Abstracts of selected papers from the 1st ISOQOL Pan-Pacific Conference, Tokyo, Japan, April 13–15 2001

Abstract List

Abstracts of selected papers from the 1st ISOQOL Pan-Pacific Conference, Tokyo, Japan, April 13–15 2001     

Trends in the health burden due to urinary tract infection in children in Australia

Objective: To estimate the health burden of urinary tract infection in children less than 15 years of age in Australia and to ascertain whether any significant change has occurred during the past decade. Methodology: The number of children less than 15 years of age who were admitted in New South Wales for urinary tract infection between 1981 and 1994 was ascertained from the Department of Health, and age and sex specific incidence rates were calculated using Australian Bureau of Statistics population data. Costs for inpatient care were calculated using the cost weights from Australia National Disease Related Groups Version 3 for urinary tract infection (DRG 577). The frequency of the four most commonly requested renal tract imaging procedures in children following urinary tract infection and which qualified for Medicare reimbursement were obtained from the Health Insurance Commission for 1984–1994: micturating cystourethrography, intravenous urography, renal ultrasonography, and nuclear medicine renal studies. Results: There were 1203 children who were admitted with urinary tract infection in New South Wales in 1994, at an estimated cost of $A1.6 million. Since 1981, the age standardized annual incidence of urinary tract infection requiring hospitalization has increased from 0.5 to 0.9 per 1000 children, largely because of an increase in the number of young children admitted (from 0.6 to 2.0 per 1000 children less than 5 years of age). In 1994, 46 230 non-inpatient renal imaging procedures were undertaken in children under 15 years of age at a cost of $A5.3 million. Conclusions: Urinary tract infection is an important and increasing health problem for Australian children, particularly for preschool children. Whether this represents a true increase in the incidence of urinary tract infection or improved diagnosis and more intensive management is not possible to establish with this study design. Prospective population based studies are required to assess more completely the frequency with which urinary tract infection occurs in children and any changes that may be occurring.     

Safety and immunogenicity of three doses of a five-valent pneumococcal conjugate vaccine in children younger than two years with and without human immunodeficiency virus infection

OBJECTIVE: To assess the safety and immunogenicity of three doses of a five-valent (types 6B, 23F, 14, 18C, and 19F) pneumococcal conjugate vaccine (PCV) among children younger than 2 years who are and are not infected with human immunodeficiency virus (HIV). METHODS: A convenience sample of 18 HIV-infected children 2 years and younger (mean, 12.9 months) received three doses (each separated by 2 months) of PCV. An additional convenience sample of 33 non-HIV-infected children of virtually identical age, race, and sex as the HIV-infected group were randomized in a double-blind fashion to receive three doses of PCV or saline placebo. Safety data were collected for 72 hours after each vaccination. Sera were obtained before each and 1 month after the third vaccination to determine vaccine type-specific immunoglobulin G pneumococcal antibody titers by an enzyme-linked immunosorbent assay. RESULTS: Seventeen HIV- and 30 non-HIV-infected children completed the study. The PCV was well tolerated by both HIV- and non-HIV-infected children. No significant differences in local or systemic reactions were noted between HIV- and non-HIV-infected PCV or placebo recipients. Three doses of PCV were immunogenic, as evidenced by 16- to 659-fold increases in type-specific geometric mean antibody titers over prevaccination levels in HIV- and non-HIV-infected children. With respect to an arbitrary protective level, 78% of the antibody titers from HIV-infected children and 88% of the titers from non-HIV-infected children were 1.0 microgram/mL or greater 1 month after the third PCV dose. HIV-infected children with milder disease (Centers for Disease Control and Prevention classes N1-2, A1-2, and B1) were more likely to have protective antibody titers after the first and second PCV doses than HIV-infected children with more advanced disease (Centers for Disease Control and Prevention classes N3, A3, B2-3, and C1-3). However, after the third PCV dose, these differences disappeared. CONCLUSION: Three doses of PCV seem safe and immunogenic in both HIV- and non-HIV-infected children younger than 2 years. This type of vaccine should result in a marked reduction in systemic pneumococcal disease in both HIV- and non-HIV-infected children. Given the high incidence of invasive pneumococcal disease in HIV-infected children, this vaccine may markedly improve the quality of life for this unfortunate group of children.     

The role of Epstein-Barr virus in Hodgkin's disease from different geographical areas

Recent studies have suggested that Epstein-Barr virus (EBV) may play a role in the aetiology of Hodgkin's disease. To determine the role of EBV in childhood Hodgkin's disease in different geographical areas, immunohistochemical staining and in situ hybridisation were used to analyse latent membrane protein 1 (LMP 1) and small nuclear non-transcribed RNAs (EBER-1) respectively. Testing for EBV within the Reed-Sternberg and Hodgkin's cells was carried out in childhood Hodgkin's disease from 10 different countries. The proportion of LMP 1 positive cases varied significantly, being 50% of cases from the United Kingdom (38/75), South Africa (9/18), Egypt (7/14), and Jordan (8/16), 60% from the United Arab Emirates (6/10), 70% from Australia (11/16), 81% from Costa Rica (34/42), 88% from Iran (7/8), 90% from Greece (20/22), and 100% of the 56 cases from Kenya. A sensitive polymerase chain reaction based EBV strain typing technique was established using archival tissues. EBV strain type 1 was shown to be predominant in childhood Hodgkin's disease from the United Kingdom, South Africa, Australia, and Greece. Type 2 was predominant in Egypt. EBV strain types 1 and 2 were both detected in some cases of childhood Hodgkin's disease in the United Kingdom, Costa Rica, and Kenya. The high incidence of EBV and the presence especially in developing countries of dual infection with both strain types 1 and 2 may reflect socioeconomic conditions leading to malnutrition induced immunological impairment. The possibility of HIV infection also needs to be explored.     

Total energy expenditure and body composition in early infancy

In adults greater energy expenditure, primarily on physical activity, is associated with greater leanness. Such an association has proved more difficult to demonstrate in infants, partly due to the difficulty of measuring fatness and free living energy expenditure in this age group. Stable isotope techniques now make such investigations more viable. OBJECTIVE: The relationship between body composition and energy expenditure was investigated in 12 week infants. METHODS: Total energy expenditure and fat mass were estimated using the doubly labelled water technique. SUBJECTS: 92 normal healthy infants. RESULTS: Fat mass was correlated with both triceps and subscapular skinfold thicknesses (p < 0.001). After controlling for body size, age was a significant predictor of fat mass (p = 0.003), whereas total energy expenditure was not (p = 0.463). CONCLUSIONS: The cross sectional link between activity level and fatness in young infants, reported previously, does not persist when energy expenditure is considered.     

Association among interleukin-6 gene polymorphism, diabetes and periodontitis in a Chinese population

Objectives:  Diabetics significantly increase risk for periodontitis. Interleukin-6 (IL-6) gene polymorphism may play certain roles in the progression of periodontitis with diabetes. The purpose of this study was to assess the association among IL-6 gene polymorphisms, type 2 diabetes mellitus (T2DM) and chronic periodontitis (CP) in a Chinese population.
Material and methods:  DNA was obtained from 159 patients with CP, 88 patients with T2DM, 110 patients with CP&T2DM and 135 control subjects. The -174/-572/-597 polymorphisms of IL-6 gene were investigated by restriction fragment length polymorphism of polymerase chain reaction products. The results were further confirmed by sequencing. Significance was set at P  < 0.008 after Bonferroni correction.
Results:  Among four groups, CP&T2DM group showed the lowest IL-6-572 CC genotype and C-allele frequencies (54.5% and 74.1%). In this regard, there were significant differences between CP&T2DM group and the control group [ P  = 0.006, odds ratio (OR)  =  0.475, 95% CI: 0.279–0.808 and P  = 0.002, OR = 0.502, 95% CI: 0.319–0.788 respectively]. Logistic regression with adjustment for age, gender, body mass index, smoking and stress showed no significant difference in terms of IL-6-572 genotypes ( P  = 0.058, OR= 0.523, 95% CI: 0.268–1.022).
Conclusions:  The IL-6-572 genotype and allele distributions are unique to subjects with CP&T2DM in a Chinese population.     

Effect of melasma on quality of life in a sample of women living in southern Brazil

Background Melasma can cause a significant effect on individual emotional well‐being. Melasma Quality of Life Scale (MELASQoL) is a specific questionnaire elaborated to assess the burden of melasma on patient's quality of life. Objective To evaluate the clinical aspects, severity and the influence of melasma on daily living of a sample of Brazilian women. Methods Cross‐sectional study that enrolled 85 women with melasma older than 15 years of age. Trained investigators asked 55 questions to collect epidemiological and clinical data. The disease severity was clinically assessed using Melasma Area and Severity Index (MASI). Patients answered the Portuguese version of 10‐item MELASQoL scale without coaching. Results The mean ± SD age was 41.1 ± 6.8 years, and the mean ± SD of MELASQoL score was 37.5 ± 15.2 (median, 35). Patients with previous psychiatric diagnosis had significantly higher MELASQoL scores (mean, 42.8; SD, 13.6) than patients without this antecedent (mean, 35.4; SD, 15.4; P < 0.05). Patients with less than 8 years of school attendance also had significantly higher MELASQoL score (mean, 44; SD, 16.9) than more graduated ones (mean, 34.4; SD, 13.5; P < 0.05). The mean ± SD MASI was 10.6 ± 6.6 (median, 10.2). There was no correlation between MASI and MELASQoL. Conclusions This study confirms that MELASQoL‐BP is easy to administer, adds important information about the impact of melasma on South American women's life and, finally, contributes to building evidence on the validity, reliability and cultural adaptation of the Portuguese language MELASQoL version.     

短刺虎刺素的结构更正及其合成

短刺虎刺素的结构文献曾报道为1-甲氧基-2-羟基-3-乙氧甲基蒽醌(1)⁽²⁾。作者以邻苯二甲酸酐和2,3-二羟基甲苯或2.6-二羟基甲苯经环合、选择性乙酰化、甲基化、溴化、乙醇钠缩合分别合成了1和1-甲氧基-2-乙氧甲基-3-羟基蒽醌(5)。经对照后证实,短刺虎刺素的结构应更正为5,即虎刺素-ω-乙基醚。     

V̇ max and nutritional status in Urban Colombian girls and women

Maximal oxygen consumption (V? max, liters min^?1) was measured in 60 nutritionally normal and 74 marginally undernourished girls 6–16 years of age and 27 upper socioeconomic (UEC) women and 22 women living in economically deprived conditions (LEC) in Cali, Colombia. All girls were recruited from the LEC neighborhoods. Lower values for V? max (liters min^?1) in undernourished girls were replaced by a nutritionally normal status in adulthood in which V? max was not significantly different from that measured in UEC women. Physical condition varied from average to fair in the younger to older subjects compared to women from industrialized countries. When V? max is expressed as ml min^?1 kg^?1 of lean body mass (LBM), all age and group effects disappear, confirming regression analysis which demonstrated a close relationship (r² = 0.81) between V? max (liters min^?1) and LBM in which there were no significant differences between nutritional or socioeconomic groups. © 1994 Wiley-Liss, Inc.