Anorexia Nervosa Complicating Pediatric Crohn Disease—Case Report and Literature Review

Crohn disease and anorexia nervosa share common symptoms of weight loss and reduced oral intake. The prevalence of both disorders has increased over time. Symptoms of Crohn disease and anorexia nervosa can mimic each other leading to a delayed diagnosis and requiring complex, multidisciplinary management. Here we present a case of a 15 year old girl with Crohn disease who subsequently developed anorexia nervosa, and review the published literature on the occurrence of both diagnoses

Neonatal outcomes following elective caesarean delivery at term: a hospital-based cohort study

<div><p></p><p><i>Objective</i>: To assess neonatal outcomes following elective caesarean delivery (CD) at term (≥37 + 0 weeks gestation).</p><p><i>Methods</i>: A retrospective cohort study was conducted in a single Irish maternity hospital. Elective CDs at term between August 2008 and July 2012 were reviewed. Outcome measures were admission to the neonatal intensive care unit (NICU), length of stay, respiratory complications, hypoglycaemia, jaundice, newborn sepsis and medical interventions.</p><p><i>Results</i>: A total of 4242 women had an elective CD at term, accounting for approximately 15% of all term deliveries. Admission rate to the NICU at 37 weeks gestation was 21.8% versus 10% at 39 weeks (<i>p</i> for trend <0.0001). Similar trends of decreasing risk with later gestational age were noted for the other outcomes. An increased odds of admission to the NICU at 37 weeks [adjusted odds ratio (OR) 2.48 (95% CI 1.28, 4.79)] and at 38 weeks [OR 1.34, 95% CI 1.02, 1.77] compared to the reference of 39 weeks gestation was found.</p><p><i>Conclusions</i>: This study supports evidence that, with regard to neonatal outcome, 39 weeks gestational age is the optimal delivery time. Heightened awareness of the increased risk of neonatal morbidity, when delivery is performed electively before 39 weeks, is warranted among healthcare workers.</p></div

Health and environmental impacts of pesticide use practices: a case study of farmers in Ekiti State, Nigeria

Commonly used pesticides and handling practices which might expose farmers and their environment to chemical hazards were investigated in the Irepodun/Ifelodun local government area of Ekiti State, Nigeria. Direct field observations and answers to a structured questionnaire from a random sample of 150 farming households showed that commonly used pesticides comprised herbicides (48.3 per cent), fungicides (28.2 per cent) and insecticides (23.5 per cent). Of these, 86.7 per cent are classified as ‘highly’ hazardous by the World Health Organization (WHO) and have been banned or restricted in many developed countries. Nearly all of the farmers (94.7 per cent) had received no formal training in safe pesticide use and mixed different products. Farmers suffered from discomforts ranging from eye irritation (91.3 per cent), skin problems (87.3 per cent), nausea (86.0 per cent), headache (83.3 per cent) and vomiting (58.0 per cent). More than half of the pesticide applicators (61.3 per cent) sprayed pesticides near water bodies. Only a few farmers reported decreasing trends in numbers of beneficial insects (27.3 per cent) and other animals (29.3 per cent). The results showed that the awareness of farmers and authorities needs to be raised regarding the use of protective equipment and correct procedures when handling pesticides and, also, that there should be stricter enforcement of existing pesticide regulation and monitoring policies to minimize the threats that the farmers’ current practices pose to their health and to the environment

mRNA or ChAd0x1 COVID-19 vaccination of adolescents induces robust antibody and cellular responses with continued recognition of omicron following mRNA-1273

Children and adolescents generally experience mild COVID-19. However, those with underlying physical health conditions are at a significantly increased risk of severe disease. Here, we present a comprehensive analysis of antibody and cellular responses in adolescents with severe neuro-disabilities who received COVID-19 vaccination with either ChAdOx1 (n=6) or an mRNA vaccine (mRNA-1273, n=8, BNT162b2, n=1). Strong immune responses were observed after vaccination and antibody levels and neutralisation titres were both higher after two doses. Both measures were also higher after mRNA vaccination and were further enhanced by prior natural infection where one vaccine dose was sufficient to generate peak antibody response. Robust T-cell responses were generated after dual vaccination and were also higher following mRNA vaccination. Early T-cells were characterised by a dominant effector-memory CD4+ T-cell population with a type-1 cytokine signature with additional production of IL-10. Antibody levels were well-maintained for at least 3 months after vaccination and 3 of 4 donors showed measurable neutralisation titres against the Omicron variant. T-cell responses also remained robust, with generation of a central/stem cell memory pool and showed strong reactivity against Omicron spike. These data demonstrate that COVID-19 vaccines display strong immunogenicity in adolescents and that dual vaccination, or single vaccination following prior infection, generate higher immune responses than seen after natural infection and develop activity against Omicron. Initial evidence suggests that mRNA vaccination elicits stronger immune responses than adenoviral delivery, although the latter is also higher than seen in adult populations. COVID-19 vaccines are therefore highly immunogenic in high-risk adolescents and dual vaccination might be able to provide relative protection against the Omicron variant that is currently globally dominant