1 LaPorte R. Assessing the human condition: capturerecapture techniques. BM_ 1994;308:5-6. 2 Hook EB, Regal RR. The value of capture-recapture methods even for apparent exhaustive surveys. The need for adjustment for sources of ascertainment intersection in attempted complete prevalence studies. Am J Epidemiol 1992;135:1060-7 Iron is involved in the metabolism of several neurotransmitters, and monoamine and aldehyde oxidase are reduced in iron deficiency anaemia4, which is common during the second and the third year of life and has been associated with behavioural and development disturbances.' Thus we investigated the association between iron deficiency anaemia and febrile seizures by a case-control study. Patients, methods, and resultsAll 156 children aged 6-24 months admitted to Castellammare di Stabia Hospital, Naples, between 1 January 1993 and 30 June 1995 with diagnosis of febrile convulsions were enrolled in the study. They were healthy children without previous afebrile seizures or central nervous system disease. A febrile convulsion was defined as a seizure that occurred while the child had a rectal temperature of at least 38.3°C or an axillary temperature of at least 37.8°C documented either in the emergency department or in the history. Tvo groups of controls were selected: a random sample of children admitted to the same ward with diagnosis of respiratory and gastrointestinal infection during that period, and a group of healthy children randomly selected from the provincial birth register for an iron deficiency survey in Greater Naples during 1994.Routine haematological investigations were performed for hospitalised patients at hospital admission and for population controls at the Department of Paediatrics of Naples. Data were collected from clinical records by two medical students unaware ofthe study hypothesis.Iron deficiency anaemia was defined as the presence of haemoglobin concentration <105 g/l, mean corpuscular volume <70 fl, and serum iron concentration of <5.4 nmol/l. In our population of this age group the prevalence of anaemia is about 10%; we assumed that a prevalence of 20-25% among cases would be clinically relevant. Relative risk was calculated by odds ratio and 95% confidence interval by Cornfield's method.No differences in distribution of gender, maternal age and education, birth weight and type of birth were found among study groups. Mean age was 15 (SD 5.6) months for cases, 12.4 (5) months for hospital controls, and 13 (2) months for population controls. Anaemia was significantly more common in cases (30%) than hospital (14%) and population (12%) controls (table 1). CommentThe association between iron deficiency anaemia and febrile seizures has not been described before, and chance or unknown confounding are possible explanations. None the less, selection bias as well as confounding by social class do not seem likely in this study.Fever can worsen the negative effects of anaemia or of iron deficiency on the brain and a seizure can occur as a consequence. Alternatively, anaemi...
Twenty-seven subjects suffering from peripheral occlusive arterial disease (POAD, clinical stage II-III according to Fontaine) were enrolled in this study to evaluate the effect of oxygen-ozone therapy upon hemorheological parameters and hemoglobin-oxygen affinity in patients with POAD. All patients underwent a major ozonized autohemotransfusion consisting of the slow reinfusion of 100 ml of autologous blood, previously exposed to a O(2)-O(3) mixture in a glass box for 10 min. Whole blood viscosity, erythrocyte filterability, hematocrit, and fibrinogen levels were assessed at the basal time and 30 min after the reinfusion of ozonized blood. At the same time p50 standard (p50std) values (an indicator of hemoglobin-oxygen affinity) and plasma values of malonyl dialdehyde (MDA, an indicator of lipid peroxidation) were evaluated. At the baseline, patients had significantly higher ( p<0.05- p<0.001) whole blood viscosity, MDA, and p50std values and significantly lower blood filterability ( p<0.01) as compared with 20 matched healthy volunteers (controls). Thirty minutes after the end of a major autohemotransfusion, whole blood viscosity significantly decreased ( p<0.01). This was accompanied by a significant fall in plasma fibrinogen level ( p<0.01) with no change in hematocrit. Blood filterability, MDA plasma level, and p50std values increased significantly at the same time ( p<0.01- p<0.005). The 2,3-DPG value did not change significantly. No significant changes occurred when the same patients received a non-ozonized autohemotransfusion (control test). In conclusion, ozonized autohemotransfusion may be useful to improve both the poor rheological properties of the blood and the oxygen delivery to tissues in patients suffering from POAD.
The association between breast feeding and acute lower respiratory infection (ALRI) was studied in a case-control study in southern Italy. Two groups of children were studied: the first group comprised 73 infants, aged 0-6 months, whose diagnosis was pneumonia or bronchiolitis; the second group included 88 infants less than 12 months of age with a diagnosis of pertussis-like illness. Control infants were two groups of infants admitted to the same ward. Compared with controls, infants in the first group were less likely to have been breast fed (odds ratio 0.42, 95% CI 0.19-0.90). The protection conferred by breast feeding was stronger among infants who were receiving human milk at the time of admission (odds ratio 0.22, 95% CI 0.09-0.55) and was absent among those infants who had stopped breast feeding for two or more weeks before admission. Among infants who were severely ill, breast feeding was less likely than among those with milder illnesses. There was evidence in the stratified analysis of effect modification by the presence of other children in the family. Among the infants with pertussis-like illness, the incidence and duration of breast feeding were not different compared with controls. The results suggest that breast feeding has a strong protective effect against ALRI in industrialized countries also. No protection seems to be conferred by human milk against pertussis-like illness.
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