乌鲁木齐市2岁以下婴幼儿喂养状况及影响因素调查

目的 了解乌鲁木齐市2岁以下婴幼儿喂养状况及其影响因素。方法 于2013年5—6月,采用自行编制问卷对新疆医科大学第一附属医院儿保科235位2岁以下体检儿童的家长进行调查。结果 4个月以内婴儿纯母乳喂养率为46．9％,4～6个月婴儿纯母乳喂养率为42．6％。在已断奶的婴幼儿中,60％的婴幼儿断奶时间是6个月之内,断奶时间中位数为6个月。婴儿母亲的文化程度、职业、家庭平均月收入以及婴幼儿是否早产对4个月以内婴幼儿喂养方式无明显影响。53．1％的婴幼儿在4个月内就添加了辅食,85．1％的婴幼儿已经添加了营养素。结论 乌鲁木齐市6个月以内婴幼儿纯母乳喂养率较低,断奶时间过早。存在辅食添加过早及滥用营养素现象。     

Iron deficiency anaemia in children of a peri-urban health facility

This cross-sectional survey, conducted in a periurban health center in Nairobi, Kenya, determined the prevalence of iron deficiency anemia (IDA) and its risk factors among 403 children aged 6 months to 6 years. Demographic data were obtained and each child was assessed for signs of IDA. Blood was drawn for hemoglobin determination. The diagnosis of IDA was made using predefined criteria. Findings revealed that the prevalence of IDA was 7.4% (95% confidence interval = 4.8-10.0) and was predominantly mild (93.6%). Age was found to be significantly associated with IDA, with a 14.6% prevalence rate in infants. No association was found between IDA and factors such as sex, birth weight, weaning age and weaning diet, sanitation, water source, or education of the mother. Although the study showed that IDA was not a major health problem in the area, as evidenced by the low prevalence rate and presence of only mild cases, there is still a need for emphasis on health education at the health facility since young children are at high risk of IDA.     

Serum vitamin E and the sickling status in children with sickle cell anaemia

Serum vitamin E levels were determined on 62 children with sickle cell anaemia and 35 age-matched controls. Among the sicklers, the irreversibly sickled cell counts were done and correlated with serum vitamin E levels. There was a significant difference in serum vitamin E values (P less than 0.001), the sickle cell anaemia patients showing a deficiency with 27% of them deficient as against 2.9% of controls. The vitamin E deficient sicklers were also found to have significantly higher irreversibly sickled counts (P less than 0.02), indicating that vitamin E is an important inhibitor of the irreversibly sickled cell formation.     

Iron status of Australian children

A national survey covering all States and Territories was conducted in urban and rural schools to determine the iron status of Australian children and adolescents. This article reports the results of blood analyses for 1696 schoolchildren aged 9, 12 and 15 years. The measures of iron status analysed were plasma levels of iron, transferrin and ferritin. Results for all of these measures were available for 1204 of the schoolchildren for whom iron status was assessed based on the plasma ferritin and transferrin saturation model. Iron status was generally satisfactory in the 9, 12 and 15 year old boys and the 9 and 12 year old girls. There was a marked and statistically significantly higher prevalence of iron deficiency among the 15 year old girls. These results are discussed in relation to the food and nutrient intakes of 12 and 15 year old children who also participated in the 1985 National Dietary Survey of Schoolchildren.     

Iron deficiency anaemia in general practice: clinical outcomes over three years and factors influencing diagnostic investigations

Background: Iron deficiency anaemia (IDA) may be a sign of significant gastrointestinal disease, and delayed diagnosis may result in chronic morbidity. Studies in patients referred to hospital for investigation of their anaemia have shown that 5%–15% have a gastrointestinal cancer but there are few studies of patients presenting to primary care. Factors influencing further investigation in these patients have not previously been identified. Patients and methods: A cohort of patients presenting to their general practitioners (GPs) with IDA was identified and clinical outcomes recorded. Logistic regression was used to determine which factors influenced GPs to investigate the anaemia. Results: 43% of patients had investigations within three months and serious pathology was found in 30% of these; 13% of patients were considered unfit for further investigation and 8% refused to have any. Independent predictors of non-investigation were a mild anaemia (odds ratio (OR) 0.38, confidence interval (CI) 0.23 to 0.61, p<0.001), female gender (OR 0.49, CI 0.3 to 0.8, p = 0.004), a previous history of anaemia (OR 0.39, CI 0.24 to 0.64, p<0.001), and age <65 years (OR 0.44, CI 0.26 to 0.74, p = 0.002). During the entire study period gastrointestinal cancer was diagnosed in 48 patients (11%); 17% of men had colorectal cancer. Of 263 patients alive at 12 months without a confirmed diagnosis, 113 (43%) had recurrent or persistent anaemia during the study period. Conclusion: Although the overall prevalence of gastrointestinal cancer in patients presenting to primary care is similar to that seen in secondary care, the diagnosis may be delayed due to lack of appropriate investigations resulting in significant morbidity.     

重庆市228例产妇婴幼儿喂养知识态度行为的现况调查

目的通过调查重庆市部分产妇关于婴幼儿喂养的知识、态度、行为现况,为母婴保健宣传项目的开展提供有效参考和指导。方法对重庆医科大学附属第一、二医院妇产科住院产妇进行问卷调查,询问产妇对婴幼儿喂养相关知识的了解程度,以及与喂养相关的态度和行为情况。结果产妇对婴幼儿喂养方面的知识平均得分率为(61.40±0.21)%,产妇对于哺乳相关知识掌握较好,但对婴幼儿营养相关疾病预防了解较少。正性的关于婴幼儿喂养的态度和行为产妇的比例并不高,尤其是纯母乳喂养的比例仅23.25%,超过半数的人对喂养没有信心。结论重庆产妇关于婴幼儿喂养方面的知识、态度和行为情况并不理想,喂养方面的健康宣教有待进一步改进和加强。     

持续喂养对早产儿喂养不耐受的影响

目的 评估持续喂养治疗早产儿喂养不耐受的疗效.方法 选择住院喂养不耐受早产儿60例,随机分为治疗组和对照组,每组30例,两组其他治疗方法均相同,治疗组采取口饲早产奶持续喂养,对照组采取口饲早产奶间断喂养.结果 治疗组早产儿喂养不耐受的临床症状明显改善,每天增加奶量、残奶量与对照组相比差异有统计学意义(P<0.01).两组患儿体质量增长比较差异有统计学意义(P<0.01).结论 持续喂养治疗新生儿喂养不耐受能提高肠道喂养的成功率,避免完全静脉营养的弊端,安全、实用. Abstract： Objective To assess the curative effect of continuous feeding on preterm infants with feeding intolerance. Methods Sixty preterm infants with feeding intolerance in hospital who used the same other treatment method were readomly divided into treatment group and control group,every group had 30 cases.The infants in treatment group toke continuous feeding and the infants in control group toke intermittent feeding with preterm milk by mouth. Results The preterm infants in treatment group had significantly lesser clinical symptoms, increase more milk per day, lesser residual milk and more body mass than that in the control group(P<0.01). Conclusions Continuous feeding on preterm infants with feeding intolerance can improve the success rate of enteral feeding to avoid the drawbacks of total parenteral nutrition,it is safe and practical.     

Iron status of very-low-birth-weight infants during the first 15 months of infancy.

The adequacy of iron stores in infants of very low birth weight (defined as less than 1500 g) in Canada is unknown. We monitored the iron status of 81 such infants at 3, 6, 9, 12 and 15 months of age. All of the infants were fed formula fortified with iron (13 mg/L) for at least 6 months, starting at 2 months of age. The plasma ferritin level decreased after the formula was no longer used. Although 90% of the infants were given cereal fortified with iron (30 mg of iron per 100 g) by 9 months of age, the plasma ferritin level continued to decrease. The level was less than 10 micrograms/L in 54% of the infants at 12 months of age and in 74% at 15 months; this indicated depleted iron stores. Because of delayed development very-low-birth-weight infants eat small amounts of cereal and therefore require iron-fortified formula throughout infancy.     

Iron deficiency in pernicious anaemia: a neglected diagnosis

In 114 patients (52 males and 62 females) with long-standing pernicious anaemia, hypoferritinaemia was found in 27 (23.7%) and hypochromic microcytic anaemia in 19 (16.6%). Our findings indicate that iron deficiency is a common yet neglected complication of long-standing pernicious anaemia and warrants greater diagnostic and therapeutic attention.     

Breastmilk feeding status and weight gain of low birth weight infants in a Neonatal Intensive Care Unit

A prospective observational study of feeding in low birth weight (LBW) infants with birth weight (BW) of at least 1.8 kg admitted to the Neonatal Intensive Care Unit (NICU) showed that nearly 80% of mothers provided expressed breastmilk (EBM) and a further 14% breastfed their infants before discharge. Weight gain was overall poor at a mean of 9.48 +/- 7.82 grams per kg per day with those on predominant EBM feeding (EBM > 70%) doing worse than those on predominant preterm formula (PTF) feeding (EBM < 31%), weight gain being 5.40 +/- 6.88 and 11.10 +/- 8.15 grams per kg per day respectively (p < 0.01). Weight gain was also poorer (7.72 +/- 5.55 grams per kg per day) in patients with respiratory distress syndrome (RDS) compared to those who did not have RDS (12.02 +/- 9.58 grams per kg per day). p < 0.05. Incidence of infants < 10th centile body weight at birth was 16.8% and at discharge was 69.1%.     

Neurological disorders in Nigerian children with homozygous sickle cell anaemia

The pattern of associated Central Nervous System (CNS) disorders in children with homozygous sickle cell anaemia was studied over a 12-month period at the University of Nigeria Teaching Hospital (UNTH), Enugu. The relative incidence of associated neurological disorders was 1.3%, and the major varieties were cerebrovascular accidents (57.5%), meningitis (22.5%) and recurrent convulsions (10%). Intellectual impairment did not feature as a separate entity, but was observed in 27.5% of children with CNS complications. Although recurrent strokes were not frequently encountered, the hypertransfusion therapy was not practised because of relative scarcity of blood donors.