Spontaneous recovery of vision following an orbital haemorrhage.

A 73-year-old man presented to casualty with a penetrating orbital injury and total loss of vision in the affected eye. He subsequently spontaneously recovered full vision. We stress the need for frequent assessment of vision before considering potentially hazardous surgical intervention.     

Infant feeding practices in a South African birth cohort—A longitudinal study

Childhood malnutrition is highly prevalent in low‐ and middle‐income countries. The choices of complementary foods, which are important in infant nutrition, are poorly described in this setting. We investigated infant feeding practices in a South African birth cohort, the Drakenstein Child Health Study. Longitudinal feeding data were collected from March 2012 to March 2015. Feeding practices at birth, 6–10 and 14 weeks and 6, 9, and 12 months, were investigated using food frequency questionnaires. Anthropometry was measured at birth and 12 months. The quality of the diet was analyzed using the World Health Organization infant and young child feeding indicators. Regression models were used to explore associations between feeding and growth outcomes at 1 year. Exclusive breastfeeding for 6 months was low (13%), and 19% of infants were introduced to solid foods before 4 months. There was high daily consumption of processed meat (56%) and inappropriate foods such as fruit juice (82%), soft drinks (54%), and refined sugary foods (51%) at 1 year. Dietary diversity and consumption of iron rich foods were low at 6 months (5% and 3%, respectively) but higher by 12 months (75% and 78%). Longer duration of exclusive breastfeeding was associated with a lower height‐for‐age z‐score at 1 year. Several dietary deficits and a rising trend in the consumption of inappropriate nutritionally poor foods were identified. These findings raise concern about poor dietary practices and the impact on child and long‐term health.     

Urinary albumin excretion is associated with pulmonary hypertension in sickle cell disease: potential role of soluble fms‐like tyrosine kinase‐1

Background: Pulmonary hypertension (PHT) is reported to be associated with measures of renal function in patients with sickle cell disease (SCD). The purpose of this exploratory study was to determine the relationship between albuminuria and both clinical and laboratory variables in SCD. Design and methods: This cross‐sectional study was performed using a cohort of adult patients with SCD and control subjects without SCD. Spot urine for microalbumin/creatinine ratio, measures of hemolysis, inflammation and other laboratory studies were obtained. Pulmonary artery systolic pressure was determined by Doppler echocardiography, and the diagnosis of PHT was defined using age‐, sex‐ and body mass index‐adjusted reference ranges. Results: Seventy‐three patients with SCD and 21 healthy, race‐matched control subjects were evaluated. In patients with SCD, normoalbuminuria was observed in 34 patients (46.6%), microalbuminuria in 24 patients (32.9%) and macroalbuminuria in 15 patients (20.5%). There was a significant correlation between urine albumin excretion and age. In patients with HbSS and Sβ⁰ thalassemia, the levels of sFLT‐1, soluble VCAM and NT pro‐BNP were significantly higher in those with macroalbuminuria, compared to patients with microalbuminuria and normoalbuminura, but no significant differences were observed in the levels of laboratory measures of hemolysis. Urine albumin excretion was associated with PHT and a history of stroke. Conclusions: Our study confirms the high prevalence of albuminuria in SCD. The association of urine albumin excretion with sFLT‐1 suggests that this vascular endothelial growth factor receptor family member may contribute to the development of albuminuria in SCD. By inducing endothelial activation and endothelial dysfunction, sFLT‐1 appears to be a link between glomerulopathy and PHT in SCD.     

Kabuki syndrome: description of dental findings in 8 patients

The cardinal features of Kabuki (Niikawa-Kuroki) syndrome (KS) include characteristic facial dysmorphic features, mild to moderate mental deficiency, skeletal abnormalities, dermatoglyphic abnormalities, and postnatal growth retardation. We identified 8 patients with KS in a genetics clinic over the past 5 years. All were Caucasians, except for 2 who were of mixed Aboriginal and Caucasian descent. All had the facial gestalt, the dermatoglyphic abnormalities characteristic of the syndrome, and developmental delay. Dental abnormalities of permanent teeth were seen in all 8 cases; 6 had missing lower incisors. Five patients had uniquely abnormal upper incisor teeth shape; the upper incisors had a 'flat head' screwdriver-shaped appearance. Other dental abnormalities included missing lower lateral incisors, missing second premolars, and ectopic upper 6-year molars. We believe the presence of the unique dental findings will prove useful in the diagnostic assessment of individuals with KS.     

Clinical Depression and Perceptions of Supportive Others: A Generalizability Analysis

Low perceived support is associated withemotional disturbance. Two important determinants ofsocial support judgments are perceptual biases of theperceivers and the Perceiver X Supporter interaction. Recent generalizability studies have found thatthe Perceiver X Supporter interaction is a much strongerinfluence on support judgments than the perceptualbiases of perceivers. However, these recent studies were based on normal samples. The presentresearch investigated whether perceptual biases insupport judgments would be stronger for clinicallydepressed inpatients. Patients and controls viewed fourvideotaped targets and rated targets' supportiveness.Compared to normal controls, depressed inpatients didnot show a negative perceptual bias that generalizedacross support providers. Consistent with normalsamples, however, the Perceiver X Supporter interactionwas more important, as patients and controls differed inwhom they saw as supportive. Controls saw supportershigh on agreeableness as more supportive, but did not rely on extraversion,conscientiousness, or openness in making supportjudgments. The support judgments of depressed patientswere harder to characterize. Implications forinterventions were discussed.