An epidemiological survey of recurrent abdominal pain in a rural Malay school

OBJECTIVE: To study the prevalence of complaints of recurrent abdominal pain (RAP) among school children aged 11-12 years in a rural setting in Malaysia. METHODOLOGY: Questionnaires were distributed to all parents and teachers of children aged 11-12 years who attended a small rural school in which all the children were Malays. Complaints of RAP were defined as at least three such complaints occurring over a period of at least 3 months. RESULTS: One hundred and sixty questionnaires were distributed, of which 148 were returned, giving a response rate of 92.5%. Sixty-one children (41.2%) had RAP. Approximately 45.2% of girls and 35.9% of boys reported having RAP. Compared with children without RAP, there was a significantly larger number of children with RAP (85.2%) who had at least one stress factor (P = 0.0109). There were no significant associations between RAP and total family income (P = 0.0573), a history of abdominal pain in at least one parent (P = 0.1686), a history of abdominal pain in at least one sibling (P = 0.0617), academic performance (P = 0.9967) or the degree of sports participation (P = 0.8469). There was an increased incidence of other systemic complaints in children with RAP when compared with children without RAP. CONCLUSION: Recurrent abdominal pain was found to be common among 11- to 12-year-old children in a rural Malay school. There was a significant association found between RAP and the presence of stressful events, as well as with the presence of other systemic complaints.     

长期应用埃索美拉唑是维持已愈合糜烂性食管炎疗效及控制胃食管反流症状的有效方法

要确保糜烂性食管炎的治愈效果 ,长期抑制胃酸是一项必要措施。在不使用维持治疗时 ,已治愈的反流性或溃疡性食管炎 ,在 1年左右有近 80 %的病人会再出现食管黏膜的破损。 1年中奥美拉唑 2 0ｍｇ或兰索拉唑 30ｍｇ每天 1次治疗 ,可使复发率降至 30 %或更低。Ｈ2 受体阻滞剂 (Ｈ2 ＲＡ)维持治疗的效果不及ＰＰＩ。Ｈ2 ＲＡ 1年维持治疗的效果约为 50 %。奥美拉唑的Ｓ 异构体———埃索美拉唑是第一个发展为同分光学异构体的质子泵抑制剂 (ＰＰＩ)。埃索美拉唑 2 0或40ｍｇ剂量的血浆浓度时间曲线下面积 (ＡＵＣ值 )明显大于奥美拉唑 2 0ｍｇ …     

广州管圆线虫病诊疗方案

0引言广州管圆线虫病又称嗜酸粒细胞增多性脑膜脑炎或嗜酸粒细胞增多性脑脊髓膜炎.主要是因进食生的或不熟的含有广州管圆线虫幼虫的螺肉而感染,幼虫寄生在中枢神经系统而致病.主要临床表现为脑膜炎、脊髓膜炎、脑炎或脊髓炎,脑脊液内有大量嗜酸性粒细胞.1病原学成虫虫体呈线状     

Congenital gastrointestinal defects in Down syndrome: a report from the Atlanta and National Down Syndrome Projects

We report Down syndrome (DS)-associated congenital gastrointestinal (GI) defects identified during a 15 year, population-based study of the etiology and phenotypic consequences of trisomy 21. Between 1989 and 2004, six sites collected DNA, clinical and epidemiological information on live-born infants with standard trisomy 21 and their parents. We used chi-squared test and logistic regression to explore relationships between congenital GI defects and infant sex, race, maternal age, origin of the extra chromosome 21, and presence of a congenital heart defect. Congenital GI defects were present in 6.7% of 1892 eligible infants in this large, ethnically diverse, population-based study of DS. Defects included esophageal atresia/tracheoesophageal fistula (0.4%), pyloric stenosis (0.3%), duodenal stenosis/atresia (3.9%), Hirschsprung disease (0.8%), and anal stenosis/atresia (1.0%). We found no statistically significant associations between these defects and the factors examined. Although not significant, esophageal atresia was observed more often in infants of younger mothers and Hispanics, Hirschsprung disease was more frequent in males and in infants of younger mothers and blacks, and anal stenosis/atresia was found more often among females and Asians.     

The woes of waiting wives : Psychosocial battle at homefront

Few studies on stress have been carried out in soldiers and other paramilitary forces deployed in operational situations because of the security concerns, practical difficulties of conducting combat psychiatric studies and various other reasons. Studies on their families, who safeguard the family interests, during the period of absence of soldiers, have been even fewer. Significant contributions of researchers in this field were reviewed and suitably interpreted. Analysis revealed various types of stress and the multiple coping methods being practiced. It also highlighted various preventive and remedial measures being undertaken by waiting wives and their children. There is a need to understand and address the psychosocial issues of these families.     

Molecular analysis of VH and VL regions expressed in IgG-bearing chronic lymphocytic leukemia (CLL): further evidence that CLL is a heterogeneous group of tumors

We report the heavy (H) and light (L) chain variable (V) region sequences of cDNAs encoding the Ig receptor of two cases of CD5+ IgG- bearing CLL P87 and P103. In both CLL cases the H chain was encoded by members of the VH3 gene family. The L chain expressed by P87 belonged to the V lambda IV subgroup, whereas P103 used a member of the V kappa III subgroup. The VH3.P87 gene differed by only three nucleotides from 38P1, a VH3 gene previously cloned from a fetal liver cDNA library. Nucleotide sequence analysis demonstrated that the V kappa III.P103 gene differed by seven nucleotides from its most homologous germline counterpart, the Humkv325 gene, a highly conserved gene frequently expressed in IgM-bearing CLL. The nucleotide sequences of VH3.P103 and V lambda IV.P87 could not be reliably matched with reported germline V genes. The analysis of multiple independently obtained VH and VL cDNA clones from each tumor showed a lack of intraclonal diversification. The data show that V regions expressed in isotype-switched CD5+ CLL may be either in/near germline configuration or somatically mutated. Furthermore, these tumors, like their IgM-bearing counterparts, do not seem to undergo intraclonal diversification.     

Gastroesophageal reflux in children with recurrent abdominal pain

In this study we investigated the presence of gastroesophageal reflux in children with recurrent abdominal pain and its possible relationship to food intolerance-associated duodenal inflammation. Twenty-four-hour intra-esophageal pH monitoring, an endoscopic duodenal biopsy and a small bowel 51Cr-EDTA permeability test were performed in 25 children with recurrent abdominal pain. In 14 cases (56%) the pH monitoring was abnormal, pointing to the presence of pathological gastroesophageal reflux. Treatment of gastroesophageal reflux in the latter patients resulted in resolution or improvement of abdominal pain in 10 cases (71%). Gastroesophageal reflux did not appear to be associated with either intestinal permeability to 51Cr-EDTA or duodenal biopsy findings. We conclude that pathological gastroesophageal reflex is a frequent finding in children with recurrent abdominal pain, that it is unrelated to duodenal inflammation and that there might be a causal relationship between pathological gastroesophageal reflux and recurrent abdominal pain in children.