Children, adolescents and HIV infection

The analysis of the occurrence of HIV infection in adults, children and adolescents under 18 years of age on the basis of statistical data by February 1, 1997, is presented. The total number HIV-infected persons registered by this date was 6,232; among them 902 (14.5%) were children and adolescents. 267 children were infected in the hospital focus of HIV infection; of these, 80 children (30%) died of AIDS during the period of 1989-1997. In 1992 only 16 adolescents, HIV infected were registered, while in 1995 the number of HIV-infected adolescents was 34, in 1996 their number rose to 144 and in 1997, to 435. The main cause of adolescent infections (80%) was the intravenous injection of narcotic drugs.     

The road will be mastered by the walker

Anonymous questioning by the distribution of questionnaires among 1,600 young people (68.9% of them were city dwellers, 31.1% were villagers) was carried out. The questioning covered 1,079 adolescents aged 12-16 years (67.3%), 501 young people aged 16-19 years (31.3%) and 20 respondents aged 19-23 years (1.4%). The analysis of answers to questionnaires indicated that all respondents had the same level of knowledge on the subject, but the information they possessed was not duly analyzed and had no influence on their own behavior. It should be pointed out that 1% of persons aged 12-19 years took drugs by intravenous injection. These data, as well as other materials, gave grounds for the development of a new educational program on the prophylaxis of HIV/AIDS/STD and its introduction in 1997. The program is intended for a school course of 6 years (forms 6-11) and must provide adolescents with reliable and comprehensible information, conductive to the formation of a healthy mode of life.     

Adolescent Obesity and Future College Degree Attainment

The current impact of adolescent obesity on educational attainment is not clear. The objectives of our study were to determine whether adolescent obesity is associated with college degree attainment and how this association may have changed over time. We used data from a contemporary national cohort of over 4,000 persons who were adolescents (aged 14–18) in 1997 to assess the relationship between adolescent obesity and education. To assess for changes in this relationship over time, we also analyzed an older, similarly structured cohort of over 3,000 persons who were adolescents (aged 16–18) in 1981. Our primary outcome was college degree completion. We found that in the older cohort (adolescents in 1979), there were no differences in college degree attainment by adolescent weight status before and after adjustment. However, unadjusted analysis of the contemporary cohort (adolescents in 1997) demonstrated that those who were normal weight as adolescents had a higher prevalence of college degree attainment at follow‐up compared to obese adolescents (24% vs. 10%). After adjustment for socio‐demographic variables (age, sex, race, height, parental income‐to‐poverty ratio, parental education, aptitude test scores), obese adolescents were less likely to have attained a college degree compared to normal weight peers (adjusted risk ratio 0.61 95% confidence interval 0.38–0.83). Expectations for a future college degree did not vary by weight status and did not explain this observation. In conclusion, adolescent obesity is associated with lower likelihood of college completion. This relationship was not observed in an older cohort of adolescents.     

Frequency of family dinner and adolescent body weight status: evidence from the national longitudinal survey of youth, 1997

Objective: To explore associations between overweight status and the frequency of family dinners (FFD) for adolescents and how those associations differ across race and ethnicity. Research Methods and Procedures: A sample of 5014 respondents between 12 and 15 years of age from the 1997 wave of the National Longitudinal Survey of Youth 1997 (NLSY97) was used. BMI was calculated using self‐reported height and weight; 13.3% of respondents qualified as overweight, 16.4% qualified as at‐risk‐of‐overweight, and 1.9% qualified as underweight. The remainder were normal weight. FFD was defined as the number of times respondents had dinner with their families in a typical week in the past year. Multinomial logistic regression models were estimated separately for non‐Hispanic whites vs. blacks and Hispanics for odds of belonging to the other weight categories compared with normal weight. A supplementary longitudinal analysis estimated the odds of change in overweight status between 1997 and 2000. Results: In 1997, the FFD distribution was as follows: 0, 8.3%; 1 or 2, 7.3%; 3 or 4, 13.4%; 5 or 6, 28.1%; 7, 42%. For whites, higher FFD was associated with reduced odds of being overweight in 1997, reduced odds of becoming overweight, and increased odds of ceasing to be overweight by 2000. No such associations were found for blacks and Hispanics. Discussion: Reasons for racial and ethnic differences in the relationship between FFD and overweight may include differences in the types and portions of food consumed at family meals. More research is needed to verify this.     

HIV infection in the penitentiaries of Ukraine

In connection with a sharp increase of the number of HIV-infected persons in the Ukraine the natural growth of the number of such persons in penitentiary institutions was registered, starting from 1995 (455 persons in 1995, 2,937 persons in 1996, 2,779 persons in 1997 and 173 persons during 5 months of 1998). 83% of HIV infection persons were drug addicts introducing drugs intravenously. In 1997 the strategy of decreasing the risk of infection in penitentiary institutions was worked out in collaboration with UNAIDS experts: repressive and isolation measures were replaced with measures aimed at the "decrease of harm". Special attention is given to circumstances aggravating the epidemic situation in HIV infection, and particularly at the sharp growth of morbidity in tuberculosis and syphilis (10.6 and 10.3 times respectively in 1997 in comparison with 1993). In addition, in 1997 the number of person having drug addiction was noted to increase 2.3 times in comparison with 1993. The necessity of taking constant information and educational measures aimed at decreasing the risk of the spread of HIV infection is emphasized.     

Cervicovaginal smear abnormalities in sexually active adolescents. Implications for management

OBJECTIVE: To assess the prevalence and spectrum of Pap smear (PS) abnormalities in sexually active adolescents in comparison to adult women in order to determine whether management of adolescents should differ from that of adults. STUDY DESIGN: Five hundred twenty-four adolescents who had an initial PS at our institution from January to September 1997 were followed for 36 months with repeat PS and/or cervical biopsy. Initial PS results were compared with those of adult women. The chi 2 test was used to calculate the statistical significance of differences between the two groups. The qualified atypical squamous cells of undetermined significance (ASCUS) cytologic diagnosis in adolescents was correlated with follow-up data. RESULTS: The overall prevalence of squamous intraepithelial lesions (SILs) in adolescents was 29% as compared to 23% in adults. Almost all initial squamous lesions were ASCUS and low grade squamous intraepithelial lesion (LSIL); only one case of high grade squamous intraepithelial lesion (HSIL) was detected. On follow-up 18% and 2.4% of adolescents developed LSIL and HSIL, with a LSIL/HSIL ratio of 8/1 as compared to 5/1 in adults. The average time from initial PS to detection of HSIL was 20 months. All patients with HSIL except one had had one or more previous abnormal PSs. The positive predictive values (PPVs) for subsequent dysplasia for ASCUS favor reactive (ASCUS.R), ASCUS not otherwise specified (ASCUS.NOS) and ASCUS favor dysplasia (ASCUS.D) in adolescents were .13, .17 and .31, respectively. ASCUS.NOS (P = .01) and ASCUS.D (P = .007) were strong indicators of dysplasia as compared to ASCUS.R. CONCLUSION: PS abnormalities are more common in sexually active adolescents, with a significantly higher prevalence of LSIL over HSIL as compared to adult women. Given the natural history of HPV infection, we recommend follow-up with cytology rather than colposcopy/biopsy for adolescents with ASCUS and LSIL PSs. Qualification of ASCUS is useful in determining which adolescents are at the highest risk of cervical dysplasia.     

Anthropometric changes in children and adolescents from 1965 to 2005 in Korea

The aim of this study was to assess the secular growth changes in Korean children and adolescents during the last four decades. In 2005, 68,790 boys and 62,557 girls were recruited for this study across the nation in 2005. Anthropometric data (weight, height, etc.) were measured. We compared the results of previous nationwide growth studies with this study. The results of this survey indicate that the growth and developmental status of Korean children and adolescents has been changed substantially compared with those in 1965, 1975, 1984, and 1997. The data presented in this study show a distinct secular increase in growth in body height and weight of Korean children and adolescents spanning this period. A nationwide survey every 5 years would be beneficial to establish a reference standard for the growth of children and adolescents according to the socioeconomic, environmental, and nutritional changes.     

Nonmedical drug use among adolescent students: highlights from the 1999 Ontario Student Drug Use Survey

BACKGROUND: During the 1990s, rates of nonmedical drug use among adolescents escalated. We assessed data from 5 cycles of the Ontario Student Drug Use Survey for overall trends in the proportion of students reporting illegal drug use between 1991 and 1999. METHODS: The survey is a repeated, cross-sectional, 2-stage cluster-design survey of students enrolled in grades 7, 9, 11 and 13. Outcome measures were prevalence of use of 17 drugs, including alcohol and tobacco, over the 12 months preceding the survey. RESULTS: The rates of drug use increased between 1993 and 1999. The 95% confidence intervals (CIs) for the differences in proportions between 1997 and 1999 indicated significant increases in the overall use of 6 drugs: alcohol (95% CIdiff 6.1, 1.9-10.3), cannabis (95% CIdiff 46.3, 0.2-8.4), glue (95% CIdiff 2.3, 1.3-3.3), other solvents (95% CIdiff 5.0, 3.1-6.3), barbiturates (95% CIdiff 1.9, 0.4-3.4) and hallucinogens such as mescaline and psilocybin (95% CIdiff 3.5, 0.8-6.9). Fewer grade 7 students in 1999 than in earlier cohorts reported using alcohol or cigarettes by age 9. INTERPRETATION: The public health implications of the findings are mixed. On the positive side, there is no evidence of increases in early onset of drug use. On the negative side, the overall proportion of students reporting illegal drug use has continued to rise.     

Hair testing for drugs of abuse

Hair testing for drugs of abuse is a developing technology, which offers the possibility of longer detection times than is commonly obtained with urine analysis. It is the main method for evaluation of an individual's drugs of abuse history. In many countries hair analysis is routinely used to detect drug abuse in forensic cases, occupational and traffic medicine and clinical toxicology. Hair analysis in pregnant women, neonates and infants is a useful tool for the detection of drug exposure in utero. In Croatia hair testing for drugs of abuse is performed at the Institute for Medical Research and Occupational Health. Three-year experience in drugs of abuse analysis in hair is described. In 331 hair samples (270 from adolescents and 61 from adults) opiates and metabolites, cocaine, methadone, and amphetamines were analyzed by gas chromatography/mass spectrometry. Most prevalent drugs of abuse in adolescents were amphetamines, and in adults heroin. From the examples cited and samples analyzed it is evident that hair testing is emerging as a reliable biological marker for cumulative account of individual exposure to drugs of abuse.     

Condom use and its consistency among metropolitan high school students in Croatia, 1997-2001: has anything changed?

Sexually active adolescents face serious health risks associated with unprotected sexual intercourse, such as HIV infection and other sexually transmitted diseases (STDs), as well as unwanted pregnancy. To assess protective behavior among urban adolescents in Croatia we surveyed over 4000 high-school students, 15-19 years of age, in two waves: 2070 in 1997 and 1972 in 2001. The survey was carried out in various types of secondary schools in the capital city. The analyses suggest statistically significant increase in HIVIAIDS related knowledge in the observed period. A slight but significant increase was also observed in the acceptance of condom use. Both changes were more substantial among female students. In regards to protective behavior, we found significant increase in condom use, as well as in its consistency. Still, a large proportion of students did not use condom at last sexual intercourse (40% in 2001). In addition to generational effect, number of sexual partners, sexual victimization and mother's education (only in the case of young women) were identified as correlates of condom use consistency. While mother's education had positive effect, having 4 or more partners and having survived sexual violence decreased the likelihood of consistent condom use. In conclusion, the authors discuss the relevance of systematic school-based prevention of sexual risk taking among Croatian adolescents.     

The determinants of the spread of HIV among injection drug addicts in Ukraine

The main tendencies in the development of drug addiction in the Ukraine, the dynamics of the spread of HIV among drug addicts introducing drugs intravenously, epidemiological data on HIV, AIDS and drug addiction, as well as prognoses on the development of HIV infection are presented. Since 1995 the number of HIV-infected persons grew 34-fold, the number of cases of HIV infection resulting from the intravenous use drugs rose to 70% simultaneously with the rise (about 34-fold) of the number of persons infected with HIV through sexual contacts (about 13 fold). In 1996-1997 such tendency increased. On the whole, the proportion of drug addicts introducing drugs by intravenous injection was 83% in the Ukraine. By April 1, 1998, official registration covered 18,800 HIV-infected persons, including 270 foreign nationals, as well as 499 AIDS patients, including 487 Ukrainian citizens, among them 28 children. Out of 18,800 HIV-infected persons, 78.3% were drug addicts, most of them young people aged 15-30 years; about 18% were young people under 20 years of age, 80% being males. According to the model the rapid spread of HIV from the group of drug addicts to the heterosexual population, the total number of HIV-infected persons reaching 1,500,000 is expected in the country by 2014.     

Inhibition of shoot induction by 5-azacytidine and 5-aza-2′-deoxycytidine in Petunia involves DNA hypomethylation

Shoot bud regeneration from Petunia leaf disks was inhibited when they were cultured with the demethylating agents, 5-azacytidine (AzaC) and 5-aza-2′-deoxycytidine (AzadC), in shoot induction (SI) medium. Explants induced shoot primordia if they were transferred after 1 week from the medium containing the drugs to medium without drugs. The fresh weight of leaf disks cultured on SI medium for 2 weeks in the presence of the drugs was 60–80% lower when compared to control shoot-forming cultures. Internode length was reduced when shoots were transferred to phytohormone-free Murashige and Skoog medium containing the drugs. However, no other morphological abnormalities were seen in these shoots, even at 20 μm AzaC or 5 μm AzadC. Coupled restriction enzyme digestion (with HpaII and MspI) and random amplification of genomic DNA was performed to detect the level of methylation of CCGG sites in the DNA of the explants exposed to AzaC and AzadC. Over 15 amplified bands were detectable in the control. Five of these bands were absent in the amplified products when digested DNA from the drug-treated explants was used as the template, showing that hypomethylation of DNA had occurred. This suggests that inhibition of shoot bud formation in the presence of the drugs AzaC and AzadC may be due to the altered methylation status. Received: 7 January 1997 / Revision received: 17 February 1997 / Accepted: 1 March 1997     

Drinking, substance use and the operation of motor vehicles by young adolescents in Canada

Background

Impaired driving is a recognized cause of major injury. Contemporary data are lacking on exposures to impaired driving behaviours and related injury among young adolescents, as well as inequities in these youth risk behaviours.

Methods and Findings

Cycle 6 (2009/10) of the Health Behaviour in School-Aged Children survey involved 26,078 students enrolled in 436 Canadian schools. We profiled cross-sectionally the reported use of alcohol, marijuana, or other illicit drugs by on-road and off-road vehicle operators when young adolescents (mean age 13.3 (±1.6) years) were either driving or riding as a passenger. Comparisons were made across vulnerable subgroups. Multi-level logistic regression analyses were used to quantify the effects of the driving behaviours on risks for motor vehicle-related injury. Attributable risk fractions were also estimated. A total of 10% (±3%) of participants reported recent operation of an on-road or off-road motor vehicle after consuming alcohol, marijuana, or other illicit drugs, while 21% (±3%) reported riding as a passenger with a driver under the same conditions. Larger proportions of youth reporting these risk behaviours were males, and from older age groups, rural communities, and socio-economically disadvantaged populations. The behaviours were consistently associated with increased risks for motor vehicle-related injury at the individual level (RR 2.35; 95% CI: 1.54 to 3.58 for frequent vs. no exposure as a driver; RR 1.68; 95% CI: 1.20 to 2.36 for frequent vs. no exposure as a passenger) and at the population level (Attributable Risk Fraction: 7.1% for drivers; 14.0% for passengers). The study was limited mainly by its reliance on self-reported data.

Conclusion

Impaired driving is an important health priority among young adolescents in Canada. Inequities in the involvement of younger adolescents in these risk behaviours suggest the need for targeted interventions for specific subgroups such as youth from rural communities, and among socially disadvantaged populations.     

Prevalence and chemosusceptibility of Neisseria meningitidis and Haemophilus influenzae in a population of central Italy

The purpose of this study was to determine the prevalence of nasopharyngeal carriers of Neisseria meningitidis and Haemophilus influenzae, and to evaluate their chemoresistance. N. meningitidis was more frequently isolated in adolescents (10-15 years). All of meningococci were susceptible to ceftriaxone and rifampin, only one isolate showed reduced susceptibility to chloramphenicol and four strains showed reduced penicillin susceptibility. The results show that these drugs are still effective for prophylaxis and treatment in our area. All strains of H. influenzae were susceptible to penicillin, ceftriaxone, chloramphenicol, rifampin, azithromicin and gentamicin. 6 nontypeable strains were resistant to sulfamethoxazole-trimethoprim, 7 strains of type a and c-f, and 3 non-typeable strains showed reduced susceptibility to tetracycline. In contrast with the current trend in the world, in our area the susceptibility of H. influenzae to betalactams was 100%, therefore these antibiotics are still the drugs of choice for treatment of invasive diseases.     

1997-2010年小儿肺炎克雷伯菌耐药性变迁分析

目的 了解1997-2010年肺炎克雷伯菌(KPN)在儿科及新生儿科临床感染中的流行状况及耐药性.方法 收集珠海市妇幼保健院儿科及新生儿科1997-2010年临床痰液标本中分离的肺炎克雷伯菌共633株,分析其对常用抗生素的耐药性.并分析2005年以后产超广谱β-内酰胺酶(ESBLs)与不产ESBLs肺炎克雷伯菌株耐药性的差异.结果 根据14年来该院临床分离的肺炎克雷伯菌药敏试验结果显示,该菌对氨苄西林及哌拉西林的耐药率最高,可达100％.对头孢他啶、头孢吡肟的耐药率各年有波动,但总体无明显变化(分别约28％、34％).对儿科临床限制使用药物如庆大霉素、左旋氧氟沙星、氯霉素、复方新诺明等耐药率呈逐年下降趋势.14年来尚未发现对亚胺培南耐药的KPN.2005年以后产ESBLs菌株的检出率呈逐年增高趋势(17％ ～38.7％),且对各种抗生素的耐药率较普通KPN明显增高.结论 肺炎克雷伯菌对临床常用β-内酰胺类抗生素耐药率高,儿科限制使用药物的耐药率有逐年下降趋势,产ESBLS菌株耐药情况严重.     

The organization of the work to determine antibodies to the human immunodeficiency virus in the Republic of Byelarus

The study revealed that the method of mass screening for the detection of antibodies to HIV antigen, carried out in the Republic till 1993, proved to be economically and diagnostically unjustified. Starting from 1993, the work on the step-by-step reduction of groups to be tested for the presence of antibodies to HIV began. At the same time from 1997 the proportion of tested donors of blood, organs and tissues, as well as persons belonging to high risk groups, increased in comparison with 1993 (from 23.3% to 40% and from 5.3% to 21% respectively). Voluntary and anonymous testing for the presence of HIV infection was organized and legally introduced. In comparison with 1991, in 1997 the number of persons who voluntarily underwent testing increased 3.7 times. The period of transition from mass screening to selective one was noted to have no effect on the detection of HIV-infected persons. Since 1995 the method of "patrol" epidemiological surveillance was also used. 2,118 persons underwent testing, the results of screening were negative. During the period of 3 years the testing of 12,547 young people called up for military service revealed 28 seropositive persons in the region where an outbreak of HIV infection had been registered among addicts using drugs intravenously.     

Propagation of handclasp grooming among captive chimpanzees

A grooming posture previously reported for two wild chimpanzee (Pan troglodytes) communities developed spontaneously in a captive group of the same species. This offered a unique opportunity to follow the propagation of a new social custom. The posture consists of two partners grasping hands—either both right hands or both left hands—and raising the arms in an A-frame above their heads while mutually grooming with their free hands. The propagation of this pattern was followed over a 5 year period. In the beginning, handclasps were always initiated by the same adult female. This female initiated the posture mainly with her adult female kin. In subsequent years, these relatives became frequent participants in the posture with each other as well as with nonrelatives. Over the years the posture increased in frequency and duration and spread to the majority of adults and also to a few adolescents and older juveniles. The pattern persisted after removal of the apparent originator. Am. J. Primatol. 43:339–346, 1997. © 1997 Wiley-Liss, Inc.     

Long-Term Monitoring of Cytogenetic Aberrations in Adolescents of a Large Industrial Town

Long-term cytogenetic monitoring was carried out in adolescents of the town of Kemerovo. In total, aberrant metaphase frequency increased from 1.53% in 1992 to 4.40% in 1996 in Kemerovo adolescents, being significantly higher than a control frequency from 1993 to 1996. In all samples, chromosome aberrations mostly included acentric fragments, while exchanges were rare. The highest number of aberrations per aberrant metaphase was 2 in Kemerovo adolescents and 1 in the control sample. The observed increase in total number of chromosome aberrations suggests that the mutagenic effect of chemical environmental pollutants on Kemerovo adolescents increased over the five years.     

Incidence of anaphylaxis in the emergency department of a general hospital in Milan

Objective: To evaluate incidence and causes of anaphylactic reactions in the emergency room (E.R.) of a general hospital in Milan during a 2-year period. Methods: We retrospectively studied the computerized records of patients discharged from an E.R. with a diagnosis of anaphylactic reaction. Anaphylaxis was established on the presence of at least two cutaneous, respiratory, gastrointestinal or cardiovascular system symptoms. Results: During 1997 and 1998, out of 38 685 patients referred to the E.R., 13 had severe anaphylaxis with loss of consciousness (LOC) and 127 had anaphylactic symptoms, without LOC. Of the 13 patients with LOC, a possible cause was identified in 12 (five foods, six drugs, one hair dye). In the other 127 patients anaphylaxis was related to foods in 49 cases (38.5%), drugs in 44 (34.6%), unknown causes in 29 (22.8%), hymenoptera stings in two (1.5%), and other causes in three (2.3%). Conclusion: The incidence of anaphylactic reactions was 0.4% and mainly affected females and atopic subjects. Foods, particularly fruits and vegetables, appeared to be the most important cause; other important causes were non steroidal antiinflammatory drugs and β-lactam antibiotics.