Metabolic biomarkers related to oxidative stress and antioxidant status in Saudi autistic children

ObjectiveMeasurement of oxidative stress and antioxidant-related parameters (enzymatic and non-enzymatic) in Saudi autistic children.Design and methods30 autistic children (22 males and 8 females) aged 3–15 years (25/30 of these were below 8 years old), and 30 healthy children as control group were included in this study. Levels of lipid peroxides, vitamin E, vitamin C, glutathione together with enzymatic activities of glutathione peroxidase (GSH-Px), and catalase were determined in plasma while superoxide dismutase (SOD was measured in red blood cells of both groups.ResultsLipid peroxidation was found to be significantly higher in autistic compared to control Saudi children. On the other hand, vitamin E and glutathione were remarkably lower in autistic patients while vitamin C shows non-significant lower values. Regarding the enzymatic antioxidants, both glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) were significantly higher in autistic compared to control while catalase recorded more or less similar activities in both groups.ConclusionSaudi autistic children are under H₂O₂ stress due to GSH depletion, over expression of SOD together with the unchanged catalase enzyme. This could be helpful in the early diagnosis of young autistic patients and suggesting the possibility of antioxidant supplementation for the early intervention with autistic children.     

Oxidative stress and antioxidant status in Saudi asthmatic patients

ObjectivesAsthma is a chronic inflammatory airway disorder associated with recruitment of inflammatory cells. This study aims to clarify the role of oxidative stress and antioxidant status in the deterioration accompanied asthma.Design and methodsVitamin E, Vitamin C, superoxide dismutase (SOD), glutathione peroxidase (GPx), reduced glutathione (GSH), total antioxidant status together with the concentrations of lipid peroxides, total nitrates and oxidative DNA damage (8-oxodeoxyguanine) were determined in plasma or whole blood of 47 Saudi asthmatic patients and compared to age-matching control samples.ResultsThe present study showed that asthmatic patients have significantly decreased levels of GSH, α-tocopherol, GPx, total antioxidant status and higher levels of SOD, lipid peroxides, total nitrate and 8-oxo-dG. Vitamin C recorded more or less similar levels in both groups.ConclusionAlteration of the selected measured parameters confirms that oxidative stress and defective antioxidant status could represent the primary causative factor in the pathogenesis of asthma.     

乌鲁木齐地区0～14岁儿童脂溶性维生素营养水平现状研究

目的研究乌鲁木齐地区0~14岁儿童脂溶性维生素A、D、E、K营养水平。方法选取2018年11月至2019年3月该院体检儿童264例,分为婴幼儿组(0~<3岁)104例,学龄前组(3~<6岁)75例,学龄组(6~<14岁)85例,利用液相色谱串联质谱法检测血清中维生素A、D、E及K水平。结果维生素D在男童中水平为(22.13±13.79)ng/mL,在女童中水平为(18.85±12.06)ng/mL,男童明显高于女童,差异有统计学意义(P<0.05)。维生素A、E、K在男、女童之间水平比较,差异无统计学意义(P>0.05)。维生素A水平为(0.30±0.08)mg/L,缺乏率为11.7%,婴幼儿组缺乏率最高(17.3%)。维生素D水平为(20.80±13.19)ng/mL,缺乏率、不足率和为60.3%,随着年龄的增加,缺乏率有所增加。维生素E水平为(10.22±2.20)mg/L,不足率为4.9%,整体处于正常水平。维生素K水平为0.36(0.19~0.69)ng/mL,缺乏率为13.3%,婴幼儿组及学龄前组儿童中缺乏较多,缺乏率分别为11.5%、18.7%。结论乌鲁木齐地区儿童脂溶性维生素存在整体缺乏的情况,在医生的指导下正确、及时地检测和合理地补充脂溶性维生素,有助于儿童的健康成长。     

Selenium status in Europe--human data. A multicenter study

In order to examine the levels of serum selenium in Europe, a collaborative study was conducted under the auspices of "The Working Group on Diet and Cancer" under "The European Organisation for Cooperation in Cancer Prevention Studies". A total of 502 serum samples was obtained from healthy, non-institutionized individuals, aged between 20 and 65 years, from 17 locations in 10 different countries in Europe. The selenium content of the samples was determined by a fluorometric method. All analyses were performed in one laboratory. Mean +/- standard deviation of the serum selenium given in microgram/l for the combined male and female data from the individual regions was: Belgium: 100 +/- 9; Denmark: Aarhus 78 +/- 15; France: Grenoble 79 +/- 15; Paris 82 +/- 11; W. Germany: Bavaria 70 +/- 10 Giessen 68 +/- 10, Heidelberg 76 +/- 9; Greece 63 +/- 14; Netherlands: 93 +/- 12; Portugal: Lissabon 102 +/- 10; Spain: Barcelona 87 +/- 14; Sweden: G?teborg 77 +/- 11, Malm? 90 +/- 14, Ume? 82 +/- 8, Uppsala 81 +/- 15; United Kingdom: Ipswich 107 +/- 13, London 109 +/- 14. None of the values represented toxic or overt deficiency levels.     

Concentrations of B vitamins and homocysteine in children with sickle cell anemia

BACKGROUND: Elevated concentration of serum homocysteine contributes to thrombosis, a frequent event in patients with sickle cell anemia. We aimed to test whether children with sickle cell anemia have elevated concentrations of serum homocysteine with diminished levels of folate or B vitamins from accelerated blood cell turnover. METHODS: We conducted a case-control study of children with homozygous sickle cell anemia (n = 17) and unaffected children (n = 11). We measured serum and red blood cell folate, vitamin B6, vitamin B12, and homocysteine concentrations, and assessed micronutrient intake. RESULTS: Children with sickle cell anemia had concentrations of homocysteine slightly higher than those of unaffected children. They had lower vitamin B6 concentrations and comparable concentrations of folate and vitamin B12. Homocysteine concentration was inversely related to vitamin B12 concentration and was not independently associated with levels of vitamin B6 or folate. CONCLUSION: Despite comparable intake, children with sickle cell anemia had lower concentrations of vitamin B6 than unaffected children. Larger studies are needed to determine if chronically low serum vitamin B6 concentration contributes to hyperhomocysteinemia in this population.     

Metabolic biomarkers related to energy metabolism in Saudi autistic children

ObjectivesEnergy metabolism is usually manipulated in many neurodegenerative diseases. Autism is considered a definable systemic disorder resulting in a number of diverse factors that may affect the brain development and functions both pre and post natal. The increased prevalence of autism will have enormous future public implications and has stimulated intense research into potential etiologic factors. This study aims to establish a connection between autism and the deterioration accompanied it, especially in the brain cognitive areas through a postulation of energy manipulation.Materials and methodsThe biochemical changes in activities of enzymes and pathways that participate in the production of ATP as the most important high-energy compound needed by the human brain were measured in Saudi autistic children. Na⁺/K⁺ATPase, ectonucleotidases (NTPDases) (ADPase and ATPase) and creatine kinase (CK), were assessed in plasma of 30 Saudi autistic patients and compared to 30 age-matching control samples. In addition, adenosine mono, di and trinucleotides (ATP, ADP, and AMP) were measured calorimetrically in the red blood cells of both groups and the adenylate energy charge (AEC) was calculated. Moreover, lactate concentration in plasma of both groups was monitored.ResultsThe obtained data recorded 148.77% and 72.35% higher activities of Na⁺/K⁺ATPase and CK respectively in autistic patients which prove the impairment of energy metabolism in these children compared to age and sex matching healthy controls. While ADPase was significantly higher in autistic patients, ATPase were non-significantly elevated compared to control. In spite of the significant increase of Na⁺/K⁺ATPase activity in autistic patients, there was no significant difference in the levels of ATP, ADP, and AMP in both groups and the calculated AEC values were 0.814 ± 0.094 and 0.806 ± 0.081 for autistic and control groups respectively. The unchanged AEC value in autistic patients was easily correlated with the induced activity of CK and ADPase as two enzymes playing a critical role in the stabilization of AEC. Lactate as an important energy metabolite for the brain was significantly higher in autistic patients compared to control showing about 40% increase.ConclusionThe present study confirmed the impairment of energy metabolism in Saudi autistic patients which could be correlated to the oxidative stress previously recorded in the same investigated samples. The identification of biochemical markers related to autism would be advantageous for earlier clinical diagnosis and intervention.     

Nutritional status and anthracycline cardiotoxicity in children

The nutritional status of children in whom cardiomyopathy resulted from anthracycline chemotherapy was compared to that of a matched control group of patients who were treated similarly but who had no evidence of cardiac toxicity. Those with cardiotoxic reactions were found to be more often malnourished than were their matched controls. Once clinical manifestations of cardiotoxocity developed, the course was relentless and resistant to treatment and ended in death in 75% of the patients.     

Contribution of insulin resistance to reduced antioxidant enzymes and vitamins in nonobese Korean children

BACKGROUND: The prevalence of insulin resistance has been reported in nonobese, nondiabetic healthy individuals. We examined the relationship between insulin resistance and the reduced antioxidant systems of plasma lipid soluble vitamins and antioxidant enzymes in erythrocytes and to determine the contributing factors to the antioxidant systems in nonobese children. METHODS: We measured blood lipid profiles, glucose, insulin concentrations, plasma antioxidant vitamins and erythrocytic antioxidant enzyme activities of 103 Korean children in the absence of obesity. Insulin resistance was estimated by homeostasis model assessment of insulin resistance (HOMA-IR). RESULTS: A significant inverse relationships between HOMA-IR and lipid corrected beta-carotene (r=-0.233, p<0.05), alpha-tocopherol (r=-0.370, p<0.0001) were observed. In addition, increased HOMA-IR was significantly related to the decreased activities of superoxide dismutase (r=-0.226, p<0.05) and catalase (r=-0.261, p<0.05). Stepwise multiple linear regression analyses showed that HOMA-IR was the independent factor to determine the antioxidant status such as plasma alpha-tocopherol (beta=-0.379, p<0.0001), beta-carotene (beta=-0.243, p<0.05), SOD (beta=-0.230, p<0.05), and catalase activity (beta=-0.255, p<0.05) after adjusting percent ideal body weight, waist circumference, gender, blood lipids and leptin levels in nonobese children. CONCLUSION: The reduced antioxidant status in insulin resistance state even in nonobese children suggests the importance of early nutritional intervention with features of insulin resistance.     

Selenium metabolites in urine: a critical overview of past work and current status

BACKGROUND: Selenium is an essential trace element that also elicits toxic effects at modest intakes. Investigations of selenium metabolites in urine can help our understanding of the transformations taking place in the body that produce these beneficial and detrimental effects. There is, however, considerable discord in the scientific literature regarding the selenium metabolites thought to play important roles in these biotransformation processes. APPROACH: We critically assessed the published reports on selenium urinary metabolites, from the first report in 1969 to the present, in terms of the rigor of the data on which structures have been proposed. CONTENT: We present and discuss data from approximately 60 publications reporting a total of 16 identified selenium metabolites in urine of humans or rats, a good model for human selenium metabolism. We assessed the analytical methods used and the validity of the ensuing structural assignments. SUMMARY: Many of the studies of selenium metabolites in urine appear to have assigned incorrect structures to the compounds. The long-held view that trimethylselenonium ion is a major human urinary metabolite appears unjustified. On the other hand, recent work describing selenosugars as major urinary metabolites looks sound and provides a firm basis for future studies.     

Effect of vitamins C and E on antioxidant status of breast-cancer patients undergoing chemotherapy

What is known and Objective: Reactive oxygen/nitrogen species generated by antineoplastic agents are prime suspects for the toxic side‐effects of acute or chronic chemotherapy. The present study was undertaken to test whether vitamins C and E (VCE) supplementation protect against some of the harmful effects of commonly used anticancer drugs in breast‐cancer patients. Methods: In a randomized 5‐month study, the activity of various antioxidant enzymes (superoxide dismutase, catalase, glutathione‐S‐transferase and glutathione reductase) and the levels of malondialdehyde and reduced glutathione were measured in forty untreated breast‐cancer patients (stage II) and compared with those of healthy controls. The degree of DNA damage was also assessed in the peripheral lymphocytes of the patients by alkaline single cell gel electrophoresis. The untreated patients were then randomly assigned to either treatment with chemotherapy alone (5‐fluorouracil 500 mg/m² i.v. day 1, doxorubicin 50 mg/m² i.v. day 1 and cyclophosphamide 500 mg/m² i.v. day 1, every 3 weeks for six cycles) or to the same chemotherapy regimen supplemented with VCE (vitamin C 500 mg tablet and vitamin E 400 mg gelatin capsule). On completion of the treatments, both the groups were studied again for the levels of the markers measured prior to treatment. Results and Discussion: The untreated group showed significantly lower levels of antioxidant enzymes (P < 0·001) and reduced glutathione (P < 0·001), and more extensive lipid peroxidation (P < 0·001) and DNA damage than healthy controls. Similar but less pronounced patterns were observed in the patients receiving chemotherapy alone. The group of patients receiving VCE supplementation had all the marker levels moving towards normal values. Activities of superoxide dismutase, catalase, glutathione‐S‐transferase and glutathione reductase, and the levels of reduced glutathione were significantly increased (P < 0·01) while, the levels of malondialdehyde and DNA damage were significantly (P < 0·01) reduced in the VCE supplemented group relative to those of patients receiving chemotherapy alone as well as relative to the pretreatment levels. What is new and Conclusion: Co‐administration of VCE restored antioxidant status, lowered by the presence of breast‐cancer and chemotherapy. DNA damage was also reduced by VCE. The results suggest that VCE should be useful in protecting against chemotherapy‐related side‐effects and a randomized control trial to evaluate the effectiveness of VCE in breast‐cancer patients using clinical outcomes would be appropriate.     

Calcium and vitamins

Sufficient calcium intake and vitamin D adequacy are prerequisite for any pharmacological treatment for osteoporosis. The latter has been often ignored in Japan, partly because serum 25(OH)D measurement is not reimbursed by health insurance policy and perhaps because natural vitamin D cannot be prescribed by phySicians in this country. Here, some of the recent metaanalyses of calcium, vitamin D metabolites, and vitamin K on osteoporosis are reviewed. A new vitamin D metabolite, eldecalcitol, will also be discussed.     

Sensory processing dysfunction among Saudi children with and without autism

[Purpose] There is a dearth of studies that have examined the occurrence of sensory processing dysfunction and its components in Saudi Arabian children with autism. Therefore, this study investigated the manifestation of sensory processing dysfunction in autism and compared the functional components of sensory processing between Saudi Arabian children with and without autism. [Subjects and Methods] A convenience sample of 46 Saudi Arabian children with autism and 30 children without autism participated in this study. The sensory processing functions of both groups were assessed with the Short Sensory Profile. [Results] The overall findings indicated that 84.8% of children with autism demonstrated definite sensory processing dysfunction. The most prevalent sensory processing dysfunctions involved the under-responsive/seeks sensation (89.13%), auditory filtering (73.90%), and tactile sensitivity (60.87%) domains. Most of the children without autism (66.66%) demonstrated typical sensory function; the most prevalent sensory processing dysfunctions involved the tactile sensitivity (33.3%), under-responsive/seeks sensation (23.33%), and movement sensitivity (20%) domains. [Conclusion] Saudi Arabian children with and without autism have clinically significant sensory dysfunctions. However, the prevalence of those sensory dysfunctions in children with autism is significantly higher than in the children without autism.Key words: Autism, Sensory integration, Sensory processing dysfunction     

Historical, cultural, and contemporary influences on the status of women in nursing in Saudi Arabia

Global nursing shortages have necessitated closer scrutiny of recruitment and retention initiatives of nurses both locally and internationally. For many decades the nursing workforce of Saudi Arabia has relied on international expatriates to be the backbone of the industry. In recent years however, Saudi women have been recruited into nursing preparation courses conducted at degree level. The many twists and turns of providing a local Saudi Arabian nursing workforce has paralleled Saudi's own history and this paper follows that journey. Our research has enabled us to provide some insights into nursing pre and post the enlightenment that accompanied the Prophet Mohammed's influence. We emphasize the influences of women leaders who emerged in Mohammed's time and bring lasting authority to the development of nursing in Saudi Arabia. The cultural issues that bind women in this society are explicated and related to recruitment and retention issues in nursing. Education matters, both past and present, are highlighted emphasizing the gains that nursing as a distinct occupation has made. Finally the paper concludes with a summation of contemporary achievements in Saudi Arabia moving nursing towards the much needed professional status and parity with other careers in health care.     

Approaches to acute asthma and status asthmaticus in children

Asthma is the most common chronic disease in pediatric patients and is the leading cause of childhood disability. The functional abnormalities of this disease--namely, airway obstruction and hyperresponsiveness--are consequences primarily of airway inflammation. Outpatient therapy for acute asthma, as well as therapy for status asthmaticus (episodes of asthma unresponsive to usually effective outpatient therapy and necessitating hospitalization), primarily addresses treatment of airway inflammation. The goal of office and emergency room management of acute asthma is reversal of airway obstruction by the administration of inhaled beta-adrenergic medications. The therapy for status asthmaticus consists of intravenously administered aminophylline, corticosteroids, nebulized beta-adrenergic agents, and oxygen. Respiratory failure, the inability to maintain adequate elimination of CO2, may be effectively treated by adding continuous nebulization of albuterol. Mechanical ventilation will still be necessary in the rare patient who does not respond to pharmacologic therapy. Acute exacerbations of asthma, as well as status asthmaticus, can best be prevented by establishing effective maintenance programs individualized for each patient.     

Epidemiological and clinical differences of snake bites among children and adults in south western Saudi Arabia

OBJECTIVES: To compare the clinical course and complications of snake bite in children and adults. METHODS: A retrospective review of 66 patients (28 children and 38 adults) admitted after snake bites for management at the Prince Abdullah Hospital in Bisha, in the south western part of Saudi Arabia, during the period May 1992 to May 1995. RESULTS: No significant difference was found in time of bite, site of bite, and sex preference between adults and children. Local complications, such as tissue necrosis, were commoner in children (14%) than in adults (5%). Systemic manifestations were also more commonly seen in children than in adults; this is possibly due to a higher ratio of injected venom to body mass in children. Leukocytosis was seen in 54% of children (adults 13%), a low haemoglobin concentration in 14% of children (adults 11%), prolonged prothrombin and partial thromboplastin times in 41% of children (adults 16%), while a high creatine phosphokinase was seen in 31% of children compared with 17% of adults. CONCLUSIONS: Children seem to have more serious local and systemic complications than adults and this may indicate the need to use a higher dose of antivenom than that being used at present.