scholarly journals Maternal Ferritin Levels during Pregnancy and ADHD Symptoms in 4-Year-Old Children: Results from the INMA–INfancia y Medio Ambiente (Environment and Childhood) Prospective Birth Cohort Study

2020 ◽  
Vol 17 (21) ◽  
pp. 7704
Author(s):  
Loreto Santa-Marina ◽  
Nerea Lertxundi ◽  
Ainara Andiarena ◽  
Amaia Irizar ◽  
Jordi Sunyer ◽  
...  
Keyword(s):  
Rating Scale ◽  
Ferritin Level ◽  
Maternal Plasma ◽  
Continuous Variable ◽  
Birth Cohort Study ◽  
Inverse Association ◽  
Adhd Symptoms ◽  
Birth Cohorts ◽  
Inattentive Type ◽  
In Pregnancy

Ferritin status during prenatal brain development may influence the risk of attention deficit and hyperactivity disorder (ADHD) symptoms in childhood. We investigated the association of maternal ferritin in pregnancy and ADHD-like symptoms in offspring. A total of 1095 mother-child pairs from three birth cohorts of the INMA Project (Spain) were studied. Maternal plasma ferritin in pregnancy was measured at 11.57 weeks of gestation. Children′s ADHD-like symptoms at ages 4–5 years were assessed using the ADHD Rating Scale-IV. The count model of the zero-inflated Poisson regression model showed a significant inverse association between ferritin (continuous variable) and inattention, β = −0.19 (−0.32, −0.07), for boys. Comparing ferritin level by tertiles, significant differences were observed between the first tertile ([1.98, 20.92]) and the second ([20.92, 38.79]) and third tertiles ([38.79, 216.5]) (mg/L).The number of symptoms was lower for those in the third tertile, β = −0.3 (−0.55, −0.5), and for those in the second one, β = −0.37 (−0.6, −0.14). The model stratification by sex also showed this inverse association for boys only, β = −0.21 (−0.34, −0.08). No associations were found between ferritin level and hyperactivity or total ADHD symptoms. High ferritin levels during pregnancy show a protective association with child inattentive-type ADHD symptoms.

scholarly journals Prevalence of severe ADHD: an epidemiological study in the Italian regions of Tuscany and Latium

2014 ◽  
Vol 24 (6) ◽  
pp. 525-533 ◽  
Author(s):  
R. Donfrancesco ◽  
A. Marano ◽  
D. Calderoni ◽  
D. Mugnaini ◽  
F. Thomas ◽  
...  
Keyword(s):  
Middle School ◽  
Rating Scale ◽  
Psychiatric Evaluation ◽  
Adhd Symptoms ◽  
Psychiatric Interview ◽  
Italian Regions ◽  
8Th Grade ◽  
Inattentive Type ◽  
Italian Children ◽  
Elementary And Middle School

Background.The rate with which attention deficit/hyperactivity disorder (ADHD) is diagnosed varies widely across countries, suggesting that cultural factors influence the clinical interpretation of child behaviour. This study estimated the point prevalence of severe ADHD among elementary and middle-school Italian children.Method.An epidemiological sample of 2016 children attending 2nd–8th grade in the Italian regions of Tuscany and Latium was selected based on census distribution of the school-age population. Teachers completed the Italian version of the ADHD Rating Scale for Teachers (SDAI). For children with at least six inattention symptoms and/or at least six hyperactivity/impulsivity symptoms rated ‘very often’ by the teachers, the parents completed the Italian ADHD Rating Scale for Parents (SDAG). Children with documented ADHD symptoms at both school and home received a complete psychiatric interview with the Kiddie Schedule for Affective Disorders and Schizophrenia-present and lifetime version (K-SADS-PL).Results.Of the 1887 assessed children, 4.45% (95% CI 3.58–5.51) met the ADHD cut-off on teacher ratings, 1.43% (0.96–2.12) had ADHD symptoms endorsed by both teacher and parent, and 1.32% (0.87–1.97) were further confirmed by the psychiatric evaluation. The male:female ratio was 7:1. The inattentive type accounted for about half of the ADHD cases.Conclusions.When applying stringent criteria for both severity and pervasiveness of symptoms, it is estimated that about 1.3% of the Italian elementary and middle-school children suffer from severe ADHD.

Epilepsi dan Attention-Deficit / Hyperactivity Disorder (ADHD) pada Anak

2017 ◽  
Vol 10 (2) ◽  
pp. 80
Author(s):  
Riki Sukiandra
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Brain Networks ◽  
Seizure Threshold ◽  
Childhood Epilepsy ◽  
Adhd Symptoms ◽  
Hyperactivity Disorder ◽  
Neurologic Disturbance ◽  
Inattentive Type ◽  
Child Age

Attention-deficit / hyperactivity disorder (ADHD) has been associated with childhood epilepsy. Epilepsy are themost common neurologic disturbance in child age. Children with epilepsy tend to get one or more ADHD symptoms,its related to lack of norepinephrine neurotransmitter in brain, that cause attenuate the effect of GABA and disruptionto fronto-striatal brain networks, these same brain networks are disrupted by seizures or the structural brainabnormalities that can cause seizures. Children with epilepsy especially absance, tend to get inattentive type ofADHD more than other types. Abnormalities of electro-encephalography found in inattentive type of ADHD withhigh focus activities in all lobe area. No data published that methylphenidate can lower seizure threshold or act asproconvulsant. Children with epilepsy tend to get one or more symptoms of ADHD in the following days.

Pharmacokinetics, Placental and Breast Milk Transfer of Antiretroviral Drugs in Pregnant and Lactating Women Living with HIV

2019 ◽  
Vol 25 (5) ◽  
pp. 556-576 ◽  
Author(s):  
E.M. Hodel ◽  
C. Marzolini ◽  
C. Waitt ◽  
N. Rakhmanina
Keyword(s):  
Breast Milk ◽  
Protease Inhibitors ◽  
Drug Class ◽  
Drug Transporters ◽  
Maternal Plasma ◽  
Antiretroviral Drugs ◽  
Physiological Changes ◽  
Women Living With Hiv ◽  
Living With Hiv ◽  
In Pregnancy

Background:Remarkable progress has been achieved in the identification of HIV infection in pregnant women and in the prevention of vertical HIV transmission through maternal antiretroviral treatment (ART) and neonatal antiretroviral drug (ARV) prophylaxis in the last two decades. Millions of women globally are receiving combination ART throughout pregnancy and breastfeeding, periods associated with significant biological and physiological changes affecting the pharmacokinetics (PK) and pharmacodynamics (PD) of ARVs. The objective of this review was to summarize currently available knowledge on the PK of ARVs during pregnancy and transport of maternal ARVs through the placenta and into the breast milk. We also summarized main safety considerations for in utero and breast milk ARVs exposures in infants.Methods:We conducted a review of the pharmacological profiles of ARVs in pregnancy and during breastfeeding obtained from published clinical studies. Selected maternal PK studies used a relatively rich sampling approach at each ante- and postnatal sampling time point. For placental and breast milk transport of ARVs, we selected the studies that provided ratios of maternal to the cord (M:C) plasma and breast milk to maternal plasma (M:P) concentrations, respectively.Results:We provide an overview of the physiological changes during pregnancy and their effect on the PK parameters of ARVs by drug class in pregnancy, which were gathered from 45 published studies. The PK changes during pregnancy affect the dosing of several protease inhibitors during pregnancy and limit the use of several ARVs, including three single tablet regimens with integrase inhibitors or protease inhibitors co-formulated with cobicistat due to suboptimal exposures. We further analysed the currently available data on the mechanism of the transport of ARVs from maternal plasma across the placenta and into the breast milk and summarized the effect of pregnancy on placental and of breastfeeding on mammal gland drug transporters, as well as physicochemical properties, C:M and M:P ratios of individual ARVs by drug class. Finally, we discussed the major safety issues of fetal and infant exposure to maternal ARVs.Conclusions:Available pharmacological data provide evidence that physiological changes during pregnancy affect maternal, and consequently, fetal ARV exposure. Limited available data suggest that the expression of drug transporters may vary throughout pregnancy and breastfeeding thereby possibly impacting the amount of ARV crossing the placenta and secreted into the breast milk. The drug transporter’s role in the fetal/child exposure to maternal ARVs needs to be better understood. Our analysis underscores the need for more pharmacological studies with innovative study design, sparse PK sampling, improved study data reporting and PK modelling in pregnant and breastfeeding women living with HIV to optimize their treatment choices and maternal and child health outcomes.

scholarly journals Diet modification impact on ADHD outcome

2021 ◽  
Vol 45 (1) ◽  
Author(s):  
Olweya Mohammed Abd El Baaki ◽  
Enas Raafat Abd El Hamid ◽  
Safaa Taha Zaki ◽  
Amani Salah El Din Alwakkad ◽  
Rania Nabil Sabry ◽  
...  
Keyword(s):  
Protein Intake ◽  
Rating Scale ◽  
Behavioral Therapy ◽  
Short Form ◽  
Adhd Symptoms ◽  
Parent Rating ◽  
Dietary Analysis ◽  
Dietary Recall ◽  
Diet Modification ◽  
Before And After

Abstract Background Attention-deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders, affects 5% of children worldwide and characterized by impaired inattention, hyperactivity and impulsivity. One of the risk factors that precipitate ADHD is food. Food affects behavior of children by different ways such as food allergy, food intolerance and gut–microbiota–brain axis. The study aimed to assess effect of diet modification on ADHD outcome and the role of food as a precipitating factor for ADHD symptomatology. The study included 47 children newly diagnosed with ADHD, not receiving medical or behavioral therapy, their ages ranged from 6 to 9 years and their intelligence quotient not below 70 with no associated comorbidities. All participants were subjected to Full history taking, clinical examination, anthropometric measurements, 24 h dietary recall. Dietary analysis and Conner’s parent rating scale-revised short form (CPR-RS) were done before and after diet modification program for 5 weeks. Results There was improvement in ADHD symptoms as measured by CPR-RS after 5-weeks of diet modification program. Carbohydrate and protein intake decreased significantly after diet modification program. Energy intake did not show statistical difference while fat intake increased significantly after the diet program. Vitamin A, C, riboflavin, thiamin and iron intakes decreased significantly after diet program but were within the recommended dietary allowance. Conclusion Following the Diet modification program, ADHD symptoms were improved as documented by decrease in CPR scores. Diminished carbohydrate and protein intake in diet were positively associated with improvement of ADHD symptoms. Diet modification program succeeded in reducing obesity and then ADHD symptoms.

Influence of maternal pre-pregnancy nutritional status on offspring anthropometric measurements and body composition in three Brazilian Birth Cohorts

2020 ◽  
pp. 1-13
Author(s):  
Mariane da Silva Dias ◽  
Alicia Matijasevich ◽  
Aluísio JD Barros ◽  
Ana Maria B. Menezes ◽  
Bruna Celestino Schneider ◽  
...  
Keyword(s):  
Body Composition ◽  
Birth Weight ◽  
Waist Circumference ◽  
Nutritional Status ◽  
Normal Weight ◽  
Birth Cohort Study ◽  
Birth Cohorts ◽  
Mediation Analyses ◽  
Association Pattern ◽  
Maternity Hospitals

Abstract Objective: We aimed at evaluating the association of maternal pre-pregnancy nutritional status with offspring anthropometry and body composition. We also evaluated whether these associations were modified by gender, diet and physical activity and mediated by birth weight. Design: Birth cohort study. Setting: Waist circumference was measured with an inextensible tape, and fat and lean mass were measured using dual-energy X-ray absorptiometry. Multiple linear regression was used to adjust for possible confounders and allele score of BMI. We carried out mediation analysis using G-formula. Participants: In 1982, 1993 and 2004, all maternity hospitals in Pelotas (South Brazil) were visited daily and all live births whose families lived in the urban area of the city were evaluated. These subjects have been followed up at different ages. Results: Offspring of obese mothers had on average higher BMI, waist circumference and fat mass index than those of normal weight mothers, and these differences were higher among daughters. The magnitudes of the association were similar in the cohorts, except for height, where the association pattern was not clear. In the 1982 cohort, further adjustment for a BMI allele score had no material influence on the magnitude of the associations. Mediation analyses showed that birth weight captured part of this association. Conclusions: Our findings suggest that maternal pre-pregnancy nutritional status is positively associated with offspring BMI and adiposity in offspring. And this association is higher among daughters whose mother was overweight or obese and, birth weight explains part of this association.

scholarly journals Alcohol and early mortality (before 65 years) in the “Seguimiento Universidad de Navarra” (SUN) cohort: does any level reduce mortality?

2021 ◽  
pp. 1-33
Author(s):  
Miguel A. Martínez-González ◽  
María Barbería-Latasa ◽  
Javier Pérez de Rojas ◽  
Ligia J. Domínguez ◽  
Alfredo Gea
Keyword(s):  
Alcohol Intake ◽  
Premature Mortality ◽  
Continuous Variable ◽  
Early Mortality ◽  
Repeated Measurements ◽  
University Graduates ◽  
Inverse Association ◽  
Cox Models ◽  
Highly Educated ◽  
Heavy Drinkers

Abstract The aim of this study was to assess the association between alcohol intake and premature mortality (younger than 65 years) and to explore the effect of potential alcohol underreporting by heavy drinkers. We followed-up 20,272 university graduates. Four categories of alcohol intake were considered (abstainer, light, moderate and heavy consumption). Repeated measurements of alcohol intake and updated information on confounders were used in time-dependent Cox models. Potential underreporting of alcohol intake by some heavy drinkers (likely misclassified as light or moderate drinkers) was explicitly addressed in an attempt to correct potential underreporting by using indirect information. During 12.3 years of median follow-up (interquartile range: 6.8-15.0), 226 participants died before their 65th birthday. A higher risk of early mortality was found for the highest category of alcohol intake (≥50 g/d) in comparison with abstention (multivariable-adjusted hazard ratio (HR) =2.82, 95% confidence interval (CI): 1.38-5.79). In analyses of alcohol as a continuous variable, the multivariable-adjusted HR was 1.17 (95% CI: 1.08-1.26), for each 10 g/d of alcohol. This harmful linear association was present both in uncorrected models and in models corrected for potential underreporting. No significant inverse association between light or moderate alcohol intake and premature mortality was observed, even after correcting for potential misclassification. Alcohol intake exhibited a harmful linear dose-response association with premature mortality (<65 years) in this young and highly-educated Mediterranean cohort. Our attempts to correct for potential misclassification did not substantially change these results.

The Functional Impact of Sleep Disorders in Children With ADHD

2017 ◽  
Vol 24 (4) ◽  
pp. 499-508 ◽  
Author(s):  
Stephanie G. Craig ◽  
Margaret D. Weiss ◽  
Kristen L. Hudec ◽  
Christopher Gibbins
Keyword(s):  
Sleep Disorders ◽  
Functional Impairment ◽  
Rating Scale ◽  
Sleep Problems ◽  
Parent Report ◽  
Adhd Symptoms ◽  
Children With Adhd ◽  
Sleep Complaints ◽  
Sleep Schedule

Objective: Children with ADHD display higher rates of sleep problems, and both sleep disorders and ADHD have been shown to affect functioning in childhood. The current study examines the frequency and relationship between sleep problems and ADHD, and their impact on quality of life (QoL) and functional impairment. Method: Parents of 192 children with ADHD ( M = 10.23 years) completed measures regarding their child’s ADHD symptoms (Swanson, Nolan and Pelham [SNAP]), sleep disorders (Pediatric Sleep Questionnaire [PSQ]), QoL (Child Health Illness Profile [CHIP-PE]), and functioning (Weiss Functional Impairment Rating Scale–Parent Report [WFIRS-P]). Results: Common sleep complaints in participants were insomnia, excessive daytime sleepiness (EDS), and variability in sleep schedule. Regression analysis indicated that sleep problems and ADHD symptoms independently predicted lower levels of QoL (Δ R2 = .12, p < .001) and social functioning (Δ R2 = .12, p < .001). Conclusion: The results suggest that ADHD may coexist with somnolence and that both conditions have a significant impact on a child’s functioning and QoL.

scholarly journals Cognitive Reserve in Early Manifest Huntington Disease Patients: Leisure Time Is Associated with Lower Cognitive and Functional Impairment

2022 ◽  
Vol 12 (1) ◽  
pp. 36
Author(s):  
Simone Migliore ◽  
Giulia D’Aurizio ◽  
Eugenia Scaricamazza ◽  
Sabrina Maffi ◽  
Consuelo Ceccarelli ◽  
...  
Keyword(s):  
Functional Impairment ◽  
Huntington Disease ◽  
Leisure Time ◽  
Cognitive Reserve ◽  
Rating Scale ◽  
Cognitive Outcome ◽  
Inverse Association ◽  
Time Points ◽  
Disease Rating

We focused on Cognitive Reserve (CR) in patients with early Huntington Disease (HD) and investigated whether clinical outcomes might be influenced by lifetime intellectual enrichment over time. CR was evaluated by means of the Cognitive Reserve Index questionnaire (CRIq), an internationally validated scale which includes three sections: education, working activity, and leisure time. The clinical HD variables were quantified at three different time points (baseline-t0, 1 year follow up-t1 and 2 years follow up-t2) as per the Unified Huntington’s Disease Rating Scale (UHDRS), an internationally standardized and validated scale including motor, cognitive, functional and behavioral assays. Our sample consisted of 75 early manifest patients, withclinical stage scored according to the Total Functional Capacity (TFC) scale. Our correlational analysis highlighted a significant inverse association between CRIq leisure time (CRIq_LA) and longitudinal functional impairment (namely, the differential TFC score between t2 and t0 or ΔTFC) (p < 0.05), and the multidimensional progression of HD as measured by the composite UHDRS (cUHDRS, p < 0.01). CRIq_LA was significantly and positively associated with better cognitive performances at all time points (p < 0.05). Our results suggest that higher is the CRIq_LA, milder is the progression of HD in terms of functional, multidimensional and cognitive outcome.

Renin, Angiotensin and Aldosterone in Human Pregnancy and the Menstrual Cycle

1971 ◽  
Vol 16 (3) ◽  
pp. 183-196 ◽  
Author(s):  
J. I. S. Robertson ◽  
R. J. Weir ◽  
G. O. Düsterdieck ◽  
R. Fraser ◽  
M. Tree
Keyword(s):  
Angiotensin Ii ◽  
Plasma Renin ◽  
Normal Pregnancy ◽  
Maternal Plasma ◽  
Plasma Aldosterone ◽  
Sodium Depletion ◽  
Aldosterone Secretion ◽  
Renin Substrate ◽  
Plasma Aldosterone Concentration ◽  
In Pregnancy

Aldosterone secretion is frequently, although not invariably, increased above the normal non-pregnant range in normal pregnancy. Substantial increases in plasma aldosterone concentration have also been demonstrated as early as the sixteenth week. In pregnancy, aldosterone secretion rate responds in the usual way to changes in sodium intake. Plasma renin concentration is frequently, but not invariably, raised above the normal non-pregnant range. Plasma renin-substrate is consistently raised in pregnancy. Plasma angiotensin II has also been shown usually to be raised in a series of pregnant women. A significant positive correlation has been shown between the maternal plasma aldosterone concentration and the product of the concurrent plasma renin and renin-substrate concentrations. This suggests that the increased plasma aldosterone in pregnancy is the consequence of an increase in circulating angiotensin II, which in turn is related to the level of both renin and its substrate in maternal blood. For these reasons, estimations of renin activity in pregnancy are of dubious value. The increased renin, angiotensin and aldosterone concentrations may represent a tendency to maternal sodium depletion, probably mainly a consequence of the increased glomerular filtration rate. It is possible that the nausea and other symptoms of early pregnancy may be a consequence of this tendency to sodium depletion, with its attendant hormonal changes. In ‘pre-eclampsia’, renin and aldosterone values are generally slightly lower than in normal pregnancy. Human chorion can apparently synthesize renin independently of the kidney. The physiological significance of this remains at present obscure, but it seems unlikely that this source contributes much, if at all, to the often elevated maternal plasma renin. Plasma renin, renin-activity and angiotensin II concentrations, and aldosterone secretion are increased in the luteal phase of the menstrual cycle.

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