David C Bellinger

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..This paper reflects a summary of the talks presented at the Neurobehavioral Testing in Human Risk Assessment symposium presented at the 11th meeting of the International Neurotoxicology Association...

..Such a judgment reflects a failure to distinguish between individual and population risk. The population impact of a risk factor depends on both its effect size and its distribution (or incidence/prevalence)...

..Studies employing neuroimaging modalities such as volumetric, diffusion tensor, and functional MRI are providing insights into the neural bases of the cognitive impairments associated with greater lead exposure...

..Children with congenitally malformed hearts who underwent reparative surgery in infancy using a strategy of severe haemodilution and alpha stat are at increased risk of behavioural problems in middle childhood...

..A final issue discussed is the need to define standards for the conduct, analysis, and reporting of epidemiologic studies of neurotoxicity, similar to those developed for other fields...

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..Subgroups of women who incurred substantial exposures to lead prior to pregnancy should be considered to be at increased risk...

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..Children were randomly assigned to a vital organ support method, deep hypothermia with either total circulatory arrest or continuous low-flow cardiopulmonary bypass...

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..In ongoing evaluations of the children as adolescents, we are testing these hypotheses more systematically by administering several instruments specifically developed to assess "theory of mind" and alexithymia...

..The review evaluates the basis for these calls...

..In addition, a systems approach to understanding the associations among contaminant exposures, covariates and health outcomes is necessary...

..The form of the relationship between continuous hematocrit levels and outcomes requires further study...

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..However, worse outcomes were concentrated in patients with hematocrit values of 20% or below, and the benefits of hematocrit values higher than 25% were uncertain...

..Our goal was to determine which of the two major methods of vital organ support used in infant cardiac surgery, total circulatory arrest and low-flow cardiopulmonary bypass, results in better neurodevelopmental outcomes at school age...

..We evaluated the modifying influence of a delta-aminolevulinic acid dehydratase (ALAD) polymorphism on the relation between lead burden and cognition among older men...

..Overall, our analyses support prior research that children's blood levels <10 microg/dL are related to compromised cognition and highlight that these may especially be related to academic achievement...

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..To test the hypothesis that postoperative length of stay (LOS) after infant heart surgery might be an easily measured surrogate marker for various events that culminate in later adverse cognitive outcome...

..Previous studies have addressed the effects of prenatal exposure, but little is known about developmental effects of early postnatal exposure...

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..Long-term follow-up of children with CHD is necessary to draw inferences about the developmental sequelae of preoperative, intraoperative, and postoperative factors...

..3, -0.9) for the WRAVMA. Fish consumption of < or =2 servings/week was not associated with a benefit. Dietary recommendations for pregnant women should incorporate the nutritional benefits as well as the risks of fish intake...

..004). These results augment evidence of a deleterious association between lead and psychiatric symptoms...

..Moreover, there was evidence that maternal self-esteem attenuated the negative effects of lead exposure, although the interaction fell short of conventional levels of statistical significance...

..We hypothesized that cognitive impairment and hemodynamic instability after infant cardiac surgery with cardiopulmonary bypass might be exacerbated by hemodilution...

..0+/-22.5, respectively. Behavior ratings were not associated with blood lead level. Lead exposure is a significant problem among Indian children, with many having blood lead levels associated with increased neurodevelopmental risk...

..We aimed to determine the incidence and type of brain injury in infants undergoing 2-ventricle repair in infancy and to determine risk factors associated with such injury...

..Also, for seven of the eight studies reviewed, effects are extrapolated from formula supplementation to maternal dietary intake...

..This investigation is part of an institutional effort to examine the neurodevelopment of 5-year-old children following repair or palliation of CHD...

..Early life lead exposure might be a risk factor for neurocognitive impairment in adulthood...

..Most toxicologic studies focus on a single agent, although this does not reflect real-world scenarios in which humans are exposed to multiple chemicals...

..The goal was to examine the association between urinary concentrations of dialkyl phosphate metabolites of organophosphates and attention-deficit/hyperactivity disorder (ADHD) in children 8 to 15 years of age...

..Future studies should include a greater number of children with prenatal diagnosis and a variety of congenital heart lesions...

..To summarize recent evidence regarding associations of early life exposure to mercury from maternal fish consumption during pregnancy, thimerosal in vaccines and dental amalgam with child neurodevelopment...

..It includes current thinking on the clinical management and prevention of childhood lead poisoning...

..A concern persists that children's exposure to mercury vapor from dental amalgams produces neurotoxicity...

..7 points. This paper identifies important sources of uncertainty influencing this estimate, concluding that the plausible range of values for this loss is 0 to 1.5 IQ points...

..High glucose concentrations were not associated with worse neurodevelopmental outcomes. Avoiding hypoglycemia may be preferable to restricting glucose in infants undergoing heart surgery...

..Effective medical/environmental treatments for the adverse effects associated with chemical exposures are largely unknown, rendering primary prevention of exposure the most effective strategy for protecting children...

..Few studies have examined the overall effect of maternal fish intake during pregnancy on child development or examined whether the developmental benefits of maternal fish intake are greater in infants breastfed for a shorter duration...

..In addition, these deficits do not seem to be clearly associated with the intraoperative methods or postoperative events evaluated...

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..This study was undertaken to assess neurodevelopment of children after biventricular repair of congenital heart defects...

..Use of neurobehavioral test scores involves considerations that differ little from those that the risk assessor routinely addresses in using end points commonly used in research on other topics in environmental epidemiology...

..Social support, however, did not moderate the relationship between stress and child behavior problems. Early detection of distressed families may assist in alleviating stress and reducing behavior problems...

..76, 95% confidence interval: 1.06, 2.92) and a similar relation for p,p'-DDE. These results support an association between low-level prenatal organochlorine exposure and ADHD-like behaviors in childhood...

..TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00065988...

..No other significant relationships were found. These results suggest the need to study further the neuropsychological correlates of developmental exposure to Mn and As, particularly as a mixture...

..Importantly, we observed these associations at exposure levels that were previously considered to be without adverse effects, and these levels are common among U.S. children...

..Gene network analysis identified further candidates to study the mechanisms of developmental lead neurotoxicity...

..Use of neurobehavioral test scores involves considerations that differ little from those that the risk assessor routinely addresses in using end points commonly used in research on other topics in environmental epidemiology...

..A biologic mechanism for lead cariogenicity has not been identified, however. Our data are also consistent with residual confounding by factors associated with both elevated lead exposure and dental caries...

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..Explicit learning was predicted by cognitive ability, but not by reading or attention problems. Thus, we found no evidence that poor reading is preferentially associated with a domain general deficit in sequential learning...

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..Nonetheless, if properly designed, the NCS could serve as an excellent resource for investigating future hypotheses regarding endocrine disruption...

..Such approaches blur the reality of how the early environment establishes enduring biologic substrates...

..5 microg/dL (p = 0.015). We conclude that environmental lead exposure in children who have maximal blood lead levels < 7.5 microg/dL is associated with intellectual deficits...

..Using data from a prospective study conducted in Mexico City, Mexico, we evaluated the dose-effect relationship between blood lead levels and neurodevelopment at 12 and 24 months of age...

..Prenatal exposure to mercury has been associated with adverse childhood neurologic outcomes in epidemiologic studies. Dose-response information for this relationship is useful for estimating benefits of reduced mercury exposure...

..04-30). Helminth infection was associated with lower performance in three of the four cognitive domains examined in this study. These relationships remained after rigorous control for other helminths and important confounding covariates...

..The effects of exposures to combinations of metals, including lead, is also a major focus. This more closely mirrors "real world" exposures, which invariably involve a mixture of compounds rather than a single compound. ..

..The effects of exposures to combinations of metals, including lead, is also a major focus. This more closely mirrors "real world" exposures, which invariably involve a mixture of compounds rather than a single compound. ..

..The effects of exposures to combinations of metals, including lead, is also a major focus. This more closely mirrors "real world" exposures, which invariably involve a mixture of compounds rather than a single compound. ..

..Members of the faculty currently conduct a wealth of multidisciplinary research, which will provide trainees with ready opportunities to apply their training in ongoing research projects. ..

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..If general and regional awake anesthesia result in neurodevelopmental outcomes that are equivalent, this would support the safety of general anesthetics as currently used. ..