Persistent measles infection in malnourished children.

Thirty malnourished and 25 well-nourished children were studied six to 31 days after the onset of a measles rash. Evidence of the virus was found in 40% of the malnourished children but in none of the well-nourished controls. Giant cells were found in the nasal secretions of five out of 17 malnourished children and measles antigen was detected in the lymphocytes of eight out of 28. The malnourished children showed depressed cell-mediated immunity to measles and candida antigens and a low response to meningococcal vaccine. Fifteen died from intercurrent infections. Malnutrition was thought to have depressed the immune response in these children, resulting in a severe and prolonged attack of measles. This, in turn, led to further damage to the immune system and more severe malnutrition. Thus these children were made susceptible to intercurrent infection.     

Response of bone and enamel formation to nutritional supplementation and morbidity among malnourished Guatemalan children

The effects of changes in nutritional and health status upon bone and enamel development are examined in a sample of 63 rural Guatemalan children (24 females, 39 males). The number of ossified hand-wrist centers at 3 years and the number of linear enamel hypoplasias (LEH) in ～0–3 year zones of developing teeth were used to monitor the response of bone mineralization and enamel matrix formation to illness and nutritional supplementation. Numbers of ossified centers and LEH were compared across sex, supplementation, and morbidity groups. Enamel matrix secretion responded positively to increased supplementation. Children who received less than 34.25 kcal/day in supplement had more LEH than those who received more supplement. No differences in ossification status were found between supplementation groups. These data suggest that enamel formation may be more sensitive to changes in nutritional status than is bone mineralization. Disruptions of bone and enamel formation were both associated with frequent illness. Children who were ill more than 3.6% of the time had more LEH and fewer ossified hand-wrist centers than children who were less frequently ill. Conclusions regarding relative environmental sensitivity must take into account the specific aspects of dental and skeletal development examined. © 1993 Wiley-Liss, Inc.     

Usefulness of circadian amplitude of blood pressure in predicting hypertensive cardiac involvement.

Twenty-four-hour blood pressure (BP) profiles of 56 patients diagnosed as 'hypertensive' by WHO criteria were analyzed by the fit of a 24-hour cosine curve according to the single cosinor method. A left ventricular mass index (LVMI) was also assessed by two-dimensional echocardiography on each patient as a gauge of target organ involvement. LVMI and the BP MESOR correlates positively for systolic, S (r = 0.324), mean arterial, MA (r = 0.334) and diastolic, D (r = 0.267) BP (P less than 0.05), yet no statistically significant linear correlation between LVMI and the circadian BP amplitude (one-half of predictable change) was found. When a second-degree polynomial regression was fitted to the circadian BP amplitudes, an association was found (SBP: R2 = 0.138, P = 0.02; MAP: R2 = 0.167, P = 0.01; DBP: R2 = 0.128, P less than 0.01). The corresponding curves were characterized by peaks in the circadian amplitudes of SBP, MAP and DBP around a value of LVMI between 110 and 120 g/m2. For further scrutiny, three subgroups had been formed on the basis of literature, a priori with respect to the LVMI (group 1: LVMI less than 100); group 2: 100 less than LVMI less than 130; group 3: 130 less than LVMI). For MESORs, there was no difference between groups 1 and 2, whereas the MESOR of group 3 were larger than the other two groups. The circadian BP amplitudes of group 2 were larger than those of the other two groups for SBP, MAP and DBP. An increasing LVMI precedes a definitive increase of BP MESOR and coincides with an increase in the circadian BP amplitude; thus an increase in extent of circadian changes can alert the self-monitoring population of a target organ involvement.     

Plasma fibronectin levels in acute and recovering malnourished children

58 malnourished children (mean age 18 months) with a clinical diagnosis of marasmus or kwashiorkor were studied with respect to plasma fibronectin levels, plasma total solids, spun hematocrits, heights, weights, mid-arm circumferences, and head circumferences. Bimodal distributions were demonstrated for plasma fibronectin versus weight deficits, total solids, hematocrits, and mid-arm circumference in children 12 months of age and older (p less than 0.003 for all). The mean plasma fibronectin level for controls was 253 micrograms/ml. The mean level for the malnourished group was 96 micrograms/ml (p less than 0.0001). Malnourished children with initial plasma fibronectin levels above 100 micrograms/ml had a higher survival rate than those with levels less than 100 (92 versus 69%). With successful therapy, plasma fibronectin levels rose quickly in most children often before detectable changes were noted in clinical and other laboratory parameters. An overshoot of the mean normal levels was observed with successful treatment wherein the mean levels rose to 315 micrograms/ml (p less than 0.05). Plasma fibronectin determinations on malnourished children can serve as an important prognostic marker as well as a reliable indicator of successful therapy and recovery.     

Differential gene expression in lymphocytes from malnourished children

Malnutrition, which is widespread in developing countries, may be particularly devastating during childhood, when tissue development is occurring and nutrient requirements are great. Since protein-energy malnutrition potentially involves many cellular alterations, we have evaluated gene expression changes in lymphocytes from malnourished children using differential hybridization cloning. A cDNA library was generated from well-nourished children and differential screenings were performed with cDNAs obtained from well-nourished and malnourished children who presented with bacterial gastrointestinal infections. Differential expression was detected for genes involved in cell development and differentiation, and for genes involved in lymphocyte and mitochondrial functions. The genes detected in the present study suggest mechanisms for the changes in cell growth and immune function that are associated with protein-energy malnutrition. Two down-regulated genes in malnourished children may represent mechanisms of protection against immunosuppression. This finding clearly merits further investigation.     

Famine in southern Ethiopia 1985-6: population structure,nutritional state,and incidence of death among children.

OBJECTIVE--To assess the effects of drought on mortality in children. DESIGN--Prospective epidemiological study forming part of nutritional monitoring during famine relief work. SETTING--24 Food distribution sites in Arero and Borana provinces in southern Ethiopia. PATIENTS--A monthly average of 14,173 and 5,334 children under 5 were examined in 1985 and 1986, respectively. Altogether 148,966 child months (105,872 for 1985 and 43,094 for 1986) were available for analysis. INTERVENTION--The families of all children were supplied with food each month. Basic medical care was also provided. MAIN OUTCOME MEASURE--Mortality in children under 5. RESULTS--A 40% increase in crude mortality was observed among children living in traditional and stable societies. The severe consequences were observed mainly among children living in relief shelters, where a threefold to fourfold increase in crude mortality was recorded among children. Increased childhood mortality was also associated with high prevalence of malnutrition, living in the most arid areas, and the dry season. A long period of food aid was needed to normalise the nutritional state, especially for children living in relief shelters. CONCLUSIONS--The most severe consequences of the widespread famine that occurred in the Arero and Borana provinces of southern Ethiopia during 1985-6 were seen among children living in relief shelters. Early food intervention may decrease the scale of migration and thus also reduce the severe consequences of a famine.     

Anthropometric indices and nutritional deficiency signs in preschool children of the Pahariya tribe of the Rajmahal Hills, Bihar

The nutritional status of preschool children of the three sects of the Pahariya tribe (Rajmahal Hills, Bihar) was studied with the help of anthropometric indices like weight for age, height for age, weight for height und nutritional deficiency signs. The correlation between age and nutritional indices showed that the relationship was significant for % expected weight for age in the male children of all the three sects; r = +0.70 in Saurias, r = +0.32 in Mals and r = -0.72 in Kumarbhags (p > 0.01). Significant relationships were also observed in the correlations between weight for height in both sexes. Based on height for age and weight/height2 (Body Mass Index, BMI), 89% of the children of the Saurias, 92% of the Mals and 93% of the Kumarbhags were malnourished. Height for age of 50% of the children of the Pahariyas were below the 3rd percentile or below 90% of the Harvard standard. Chronic and current severe forms of malnutrition (i.e. height for age below 3rd percentile of standard and BMI 13.5) was highest in the Kumarbhags (17.5%). According to the modified Waterlow's classification chronic and current severe forms of malnutrition (i.e. height for age below 3rd percentile of the National Centre for Health Statistics, NCHS, and weight for height less than 80% of the standard) was highest in the Saurias (21.6%) and least in the Kumarbhags (15.4%). Kwashiorkor and marasmus for all the children of the Pahariyas ranged between 0.5-1.4% and 1.5-5.2%, respectively. Associated with signs of Protein Caloric Malnutrition (PCM), like moon face, dyspigmentation, sparseness and easy pluckability were more prevalent in all the three sects of the Pahariyas. Ocular manifestation of vitamin-A deficiency like conjunctiva xerosis and Bitos' spots were also frequent among these children.     

Reduced secretory antibody response to live attenuated measles and poliovirus vaccines in malnourished children.

Serum and nasopharyngeal IgA antibody levels were estimated in 20 malnourished children and 20 matched healthy controls after immunization with a single dose of live attenuated measles or poliovirus vaccine. Seroconversion and serum neutralizing antibody titres were comparable in the two groups. Secretory IgA antibody was detected significantly less often in undernourished children; the time of its first appearance was delayed-and its maximum level was significantly lower. Impaired secretory antibody response in malnourished children may contribute to slow inadequate recovery from viral and enterobacterial infections and predispose to lifethreatening complications.     

Self-similarity in biological classifications.

Size distributions of supraspecific taxa, e.g. genera, measured as the number of included subtaxa, e.g. species, are found to follow a power law. This behaviour has been verified for a number of taxa of different size and taxonomic rank, thus suggesting a fractal structure of biological classifications. This is regarded as probably dependent on evolutionary processes shaping the phylogenetic tree, especially speciation and extinction, as well as on the topological properties of developmental constraints and/or of the ecospace(s) with which the group has been confronted during its history. The role of taxonomic bias is deemphasized.     

Screening Rastafarian children for nutritional rickets.

We examined 42 Rastafarian children under 5 years of age who were registered with a single inner city general practice to determine the prevalence of nutritional rickets. Twenty children were receiving a strict vegan(I-tal) diet and were considered to be at high risk of developing rickets and were referred for biochemical and radiological investigation. Seven of 20 children investigated had rickets, giving an overall prevalence of 7/42. Treatment with oral cholecalciferol was successful in all seven children. Fourteen out of 18 children had evidence of iron deficiency, with low haemoglobin concentrations and hypochromic-microcytic blood films. Before this study Rastafarian children rarely attended the well baby clinic, received no vitamin supplements, and few had been immunised. They now regularly attend the clinic, receive vitamin and iron supplements, and all have completed primary immunisation.     

Soil-transmitted helminth infections and nutritional indices among Filipino schoolchildren

BackgroundSoil-transmitted helminth (STH) infections are still prevalent among schoolchildren in the Philippines. We evaluated the risk factors associated with STH and the relationship between STH and nutritional indices among schoolchildren aged 9–10 years in Laguna province, the Philippines.MethodsWe used the baseline data from 40 schools enrolled in a randomised controlled trial of the Magic Glasses Philippines health education package. Data on demographic and socio-economic variables, and STH related knowledge, attitudes and practices, were obtained through a questionnaire. Stool samples were collected and assessed for STH egg presence using the Kato-Katz technique. Haemoglobin levels and height and weight of study participants were also determined. The generalized estimating equations approach was used to construct logistic regression models to assess STH-associated risk factors, and the association between any STH infection and anaemia, child stunting, wasting and being underweight. The trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12616000508471).FindingsAmong 1,689 schoolchildren, the prevalence of any STH was 23%. The prevalence of anaemia, stunting, being underweight and wasting was 13%, 20.2%, 19% and 9.5%, respectively. Age, socio-economic status, rural/urban classification of schools and knowledge of STH were significant risk factors for acquiring a STH infection. Moreover, infections with any STH were significantly associated with stunting (P = <0.001) and being underweight (P = <0.003), but not wasting (P = 0.375) or anaemia (P = 0.462) after controlling for confounding covariates.ConclusionThe study findings emphasise the need for sustainable deworming in tandem with other measures such as the provision of health education, improvements in sanitation and hygiene, and nutritional programs in order to control STH infections and improve morbidity outcomes in schoolchildren.Trial registrationAustralian New Zealand Clinical Trials Registry (ACTRN12616000508471).     

Biometeorological and autoregressive indices for predicting olive pollen intensity

This paper reports on modelling to predict airborne olive pollen season severity, expressed as a pollen index (PI), in Córdoba province (southern Spain) several weeks prior to the pollen season start. Using a 29-year database (1982–2010), a multivariate regression model based on five indices—the index-based model—was built to enhance the efficacy of prediction models. Four of the indices used were biometeorological indices: thermal index, pre-flowering hydric index, dormancy hydric index and summer index; the fifth was an autoregressive cyclicity index based on pollen data from previous years. The extreme weather events characteristic of the Mediterranean climate were also taken into account by applying different adjustment criteria. The results obtained with this model were compared with those yielded by a traditional meteorological-based model built using multivariate regression analysis of simple meteorological-related variables. The performance of the models (confidence intervals, significance levels and standard errors) was compared, and they were also validated using the bootstrap method. The index-based model built on biometeorological and cyclicity indices was found to perform better for olive pollen forecasting purposes than the traditional meteorological-based model.     

Selenium, copper, and zinc indices of nutritional status

The objective was to estimate the possible influence of season or season and sex on the selenium, glutathione peroxidase (GSH-Px), copper, zinc, and superoxide dismutase (SOD) values in plasma with a view to establishing reference values. For this purpose, 55 healthy volunteers (36 women and 19 men) were selected and their whole-blood samples were collected four times a year at the beginning of each season. In the population as a whole, no statistically significant seasonal differences were detected in copper, selenium, and GSH-Px values in plasma, whereas zinc and SOD values in plasma depended on the season. In general, the variability was higher among the women. In view of the differences detected according to sex and/or season in the parameters studied, we recommend taking samples from men and women and from different seasons to establish reference values.