Comparison of actual (measured) weights and heights with the standard formula methods of estimation among children in Enugu

Background: In paediatric practice, weight and height are required for therapeutic and diagnostic interventions. In some circumstances actual anthropometric measurements are not possible and estimates are used. Several formulae are in use for weight and height estimations. The adequacy of these estimates has not been tested for our children. The aim of the current study was to compare the adequacy of formula methods ofweight and height estimation with measured values in children.Materials and Methods: This was a comparative observational study.Children who met the inclusion criteria were selected consecutively and studied over a two month period using a semi-structured questionnaire.Weight and height of each child were measured and recorded to the nearest 0.1kg and 0.1cm respectively using standard protocols. Weight and height for age were also estimated using the universally accepted formulae. Data were analyzed using SPSS 19.0. Paired t- test was used to compare the means of actual and estimated weights and heights according to age. The level of significance was set at p<0.05.Results: A total of 370 children were studied. They were aged one year two months to 12years. Among children .2 years the measured weights and estimated values showed no significant difference. However, in children3-5years, the estimated weights were significantly lower than the measured weights. There was no consistent relationship for children 7.12 years where a different formula was used to estimate weight. For heights, the estimated values were significantly lower than the measured except for two year oldswhere both where almost similar. Scatter diagrams comparing actual and estimated plots showed linear relationship.Conclusion: The current methods of estimation are underestimating weights and heights of children in our environment. There is need for a multi-centre cohort study to test the various formulae in our children.Key words: Measured, Estimated, Weight, Height, Children

Challenges of childhood obesity in a developing economy: A review

Background: Obesity once considered a high income country’s malady is now on the rise in most developing countries particularly in urban settings. Most of these emerging economies have been reported to have different shades of under – nutrition coexisting side by side with over-nutrition. It is pertinent therefore that we determine the factors driving the increase in obesity rates in developing countries as they generally lack the infrastructure to adequately handle the associated complications.Objectives: This communication is aimed at reviewing the burden and risk factors for obesity in children in developing countries, double burden of malnutrition, challenges including medical as well as economic costs and sustainable preventive programmes of obesity in our environment with the hope of sensitizing both the health community and policy makers of this emerging epidemic.Methods: We searched relevant literature on the subject published only in English language or translated into English language manually and electronically. The Index Medicus, AJOL, Medline, PUBMED, and HINARI were specifically searched for the period between 1980 and 2014 and reviewed. The following key words were applied in the search: Obesity in childhood, its burden and associated risk factors, complications of obesity in childhood, double burden of malnutrition in developing countries, assessment of obesity, childhood challenges of obesity including its direct and indirect costs in developing countries as well as practical preventive models in developing economies.Results: Several relevant studies were identified. The health as well as economic costs of obesity is diverse. Obesity is the major risk factor for a variety of non – communicable diseases including cardiovascular diseases, type 2 diabetes and malignancies in later life. Also obese children have higher risk of orthopaedic problems and psychological disturbances like low -self esteem and bullying. This can also lead to poor social adjustments among our teeming youths who are the bedrock of our future economy. Most of these diseases cause premature deaths in addition to long term morbidities. Many of these obesity associated complications impose substantial burden on the health care system in developing countries with weak health systems, and if allowed unmitigated the implications are that the cost of its care may overwhelm not only the health budget but also affect the provisions of basic social amenities.Conclusions: Preventive programmes have been shown to reduce the burden of obesity in developed countries. Dearth of data on burden of obesity and its associated complications in children and adolescents still a challenge in most developing economies. Efforts should be made to prevent childhood obesity using multi- pronged approach at population level through targeted education, sustainable interventions related to healthy nutritional practices as well as physical activity promotion.Key words: Challenges; Obesity; Children; Developing Economie

Health-related quality of life in school-aged children with and without asthma in Enugu, South East Nigeria

Background: Identifying impaired quality of life is a recognized component of asthma management with no published data in Nigerian children withasthma. The aim of this study was to describe the health-related quality of life of school-aged children with and without asthma seen at the Asthma Clinic of the University of Nigeria Teaching Hospital, Enugu.Methods: Cross-sectional hospital -based study of children aged 7- 17 years (with and without asthma) attending the Paediatric Asthma and General Children Outpatient Clinic of the University of Nigeria Teaching Hospital (UNTH) from parts of the south – east region of Nigeria were consecutively enrolled. Quality of life (QOL) scores were obtained usingthe Paediatric Quality of Life inventory (PedsQLTM) questionnaire which measures the core dimensions of health: physical functioning, emotional functioning, social functioning and school functioning.Results: There were a total of 180 study participants: (90 with asthma and 90 without asthma). Overall quality of life scores for children with asthma was worse than in those without asthma; 75.5, SD19.3 and 82.7, SD14.5respectively (MD 7.1, CI = 2.3 to 12.3, p=0.01). Physical function domain was significantly more affected in asthmatics than nonasthmatics; 73.4, SD 23.2 vs. 84.4, SD17.3 respectively (MD 11.1, CI = 5.0 to 17.1, p=0.002). The psychosocial health summary scores in children with and withoutasthma were 77.6 SD 18.1 vs.81.1 SD15.1 (MD 3.5, CI= -1.4 to 8.4,p= 0.24), with the highest scores obtained in the social functioning domain for both asthma and nonasthma patients; 82.7, SD 20.3 and 87.6, SD 15.7(MD 4.9, p = 0.08) respectively. In both the overall and specificQOL domains, boys had higher scores than girls, irrespective of age or socioeconomic status with an inverse relationship between increasing age and QOL scores (r=-0.2, p=0.07).Conclusions: Children with asthma showed worse QOL and significant impairment in their physical functioning, more noticeable among the female study population. Information obtained from our QOL study forms a basis for a more informed management plan with regards to which age groups are more affected and the specific domains of health in children with asthma that need to be given closer attention to reduce asthma morbidity. The study emphasizes the need for QOL integration in asthmamanagement for a more holistic approach to outcome evaluation oftreatment rather than the physical outcomes

Oseltamivir–Resistant Pandemic H1N1/2009 Influenza Virus Possesses Lower Transmissibility and Fitness in Ferrets

The neuraminidase (NA) inhibitor oseltamivir offers an important immediate option for the control of influenza, and its clinical use has increased substantially during the recent H1N1 pandemic. In view of the high prevalence of oseltamivir-resistant seasonal H1N1 influenza viruses in 2007–2008, there is an urgent need to characterize the transmissibility and fitness of oseltamivir-resistant H1N1/2009 viruses, although resistant variants have been isolated at a low rate. Here we studied the transmissibility of a closely matched pair of pandemic H1N1/2009 clinical isolates, one oseltamivir-sensitive and one resistant, in the ferret model. The resistant H275Y mutant was derived from a patient on oseltamivir prophylaxis and was the first oseltamivir-resistant isolate of the pandemic virus. Full genome sequencing revealed that the pair of viruses differed only at NA amino acid position 275. We found that the oseltamivir-resistant H1N1/2009 virus was not transmitted efficiently in ferrets via respiratory droplets (0/2), while it retained efficient transmission via direct contact (2/2). The sensitive H1N1/2009 virus was efficiently transmitted via both routes (2/2 and 1/2, respectively). The wild-type H1N1/2009 and the resistant mutant appeared to cause a similar disease course in ferrets without apparent attenuation of clinical signs. We compared viral fitness within the host by co-infecting a ferret with oseltamivir-sensitive and -resistant H1N1/2009 viruses and found that the resistant virus showed less growth capability (fitness). The NA of the resistant virus showed reduced substrate-binding affinity and catalytic activity in vitro and delayed initial growth in MDCK and MDCK-SIAT1 cells. These findings may in part explain its less efficient transmission. The fact that the oseltamivir-resistant H1N1/2009 virus retained efficient transmission through direct contact underlines the necessity of continuous monitoring of drug resistance and characterization of possible evolving viral proteins during the pandemic

Dichromatic dark matter

Both the robust INTEGRAL 511 keV gamma-ray line and the recent tentative hint of the 135 GeV gamma-ray line from Fermi-LAT have similar signal morphologies, and may be produced from the same dark matter annihilation. Motivated by this observation, we construct a dark matter model to explain both signals and to accommodate the two required annihilation cross sections that are different by more than six orders of magnitude. In our model, to generate the low-energy positrons for INTEGRAL, dark matter particles annihilate into a complex scalar that couples to photon via a charge-radius operator. The complex scalar contains an excited state decaying into the ground state plus an off-shell photon to generate a pair of positron and electron. Two charged particles with non-degenerate masses are necessary for generating this charge-radius operator. One charged particle is predicted to be long-lived and have a mass around 3.8 TeV to explain the dark matter thermal relic abundance from its late decay. The other charged particle is predicted to have a mass below 1 TeV given the ratio of the two signal cross sections. The 14 TeV LHC will concretely test the main parameter space of this lighter charged particle.University of Wisconsin--Madison (Start-up funds)SLAC National Accelerator Laboratory (US DOE contract DE-AC02-76SF00515)Aspen Center for Physics (NSF Grant No. 1066293)United States. National Aeronautics and Space Administration (Einstein Postdoctoral Fellowship grant number PF2-130102)Smithsonian Astrophysical Observatory (Chandra X-ray Center, NASA under contract NAS8-03060

Analysis of infectious virus clones from two HIV-1 superinfection cases suggests that the primary strains have lower fitness

<p>Abstract</p> <p>Background</p> <p>Two HIV-1 positive patients, L and P, participating in the Amsterdam Cohort studies acquired an HIV-1 superinfection within half a year from their primary HIV-1 infection (Jurriaans <it>et al</it>., <it>JAIDS </it>2008, <b>47:</b>69-73). The aim of this study was to compare the replicative fitness of the primary and superinfecting HIV-1 strains of both patients. The use of isolate-specific primer sets indicated that the primary and secondary strains co-exist in plasma at all time points after the moment of superinfection.</p> <p>Results</p> <p>Biological HIV-1 clones were derived from peripheral blood CD4 + T cells at different time point, and identified as the primary or secondary virus through sequence analysis. Replication competition assays were performed with selected virus pairs in PHA/IL-2 activated peripheral blood mononuclear cells (PBMC's) and analyzed with the Heteroduplex Tracking Assay (HTA) and isolate-specific PCR amplification. In both cases, we found a replicative advantage of the secondary HIV-1 strain over the primary virus. Full-length HIV-1 genomes were sequenced to find possible explanations for the difference in replication capacity. Mutations that could negatively affect viral replication were identified in the primary infecting strains. In patient L, the primary strain has two insertions in the LTR promoter, combined with a mutation in the <it>tat </it>gene that has been associated with decreased replication capacity. The primary HIV-1 strain isolated from patient P has two mutations in the LTR that have been associated with a reduced replication rate. In a luciferase assay, only the LTR from the primary virus of patient P had lower transcriptional activity compared with the superinfecting virus.</p> <p>Conclusions</p> <p>These preliminary findings suggest the interesting scenario that superinfection occurs preferentially in patients infected with a relatively attenuated HIV-1 isolate.</p

Doxorubicin-induced chronic dilated cardiomyopathy—the apoptosis hypothesis revisited

The chemotherapeutic agent doxorubicin (DOX) has significantly increased survival rates of pediatric and adult cancer patients. However, 10% of pediatric cancer survivors will 10–20 years later develop severe dilated cardiomyopathy (DCM), whereby the exact molecular mechanisms of disease progression after this long latency time remain puzzling. We here revisit the hypothesis that elevated apoptosis signaling or its increased likelihood after DOX exposure can lead to an impairment of cardiac function and cause a cardiac dilation. Based on recent literature evidence, we first argue why a dilated phenotype can occur when little apoptosis is detected. We then review findings suggesting that mature cardiomyocytes are protected against DOX-induced apoptosis downstream, but not upstream of mitochondrial outer membrane permeabilisation (MOMP). This lack of MOMP induction is proposed to alter the metabolic phenotype, induce hypertrophic remodeling, and lead to functional cardiac impairment even in the absence of cardiomyocyte apoptosis. We discuss findings that DOX exposure can lead to increased sensitivity to further cardiomyocyte apoptosis, which may cause a gradual loss in cardiomyocytes over time and a compensatory hypertrophic remodeling after treatment, potentially explaining the long lag time in disease onset. We finally note similarities between DOX-exposed cardiomyocytes and apoptosis-primed cancer cells and propose computational system biology as a tool to predict patient individual DOX doses. In conclusion, combining recent findings in rodent hearts and cardiomyocytes exposed to DOX with insights from apoptosis signal transduction allowed us to obtain a molecularly deeper insight in this delayed and still enigmatic pathology of DC

Neural Circuits Underlying Rodent Sociality: A Comparative Approach

All mammals begin life in social groups, but for some species, social relationships persist and develop throughout the course of an individual’s life. Research in multiple rodent species provides evidence of relatively conserved circuitry underlying social behaviors and processes such as social recognition and memory, social reward, and social approach/avoidance. Species exhibiting different complex social behaviors and social systems (such as social monogamy or familiarity preferences) can be characterized in part by when and how they display specific social behaviors. Prairie and meadow voles are closely related species that exhibit similarly selective peer preferences but different mating systems, aiding direct comparison of the mechanisms underlying affiliative behavior. This chapter draws on research in voles as well as other rodents to explore the mechanisms involved in individual social behavior processes, as well as specific complex social patterns. Contrasts between vole species exemplify how the laboratory study of diverse species improves our understanding of the mechanisms underlying social behavior. We identify several additional rodent species whose interesting social structures and available ecological and behavioral field data make them good candidates for study. New techniques and integration across laboratory and field settings will provide exciting opportunities for future mechanistic work in non-model species