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ADHD, Autism, and Phenylketonuria

January 11, 2015 By admin

Acta Neurologica BelgicaResearchers at Assiut University have in collaboration with Geir Bjørklund evaluated the neuropsychological status in 78 children with early and continuously treated phenylketonuria (PKU) in Assiut, Upper Egypt. The article was on 10 January  2015 published online first in Acta Neurologica Belgica. The first author of the study, Khaled Saad, is Associate Professor of Pediatrics at Assiut University, Assiut, Egypt. Bjørklund is founder and president of the Council for Nutritional and Environmental Medicine (CONEM).

 

Khaled Saad, Yasser Elserogy, Ahmed A. Abdel rahman, Abdulrahman Abdullah Al-Atram, Ismail L. Mohamad, Tarek T. H. ElMelegy, Geir Bjørklund, and Amira A. El-Houfy

ADHD, autism and neuroradiological complications among phenylketonuric children in Upper Egypt

Acta Neurol Belg. Article first published online: 10 JAN 2015. doi: 10.1007/s13760-014-0422-8 

 

ABSTRACT

The aim of this study is to evaluate the neuropsychological status in a cohort of children with early and continuously treated phenylketonuria in Assiut, Upper Egypt. The study was implemented in seventy-eight phenylketonuria (PKU) children. Only 34 patients met the inclusion criteria. Investigated patients were evaluated according to detailed history, neurological examination, Childhood Autism Rating Scale, full scale Intelligence Quotient, attention deficit hyperactivity disorder, electroencephalography and magnetic resonance imaging (MRI). This study concluded that the prognosis for early diagnosed children with PKU treated from the first weeks of life is generally good. However, they are at increased risk for neurological complications and behavioral problems. So, neonatal screening for PKU is highly recommended in Egypt, for early detection and management. In addition, neuropsychological and MRI assessments in PKU children should be done.

 

 

Unani Medicine: Its Origin and Development

January 8, 2015 By admin

The Unani system of medicine owes as its name suggests (Unani is an Arabic spelling of Ionian, meaning Greek), its origin to Greece. It was the Greek philosopher cum physician Hippocrates (c. 460 – c. 370 BC) who freed medicine from the realm of superstition and magic, and gave it the status of Science. The theoretical framework of Unani medicine is based on the teachings of Hippocrates. After Hippocrates, a number of other Greek scholars enriched the system considerably. Of them, Galen (129 – c. 200/c. 216 AD) stands out as the one who stabilized its foundation, on which Arab physicians like Muhammad ibn Zakariyā Rāzī (also known as Rhazes and Rasis) (854-925 AD) and Avicenna (980-1037 AD) constructed an imposing edifice.

Unani medicine got enriched by imbibing what best in the contemporary systems of traditional medicine in Egypt, Syria, Iraq, Persia, India, China, and other Middle East and Far East countries.

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Copper Amalgam and Norwegian Dental Health Personnel

December 14, 2014 By admin

Fig 1 Heating of copper amalgam
Fig 1 Heating of copper amalgam

Copper amalgams, consisting 60-70% mercury (Hg) and 30-40% copper (Cu) (1, 2), were used very commonly in Norway for children with caries – allegedly because they were thought to inhibit the development of new caries. But they were used in a way making them far more dangerous for dental health personnel than other types of amalgam because the amalgam powder was heated in a metal spoon in a gas flame until Hg droplets could be observed (Fig 1). In poorly ventilated rooms, this gave an enormous Hg exposure by inhalation to the dental health personnel, but even more to the dental assistants than to the dentists.

The average levels of occupational exposure to Hg among dental health personnel was earlier very high, at least in the Scandinavian countries including Norway, and in some cases (not very infrequently) excessively high (3, 4), especially in public dental health clinics with large numbers of schoolchildren as patients, where copper amalgam was used as a matter of routine to make fillings for the children because of its assumed cariostatic effect. A medical student at the University of Oslo made a student thesis, where he studied the Hg concentration in the air in dental health clinics, and in some of them found excessively high levels far exceeding (by more than a factor of 10) what was at that time the maximal permitted levels of exposure (3). This student thesis was carried out under supervision of his older brother, who was working in a leading position at the Norwegian Institute of Occupational Health. But the older brother, who had been the supervisor, did never inform the Directorate of Occupational Health about his younger brother’s observations, as nevertheless had been his duty (because of his job in a leading position at the institute) to do (Olav Albert Christophersen, personal communication).

The late Dr. Hans Tjønn, who at that time was chief doctor at the Institute of Occupational Health, had suspected that the conditions at Norwegian dental health clinics were not satisfactory from the point of view of occupational hygiene, and had taken up this question in meetings both with the Norwegian Directorate of Health and professors at the Faculty of Dentistry at the University of Oslo (Olav Albert Christophersen, personal communication). But he had been assured both by the people in the Norwegian Directorate of Health and the professors at the Faculty of Dentistry that everything was O.K., and that there was no need for him to be worried (Olav Albert Christophersen, personal communication). If he had been informed about the findings of Jon Norseth, he would have had the evidence he needed to tell the people in the Norwegian Directorate of Health that their assumptions about good occupational health conditions in the Norwegian dental health clinics were far from correct (Olav Albert Christophersen, personal communication). And the Norwegian Directorate of Occupational Health had the necessary legal mandate in Norwegian law (Arbeidsmiljøloven) that it would not have been necessary for them to ask the Directorate of Health for permission in order to stop the problems. If that, historically counterfactually, had happened, several hundred Norwegian dental health assistants and dentists might have been spared for sometimes severe health problems caused by Hg poisoning, and also because of poisoning by some of those organic toxic substances that have been much used in dental health clinics, such as chloroform and hydroquinone.

This article is based on/excerpted from material by Olav Albert Christophersen and Geir Bjørklund.

 

References

1. Bjørklund G. The history of dental amalgam (in Norwegian). Tidsskr Nor Laegeforen 1989; 109: 3582-3585.

2. Bjørklund G. Health authorities and copper amalgam (in Norwegian). Tenner & Helse 1995; No. 2/3: 3-6.

3. Norseth J. Exposure to mercury in public dental clinics in Oslo–an occupational hazard evaluation (in Norwegian). Nor Tannlaegeforen Tid 1977; 87: 371-376.

4. Bjørklund G. Mercury in dental workers’ occupational environment. A toxicological risk evaluation (in Norwegian). Tidsskr Nor Laegeforen 1991; 111: 948-951.

 

Medical Geology: An Emerging Discipline in Environmental and Human Health

November 27, 2014 By admin

Olle Selinus, PhD
Former geologist at the Geological Survey of Sweden (SGU), and now Associated Professor at Linneaus University in Kalmar, Sweden. Board member of CONEM.

Medical geology is the science dealing with the influence of geology on the distribution of health in humans and animals. Medical geology is a rapidly growing discipline that has the potential of helping medical and public health communities all over the world pursue a wide range of environmental and naturally induced health issues. Medical geology brings together geoscientists and medical/public health researchers to address health problems caused, or exacerbated by geological materials (rocks, minerals, atmospheric dust, and water) and processes.  Among the environmental health problems that geoscientists are working on in collaboration with the medical and public health community are: exposure to toxic levels of trace essential and non-essential elements such as arsenic and mercury; trace element deficiencies; exposure to natural dusts and to radioactivity; naturally occurring organic compounds in drinking water; volcanic emissions, etc.

Among the medical geology described are examples of both deficiency and toxicity of trace element exposure. Goiter is a widespread and serious health problem in many developing countries caused by deficiency of iodine. Deficiency of selenium in soil is the principal cause of juvenile cardiomyopathy and muscular abnormalities. Overexposure to arsenic is one of the most widespread medical geology problems affecting more than one hundred million people in Bangladesh, India, China, Europe, Africa and North and South America. The arsenic exposure is primarily due to naturally high levels in groundwater, but combustion of mineralized coal has also caused arsenic poisoning in several developing countries. Dental and skeletal fluorosis also impacts the health of millions of people around the world and is due to naturally high concentrations in drinking water and, to a lesser extent, coal combustion. Other medical geology issues described include geophagia in developing countries, exposure to radon, natural global dusts and ingestion of high concentrations of organic compounds in drinking water.

Promotion of medical geology under ICSU, UNESCO etc, under leadership from Sweden, has been carried out at meetings in many countries, organization and sponsoring of symposia on medical geology and also providing financial support for students and professionals to participate. Short courses have been presented in almost 45 countries since 2001, attended by thousands of students and professionals with backgrounds in geoscience, biomedical/public health science, enviromental science, chemistry, etc.

The International Medical Geology Association (IMGA) was established in January 2006. This was done from Sweden. Every second year IMGA has an international conference. The next will be in Portugal July 2015. Information can be found on the website http://www.medicalgeology.org.

 

References

Selinus O, ed. Medicinsk geologi. Lund: Studentlitteratur, 2010.

Selinus O, Finkelman B, Centeno J, eds. Medical Geology: A Regional Synthesis. Dordrecht: Springer, 2010.

Selinus O, Alloway B, Centeno JA, Finkelman RB, Fuge R, Lindh U, Smedley P, eds. Essentials of Medical Geology: Revised Edition. Dordrecht: Springer, 2013.

 

Serum Zinc and Copper Levels in Autistic Children

November 23, 2014 By admin

NeuroReport 25 (15) 2014In collaboration with Chinese researchers, Geir Bjørklund investigated the serum levels of zinc (Zn) and copper (Cu) in 60 Chinese children with autism (48 boys, 12 girls) and a control group of 60 healthy sex-matched and age-matched individuals. The researchers also evaluated the severity of autism using the Childhood Autism Rating Scale (CARS) score. The mean serum Zn levels and Zn/Cu ratio in the study were significantly lower in the autistic children compared with the control group (P<0.001). At the same time were the serum Cu levels significantly higher in the autistic children compared with the control group (P<0.001). It was in the study found a significant negative association between the Zn/Cu ratio and CARS scores (r=-0.345, P=0.007). 

The original article is published in NeuroReport (2014; 25 (15): 1216–1220). Bjørklund is founder and president of Council for Nutritional and Environmental Medicine (CONEM).

 

Si-Ou Li, Jia-Liang Wang, Geir Bjørklund, Wei-Na Zhao, and Chang-Hao Yin

Serum copper and zinc levels in individuals with autism spectrum disorders

Neuroreport 2014; 25 (15): 1216-1220

 

ABSTRACT

Trace elements play a critical role in the pathogenesis of autism spectrum disorders (ASD). The aim of this study was to investigate the serum levels of zinc (Zn) and copper (Cu) in Chinese children with ASD. Sixty patients (48 males, 12 females) diagnosed with ASD and 60 healthy sex-matched and age-matched control participants were assessed for serum Zn and Cu content at admission. The severity of ASD was also evaluated using the Childhood Autism Rating Scale (CARS) score. The results indicated that the mean serum Zn levels and Zn/Cu ratio were significantly lower in children with ASD compared with normal cases (P<0.001, respectively), whereas serum Cu levels were significantly higher (P<0.001). There was a significant negative association between Zn/Cu and CARS scores (r=-0.345, P=0.007). On the basis of the receiver operating characteristic curve, the optimal cut-off value of serum levels of Zn/Cu as an indicator for an auxiliary diagnosis of autism was projected to be 0.665, which yielded a sensitivity of 90.0% and a specificity of 91.7%; the area under the curve was 0.968 (95% confidence interval, 0.943-0.993). In conclusion, these results suggested an association between serum levels of Zn and Cu and ASD among Chinese patients, and the Zn/Cu ratio could be considered a biomarker of ASD.

 

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