A study of menarcheal age in India

A study of menarcheal age was carried out in southern India. A logit method of analysis was applied to status quo data on 1267 Tamil and Telugu speaking girls aged 9 to 18 years in 3 schools catering for different socio-economic groups. There appears to be no relationship of menarcheal age with dietary pattern classified simply as vegetarian and non-vegetarian. Differences in median age at menarche between schools correspond well with the socio-economic differences between them. The median age in the most advantaged school (12·86 years) is comparable with that in recent studies in southern and eastern Europe, and may perhaps be in advance of some recent north-west European samples.     

Evidence of mitochondrial dysfunction in obese adolescents

Aim: Although obesity and weight gain generally are anticipated to be caused by an imbalance between energy intake and energy expenditure, the significance of thyroid hormones (TH) remains unclear. Examination of mitochondrial function may reflect intracellular thyroid hormone effect and elucidate whether a lower metabolic rate is present. Methods: In a group of 34 obese adolescents (age <16 years and body mass index above the age‐related 95th percentile), and an age‐ and gender‐matched group of 32 lean adolescent, thyroid stimulating hormone (TSH) and basal oxygen consumption were measured and mitochondrial function in peripheral blood monocytes was determined by flow cytometry. Results: Significant increase in TSH (3.06 ± 1.56 mU/L vs. 2.33 ± 0.91 mU/L, p < 0.05) and a decrease in VO₂ (129 ± 16 mL O₂/m²*min vs. 146 ± 15 mL O₂/m²*min, p < 0.05) were observed in obese adolescents compared with lean adolescents. Flow cytometry analysis demonstrated a lower mitochondrial mass (6385 ± 1962 a.u. vs. 7608 ± 2328 a.u., p < 0.05) and mitochondrial membrane potential (11426 ± 3861 a.u. vs. 14017 ± 5536 a.u., p < 0.05) in obese adolescents compared with lean adolescents. These results are even more pronounced in adolescents with obese mothers. Conclusion: In obese adolescents, the increased TSH and lowered VO₂ propose a lowered basal metabolic rate and the impaired mitochondrial function suggests a decreased thyroid hormone stimulation of mitochondrial energy production. The maternal in‐heritage is suggestive of a basal metabolic defect or mitochondrial resistance for TH.     

不同氮量全胃肠外营养支持对脓毒症病人蛋白质代谢的影响

如何提高脓毒症闰人营养支持的效果是当前的热点和难点之一。本实验前瞻性地对比观察了不同蛋白质供应负荷０．２５ｇ／Ｖ（ｋｇ．ｄ）ｖｓ０．３５ｇＮ／（ｋｇ．ｄ），在脓毒症病人全有肠外营养支持中对蛋白质代谢状况的影响。结果发现，与低氮量ＴＰＮ相比，高氮量ＴＰＮ支持可改善血浆蛋白水平，增加累积氮平衡，但尿中３－ＭＨ排出量也有相应增加。     

Sonographically demonstrated intra-amniotic hemorrhage following transplacental genetic amniocentesis. Frequency, sonographic appearance, and clinical significance

Over a 9-month period, 11 transplacental amniocenteses were performed. Following completion of amniocentesis, intra-amniotic hemorrhage occurred in all 11 cases. Amniotic masses and intra-amniotic strands occurred in three cases as a result of intra-amniotic hemorrhage. The 11 pregnancies in which transplacental amniocentesis were performed were uncomplicated, and they resulted in normal infants. Transplacental amniocentesis can yield unusual sonographic appearances but does not appear to have an adverse effect on pregnancy outcome.     

Haemophilus aphrophilus bleb infection after a mitomycin trabeculectomy

Background: Haemophilus aphrophilus is a rare cause of ocular infection. It has been reported once as a cause of late-onset endophthalmitis in a patient with an inadvertent bleb after cataract surgery. We present a case of Haemophilus aphrophilus bleb infection after a mitomycin trabeculectomy.
Methods: A 56-year-old woman presented with a bleb infection 10 weeks after a mitomycin C augmented trabeculectomy at a University tertiary referral practice of one of the authors (GET). The causative organism was Haemophilus aphrophilus , identified by the Toronto Public Health Laboratory, Ontario, Canada.
Results: The bleb infection resolved following topical, subconjunctival and intravenous antibiotic therapy. A formal bleb revision was required to repair a persistent bleb leak.
Conclusion: Patients who have had trabeculectomies augmented with mitomycin C may be predisposed to bleb infection with unusual organisms. Prompt diagnosis and treatment is necessary to control the infection. Increased awareness and communication with laboratory personnel may increase the isolation of this fastidious organism.     

Weight-for-height in children aged 4-12 years. A new index compared to the normalized body mass index.

Data from the 1990 survey of the National Study of Health and Growth, comprising 3357 white English boys and 3050 white English girls, were used to construct and evaluate a new index of weight-for-height. Prediction of triceps + subscapular skinfold thickness, using half of the data, led to the index (weight -9)/height3.7, where weight was in kilograms, height in metres. Using the second half of the data the index was shown to have almost as good a correlation with normalized (triceps + subscapular skinfold) as the body mass index (BMI) in children aged 4-12 years. The new weight-for-height index had stable variance from age 4 to 12 years after simple log transformation, unlike the BMI which required transformation via three age-related parameters prior to analysis or centile calculation. Neither index was a good proxy for skinfold measurements for comparison of ethnic groups. From data from inner city areas surveyed in 1989 children of Indian subcontinent origin had substantially lower weight-for-height, but only Gujarati children were thinner than white children, whereas Afro-Caribbean children were slightly heavier for their height, but thinner. Centiles of weight-for-height, and of BMI by age, for ages 4-12 years, were calculated for white English boys and white English girls.     

Associations of excessive irritability with common illnesses and food intolerance

Summary. In a national study of almost 7000 primary school children, parents' perceptions were used to test the hypothesis that the child's irritability was associated with food intolerance independently of other symptoms. After adjustment in a multiple regression analysis for asthma or wheeze, cough, eczema, hives, diarrhoea and vomiting, rhinitis, hay fever and headache, and the social factors of father's social class, maternal education and maternal age, a highly significant association between perception of food intolerance and irritability (P<0.001) remained. Though we cannot rule out that irritable children's parents could be biased towards diagnosing food intolerance the possibility that some children do have behavioural disturbance associated with reactions to food needs to be explored further, preferably with a double blind challenge assessment.