Acute myocardial infarction in an adolescent

Myocardial infarction (MI) is known to be common in adults. Interestingly, we report a case of a 15-year-old boy who presented with typical chest pain secondary to myocardial infarct attributable to a combination of familial hyperlipidemia and possible episode of Kawasaki disease in the past. The patient failed treatment and follow-up care, and died 2 years later. Although rare, this case demonstrates that MI should be considered as a diagnosis in adolescents presenting with typical chest pain as early detection, and management is vital for survival.     

Clonidine toxicity in an adolescent patient

Clonidine is a central acting a2-agonist used primarily as an antihypertensive agent. Recently, it has been used for the treatment of attention deficit hyperactivity disorder in children and adolescents. When taken in excess, it can produce profound CNS depression, apnea, bradycardia and hypotension. A transient period of hypertension can sometimes occur. Treatment is primarily supportive, including respiratory support, atropine for bradycardia, and fluids and dopamine for hypotension. The CNS depression sometimes responds to naloxone. Young children are very sensitive to the toxic effects of clonidine. A case of an 11 year old adolescent who took an overdose of his clonidine is described to illustrate the toxicity of this agent.     

幽门螺杆菌根除可诱导H＋／K＋-ATP酶的高表达而不改变胃黏膜壁细胞数量

背景与目的：已知幽门螺杆菌（HP）感染时胃酸分泌下降，HP根除后上调，但这种机制却不明确。该研究拟探讨HP根除对人胃黏膜壁细胞数量及胃酸分泌功能分子表达的影响。方法：选取患有HP相关的慢性胃炎患111例，于成功根除HP之前及之后12周经内镜取组织活检，计算壁细胞数量；应用实时逆转录聚合酶链反应（RF—PCR）检测H＋／K＋-ATP酶、阴离子交换子2、毒蕈碱受体M3、内因子及白介素-1β的mRNA表达水平；应用血清胃蛋白酶原Ⅰ／Ⅱ比值来评价胃萎缩的程度。结果：HP根除前后壁细胞数量无显性差异。HP根除后胃黏膜H＋／K＋-ATP酶mRNA表达的中位数升高250倍，而白介素-1β则下降，即使在严重萎缩性胃炎中H＋／K＋-ATP酶也有明显升高。与此不同，HP根除后内因子、阴离子交换子2和毒蕈碱受体M3的mRNA表达水平仅分别升高1．4倍、2．3倍和2．5倍。     

Birth control counselling in an adolescent clinic

The number of requests for contraceptive advice from the Teen Clinic at The Hospital for Sick Children increased in the past two years. Patients came directly or were referred by social service agencies. All were girls, nulliparous and unmarried and from 14 to 19 years old. Every patient was extensively interviewed and counselled with particular attention to sexual knowledge, emotional and social background. Individual decisions were made regarding the risk of unwanted pregnancy, the need for contraceptive advice and supply and the total health needs of the patient.     

Myofibroblastoma of the breast in an adolescent

A case of myofibroblastoma of the breast was recently diagnosed in an adolescent Omani boy. In this report, the clinical, histopathological and the radiological features of this rare disease are being discussed. We conclude that, myofibroblastoma of the breast, which was earlier described, predominantly, in elderlies, can occur in people from any age group.