Juan J. Urrutia

The effects of short-term oral iron therapy on developmental deficits in iron-deficient anemic infants

To assess the effects of iron therapy on developmental test scores in infants with iron deficiency anemia, 68 Guatemalan babies 6 to 24 months of age, with and without mild iron deficiency anemia, were tested with the Bayley Scales of Infant Development before and after one week of oral iron treatment. The two major findings of the study were developmental deficits in the anemic group prior to treatment, and lack of rapid improvement with short-term oral iron therapy. The mean pretreatment Mental Development Index of the anemic group was significantly lower than that of nonanemic infants. The anemic groups pretreatment Psychomotor Development Index was also lower than that of the nonanemic control group. In a double-blind randomized study, six to eight days of oral iron therapy did not reverse these deficits. Consequently, the deficits of the anemic group cannot be unequivocably attributed to iron lack. However, no significant differences were found between anemic and nonanemic groups in birth histories, socioeconomic level, or general nutritional status which might otherwise explain the lower developmental test scores of the anemic babies.

Secretory antibody directed against rotavirus in human milk—measurement by means of enzyme-linked immunosorbent assay

Human milk contains antibodies to a variety of enteropathic agents. We utilized the method of enzyme-linked immunosorbent assay to investigate anti-rotavirus secretory IgA in 113 human milk and colostral specimens from a rural area in Guatemala, 32 colostral specimens from an urban area of Costa Rica, and 12 from an urban area of the United States. Anti-rotavirus SCIgA was found in all colostral samples and in 94% of the milk specimans. Both the absolute concentration of anti-rotavirus SCIgA and concentration relative to total SCIgA were highest in colostrum, falling to lower but detectable levels from one week to two years after birth. No significant differences were noted in the results from the specimens from the three different geographic areas. The possible role of this antibody in immunity to rotavirus infections is discussed.

Abnormal Behavior and Low Developmental Test Scores in Iron-Deficient Anemic Infants

The relationship between abnormal behavior and poor developmental test performance was analyzed in 68 6− to 24-month-old Guatemalan babies with and without mild iron deficiency anemia. Regardless of age, the 10 anemic infants with abnormal affective responses during developmental testing had very low mental scores (x = 65.7 ± 5.2 SEM), while the 18 with normal affect had mental scores (x = 97.1 ± 4.5 SEM) which were normal by U.S. standards and comparable to the nonanemic groups scores. Five anemic infants with pervasive behavioral disturbance, who showed abnormal orientation to tasks in addition to disturbed affect, did poorly on the motor test (x = 59.8 ± 6.2 SEM). Those anemic infants who were normal in task orientation achieved motor scores similar to those of the nonanemic control group. The observed behavioral disturbances are consistent with biochemical evidence concerning the role of iron in the metabolism of central nervous system neurotransmitters which influence affect and arousal. These results suggest that poor mental developmental test performance in infants with iron deficiency anemia may be mediated by disturbances in affective behavior.

Infection and Low Birth Weight in a Developing Country: A Study in an Indian Village of Guatemala

articulo -- Universidad de Costa Rica, Instituto de Investigaciones en Salud. 1975. Este documento es privado debido a limitaciones de derechos de autor.

Immature circulating lymphocytes in severely malnourished Guatemalan children.

The percentage of peripheral blood lymphocytes forming rosettes with sheep erythrocytes (E-rosettes) was determined in 33 severely malnourished Guatemalan children, and in two groups of clinically well but mildly growth retarded children from the same environment. Mean E-rosettes in the acutely ill patients was lower than the value observed in the mildly malnourished children, although there was considerable overlap between groups. These data differ from previously published studies of severely malnourished children from other parts of the world in that not all patients had decreased values for E-rosettes, in contrast to the uniform depression reported by others. As all patients were clinically similar, the results suggest that there may be specific nutrient defects associated with protein-energy malnutrition that particularly affect immune function. In addition, in vitro incubation of lymphocytes from the acutely malnourished children with the thymic factor, thymosin fraction 5, increased the percentage of E-rosettes in a dose-dependent fashion. These data suggest that immature, thymosin-responsive T cells are present in circulation. It is possible that in vivo thymosin administration may be beneficial for malnourished individuals.

Giardiasis: Impact on child growth

Articulo cientifico -- Universidad de Costa Rica. Instituto de Investigaciones en Salud, 1986

Levels of immunoglobulin M (IgM) in cord blood of Latin American newborns of low socioeconomic status

While studying the ecology of fetal malnutrition, levels of cord serum IgM were determined by radial immuno‐diffusion in cord blood taken from seven groups of newborns. Group 1 was selected among the high socioeconomic Peruvian urban population. The other six groups were from the low socioeconomic strata of Peru and Guatemala (Ladino and Indian, urban and rural), among whom, very poor environmental conditions prevailed. The results were compared with values corresponding to the low income black population of Birmingham, Alabama. All IgM levels above 0.19 mg/ml were considered high, since the point of inflexion appeared between 0.19 and 0.20 mg/ml in a log normal probability chart. In Group 1, only 6 percent of infants had high IgM values, a value similar to the 4 percent in the Birmingham low‐income population. On the other hand, 40 to 65 percent of infants from Groups 2 to 7 showed high IgM levels. It is suggested that one of the main factors responsible for the high IgM concentrations was intrauterine i...