05) in the early embryo loss group (15.3 +/- 1.1 pg/mL, n = 27) than in pregnant (9.4 +/- 0.6 pg/mL, n = 26) or not pregnant (9.6 +/- 0.7 pg/mL, n = 25) group. The cows on 3 farms which were fed 1 to 2 kg/d of vetch (Vicia sativa), an estrogenic legume, had higher estrogen concentrations on the day of insemination than cows (2 farms) fed other legumes (13.7 +/- 0.64, n = 58 vs 10.7 +/- 0.8 pg/mL, n = 42; P < 0.01). On one of the 3 farms, vetch was replaced with alfalfa after the first year. Following the cessation of vetch feeding the estrogen concentrations in the blood decreased from 32 +/- 5 pg/mL to 14 +/- 2 pg/mL (n = 9). These data suggest that high peripheral estrogen on the day of insemination is associated with early embryonic loss. These data also indicate that estrogen concentrations on the day of insemination can be influenced by diet.