Febrile convulsions in a national cohort followed up from birth. I--Prevalence and recurrence in the first five years of life.

Of 13 135 children followed up from birth to the age of 5 years, 303 (2.3%) had febrile convulsions. Prior neurological abnormality had been noted in 13. Of the 290 remaining children, 57 (20%) presented with a complex convulsion, and 103 children (35%) went on to have further febrile convulsions. The risk of further febrile convulsions varied with the age at first convulsion and the presence of a history of convulsive disorders in relatives. There were no significant differences between the sexes.     

Complications of ileal cannulation in cats.

BACKGROUND AND PURPOSE: The anatomic position of the ileum is such that use of simple, noninvasive sampling techniques is difficult. Sampling of ileal contents by use of a cannula provides information about those contents-digestibility and fermentation patterns; however, complications with use of cannulas in horses and dogs have been reported. Therefore, cats were chosen as a laboratory model in which to study ileal cannulation. METHODS: Simple T-piece cannulas were surgically placed in the ileum of six adult cats. RESULTS: Postsurgical complications included cannula displacement and leakage, with subsequent abscessation and skin inflammation. Owing to these complications, the cannulas were removed from four of the six cats. Similar complications developed after removal of the cannulas. In the only attempt to collect a sample, obtaining a 0.5-ml sample of ileal fluid from one cannula took 3 h. Of the six cats, four died or were euthanized. CONCLUSION: Use of cannulas is not a viable technique of collecting ileal fluid samples in cats.     

Invasive cancer of the cervix in women with mild dyskaryosis followed up cytologically.

Mildly dyskaryotic smears are common, and women with such results are often followed up with further cervical smear tests. An important consideration in evaluating this practice would be the annual incidence of invasive cervical cancer. A reanalysis of five previous studies of the cytological follow up of women with mildly abnormal smear test results was undertaken to calculate this incidence. The annual incidence of invasive cancer in these women ranged from 0 to 420 per 100,000 women years. The large studies providing the most precise estimates had annual rates of 143 to 420 per 100,000 women years. This is 16 to 47 times greater than in women aged 15-34 years in England and Wales. The average rate was 208 per 100,000 women years. Women with mild dyskaryosis are at high risk of developing invasive cervical cancer despite cytological follow up. A full appraisal of the costs and benefits of colposcopy in this situation is urgently required.     

Mortality in two radom samples of women aged 55-64 followed up for 20 years.

Two random samples of women aged 55-64 living in the Vale of Glamorgan and the Rhondda Fach were followed up for 20 years. In each sample heights, weights, serum cholesterol concentrations, and specific causes of death were noted and the Quetelet index (weight/height2) calculated. The two samples were combined for analysis of total mortality. In the combined sample there was a strong positive association between Quetlet index and both total mortality and mortality from ischaemic heart disease. Multiple logistic regression analysis showed that both of these associations were significant, as was the strong positive association between Quetelet index and mortailty from ischaemic heart disease in the samples considered separately. There was no significant association between cholesterol concentration and mortality from ischaemic heart disease in each sample. There was a small negative association between cholesterol concentration and both total mortaility in the combined sample and ischaemic heart disease in the Rhondda Fach sample. These results suggest that the Quetelet index is important for prognosis, whereas the serum cholesterol concentration is not.     

Febrile convulsions in a national cohort followed up from birth. II--Medical history and intellectual ability at 5 years of age.

Three hundred and three children with febrile convulsions were identified in a national birth cohort of 13 135 children followed up from birth to the age of 5 years. Breech delivery (p less than 0.05) was the only significantly associated prenatal or perinatal factor. There were no associations with socioeconomic factors. Excluding the 13 known to be neurologically abnormal before their first febrile convulsion, children who had had a febrile convulsion did not differ at age 5 from their peers who had not had febrile convulsions in their behaviour, height, head circumference, or performance in simple intellectual tests.     

HLA types in women with cervical human papillomavirus (HPV) lesions prospectively followed up for 10 years

Certain genotypes of HPV have been recently implicated in the etiology of carcinoma of the uterine cervix. In order to determine whether HLA antigen‐controlled immunoregulatory functions have a role in the pathogenesis of HPV infections, class I and II HLA antigen typing was carried out on a series of 96 randomly selected women who were part of a cohort of 530 women prospectively followed up for cervical HPV infections in our clinic since 1981. The frequency of the DQ3 antigen, which has previously been reported to be increased among cervical cancer patients, was decreased in our HPV patients compared with the control group of Finnish women, but it was slightly increased in HPV16‐infected women ( P =0.0812). However, we were able to demonstrate that HLA‐DR5 antigen is significantly increased (i) in patients with high grade cervical intraepithelial neoplasia (CIN) ( P <0.02), and (ii) in women harbouring the high risk HPV type 16 ( P =0.0003), thus confirming earlier reports of an association of this HLA antigen and cervical cancer. Such a close association between the high risk HPV type 16 with an HLA antigen might have important implications in the possible immunogenetic basis of the increased risk for squamous cell carcinoma of the uterine cervix.     

Screen detected high blood pressure under 40: a general practice population followed up for 21 years.

OBJECTIVE--To assess hypertension detected under 40 in a general practice population. DESIGN--Prospective case-control study. SETTING AND SUBJECTS--Former coal mining community in south Wales. Systematic case finding for hypertension and associated risk factors applied to a mean total population of 1945 from age 20 on a five year cycle through 21 years. Mean population aged 20-39, 227 men and 213 women. Case criteria: age < 40 and mean systolic pressure > or = 160 mm Hg or diastolic pressure > or = 100 mm Hg. Age and sex matched controls randomly sampled from the same population. MAIN OUTCOME MEASURES--Mean initial pressures and pressures at follow up in 1989 or preceding death, and all cardiovascular events. RESULTS--25 men and 16 women met criteria. Estimated five yearly inceptions were 26/1000 for men and 18/1000 for women. Male group mean initial blood pressure was 164/110 mm Hg for cases, falling to 148/89 mm Hg at follow up. Five male cases died at mean age 47.8, compared with two controls at 49.5. Female group mean initial pressure was 172/107 mm Hg for cases, falling to 145/86 mm Hg at follow up. One female case died aged 50, no controls. 10 male cases had non-fatal cardiovascular events at mean age 40.2, compared with two controls at mean age 50.5. Four female cases had non-fatal events at mean age 47.2, compared with one control aged 58. Male differences were statistically significant. CONCLUSIONS--Hypertension under 40 is dangerous, commoner in men than women, rarely secondary to classic causes, and may be controlled in general practice on a whole community basis.     

The preservation of bovine erythrocytes frozen in liquid nitrogen and stored at -170°C for up to five years

Bovine erythrocytes were frozen in liquid nitrogen and stored at —170°C for five years. Every criterion investigated revealed that no significant deterioration had occurred over the long storage period.     

A study of occlusion in elderly Japanese over 80 years with at least 20 teeth

Objectives: The purpose of this study was to identify the occlusal status of elderly Japanese over 80 years with at least 20 teeth. Materials and methods: The study enrolled 76 elderly Japanese (44 male, 32 female) with a mean age of 82 years and an average of 25.7 remaining teeth. The study consisted of intra‐oral examination, intra‐oral and facial photographs, radiographs and impressions for study casts. Results: No gender difference was observed in age or number of remaining teeth. Anteroposterior occlusal relationship was characterised by maxillary protrusion in 67.6%, acceptable overjet in 31.0%, and anterior crossbite in 1.4%. Vertically, deep bite was noted in 33.8%, acceptable overbite in 64.8%, and open bite in 1.4%. Most of the subjects had either Angle class I (68.4%) or class II (25.7%) canine relationship. Only 3.9% of the subjects had upper anterior crowding. Lower anterior crowding was observed in 23.7%, but tended not to be severe. Conclusion: These results indicate that Japanese who attained the goal of ‘8020’ have a relatively good occlusion.     

Single endemic genotype of measles virus continuously circulating in China for at least 16 years

The incidence of measles in China from 1991 to 2008 was reviewed, and the nucleotide sequences from 1507 measles viruses (MeV) isolated during 1993 to 2008 were phylogenetically analyzed. The results showed that measles epidemics peaked approximately every 3 to 5 years with the range of measles cases detected between 56,850 and 140,048 per year. The Chinese MeV strains represented three genotypes; 1501 H1, 1 H2 and 5 A. Genotype H1 was the predominant genotype throughout China continuously circulating for at least 16 years. Genotype H1 sequences could be divided into two distinct clusters, H1a and H1b. A 4.2% average nucleotide divergence was found between the H1a and H1b clusters, and the nucleotide sequence and predicted amino acid homologies of H1a viruses were 92.3%-100% and 84.7%-100%, H1b were 97.1%-100% and 95.3%-100%, respectively. Viruses from both clusters were distributed throughout China with no apparent geographic restriction and multiple co-circulating lineages were present in many provinces. Cluster H1a and H1b viruses were co-circulating during 1993 to 2005, while no H1b viruses were detected after 2005 and the transmission of that cluster has presumably been interrupted. Analysis of the nucleotide and predicted amino acid changes in the N proteins of H1a and H1b viruses showed no evidence of selective pressure. This study investigated the genotype and cluster distribution of MeV in China over a 16-year period to establish a genetic baseline before MeV elimination in Western Pacific Region (WPR). Continuous and extensive MeV surveillance and the ability to quickly identify imported cases of measles will become more critical as measles elimination goals are achieved in China in the near future. This is the first report that a single endemic genotype of measles virus has been found to be continuously circulating in one country for at least 16 years.     

Residence at 3,800-m altitude for 5 mo in growing dogs enhances lung diffusing capacity for oxygen that persists at least 2.5 years.

Mammals native to high altitude (HA) exhibit larger lung volumes than their lowland counterparts. To test the hypothesis that adaptation induced by HA residence during somatic maturation improves pulmonary gas exchange in adulthood, male foxhounds born at sea level (SL) were raised at HA (3,800 m) from 2.5 to 7.5 mo of age and then returned to SL prior to somatic maturity while their littermates were simultaneously raised at SL. Following return to SL, all animals were trained to run on a treadmill; gas exchange and hemodynamics were measured 2.5 years later at rest and during exercise while breathing 21% and 13% O(2). The multiple inert gas elimination technique was employed to estimate ventilation-perfusion (Va/Q) distributions and lung diffusing capacity for O(2) (Dl(O(2))). There were no significant intergroup differences during exercise breathing 21% O(2). During exercise breathing 13% O(2), peak O(2) uptake and Va/Q distributions were similar between groups but arterial pH, base excess, and O(2) saturation were higher while peak lactate concentration was lower in animals raised at HA than at SL. At a given exercise intensity, alveolar-arterial O(2) tension gradient (A-aDo(2)) attributable to diffusion limitation was lower while Dlo(2) was 12-25% higher in HA-raised animals. Mean systemic arterial blood pressure was also lower in HA-raised animals; mean pulmonary arterial pressures were similar. We conclude that 5 mo of HA residence during maturation enhances long-term gas exchange efficiency and Dl(O(2)) without impacting Va/Q inequality during hypoxic exercise at SL.     

Trends in undernutrition mortality among children under five years of age and adults over 60

Introduction: Children under five years of age living in poor areas and with low availability of healthy food have a higher risk of undernutrition-related mortality. However, this relationship has not been well established among older adults.Objective: To analyse socioeconomic inequality trends related to undernutrition mortality in children under five years of age and adults over 60 in Colombian municipalities during 2003-2009 and 2010-2016.Materials and methods: We conducted an ecological study of trends between 2003 and 2016. The study population consisted of children under five years of age and adults over 60 residing in the Colombian municipalities during the study period. We estimated smoothed and standardized mortality rates by fitting a hierarchical Bayesian model and explored their relationship with five socioeconomic area-level variables.Results: In most of the municipalities, undernutrition-related mortality was three times higher in older adults compared to children. Moreover, the difference in the risk of undernutrition-related mortality between municipalities showed a marked reduction. Finally, the poor and less developed municipalities had higher rates of undernutrition-related mortality in children; conversely, wealthier territories had higher rates in older adults.Conclusions: Although in most of the municipalities the mortality rates due to undernutrition in children under five and older adults have decreased, their socioeconomic conditions influence in different ways the risk of mortality for these two populations so there is the need to develop age-specific strategies to close social gaps considering the structural conditions of the areas.