A Population-based Case-Control Teratological Study of Three Parenteral Penicillins G

The purpose of the study was to check the human teratogenic potential of three penicillins G: parenteral treatments with benzylpenicillin, benzylpenicillin-procaine, and benzylpenicillin + benzylpenicillin-procaine during pregnancy in the population-based dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities, 1980–1996. Of 38,151 pregnant women who had babies without any defects (population control group), 303 (0.8%) were treated with penicillin G. Of 22,865 pregnant women who had offspring with congenital abnormalities, 236 (1.O%) were treated with penicillin G (crude OR with 95% CI = 1.3, 1.1–1.5). Of 812 mothers who deliveried babies affected with Down syndrome (patient controls), 15 (1.8%) had penicillin G treatment, and this rate exceeded significantly the figure of both the case and population control groups. This finding needs further studies. The case-control pair analysis did not indicate a teratogenic risk of three parenteral penicillin G treatments during the second-third months of gestation, i.e., in the critical period for major congenital abnormalities. The lower use of penicillins G was explained mainly by recall bias in the population control group. Thus, parenteral penicillin G treatments during pregnancy do not present a detectable teratogenic risk to the fetus.     

Acute respiratory infections during pregnancy and congenital abnormalities: a population-based case-control study

Diseases of respiratory system caused by acute infections are among the most common maternal diseases during pregnancy. The objective of the study was to estimate the association between congenital abnormalities and acute respiratory infections during the first trimester of pregnancy. The data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities including 22 843 cases with congenital abnormalities, 38 151 population controls without congenital abnormalities and 834 malformed controls with Down syndrome between 1980 and 1996 was evaluated. 2118 cases with congenital abnormalities (9.3%), 3455 population controls (9.1%) and 92 malformed controls with Down syndrome (11.0%) had mothers with acute respiratory infections. Of 25 different congenital abnormality groups, esophageal atresia/stenosis showed a high adjusted prevalence odds ratios (POR) with 95% confidence interval (CI) for acute respiratory infections during the first trimester of pregnancy in case mothers compared with population controls (3.6, 1.4-9.1) and malformed controls (1.9, 1.0-3.5), respectively. In addition there was an association between medically recorded acute respiratory infections during the first trimester of pregnancy and a higher risk for some other congenital abnormalities, such as posterior cleft palate and multiple congenital abnormalities. In conclusion a possible association between some congenital abnormalities, particularly esophageal atresia/stenosis and maternal acute respiratory infections cannot be excluded due to the interactions of the microbial agents, related drug treatments and last but not least the indirect effect of maternal diseases, such as fever-hyperthermia, hypoxia and dietary deficiency. However, periconceptional multivitamin/folic acid supplementation during the early pregnancy was able to reduce the acute respiratory infection related risk for congenital abnormalities.     

Corrigendum: The Associations Between Maternal Factors During Pregnancy and the Risk of Childhood Acute Lymphoblastic Leukemia: A Meta‐Analysis

Because of the erroneous application of multiple publications, the conclusions of our recent paper (Pediatr Blood Cancer 2015;62:1162‐70) were not reliable. The corrected results show that coffee drinking during pregnancy was risk factor for childhood acute lymphoblastic leukemia (OR = 1.44, 95% confidence interval = 1.07–1.92).     

The cardio-facio-cutaneous syndrome: report of a patient and review of the literature

We report a 3-year-old girl with the cardiofacio-cutaneous (CFC) syndrome. She presented the typical combination of mild developmental delay, postnatal onset short stature with relative macrocephaly, a wide and prominent forehead with posteriorly rotated ears and down-slanting palpebral fissures, an atrial septal defect, and ectodermal abnormalities. All cases reported to date occurred sporadically. The actiology remains unknown; de novo mutations of an autosomal dominant gene seem the most likely explanation.     

Use of micronutrient supplements among pregnant women in Alberta: results from the Alberta Pregnancy Outcomes and Nutrition (APrON) cohort

Maternal nutrient intake in the prenatal period is an important determinant of fetal growth and development and supports maternal health. Many women, however, fail to meet their prenatal nutrient requirements through diet alone and are therefore advised to consume nutrient supplements. The purpose of this study was to describe the use of natural health products (NHP) by pregnant women in each trimester of pregnancy. Women (n = 599) participating in the first cohort of the Alberta Pregnancy Outcomes and Nutrition (APrON) study completed an interviewer‐administered supplement intake questionnaire during each trimester of pregnancy. NHP use was high, with >90% taking multivitamin/mineral supplements, and nearly half taking at least one additional single‐nutrient supplement. Compliance with supplementation guidelines was high for folic acid (>90%), vitamin D (～70%) and calcium (～80%), but low for iron (<30%) and for all four nutrients together (≤11%). On average, women met or exceeded the recommended dietary allowance for folic acid, vitamin D and iron from NHPs alone, with median daily intakes of 1000 μg, 400 IU and 27 mg, respectively. The median calcium intake was 250 mg d^?1. Up to 26% of women exceeded the tolerable upper intake level for folic acid and up to 19% did so for iron at some point of their pregnancy. Findings highlight the need to consider both dietary and supplemental sources of micronutrients when assessing the nutrient intakes of pregnant women.     

64例先天性胆总管囊肿术后随访及中药治疗

１９７９～１９９２年共手术治疗先天性胆总管囊肿并随访６４例，男１９例，女４５例，年龄５天～１２岁，随访时间１０个月～１４年，平均４年３个月。未发现癌变患儿。经临床体检、血肝功能测定、血透明质酸测定、Ｂ超及ＧＩ检查，碱性磷酸酶增高６０例，透明质酸增高６例，钡剂返流７例，胆道积气２ｌ例，胆道蛔虫４例，胆道结石５例。发现囊肿切除肝管空肠Ｒｏｕｘ－Ｙ吻合加矩形瓣手术可预防返流的发生，且其术后并发症最少。根据患儿随访情况，采用中药“胆康１号”治疗各种并发症，总有效率达９５％。     

The Use of Questionnaires in Child Psychiatry Research: Measuring their Performance and Choosing an Optimal Cut-Off

This paper introduces the basic principles of Receiver Operating Characteristics (ROC) analysis, a technique to evaluate and compare the discriminant power of questionnaires employed in psychiatric research. ROC curves may assist in the selection of an optimal cut-off point, which has been shown to depend upon the prevalence rate, the consequences of correct and incorrect classifications, and the distributions of scale scores among normal individuals and cases. Then, ROC analysis is applied to the Child Behavior Checklist on a sample of 564 6-11-year old French children. The performances of the social competence scales of this instrument are poorer than those of the behavior problem scales. The findings suggest also that the cut-offs should be varied within this same age group and be higher for screening in community surveys. Further applications of ROC analysis are discussed.