重视儿童人类免疫缺陷病毒感染和艾滋病的防治

198 1年发现首例人类免疫缺陷病毒 1(humanimmunod eficiencyvirustype 1,HIV 1)感染 ,即获得性免疫缺陷综合征(acquiredimmunodeficiencysyndrome,AIDS ,艾滋病 ) ,至今该病在全世界 190多个国家和地区迅速传播流行 ,2 0 0 2年已有36 0 0万人被HIV 1感染。联合国艾滋病规划署公布的全球艾滋病最新报告显示 2 0 0 2年新发病人数达 5 0 0万例 ,已有30 0万人死于艾滋病。 2 0 0 2年亚太地区感染人数达 72 0万 ,其中艾滋病病人 97万 ,比 2 0 0 1年增长 10 %。估计到 2 0 10年全球艾滋病病人将达到 4 5 0 0万例 ,其中 4 0 %在亚洲和太平洋…     

人类免疫缺陷病毒感染的流行现状及发病机制研究进展

1　艾滋病流行现状艾滋病又称获得性免疫缺陷综合征(AIDS) ,是目前威胁人类健康和生命安全的主要传染病之一。自从1981年世界上发现首例AIDS患者以来,AIDS在全球以惊人的速度迅速蔓延。据联合国AIDS规划署发布的一份最新全球AIDS情况调查报告显示,目前全球AIDS患者和人类免疫缺陷病毒(HIV)携带者已达4 2 0 0万例,其中,15岁以下儿童就有2 5 0万例,仅在已经过去的2 0 0 3年里,全球就有30 0万例死于AIDS ,另有5 0 0万例新感染者,达到了历年来的最高峰[1] 。报告还指出,全世界平均每天有1 4万例新感染AIDS病毒,80 0 0多例死于AI…     

小儿感染及传染病诊治进展

1　病毒感染性疾病1.1　小儿艾滋病(AIDS)　自从1981年发现首例人类免疫缺陷病毒(HIV)感染以来,该病在全世界迅速蔓延,至2 0 0 2年全世界已达36 0 0万例,其中儿童病例为12 0万,我国目前HIV感染人群已超过10 0万(2 0 0 2年) ,且大多数集中在生育期成人[1] 。我国中部某艾滋病高发农村15岁以下儿童HIV感染情况调查研究表明,儿童HIV阳性病例中,母婴传播途径感染占89 2 % ,输血感染占8 1% ,艾滋病状态母亲母婴传播率为6 8 8% ,HIV携带状态母亲母婴传播率为2 0 4 % [1] 。因此,小儿艾滋病的预防、诊治工作已成为我国医务界所面临的严峻…     

艾滋病发病机制研究进展

艾滋病又称获得性免疫缺陷综合征 (acquiredimmunode ficiencysyndrome,AIDS) ,是由于感染人类免疫缺陷病毒 (hu manimmunodeficiencyvirus,HIV)所导致的以CD4 T淋巴细胞减少为特征的免疫衰竭 ,患者常于感染后 10～ 15年因并发各种机会性感染或恶性肿瘤而死亡。自 1981年发现首例艾滋病患者以来 ,HIV感染蔓延十分迅速。例如 1981年全世界HIV感染人数仅 15 2例 ,而到2 0 0 2年全球感染人数已达 4 2 0 0万例 ,其中 32 0万例是 15岁以下儿童 ,并且新感染人数仍以每天 1.6万例的速度急剧攀升。在我国 ,HIV感染的传播速度也极快 ,目前…     

人类免疫缺陷病毒感染的母婴传播及其预防

我国自1985年发现首例艾滋病(即获得性免疫缺陷综合征,AIDS)病例以来,人类免疫缺陷病毒(HIV)感染例数增长速度惊人。值得注意的是,我国女性HIV感染者近年明显增加,2 0 0 0年已经接近感染者的2 0 % ,2 0 0 1年达到了2 6 %。随着育龄妇女感染例数的增加,母婴传播在我国也会日趋严重。所以有必要提高对HIV感染及其母婴传播的认识,从而阻断艾滋病的母婴传播。1　HIV的传播途径与母婴传播1.1　艾滋病的传播途径　人体感染HIV后,HIV主要存在于体液中,如血液、精液、阴道分泌液、乳液、唾液、泪液、尿液、汗液和痰液等。有传播意义的是血…     

小儿HIV感染和艾滋病诊断及处理建议

艾滋病即获得性免疫缺陷综合症 (AIDS) ,是由人类免疫缺陷病毒 (HIV)感染所致的一种传播迅速、病死率极高的恶性病。我国目前HIV感染人群已超过 10 0万 (2 0 0 2年 ) ,且大多数集中在生育期成人。如果控制不好 ,10年后HIV感染者可能超过 10 0 0万。HIV感染的母婴传播率高达 2 2 %～6 5 %。小儿HIV感染与成人比较 ,其发生率增长快、潜伏期短、疾病进展快、死亡率高。因此小儿HIV感染和AIDS防治已成为我国儿科所面临的严峻挑战和紧迫任务。本建议适用于各级儿科医疗机构对HIV感染和AIDS患儿的诊断、报告和处理。一、诊断标准小…     

艾滋病23例

获得性免疫缺陷综合征 (AIDS)又名艾滋病。我国自1985年以来医学文献陆续可见成人AIDS报道 ,但小儿AIDS报告仍较少 ,为提高对AIDS认识 ,现将 2 0 0 0年 1月～ 2 0 0 2年3月在非洲布隆迪医疗队工作期间Gitega医院收治AIDS 2 3例报告如下。临床资料一、一般资料　男 14例 ,女 9例 ;年龄 1～ 2岁 4例 ,～ 4岁 9例 ,～ 10岁 9例 ,11岁 1例。母亲死于AIDS者 5例 ,母亲为AIDS患者 7例 ,母亲为病毒携带者 [艾滋病病毒 (HIV)抗体阳性 ]11例。父母均为AIDS患者 5例 ,父母均为HIV携带者 10例。二、临床表现　均有长期发热、乏力、反复…     

小儿人类免疫缺陷病毒感染/艾滋病诊断及处理建议

艾滋病即获得性免疫缺陷综合征 (acquriedimmunodefi ciencysyndrome ,AIDS) ,是由人类免疫缺陷病毒 (humanim munodeficiencyvirus ,HIV)感染所致的一种传播迅速、病死率极高的恶性病。我国目前HIV感染人群已超过 10 0万 (2 0 0 2年 ) ,且大多数集中在生育期成人。如果控制不好 ,10年后HIV感染者可能超过 10 0 0万。HIV感染母婴传播率高达2 2 %～ 6 5 %。小儿HIV感染发生率增长较成人快、潜伏期短、疾病进展快、死亡率高。因此小儿HIV感染 /艾滋病防治已是我国儿科所面临的严峻挑战和紧迫任务。本建议适用于各级儿科医疗机构对HI…     

小儿人类免疫缺陷病毒感染/艾滋病的实验室诊断

艾滋病 (acquiredimmunodeficiencysyndrome,AIDS)是由人类免疫缺陷病毒 (humanimmunodeficiencyvirus,HIV)感染引起的一种传染病。自 1981年美国首次报告该病以来AIDS已在全球广泛流行。目前全球已有 4 0 0 0万以上人口感染HIV ,尤其是许多无辜儿童也不幸受染。根据联合国艾滋     

儿童HIV感染

近年，儿童人类免疫缺陷病毒(HIV)感染已成为世界关注的问题。世界卫生组织(WHO)和联合国艾滋病规划署(UNAIDS)统计，至2002年底全球存活HIV／AIDS人数已达4200万，2002年新感染的HIV人数为500厅，其中成人420万(妇女200万)，15岁以下儿童80万。迄今全世界已有400万儿童死于爱滋病。我国情况也不容乐观，1995年发现     

Pubertal growth and development and prenatal and lactational exposure to polychlorinated biphenyls and dichlorodiphenyl dichloroethene

OBJECTIVES: Polychlorinated biphenyls (PCBs) and dichlorodiphenyl dichloroethene (DDE) are ubiquitous toxic environmental contaminants. Prenatal and early life exposures affect pubertal events in experimental animals. We studied whether prenatal or lactational exposures to background levels of PCBs or DDE were associated with altered pubertal growth and development in humans.Study design: Follow-up of 594 children from an existing North Carolina cohort whose prenatal and lactational exposures had previously been measured. Height, weight, and stage of pubertal development were assessed through annual mail questionnaires. RESULTS: Height of boys at puberty increased with transplacental exposure to DDE, as did weight adjusted for height; adjusted means for those with the highest exposures (maternal concentration 4+ ppm fat) were 6.3 cm taller and 6.9 kg larger than those with the lowest (0 to 1 ppm). There was no effect on the ages at which pubertal stages were attained. Lactational exposures to DDE had no apparent effects; neither did transplacental or lactational exposure to PCBs. Girls with the highest transplacental PCB exposures were heavier for their heights than other girls by 5.4 kg, but differences were significant only if the analysis was restricted to white girls. CONCLUSIONS: Prenatal exposures at background levels may affect body size at puberty.     

Prevention and treatment of overweight and obesity in children and adolescents

Increasing numbers of obese children and adolescents all over the world demand an investment in the primary and secondary prevention of obesity and overweight in this age group. The goal of preventive measures in children is to avoid the negative short- and long-term health problems associated with obesity. Primary prevention aims at establishing a healthy, active lifestyle and keeping children and adolescents within a range of body weight which is considered to be healthy. Constant availability and affordability of palatable and energy-dense food in the affluent society of the western world demands preventive strategies. Universal or public health prevention seems to be the most suitable form because several other cofactors of morbidity and mortality of affluent societies can also be prevented. However, in most European countries there is a lack of awareness of the necessity of prevention programmes, not only among the general population but also among the medical society. More awareness and consciousness to the problem of obesity must be generated in order to lead to effective therapeutic programmes. For those children and adolescents who are already obese, secondary prevention is mandatory. Therapeutic intervention programmes for the obese aim at long-term weight maintenance and normalisation of body weight and body fat. They have to modify eating and exercise behaviour of the obese child and establish new, healthier behaviour and lifestyle. Treatments programmes must include behavioural components in order to permanently change nutrition and physical exercise of the obese children and adolescents. However, long-term results of treatment programmes in European countries are scarce and the reported results, even of multidisciplinary regimens, are not impressive. Conclusion In most European countries there is an urgent need not only for a growing awareness of the problem of obesity in children and adolescents but also for development of new comprehensive approaches in treating this group.     

Hypokalemia and Hyperkalemia in Infants and Children: Pathophysiology and Treatment

Potassium is the second most abundant cation in the body. About 98% of potassium is intracellular and that is particularly in the skeletal muscle. Electrical disturbances associated with disorders of potassium homeostasis are a function of both the extracellular and intracellular potassium concentrations. Clinical disorders of potassium homeostasis occur with some regularity, especially in hospitalized patients receiving many medications. This article will review the pathophysiology of potassium homeostasis, symptoms, causes, and treatment of hypo- and hyperkalemia.