Prevalence and risk factors of developmental disabilities among preschool children in the Arab world: a narrative literature review

Purpose@#Developmental disabilities (DDs) are a global childhood problem whose prevalence is rising, with a disproportionate impact on individuals in low-and middle-income countries. However, data on the prevalence of DDs in the Arab world are limited. This review highlights what is currently known about the prevalence and risk factors of DDs in preschool children in the Arab world. @*Methods@#PubMed, Cochrane Library, Scopus, CINAHL, Science Direct, and Google Scholar were searched for publications on DDs among preschool children in the Arab world. Only 14 studies were identified in the literature, from 12 Arab countries. @*Results@#The overall estimated prevalence of DDs among preschool children in the Arab world is 27.5%. An analysis of risk factors for DDs showed that child-related, maternal, and family-related factors account for a significant cumulative risk of developing DDs in preschool children. Maternal factors, such as antenatal and perinatal complications, were the most common risk factors. @*Conclusion@#The prevalence of DDs among preschoolers is significantly high in the Arab world, which emphasizes the importance of the early detection and diagnosis of DD, as well as its associated risk factors.

Molecular characterisation and genetic affinities of Cyclophyllidean cestodes infecting wild rats in Peninsular Malaysia

@#Cestode infections is widely reported in rodents, however species identification remains problematic due to the genetic or interspecies variation. Therefore, this study was aimed to verify the Cyclophyllidean parasites recovered from wild rats captured from different forest types using molecular based methods. Maximum-likelihood (ML) and neighbour-joining (NJ) trees were constructed inferred from 18 small subunit nuclear ribosomal RNA gene (18SrDNA) and mitochondrial cytochrome c oxidase subunit one gene (COX1) sequences of cestode worms recovered from 124 individuals from four rat species. Sequences obtained from both Hymenolepis diminuta and Hydatigera parva represents the first records in Malaysia. All the sequences were successfully amplified with product with total length of 205 and 1202 base pairs (bp), respectively. Three cestode species from the Family Hymenolepididae (Hymenolepis diminuta) and Family Taeniidae (Hydatigera parva; Hydatigera taeniaeformis) were successfully characterized using phylogenetic analyses and haplotype networking. Phylogenetic analysis showed that H. diminuta, Hydatigera parva (Hy. parva) and Hydatigera taeniaeformis (Hy. taeniaeformis) formed its own monophyletic clade in 18SrDNA analyses. Results also showed that Hy. taeniaeformis shared the same haplotype group with Hy. taeniaeformis from China (COX1) and linked with Hy. taeniaeformis from Japan (18SrDNA) while the Malaysian H. diminuta clearly formed a separate haplotype and networked with other regions. The Malaysian Hy. parva isolation, on the other hand, appeared to be genetically distinct from the European Hy. parva (Spain) strain, but closely linked to the local isolates. Molecular methods employed successfully improved in the detection of complex species in this group. The findings showed that molecular data can be useful to deeply study intra-specific variation in other cestode worms.

Enteral myiasis causing acute dysentery: A case report

@#Enteral myiasis or intestinal myiasis is acquired by ingesting food or water contaminated with dipteran fly eggs or larvae. Here, we describe a patient with intestinal myiasis presenting with acute dysentery caused by the larva of Hermetia illucens. The larva was identified morphologically, and its species confirmed through molecular analysis using polymerase chain reaction and sequencing based on mitochondrial cytochrome c oxidase subunit I gene (COI).

Immunotherapy treatment against cervical cancer

ABSTRACT Cervical cancer (CC) is one of the most common gynecological tumors and an important health problem, especially in developing countries. The vast majority of patients in early stages are cured of the disease with surgical treatment and with concomitant chemoradiotherapy in locally advanced stages. However, in patients with recurrent, persistent, or metastatic cervical CC, the effectiveness of treatment is limited, except for the combination of chemotherapy based on platinum doublets plus bevacizumab, the treatment that has achieved the best results to date. Programmed cell death-1/PD ligand-1 (PD-1/PD-L1) inhibitors could be a novel and cutting-edge therapeutic option to improve clinical outcomes in this group of patients. Thus far, there are a few Phase I/II clinical trials that have assessed the usefulness of pembrolizumab and nivolumab in this group of patients; these include the KEYNOTE 028, KEYNOTE 158, and CHECKMATE 358 trials, in which clinical benefit has been proven with PD-1/PD-L1 inhibitors in recurrent, persistent, or metastatic CC, as second-line treatment. There are also some ongoing trials that could provide further evidence on the PD-1/PD-L1 pathway as a therapeutic target in CC. In this review, we will focus on the usefulness of these PD-1/PDL1 inhibitors in CC, as well as on trials that are still in the recruitment phase, to confirm their effectiveness in this clinical setting.

Síndrome neuroléptico maligno inducido por risperidona y facilitado por sepsis de origen urinario: clínica y fisiopatología / Malignant neuroleptic syndrome induced by risperidone and facilitated by sepsis of urinary origin: clinical aspects and physiopathology

La risperidona es un antagonista selectivo monoaminérgico, con una elevada afinidad por receptores dopaminérgicos, que puede producir síndrome neuroléptico maligno (SNM), considerado una emergencia médica con alto riesgo de muerte. Tiene una incidencia de hasta el 3% y su mortalidad está entre el 10 y 20%. Se reporta el caso de una paciente de 56 años, que reunía los criterios clínicos del SNM, inducido por el uso de risperidona y facilitado por una sepsis de origen urinario. El tratamiento se condujo con un agente agonista dopaminérgico y cambio del antipsicótico, procedimientos que resultaron en una adecuada evolución clínica. El SNM es una entidad de baja prevalencia, para la cual existen criterios diagnósticos con especificidad y sensibilidad mayor del 90%, por lo que debe diferenciarse claramente de otras patologías. Se discute el mecanismo mediante el cual la infección urinaria facilitaría la ocurrencia de esta enfermedad. El diagnóstico precoz mejora la respuesta al manejo adecuado que se establezca en cada caso.

Risperidone is a selective monoaminergic antagonist with a high affinity for dopamine receptors that can cause neuroleptic malignant syndrome (NMS), considered a life-threatening medical emergency. It has an incidence of up to 3% and its mortality is between 10 and 20%. The case of a 56-year-old female who met the clinical criteria of NMS, induced by the use of risperidone and facilitated by a sepsis of urinary origin, is reported. It was managed with a dopamine agonist and the change of antipsychotic, which resulted in a favorable clinical course. The NMS is a low-prevalence entity whose diagnosis has specificity and sensitivity greater than 90%, reason for which must be clearly differentiated from other pathologies. The mechanism by which urinary infection could facilitate the occurrence of this disease is discussed. Early diagnosis improves the response to an adequate management to be established in each case.

Evaluation Of The Co-Relation Between The Vertical Dimension Of Occlusion And The Length Of The Right-Hand Palm- An Anthropometric Study

CONTEXT: The accurate determination of vertical jaw relation is extremely important for successfully achieving comfort, function and esthetics for an edentulous patient.AIM:The aim of this study was to find a correlation between vertical dimension of occlusion (VDO) and length of right hand palm.METHODS AND MATERIAL:The study was conducted on 60 dentate subjects (30 Males and 30 Females) who fulfilled the inclusion criteria. Anthropometric measurements of vertical dimension of occlusion and length of right hand palm were recorded. Correlation between VDO and length of right hand palm was studied using Pearson's correlation test and unpaired t test used to find correlation among males and females VDO & right palm.RESULTS:Pearson's correlation test showed that VDO in both males (r=0.8001, p value=000) and females (r= 0.9556, p value=000) has strong coefficient correlation with the length of right hand palm. The study also suggested by unpaired t test that there is no statistical correlation between the males and females VDO (t= -0.3366, p value=0.7377) and length of right palm (t= -0.1046, p value=0.9170)CONCLUSIONS: Within the limitations of this study, it was concluded that for males and female subjects VDO and length of right hand palm was highly correlated and this anthropometric measurement can be used to determine VDO in edentulous patient.

Antitumor effect of thymoquinone combined with resveratrol on mice transplanted with breast cancer

OBJECTIVE@#To test the anticancer potential activity of the combination of thymoquinone (TQ) and resveratrol (RES) against breast cancer in mice.@*METHODS@#The antiproliferative activity of TQ, RES and their combination was assessed against three breast cancer cell lines and one normal cells using MTT assay. The combination index was calculated using isobolographic method. Balb/C mice were inoculated with EMT6/P cells and in vivo antitumor activity was evaluated.@*RESULTS@#The combination therapy also caused significant decrease in tumor size with a percentage cure of 60%. The combination therapy induced geographic necrosis, enhanced apoptosis, and decreased VEGF expression. Serum levels of IFN-γ were elevated in mice treated with combination therapy with no liver or kidney toxicity.@*CONCLUSIONS@#The combination of TQ and RES against breast cancer in mice can work synergistically. The anticancer effect of this combination is mediated by apoptosis induction, angiogenesis inhibition and immune modulation.

Antitumor effect of thymoquinone combined with resveratrol on mice transplanted with breast cancer

Objective To test the anticancer potential activity of the combination of thymoquinone (TQ) and resveratrol (RES) against breast cancer in mice. Methods The antiproliferative activity of TQ, RES and their combination was assessed against three breast cancer cell lines and one normal cells using MTT assay. The combination index was calculated using isobolographic method. Balb/C mice were inoculated with EMT6/P cells and in vivo antitumor activity was evaluated. Results The combination therapy also caused significant decrease in tumor size with a percentage cure of 60%. The combination therapy induced geographic necrosis, enhanced apoptosis, and decreased VEGF expression. Serum levels of IFN-γ were elevated in mice treated with combination therapy with no liver or kidney toxicity. Conclusions The combination of TQ and RES against breast cancer in mice can work synergistically. The anticancer effect of this combination is mediated by apoptosis induction, angiogenesis inhibition and immune modulation.

Serum Sclerostin Levels in Patients with Human Immunodeficiency Virus Infection and Their Association with Bone Turnover Markers and Bone Mineral Densitometry

BACKGROUND: The aim of the study was to compare serum sclerostin levels in human im-munodeficiency virus (HIV)-infected patients and healthy controls, and to evaluate their relationship with bone turnover markers (BTM) and bone mineral density (BMD). METHODS: We prospectively studied 33 HIV treatment-naive patients and 63 healthy individuals; matched for age and sex. Serum sclerostin levels, BTM, BMD were measured. Viral load and cluster of differentiation 4 (CD4) levels were also assessed in HIV-infected patients. RESULTS: The mean+/-standard deviation (SD) age of sample was 37.6+/-10.3 years (range, 19 to 59 years). Of the 96 subjects, 58 (60.4%) were male and 38 (39.6%) were female. Infection with HIV is associated with significant reduction in serum sclerostin levels (HIV-infected: 39.4+/-28.3 vs. non HIV: 76.6+/-15.7 pmol/L; P0.05). CONCLUSIONS: These findings suggest that untreated HIV and the resulting immune deficiency and/or systemic inflammation could be an important regulator of serum sclerostin in this population.

Knowledge, Attitude and Practices Concerning Cosmetic Surgery among Female Medical Students at the University Hospital, King Saud University, Riyadh, Saudi Arabia.

Background: This study investigates the knowledge, attitudes and practices of cosmetic surgery among female medical students at King Saud University (KSU). Methods: A quantitative observational cross-sectional approach was used to carry out the study at the KSU College of Medicine. A web-based questionnaire was first developed to collect the data necessary to fulfill the objectives of the research. The population under study included a random sample in which the questionnaire was sent to all female medical students at KSU. The sample size was estimated by using a single proportion formula with an acceptable margin of error at 5%. The sample size obtained was 384. Results: A response rate of 99% was achieved. The mean age of the participants was 20.9±1.48.Out of 381 KSU female medical students in our study, almost all participants (360, 94.5%) have heard about cosmetic surgery. Television was the source of knowledge for more than one third (38%) of participants who had already heard about cosmetic surgery. Just over half (51.4%) of surveyed KSU female medical students recognized the best definition of cosmetic surgery as “a surgery that modifies or improves the appearance of a physical feature electively”. A great majority of participants (86%) reported knowing of a particular type of cosmetic surgery, namely breast augmentation. Almost all participants (92.4%) agreed that “women perform more cosmetic surgery than men”. Only 9% of participants reported undergoing cosmetic surgery, where most of them (19 out of 35) went through laser treatment for the skin and almost the same number had a cosmetic surgery for personal satisfaction. Conclusion: From this research, we recommend further studies to go beyond educational institutions to the public at large, and to study different sub-populations.

Relationship between coronary risk factors, c-reactive protein, bone mineral density and carotid circulation among frail elderly

Frailty may now be regarded as a geriatric syndrome of decreased reserve and resistance tostressors, resulting from cumulative declines across multiple physiologic systems, causing vulnerability toadverse health outcomes including falls, hospitalisation, institutionalisation and mortality. Theinflammatory mediators as C-reactive protein have been associated with the development of the geriatricfrailty. Several studies have pointed out increased level of homocystiene in frail elderly Increasing frailtywas associated with lower bone mineral density, as both bone mass and muscle strength decrease duringageing and this has also been associated with higher risk of osteoporotic fractures in frail elderly. To compare frail and non-frail elderly regarding Bone mineral density, carotid circulation andserum levels of Homocysteine, coronary risk factors and CRP. 104 elderly patients, who were assigned to 2 groups. Group A [52 frail participants]:diagnosed byFried's criteria as applied byAvila-Funes et al., 2008. Group B [52 non-frailparticipants].All participants were subjected to the following: through history, physical examination,ADL, IADL assessment, MMSE ,GDS, laboratory investigations including; CRP, homocystiene and totallipid profile, measurement of bone mineral density by DEXA and carotid intima-media thickness bycarotid duplex. There was no statistically significant difference in age, sex, among both groups.Frail participantshad higher ADL and IADL dependence, higher incidence of depression, cognitive impairment andosteoprosis.They also had higher levels of homocystiene, CRP, CIMT and lower levels of HDLcholesterol. Osteoporosis is more prevalent among frail elderly also frailty is associated with more ADL and IADL dependence, higher GDS scores and lower MMSE score in addition to higher mean level ofhomocystiene, CRP and triglycerides in addition to low serum HDL and higher CIMT

Evaluation of two enrichment broths, three plating media and ELISA technique for the isolation of salmonella from dairy products

Salmonella is one of the most important food-borne pathogens that can be transmitted through the consumption of contaminated milk and milk products. Early detection of Salmonella in food is important for food safety. Two selective media, brilliant green agar [BGA] and xylose lysine desoxycholate [XLD] agar are commonly used in diagnostic laboratories for the isolation of Salmonella, often after enrichment of the samples in a broth before plating on the solid medium. Recently, a new medium called CHROmagar Salmonella [CAS] has become available for the rapid detection of Salmonella. In the present study, we compared this new medium with BGA and XLD for the isolation of Salmonella from 160 dairy products samples [80 ice cream and 80 kariesh cheese samples] with enrichment in Rappaport- Vassiliadis [RV] and tetrathionate [TT] broth. TECRA Unique Salmonella ELISA test was used. Only one sample was positive for Salmonella, which appeared on each of CAS and XLD agars, after enrichment using RV but not TT. This was associated with a sensitivity and specificity of [100%, 92.45%], [100%, 93.71%] and [0%, 100%] for each of CHROmagar Salmonella, XLD and BGA respectively. TECRA Unique Salmonella test yielded the highest sensitivity and specificity among all used methods; it had 100% sensitivity with 100% specificity

Bacteriological quality of some dairy products [Kariesh cheese and ice cream] in Alexandria

The present study estimated the total viable bacterial density, total and faecal coliforms, and E. coli in Kariesh cheese and ice cream. The study included 160 ice cream and Kariesh cheese samples [80 samples each]. Ice cream samples were 47 packed [33 cup and 14 stick] and 33 open samples while Kariesh cheese samples were 62 open, 18 packed samples [8 of known brand and 10 of unknown brand]. Samples were collected from supermarkets, shops and street vendors. All samples were analyzed for enumeration of total viable heterotrophic bacteria using standard pour plate method, and for the determination of the total coliforms, fecal coliforms and E. coli using multiple tube dilution method. Ice cream samples, showed that the total bacterial count was >/= 1.5x105 cfu/g in 26 [32.5%] samples, total coliforms were >/= 10 MPN/g in 36 [45.0%] samples, fecal coliforms were detected in 45 [56.3%] samples, and E. coli was detected in 34 [42.5%]. Kariesh cheese samples, showed a total coliforms of >/= 10 MPN/g in 54 [67.5%] samples, while fecal coliforms were detected in 64 [80%] samples, and E. coli was detected in 60 [75%]. It is recommended to use and implement immediate regulatory measures like good manufacturing practices as well as distribution and retail storage practices for ensuring microbiological safety of ice cream and Kariesh cheese

Transplante cardiaco en niños: reporte del primer caso atendido en la Fundación Cardiovascular de Colombia / Cardiac transplantation in children: report of the first case treated in the Colombian Cardiovascular Foundation

En los últimos años, el trasplante cardiaco ha mejorado sustancialmente la calidad de vida y la sobrevida de los niños con enfermedad cardiaca terminal. En la actualidad, es un procedimiento rutinario en centros especializados; sin embargo, pese a los numerosos avances, existen complicaciones a largo plazo, como el rechazo tardío, la enfermedad vascular del injerto y los desórdenes linfoproliferativos que limitan la sobrevida y la calidad de vida (2). Estas limitaciones podrían disminuirse con la identificación oportuna de los donantes potenciales, lo cual permite disponer de órganos de mejor calidad, el mejoramiento del soporte al donante, un adecuado sistema de transporte y de preservación de los órganos, la actualización y el mejoramiento de los protocolos de manejo, y la utilización de nuevos fármacos.

During the last years, cardiac transplantation has substantially improved survival and life quality in children with terminal heart disease. It is actually a routine procedure in specialized centers. Nevertheless, in spite of the numerous advances, there are long-term complications, such as late rejection, implant vascular disease and lymphoproliferative disorders that limit survival and life quality (2). These limitations could be diminished by an opportune identification of the potential donors, allowing best quality organs disposal, improvement of donor support, adequate transport and preservation system, updating and improvement of treatment protocols and new medicines utilization. The scarce donors’ availability obliges the implement of strategies tending to sensitize the community on the need of adopting a culture of organs’ donation. In order to achieve the treatment’s goals, to offer an integral rehabilitation and to have a prompt reincorporation to society of the transplanted patient, educational programs and multidisciplinary support are required, not only for the patients, but also for their families.

Mortalidad quirúrgica de la corrección de cardiopatías congénitas en la Fundación Cardiovascular de Colombia: 2000-2005 / Surgical mortality in the correction of congenital heart disease at the Colombian Cardiovascular Foundation: 2000-2005

Antecedentes: la cirugía cardiaca se reconoce como uno de los mayores logros de la medicina. En las últimas décadas, ha experimentado enormes progresos en relación con el perfeccionamiento de las técnicas quirúrgicas, anestésicas y de cuidado crítico, técnicas que en conjunto han permitido corregir de manera oportuna y definitiva la mayoría de cardiopatías congénitas.Objetivo: describir el porcentaje de mortalidad quirúrgica institucional de los pacientes intervenidos por cardiopatías congénitas según su nivel de complejidad (Pediatric Cardiac Care Consortium RACHS-1 - based method for Risk Adjusment for Surgery congenital Heart disease).Métodos: estudio descriptivo de corte transversal. Se revisaron las historias clínicas de los pacientes intervenidos mediante cirugía para corrección de cardiopatías congénitas de enero de 2000 a octubre de 2005. Se contemplaron las siguientes variables: grupo etáreo, clasificación del riesgo del procedimiento y número de muertes operatorias.

Background: Cardiac surgery is recognized as one of the biggest achievements in medicine. In the last decades, it has experienced enormous progresses through the improvement of the surgical, anesthetic and critical care techniques that have allowed the correction of most of the congenital cardiac defects opportunely and definitively. Method: To describe the percentage of institutional surgical mortality of patients operated for cardiac congenital defects according to the complexity level (Pediatric Cardiac Care Consortium RACHS-1 - based method for Risk Adjusment for Surgery congenital Heart disease). Results: Between January 2000 and October 2005, 1132 patients were operated. The surgical mortality accumulated in the described period was 7.2%, 7.8% in 2000, 13.8% in 2001, 6.5% in 2002, 7.9% in 2003, 5.1% in 2004 and 3.9% in 2005. The mortality by category of risk was 1.8% in the category 1, 4.8% in the category 2, 11.8% in the category 3, 11.5% in the category 4, 0% in the category 5 and 50% in the category 6. Conclusions: In the last six years, an important decrease in pediatric mortality due to cardiovascular surgical procedures has been observed. Maintaining an adequate register in the long term will allow the systematic analysis of the survival performance (tendencies) which will permit to establish comparisons with the main reference centers worldwide.

Mutations in CFTR gene and clinical correlation in argentine patients with congenital bilateral absence of the vas deferens

Correlación de las características clínicas con mutaciones del gen CFTR en pacientes argentinos con ausencia bilateral congénita de vasos deferentes. La ausencia bilateral congénita de vasos deferentes (CBAVD) es una forma de infertilidad masculina en la que se han identificado mutaciones en el gen de la conductancia transmembrana de la fibrosis quística (CFTR). Hemos estudiado en pacientes argentinos diferentes mutaciones en el CFTR y la variante poli T del intron 8 (IVS8) y analizado los valores de test del sudor y las características clínicas relacionadas a la Fibrosis Quística (FQ). Para el asesoramiento genético se han estudiado en las esposas de estos pacientes, las dos mutaciones más frecuentes en la población FQ del país, ∆F508 y G542X. Como no se encontraron mutaciones, el riesgo de descendencia CF/CBAVD fue reducido del 2 al 0.7%. Ocho pacientes (23%) presentaban test del sudor anormales (> 60 mmol/l). Un segundo grupo de 6 pacientes (18%) presentaron valores dudosos (40-59 mmol/l). Hemos definido un tercer grupo de 6 pacientes con valores normales de test del sudor (18%), comprendidos entre los 30 y 39 mmo/l, y un cuarto grupo de 14 pacientes (41%) con valores de cloruro en sudor inferiores a 30 mmol/l. La mutación más frecuente en la población CF argentina, ∆F508, fue encontrada en 15 de los 72 cromosomas (21%) analizados, la R117H fue encontrada en 2 de los 62 cromosomas estudiados (3%). Un único alelo R347P fue encontrado en los 28 cromosomas analizados (2%). De los 27 pacientes a los que se les estudió el tracto IVS8, 6/56 cromosomas (11%) presentaban el alelo 5T. Si bien estos hallazgos representan un avance en relación a la detección de mutaciones correlacionadas con los síntomas clínicos en la población CBAVD argentina, se debe continuar la búsqueda de otras mutaciones comunes y raras con el fin de establecer una conducta terapéutica en estos pacientes.

Diagnóstico laboratorial do hiperparatireoidismo primário / Laboratory diagnosis of primary hyperparathyroidism

O hiperparatiroidismo primário (HPP) é uma endocrinopatia muito freqüente. A elevaçäo do cálcio sérico é via de regra um marcador do estado de autonomia paratiroidiana, o que faz com que a hipótese de HPP seja investigada em todos os pacientes que apresentem hipercalcemia. Níveis de PTH aumentados ou inapropriadamente normais na vigência de uma hipercalcemia säo fortemente sugestivos de HPP. Por outro lado, é extremamente improvável levantar uma hipótese de HPP na ausência de hipercalcemia. A dosagem de cálcio ionizado tem a vantagem de näo sofrer influência dos níveis de proteína sérica. Os métodos atuais para dosagem de PTH (ensaios imunorradiométricos e imunoquimioluminométricos) säo voltados para a medida da molécula "intacta", mas reconhecem näo só o PTH 1-84, como o fragmento 7-84. Recentemente, ensaios que medem apenas o chamado PTH bioativo (PTH 1-84) tornaram-se disponíveis comercialmente. Nos casos de hipercalcemia humoral maligna, os níveis de PTH säo indetectáveis, o que facilita muito o diagnóstico diferencial com HPP na maioria dos casos. Apesar das dosagens de cálcio e de PTH serem suficientes e necessárias para o diagnóstico de HPP, outros exames complementares säo úteis para a caracterizaçäo das possíveis complicaçöes de HPP com conseqüentes implicaçöes para a avaliaçäo da decisäo a ser tomada (indicaçäo cirúrgica ou apenas observaçäo e monitorizaçäo clínica e laboratorial periódica). Estes exames incluem avaliaçäo da funçäo renal, calciúria de 24 horas, ultrassonografia renal e de vias urinárias e densitometria óssea.

Bone density in survivors of childhood acute leukemia and malignant lymphomas

This study aimed to assess bone mineral density in survivors of childhood acute leukemia and malignant lymphomas to determine the prevalence of osteoporosis and identify the possible predisposing factors and patients at the greatest risk of reduced bone mineral density. The study included 41 survivors [27 patients had acute lymphoblastic leukemia and 14 patients had malignant lymphomas]. In conclusion, 60.9% of the survivors of childhood leukemias and lymphomas had decreased BMD, osteoporosis being especially severe in 17.1% of these patients. In view of the risk of fractures among patients with osteoporosis, the survivors of childhood malignancy were at an increasing risk of bone fractures later in life irrespective of the underlying cause of osteoporosis, thus the intervention should be considered for prevention and proper management

Growth pattern of primary schoolchildren in Benghazi, Libya

To fi nd the growth trends in a sample of schoolchildren in Benghazi [Libya], and to compare it with international and other local growth charts, as a step for setting the national curves. From 25th February to 31st October 1993, a sample of 2,022 pupils [1,160 boys and 862 girls] were randomly selected from three public primary schools in three different socio-economic areas in Benghazi. A questionnaire consisting of social and scholastic items was distributed to teachers a few days before the examination. The height and weight of all the pupils were measured according to the standards of Jellife, Gorstein, WHO, and de Onis. Data were analyzed and compared with both the reference standard of the United States National Center for Health Statistics [NCHS-USA], and the local standards of Tripoli-1986. The boys and girls in the lowest age-group had a pattern similar to that of the reference population for both height/age and weight/age, but it dropped sharply from mid-school years. The Benghazi curves were consistently higher than those of Tripoli, particularly for height/age. The nutritional status of these children, which was good before the beginning of schooling, was negatively affected during the school years. This could be attributed either to births in the family and consequent neglect, or to the school-s negative effects on the child, such as lack of appetite created by anxiety or other factors. Further studies from dif ferent regions of the country are needed to set national growth curves

El parto pretérmino: detección de riesgos y tratamientos preventivos / Preterm delivery: prevention through risk detection and treatment

Todos los años nacen en el mundo alrededor de 13 millones de niños prematuros. La mayor parte de esos niños nacen en países en desarrollo y constituyen el componente principal de la morbilidad y la mortalidad perinatales. En el presente estudio de revisión se analizaron los datos científicamente validados sobre las intervenciones que se emplean con la intención de evitar al menos una parte de los partos pretérmino y disminuir su impacto en la salud neonatal. Se consultaron las bases de datos Biblioteca Cochrane y Medline y se estudiaron 50 trabajos de revisión y artículos de investigación relacionados con el tema del parto pretérmino en sus siguientes aspectos: factores de riesgo y detección precoz del riesgo de parto pretérmino; prevención de la amenaza de parto pretérmino; tratamiento del parto pretérmino iniciado, y prevención del síndrome de dificultad respiratoria neonatal. Se encontraron pocos medios ensayados con éxito para predecir, prevenir o detectar precozmente la amenaza de parto pretérmino. Solo el tamizaje y tratamiento de la bacteriuria asintomática pueden recomendarse para todas las embarazadas como parte del control prenatal. El tamizaje de la vaginosis bacteriana y su tratamiento ulterior y el cerclaje profiláctico reducen, respectivamente, la incidencia de nacimientos adelantados en embarazadas con antecedentes de parto prematuro y en las que tienen antecedentes de más de tres partos pretérmino. Como tratamiento del parto iniciado antes de tiempo, con o sin rotura prematura de membranas, las intervenciones que han mostrado eficacia son la administración de betamiméticos a la parturienta para prolongar por 48 horas el período de latencia del parto y de indometacina con el mismo objetivo como medicamento de segunda elección. La administración prenatal de corticoides a la embarazada puede inducir la maduración pulmonar del feto y reducir el síndrome de dificultad respiratoria y la hemorragia ventricular, reduciendo así la mortalidad neonatal. Se recomienda continuar y apoyar las investigaciones básicas y epidemiológicas sobre la prevención para adquirir más conocimientos sobre las causas y mecanismos del parto pretérmino y cómo prevenir la morbilidad y mortalidad que produce

Every year around the world some 13 million premature children are born. Most of these children are born in developing countries, and they account for the largest share of perinatal morbidity and mortality. This review study analyzed scientifically validated data on interventions to prevent at least some portion of these preterm deliveries and to lessen their impact on neonatal health. The Cochrane and MEDLINE bibliographic databases were consulted. Fifty review pieces and research articles were studied, relating to the following aspects of preterm delivery: risk factors and early detection of the risk of preterm delivery; preventing the risk of preterm delivery; treating preterm delivery once it has begun; and preventing neonatal respiratory distress syndrome. There were few successful approaches to the prediction, prevention, or early detection of the threat of preterm delivery. The only measures that can be recommended for all pregnant women are screening for and treating asymptomatic bacteriuria as a part of prenatal check-ups. Screening for bacterial vaginosis and treating it reduce the incidence of preterm births in pregnant women with a history of premature delivery. In addition, prophylactic cerclage decreases the incidence of premature births in pregnant women who have had more than three preterm births. To treat a delivery that starts early, with or without premature membrane rupture, the interventions that have proved to be effective are administering betamimetics to the parturient woman in order to delay delivery for 48 hours, and using indomethacin for the same purpose, as the second-choice drug. The prenatal administration of corticosteroids to the pregnant woman can induce lung maturation in the fetus and reduce respiratory distress syndrome and ventricular hemorrhage, thus decreasing neonatal mortality. There is a need to continue and support basic and epidemiological research in order to develop new knowledge on the causes and mechanisms of preterm delivery and on preventing the morbidity and mortality that preterm delivery produces