The lifespan of patients with cystic fibrosis (CF) is increasing significantly. The objective of this international pilot study was to study the characteristics of these long-term survivors.
Four centres with large CF clinics from London (UK), Minneapolis (USA), Toronto (Canada) and Verona (Italy) identified 366 patients who had survived 40 years and longer.
At all centres males survived longer than females. There were more pancreatic sufficient patients in Verona (60%) and Toronto (40%) than in London (16%) and Minneapolis (21%). The percentage of DeltaF508 homozygous patients varied between 47% in London and 45% in Minneapolis to only 26% in Toronto and 9% in Verona. Average FEV(1) and BMI values of the surviving population appeared to stabilise after 40 years of age. FEV(1) was on average 12% higher in patients who were pancreatic sufficient (p > 0.0001). There was no difference in survival between the centres. The overall median survival after the age of 40 was 13 years. The estimated annual death rate was approximately 3.4% from the age of 40-60 years.
Significant numbers of patients are now surviving to 40 years or more, and it is hoped that an in-depth study of these patients may identify the factors contributing to longer survival.
In several large epidemiological studies chronic periodontitis has been implicated as an additional risk factor, independent of other risk factors, for the development of ischaemic heart disease. The underlying mechanism is thought to be a localised infection giving rise to an inflammatory host response, and some experimental data agree with this hypothesis. Recently, however, some studies have questioned the post dated relationship between the two diseases. The current case-record study was undertaken to evaluate the prevalence of chronic periodontitis and the severity of such periodontal disease in a heart transplant population, assuming the latter represented a relatively severely compromised cardiovascular patient population. The study demonstrated that 76% of the patients had various degrees of periodontal disease prior to undergoing a heart transplant. Thus, it is possible that a relationship between cardiovascular disease and periodontal disease exists, but further, large intervention studies will be needed to confirm such a conclusion.
Asperger syndrome has so far been the subject of very little systematic empirical inquiry. This paper reviews those few studies in the literature and some data from a new Swedish study which has reported findings pertinent to estimations of Asperger syndrome prevalence. It is concluded that among children with normal intelligence, rates of 10-26 per 10,000 children are minimum figures. Another 0.4 per 10,000 Swedish teenagers showed the combination of Asperger syndrome and mild mental retardation.
Specific reading retardation was found to occur in a minimum of 9-9 per cent of ten-year-old 'indigenous' children in one inner London borough. This rate was nearly three times that (3-9 per cent) in Isle of Wight children. There was a comparably higher rate of general reading backwardness in London (19-0 per cent vs 8-3 per cent). Since the same epidemiological methods were followed in the two areas, and since the reading-retarded children had similar psychological characteristics in both cases, it is concluded that there is a real difference between London and the Isle of Wight in the prevalence of reading retardation and of reading backwardness.
BACKGROUND: A growing number of European studies, particularly from Nordic countries, suggest an increased frequency of autism in children of immigrant parents. In contrast, North American studies tend to conclude that neither maternal ethnicity nor immigrant status are related to the rate of autism-spectrum disorders. AIMS: To examine the hypotheses that maternal ethnicity and/or immigration are linked to the rate of childhood autism-spectrum disorders. METHOD: Retrospective case-note analysis of all 428 children diagnosed with autism-spectrum disorders presenting to the child development services in two centres during a 6-year period. RESULTS: Mothers born outside Europe had a significantly higher risk of having a child with an autism-spectrum disorder compared with those born in the UK, with the highest risk observed for the Caribbean group (relative risks (RRs) in the two centres: RR = 10.01, 95% CI 5.53-18.1 and RR = 8.89, 95% CI 5.08-15.5). Mothers of Black ethnicity had a significantly higher risk compared with White mothers (RR = 8.28, 95% CI 5.41-12.7 and RR = 3.84, 95% CI 2.93-5.02). Analysis of ethnicity and immigration factors together suggests the increased risk is predominately related to immigration. CONCLUSIONS: Maternal immigration is associated with substantial increased risk of autism-spectrum disorders with differential risk according to different region of birth and possibly ethnicity.
