Congenital malformations detected in 731 autopsies of children aged 0 to 14 years

A retrospective study of 731 autopsies of children aged 0 to 14 years, performed in the Pathological Anatomy Service of the University Hospital of Porto Alegre from 1977 to 1982, was carried out to determine the frequency, type, and seriousness of congenital malformations. The subjects were divided into five age ranges: stillborn (6), 0 to 24 hours (42), 1 to 30 days (50), 1 to 12 months (24), and 1 to 14 years (9). The malformations were classified as single or multiple (presence of two or more independent defects), and their contribution to death was evaluated. Congenital malformations were detected in 131 autopsies (18%). In most cases the defects were single (91), and the most common ones involved the cardiovascular system (37) and the genitourinary system (21). In the patients with multiple malformations (40), the cardiovascular system (24) and the genitourinary system (19) were also most frequently involved. Defects of the osteoarticular system were also frequently encountered in patients with multiple defects (25), although most of them were deformations caused by mechanical factors. Proportionally, congenital malformations were most frequently detected in the 0 to 24 hours range, which also included the highest proportion of multiple defects in relation to single ones (1:1). Congenital malformations were considered responsible for death in 76% of the 131 cases (87% of the multiple defects patients and 60% of the single defect patients). We believe that the data collected in the present study may contribute to a better understanding of the role played by congenital malformations in child mortality.     

Physical fitness of children aged 5 and 6 years

Maximal oxygen uptake (Vo2 max) of 85 healthy kindergarten children, 46 boys and 39 girls, aged 5 and 6 years, was determined by means of track running. Their physique, skinfold thickness, grip and back muscle strength, and performances of 25 m-run, 50 m-run, standing broad jump, and 5 min-endurance run were also measured. Skinfold thickness of girls was significantly larger than that of boys. Boys were significantly superior to girls in all the motor performances. The Vo2 max per unit of body weight was 49.46 ml/kg/min for boys and 46.30 ml/kg/min for girls, the sex difference being significant at the 0.001 level. The correlation coefficient between Vo2 max per kg body weight and 5 min-endurance run performance was 0.417 for boys and 0.049 for girls, while that between absolute Vo2 max and body weight was 0.899 for boys and 0.563 for girls. The regression equation of the absolute value of Vo2 max (liter/min) on body weight (kg) was: Y=0.051X-0.025 for boys and Y=0.024 + 0.408 for girls, the regression coefficient of boys being twice as large as that of girls. It appears that at ages 5-6 sex differences are exhibited ont only in muscle strength and agility but also in endurance run and aerobic work capacity.     

Relationships between cognitive and motor abilities in female children aged 10-14 years

The aim of the study was to determine cognitive and motor status factors in female children aged 10-14 years and to identify developmental and/or integration functions according to age. The study included a sample of 162 female schoolchildren aged 10-14 years divided into two groups: 84 girls aged 10-12 (X 11.26, SD 0.68) years and 78 girls aged 13-14 (X 13.52, SD 0.63) years. Study results showed a statistically significant between-group difference in the overall system of variables (MANOVA), with the level of significance determined for each individual variable (ANOVA). The older group of subjects showed significantly superior results in comparison with the younger group in the motor tests assessing flexibility, agility, psychomotor speed, explosive strength of throwing type and repetitive strength of the trunk, as well as in the test assessing cognitive functioning. Qualitative differences between the two age groups (prepubertal and pubertal) were determined by use of the matrix of variable inter-correlations factorized by the procedure of principal components that were then transformed to promax solution. The results thus obtained indicated cognitive functioning to take significant part in the motor efficacy of girls aged 10-14 years. In the younger age group (10-12 years), cognitive functioning was related to the motor system that integrates muscle tone regulation and agility/coordination. In the older age group (13-14 years), cognitive functioning was involved in the formation of the first and third factor isolated, i.e. in the factor regulating coordination and intensity of energy mobilization of lower extremities (general motor efficiency) and, to a lesser extent, in third factor regulation the intensity of energy mobilization of upper extremities and trunk strength.     

Prevalence of autoantibodies to endocrine organs in girls with Ullrich-Turner syndrome aged 5-14 years.

Endocrine function tests and a broad panel of autoantibodies to endocrine organs were assessed in 77 patients aged 5-14 years with Ullrich-Turner syndrome (UTS), who were included in the German UTS Multicenter Study. None of these patients had abnormal pituitary, thyroid or adrenocortical function, as assessed by the adequate hormone tests. Antibodies to thyroid microsomes were found in 3 of the 77 (3.9%), antibodies to thyroglobulin in 0/77, antibodies to adrenocortical cells in 1/77 (1.3%), gastric parietal cell antibodies in 2/77 (2.6%), and anterior pituitary cell antibodies in 3/77 (3.9%) probands. These prevalences were not significantly higher than those obtained in 154 age- and sex-matched normal control children when 2 control subjects were assigned to each patient with UTS. Our data do not show an increase in serological signs of endocrine autoimmunity in young patients with UTS suggesting that a putative association of these syndromes does not exist from birth and is not usually present in childhood. However, we cannot exclude the possibility that UTS is associated with factors that render these patients more susceptible to endocrine autoimmunity later in life.     

Passive exposure to tobacco smoke in children aged 5-7 years: individual,family, and community factors.

OBJECTIVE--To examine the importance of parental smoking on passive exposure to tobacco smoke in children and the social and geographical patterns of exposure. DESIGN--Cross sectional study. SETTING--Schools in 10 towns in England and Wales; five towns with high adult cardiovascular mortality and five with low rates. SUBJECTS--4043 children aged 5-7 years of European origin. MAIN OUTCOME MEASURES--Salivary cotinine concentration and parents self reported smoking habits. RESULTS--1061 (53.0%) children were exposed to cigarette smoke at home or by an outside carer. Geometric mean cotinine rose from 0.29 (95% confidence interval 0.28 to 0.31) ng/ml in children with no identified exposure to 4.05 (3.71 to 4.42) ng/ml in households where both parents smoked and 9.03 (6.73 to 12.10) ng/ml if both parents smoked more than 20 cigarettes a day. The effect of mothers'' smoking was greater than that of fathers'', especially at high levels of consumption. After adjustment for known exposures geometric mean cotinine concentrations rose from 0.52 ng/ml in social class I to 1.36 ng/ml in social class V (P < 0.0001); and were doubled in high mortality towns compared with the low mortality towns (P = 0.002). In children with no identified exposure similar trends by social class and town were observed and the cotinine concentrations correlated with the prevalence of parental smoking, both between towns (r = 0.69, P = 0.02) and between schools within towns (r = 0.50, P < 0.001). CONCLUSIONS--Mothers'' smoking is more important that fathers'' despite the lower levels of smoking by mothers. Children not exposed at home had low cotinine concentration, the level depending on the prevalence of smoking in the community.     

Diarrhea caused by enterotoxigenic Bacteroides fragilis in children less than 5 years of age in Hanoi, Vietnam

Enterotoxigenic Bacteroides fragilis (ETBF) are considered as an emerging enteropathogen causing diarrhea in children. Eight hundred and thirty-six (836) children less than 5 years of age including 587 children with diarrhea and 249 age-matched controls were involved in the study. Within the group of children with diarrhea, 7.3% (43/587) ETBF was detected by immunoseparation in combination with polymerase chain reaction. The corresponding figure for the controls was 2.4% (6/249) (P<0.01). Within the diarrhea group, the prevalence was significantly higher in children older than 1 year of age. Three subtypes of ETBF isolates have been identified with the prevalence of 67.4%, 18.6%, and 16% for bft-1, bft-2, and a new bft, respectively. In the controls, two of the subtypes were identified, 5 bft-1 and 1 bft-2. More than half (55.8%) of the samples harboring ETBF also had other identified pathogens. The clinical symptoms of the single ETBF infection were not different from those of co-infections. This is the first study of the role of ETBF in children's diarrhea in Vietnam and it is concluded that this pathogen is an important causative agent of diarrhea in children in Hanoi, Vietnam.     

Bone growth and mineralisation in children aged 4 to 10 years

The relationships between bone width and mineral content and age, sex, height and weight were studied in 420 children aged 4–10 years living in Cambridge using single photon absorptiometry. The relationship of bone width with bone mineral content was significantly different between the sexes after adjusting for differences in body size. In addition, bone width in boys was found to be greater for a given height and weight; changes in weight had a greater effect on bone width in boys than in girls. Prediction equations for bone width and mineral content based on height and weight are given, which should enhance the application of single photon absorptiometry in clinical practice.     

Aluminium, calcium and magnesium content of Hungarian foods and dietary intakes by children aged 3.9 and 14 years

The Al, Ca and Mg content of 147 kinds of foods and beverages, representing a large proportion of the Hungarian diet, has been determined using replicate samples. Dietary intakes of these minerals by 67 kindergarten children and 139 schoolchildren have been assessed. The richest sources of Al were: parsley, celery, gherkins, barley-malt; of Ca: dairy products, celery, parsley, savoy; of Mg: dried beans and peas, parsley, dill, maize-flour, rice, gherkins, chocolate. Flavouring agents (e.g. salt, pepper, paprika, caraway-seed) had very high concentrations of all three minerals and poppy-seeds that of Ca and Mg. The presence of bone-dust or fragments elevated the Ca content of some meats and cooked dishes. The main source of dietary intake of all three minerals was food; as opposed to F, the contribution of water-borne Al, Ca and Mg was negligible. Based on average values, the daily intake of all three minerals was satisfactory in both age groups. Mg intake was marginally below the recommended limit for a few children, but no signs of Mg deficiency were seen.     

青海省2008年15岁以下儿童麻疹抗体水平调查分析

对青海省1～14岁健康儿童麻疹抗体水平进行了调查,抽样分析并评价其预防接种质量.在全省六州一地一市各选择1个县,对1～14岁健康儿童进行抗体检测.结果显示,麻疹疫苗抗体阳性(≥1∶200)率为89.90%,保护率(≥1∶800)为81.91%,几何平均滴度GMT为1∶1551.76.不同性别、民族及年龄间麻疹抗体阳性率和GMT无显著的统计学意义.麻疹疫苗抗体阳性率除化隆县为79.41%外,其它各地均在85%以上,不同地区麻疹抗体阳性率仍有差别,保护率距消灭麻疹尚有较大差距,还应进一步提高疫苗接种率.     

Developmental changes in hierarchical visual stimulus recognition in children aged 5-10 years

Reaction time (RT) and performance accuracy in hierarchical visual stimulus recognition at local and global levels were studied in 95 healthy 5-6, 6-7, 7-8 and 9-10-year-old children and 10 adults. Task performance of all examined subjects, both children and adults, was faster and more accurate during global feature recognition (global advantage effect), with increased RT to incongruent stimuli in local condition (global interference effect). Significant inter-individual differences were found in the youngest group (5-6-year-olds): 7 children from the total number of 37 subjects failed to show the global advantage and global interference effects. Significant progressive shifts in performance accuracy during hierarchical stimulus recognition at both local and global levels were observed in the period between 6-7 and 7-8 years and then between 9-10 years and adulthood. The time course of age-dependent changes in recognition time was different for the global and local features of the hierarchical stimuli: the RT significantly decreased in every successive age group for local feature recognition beginning from 6-7-year-old children, whereas there was no significant difference between 7-8 and 9-10-year-old children in the RT of the recognition of the global feature. In the two younger groups (5-6 and 6-7 years), the stimulus type affected performance in a specific manner: RT increased to both incongruent and neutral stimuli irrespective of the level of the target feature. It was assumed that nonlinear developmental trends in hierarchical stimulus recognition parameters depend on both maturation of visual information processing and development of executive functions, especially those related to selection of relevant signals.     

Study of somatotype in Italian children aged 6 to 10 years

The aim of the present research was to study the variations of somatotype, calculated by the Heath-Carter anthropometric technique, during growth in a sample of children (416 males and 402 females), aged 6 and 10 years, attending primary and secondary schools of L'Aquila and its province (Abruzzo, Italy). The sample was subdivided into “urban” and “non-urban” groups, on the basis of the residence of the children, to examine possible differences in growth related to the different environments. This study give an account of the somatotype components between urban and non urban childreen between the age 6 and 10 years. A tendency toward an increase of endomorphy (adipose component) with age was noticed in both sexes. In females, ectomorphy (component of physical linearity) tended to increase and mesomorphy (muscular-skeletal component) showed a slight decrease during growth, while males exhibited a discontinuous trend. The differences between urban and non-urban children were not significant, although generally higher values of endomorphy and mesomorphy were found in males and females of the urban sample. The differences between the sexes consisted of higher values of endomorphy and lower values of mesomorphy in females. Ectomorphy was similar in the two sexes.     

Factors associated with diarrheal disease among children aged 1–5 years in a cholera epidemic in rural Haiti

Diarrheal illness is a major cause of morbidity and mortality among children in Haiti, and the impact of diarrheal illness was compounded by a cholera outbreak between 2010 and 2019. Our understanding of risk factors for diarrhea among children during this outbreak is limited. We conducted a secondary analysis of data collected as part of a cholera vaccine effectiveness study to identify factors associated with medically attended diarrhea among children in central Haiti from October of 2012 through November of 2016. We identified 47 children aged one to five years old who presented to medical clinics with acute, watery diarrhea, and 166 matched controls who did not have diarrhea, and we performed conditional logistic regression to identify factors associated with diarrhea. Discontinuing exclusive breastfeeding within one month of birth was associated with increased risk of diarrhea (RR 6.9, 95% CI 1.46–32.64), and diarrhea was inversely associated with reported history of supplementation with vitamin A (RR 0.05, 95% CI 0.004–0.56) and zinc (reported among 0% of cases vs. 17% of controls). Because of the concordance in supplementation patterns, it was not possible to attribute the association to vitamin A or zinc independently. While having a respondent who correctly identified ≥3 means of avoiding cholera was associated with reduced risk of diarrhea (RR 0.43, 95% CI 0.19–1.01), reported household sanitation practices and knowledge of cholera were not consistently associated with risk of diarrhea. These findings support ongoing efforts to reduce barriers to breastfeeding and promote pediatric supplementation with vitamin A and zinc in Haiti. Given the reduced efficacy of current oral cholera vaccines (OCV) among children, the results reinforce the importance of breastfeeding and micronutrient supplementation in preventing all-cause pediatric diarrheal illness generally and during cholera outbreaks.     

儿童肺炎链球菌和流感嗜血杆菌耐药及感染特征分析

目的 了解儿童呼吸道感染肺炎链球菌(Streptococcus pneumonia,SP)和流感嗜血杆菌(Haemophilus influenzae,Hi)的分布特征、耐药情况,及耐药菌抗生素间的相互影响,以更合理地指导临床用药.方法 对2009-2010年临床呼吸道感染患儿进行痰、咽拭子或肺泡灌洗液培养分离Hi和SP.因子需求试验鉴定Hi,头孢硝噻酚法检测β-内酰胺酶;奥普托辛和胆汁溶菌试验确认SP.两菌均采用K-B法检测常用对抗生素的耐药性.结果 收集SP 495株,Hi 515株,多见于3岁以下儿童,以呼吸科分离率最高.SP对红霉素、四环素、阿奇霉素、复方新诺明的耐药率分别为98.4％、66.1％、98％和81.6％,其对青霉素敏感性仅为9.5％.Hi有42.7％产生β-内酰胺酶,Hi对氯霉素、复方新诺明、氨苄青霉素、阿奇霉素的耐药率分别为22.1％、21.6％、36.7％和62.7％.与青霉素敏感SP和β-内酰胺酶阴性Hi相比,耐药SP和阳性Hi更易对氯霉素、四环素和复方新诺明耐药.结论 SP和Hi以婴幼儿为主,多见于呼吸科.其耐药情况严峻,青霉素耐药和产β-内酰胺酶菌株会诱导其他抗生素耐药,引发多重耐药.合理使用抗生素以及对两菌的耐药监测应引起高度重视.