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Biomedical subjects

G Alperstein

Publications and source records attributed to G Alperstein.

33 records · Page 2Linked to original sources
PubMed1996

Iron status and anaemia in preschool children in Sydney.

The purpose of this study was to determine the iron status of preschool children in Sydney. We assessed 678 children aged 9 to 62 months living in 32 randomly selected census collection districts in central and southern Sydney for iron status using plasma ferritin; of these 678 children, 542 had zinc protoporphyrin tests, red cell indices and haemoglobin tests. Risk factors for iron deficiency were assessed by an administered questionnaire. Overall, the prevalence of iron depletion was 10.5 per cent, iron deficiency 2.8 per cent and iron deficiency anaemia 1.1 per cent. The 24-to-35-month age group (176 children) had the highest prevalence of iron deficiency anaemia of 3.0 per cent although iron depletion (18.7 per cent) and iron deficiency (5.4 per cent) were highest among the 9-to-23-month age group (182 children). Low iron status was related to age of under 24 months (odds ratio (OR) 2.86,95 per cent confidence interval (CI) 1.72 to 4.76). After adjustment for this age effect, the consumption of red meat fewer than four times a week was significantly associated with iron depletion (OR 2.27, CI 1.25 to 4.17) and there was a tendency for children who were being given a vitamin supplement to be less likely to be iron depleted (OR 4.00, CI 0.95 to 16.67). Iron deficiency and iron deficiency anaemia do not represent a major public health problem in preschool children in Sydney. However, for children in the age range of 12 to 36 months there is scope for interventions to further reduce the prevalence of iron deficiency anaemia.

Anemia, Iron-Deficiency↗
PubMed1996

Prevalence of tuberculosis infection among primary school-entry children in Sydney.

A cross-sectional survey of 2044 Year I children enrolled in 24 primary schools was performed to determine the prevalence of tuberculosis (TB) infection. Of the 2044 children, 1458 (71 per cent) were Mantoux-tested and 1452 Mantoux reactions were read. Of the total, 6.5 per cent were Mantoux-positive; 17.8 per cent of overseas-born children and 2.8 per cent of Australian-born children were Mantoux-positive (relative risk for overseas-born 6.9, 95 per cent confidence interval 4.2 to 9.6). In the areas of Sydney where the study was conducted, there is a high prevalence of TB infection (non-contagious) among overseas-born children in the five- to seven-year age group. This indicates that there may be a large pool of infected children, a proportion of whom are at risk of developing active (contagious) adult-type TB in the future. These data, with other published data on TB infection rates in other age groups, can contribute to the estimation of the size of the infected pool in Australia to allow rational decisions regarding control of TB in Australia, including the possibility of introducing Mantoux screening and preventive therapy programs for high-risk groups.

BCG Vaccine↗
PubMed1994

The prevalence of tuberculosis infection among Year 8 schoolchildren in inner Sydney in 1992.

OBJECTIVE: To determine the prevalence of tuberculosis (TB) infection in Year 8 schoolchildren (aged 12-14 years) in Sydney. DESIGN: Cross-sectional survey. SETTING: 22 inner city Sydney secondary schools. PARTICIPANTS: 2290 Year 8 school children enrolled in 1992. OUTCOME MEASURES: Distribution of Mantoux test reaction size and proportion of children who were Mantoux positive (i.e., having Mantoux reaction > or = 15 mm with previous Bacille Calmette-Guérin vaccination; > or = 10 mm without). RESULTS: Of the 2290 children, 1836 (81%) were screened and 1801 Mantoux reactions were read. Ten per cent of children were Mantoux positive--27% of foreign-born children and 2% of Australian-born children (relative risk 16.7, 95% confidence interval 10.6-26.4). Two children were found to have active TB disease. CONCLUSION: There is a high prevalence of primary (non-contagious) TB infection in children aged 12-14 years in inner Sydney, mostly confined to children born overseas. Thus there is a large pool of infected children at risk of developing active (contagious) adult-type TB disease in the future. This public health problem should be addressed by identification and treatment of those infected.

Adolescent↗
PubMed1992

Community prevalence survey of children's blood lead levels and environmental lead contamination in inner Sydney.

OBJECTIVE: To determine the distribution of blood lead levels in preschool children in inner Sydney and identify possible sources of environmental lead. DESIGN: Cross sectional community based prevalence survey of children and the houses in which they live, and a survey of volunteer children. SETTING: Mort Bay and Summer Hill, residential localities in inner Sydney. PARTICIPANTS: Ninety-five children aged 9-48 months able to be identified in a defined geographic area and 63 children aged 9-48 months volunteered by their parents. OUTCOME MEASURES: Concentrations of lead in venous blood of all children and in samples from the home environment of Mort Bay children. RESULTS: Four of the children (2.5%) had blood lead levels > or = 1.21 mumol/L (25 micrograms/dL, the current Australian threshold of concern), 27 (17.1%) had levels > or = 0.72 mumol/L (15 micrograms/dL, the new US threshold for individual intervention) and 80 (50.6%) had levels > or = 0.48 mumol/L (10 micrograms/dL, the new US threshold for community intervention). Blood lead concentrations were significantly correlated with concentrations of lead in "sink" soil (r = 0.555, P = 0.026), play area soil (r = 0.492, P = 0.016) and dust from vacuum cleaners (r = 0.428, P = 0.05), and with age of child (r = -0.182, P = 0.023). The presence of the child during house renovation was a strong predictor of having a blood lead level above 0.72 mumol/L (15 micrograms/dL) (odds ratio, 4.6; 95% confidence interval, 1.8-11.7, P = 0.001). CONCLUSIONS: Lead in soil and in household dust in older areas of Sydney is likely to represent a significant health hazard to young children. Many thousands of children may be affected in Sydney and other Australian cities. There is an urgent need for expanded prevalence surveys, public education and the development of strategies for the abatement of lead in urban environments.

Child, Preschool↗
PubMed1988

Homeless children--a challenge for pediatricians.

The health status of homeless children has become of major concern as the numbers of homeless families and children has dramatically increased in the United States over the past decade. There is some evidence to suggest that the health problems of homeless children are of greater frequency and of greater severity than those of poor children with homes. It is imperative that pediatricians begin to play a major role in handling this problem before the health status of this disenfranchized group of children is jeopardized even further.

Child↗
PubMed1988

Health problems of homeless children in New York City.

We reviewed the outpatient medical records of 265 homeless children less than 5 years of age in New York City and compared them with children of similar low socioeconomic status (SES) attending the same pediatric clinic. The frequency of health problems among the homeless children, including delayed immunizations, elevated blood lead levels, the rate of admission to hospital, and the rate of child abuse and neglect reports, exceeded those for the comparison groups.

Child, Preschool↗
PubMed1985

Linear growth following surgery in children and adolescents with Crohn's disease: relationship to pubertal status.

Studies of the effect of surgery on growth failure in adolescents with Crohn's disease have revealed conflicting data. To better determine the role of surgery for growth delay, growth data from 26 patients with Crohn's disease with intestinal resections and/or ileostomies were reviewed, 3 of whom had surgery twice. Operations were performed on 14 Tanner Stage I, 1 Tanner II, 1 Tanner III, and 13 Tanner IV or V patients. In the prepubertal group, 13 of the 14 had growth impairment, only one of whom had surgery primarily for that growth failure. One year after operation, 11 of 13 Tanner I growth failure patients experienced an increase in height velocity of 5.38 +/- 1.18 cm/yr (mean +/- SE;P less than 0.01); 9/11 achieved normal height velocity for Tanner I. Two attained their preillness height percentiles at one year follow-up, while 5 patients attained their preillness height percentiles 2.5 to 10 years following surgery. Of the four who failed to achieve normal height velocity, 3 had early recurrence of active disease. The Tanner Stage II and III patients both had growth failure, and both had a growth spurt following surgery. Of those who were Tanner Stage IV or V at the time of surgery, 5 of 13 had growth failure. Following surgery, none had an increase in height velocity. These data suggest that when patients with Crohn's disease and growth failure are prepubertal and surgery is performed primarily because of failure of medical therapy and/or other complications, a postoperative growth spurt may be expected within one year.

Adolescent↗
PubMed1983

Urethroperineal-rectal fistula in Crohn's disease.

A 19-year-old white male with Crohn's disease, who complained of passing urine per rectum and having retrograde ejaculations, was noted to have a urethroperineal-rectal fistula. The fistulous communication remained patent despite pharmacologic therapy, a diversion ileostomy, and a total proctocolectomy. A fistulectomy and definitive urethral repair finally resulted in resolution of the problem.

Adult↗
PubMedDate not supplied

Arteriohepatic dysplasia. I. Pitfalls in diagnosis and management.

Differentiating intrahepatic cholestasis from extrahepatic biliary tract obstruction may be difficult. Four patients with intraoperative cholangiographic evidence of extrahepatic ductal atresia who underwent hepatoportoenterostomy are described. All were ultimately shown to have arteriohepatic dysplasia with hypoplastic but patent extrahepatic ductal systems. The difficulty in establishing an accurate diagnosis, hazards associated with hepatoportoenterostomy, and suggestions for evaluation and management are discussed.

Bile Ducts↗