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ABSTRACT: Environmental factors may play equally critical role as genes in facial embryogenesis. It was suggested that cleft palate occurring in association with cleft lip may result from environmental factors that affect development of both the lip and the palate. Cleft lip forms from the third through seventh week of embryonic development. During these period fetal nutrition is histotrophic, pressure of oxygen is low, genes for antioxidant enzymes are supressed and alpha-tocopherol play an essential role in the fetal tissues antioxidant capacity. Cleft palate forms from the fifth through twelfth weeks of gestation, when hemonutrition and antioxidant enzymes are developing, and hypothetical deficiency of tocopherol is not so crucial.
The goal of the study was to investigate concentrations of alpha-tocopherol in women who gave birth to a child with cleft lip and mothers of children with cleft lip and palate.
Blood samples from 31 healthy mothers of children with isolated cleft lip (CL) and 29 healthy mothers of children with isolated cleft lip and palate (CLP) were collected. Fasting plasma alpha-tocopherol concentrations were measured by the high performance liquid chromatography. Kolmologorov-Smirnov test with Lilefors correction and k-means cluster analysis were applied to determine differences between the groups of women.
We found that alpha-tocopherol concentrations were lower in CL compared to CLP, but the difference did not achieve level of statistical significantly (medians: 15.8 micromol/L vs. 20.0 micromol/L; p = 0.066). There were identified three clusters of alpha-tocopherol concentrations: 14.0 micromol/L (19CL+8CLP), 19.6 micromol/L (8CL+13CLP), and 21.1 micromol/L (4CL+8CLP). The distribution of results to the clusters was dependent on type of the orofacial cleft (chi squared = 6.95 with 2 degrees of freedom, p = 0,031).
Analysis for environmental risk factors should be performed separately for cleft lip and cleft lip and palate because these two conditions appear to be etiologically distinct. The role of a higher periconceptional intake of alpha-tocopherol in reduction of risk of giving birth to a child with cleft lip requires further research.
Ginekologia polska 05/2006; 77(4):255-62. · 0.41 Impact Factor
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ABSTRACT: We report a case of 4-years-old girl who suffered one episode of clinically typical erythema nodosum and arthralgia of short duration. Stool culture showed growth of Salmonella enteritidis. Levels of serum anti-Salmonella antibodies and immunocomplexes lowered during resolution of skin nodules. Erythema nodosum probably results from the formation of immunocomplexes and their deposition in and around blood vessels of the skin. Salmonellosis should be considered in patients presenting with erythema nodosum. Routine stool culture might provide an important diagnostic clue.
Wiadomości lekarskie (Warsaw, Poland: 1960) 02/2006; 59(5-6):416-8.
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ABSTRACT: Coeliac disease is characterized by life-long gluten intolerance. There are a wide variety of clinical presentations, which range from severe diarrhoea and weight loss to asymptomatic forms. The primary treatment for coeliac disease is the removal of gluten from the diet to prevent both immediate and long-term complications. The case of 16-year-old girl with coeliac disease was presented. At the age of 2 years the patient with impaired growth and abnormal stools was suspected to have coeliac disease. She experienced symptomatic improvement on gluten-free diet, but after 3 years the treatment was discontinued. The patient denied gastrointestinal or skin problems. At the age of 14 years Raynaud's phenomenon was observed for the first time. Two years later episodes of Raynaud's phenomenon involved all fingers and toes. Body mass index (BMI) was 23.8 kg/m2. Levels of free-carnitine, tocopherol, vitamin B12 were below normal limits and homocysteine level was increased. Antiendomysial IgA, antireticulin IgA, antigliadin IgA and IgG antibodies were positive. The duodenal mucosa showed total villous atrophy. Gluten free-diet and multivitamin supplementation provided some benefit in reducing Raynaud's phenomenon. The patient's well being has improved markedly. Atypical coeliac disease is usually seen in adolescents and adults in whom features of overt malabsorption are often absent. In cases of health problems occurring in persons with history of malabsorption syndrome in childhood suspicion of coeliac disease should be heightened and appropriate evaluation undertaken.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 12/2004; 17(101):491-3.
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ABSTRACT: Undeclared allergens in processed products represent a major health problem for sensitized persons. Peanut flour and gluten are known as potent food allergens. The study was designed to evaluate with enzymeimmunoassay (ELISA) test kits the presence of gluten and peanut in Polish products. Hidden peanut contamination was detected in 4 of 34 (11.8%) processed foods (corn crisps, wafers, cereal bar and halva). 5 of 37 (13.5%) foodstuffs (cornflakes, corn crisps, bouillon cube, vegetable soup for infants, curry powder) contained undeclared gluten. The nutritional management of sensitized persons with food allergy requires new labeling regulations.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 11/2004; 17(100):374-7.
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ABSTRACT: It had been suspected for many years that mother's periconceptional diet may have a role in the causation of birth defects. Over the past 10 years, many studies have reported that women who used multivitamins periconceptionally had a reduction in risk for offspring with orofacial cleft. This study was aimed to establish vitamin E status in Polish mothers of children with isolated cleft lip. 37 mothers of children with cleft lip (CL) and 67 women who gave birth to healthy children were studied. All participants were healthy women without symptoms of malabsorption. Levels of alpha-tocopherol in plasma and erythrocytes were determined by high-performance liquid chromatography. There was no differences between mean plasma alpha-tocopherol level in mothers of children with birth defect and mothers of healthy children (17.81 +/- 4.81 micromol/l vs 19.44 +/- 5.01 micromol/l; p>0.05). It is believed that the ratio of alpha-tocopherol to total cholesterol is more useful as a measure of vitamin status than the a-tocopherol level alone. In mothers of children with CL plasma alpha-tocopherol to total serum cholesterol ratio was statistically lower compared to those in the control group (3.35 +/- 0.88 micromol/mmol vs 3.89 +/- 0.79 micromol/mmol; p<0.02). Ratio of alpha-tocopherol level in erythrocytes to total serum cholesterol was also lower in mothers of children with CL (0.38 +/- 0.06 micromol/mmol vs 0.48 +/- 0.10 micromol/mmol; p<0.05). Our results suggested that vitamin E may play a role in prevention of orofacial clefts.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 07/2004; 17(97):25-7.
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ABSTRACT: The contribution and exact role of exogenous factors, such as medications and drugs during pregnancy, maternal nutrition, in the etiology of orofacial clefts is not established. Vitamin A is essential for embryogenesis, both the lack and excess of retinol result in congenital malformations.
This study was aimed to establish vitamin A status in Polish mothers of children with isolated orofacial clefts.
34 mothers of children with isolated cleft lip (CL), 83 mothers of children with cleft lip and palate (CLP), 42 mothers of children with isolated cleft palate (CP) were studied. The control group consisted of 67 women who gave birth to healthy children. All participants were healthy women without symptoms of malabsorption. Plasma retinol levels were determined by high-performance liquid chromatography.
There were no differences in mean plasma vitamin A levels between CL--2.09 +/- 0.61 mumol/l, CLP--2.21 +/- 0.52 mumol/l, CP--2.15 +/- 0.62 mumol/l and control--2.08 +/- 0.52 mumol/l. None of participants had vitamin A deficiency (concentration of retinol < 0.8 mumol/l). Among women, who were not supplemented with retinol containing vitamins during 3 months prior the study, 10.6% of mothers of children with orofacial clefts (n = 132) and only 5.8% of controls (n = 52) had levels of retinol above upper norm for women of childbearing age (N < 2.8 mumol/l).
Periconceptional multivitamin supplementation has been reported to decrease the risk of orofacial clefts in offspring, but high intake of preformed vitamin A (retinol) might be undesirable.
Ginekologia polska 02/2004; 75(2):139-44. · 0.41 Impact Factor
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Indian Journal of Gastroenterology. 01/2004;
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ABSTRACT: Psychiatric symptoms and psychological behavioral pathologies are common in patients with untreated coeliac disease. There are several case reports of coexistence of coeliac sprue and depression, schizophrenia and anxiety. Views on association between coeliac disease and psychiatric disturbances and results of the most important studies are discussed. Biological background is referred. Malabsorption and deficiency of aminoacids and vitamins implicate reduction of synthesis of neurotransmitters in the central nervous system. Psychiatric symptoms could also be linked to immunological disregulation in coeliac patients. Psychological pathologies do appear in treated and untreated coeliacs, the need of psychological support is stressed. Coeliac disease should be taken into consideration in patients with psychiatric disorders, particularly if they are not responsive to psychopharmacological therapy, because withdrawal of gluten from the diet usually results in disappearance of symptoms. In recent years, an increased incidence of subclinical/silent coeliac disease has been reported. Psychiatric symptoms and psychological behavioral pathologies could be the only clinical manifestation of coeliac disease, but the epidemiological aspects need further investigation.
Psychiatria polska 36(4):567-78. · 0.19 Impact Factor
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ABSTRACT: Aspects of Toxocara spp. epidemiology and paratenic infestation of children are described. Human toxocariasis is caused by infestation of zoonotic roundworms of dogs and cats. Soil sampling showes widespread contamination of the environment, particularly parks and playgrounds, with the eggs of Toxocara spp. Toxocara seroprevelance values in children vary between 3.5% in the West Poland and 19% in the South-East Poland. Children more frequently have clinical symptoms o the disease because of the closer contact with contaminated soil in sand-boxes and relatively frequent geophagia. A 3 years old girl with covert toxocariasis is described. As this case illustrates, this disease can be present without its classic visceral, ocular or neurological manifestations. On admission to the hospital the results of blood tests were as follows: white blood cells count, 43x10(3)/ mm3 (norm <13x10(3)) and hyperosinophilia, 81%. The girl was treated with albendazole 15 mg/kg for five days, after one year the treatment was repeated. The patient was followed with blood samples throughout a period of one and half year. During that time results of serological tests for Toxocara canis were strongly positive. The lowest blood count was 20.0x10(3)/mm3 and eosinophilia, 19%. Possible association between high eosinophilia in toxocariasis and development of allergic and cardiovascular diseases is discussed.
Medycyna wieku rozwojowego 6(2):155-62.
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ABSTRACT: A 17 year old girl with coeliac disease was found to have hyperhomocysteinaemia (fasting plasma total homocysteine concentration - 19.93 micromol/L; N<12.75 micromol/L). At the age of 1 5 she gave up gluten-free diet and had only subtle signs of chronic malabsorption such as folic acid and iron deficiency. The patient was heterozygote for both common mutations (677C->T and J298A->C) of the methylenetetrahydrofolate reductase gene. On gluten diet an intake of 5 mg folic acid/d from supplements for two weeks resulted in an increase in serum folate and a reduction in homocysteine concentration (13.20 micromol/L). The patient continued to consume a gluten containing diet and 0.5mg folic acid/d from supplements for 4 months and homocysteiene decreased to 12.1 mmol/L. Hyperhomocysteinaemia - a cardiovascular and obstetrical risk factor - might be a significant problem for patients with celiac disease on gluten-containing diet.
Medycyna wieku rozwojowego 6(1):57-61.
