In 1993, a cross-sectional study of sexual maturation of normal Chinese schoolgirls was performed in Hong Kong. The aim of the study was to obtain an up-to-date reference for normal pubertal development in Chinese girls. Breast development was assessed in 3749 girls aged 7-19 y, and pubic hair rating was assessed in 3745 girls. Menstrual status was recorded in 6467 girls over 6 y of age. The median age of onset of puberty as indicated by breast stage II or above was 9.78 (95% CI 9.70-9.85) y. The median age of onset of pubic hair development was 11.64 (95% CI 11.56-11.72) y. The median age of menarche was 12.38 (95% CI 11.98-12.78) years. Percentile values for the age at which each puberty staging appeared were constructed and incorporated into the height-for-age charts. When comparison is made with similar studies done in 1962 and 1979, a significant downward secular trend in sexual maturation is observed (p < 0.01). Except for breast development the downward secular trend in sexual maturation appears to be diminishing and may be coming to a halt in the Chinese girls in Hong Kong. Their median ages of sexual maturation are now among one of the earliest medians recorded in the world population studied.

Chronic HBsAg carriers are known to have a higher risk of hepatitis-related mortality and morbidity when undergoing kidney transplantation. Immunosuppressants might flare up the infection that could be fulminating. Lamivudine and mycophenolate mofetil (MMF) have been shown to be effective in inhibiting replication of hepatitis B virus (HBV). With these two drugs, hepatitis related adverse outcome might be preventable when these patients are being transplanted. Four Chinese adolescents with chronic HBV infection were transplanted in our Department from 1999 to 2001. Immunosuppresants included prednisolone, cyclosporin A and MMF; azathioprine was not used for its potentially liver toxic effect. Prophylactic lamivudine 3 mg/kg and maximum 100 mg daily was given just before transplantation and was continued afterwards. HBV status and liver enzymes were monitored serially. Patients were followed up for 26.0 +/- 10.3 (11-34) months post-transplant and no mortality was reported. All grafts were functioning and no rejection was noted. MMF and lamivudine were well tolerated. Alanine transaminase was only transiently elevated in the first 2 months post-transplant in all patients and became normal afterwards. The patients were clinically well and liver function was normal at the last follow-up. However, HBV DNA became positive in three patients after the transplantation. YMDD mutant HBV was negative in one patient and undeterminable in the other three due to low virus load. In summary, with prophylactic lamivudine and MMF, short-term follow-up showed that renal transplant might be feasible and safe in chronic HBV carriers.

AbstractsConclusions Recommendations developed and spread by a Working Group have approached the management of acute pediatric poisonings in Spain to international guidelines based on scientific evidence. Main results 1. 1007 patients presented with abdominal pain with a female preponderance. A peak in incidence about the age of 6-7 in both sexes was noted. The incidence in both sexes then stabilised till a pubertal rise in female incidence. PAEDIATRIC ABDOMINAL PAIN: A CALL FORThere is a seasonal variation with approx 25% more pain presentations in winter. No such seasonal effect was seen for appendicitis.Overall abdominal pain is more likely to present after midday, while appendicitis presents throughout the day. 81 of 1007 patients had appendicectomies, 61 with appendicitis. Adolescent females were much more likely to have normal appendixes removed, with p<0.001.2. Mean WCC was 15.1 for those with true appendicitis, compared to 11.4 for those with normal appendices: WCC sensitivity 87% and specificity 90%.In those who had ultrasound, the appendiceal visualisation rate was 57%. Conclusion Paediatric abdominal pain presentations vary in incidence depending on sex, age, season and time of day. Conditions requiring operation are relatively uncommon, and the patient's background, history and a priori likelihood of disease should be considered before ordering investigations or operation.