Kawasaki disease: an evidence based approach to diagnosis, treatment, and proposals for future research.

This article proposes a clinical guideline for the diagnosis and treatment of Kawasaki disease in the UK based on the best available evidence to date, and highlights areas of practice where evidence is anecdotal or based on retrospective data. Future research as proposed by the London Kawasaki Disease Research Group is outlined, and clinicians are invited to prospectively enroll their suspected cases into this collaborative research project.     

Reduced serum amino acid concentrations in infants with necrotizing enterocolitis

OBJECTIVE: To determine whether premature infants who have necrotizing enterocolitis (NEC) have deficiencies in glutamine (GLN) and arginine (ARG), which are essential to intestinal integrity. STUDY DESIGN: A 4-month prospective cohort study of serum amino acid and urea levels in premature infants was done. Serum amino acid and urea levels were measured by high-pressure liquid chromatography and enzymatic methods, respectively, on samples obtained on days of life 3, 7, 14, and 21. RESULTS: Infants in the control (n = 32) and NEC groups (n = 13) were comparable for birth weight, gestational age, and Apgar scores. NEC began on mean day of life 14.5 (95% CI, day of life 11 to 18). Median values of GLN were 37% to 57% lower in the NEC group on days 7, 14, and 21 compared with those in the control group (P <.05). On days 7 and 14, median values of ARG, GLN, alanine, lysine, ornithine, and threonine were decreased 36% to 67% (P <.05) in the NEC group. Total nonessential amino and total essential amino acids were 35% to 50% lower in the NEC group on days 7 and 14 (P <.05). Infants in the NEC group had significant reductions in GLN and ARG 7 days before the onset of NEC. CONCLUSIONS: Infants who have NEC have selective amino acid deficiencies including reduced levels of GLN and ARG that may predispose to the illness.     

Anemia and iron deficiency in pregnant Ghanaian women from urban areas.

OBJECTIVES: To determine the prevalence and identify risk factors for iron deficiency and anemia in pregnant Ghanaian women from urban areas. METHODS: A cross-sectional study of 452 healthy pregnant women receiving prenatal care in Accra, Ghana, was conducted. A sociodemographic health questionnaire was performed and hematologic parameters were measured. Logistic regression methods were used to identify risk factors for anemia and iron status. RESULTS: Complete data were available for 428 women. Anemia (hemoglobin <11 g/dL) was present in 144 (34%), iron deficiency (ferritin < or =16 microg/L) in 69 (16%), and iron deficiency anemia in 32 (7.5%) women. The adjusted odds ratio (OR) for anemia was 3.4 and 9.8 if iron deficiency and malaria parasitemia were present, respectively; the OR was 0.6 if women were at > or =36 weeks of pregnancy. The adjusted OR for iron deficiency was 2.7 if women were at > or =36 weeks of pregnancy and 0.12 if they had sickle trait. CONCLUSION: Although anemia and iron deficiency remain substantial problems in pregnant Ghanaian women from urban areas, their prevalence is less than previously reported.     

贲门失弛缓症的内镜诊断与治疗（附7例报告）

对７例贲门失弛缓症的内镜诊断与治疗进行讨论，认为内镜检查与活检组织检查合并应用不仅能诊断贲门失弛缓症，而且对于排除癌变或与贲门癌及其它性质的狭窄相鉴别很有用，但仍需和钡餐检查相互配合。内镜下食管狭窄扩张术和内镜下肌切开术被认为是目前治疗贲门失弛缓症的简单、快速、有效、安全的新方法，值得提倡。     

Correlation of Messenger RNA Function with Adenylate-Rich Segments in the Genomes of Single-Stranded RNA Viruses

Oligonucleotides enriched in adenylate residues have been demonstrated in the genomes of two positive-strand RNA viruses, Sindbis and Columbia SK. Such oligonucleotides were not found in the genome of vesicular stomatitis virus, a negative-strand virus. The adenylate-rich oligonucleotides from Sindbis and Columbia SK viruses appeared similar when analyzed by zonal sedimentation in sucrose-sodium dodecyl sulfate.