Management of childhood gastroenteritis in the community

Good evidence-based research exists for the management of gastroenteritis. However, we encountered local anecdotal evidence of wide variations in the management of gastroenteritis. In order to assess the prevailing practice in gastroenteritis management in primary care, in the Tees Health region, an anonymous questionnaire study involving general practitioners (GPs) and health visitors (HVs) was performed. Three case scenarios were presented in the questionnaire, involving a breast-fed infant, a formula-fed infant and a four-y-old child all with diarrhoea and vomiting, but able to tolerate oral fluids and not ill enough to need hospital admission. Most GPs (78.6%) and HVs (80.5%) advised continuation of breast-feeding, though the practice of giving advice to stop breast-feeding, starve the child and substitute inappropriate fluids such as flat coke, was still common. For infants who were bottle-fed, this inappropriate advice was given much more commonly (only 25.6% and 52.8% of GPs and HVs, respectively gave advice to continue bottle-feeding). This was even more true for the four-y-old, for whom advice to continue with a normal diet was very much the exception (7.7% of GPs and 19.5% of HVs). Advice given to parents of children with gastroenteritis was inconsistent and, in many cases, inappropriate. This has implications for clinical governance. There is an urgent need for the development and implementation of local guidelines.     

Synthesis of cystine peptides 21–25/70–73 and 35–39/56–59 of the β-subunit of human choriogonadotropin

Syntheses of two asymmetrical cystine peptides with the amino acid residues 21–25/70–73 and 35–39/56–59, based on the linear amino acid sequence and the disulfide bond assignment in the β-subunit of human choriogonadotropin (hCG-β), are described. S-trityl and S-acetamidomethyl peptide fragments of each cystine peptide were prepared in solution phase and were subjected to oxidation with I₂/MeOH to form the disulfide bridge. The cystine peptides were characterized by their amino acid analyses and fast atom bombardment mass spectrometry. Immunological characterization by several homologous radioimmunoas-say systems showed that peptide 21–25/70–73 had significant hCG, hCG-β, and hLH activities while peptide 35–39/56–59 failed to reveal any immunoreactivity.     

Comparison of antegonial index,mental index,panoramic mandibular index and mandibular cortical index values in the panoramic radiographs of normal males and male patients with osteoporosis

Objective

The aim of the study was to compare the values of the antegonial index (AI), mental index (MI), panoramic mandibular index (PMI) and mandibular cortical index (MCI) in the panoramic radiographs of normal males and male patients with osteoporosis.

Methods

In panoramic radiographs obtained from 40 male individuals (20 normal and 20 with osteoporosis), the mean was calculated for MI, AI, PMI and MCI index values measured in the right and left mandibles. The MI, AI and PMI index values were evaluated using the paired t-test, and MCI values were analysed using the χ² test.

Results

MI (P < 0.001), AI (P < 0.01) and PMI (P < 0.05) values were significantly smaller in the group with osteoporosis; however, MCI (P > 0.05) was not significantly different.

Conclusion

MI, PMI and AI values, as radiomorphometric indices, were found to be smaller among male patients with osteoporosis, compared with normal patients in this study. It is suggested that these indices, used as an ancillary method in the diagnosis of osteoporosis in women, could also be useful for male patients. Further studies, of larger groups are needed on this subject, including of the MCI, which in this study showed no significant difference.     

Prevalence and risk factors of hyperuricemia in patients with IgA nephropath

Objective To evaluate the prevalence of hyperuricemia in patients with IgA nephropathy and find out the risk factors of hyperuricemia, including clinical and pathological characteristics. Methods A retrospective study enrolled 2566 adult patients, who admitted to the First Affiliated Hospital, Sun Yat-sen University from 1996.01 to 2012.12 and diagnosed with biopsy- proven IgA nephropathy was conducted. Results Among 2566 IgA nephropathy patients, the prevalence of hyperuricaemia was 36.6%. Prevalence of hyperuricaemia for CKD stage 1, 2, 3, 4, 5 was 16.2%, 37.4%, 66.4%, 87.7% and 76.4%, respectively. Adjusting Logistic regression analysis showed male gender, progressive stages of CKD, increased percentage of global glomerulosclerosis were independent risk factors of IgA nephropathy; male gender, progressive stage of CKD, increased level of cholesterol, increased percentage of global glomerulosclerosis were independent risk factors for CKD stage 1 - 2 patients; progressive stages of CKD and increased percentage of global glomerulosclerosis were independent risk factors for CKD stage 3 - 5 patients. Conclusion The prevalence of hyperuricemia in patients with IgA nephropathy was 36.6%, and identifying the risk factors associated with hyperuricaemia among different CKD stages of IgA nephropathy will be important to improve our understanding in intervention of this disease.     

Interleukin-5 is at 5q31 and is deleted in the 5q- syndrome

Human interleukin-5 (IL-5) is a selective eosinophilopoietic and eosinophil-activating growth hormone. By in situ hybridization this gene is mapped to chromosome 5q23.3 to 5q32. It is shown to be deleted in two patients with the 5q-syndrome and in one patient previously diagnosed with myelodysplasia whose condition had progressed to acute myeloblastic leukemia. The clustering of other genes involved in hematopoiesis (IL-3, granulocyte-macrophage colony-stimulating factor, feline sarcoma viral oncogene homolog, colony-stimulating factor 1) to the same region as IL-5 suggests a nonrandom localization and raises interesting questions concerning the evolution and regulation of these genes.     

Relationship between Myopia and Optical Components - A Study among Chinese Hong Kong Student Population

Purpose: To establish the prevalence and severity of myopia among the Chinese Hong Kong students and to study the relationship between myopia and optical components.Methods;One thousand and seventy-five freshmen of the 1993-1994 academic year in the Chinese University of Hong Kong underwent the eye examination including evaluation of refractive error, keratometry, and A-scan ultrasonic biometry. The data were analyzed with the SPSS/PC 4. 01 statistical package. Results: The prevalence of myopia was 91. 7% with the mean refraction being -4. 00 ± 2. 64D in this young adult population. The statistical analyses demonstrated a significant correlation between refractive value and axial length of the globe (r=-0. 78), vitreous length (r=-0. 76), anterior chamber depth (r=-0. 33), lens thickness (r = 0. 13) and corneal curvature (r = 0. 19). Conclusion: The refractive status is mainly dependent on the axial length. In general, the higher the myopia was, the longer the eyeball, the deeper the anterior chamber,     

Solvent effects on the conformation of cyclo(-D-Trp-D-Asp-Pro-D-val-Leu-) An NMR spectroscopy and molecular modeling study

The conformations of cyclo(-D-Trp-D-Asp-Pro-D-val-Leu-) in dimethyl sulfoxide-d₆ (DMSO-d₆) and water were determined using two-dimensional nuclear magnetic resonance spectroscopy and restrained molecular dynamics. Comparisons were made between conformations of the cyclic pentapeptide in both solvents. The NMR study revealed that, while the backbone remained relatively unchanged in both solvents, the side-chains adopted distinctly different orientations in DMSO-d₆ vs. H₂O. A modeling study, minus NOE constraints, produced a set of low-energy conformers possessing agreement in backbone conformation with the NMR-derived structures; however, lowest-energy conformers did not have this agreement. These results show that different solvents can significantly affect the preferred side-chain conformation of small cyclic peptides in solution. This finding will impact the selection of solvent when determining structures for use as templates in rational drug design.     

CFU-GM content of bone marrow graft correlates with time to hematologic reconstitution following autologous bone marrow transplantation with 4- hydroperoxycyclophosphamide-purged bone marrow

Autologous bone marrow transplants (BMTs) can repopulate the hematologic system of patients treated with marrow-ablative chemotherapy and/or radiotherapy. However, treatment of the bone marrow graft to eliminate residual tumor cells prior to reinfusion can delay the return of peripheral blood elements, presumably from damage to or loss of hematopoietic stem cells responsible for hematologic recovery. To develop a model predictive of hematologic recovery, we studied the progenitor cell contents of 4-hydroperoxycyclophosphamide (100 micrograms/mL)-purged bone marrow grafts of 40 consecutive patients undergoing autologous BMT at this center. Granulocyte-macrophage colonies (CFU-GM) were grown from all grafts after treatment with this chemotherapeutic agent, but erythroid (BFU-E) and mixed (CFU-GEMM) colonies were grown from only 44% and 33% of the grafts respectively. The recovery of CFU-GM after purging ranged from 0.07% to 23%. The logarithm of CFU-GM content of the treated grafts was linearly correlated with the time to recovery of peripheral blood leukocytes (r = -0.80), neutrophils (r = -0.79), reticulocytes (r = -0.60), and platelets (r = -0.66). The CFU-GM content of purged autologous bone marrow grafts may reflect the hematopoietic stem cell content of the grafts and thus predict the rate of hematologic recovery in patients undergoing autologous BMT.