Disparities in late and lost: Pediatricians' role in following Pompe disease identified by newborn screening.

BACKGROUND AND OBJECTIVES: Pompe disease (PD) results from a deficiency of lysosomal acid α-glucosidase that leads to glycogen accumulation in lysosomes in multiple tissues. There are two phenotypes: infantile-onset Pompe disease (IOPD) and late-onset Pompe disease (LOPD). The objective was to evaluate the diagnostic and follow-up outcomes of children identified with PD through newborn screening (NBS) in the state of Minnesota over a 4-year period. METHODS: This study is a retrospective analysis of infants born in Minnesota between August 1, 2017, and July 31, 2021, by the Minnesota Department of Health NBS Program for Pompe disease. Newborn screening and clinical diagnostic data are summarized for all newborns with positive newborn screens for Pompe disease. RESULTS: Children with IOPD had abnormal biomarkers necessitating immediate initiation of treatment. Children with LOPD are asymptomatic to date (1.25-4.58 years) with normal biomarkers including creatine kinase, urine glucotetrasaccharides, liver function tests, and echocardiogram. The estimated birth prevalence of PD is 1:15,160. The positive predictive value for PD was 81% with a false positive rate of 1.9 per 10 positive screens. 32% of the children with LOPD were lost to follow up among which 66% were from minority ethnic groups. CONCLUSION: This emphasizes the disparity in access to health care among specific demographics, as well as the importance of a primary care provider's early involvement in educating these families. To accomplish this, and ensure equality in follow-up care, the Minnesota Pompe Disease Consortium has been formed.

Seroprevalence of Brucella canis antibodies in dogs entering a Minnesota humane society, Minnesota, 2016-2017.

BACKGROUND: Canine brucellosis, caused by the bacterium Brucella canis, is a zoonotic and largely reproductive disease of dogs. The disease is a recognized problem in canine breeding populations, and the risk to individuals assisting with birthing is well described. Prior to 2015, all cases of canine brucellosis reported to the Minnesota Board of Animal Health were in dogs used for breeding. In 2015, canine brucellosis was identified in eight Minnesota rescue dogs, all originating from specific geographic areas in South Dakota. Our objective was to measure the seroprevalence of B. canis in stray and previously owned dogs entering a large Minnesota animal rescue organization to determine if our observations represented a localized or generalized disease issue among rescue dogs. METHODS: A stratified random sample of stray and previously owned dogs entering the largest Minnesota animal rescue organization between November 1, 2016 and November 7, 2017, was tested for B. canis antibodies by the 2-Mercaptoethanol Rapid Slide Agglutination Test (2ME-RSAT) (Zoetis d-TEC® CB kit). Sample sizes for each strata were calculated using previously published seroprevalence estimates. Blood from selected dogs was collected, serum harvested, and transported to the Minnesota Veterinary Diagnostic Laboratory for testing. Positive samples in the 2ME-RSAT were shipped to Cornell University for confirmation by Agarose Gel Immunodiffusion (AGID) testing. Demographics, state and setting of origin, and health status were collected on study-dogs. RESULTS: Of the 10,654 dogs accepted by AHS during the study period, 943 (8.9%) were selected for testing. Most study dogs arrived from Oklahoma (28%), Alabama (18%), and Minnesota (12%). The median age of study dogs was 1.5 years; 303 (32%) were intact males and 294 (31%) were intact females. Most study dogs were strays (n = 716, 76%). Of the total, 22 (3.1%) stray and eight (3.5%) owner-surrendered dogs were presumptively positive by RSAT; one (0.11%) of the stray dogs was positive by 2ME-RSAT and confirmed by AGID. The positive dog was a healthy-appearing 1 year-old neutered male beagle from Texas. CONCLUSIONS: The seroprevalence of canine brucellosis in dogs entering Minnesota for adoption from multiple states was low. Never-the-less, care must to be taken to consider all potential risks and outcomes of interstate and international dog trade, including the spread of infectious diseases such as canine brucellosis.

Public Health and Law Enforcement Joint Investigation of Unknown Suspicious Substances and Potential Threat Evaluations, Minnesota, 2007-2016.

From the Field is a semi-regular column that explores what it means to be a local health professional on the front lines of an emergency. Typically, National Association of County and City Health Officials (NACCHO) members share their stories of preparing for and responding to disasters, epidemics, and other major health issues. This month's column features a submission from a state health department that describes their experience in investigating white powder incidents. Through exploring the analysis of the challenges faced and the solutions developed, readers can learn how these public health champions keep their communities safe even in extreme situations. Readers may submit topics of interest to the column's editor, Meghan McGinty, PhD, MPH, MBA, at mmcginty@naccho.org.

Atherosclerosis risk factors in children of high risk families.

UNLABELLED: The Objective of this study was to determine the frequency of care reactive atherosclerosis risk factors in children of parents with premature coronary heart disease observed before their 45 years of age for the promotion of the effectivity of the preventive work started in childhood and adolescent ages. METHODS: Height and weight was measured. Body mass index (BMI) was calculated. Fat analysis was performed in children with overweight. Blood pressure was measured and both 24 hour monitoring and fundoscopy were performed in cases with a blood pressure higher than 90 centile values. Fasting blood sugar (BS) level was measured. Oral glucose tolerance test was made in cases with a fasting BS level higher than 5 mmol/l. Serum total cholesterol (TC), HDL-cholesterol (HDLC) and total triglyceride (TT) levels were measured and LDL-cholesterol (LDLC) level was calculated. The plasma thiobarbituric acid reactive system (TBARS) was investigated. Statistical analyses were performed by chi2 and Student t-probes. Data of 1140 offsprings and 457 referents without any high atherosclerotic risk family history were analyzed. RESULTS: BMI of 87 offsprings was higher than the 90 centile value. The fat percent of the body of these children was higher than 40. The blood pressure of 311 children and adolescents was higher than the 90 centile value. Fasting BS level was higher than 5 mmol/l in 47 cases 17 of them showed a pathologic oral glucose tolerance test. High serum TC level was observed in 67 cases, high serum TT level was found in 8 cases. 245 offsprings had a low serum HDLC level. The plasma TBARS level was high in 241 cases. Data of referents differed significantly from those of offsprings. Their serum TC, LDLC levels and plasma TBARS level were lower, serum HDLC level was higher than that of children and adolescents with high risk atherosclerotic family history. CONCLUSION: Risk factors of atherosclerosis are detectable in children and adolescents of high risk families. The measurement of these factors may help the efficacy of the preventive work.