[Dietary intervention in children with hypercholesterolemia: a plan to follow].
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Biomedical subjects
Publications and source records attributed to L Moreno.
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This study gave us the opportunity to know the roles iron deficiency and the presence of lead in blood play, as confounding variables, in relation to the state of malnutrition and the intellect of those children. A sample of 169 school children were classified according to their state of nutrition, their condition in reference to serum iron and lead concentrations. In addition, their intelligence was evaluated. The results confirmed that those children with lower weights and heights registered lesser points of intelligence; in fact, iron deficiency cancels out the difference in favor of those taller and weighing more. Lead did not contribute as a confounding variable, but more than half of the children showed possible toxic levels of this metal.
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The incidence of inflammatory bowel disease (IBD) in French children is not known. Therefore we conducted a prospective epidemiologic study of IBD in the region Nord-Pas-de-Calais (3.9 millions inhabitants). During the first 17 months of the study each new suspected case was reported by all (private and public) gastroenterologists in the region (n = 104) and a questionnaire was filled up at the gastroenterologist office by an epidemiologist. The final diagnosis of Crohn's disease (CD), ulcerative colitis (UC) or proctitis was made in a blind manner by two expert gastroenterologists. During the period under study, 47 new cases of IBD were registered in children (less than 17 years of age); 31 (66%) had CD, 7 (15%) had UC, and 9 (19%) had unclassified colitis. The incidence was 2.07/100,000 children/year for CD and 0.46/100,000 children/year for UC. These preliminary data suggest that the incidence of CD is high in Northern France.
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The peplomer protein (S) and the transmembrane protein (M) of transmissible gastroenteritis virus (TGEV) of swine were identified by iodination and serologically on the surface of infected cells. Of a total of 4 monoclonal antibodies (mAb) directed against four antigenic sites of S protein (Correa et al., 1988), 3 specific for sites A, B and D attached to the plasma membrane of infected cells, as disclosed by indirect immunofluorescence and by complement-mediated cytolysis. Four of the mAbs assayed were specific for the viral protein M and two of them gave plasma membrane immunofluorescence and mediated cytolysis in the presence of complement. The viral nucleoprotein N could not be demonstrated on the surface of infected cells either by iodination or employing 3 mAbs against this protein. Finally, a time course infection experiment demonstrated that S and M proteins were expressed on the surface of infected cells at 4 h after infection, before infective virus was released from infected cells.
The objective of this analysis is to determine whether useful information on birthweight can be obtained from a retrospective survey. The 1986 Peru Demographic Health Survey collected both numerical weights (in grams) and subjective assessments of relative size at birth, for infants born during 1981-86. Simple tabulations suggest that reports of both measures are of reasonably high quality. However, a more detailed analysis demonstrates that exclusion of the large proportion (almost one-third) of missing responses on numerical weights can lead to biases in the resulting estimates of the incidence and correlates of low birthweight, of the level of infant mortality, and probably of the relative risk of mortality for low birthweight infants. The results emphasize the necessity of collecting data on the relative size of infants, in addition to information on numerical weights, in populations in which a substantial fraction of infants are born outside the formal health system. The subjective assessments allow the analyst to examine the extent to which infants with missing numerical weights are select and to assess the degree of bias in estimates which are based on the subsample of births with reported weights.
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The presence of antibodies to two influenza viruses of the type A (H1N1 and H3N2) and to a porcine respiratory coronavirus was investigated in a study lasting a year. 735 blood serum samples were collected from 79 closed pig fattening farms in the province Segovia (Spain). Hemagglutination inhibition was used with influenza viruses. The percentage of positive results was 78.5% and 62.5% respectively for the serotypes H1N1 and H3N2. A clear reduction in the spread of antibodies was observed in the autumn. The ELISA technique was used with the porcine respiratory coronavirus. As antigen we used the antigenically related transmissible porcine gastroenteritis virus. Using this technique 87% of the sera were positive. Some of these sera with representative ELISA values were confirmed by means of serum neutralisation and radioimmune precipitation of the viral proteins. The incidence of these antibodies remained unchanged over the whole year of the investigation.
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Systematic neonatal screening of congenital hypothyroidism (CH) allowed to detect 82 children (62 girls and 20 boys) including 73% with ectopic thyroid, 18% with athyreosis and 9% with eutopic thyroid. They were followed for 1 to 7 years according to the same protocol. Skeletal maturity was studied according to 2 methods: TW2 and Sempé's numerical. Height growth was compared to the standards for French children. T4 values were normal at all ages, TSH values were slightly higher than standard. Concerning the skeletal maturity the delay observed in boys lessened from age 6 years (TW2 method: less than 25th percentile until 3 years, = 25th from 3 to 5 years, between P25 and P50 by 7 years of age). This delay was less important in children who, at the time of diagnosis (day 15) had an epiphyseal surface greater than or equal to 5 mm2. In girls, it was always above the 25th percentile. The expression of the delay was greater with Sempé's method than with the TW2 method. Thus, early substitutive treatment of CH allows a normal height growth. The skeletal maturity is somewhat abnormal in boys. This could be explained by the high percentage (66.6%) of boys with a small epiphyseal surface during the neonatal period and by a slight under-treatment.
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Faced to the success of the neonatal screening for phenylketonuria and congenital hypothyroidism, it was tempting to introduce screening of other metabolic diseases. "Ideal" diseases to be screened are treatable, are not easily recognized by clinical means during the neonatal period, need immediate therapy to prevent irreversible disabilities, have a reasonable frequency and can be detected by and easy test. There is some controversy concerning the list of diseases recommended for mass screening, among them four can be discussed: congenital adrenal hyperplasia, due to 21-hydroxylase deficiency, fulfils most of the criteria, but some changes in the general screening strategy should be made to provide a result as soon as possible, and at least before the 10th day of life; cystic fibrosis, immunoreactive trypsin is a good marker of the disease but its assay needs technical adaptation for mass screening; more information are also required about the efficacy of an early management of the disease; Duchenne muscular dystrophy has a good marker for neonatal screening (creatine kinase), but no treatment exists and the possibility of genetic counselling can only be provided; hypercholesterolaemia is a frequent disease; however, the good marker and the adequate treatment remain to be defined. Pilot programmes, on the behalf of the French Association for Neonatal Screening, are evaluation these problems. However, at the present time, a consensus has been reached that only phenylketonuria and hypothyroidism fulfils criteria for an efficient mass screening programme.
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Authors analyze Greulich and Pyle's atlas, using TW2 and TW2-A methods, in their three respective modalities (20B, C, RUS). They observe that there are differences between three variables and GP. Results are compared with those of other authors concluding that use of numerical methods adapted to population in study are the ideal ones.