***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Other workers have reported preliminary results suggesting that vitamin and mineral supplements might improve the mental performance of mentally retarded children . The current study examined the effect of 20 wk of the suggested supplement on Stanford Binet scores in mentally retarded adults with nonspecific diagnoses , Down 's syndrome , and subjects receiving anticonvulsant medication .  No improvement in Stanford Binet scores was observed . However , serum pyridoxal phosphate concentrations were significantly ( p less than 0.05 ) increased in subjects with Down 's syndrome receiving the supplement compared with subjects with nonspecific diagnoses receiving the same treatment thus providing further evidence of abnormal vitamin B6 metabolism in Down 's syndrome Abstract Objective : To investigate whether early selenium ( Se ) supplementation can modify the post-traumatic alterations of thyroid hormone metabolism , since the first week after trauma is characterised by low plasma Se and negative Se balances . Design : Prospect i ve , placebo-controlled r and omised supplementation trial . Setting : Surgical ICU in a tertiary university hospital . Patients : Thirty-one critically ill trauma patients aged 42±16 years ( mean±SD ) , with severe multiple injury ( Injury Severity Score 30±7 ) . Intervention : Supplementation during the first 5 days after injury with either Se or placebo . The selenium group was further r and omised to receive daily 500 µg Se , with or without 150 mg α-tocopherol ( AT ) and 13 mg zinc supplements . The placebo group received the vehicle . Circulating Se , AT , zinc , and thyroid hormones were determined on D0 (= day 0 , admission ) , D1 , D2 , D5 , D10 , and D20 . Results : Plasma Se , low on D0 , normalised from D1 in the  selenium group ; total T4 and T3 increased more and faster after D2 ( P=0.04 and 0.08 ) , reverse T3 rising less between D0 and D2 ( P=0.05 ) . Conclusions : Selenium supplements increased the circulating Se levels . Supplementation was associated with modest changes in thyroid hormones , with an earlier normalisation of T4 and reverse T3 plasma levels . The addition of AT and zinc did not produce any additional change The effects of parathyroid hormone ( PTH ) administered to six young normal adult subjects on protein , calcium , magnesium , phosphorus , sodium and potassium concentrations in parotid saliva have been studied in relation to the salivary flow rate . Stensen 's duct was cannulated and excretion patterns of the constituents determined before and after stimulation of saliva production by lemon juice . After a control period ( period 1 ) , 50 U of PTH were given i.v . followed by an infusion of 2 U/min for 60 - 90 min ( period 2 ) . In the absence of any detectable changes in plasma , PTH induced a significant rise of salivary protein , calcium , and phosphorus concentrations at rest and following lemon juice stimulation , and of sodium concentration , but only at high flow rates for the latter . PTH did not change magnesium and potassium excretions significantly . Control experiments without PTH were performed on five other subjects . Protein , phosphorus and potassium concentrations did not change significantly between period 1 and period 2 . Calcium and sodium excretions were reduced and magnesium excretion increased during period 2 . These results provide evidence that PTH acts on the parotid gl and by affecting protein secretion and electrolyte transport . Possible mechanisms of these changes are discussed Plasma levels of TSH , T4 , T3 , and reversal T3 ( rT3 ) were measured in 51 children with trisomy of the chromosome 21 and in 15 controls .  Levels of TSH were higher in children with DS than in controls and rT3 levels were decreased . However , T3 and T4 levels were in the normal range . Plasmic zinc and thymulin , a zinc-dependent thymic hormone , were also decreased . After dietary supplementation with ZnSO4 , levels of plasmic zinc , thymulin , TSH and rT3 were restored . A follow up of DS children one year after the cessation of zinc therapy showed that plasma levels of zinc decreased and TSH lightly increased . Zinc deficiency may play a crucial role in the pathogenesis of thyroid gl and disfunction which leads to the autoimmune hypothyroidism often observed in this syndrome Objective : To assess the status of vitamin D and the effects of calcium and vitamin D3 supplementation on the bone metabolism in a group of adults with Down 's syndrome ( DS ) . Design : R and omized , parallel , controlled and open clinical trial . Setting : Institution for mentally h and icapped : Fundación Uliazpi , Diputación Foral de Guipúzcoa , San Sebastián , Spain . Subjects : A total of 23 persons with DS , residents at the Uliazpi Foundation were recruited and all completed the study .Intervention : In all , 12 participants were r and omly allocated to receive 1 g of calcium and 800 IU of vitamin D once daily for 1 year while 11 were assigned to the control group , receiving no supplementation . Results : We found no differences between groups regarding serum calcium and phosphorous levels . The remaining parameters showed differences between the two groups consistent with a beneficial effect of the intervention : serum levels of parathyroid hormone , osteocalcin and crosslaps diminished while serum 25 OH vitamin D3 level increased . Conclusions : The results obtained allow to include people with DS as a risk group with regards to vitamin D deficit , which that can be corrected with vitamin D and calcium supplementation , and giving rise to an improvement of the biochemical markers related to the phospho-calcium metabolism and bone remodelling . Sponsorship : This study was sponsored by de Uliazpi Foundation , a public entity devoted to the study and care of persons with intellectual disability who require extensive and pervasive support Thyroid function parameters and immunoglobulin concentrations in sera of out patients with Down ’s syndrome ( DS , n=110 ) of different ages ( DS1= 1–9 years ; DS2= 6–15 ; DS3= 15–35 ) were compared with those of age-matched controls ( n=110 ) . Although mean serum TSH was higher in all DS groups , thyroid hormone concentrations were significantly lower only in DS3 . In DS1 , a notable frequency rate of high T4 and T3 was found . Serum concentrations of thyroxine binding globulin ( TBG ) were significantly higher in all DS groups . Free T4 and T3 indexes , calculated as the ratio of total hormone : TBG concentrations , were lower in all DS groups . IgA serum concentrations were significantly higher in all DS groups , IgA was higher in DS1 and DS2 . Serum zinc levels were lower in all DS groups . Repeated examination after one year revealed lower T4 and higher TSH in DS patients treated with zinc during this interval as compared to values observed before treatment . Our results suggest a high occurrence rate of complex immune and endocrine disorders with thyroid dysregulation in DS patients , with zinc deficiency playing a considerable role The aim of this study was primarily to investigate whether similar signs of copper dyshomeostasis occur in dementia with age in Down 's syndrome as previously found in Alzheimer 's disease . Copper was accordingly determined in plasma , ceruloplasmin concentration in serum , ceruloplasmin oxidative activity and ceruloplasmin specific oxidative activity ( activity related to mass ) in serum , and superoxide dismutase ( SOD1 ) in erythrocytes in 35 ( 27 males , 8 females ) 18 - 53 years old ( average 37 years ) patients with Down 's syndrome ( Down 's patients ) and their age- and gender-matched controls .  SOD1 activity was on an average almost 50 % higher in the patients than in their controls but the evidence of a causal relationship between increased SOD1 activity and Down 's syndrome appears at best equivocal . Copper and ceruloplasmin levels and ceruloplasmin activities were similar in the patients and their controls . Ceruloplasmin and copper levels increased significantly with age in the patients but not in the controls . Ceruloplasmin activities or SOD1 activity did not change significantly with age , neither in the patients nor in the controls as whole groups . When SOD1 activity and ceruloplasmin activities of the oldest in the patients group ( 40 years or older ) were compared with those of the younger patients , respectively , SOD1 activity and specific oxidative activity , but not ceruloplasmin oxidative activity were found to decrease significantly with age . The results thus suggest that development of dementia in Down 's patients with age is paralleled with decrease in SOD1 activity and specific oxidative activity but not with decrease in ceruloplasmin oxidative activity itself as was also found in Alzheimer 's patients In subjects affected by trisomy 21 ( Down syndrome ) , hypothyroidism is the most common endocrinological deficit . Plasma zinc levels , which are commonly detected below the normal range in Down patients , are related to some endocrinological and immunological functions ; in fact , zinc deficiency has been shown to impair immune response and growth rate . Aims of this study were to evaluate ( 1 ) the role of zinc deficiency in sub clinical hypothyroidism and ( 2 ) thyroid function changes in Down children cyclically supplemented with zinc sulfate . Inverse correlations have been observed between age and triiodotironine ( T3 ) and between zinc and thyroid-stimulating hormone ( TSH ) ; higher TSH levels have been found in hypozincemic patients at the beginning of the study . After 6 mo of supplementation , an improvement of thyroid function ( TSH levels : 3.96 ± 1.84 vs 2.64 ± 1.33 mUI/mL basally and after 6 mo , respectively ) was observed in hypozincemic patients . In the second cycle of supplementation , a similar trend of TSH was observed . At the end of the study , TSH significantly decreased in treated hypozincemic subjects ( 4.48 ± 1.93 vs 2.96 ± 1.20 mUI/mL ) and it was no longer different in comparison to normozincemic patients . We suggest zinc supplementation to the diet in hypozincemic Down children as a simple and useful therapeutic tool 
    Output:
    
Our findings that micronutrient levels are different in people with DS raise the question whether these differences are related to the different metabolic profiles , the common comorbidities or merely reflect DS