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Biomedical subjects

L S Taitz

Publications and source records attributed to L S Taitz.

At least 19 recordsLinked to original sources

Familial hypercholesterolaemia: pilot study to identify children at risk.

AIMS: To evaluate a more effective method of identifying children with familial hypercholesterolaemia by screening a population at high risk. METHODS: Domiciliary measurement of random cholesterol concentration was made in 200 children who were first or second degree relatives of subjects with premature onset coronary artery disease. Measurements were taken by a health visitor using a portable analyser. RESULTS: Twelve new cases of familial hypercholesterolaemia were identified during the first nine months of the study. Random cholesterol concentrations were within the normal range (< 5.2 mmol/l) in 70.5% of samples tested. Forty two (21%) of patients tested had a borderline cholesterol (5.2-5.9 mmol/l) but 50% of these fell within the normal range when fasting capillary samples were analysed. Children with significant hypercholesterolaemia on random testing (concentrations of > 5.9 mmol/l) (8.5%) also had fasting venous blood assayed for high density lipoprotein (HDL) cholesterol and tri-glyceride in the laboratory. Results indicated that 6.5% of patients screened were at high risk of cardiovascular disease (ratio of total: HDL cholesterol of > 4.5), and 1% had a moderately increased risk (ratio 3.5-4.5). CONCLUSIONS: Children with familial hypercholesterolaemia can be identified from a selected "high risk" population by measuring random capillary cholesterol concentration.

Adolescent↗

Height and body proportions in child abuse.

Abused children are said to retain 'infantile body proportions'. The presenting height, sitting height, and leg length standard deviation scores of 91 victims have been calculated from data derived from a study of local inner city schoolchildren. In the study population 31/91 (34%) were significantly short and all but two of these had relatively shorter legs than backs, this limb disproportion being significant in 17. In 25 patients of the original group followed up after various social interventions there was a significant recovery of leg length. Measurement of height and proportionality, especially when compared with appropriate modern or local standards, is an important means of detecting and following up victims of child abuse.

Adolescent↗

Medium-chain acyl-CoA dehydrogenase deficiency: a useful diagnosis five years after death.

We report a family in whom a fatal case of medium-chain acyl-CoA dehydrogenase (MCAD; EC 1.3.99.3) deficiency was diagnosed by enzymatic analysis of heart tissue that had been stored for five years. Three healthy siblings underwent subsequent investigation with the 3-phenylpropionic acid loading test. All siblings had been asymptomatic; however, one (age 2.5 years) excreted large amounts of 3-phenylpropionylglycine in response to the load and exhibited an organic aciduria consistent with the diagnosis of MCAD deficiency. The other two siblings did not demonstrate 3-phenylpropionylglycinuria after the loading test. This case underlines the importance of considering family history and using appropriate diagnostic tests in the recognition of hereditary metabolic disorders.

Acyl-CoA Dehydrogenase↗

Are babies more satisfied by casein based formulas?

A review of 173 infants who were started on whey based formula showed that 40 (23%) had their feeds changed, usually to a casein based feed by 6 weeks. A double blind randomised trial, comparing casein based with whey based formula confirmed that about 20-25% of babies have their formula changed within six weeks irrespective of the nature of the feed on which the infant was started.

Caseins↗

Haemolytic uraemic syndrome and pseudomembranous colitis.

Two cases of haemolytic uraemic syndrome (HUS) associated with pseudomembranous colitis (PMC) are described. The toxin of Clostridium difficile was detected post mortem in the stool of one patient and the other patient showed a good therapeutic response to oral vancomycin, an antibiotic with established efficacy in the management of PMC. When associated with HUS, PMC is probably an independent specific disease that, in common with many other infections, may activate HUS.

Bacterial Proteins↗

Growth patterns in child abuse.

This study reports clinical details and statistical analysis of linear and body mass growth retardation in a cohort of 260 abused children. Seventy-one children (26%) showed impairment of growth for weight or height; 21 out of 92 children who spent time in foster homes showed catch-up growth whereas only 5 out of 168 never separated from their parents demonstrated improvement in height or weight centiles. Out of 11 children placed in foster care who were more than 2 SD below the mean for height, 10 demonstrated significant catch-up whereas only 4 out of 28 children who remained in their natural homes did so. Catch-up growth among children who remained at home was generally less than that which occurred in foster homes. In 17 cases diagnosis of growth impairment preceded nonaccidental injury. Growth of growth-retarded children in natural homes was poor. Because of the relationship between poor growth and other parameters of development, children who show catch-up growth in foster homes should probably not be 'rehabilitated' with their natural parents.

Body Height↗

A profile of abuse.

Of 260 children considered to have been the victims of child abuse or neglect, or both, 149 suffered non-accidental injury, 71 had evidence of growth problems, 87 had developmental and speech delay, and 63 showed evidence of appreciable behaviour disturbance. While the overall prevalence of development and behaviour problems in the series was high there were particular associations noted between growth problems and developmental delay, between increasing age and behaviour disturbance, and between evidence of emotional deprivation and both behaviour disturbance and developmental delay. Children with non-accidental injury but without growth problems or emotional deprivation were least likely to show behaviour or developmental problems.

Affective Symptoms↗

Clinical trial of a concentrated amino acid formula for older patients with phenylketonuria (Maxamum XP).

Ten children with phenylketonuria aged between 9 and 11 years were studied for a period of 1 year. Their usual phenylalanine free amino acid supplement was replaced by Maxamum XP (Scientific Hospital Supplies). There was no evidence of any change in the clinical status of these children and all claimed to prefer Maxamum XP to previous amino acid mixtures. Growth was normal and various biochemical parameters of nutritional status remained unaltered.

Amino Acids↗

Unemployment and child abuse.

The employment state of men living in the homes of children at the time that child abuse was diagnosed was determined. The series included a wide range of abuse, including non-accidental injury, failure to thrive, neglect, and emotional deprivation. Two cohorts of children seen during 1974-9 and 1980-5 were compared; these periods were chosen because a large increase in unemployment began in Sheffield in 1980. Although the proportion of the men without work was significantly increased during the second period, this increase could not be ascribed to the rise in either long term or short term unemployment among those who had previously been in regular employment. It was accounted for by a rise in the proportions of single parent families and families in which the resident man had never had regular employment. This may reflect an increase in pregnancies among young mothers. There was no evidence to support the belief that the loss of a job in otherwise stable families leads to an increase in child abuse.

Child↗