THEROSCLEROSIS IS THOUGHTto begin in childhood and to develop silently for decades before clinical events such as myocardial infarction or stroke occur. Autopsy studies in children and adolescents have confirmed the presence of preclinical atherosclerotic lesions and shown their associations with antemortem vascular risk factors. [1][2][3] Studies using ultrasound imaging have demonstrated atherosclerotic wall thickening in the arteries of children with risk factors. [4][5][6] Longitudinal studies have shown that risk factor levels measured in childhood are predictive of risk factor levels in adulthood. [7][8][9] Moreover, levels of serum cholesterol measured in young adult men have been associated with cardiovascular disease in midlife. 10,11 Al-

The occurrence of acute otitis media (AOM) has increased steadily during the last 15 years. The possible environmental risks associated with AOM should be well identified to prevent any further increase in its occurrence. A meta-analysis of the studies evaluating the risk factors for AOM was performed. A MEDLINE search of the medical literature from 1966 to 1994 with the key words children, risk, acute otitis media, and recurrent acute otitis media was performed, and the references of the articles that were found served as the sources for the studies used in the meta-analysis. Sixty-one studies were identified. Twenty-two (36%) of these studies were accepted for the meta-analysis. Depending on the risk factor, there were two to seven different studies from which risk ratios (RRs) could be pooled. The studies were performed in six different countries. If any other member of the family had had AOM, the risk increased (RR, 2.63; 95% confidence interval [CI], 1.86-3.72; P = .00001). The risk of AOM increased with day care outside the home (RR, 2.45; 95% CI, 1.51-3.98; P = .0003) and family day care (RR, 1.59; 95% CI, 1.19-2.13, P = .002). The risk of AOM increased with parental smoking (RR, 1.66; 95% CI, 1.33-2.06; P < .00001). Breast-feeding for at least 3 months reduced the risk of AOM (RR, 0.87; 95% CI, 0.79-0.95; P = .003). The use of a pacifier increased the risk of AOM (RR, 1.24; 95% CI, 1.06-1.46; P = .008). Child care outside the home and parental smoking were the factors that most significantly increased the occurrence of AOM

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The hematopoietic-specific transmembrane protein tyrosine phosphatase CD45 functions to regulate Src kinases required for T- and B-cell antigen receptor signal transduction. So far, there have been no reports to our knowledge of a human deficiency in a tyrosine-specific phosphatase. Here, we identified a male patient with a deficiency in CD45 due to a large deletion at one allele and a point mutation at the other. The point mutation resulted in the alteration of intervening sequence 13 donor splice site. The patient presented at 2 months of age with severe combined immunodeficiency disease. The population of peripheral blood T lymphocytes was greatly diminished and unresponsive to mitogen stimulation. Despite normal B-lymphocyte numbers, serum immunoglobulin levels decreased with age. Thus, CD45 deficiency in humans results in T- and B-lymphocyte dysfunction.

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Xylitol sugar, when given in a syrup or chewing gum, was effective in preventing AOM and decreasing the need for antimicrobials.

Respiratory viruses are found commonly during febrile episodes in children with leukemia. The detection of viruses permits the use of available antiviral agents, may explain a poor response to antimicrobial agents, and minimizes the proportion of febrile episodes without possible etiologic agents in children with leukemia.

This report describes the general outline and progress of a multicentre study on risk factors of coronary heart disease and their determinants in children and adolescents. "Cardiovascular Risk in Young Finns" comprises a cross-sectional study of 3 to 18-year old subjects in 1980, and follow-up studies in 1983 and 1986 in various parts of Finland, and in 1989 in one of the study areas (Turku). The number of participants in 1980 was 3596 (83.1%) of those invited. In 1983 and 1986 83.2% and 77.8% of them, respectively, participated. The study programme has comprised questionnaire data on, for example, general health and living conditions, physical activity, eating habits, smoking, and psychological variables. The physical examination covered height, weight, skinfold thickness, pubertal stages and blood pressure. Blood specimens were obtained to assess concentrations of serum lipids and insulin, and in 1986 also for possible genetic markers of hypercholesterolemia. A 48 hour recall on nutrient intake was obtained from some of the subjects. The follow-up studies have enabled a study of the tracking phenomenon. Other important questions under study include, for example, the possible clustering of risk factors and their determinants. The cohorts studied provide a valuable research basis for the future, with emphasis on enabling a long-term follow-up of the subjects.