RESUMEN
Although identifying the referents of single words is often cited as a key challenge for getting word learning off the ground, it overlooks the fact that young learners consistently encounter words in the context of other words. How does this company help or hinder word learning? Prior investigations into early word learning from children's real-world language input have yielded conflicting results, with some influential findings suggesting an advantage for words that keep a diverse company of other words, and others suggesting the opposite. Here, we sought to triangulate the source of this conflict, comparing different measures of diversity and approaches to controlling for correlated effects of word frequency across multiple languages. The results were striking: while different diversity measures on their own yielded conflicting results, once nonlinear relationships with word frequency were controlled, we found convergent evidence that contextual consistency supports early word learning. RESEARCH HIGHLIGHTS: The words children learn occur in a sea of other words. The company words keep ranges from highly variable to highly consistent and circumscribed. Prior findings conflict over whether variability versus consistency helps early word learning. Accounting for correlated effects of word frequency resolved the conflict across multiple languages. Results reveal convergent evidence that consistency helps early word learning.
Asunto(s)
Desarrollo del Lenguaje , Aprendizaje Verbal , Vocabulario , Humanos , Aprendizaje Verbal/fisiología , Preescolar , Femenino , Masculino , Aprendizaje , Lenguaje Infantil , LenguajeRESUMEN
The rapid trend of industrialization and urbanization can lead to greater exposure of the general population to chromium, cobalt, and nickel. Their total body burden from all routes of recent exposure, as well as interindividual variability in exposure levels, metabolism, and excretion rates, are reflected in the blood metal concentrations. The main goals in this study were as follows: observing the reference levels of chromium, cobalt, and nickel in the blood of the population living in Belgrade, identification of individual and sociodemographic factors that most affect their blood levels, and comprehension of recent exposure to chromium, cobalt, and nickel. Blood was sampled from 984 participants, voluntary blood donors, who agreed to participate in this study. Individual and sociodemographic data were collected using questionnaire adapted for different subpopulations. Blood metal analyses were measured using ICP-MS method (7700×, Agilent, USA). Our study provided reference values of chromium, cobalt, and nickel in blood for adult population (18-65 years) and confirmed that blood cobalt and nickel levels were mostly influenced by age and gender, and age, respectively. Furthermore, weight status affected blood chromium and cobalt levels, while national origin affected blood chromium levels. The present study highlighted the importance of human biomonitoring studies to monitor exposure status and identify subpopulations with increased exposure to chromium, cobalt, and nickel.
Asunto(s)
Cromo , Níquel , Adulto , Humanos , Níquel/análisis , Cromo/análisis , Cobalto/análisis , Serbia , Metales/análisisRESUMEN
The size of circulating immune complexes (CICs) in rheumatoid arthritis (RA) could be an emerging criterion in disease diagnosis. This study analyzed size and electrokinetic potential of CICs from RA patients, healthy young adults, and RA patients age-matched controls aiming to establish their unique CIC features. Pooled CIC of 30 RA patients, 30 young adults, and 30 RA group's age-matched controls (middle-aged and oldеr healthy adults), and in vitro IgG aggregates from pooled sera of 300 healthy volunteers were tested using dynamic light scattering (DLS). Size distribution of CIC in healthy young adults exhibited high polydispersity. RA CIC patients and their age-matched control showed distinctly narrower size distributions compared with young adults. In these groups, particles clustered around two well-defined peaks. Particles of peak 1 were 36.1 ± 6.8 nm in RA age-matched control, and 30.8 ± 4.2 nm in RA patients. Particles of peak 2 of the RA age-matched control's CIC was 251.7 ± 41.2 nm, while RA CIC contained larger particles (359.9 ± 50.5 nm). The lower zeta potential of RA CIC, compared to control, indicated a disease-related decrease in colloidal stability. DLS identified RA-specific, but also age-specific distribution of CIC size and opened possibility of becoming a method for CIC size analysis in IC-mediated diseases.
Asunto(s)
Complejo Antígeno-Anticuerpo , Artritis Reumatoide , Persona de Mediana Edad , Adulto Joven , Humanos , Anciano , Dispersión Dinámica de LuzRESUMEN
Recent years have seen a flourishing of Natural Language Processing models that can mimic many aspects of human language fluency. These models harness a simple, decades-old idea: It is possible to learn a lot about word meanings just from exposure to language, because words similar in meaning are used in language in similar ways. The successes of these models raise the intriguing possibility that exposure to word use in language also shapes the word knowledge that children amass during development. However, this possibility is strongly challenged by the fact that models use language input and learning mechanisms that may be unavailable to children. Across three studies, we found that unrealistically complex input and learning mechanisms are unnecessary. Instead, simple regularities of word use in children's language input that they have the capacity to learn can foster knowledge about word meanings. Thus, exposure to language may play a simple but powerful role in children's growing word knowledge. A video abstract of this article can be viewed at https://youtu.be/dT83dmMffnM. RESEARCH HIGHLIGHTS: Natural Language Processing (NLP) models can learn that words are similar in meaning from higher-order statistical regularities of word use. Unlike NLP models, infants and children may primarily learn only simple co-occurrences between words. We show that infants' and children's language input is rich in simple co-occurrence that can support learning similarities in meaning between words. We find that simple co-occurrences can explain infants' and children's knowledge that words are similar in meaning.
Asunto(s)
Lenguaje , Aprendizaje , Niño , Lactante , Humanos , Desarrollo del Lenguaje , Semántica , Aprendizaje VerbalRESUMEN
With development knowledge becomes organized according to semantic links, including early-developing associative (e.g., juicy-apple) and gradually developing taxonomic links (e.g., apple-pear). Word co-occurrence regularities may foster these links: Associative links may form from direct co-occurrence (e.g., juicy-apple), and taxonomic links from shared co-occurrence (e.g., apple and pear co-occur with juicy). Four experiments (2017-2020) investigated this possibility with 4- to 8-year-olds (N = 148, 82 female) and adults (N = 116, 35 female) in a U.S. city with 58.6% White; 29.0% Black, and 5.8% Asian demographics. Results revealed earlier development of the abilities to form direct (ds > 0.536) than the abilities to form shared co-occurrence-based links (ds > 1.291). We argue that the asynchronous development of abilities to form co-occurrence-based links may explain developmental changes in semantic organization.
Asunto(s)
Lenguaje , Semántica , Adulto , Humanos , Femenino , Desarrollo del LenguajeRESUMEN
S. pneumoniae is an important human pathogen which has a polysaccharide capsule with virulent properties. This work aims to estimate the titres of S. pneumoniae specific IgG and IgA isotypes, with respect to age and sex. An in-house whole bacterial cell ELISA was used for the determination of relative levels and endpoint titres of IgG subclasses and IgA1 subclass specific for S. pneumoniae serogroup 1, and to quantify specific IgG1 and IgG2 levels. Significantly lower anti-pneumococcus IgG1 titres were found in older individuals, which was more pronounced in men. Lower IgG2 titres were detected in men over 50 years of age, in comparison to women under 50 years of age. The levels of IgG3 and IgG4 did not differ between different sex and age groups. Lower IgA1 levels were detected in male individuals in both age groups in comparison to females under 50 years of age. The levels of IgG1 showed a moderate correlation with IgG4 in younger individuals of both sexes (r = 0.61 in men and 0.63 in women) which was not noted in the older age group. We highlight the deficiency in humoral immunity in older people, especially male and suggest immunization of this population with pneumococcal vaccines.
Asunto(s)
Anticuerpos Antibacterianos , Streptococcus pneumoniae , Animales , Femenino , Humanos , Inmunoglobulina A , Inmunoglobulina G , Masculino , SerogrupoRESUMEN
Human word learning is remarkable: We not only learn thousands of words but also form organized semantic networks in which words are interconnected according to meaningful links, such as those between apple, juicy, and pear. These links play key roles in our abilities to use language. How do words become integrated into our semantic networks? Here, we investigated whether humans integrate new words by harnessing simple statistical regularities of word use in language, including: (a) Direct co-occurrence (e.g., eat-apple) and (b) Shared co-occurrence (e.g., apple and pear both co-occur with eat). In four reported experiments (N = 139), semantic priming (Experiments 1-3) and eye-tracking (Experiment 4) paradigms revealed that new words became linked to familiar words following exposure to sentences in which they either directly co-occurred, or shared co-occurrence. This finding highlights a potentially key role for co-occurrence in building organized word knowledge that is fundamental to our unique fluency with language. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Asunto(s)
Lenguaje , Semántica , Humanos , Desarrollo del Lenguaje , Aprendizaje Verbal , VocabularioRESUMEN
Learning of exceptions - those items that violate a known regularity - takes longer than learning of rule-following items. Studies reporting this disparity have used exceptions that share most of their features with members of the opposite category (crossover exceptions). Yet, exceptions can be distinctly different from members of their own category and other categories as well (oddball exceptions). Here, we trained two groups of pigeons to discriminate two categories containing regular and exception items. For one group, the exceptions were crossovers, whereas for the other, the exceptions were oddballs. Pigeons learned to classify the oddball exceptions faster than the crossover exceptions. Moreover, the regular items were learned more quickly than the crossover exceptions, but more slowly than the oddball exceptions. Deviation from the rule per se is not why exceptions are typically more difficult to learn. Rather, confusability with members of the opposite category hinders learning, whereas distinctiveness facilitates learning.
Asunto(s)
Columbidae , Aprendizaje , Animales , Formación de Concepto , Aprendizaje DiscriminativoRESUMEN
This research paper addresses the hypothesis that an oral supplementation with organically modified clinoptilolite will improve colostrum quality in primiparous dairy cows whilst having no adverse effects on the cows' health. A total of 36 pregnant Holstein primiparous dairy cattle were randomly assigned to receive daily oral drenching, two hours following morning feeding, with 1 l of water containing either 0 g/l (n = 16) or 150 g/l (n = 20) of clinoptilolite. Treatment lasted from 24 ± 4 d prior to expected parturition until two days postpartum (pp). Colostrum was collected at 2 to 3 h, 12, 24 and 36 h pp and blood samples were collected at 24 ± 4 and 4 ± 2 d prior to parturition and 1, 2 and 7 d pp. Overall mean dry matter, fat and total protein percentage as well as IgG concentration and mass were significantly greater in colostrum collected from cattle drenched with clinoptilolite (total protein increased by 15% and IgG concentration and mass by 21 and 38% respectively at first sampling and further at second sampling). Total γ globulin and most other blood serum biochemistry parameters did not differ between cattle treated and not treated with clinoptilolite, the only exception being the fast anionic γ globulin fraction that was 17% greater at 4 ± 2 d prior to parturition and 10% lower on the 1st day pp in treated cattle. These results showed that organically modified oral clinoptilolite supplementation at 150 g/d significantly increases the IgG concentration in colostrum and has no adverse effects on the energy status, protein, lipid, and mineral metabolism in primiparous dairy cattle during prepartum period.
Asunto(s)
Bovinos/fisiología , Calostro/química , Dieta/veterinaria , Suplementos Dietéticos , Zeolitas/farmacología , Alimentación Animal/análisis , Fenómenos Fisiológicos Nutricionales de los Animales , Animales , Esquema de Medicación , Femenino , Paridad , Embarazo , Fenómenos Fisiologicos de la Nutrición Prenatal , Zeolitas/administración & dosificación , gammaglobulinas/metabolismoRESUMEN
Attention to relevant stimulus features in a categorization task helps to optimize performance. However, the relationship between attention and categorization is not fully understood. For example, even when human adults and young children exhibit comparable categorization behavior, adults tend to attend selectively during learning, whereas young children tend to attend diffusely (Deng & Sloutsky, 2016). Here, we used a comparative approach to investigate the link between attention and categorization in two different species. Given the noteworthy categorization ability of avian species, we compared the attentional profiles of pigeons and human adults. We gave human adults (Experiment 1) and pigeons (Experiment 2) a categorization task that could be learned on the basis of either one deterministic feature (encouraging selective attention) or multiple probabilistic features (encouraging distributed attention). Both humans and pigeons relied on the deterministic feature to categorize the stimuli, albeit humans did so to a much greater degree. Furthermore, computational modeling revealed that most of the adults exhibited maximal selectivity, whereas pigeons tended to distribute their attention among several features. Our findings indicate that human adults focus their attention on deterministic information and filter less predictive information, but pigeons do not. Implications for the underlying brain mechanisms of attention and categorization are discussed.
Asunto(s)
Columbidae , Aprendizaje , Adulto , Animales , Niño , Preescolar , Aprendizaje Discriminativo , HumanosRESUMEN
In order to determine whether preference in object matching tasks measures participants' strategy or tells us something about the salience of relations between corresponding concepts, we conducted three experiments. In Experiment 1 and Experiment 2, we approached this question by measuring the ease with which adult participants process different relations when they are under strategic instruction. When asked to group objects based on thematic or taxonomic relatedness, participants were slower (Experiment 2) and tended to make more errors (Experiment 1-2) when they had to find a taxonomically related pair than when they searched for a thematically related one. In Experiment 3, participants performed a standard matching task and their eye-movements were monitored throughout. In addition to the strong thematic preference in participants' choices, we measured longer fixations to thematically related objects than taxonomic competitors. Even though thematic and taxonomic information appear to compete for selection in early phases of observation, thematic conceptual relations appear to be more salient and preferred, independently of instruction.
Asunto(s)
Formación de Concepto/fisiología , Movimientos Oculares/fisiología , Desempeño Psicomotor/fisiología , Estimulación Acústica/métodos , Adolescente , Adulto , Femenino , Humanos , Masculino , Estimulación Luminosa/métodos , Distribución Aleatoria , Adulto JovenRESUMEN
Our knowledge about the world is represented not merely as a collection of concepts, but as an organized lexico-semantic network in which concepts can be linked by relations, such as "taxonomic" relations between members of the same stable category (e.g., cat and sheep), or association between entities that occur together or in the same context (e.g., sock and foot). To date, accounts of the origins of semantic organization have largely overlooked how sensitivity to statistical regularities ubiquitous in the environment may play a powerful role in shaping semantic development. The goal of the present research was to investigate how associations in the form of statistical regularities with which labels for concepts co-occur in language (e.g., sock and foot) and taxonomic relatedness (e.g., sock and pajamas) shape semantic organization of 4-5-year-olds and adults. To examine these aspects of semantic organization across development, we conducted three experiments examining effects of co-occurrence and taxonomic relatedness on cued recall (Experiment 1), word-picture matching (Experiment 2), and looking dynamics in a Visual World paradigm (Experiment 3). Taken together, the results of the three experiments provide evidence that co-occurrence-based links between concepts manifest in semantic organization from early childhood onward, and are increasingly supplemented by taxonomic links. We discuss these findings in relation to theories of semantic development.
Asunto(s)
Lenguaje , Semántica , Adulto , Preescolar , Humanos , Conocimiento , Recuerdo MentalRESUMEN
Evidence from multiple category learning studies suggest that exceptions to a category rule are remembered better than the items that follow that rule (Davis, Love, & Preston, 2012; Palmeri & Nosofsky, 1995; Sakamoto & Love, 2004). Based on differences in recognition memory, it has been suggested that category exceptions may be represented separately from regular category members. Here, we present 4 experiments investigating representations of regular and exceptional category members as well as potential developmental changes in these representations. Although 4-year-olds and adults demonstrated different memory patterns, both age groups showed (a) higher memory sensitivity for regular members of the category and (b) isomorphic memory patterns for regular and exception items. Additionally, we report important developmental differences in generalization patterns. In children, features of regulars and of exceptions contributed to categorization of both regular and exception items. In contrast, an asymmetry was found in adults: features of regulars contributed to categorization of both regular and exception items, whereas features of exceptions contribution only to categorization of exceptions. These findings challenge the hypothesis that items that violate known knowledge structures have a special status in memory and suggest that exceptions can be represented jointly with regular items early in development and as a subset of regular items later in development. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Asunto(s)
Memoria/fisiología , Reconocimiento en Psicología/fisiología , Adulto , Factores de Edad , Preescolar , Femenino , Humanos , Masculino , Estimulación Luminosa/métodosRESUMEN
[This corrects the article DOI: 10.1371/journal.pone.0189362.].
RESUMEN
We report the results of a study comparing the temporal dynamics of thematic and taxonomic knowledge activation in a picture-word priming paradigm using event-related potentials. Although we found no behavioral differences between thematic and taxonomic processing, ERP data revealed distinct patterns of N400 and P600 amplitude modulation for thematic and taxonomic priming. Thematically related target stimuli elicited less negativity than taxonomic targets between 280-460 ms after stimulus onset, suggesting easier semantic processing of thematic than taxonomic relationships. Moreover, P600 mean amplitude was significantly increased for taxonomic targets between 520-600 ms, consistent with a greater need for stimulus reevaluation in that condition. These results offer novel evidence in favor of a dissociation between thematic and taxonomic thinking in the early phases of conceptual evaluation.
Asunto(s)
Potenciales Evocados , Adulto , Femenino , Humanos , Masculino , Análisis y Desempeño de Tareas , Adulto JovenRESUMEN
In this work we studied if circulating immune complexes (CIC) of calves with bronchopneumonia have the capacity to modulate function of peripheral blood leukocytes of healthy cattle. CIC of three month old calves (6 healthy and 6 diseased) were isolated by PEG precipitation. Peripheral blood mononuclear cells (MNCs) and granulocytes from healthy calves and cows were the CIC responder cells in in vitro tests. The most remarkable increase of adhesiveness to polystyrene and ROS synthesis (assessed by NBT test) was detected in cows' granulocytes stimulated with CIC of diseased calves. Results of MTT test showed that CIC of both healthy and diseased calves reduced granulocytes' viability. The strongest effect of inhibition of cows' granulocytes resulted from CIC of diseased calves. CIC only moderately reduced spontaneous viability of calves' MNCs. Again, the strongest effect of CIC isolated from diseased calves was observed. In contrast to the low impact of CIC on non-stimulated cells, their inhibitory effect on viability of mitogen stimulated MNCs was very strong. With CFSE assay we showed that both types of CIC stimulated spontaneous, but inhibited mitogen induced proliferation of calves' MNCs. Propidium iodide staining reviled that CIC increased apoptosis/necrosis of both non-stimulated and mitogen stimulated MNCs. CIC of both healthy and diseased calves modulated the function of peripheral blood MNCs and granulocytes, but a stronger effect of CIC of diseased calves was shown. The age of the donors (calves or cows) of the responder cells, and the activation state of these cells, were also of influence.
Asunto(s)
Complejo Antígeno-Anticuerpo/inmunología , Bronconeumonía/veterinaria , Enfermedades de los Bovinos/inmunología , Granulocitos/inmunología , Leucocitos Mononucleares/inmunología , Factores de Edad , Animales , Bronconeumonía/sangre , Bronconeumonía/inmunología , Bovinos , Enfermedades de los Bovinos/sangre , FemeninoRESUMEN
Immune complexes (IC) could have an important role in the pathogenesis of pre-ruminant calves' bronchopneumonia. IC are potent activators of complement and neutrophils and they might be responsible for immune protection, as well as for pulmonary damage. Immunoglobulin G (IgG), as constituents of IC, initiates the effector phase of immune response through binding of Fcγ and complement receptors. The oligosaccharide moieties expressed on IgG can modulate their antigen affinity and effector function. Structural characteristics of IgG molecules from IC in the pre-ruminant calves have not been studied in detail. The aim of our study was to determine if the glycosylation profile of IgG from circulating IC (CIC) in calves with bronchopneumonia differed from those of healthy control calves. A total number of 13 Holstein-Friesian calves, at the age of three months were included in the study. All calves were clinically examined by a veterinarian. Calves were classified by signs of respiratory disease in two groups: healthy (n=6) and diseased (n=7) calves. The CIC from calves' sera were isolated by the polyethylene glycol precipitation (PEG) method. IgG molecules were isolated from PEG precipitates by Protein G affinity method. The level of expression and localization N-acetylglucosamine, galactose, sialic acid, and fucose within the isolated IgG was determined by lectin blot assay. Calves with bronchopneumonia had a statistically significantly increased level of CIC. IgG molecules were isolated from CIC of both healthy and diseased calves. Several other proteins in complex with IgG were detected in both groups of animals. The isolated IgG heavy chains of healthy calves expressed N-acetylglucosamine, galactose, sialic acid, and fucose. The light chains of IgG expressed N-acetylglucosamine, sialic acid, and fucose whereas galactose was not detected in healthy calves. In diseased animals, galactose was detected on light chains, and both heavy and light IgG chains were more sialylated. Proteins in complex with IgG were also lectin reactive, and their glycosylation in diseased animals was different compared to healthy controls. Increased sialylation is a characteristic of anti-inflammatory IgG. The increased sialylation of IgG from CIC in bronchopneumonia might be an attempt of immune system of calves to protect lung tissues against damages provoked by activated cells and secreted pro-inflammatory cytokines. At the same time, increased IgG sialylation could explain the inability of calves' immune system to initiate the process of antigen elimination by activation of Fcγ receptors.
Asunto(s)
Complejo Antígeno-Anticuerpo/sangre , Bronconeumonía/veterinaria , Enfermedades de los Bovinos/inmunología , Inmunoglobulina G/metabolismo , Animales , Complejo Antígeno-Anticuerpo/inmunología , Complejo Antígeno-Anticuerpo/metabolismo , Infecciones Bacterianas/sangre , Infecciones Bacterianas/inmunología , Infecciones Bacterianas/veterinaria , Bronconeumonía/inmunología , Bovinos , Enfermedades de los Bovinos/sangre , Enfermedades de los Bovinos/metabolismo , Galactosa/química , Galactosa/metabolismo , Inmunoglobulina G/sangre , Inmunoprecipitación/veterinaria , Ácido N-Acetilneuramínico/química , Ácido N-Acetilneuramínico/metabolismoRESUMEN
OBJECTIVES: Data based on randomized clinical trials regarding intravenous thrombolysis (IVT) versus placebo or any other antithrombotic treatment in ischemic stroke (IS) due to artery dissection (AD) are not available. METHODS: We used data from our observational study to examine the efficacy and safety of IVT in patients with IS due to spontaneous AD, as compared with stroke patients of the same cause who were not treated with IVT. Outcome measures were modified Rankin score (mRS) for functional outcome, death from all causes, occurrence of any intracranial hemorrhage, local signs of an intramural hematoma extension, recurrent IS, and recurrent AD. RESULTS: In a 4-year period, 19 of 46 patients with IS due to spontaneous AD were treated with IVT. Favorable outcome (mRS 0-2) after the follow-up period reached 81.5% of non-IVT patients compared with 94.7% of IVT-treated patients (odds ratio, 4.09; 95% confidence interval, 0.44-38.26; P=0.377). However, the patients who received IVT had a significantly higher chance of being without any neurological deficit (mRS 0) after adjusting for age, sex, baseline National Institutes of Health Stroke Scale score, and site of dissection compared with non-IVT patients after the follow-up period (P=0.012). No symptomatic intracerebral hemorrhage, worsening of local signs, cases of subarachnoid hemorrhage, or death occurred in both groups of patients. CONCLUSIONS: The efficacy of IVT in patients with IS due to the spontaneous AD seemed to be similar or even better to those of patients of the same cause who were not treated with IVT. The complication rate of IVT in spontaneous AD is low.
Asunto(s)
Disección Aórtica/complicaciones , Isquemia Encefálica/tratamiento farmacológico , Fibrinolíticos/uso terapéutico , Accidente Cerebrovascular/tratamiento farmacológico , Terapia Trombolítica/métodos , Activador de Tejido Plasminógeno/uso terapéutico , Adolescente , Adulto , Anciano , Isquemia Encefálica/etiología , Femenino , Humanos , Infusiones Intravenosas , Hemorragias Intracraneales/epidemiología , Masculino , Persona de Mediana Edad , Accidente Cerebrovascular/etiología , Resultado del TratamientoRESUMEN
INTRODUCTION: Acute intermittent porphyria emerges as a result of partial defect of porphobilinogen deaminase and is manifested by repeated episodes of somatic, psychiatric and neurological disorders. The disease is conducted via the autosomal-dominant gene of variable penetration, so most of the carriers never experience seizures. Timely making of diagnosis, screening of blood relatives of the patient and education of patients on avoidance of provoking factors are the key to adequate treatment. CASE OUTLINE: A 23-year-old patient having born the third child was hospitalized due to pains in the abdomen and convulsive seizures nine days after the vaginal delivery. At admittance, she suffered a generalized convulsive seizure of clonic-tonic type. The patient immediately underwent a complete clinical, laboratory, bacteriological and ultrasound examination. Bearing in mind the fact that the patient had several convulsive seizures even after the given neurological therapy, haem-arginate was introduced into therapy during four days. The administration of haem-arginate led to the normalization of blood pressure, pulse and bowel function. The administration of haem-arginate led to the normalization of blood pressure, pulse and bowel function. The patient was treated by a team of doctors, in the intensive care ward, with the use of medicaments, which are allowed in the case of acute porphyria. Sixteen days after the admittance, with clean neurological status and gynaecological and ultra-sound findings, she was released for ambulatory treatment. CONCLUSION: The presented case exhibits the gravity of making a diagnosis of acute intermittent porphyria in puerperium and the necessity of multi-disciplinary approach in treating this disease. Acute intermittent porphyria should be considered in cases of ambiguous abdominal pain, as well as in patients having abdominal pains followed by neuro-psychiatric disorders.
Asunto(s)
Porfiria Intermitente Aguda/diagnóstico , Periodo Posparto , Adulto , Femenino , Humanos , Porfiria Intermitente Aguda/terapia , Embarazo , Adulto JovenRESUMEN
INTRODUCTION: Balkan endemic nephropathy (BEN) is a familial chronic progressive tubulointerstitial disease of unknown aetiology that occurs with high prevalence in endemic rural environments of Serbia, Bosnia and Herzegovina, Croatia, Bulgaria and Romania. It has been documented only in adults. OBJECTIVE: The aim of this study was to examine clinical markers of BEN in children and adolescent offspring of BEN patients. METHODS: Prospective clinical trial involved two groups of children and adolescents: I consisted of 30 offspring of BEN patients and II of 29 offspring of non-BEN dialysis patients, both of them living in the same South Morava region of Serbia. All of them were healthy at the time of the investigation, not receiving any drugs. The study included personal and family history, physical examination, comprehensive laboratory analyses and renal ultrasound. Blood pressure (BP) was determined by using casual BP and 24 h ABPM in subjects older than 5 years. Urinary proteins were investigated by analysing microalbumin, alfa 1 microglobulin, beta 2 microglobulin and SDS-PAGE electrophoresis. GFR was measured by estimated creatinine clearance and by serum Cystatin C concentrations. RESULTS: There were no statistically significant differences in age, gender, history of urinary tract infections or functional voiding disorders between these two groups. All of the studied subjects had normal BP and GFR. Renal ultrasound was abnormal only in BEN offspring (6.66%) as well as increased urine concentrations of microalbumin (3.3%), alpha 1 microglobulin (10%) and beta 2 microglobulin (13.3%) while low molecular protein (<66,000 D) was prevalent in BEN compared with non-BEN offspring (21.43% vs. 3.7%). CONCLUSION: Renal abnormalities in offspring of BEN patients may be an early marker of BEN.This has to be confirmed in long term follow-up of a greater number of BEN paediatric offspring.