Babywalkers: prevalence of use and relationship with other safety practices

Setting—36 primary care practices across Nottingham, UK.     

Samonella associated with diarrheal diseases in a pediatric hospital (1979–82)

A total of 241 Salmonella strains were isolated from diarrheal cases in a pediatric hospital during the year 1979–1982. The serotyped isolated were S. typhimurium (209), S. oranienburg (22), S. indiana (4), S. newport (4), S. stanley (1) and S.virchow (1). All except on strain of S.typhimurium were resistant to most of the antibiotics tested. The different Salmonella strains were also isolated from all the months with no seasonal variation. Enterotoxin production was detected in 6.6 percent of the diarrheal cases. Enterotoxigenic serotypes were S.typhimurium (11), S.oranienburg (3), and S. indiana (2) diseases.     

父母亲高同型半胱氨酸血症与子女先天性心脏病的相关性研究

为研究父母亲同型半胱胺酸血症（Hhe）与子女先天性心脏病（CHD）的相关性，选择33例正常儿童父母亲和49例CHD患儿父母亲，应用高压液相色谱检测血浆同型半胱氨酸（HCY）。结果显示，如以15μmol／L为正常上限，CHD母亲组发生Hhe／11／32例（34．38％），对照组未见异常，χ^2检验差异有高度显著性（P＝0．0014）；CHD父亲组发生HHE9／17例（52．94％），对照组仅1例，差异有显著性（P＝0．04）。病例组中有CHD家庭史的父母亲发生Hhe者占83．3％（5／6例），高于无CHD家族史的Hhe发生率36．9％（15／43例），P＝0．035。结果表明，父母亲Hhe与子女CHD有相关性，Hhe可能是子女发生CHD的病因之一；具有CHD家族史的父母亲更易发生Hhe。     

Reference values of the steatocrit and its modifications in diarrheal diseases.

Conflicting results have been reported on the use of the steatocrit to measure fecal fat excretion. Aiming to assess the reliability of this method and its usefulness in the diagnosis of intestinal enteropathies, we measured the steatocrit in 747 healthy children and 442 children with diarrhea grouped according to diagnosis. The steatocrit was found to correlate strictly (r = 0.93) with the chemical measurement of fecal fat. Reference values and ranges were established. The maximal steatocrit was observed in neonates; afterwards, it progressively decreased to an undetectable level in children older than 2 years of age. A steatocrit abnormally high for age was found in 20% of patients with acute diarrhea and in 53% of those with chronic diarrhea. All celiac patients with a gluten-containing diet showed a marked increase of steatocrit. We conclude that the steatocrit is a reliable and easy-to-perform test, which quickly provides valuable information in the diagnostic workup of the child with diarrhea.     

Child-feeding practices in children with down syndrome and their siblings

OBJECTIVE: To compare parental feeding practices and evaluate their relationship to weight status among children with Down syndrome (DS) and their unaffected siblings. STUDY DESIGN: Cross-sectional study of sibling pairs, one child with DS (n = 36) and one child without DS (n = 36), between 3 and 10 years of age. Parents completed the Child Feeding Questionnaire (CFQ), which assesses six aspects of control in feeding, separately for each child. Children's height and weight were measured using standard research procedures for calculation of body mass index (BMI) and BMI Z scores (BMIZ). RESULTS: Mean BMIZ was higher among children with DS than their siblings (1.1 +/- 0.9 vs 0.1 +/- 1.1; P <.001), but there were no between-group differences in parents' perception of children's weight status. Parents reported greater use of restriction, greater feelings of responsibility for feeding and concern about child weight status, and lower pressure to eat for children with DS than for their siblings. After adjustment for BMIZ, differences remained significant only for concern (10.6 +/- 3.5 vs 6.4 +/- 3.4; P <.002). Perceived child overweight and concern were positively associated with BMIZ, whereas pressure was inversely associated with BMIZ. CONCLUSIONS: Differences in child-feeding practices may play a role in the development of obesity in DS.     

儿童腹泻病诊断治疗原则的专家共识

一、概述 腹泻病为多种病原、多种因素引起的以大便次数增多和大便性状改变为特点的一组疾病,是儿童患病和死亡的主要原因,也是营养不良的重要原因.据世界卫生组织(WHO)统计,除中国外,全世界每年有10亿人患腹泻,其中5亿发生在发展中国家.我国卫生部疾病控制司(卫生部疾病预防控制局)的调查结果显示,我国每年有8.36亿人次患腹泻,其中5岁以下儿童占3亿人次,腹泻病年发病率约为0.7次/人,5岁以下儿童的年发病率平均为1.9次/人.WHO于1978年制订全球性腹泻病控制规划,1980年正式实施,1991年推出第1版<腹泻病诊断治疗指南>.     

Morbidity and risk factors of diarrheal diseases among under-five children in rural Upper Egypt

Diarrhea is a leading cause of mortality and morbidity in developing countries. In Egypt, researchers have traditionally been targeting diarrhea-related mortality. This study is an attempt to portray the morbidity and risk factors of diarrhea among children under 5 years old (under-fives) in rural Upper Egypt. The incidence of diarrhea in the 6 months before the study was determined among 1025 under-fives in six sentinel sites by interviewing mothers or caretakers. The association between diarrhea and a set of risk variables was examined using a multivariate logistic regression model. Variables that appeared to have a significant predictive power were then included in a forward wald stepwise logit analysis model to estimate statistical functions which best predict the diarrheal morbidity. The incidence rate of diarrhea was found to be 3.6 episodes per child semiannually and the point prevalence was 19.5 per cent. The average duration of current episodes was 4.8 +/- 3.7 days; 33.6 per cent of children had had diarrhea more than three times (recurrent diarrhea). Four variables were found to have a significant association with recurrent diarrhea. The logit coefficients and their significance levels indicated that, in order of contribution to risk prediction, the variables ranked as follows: household meat consumption, mother's age at the time of birth of the child, child's age, and father's illiteracy. A total of 74.8 per cent of overall children were correctly predicted by these risk factors, a figure which indicates the goodness of fit of the model. It is concluded that the diarrheal morbidity is still unacceptably high in rural Upper Egypt. More interventions are needed to control for specific risk factors.     

Association between household conditions and diarrheal diseases among children in Turkey: A cohort study

BACKGROUND: This aim of the present study was to estimate the frequency of diarrheal diseases among children as well as investigating the relationship between diarrheal diseases and household conditions and other factors. METHODS: The study was performed over 12 month period in Binevler Health Center, Gaziantep, Turkey. Five health stations were selected by using a sampling technique with probability proportional to size, and all households with children under the age of 5 years were visited. A questionnaire on diarrhea, household conditions, socioeconomic status of the family and individual characteristics of the children was applied to the mothers by doctors. Three composite indices, including household conditions, socioeconomic status of the family and individual status of the children, were prepared and a classification was made as good, mild or poor in order to better evaluate the results of the study. Daily recordings of diarrheal disease symptoms were made by the parents and these records were collected every month for 1 year. RESULTS: The annual mean incidence of diarrheal diseases was found to be 1.09 per child per year (median = 1). The mean was higher in children with poor household conditions (1.48 +/- 0.12) and with poor individual status (1.48 +/- 0.14), compared with good household conditions (0.76 +/- 0.07) and good individual status (0.71 +/- 0.08). The mean was also higher in children aged between 6 and 11 months (1.51 +/- 0.18), whose father graduated from primary school or lower (1.34 +/- 0.09) and with parents having no habit of washing their hands before taking care of the child (2.00 +/- 0.33). Person-month and case-month incidence rates of diarrhea were calculated to be 8.56 and 9.12%, respectively. CONCLUSIONS: Household conditions, individual status, age, education level of fathers and parents' habit of washing hands before taking care of the child were major factors affecting the incidence of diarrhea.     

硫氧还蛋白与人类疾病相关性的研究进展

硫氧还蛋白是一个广泛分布的氧化还原蛋白,通过二硫化物活性中心可逆地催化许多氧化还 原反应,参与机体多种生物学活性,如刺激细胞生长,转录因子的调节、抑制凋亡等。它与人类许多疾病有 关,硫氧还蛋白特异性抑制剂可能成为化学治疗干预的重要靶点。     

性早熟儿童甲状腺激素水平及与其他内分泌激素的关系

目的　了解性早熟儿童甲状腺轴激素水平及与其他内分泌激素水平的关系。方法　对 2 8例真性性早熟儿童及正常对照组 14例进行血清促甲状腺激素 (TSH)、T3 、T4、卵泡刺激素 (FSH)、黄体生成素 (LH)、雌二醇 (E2 )、胰岛素样生长因子 1(IGF 1)、胰岛素样生长因子结合蛋白 3(IGFBP3)、骨钙素 (BGP)等水平测定 ,对两组进行独立样本t检验 ,对观察组各指标进行两两指标相关分析。结果　TSH、T3 水平性早熟组高于对照组 ,但无统计学意义 (tT3=1.896 ,tTSH=0 .0 71　P均 >0 .0 5 ) ;T4水平低于对照组 ,但无统计学意义 (t=- 1.0 73　P >0 .0 5 )。T3 与IGF 1呈负相关 (r=- 0 .4 71　P <0 .0 5 ) ;TSH与IGFBP3呈正相关 (r =0 .4 5 8　P <0 .0 5 ) ;TSH与BGP呈负相关 (r =- 0 .4 91　P <0 .0 1) ;TSH、T3 、T4分别与FSH、LH、E2 值无相关关系 (P均 >0 .0 5 )。结论　性腺轴与甲状腺轴相对独立 ;甲状腺轴的促生长作用可能通过直接或间接方式调节IGF 1、IGFBP3分泌 ,甲状腺轴参与BGP的调节 ,促进骨骼生长     

Sequelae of storage in Fabry disease--pathology and comparison with other lysosomal storage diseases

AIM: To evaluate the sequelae of the lysosomal storage of globotriaosylceramide (Gb3) in a series of patients with Fabry disease. METHODS: Biopsy and post-mortem samples from 12 patients with Fabry disease were examined microscopically, including, in some cases, immunohistochemistry and electron microscopy. Where possible, comparisons were made with other lysosomal storage disorders. RESULTS: Storage of Gb3 in cardiocytes leads commonly to progressive hypertrophy, which is a non-specific phenomenon also observed in other lysosomal storage disorders. Capillary endothelial storage was associated with a tendency for capillary basement membrane multiplication. In the single angiokeratoma studied, the basement membrane was rudimentary. Sinusoids in the adrenal cortex and liver displayed either a slight degree of storage or were unaffected. The glomeruli of the kidney exhibited focal hyalinization starting in the mesangial region. Proximal tubular cells were essentially free of lysosomal accumulation, including protein absorption droplets, despite the presence of proteinuria. In only one case, an autopsied Fabry heterozygote, were the proximal tubular cells loaded with protein absorption droplets. The arterial wall in large muscular arteries (coronary, renal and intrarenal) displayed arteriopathy with pronounced involvement of the smooth muscle cells in the media. Arteriopathy started with storage, followed by cell degeneration and breakdown, extracellular matrix deposition and, often, calcification (confined to the muscular layer). Smooth muscle cells occasionally exhibited shrinkage-type necrosis, with dispersion of the stored lipid into the dense cytoplasmic mass. Intimal and mitral valve fibroblasts exhibited variable storage, which was associated with cell loss and necrosis. Intensive storage was found in Leydig cells and in the epididymal epithelium. CONCLUSION: These long-term sequelae of Gb3 storage are mostly irreversible. Some may interfere with enzyme replacement therapy. It is important, therefore, to consider starting enzyme replacement therapy as early as possible.