El consum matern de substàncies d'abús pot provocar canvis adversos en la placenta

Investigadors de la UAB han realitzat un estudi en el que controlant el creixement de més de dues-centes placentes han pogut apreciar canvis en els vasos sanguinis d'aquestes deguts al consum matern de substàncies d'abús, com el tabac o l'alcohol. Aquests canvis porten a una baixa aportació de sang a la placenta i al fetus, provocant així un ambient pobre en oxigen. Aquest tipus de canvis adversos es poden donar abans, durant i fins i tot, després del naixement. Segons aquests investigadors, calen més estudis per entendre millor els mecanismes pels quals el consum d'aquestes substàncies en les mares provoca una disminució en pes i talla en els acabats de néixer.Investigadores de la UAB han realizado un estudio en el que controlando el crecimiento de más de doscientas placentas han podido apreciar cambios en los vasos sanguíneos de estas debidos al consumo de sustancias de abuso, como el tabaco o el alcohol por de la madre. Estos cambios llevan a una baja aportación de sangre a la placenta y al feto, provocando así un ambiente pobre en oxígeno. Este tipo de cambios adversos se pueden dar antes, durante e incluso después del nacimiento. Según estos investigadores, se necesitan más estudios para entender mejor los mecanismos por los que el consumo de estas sustancias en las madres provoca una disminución en peso y talla en los recién nacidos

Transient Exposure to Ethanol during Zebrafish Embryogenesis Results in Defects in Neuronal Differentiation : An Alternative Model System to Study FASD

The exposure of the human embryo to ethanol results in a spectrum of disorders involving multiple organ systems, including the impairment of the development of the central nervous system (CNS). In spite of the importance for human health, the molecular basis of prenatal ethanol exposure remains poorly understood, mainly to the difficulty of sample collection. Zebrafish is now emerging as a powerful organism for the modeling and the study of human diseases. In this work, we have assessed the sensitivity of specific subsets of neurons to ethanol exposure during embryogenesis and we have visualized the sensitive embryonic developmental periods for specific neuronal groups by the use of different transgenic zebrafish lines. In order to evaluate the teratogenic effects of acute ethanol exposure, we exposed zebrafish embryos to ethanol in a given time window and analyzed the effects in neurogenesis, neuronal differentiation and brain patterning. Zebrafish larvae exposed to ethanol displayed small eyes and/or a reduction of the body length, phenotypical features similar to the observed in children with prenatal exposure to ethanol. When neuronal populations were analyzed, we observed a clear reduction in the number of differentiated neurons in the spinal cord upon ethanol exposure. There was a decrease in the population of sensory neurons mainly due to a decrease in cell proliferation and subsequent apoptosis during neuronal differentiation, with no effect in motoneuron specification. Our investigation highlights that transient exposure to ethanol during early embryonic development affects neuronal differentiation although does not result in defects in early neurogenesis. These results establish the use of zebrafish embryos as an alternative research model to elucidate the molecular mechanism(s) of ethanol-induced developmental toxicity at very early stages of embryonic development

Acute heroin intoxication in a baby chronically exposed to cocaine and heroin: a case report

<p>Abstract</p> <p>Introduction</p> <p>Acute intoxication with drugs of abuse in children is often only the tip of the iceberg, actually hiding chronic exposure. Analysis using non-conventional matrices such as hair can provide long-term information about exposure to recreational drugs.</p> <p>Case presentation</p> <p>We report the case of a one-month-old Caucasian boy admitted to our pediatric emergency unit with respiratory distress and neurological abnormalities. A routine urine test was positive for opiates, suggesting an acute opiate ingestion. No other drugs of misuse, such as cocaine, cannabis, amphetamines or derivatives, were detected in the baby's urine. Subsequently, hair samples from the baby and the parents were collected to evaluate the possibility of chronic exposure to drug misuse by segmental analysis. Opiates and cocaine metabolites were detected in hair samples from the baby boy and his parents.</p> <p>Conclusions</p> <p>In light of these and previous results, we recommend hair analysis in babies and children from risky environments to detect exposure to heroin and other drug misuse, which could provide the basis for specific social and health interventions.</p

Prenatal and Postnatal Exposure to DDT by Breast Milk Analysis in Canary Islands

The use of p,p' -dichlorodiphenyltrichloroethane (DDT) has been banned since the late 1970s due to its toxicity. However, its long half-life makes it persistent in the environment and, consequently, almost everyone has DDT residues in the body. Human milk constitutes an ideal non-conventional matrix to investigate environmental chronic exposure to organochlorine compounds (OCs) residues. The study aimed to identify potential population risk factors of exposure to DDT due to the proximity to countries where it is still used. Seventy-two consecutive lactating women were prospectively included in Tenerife, Canary Islands (Spain). A validated questionnaire was used to obtain socioeconomic, demographics data, and daily habits during pregnancy. DDT levels in breast milk were measured by gas chromatography with-electron capture detector (GC-ECD). Anthropometrics measurements in newborns were obtained. Thirty-four out of 72 (47.2%) of the analysed milk samples presented detectable levels of DDT (mean: 0.92 ng/g), ranging between 0.08 to 16.96 ng/g. The socio-demographic variables did not significantly differ between detectable DDT and non-detectable DDT groups. We found positive association between DDT levels and vegetables (OR (95%CI): 1.23 (1.01-1.50)) and poultry meat (OR (95%CI): 2.05 (1.16-3.60)) consumption, and also between the presence of DDT in breast milk and gestational age (OR (95%CI): 0.59 (0.40-0.90)). DDT is present in breast milk of women at the time of delivery. Residual levels and the spread from countries still using DDT explain DDT detection from vegetables and from animal origin food. The presence of this compound in breast milk represents a pre- and postnatal exposure hazard for foetuses and infants due to chronic bioaccumulation and poor elimination, with possible deleterious effects on health. This data should be used to raise awareness of the risks of OCs exposure and to help establish health policies in order to avoid its use worldwide and thus, to prevent its propagation

Hair analysis following chronic smoked-drugs-of-abuse exposure in adults and their toddler: a case report

<p>Abstract</p> <p>Introduction</p> <p>Over the past two decades, the study of chronic cocaine and crack cocaine exposure in the pediatric population has been focused on the potential adverse effects, especially in the prenatal period and early childhood. Non-invasive biological matrices have become an essential tool for the assessment of a long-term history of drug of abuse exposure.</p> <p>Case report</p> <p>We analyze the significance of different biomarker values in hair after chronic crack exposure in a two-year-old Caucasian girl and her parents, who are self-reported crack smokers. The level of benzoylecgonine, the principal metabolite of cocaine, was determined in segmented hair samples (0 cm to 3 cm from the scalp, and > 3 cm from the scalp) following washing to exclude external contamination. Benzoylecgonine was detectable in high concentrations in the child's hair, at 1.9 ng/mg and 7.04 ng/mg, respectively. Benzoylecgonine was also present in the maternal and paternal hair samples at 7.88 ng/mg and 6.39 ng/mg, and 13.06 ng/mg and 12.97 ng/mg, respectively.</p> <p>Conclusion</p> <p>Based on the data from this case and from previously published poisoning cases, as well as on the experience of our research group, we conclude that, using similar matrices for the study of chronic drug exposure, children present with a higher cocaine concentration in hair and they experience more serious deleterious acute effects, probably due to a different and slower cocaine metabolism. Consequently, children must be not exposed to secondhand crack smoke under any circumstance.</p

Efectes de l'alcohol durant el desenvolupament embrionari

L'exposició de l'embrió humà a etanol resulta en un espectre de trastorns que impliquen múltiples sistemes d'òrgans, incloent el deteriorament del desenvolupament del sistema nerviós central. Tot i la importància que té per a la salut humana, la base molecular de l'exposició prenatal a l'alcohol segueix sent poc coneguda. En aquest treball, hem avaluat en diferents línies de peix zebra transgènic, un organisme de gran abast per al modelatge i l'estudi de malalties humanes, la sensibilitat de subconjunts específics de neurones a l'exposició a etanol durant l'embriogènesi i hem visualitzat els seus períodes sensibles de desenvolupament embrionari.La exposición del embrión humano a etanol resulta en un espectro de trastornos que implican a múltiples sistemas de órganos, incluyendo el deterioro del desarrollo del sistema nervioso central. A pesar de la importancia que tiene para la salud humana, la base molecular de la exposición prenatal al alcohol sigue siendo poco conocida. En este trabajo, hemos evaluado en diferentes líneas de pez cebra transgénico, un organismo de gran alcance para el modelado y el estudio de enfermedades humanas, la sensibilidad de subconjuntos específicos de neuronas en la exposición a etanol durante la embriogénesis y hemos visualizado sus períodos sensibles de desarrollo embrionario

How can cry acoustics associate newborns’ distress levels with neurophysiological and behavioral signals?

IntroductionEven though infant crying is a common phenomenon in humans’ early life, it is still a challenge for researchers to properly understand it as a reflection of complex neurophysiological functions. Our study aims to determine the association between neonatal cry acoustics with neurophysiological signals and behavioral features according to different cry distress levels of newborns.MethodsMultimodal data from 25 healthy term newborns were collected simultaneously recording infant cry vocalizations, electroencephalography (EEG), near-infrared spectroscopy (NIRS) and videos of facial expressions and body movements. Statistical analysis was conducted on this dataset to identify correlations among variables during three different infant conditions (i.e., resting, cry, and distress). A Deep Learning (DL) algorithm was used to objectively and automatically evaluate the level of cry distress in infants.ResultsWe found correlations between most of the features extracted from the signals depending on the infant’s arousal state, among them: fundamental frequency (F0), brain activity (delta, theta, and alpha frequency bands), cerebral and body oxygenation, heart rate, facial tension, and body rigidity. Additionally, these associations reinforce that what is occurring at an acoustic level can be characterized by behavioral and neurophysiological patterns. Finally, the DL audio model developed was able to classify the different levels of distress achieving 93% accuracy.ConclusionOur findings strengthen the potential of crying as a biomarker evidencing the physical, emotional and health status of the infant becoming a crucial tool for caregivers and clinicians

Prevalence of Fetal Alcohol Spectrum Disorders (FASD) among Children Adopted from Eastern European Countries: Russia and Ukraine

Fetal alcohol spectrum disorders; Adopted children; Cognitive disorderTrastornos del espectro alcohólico fetal; Niño adoptado; Trastorno cognitivoTrastorns de l'espectre alcohòlic fetal; Nens adoptats; Trastorn cognitiuFetal alcohol spectrum disorder (FASD) is a leading cause of neurodevelopmental disorders. Children adopted internationally from countries where alcohol consumption during pregnancy is very high are at greater risk for FASD. Lack of expertise in diagnosing FASD and mixed neurodevelopmental and behavioral signs due to abandonment complicate a timely diagnosis. The aim of this study was to determine the prevalence of FASD in adopted children. Children between the ages of 8 and 24 adopted from Russia and Ukraine were evaluated for clinical and historical features of FASD. Of the 162 children evaluated, 81 (50%) met FASD diagnostic criteria. Thirty-three (20.4%) children had fetal alcohol syndrome (FAS), 28 (17.2%) had partial FAS, 2 (1.2%) had alcohol-related birth defects (ARBD) and 18 (11.1%) had alcohol-related neurodevelopmental disorder (ARND). Of the 81 children in which fetal alcohol exposure could not be confirmed, many had manifestations that would have established a diagnosis of FASD if a history of maternal alcohol consumption was confirmed. In a population of children with a high risk of prenatal alcohol exposure (adoptees from Eastern European countries), at least 50% showed manifestations associated with FASD. The reported prevalence in this study is in line with the results obtained in a previous study as well as in orphanages of origin

A longitudinal study of environmental tobacco smoke exposure in children: Parental self reports versus age dependent biomarkers

<p>Abstract</p> <p>Background</p> <p>Awareness of the negative effects of smoking on children's health prompted a decrease in the self-reporting of parental tobacco use in periodic surveys from most industrialized countries. Our aim is to assess changes between ETS exposure at the end of pregnancy and at 4 years of age determined by the parents' self-report and measurement of cotinine in age related biological matrices.</p> <p>Methods</p> <p>The prospective birth cohort included 487 infants from Barcelona city (Spain). Mothers were asked about maternal and household smoking habit. Cord serum and children's urinary cotinine were analyzed in duplicate using a double antibody radioimmunoassay.</p> <p>Results</p> <p>At 4 years of age, the median urinary cotinine level in children increased 1.4 or 3.5 times when father or mother smoked, respectively. Cotinine levels in children's urine statistically differentiated children from smoking mothers (Geometric Mean (GM) 19.7 ng/ml; 95% CI 16.83–23.01) and exposed homes (GM 7.1 ng/ml; 95% CI 5.61–8.99) compared with non-exposed homes (GM 4.5 ng/ml; 95% CI 3.71–5.48). Maternal self-reported ETS exposure in homes declined in the four year span between the two time periods from 42.2% to 31.0% (p < 0.01). Nevertheless, most of the children considered non-exposed by their mothers had detectable levels of cotinine above 1 ng/mL in their urine.</p> <p>Conclusion</p> <p>We concluded that cotinine levels determined in cord blood and urine, respectively, were useful for categorizing the children exposed to smoking and showed that a certain increase in ETS exposure during the 4-year follow-up period occurred.</p

Model de relació entre l’atenció primària i comunitària i l’atenció hospitalària ambulatòria

Atenció primària; Atenció hospitalària; PacientAtención primaria; Atención hospitalaria; PacientePrimary care; Hospital care; PatientL’objectiu del present document és definir un model de relació entre l’atenció primària i comunitària i l’atenció hospitalària ambulatòria que doni una resposta resolutiva, equitativa i de qualitat durant tot el procés assistencial. A tal fi es defineix el diagrama del procés assistencial pel qual els metgesa especialistes de medicina de família i comunitària (MFiC) sol·liciten l’atenció, mitjançant l’ordre clínica, dels seus homòlegs d’atenció hospitalària ambulatòria (MAH). A més, s’estableixen un seguit de recomanacions relatives a la relació que s’estableix entre l’MFiC i el MAH a l’hora de contribuir a la millora de la salut de la persona atesa