Identification of viral agents associated with diarrhea in young children during a winter season in Beijing, China.

BACKGROUND: Viral diarrhea remains a major cause of childhood morbidity and mortality worldwide. Although rotavirus was extensively studied in China, few comprehensive studies of all viral agents related to diarrhea in children have been conducted. OBJECTIVES: Our study was performed to investigate the role of enteric viruses in acute diarrhea in our country and to evaluate methods that could be used in routine diagnostics. STUDY DESIGN: One hundred stool samples were collected from children under 5 years of age seeking medical care for acute diarrhea during the winter season 2000/2001 in Beijing Children's Hospital. All specimens were initially screened microscopically for leucocytes/red blood cells. Samples with negative results were analyzed for virus presence using commercial EIAs and/or in-house RT-PCRs. RESULTS: At least one viral agent was found in 67% of the specimens. The frequency of rotavirus, astrovirus, norovirus and enteric adenovirus was 59%, 8%, 6% and 2%, respectively. Dual infections were found in 9.0% (6/67) of the positive samples. The results from rotavirus and astrovirus EIAs were concordant with those of rotavirus and astrovirus RT-PCRs. CONCLUSIONS: Enteric viruses play an important role in pediatric diarrhea during the winter season in China. A combination of microscopic examination of stool samples with specific EIA assays to detect virus antigen in stool specimens may be suitable for routine diagnostics.     

Infective endocarditis at a Hospital of the University of Kiel, 1958–1987

Summary The clinical courses of 214 patients with infective endocarditis treated between 1958 and 1987 at the First Medical Hospital of the University of Kiel (FRG) were analyzed retrospectively. A decrease in the incidence of endocarditis occurred during the 30-year observation period. The mean age of patients was 48 years, and men were more frequently affected than women. In the course of the investigation, a rise in isolated aortic valve disease was noted, whereas the number of patients with isolated involvement of the mitral valve and combined mitral-aortic valvular defects declined. Streptococci (57%) were the most frequent pathogens isolated; as opposed to their increase, the percentages ofStaphylococcus aureus and enterococci decreased. Otolaryngological, dentogenic and urogenital diseases were most frequently held to be responsible for the development of infective endocarditis. Prior cardiosurgical interventions became increasingly significant as a cause of the disease. In this connection, a rising percentage of endocarditis cases was linked with prosthetically replaced heart valves. Complications and concomitant symptoms of endocarditis included the development of heart failure, cerebral embolism and encephalitis, splenomegaly, and renal inflammation. Finally, the marked decrease in mortality contrasted with a simultaneous rise in the number of endocarditis cases achieving full recovery.     

Effect of omeprazole and cimetidine on duodenal ulcer. A double-blind comparative trial

We conducted a double-blind randomized study of 132 patients to determine whether the new, investigational proton-pump inhibitor, omeprazole (30 mg per day), would accelerate healing and pain relief, as compared with cimetidine (1 g per day), in patients with duodenal ulcer. After two weeks of treatment, which was completed by all patients, the healing rates were 73 per cent in the omeprazole group and 46 per cent in the cimetidine group (P less than 0.01). After four weeks of treatment, which was completed by 118 patients, the corresponding figures were 92 and 74 per cent (P less than 0.05). In the omeprazole group 55 per cent of the patients were free of pain after the first week, as compared with 40 per cent of those treated with cimetidine (P greater than 0.05). No major clinical or biochemical side effects of omeprazole or cimetidine were noted. A six-month follow-up study revealed no significant difference between the recurrence rates after omeprazole and after cimetidine treatment. In May 1984 clinical trials with omeprazole were temporarily suspended, since a study of long-term toxicity in rats had shown the development of gastric carcinoid tumors.     

Aktion ?Gesunde Ern?hrung? im Kanton St.Gallen

Zusammenfassung Die Aktion «Gesunde Ernährung» in der Gemeinde-wurde vom Gesundheitsdepartement des Kanton St. Gallen unter der Leitung des kantonalen Präventivmediziners gemeinsam mit den interessierten Gemeinden geplant, koordiniert und durchgeführt.Im Zentrum der Aktion standen gemeindeeigene, individuell gestaltete Aktivitäten von Vereinen, Schulen und des lokalen Gewerbes. Das Gesundheitsdepartement ergänzte die Aktion mit einer Wanderausstellung über Ernährungsfragen, begleitet von einer Ernährungsberaterin. Der Aufbau der Ausstellung erfolgte nach den 10 goldenen Regeln der gesunden Ernährung.Diese Aktion stellt ein konkretes Beispiel der Arbeitsteilung zwischen Kanton und Gemeinde in der Gesundheitsvorsorge dar. Das Beispiel dieser einmaligen Aktion soll Behörden, Vereinen und Einzelpersonen Wege und Methoden aufzeigen, Anliegen der Gesundheitsvorsorge auf längerfristiger Basis in der Gemeinde zu planen.

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Healthy Nutrition an experience of health promotion in the county of St. Gall

Summary The drive Healthy Nutrition in communities was planned, co-ordinated und carried out as a joint action by the Health Department of the County of St. Gall, and 37 communities interested in the idea. The drive centred around the activities of the community itself, individuals, clubs, schools and local industry.The County Health Department supplemented the activity with a travelling exhibition about nutrition problems, attended by an advisor to answer questions. The build-up of the exhibition followed the 10 Golden Rules of sound nutrition.This drive was an excellent example of how health-promotion programms can be shared by county und community.This unique action should set an example to other authorities, clubs, and individuals, and show the ways and means needed to provide long-term planning for health promotion in the community.

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«Alimentation saine»: le programme du canton de St-Gall

Résumé Un programme «Alimentation saine» a été planifié, coordonné et réalisé en étroite collaboration entre le Service cantonal de médecine préventive et les communes intéressées.Les activités développées par les sociétés locales, les écoles et les commerÇants ont été les éléments essentiels du programme. Le canton a, quant à lui, engagé une diététicienne et mis un bus à disposition ce qui a permis d'organiser une exposition itinérante conÇue selon les 10 règles d'or de l'alimentation saine.Ce programme est une expérience de collaboration entre le canton et les communes pour la promotion de la santé. Il devrait servir d'exemple aux autorités, sociétés locales et individus qui désirent répondre au défi de la promotion de la santé.

     

Association of the TNF +489 polymorphism with susceptibility and radiographic damage in rheumatoid arthritis

Multiple genetic factors contribute to susceptibility to rheumatoid arthritis (RA). The extent of variability in disease presentation in RA may be related to genetic heterogeneity. In this study we investigated the association of the TNF gene polymorphism at position +489 with susceptibility to and severity of RA. Analysis of the frequency of the +489 A and G alleles in a group of 293 consecutive RA patients and 138 healthy controls revealed a significant decrease of the A allele. The +489 GA patients had a 3.9 times decreased chance of having erosive disease than +489 GG patients. These results were confirmed in a prospective study using a cohort of 112 patients who were followed for 12 years. The progression rate of the erosion score over 12 years expressed as Sharp score for X-rays of hands and feet was 3.4 per year for the GA-genotyped patients and 12.1 for the GG-genotyped patients. These associations were independent of rheumatoid factor and HLA-shared epitope positivity. In conclusion, these data suggest that the intron TNF +489 polymorphism is associated with susceptibility to and disease severity of RA independently of HLA-shared epitope-positive alleles.     

Utility of the sickness impact profile in Parkinson's disease.

The Sickness Impact Profile (SIP) is a questionnaire consisting of 136 items grouped into 12 categories and two dimensions (physical and psychosocial). To characterize its utility in Parkinson's disease (PD), we administered the SIP to 44 consecutive clinic patients with PD. Compared to 44 age- and sex-matched control subjects, PD patients had their greatest dysfunction in the categories of mobility, communication, and home management. The two items that PD patients most commonly endorsed were, "I am having trouble writing or typing" (75%) and, "My sexual activity is decreased" (61%). In general, these treated PD patients had greater dysfunction in the psychosocial than physical dimensions. Two simple PD-specific scales correlated well with the physical dimension score but less so with the psychosocial dimension, suggesting that the SIP assesses more functional domains than the PD-specific scales used. The SIP holds some promise as a broad measure of functional status in PD patients.     

Properties of growing trabecular ovine bone. Part I: mechanical and physical properties

Our aim was to determine the relationship between age and the mechanical and physical properties of trabecular bone, to describe the patterns in which the variations in these properties take place, and to investigate the influence of the physical properties on the mechanical characteristics of trabecular bone during growth. We used 30 lambs in three age groups and 20 sheep in two age groups. Cubes of subchondral bone were cut from the proximal tibia according to a standardised protocol. We performed non-destructive compression tests of the specimens in three orthogonal directions and compression tests to failure in the axial direction. The physical properties of the specimens were also determined. The data were correlated with age and compared in skeletally immature and mature animals. Multiple regression analyses were performed between the mechanical and the physical properties. Age correlated positively with elastic modulus, bone strength, energy absorption to failure, elastic energy, mechanical anisotropy ratio, tissue density, apparent density, apparent ash density, and bone mineral content, and inversely with ultimate strain, viscoelastic energy absorption, relative energy loss, the collagen content of bone and the percentage porosity. The values of all variables were significantly different in the skeletally mature and immature groups. The apparent density of trabecular bone tissue was found to be the major predictor of its compressive mechanical properties. Together with the content of bone muscle and bone collagen, the apparent density could explain 84% of the variation in the elastic modulus, whereas only a small portion of the variation in ultimate strain could be explained by the variation in apparent density.     

Testing a Brief Self-Directed Behavioral Weight Control Program

Clinical obesity treatments are of limited reach. Self-directed weight control attempts are common, but little attention has been given to providing guidance for such efforts in the population. The present research tests a brief intervention approach to weight control. Pilot data were collected from 66 University of Minnesota employees (72.7% women, 81.8% white) randomized to an assessment-only control condition or a single intervention session to teach empirically valid self-directed weight-control methods. Mean baseline weight was 87.1 kilograms (range 64.0–120.3 kilograms). Though statistically nonsignificant, intervention participants averaged greater weight loss by 6 months than controls (–.80 kilograms vs. –.19 kilograms), F(1, 44) = .47, p = .50, Cohen's d = .21. There was a significant group × time interaction for self-weighing frequency, F(2, 41) = 10.84, p < .001. With some enhancement and more attention to dissemination, a brief self-directed program has potential as a useful approach to population weight-gain prevention.