Mapping of Dietary Interventions Beneficial in the Prevention of Secondary Health Conditions in Spinal Cord Injured Population: A Systematic Review.

OBJECTIVES: Individuals with spinal cord injury are at risk of secondary health conditions (SHC) that develop as a consequence of autonomic dysfunction, prolonged oxidative stress and inflammation, and physical inactivity coupled with inadequate energy and nutritional intake. SHC can be debilitating and even life-threatening, and its prevention remains one of the major challenges in the continuum of medical care of aging SCI population. An unhealthy diet is a major driver of inflammation, oxidative stress, and unfavourable metabolic status and may be a practical preventive target to tackle increased SHC risk post-injury. AIMS: To provide a catalogue of dietary interventions beneficial in prevention of SHC among individuals with SCI by conducting a systematic review of the literature on dietary interventions and dietary supplementation in promoting health and well-being after the injury. In addition, we aimed to provide a summary of observational studies exploring the association between habitual diet (macro- and micronutrients intake and dietary patterns) and health patterns following the injury. METHOD: This review was registered at PROSPERO (University of York) with registration number CRD42022373773. Four medical databases (EMBASE.com, MEDLINE [Ovid], Cochrane CENTRAL, and Web of Science Core Collection) and Google Scholar were searched from inception until 11th July 2022. Studies were included if they were clinical trials or observational studies conducted in adult individuals with SCI and provided information of interest. Based on strength of the study design and risk of bias assessment (using the NIH tool), we classified studies from Level 1 (most reliable studies) to Level 4 (least reliable studies). RESULTS: Of 12,313 unique citations, 47 articles (based on 43 original studies) comprising 32 interventional (22 RCTs, 3 NRCT, and 7 pre-post studies) and 11 observational studies (2 cohort studies, 2 case-control, 1 post-intervention follow-up study, and 6 cross-sectional studies) were included in the present systematic review. Twenty studies (46.5%) were classified as Level 1 or 2, indicating high/moderate methodological quality. Based on those studies, dietary strategies including high protein diet, intermittent fasting, balanced diet in combination with physical conditioning and electrical stimulation, and dietary supplementation including alpha-lipoic acid, creatine, vitamin D, and cranberry-derived supplements and probiotics were mapped as the most promising in prevention of SHC among individuals with SCI. CONCLUSIONS: To develop timely and effective preventive strategies targeting major SHC (e.g., cardiometabolic diseases, urinary tract infections) in SCI, further research is warranted to confirm the effectiveness of dietary strategies/interventions identified through the current systematic review of the literature.

A document. Jung to Freud 1905: a report on Sabina Spielrein.

A recently discovered letter, dated September 25, 1905, proves that Jung's first attempt to get in contact with Freud had taken place earlier than it had been assumed on the basis of their published correspondence. The letter contains a brief case history of Sabina Spielrein's illness. It was addressed to Freud and handed over to Sabina Spielrein's mother who intended to remove her daughter from Jung with whom the girl had fallen in love. However, the letter was never passed on to Freud.

Cognition in children does not suffer from very low lead exposure.

We studied the relationship between exposure to lead and memory and attention in children. Participants were 313 boys aged 9 to 12 years who attended special education schools in the Netherlands. Children whose possible attentional or memory problems were obviously due to causes other than lead contamination were excluded from the study. Cognition was assessed by extensive theory- based testing. Blood lead concentration was measured to assess body lead burden. Possible confounding factors that might affect blood lead level and/or cognitive functioning were assessed. Blood lead levels were higher in children with lower socioeconomic status and in children with more hand-to-mouth behavior, and varied seasonally, with higher values in spring and summer. The mean blood lead level was 44.4 microgram lead per liter blood, which is considered low. Only 2% of the children showed a slightly higher blood lead level than the American safety standard. To obtain robust measures of cognitive aspects, we performed a factor analysis. The results showed that blood lead level did not influence any of the cognitive factors. Therefore this study, despite being designed to maximize the chance of finding an effect in asymptomatic children, does not support a relationship between lead at very low doses (below 100 micrograms/liter blood) and cognition in schoolchildren.

Exposure to lead and specific attentional problems in schoolchildren.

A pilot study was carried out to investigate the relationship between exposure to lead and attention in children. The participants were 43 boys, 8 to 12 years of age, attending special schools for children with educational and/or learning problems (so called LOM schools). Children with probable causes of attentional or memory problems other than lead contamination were excluded from the study. Various aspects of attention were measured using neuropsychological tests. As an assessment of body lead burden, lead concentration in the boys' hair was measured by means of the Synchrotron Radiation-Induced X-ray Fluorescence technique (SXRF). Information was collected about variables that possibly could influence attention and/or body lead burden (confounding factors). A multiple regression analysis was used to determine the contribution of lead to variance in performance, after correction for confounding factors. The results showed that children with relatively high concentrations of lead in their hair reacted significantly slower in a simple reaction-time task than did children with relatively low concentrations of lead in their hair. In addition, the former were significantly less flexible in changing their focus of attention, even after correction for the influence of their delayed reaction time.

[Jung to Freud 1905: a report on Sabina Spielrein]. / Jung an Freud 1905: Ein Bericht über Sabina Spielrein.

A recently discovered letter, dated September 25, 1905, proves that Jung's first attempt to get in contact with Freud had taken place earlier than it was assumed on the basis of their published correspondence. The letter contains a brief case history of Sabina Spielrein's disease. It was addressed to Freud and handed over to Sabina Spielrein's mother who intended to remove her daughter from Jung with whom the girl had fallen in love. However, the letter was never passed on to Freud.