Morbidity and mortality amongst infants of diabetic mothers admitted into a special care baby unit in Port Harcourt, Nigeria

Background

A number of studies have shown that current classification systems (ICD 10, DSM IV TR) have limitation when applied to autistic children and the category PDD NOS (DSM IV TR) has in particular been criticized. To check the possible usefulness of other classification systems to better describe patient's functioning, we retrospectively studied 84 patients, seen consecutively in our Child Neurology and Psychiatry Department (excluding only those presenting for another disease even if with clinical signs of a PDD).

Methods

We tried to classify them according to ICD 10, DSM IV TR, CFTMEA-R, "operational classification" (Manzano and Palacio) and de Ajuriaguerra's classification.

Results

We found a good correspondence between DSM IV TR and ICD 10 and the use of psychodynamic classification systems (in particular CFTMEA-R) was useful to differentiate clinical subtypes collected under the PDD NOS etiquette according to DSM IV TR.

Conclusions

To rationalize research efforts and find better tailored therapies, we need to improve PDD classification systems, using contributions coming from every field of child psychiatry and neurology: it's possible that 0-3 Classification could help this.     

THYROTOXICOSIS AND RENAL TUBULAR ACIDOSIS PRESENTING AS HYPOKALAEMIC PARALYSIS

A 34-yr-old Chinese woman presented with hypokalaemic periodicparalysis. She had a goitre and was biochemically thyrotoxic.However, she also had urinary potassium loss with a metabolicacidosis and reduced ability to acidify her urine. The co-existenceof distal renal tubular acidosis (RTA) was confirmed. Therewas no evidence of xerostomia or xerophthalmia, although anti-Roantibody and rheumatoid factor were positive. Paralytic attacksdid not recur after the thyrotoxicosis was controlled with radioactiveiodine. Possible pathogenic mechanisms for the association ofthese disorders are discussed. Female patients presenting withthyrotoxic periodic paralysis (TPP) should be thoroughly investigatedfor possible additional precipitating factors in view of thestrong male predominance of TPP, particularly when there areatypical metabolic features. KEY WORDS: Hypokalaemic paralysis, Renal tubular acidosis, Thyrotoxicosis     

Osteomyelitis infection disguised as Reiter's syndrome in a child: A case report

Reiter''s syndrome (reactive arthritis) should always prompt a thorough clinical investigation of a potentially more serious disease condition in every pediatric patient and adults. It should always be regarded as a warning sign and not a disease. This is a case of a 16‐year‐old African boy with osteomyelitis presenting with symptoms of reactive arthritis (Reiter''s syndrome).     

Durability of sodium sulfate-treated polylysine-alginate microcapsules

Chelated hollow microcapsules are unstable under in vitro conditions because of their hygroscopic nature. Nongel inducing cations, such as Na+, stabilize the outer membrane of the alginate-polylysine-alginate microcapsules leading to more stable beads. We made different batches of empty capsules with a mean +/- SEM diameter of 607+/-11 microns, and found that within 1 week of incubating these capsules in normal saline at 37 degrees C, they increased to 718+/-10 microns (p < 0.05, n = 5). In initial experiments, we made different batches of capsules and divided them into two groups. One group was left untreated (control) whereas the other was treated with 6 mM Na2SO4 for 30 min, before incubation in saline at 37 degrees C. Control capsules increased in weight and size, before beginning to melt in less than 1 week. In contrast, treated capsules rapidly lost weight and remained intact during 1 month of follow-up. In perifusion experiments, we found no deleterious effect of sodium sulfate treatment on the function of islets enclosed in the capsules.     

Stereoselectivity of Butylidenephthalide on Voltage-dependent Calcium Channels in Guinea-pig Isolated Ileum

Two geometric isomers, the Z- and the E- forms, can be separated from synthetic mixtures of butylidenephthalide (Bdph). Z-Bdph (50–100 μm ) non-competitively inhibited Ca²⁺-induced contractions in depolarized (K⁺, 60 mm ) guinea-pig ileum longitudinal smooth muscle, with a pD₂' value of 3.88 ± 0.20 (n = 5). However, E-Bdph (20–100 μm ) competitively inhibited these contractions with a pA₂ value of 4.56 ± 0.18 (n = 5) which was significantly (P < 0.05) greater than the pD₂' value of Z-Bdph. In contrast, the two isomers had no stereoselective inhibitory action on Ca²⁺ influx through pre- or post-junctional membranes of cholinergic nerve endings from which the transmitter acetylcholine is released or on Ca²⁺ release from intracellular stores. Therefore, the trans-Z and cis-E forms of Bdph might have geometric stereoselectivity for voltage-dependent calcium channels (VDC) in guinea-pig longitudinal smooth muscle. Both isomers might inhibit more selectively the contractile twitch responses evoked by electrical stimulation than by cumulative acetylcholine-or carbachol-induced transient contractions in guinea-pig ileum longitudinal smooth muscle.