Prognosis for infants weighing 1000 g or less at birth

During the 10 years 1966-1975, 148 infants weighing less than or equal to 1000 g were admitted to the Neonatal Unit of University College Hospital. 48 (32%) survived the neonatal period. The neonatal survival rate for infants weighing less than or equal to 750 g was 8% and for infants weighing 751-1000 g, 41% 9 infants died later, leaving 39 (26%) long-term survivors, all of whom are being followed-up. The progress of the 27 older children, born in 1966-74 (median birthweight 899 g, range 648-998 g; median gestational age 28 weeks, range 24-35 weeks), was assessed at ages between 15 months and 8 years (median 3 years). No abnormalities were detected in 21 infants (78%): 2 (7%) had major handicaps and 4 (15%) minor handicaps. We conclude that provided intensive care methods are available, the prognosis for infants weighing less than or equal to 1000 g is now better than in the past.     

酶联免疫吸附试验测定血清内源性哇巴因

目的建立血清内源性哇巴因（ＥＯ）浓度测定的酶联免疫吸附试验，促进对这一新的皮质类固醇激素的研究。方法利用外源性哇巴因免疫家兔制备哇巴因抗血清，用棋盘试验确定抗血清的稀释度及包被抗原的浓度；进行灵敏度、精密度、回收率、特异性试验。结果以抗血清稀释度为１：１００００、包被抗原浓度为１μｇ／ｍｌ时标准曲线最理想，灵敏度为０．２３μｇ／Ｌ，血清ＥＯ高（２．４μｇ／Ｌ）、中（１．２μｇ／Ｌ）、低（０．６μｇ／Ｌ）浓度的平均批内变异系数为４．７％，批间变异系数为１２．３％；高、低浓度的回收率分别为９６．３％和９１．４％；与肾上腺素、去甲肾上腺素、血管紧张素Ⅱ、醛固酮、氢化可的松及地塞米松无交叉结合反应，与地高辛存在１．８％的交叉反应。用该法测定正常人（１０例）、孕妇（２３例）及原发性高血压患者（１０例）血清ＥＯ含量分别为０．５１±０．１７、０．８１±０．２６、０．７４±０．２０μｇ／Ｌ。结论该方法具有方便、快速、准确、特异和成本低的优点，可用于对内源性哇巴因的临床与实验研究。     

Living conditions of children at risk for noma: Nigerian experience

The study reported in this paper was carried out in the Northwestern and Southwestern regions of Nigeria, between October 1996 and April 1998. The study examined the possible contributory role of living conditions in the development of acute necrotizing gingivitis (ANG) or noma from oral lesions. Questionnaire data obtained from 42 fresh noma cases seen in the Northwest and four fresh cases seen in the Southwest were examined. In addition 46 cases of advanced ANG from the Southwest were included. The main focus was to compare some of the environmental living conditions of cases with advanced ANG and those with noma in these regions. All the noma and ANG cases were seen in children aged 2-12 years. The level of good oral hygiene practices and general environmental living conditions were significantly higher in the Southwest than in the Northwest. Data also showed that living in close proximity with livestock was significantly higher in the Northwest than in the Southwest (P < 0.05). The environmental living conditions of children in the Northwest were further compounded by poor sanitary faecal disposal practices as well as minimal access to potable water. The overall data indicated that living in substandard accommodations, exposure to debilitating childhood diseases, living in close proximity to livestock, poor oral hygiene, limited access to potable water and poor sanitary disposal of human and animal faecal waste could have put the children in the Northwest at higher risk for noma than the children in the Southwest. These could have been responsible for the higher prevalence of noma in the Northwest than in the Southwest.     

Tooth sensitivity experience among residential university students

To cite this article:
Int J Dent Hygiene
DOI: 10.1111/j.1601‐5037.2009.00385.x
Bamise CT, Kolawole KA, Oloyede EO, Esan TA. Tooth sensitivity experience among residential university students Abstract: Objectives: The aim of this study was to assess the experience of residential University students about ‘sensitive teeth’. Subject and methods: Self‐administered questionnaires were given randomly to students in all the residential hostels located in the University campus. Data on presence of sensitive teeth, initiating stimulus and duration of each episode of discomfort were elicited. History of common aetiological factors of tooth sensitivity was also taken. Results: One thousand and nineteen responses (650 males; 369 females) were analysed in this study. Approximately 697 (68.4%) volunteers claimed to have sensitive teeth. Majority described their discomfort as sharp pain, cold as the initiating stimulus and drinking was mostly interfered with. Tooth sensitivity was found to be common among hard toothbrush users. Multiple regression analysis showed that hard toothbrush had a significant association with tooth sensitivity. Other common aetiological factors, such as history of gastric acid reflux, vomiting, soft drinks and the use of vitamin C were found to have a weak association with tooth sensitivity. Conclusion:  Prevalence of tooth sensitivity was 68.4%. Presence of tooth sensitivity among these students was associated more with history of hard toothbrush use contrary to widely held belief that erosive agents were mostly responsible. Future studies are needed to provide more epidemiological data on tooth brushing and tooth sensitivity.     

The Novel Antihyperglycaemic Action of Hunteria Umbellata Seed Fractions Mediated Via Intestinal Glucose Uptake Inhibition

The present study evaluated the antihyperglycaemic effect and mechanism of action of fractions of the aqueous seed extract of Hunteria umbellata (K. Schum.) Hallier f. (HU) in normal and alloxan-induced hyperglycaemic rats. HU was partitioned in chloroform, acetyl acetate and butan-1-ol to give chloroform fraction (HU_c), ethyl acetate fraction (HU_e), butanol fraction (HU_b) and the “residue” (HU_m), respectively. 200 mg/kg of each of these fraction dissolved in 5% Tween 20 in distilled water was investigated for its acute oral hypoglycaemic effects in normal rats over 6 hours while its repeated dose antihyperglycaemic effect was evaluated in alloxan-induced hyperglycaemic rats over 5 days. In addition, 50 mg/kg of the crude alkaloid fraction (HU_Af) extracted from HU was evaluated for its possible antihyperglycaemic activity in alloxaninduced hyperglycaemic rats using oral glucose tolerance test (OGTT) over 6 hours. Using the solvent system, distilled water-butanol-ammonium hydroxide (2:15:1, v/v/v), HU_b was chromatographed and stained with Dragendorff''s reagent for confirmatory qualitative analysis for alkaloids. Results showed that oral pre-treatment with 200 mg/kg of HU_e, HU_b and HU_m resulted in a significant (p<0.05, p<0.001) time dependent hypoglycaemic effect, with the butan-1-ol fraction HU causing the most significant (p<0.001) hypoglycaemic effect. In the alloxan-induced hyperglycaemic rats, repeated oral treatment with 200 mg/kg of same HU fractions for 5 days resulted in significant (p<0.05) decreases in the fasting blood glucose concentrations with the most significant (p<0.01) antihyperglycaemic effect also recorded for HU_b. Similarly, oral pretreatment with 50 mg/kg of HU_Af significantly (p<0.05, p<0.01 and p<0.001) attenuated an increase in the post-absorptive glucose concentration at 1^st – 6^th h in the alloxan-induced hyperglycaemic OGTT model. In addition, alkaloid was present in most of the separated spots on the TLC plate. In conclusion, results of this study showed that HU contains a relative high amount of alkaloids which could have accounted for the antihyperglycaemic action of HU that was mediated via intestinal glucose uptake inhibition.     

The Impact of Immigration on the Development of Adolescent Schizophrenia

PROBLEM: Impact of immigration on the development of adolescent schizophrenia. METHODS: The review of literature used Academic Search Premier, CINHAL, PsychINFO, PubMed, and MEDLINE databases to examine reasons given to immigration as a risk factor to adolescent schizophrenia. FINDINGS: There is not a single factor or a group of related factors that could explain why the incidence of schizophrenia among immigrants is higher compared with natives of the host county. CONCLUSION: Further inquiry into this phenomenon is needed to understand factors that increase the risk of schizophrenia among immigrant children and to help plan and implement strategies for prevention.     

Anaemia in pregnancy: associations with parity,abortions and child spacing in primary healthcare clinic attendees in Trinidad and Tobago

Objective

To determine the prevalence of anaemia in antenatal clinic attendees; to investigate the effects of parity, age, gravidity, previous abortions, child spacing and other factors on the prevalence of anaemia in pregnancy.

Methods

This was a retrospective and cross-sectional study. Antenatal records of 2287 pregnant women attending 40 public healthcare centres from January 2000 to December 2005 in Trinidad and Tobago were used. Data pertaining to the investigated variables were recorded. The national prevalence of anaemia was calculated and chi-square tests, odds ratios and logistic regression were used to assess the relationship between anaemia and each variable.

Results

The prevalence of anaemia was 15.3% (95% CI 13.4%, 16.6%). No significant difference in the prevalence of anaemia was found among the different clinics or counties. At the first haemoglobin reading, age was inversely related to the presence of anaemia, whereas gestational age at first visit was directly related. At the final haemoglobin reading, parity, gravidity, and previous spontaneous abortions were directly related to the prevalence of anaemia, while the number of visits was inversely related. Age was inversely associated to the severity of anaemia while gravidity was directly related.

Conclusion

The prevalence of anaemia decreased by 18.7% from 1967. Despite this positive indication, women under 24 years and those commencing antenatal care after the first trimester are still at a higher risk for developing anaemia. Early commencement of antenatal care and close monitoring of the risk groups identified should be strongly advocated.     

Three-year multicenter surveillance of pneumococcal meningitis in children: clinical characteristics, and outcome related to penicillin susceptibility and dexamethasone use

OBJECTIVES: To evaluate the antibiotic susceptibility of Streptococcus pneumoniae isolates obtained from the blood and cerebrospinal fluid of children with meningitis. To describe and compare the clinical and microbiological characteristics, treatment, and outcome of children with meningitis caused by S pneumoniae based on antimicrobial susceptibility of isolates and the administration of dexamethasone. DESIGN AND PATIENTS: Children with pneumococcal meningitis were identified from among a group of patients with systemic infections caused by S pneumoniae who were enrolled prospectively in the United States Pediatric Multicenter Pneumococcal Surveillance Study at eight children's hospitals in the United States. From September 1, 1993 to August 31, 1996, 180 children with 181 episodes of pneumococcal meningitis were identified and data were collected by retrospective chart review. OUTCOME: Clinical and laboratory characteristics were assessed. All pneumococcal isolates were serotyped and antibiotic susceptibilities for penicillin and ceftriaxone were determined. Clinical presentation, hospital course, and outcome parameters at discharge were compared between children infected with penicillin-susceptible isolates and those with nonsusceptible isolates and for children who did and did not receive dexamethasone. RESULTS: Fourteen (7.7%) of 180 children died; none of the fatalities were because of a documented failure of treatment caused by a resistant strain. Only 1 child, who had mastoiditis and a lymphangioma, experienced a bacteriologic failure with a penicillin-resistant (minimum inhibitory concentration = 2 microgram/mL) organism. Of the 166 surviving children, 41 (25%) developed neurologic sequelae (motor deficits) and 48 (32%) of 151 children had unilateral (n = 26) or bilateral (n = 22) moderate to severe hearing loss at discharge. Overall, 12.7% and 6.6% of the pneumococcal isolates were intermediate and resistant to penicillin and 4.4% and 2.8% were intermediate and resistant to ceftriaxone, respectively. Clinical presentation, cerebrospinal fluid indices on admission, and hospital course, morbidity, and mortality rates were similar for patients infected with penicillin- or ceftriaxone-susceptible versus nonsusceptible organisms. However, the relatively small numbers of nonsusceptible isolates and the inclusion of vancomycin in the treatment regimen for the majority of the patients limit the power of this study to detect significant differences in outcome between patients infected with susceptible and nonsusceptible isolates. Nonetheless, our results show that the nonsusceptible organisms do not seem to be intrinsically more virulent. Forty children (22%) received dexamethasone (>/=8 doses) initiated before or within 1 hour after the first dose of antibiotics. The incidence of any moderate or severe hearing loss was significantly higher in the dexamethasone group (46%) compared with children not receiving any dexamethasone (23%). The incidence of any neurologic deficits, including hearing loss, also was significantly higher in the dexamethasone group (55% vs 33%). However, children in the dexamethasone group more frequently required intubation and mechanical ventilation and had lower initial concentration of glucose in the cerebrospinal fluid than children who did not receive any dexamethasone. When we controlled for the confounding factor, severity of illness (intubation), the incidence of any deafness and of any neurologic sequelae, including deafness, were no longer significantly different between children who did or did not receive dexamethasone. CONCLUSIONS: Children with pneumococcal meningitis caused by penicillin- or ceftriaxone-nonsusceptible organisms and those infected by susceptible strains had similar clinical presentation and outcome. The use of dexamethasone was not associated with a beneficial effect in this retrospective and nonrandomized study. (ABSTRACT TRUNCATED)