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Children with weight-for-age z-score (WAZ)

Risk of death from undernutrition is thought to be higher in younger than in older children, but evidence is mixed. Research also demonstrates sex differences whereby boys have a higher prevalence of undernutrition than girls. This analysis described mortality risk associated with anthropometric deficits (wasting, underweight and stunting) in children 6–59 months by age and sex. We categorised children into younger (6–23 months) and older (24–59 months) age groups. Age and sex variations in near-term (within 6 months) mortality risk, associated with individual anthropometric deficits were assessed in a secondary analysis of multi-country cohort data. A random effects meta-analysis was performed. Data from seven low-or-middle-income-countries collected between 1977 and 2013 were analysed. One thousand twenty deaths were recorded for children with anthropometric deficits. Pooled meta-analysis estimates showed no differences by age in absolute mortality risk for wasting (RR 1.08, p = 0.826 for MUAC < 125 mm; RR 1.35, p = 0.272 for WHZ < −2). For underweight and stunting, absolute risk of death was higher in younger (RR 2.57, p < 0.001) compared with older children (RR 2.83, p < 0.001). For all deficits, there were no differences in mortality risk for girls compared with boys. There were no differences in the risk of mortality between younger and older wasted children, supporting continued inclusion of all children under-five in wasting treatment programmes. The risk of mortality associated with underweight and stunting was higher among younger children, suggesting that prevention programmes might be justified in focusing on younger children where resources are limited. There were no sex differences by age in mortality risk for all deficits.

The purpose of this study was to investigate the relationship between dyadic and triadic family interactions and their association with the development of children's externalizing behaviors. Data were obtained from a longitudinal study of family interactions (N = 125), followed from before parents had their first child until children were 7 years old. Family interactions (marital, father–child, mother–child, and triadic mother–father–child) were observed in separate interaction tasks when children were 24 months old as predictors of children's externalizing behaviors at age 7 (n = 71 children). Results demonstrated that the triadic measure of competitive coparenting and the dyadic mother–child interaction characterized by negative emotional socialization related to children's later externalizing behavior, even after controlling for covariates and effects of all other family interaction variables. Results emphasize the importance of examining the family holistically and provided new information for designing more effective whole-family interventions to reduce the development of children's externalizing behaviors.

Magnetohydrodynamics (MHD) is a unique approach for pumping fluids on a microscale and is highly suitable for enabling multiple functions for chemical analysis on a chip. An ionic current, j, is established in the fluid between selectively-activated electrodes in the presence of a magnetic field, B, that is perpendicular to the current, to generate a force, FB , orthogonal to j and B, through the right hand rule. FB is a body force that propels the liquid in the same direction through momentum transfer. We use microelectrodes, which are patterned into different, individually-addressable geometries on chips. Those electrodes are modified with poly(3,4-ethylenedioxythiophene), PEDOT, a conducting polymer, that converts the applied electronic current in the external circuit to ionic current in the liquid [1] via redox (R) processes and charging. A small NdFeB permanent magnet is placed under the chip to provide B. By strategic activation of the electrodes, fluid flow can be programmed. For example, we previously demonstrated that R-MHD can start, stop, reverse, adjust speed, and alter profiles of the fluid flow. We have also shown recently that R-MHD fluid flow can be diverted in a contactless way by magnetic field gradients when paramagnetic species are present [2]. In our presentation, we will discuss recent studies on using R-MHD to control the paths of individual microvolumes of fluids for different applications, which include chemical separations of mixtures of small biologically-relevant molecules as well as fluorescence imaging [3] and identification of cyanobacteria responsible for algal blooms in fresh water samples. Fluid manipulation and flow profiles under different experimental conditions and solvent and solution compositions will be described. These involve sustained and redirection of flow, adjacent counter flows, transverse paths, sampling, and injection. Acknowledgements: We are grateful for financial support from the National Science Foundation (CMI-1808286) and Arkansas Bioscience Institute, the major research component of the Arkansas Tobacco Settlement Proceeds Act of 2000. References [1] Khan, F. Z.; Fritsch, I. “Chip-Scale Electrodeposition and Analysis of Poly(3,4-ethylenedioxythiophene) (PEDOT) Films for Enhanced and Sustained Microfluidics Using DC-Redox-Magnetohydrodynamics”, Journal of The Electrochemical Society 2019, 166 (13), H615-H627. [2] Hähnel, V.; Khan, F. Z.; Mutschke, G.; Cierpka, C.; Uhlemann, M.; Fritsch, I. “Combining magnetic forces for contactless manipulation of fluids in microelectrode-microfluidic systems:, Scientific Reports 2019, 9:5103. [3] Khan, F. Z.; Hutcheson, J.; Hunter, C. J.; Powless, A. J. Benson, D.; Fritsch, I.*; Muldoon, T. J.* “Redox-Magnetohydrodynamically controlled fluid flow with poly(3,4-ethylenedioxythiophene) (PEDOT) coupled to an epitaxial light sheet confocal microscope for image cytometry applications”, Anal. Chem., 2018, 90(13), 7862-7870.

OBJECTIVES: Identify the most significant factors affecting the trajectory of recovery from severe acute malnutrition (SAM), as measured by average daily weight gain in each child 6–59 months of age who were diagnosed and treated for SAM and treated, adjusting for covariates including: breastfeeding status, number of children in household, illness, and distance to health center. Hypothesis 1a:Children 6–59 months enrolled in SAM treatment have slower times to recovery and slower weight gain if they are admitted for treatment at a lower anthropometric cut-off admission (weight for height z-score 5) and H/A (6), children who were referred for inpatient therapeutic feeding to a stabilization center, and children from the same household, except in the case of twins, were eliminated from the analysis. There was one database per country. A total of 1384 children between 6–59 months were included in the analysis. RESULTS: The most significant factors affecting the proportional weight gain include age at enrollment (P = 0.001, 95%CI = −0.00—0.00) and Weight for height z-score (WHZ) (P = 0.00, 95%CI = 0.04—0.05) in each child 6–59 months of age who were diagnosed with SAM and treated, adjusting for covariates including: breastfeeding status, number of children in household, illness, and distance to health center. Sex of child did not significantly affect proportional weight gain (P = 0.404, 95%CI = −0.012–0.005). CONCLUSIONS: The existing protocol to treat severe acute malnutrition should be modified to treat younger children and children who are admitted with a lower weight for height z-score due to different vulnerabilities. FUNDING SOURCES: The research was conducted as part of a dissertation at The Friedman School of Nutrition Science and Policy at Tufts University. Data were obtained from World Vision.

In 2010 Pakistan experienced the worst floods recorded in its history; millions of people were affected and thousands lost their lives. Nutrition assessment surveys led by UNICEF were conducted in flood‐affected areas of Punjab and Sindh provinces to assess the nutrition status of children between 6–59 months while Aga Khan University (AKU) undertook a parallel assessment including micronutrient status in their project areas within Balochistan, Sindh and Punjab. Standardised Monitoring and Assessment of Relief and Transition (SMART) methodology was used. 881 children from Sindh, 1,143 from Punjab and 817 from AKU project areas were measured for anthropometry and their households were interviewed. The findings indicated that while immediate life‐saving interventions were essential, there was also an urgent need to address chronic malnutrition. Through high‐level dissemination of the survey results, treatment and prevention of malnutrition has become a priority for the provincial and federal government in Pakistan and for donors.

The association between fathers' adult attachment representations and their recollections of childhood experiences with their caregiving quality with their eight-month-old infants and with father–infant attachment classification was examined in a longitudinal study of 117 fathers and their infants. Sensitive caregiving was related to secure-autonomous classification in the Adult Attachment Interview (AAI), hostile caregiving was related to fathers' dismissing and unresolved attachment, and emotional disengagement and role-reversed caregiving were both related to fathers' unresolved attachment. Childhood experiences of parental pressure to achieve were related to fathers' hostile and role-reversed caregiving and low sensitivity, independent of AAI classification. However, fathers' childhood experiences of maternal neglect were related to high-quality caregiving. It was also found that fathers' secure-autonomous AAI classification was related to secure father–child attachment in the Strange Situation Paradi...

This longitudinal study of 125 families investigated whether negative child outcomes related to fathers’ frightening (FR) behaviours with infants would be mitigated if fathers were also sensitive. Results indicated that children whose fathers were frightening and insensitive with them during infancy showed the highest emotional under‐regulation at 24 months and highest teacher ratings of attention problems at age 7, whereas those whose fathers were frightening and sensitive did not differ from children whose fathers were sensitive but not frightening. Sensitive caregiving mitigated the negative impact of FR behaviours on child outcomes for fathers, but not mothers. Perhaps fathers who can be sensitive but also engage in stimulating, albeit frightening, interactions with their infants may actually be scaffolding their ability to regulate their affect in intensely emotional situations. FR behaviours by mothers may be more problematic for child outcomes since these behaviours conflict with the primary caregi...

In this report, we examine and compare how tradable mass-based polices and tradable rate-based policies create different incentives for energy efficiency investments. Through a generalized demonstration and set of examples, we show that as a result of the output subsidy they create, traditional rate-based policies, those that do not credit energy savings from efficiency measures, reduce the incentive for investment in energy efficiency measures relative to an optimally designed mass-based policy or equivalent carbon tax. We then show that this reduced incentive can be partially addressed by modifying the rate-based policy such that electricity savings from energy efficiency measures are treated as a source of zero-carbon generation within the framework of the standard, or equivalently, by assigning avoided emissions credit to the electricity savings at the rate of the intensity target. These approaches result in an extension of the output subsidy to efficiency measures and eliminate the distortion between supply-side and demand-side options for GHG emissions reduction. However, these approaches do not address electricity price distortions resulting from the output subsidy that also impact the value of efficiency measures. Next, we assess alternative approaches for crediting energy efficiency savings within the framework of a rate-based policy. Finally, we identify amore » number of challenges that arise in implementing a rate-based policy with efficiency crediting, including the requirement to develop robust estimates of electricity savings in order to assess compliance, and the requirement to track the regionality of the generation impacts of efficiency measures to account for their interstate effects.« less

The 2010 earthquake in Haiti displaced about 1.5 million people, many of them into camps for internally displaced persons. It was expected that disruption of breastfeeding practices would lead to increased infant morbidity, malnutrition and mortality.Haiti's health ministry and the United Nations Children's Fund, in collaboration with local and international nongovernmental organizations, established baby tents in the areas affected by the earthquake. The tents provided a safe place for mothers to breastfeed and for non-breastfed infants to receive ready-to-use infant formula. Such a large and coordinated baby tent response in an emergency context had never been mounted before anywhere in the world.Baby tents were set up in five cities but mainly in Port-au-Prince, where the majority of Haiti's 1555 camps for displaced persons had been established.Between February 2010 and June 2012, 193 baby tents were set up; 180 499 mother-infant pairs and 52 503 pregnant women were registered in the baby tent programme. Of infants younger than 6 months, 70% were reported to be exclusively breastfed and 10% of the "mixed feeders" moved to exclusive breastfeeding while enrolled. In 2010, 13.5% of registered infants could not be breastfed. These infants received ready-to-use infant formula.Thanks to rapid programme scale-up, breastfeeding practices remained undisrupted. However, better evaluation methods and comprehensive guidance on the implementation and monitoring of baby tents are needed for future emergencies, along with a clear strategy for transitioning baby tent activities into facility and community programmes.Le tremblement de terre de 2010 en Haïti a déplacé environ 1,5 million de personnes, dont beaucoup dans des camps pour personnes déplacées à l'intérieur de leur propre pays. On avait prévu que la perturbation des pratiques d'allaitement conduirait à l'augmentation de la morbidité, de la malnutrition et de la mortalité infantile.Le ministère de la Santé d'Haïti et l'UNICEF, en collaboration avec des organisations non gouvernementales locales et internationales, avaient érigé des tentes pour bébés dans les zones touchées par le tremblement de terre. Ces tentes représentaient un endroit sûr pour les mères qui allaitaient, mais aussi pour les nourrissons non allaités qui recevaient du lait maternisé prêt à l'emploi. Une telle action coordonnée à grande ampleur dans un contexte d'urgence n'avait jamais été mise en place dans le monde auparavant.Les tentes pour bébés ont été mises en place dans cinq villes, mais surtout à Port-au-Prince, où a été créée la majorité des 1555 camps d'Haïti pour les personnes déplacées.Entre février 2010 et juin 2012, 193 tentes pour bébés ont été mises en place; 180 499 couples mère-enfant et 52 503 femmes enceintes ont été enregistrés dans le programme des tentes pour bébés. Parmi les nourrissons de moins de 6 mois, 70% suivaient un allaitement exclusif et 10% de ceux qui avaient une «alimentation mixte» sont passés à l'allaitement maternel exclusif à leur arrivée. En 2010, 13,5% des nourrissons inscrits ne pouvaient pas être allaités. Ces bébés ont reçu du lait maternisé prêt à l'emploi.Grâce à une mise en place rapide du programme, les pratiques d'allaitement n'ont pas été perturbées. Cependant, l'amélioration des méthodes d'évaluation et d'orientation globale sur la mise en œuvre et le suivi des tentes pour bébés reste nécessaire pour les situations d'urgence futures. De plus, une stratégie claire doit être définie en matière de transition des activités des tentes pour bébés vers des centres et des programmes communautaires.El terremoto de 2010 en Haití desalojó a unos 1,5 millones de personas, muchas de las cuales se trasladaron a campos de desplazados internos. Se esperaba que la interrupción de las prácticas de lactancia conduciría a un aumento de la morbilidad infantil, la desnutrición y la mortalidad.El Ministerio de Salud de Haití y el Fondo para la Infancia de las Naciones Unidas, en colaboración con organizaciones no gubernamentales locales e internacionales, establecieron tiendas para bebés en las zonas afectadas por el terremoto. Las tiendas ofrecieron un lugar seguro para que las madres pudieran amamantar a sus hijos y para que los bebés no alimentados con leche materna recibieran sucedáneos de la leche materna listos para el consumo. Nunca antes, en ninguna parte del mundo, se había logrado establecer un despliegue de tiendas para bebés tan amplio y bien coordinado en una situación de emergencia.Las tiendas para bebés se establecieron en cinco ciudades, pero sobre todo en Port-au-Prince, donde se había instalado la mayoría de los 1 555 campamentos de Haití para las personas desplazadas.Entre febrero de 2010 y junio de 2012, se establecieron 193 tiendas para bebés. Se inscribieron 180 499 parejas madre-hijo y 52 503 mujeres embarazadas en el programa de tienda para bebés. Entre los bebés menores de 6 meses, se observó que el 70% se alimentaba únicamente de leche materna, y que el 10% de los bebés que anteriormente recibía una "alimentación mixta", recibió una alimentación basada exclusivamente en leche materna durante la estancia en las tiendas. En 2010, el 13,5% de los bebés inscritos no pudo ser amamantado. Estos bebés recibieron sucedáneos de leche materna listos para el consumo.La rápida ampliación de los programas permitió que las prácticas de lactancia se mantuvieran sin interrupciones. Sin embargo, es necesario disponer de mejores métodos de evaluación y de orientación integral sobre la aplicación y el seguimiento de las tiendas para bebés para futuras emergencias, junto con una estrategia clara para trasladar las actividades de tiendas de campaña para bebés a los programas comunitarios y de servicios.أدى الزلزال الذي ضرب هايتي في 2010 إلى تشريد حوالي 1.5 مليون شخص، وكان العديد منهم في مخيمات للأشخاص المشردين داخلياً. وكان من المتوقع أن يؤدي قطع ممارسات الرضاعة الطبيعية إلى ازدياد معدل مراضة الأطفال وسوء التغذية والوفيات.قامت وزارة الصحة في هايتي وصندوق الأمم المتحدة للطفولة (اليونيسيف)، بالتعاون مع المنظمات غير الحكومية المحلية والدولية، بإنشاء خيام للأطفال في المناطق التي ضربها الزلزال. ووفرت الخيام مكاناً آمناً للأمهات لكي يمارسن الرضاعة الطبيعية، وللأطفال الذين لا يرضعن رضاعة طبيعية لكي يتلقون الغذاء البديل عن لبن الأم الجاهز للاستخدام. ولم يتم على الإطلاق تنفيذ مثل هذه الاستجابة الضخمة والمنسقة لخيام الرضع في سياق الطوارئ في أي منطقة في العالم.تم إنشاء خيام الأطفال في خمس مدن، ولكنها أقيمت بشكل رئيسي في بورت أو برانس، التي شهدت إنشاء معظم مخيمات هايتي البالغ عددها 1555 مخيماً للأشخاص المشردين.في الفترة من شباط/ فبراير 2010 إلى حزيران/ يونيو 2012، تم إنشاء 193 خيمة للأطفال؛ وتم تسجيل 180499 زوجاً من الأمهات وأطفالهن و52503 سيدة حامل في برنامج خيام الأطفال. وتم الإبلاغ عن إرضاع 70 % من إجمالي الرضع الذين تقل أعمارهم عن 6 أشهر رضاعة طبيعية خالصة وتحول 10 % من الرضع الذين يتلقون "تغذية مختلطة" إلى الرضاعة الطبيعية الخالصة أثناء تسجيلهم. وفي 2010، تعذر إرضاع 13.5 % من الرضع المسجلين رضاعة طبيعية. وتلقى هؤلاء الرضع الغذاء البديل عن لبن الأم الجاهز للاستخدام.بفضل الاستنهاض السريع للبرنامج ، ظلت ممارسات الرضاعة الطبيعية مستمرة. ومع ذلك، لابد من وجود طرق تقييم أفضل وإرشاد شامل حول تنفيذ خيام الرضع ومراقبتها من أجل الطوارئ المستقبلية، بالإضافة إلى وجود استراتيجية واضحة لتحويل أنشطة خيام الرضع إلى برامج مرفقية ومجتمعية.2010 年海地地震中大约有 150 万人流离失所，其中许多人进入为国内难民搭建的营地。预计中断母乳喂养将导致新生儿疾病、营养不良和死亡数增加。海地卫生部和联合国儿童基金会与当地及国际非政府组织合作，在受地震影响的地区建立婴儿帐篷。这些帐篷为母乳喂养的母亲以及没有母乳喂养的婴儿接受液体婴儿配方奶提供安全场所。这种为应对紧急情况而建立的如此大规模并且协调的婴儿帐篷在世界任何地方均前所未有。在5 个城市中建立了婴儿帐篷，但主要位于太子港，海地1555 处为无家可归者搭建的营地绝大多数建在这里。2010 年2 月到2012 年6 月之间，建立了193 个婴儿帐篷；180499 对母婴和52503 名孕妇在婴儿帐篷计划中登记。据报告，6 个月以下的婴儿中有70%是纯母乳喂养，10%“混合喂养”婴儿在登记后转为纯母乳喂养。在2010 年，13.5%的登记婴儿无法接受母乳喂养。这些婴儿接受液体婴儿配方奶。由于计划快速扩大，母乳喂养实践可以有序保持。然而，为了应对未来突发事件，婴儿帐篷的实施和监控需要有更好的评价方法和综合指导，还需要将婴儿帐篷活动过渡到设施和社区计划中的清晰战略。Землетрясение 2010 года на Гаити заставило покинуть место своего проживания около 1,5 миллиона людей, многие из которых поселились в лагерях для вынужденных переселенцев. Ожидалось, что прерывание практик грудного вскармливания приведет к увеличению заболеваемости, недостаточному питанию и смертности грудных детей.Министерство здравоохранения Гаити и Детский фонд Организации Объединенных Наций, совместно с локальными и международными неправительственными организациями, установили детские палатки в пострадавших от землетрясения областях. Палатки обеспечивали безопасное место матерям для грудного вскармливания, а младенцы на искусственном вскармливании получали там готовые к использованию детские смеси. Такое масштабное и координированное задействование детских палаток в условиях чрезвычайной ситуации до сих пор не имело аналогов в мире.Детские палатки были установлены в пяти городах, в основном в Порт-о-Пренсе, где располагалась большая часть из 1555 гаитянских лагерей для вынужденных переселенцев.В период с февраля 2010 года по июнь 2012 года было установлено 193 детских палатки. В программе детских палаток зарегистрировались 180 499 пар матерей с грудными детьми и 52 503 беременных женщин. Согласно собранным данным, из младенцев в возрасте до 6 месяцев, 70% находились исключительно на грудном вскармливании и 10% детей на смешанном вскармливании были переведены на исключительно грудное вскармливание за время участия в программе. В 2010 году 13,5% зарегистрированных младенцев не имели возможности получать грудное вскармливание. Эти младенцы получали готовые к использованию детские смеси.Благодаря быстрому развертыванию программы удалось добиться сохранения практик грудного вскармливания. Тем не менее, на случай подобных чрезвычайных ситуаций в будущем необходимы более совершенные методы оценки и более подробные руководства по внедрению и мониторингу детских палаток, а также ясная стратегия по переходу от детских палаток к лечебным учреждениям и социально-ориентированным программам.

Irritable bowel syndrome (IBS) imposes significant clinical and economic burdens. We aimed to characterize practice patterns for patients with IBS in a large health maintenance organization, analyzing point of diagnosis, testing, comorbidities, and treatment.Members of Kaiser Permanente Northern California who were diagnosed with IBS were matched to controls by age, sex, and period of enrollment. We compared rates of testing, comorbidities, and interventions.From 1995-2005, IBS was diagnosed in 141,295 patients (mean age, 46 years; standard deviation, 17 years; 74% female). Internists made 68% of diagnoses, gastroenterologists 13%, and others 19%. Lower endoscopy did not usually precede IBS diagnosis. Patients with IBS were more likely than controls to have blood, stool, endoscopic, and radiologic tests and to undergo abdominal or pelvic operations (odds ratios, 1.5-10.7; all P.0001). Only 2.7% were tested for celiac disease, and only 1.8% were eventually diagnosed with inflammatory bowel disease. Chronic pain syndromes, anxiety, and depression were more common among IBS patients than among controls (odds ratios, 2.7-4.6; all P.0001). Many patients with IBS were treated with anxiolytics (61%) and antidepressants (55%). Endoscopic and radiologic testing was most strongly associated with having IBS diagnosed by a gastroenterologist. Psychotropic medication use was most strongly associated with female sex.In a large, managed care cohort, most diagnoses of IBS were made by generalists, often without endoscopic evaluation. Patients with IBS had consistently higher rates of testing, chronic pain syndromes, psychiatric comorbidity, and operations than controls. Most patients with IBS were treated with psychiatric medications.

Background Individuals with generalized social anxiety disorder (GSAD) exhibit exaggerated amygdala reactivity to aversive social stimuli. These findings could be explained by microstructural abnormalities in white matter (WM) tracts that connect the amygdala and prefrontal cortex, which is known to modulate the amygdala's response to threat. The goal of this study was to investigate brain frontal WM abnormalities using diffusion tensor imaging (DTI) in patients with social anxiety disorder. Methods A Turboprop DTI sequence was used to acquire diffusion tensor images in 30 patients with GSAD and 30 matched healthy control subjects. Fractional anisotropy, an index of axonal organization, within WM was quantified in individual subjects, and an automated voxel-based, whole-brain method was used to analyze group differences. Results Compared with healthy control subjects, patients had significantly lower fractional anisotropy localized to the right uncinate fasciculus WM near the orbitofrontal cortex. There were no areas of higher fractional anisotropy in patients than controls. Conclusions These findings point to an abnormality in the uncinate fasciculus, the major WM tract connecting the frontal cortex to the amygdala and other limbic temporal regions, in GSAD, which could underlie the aberrant amygdala-prefrontal interactions resulting in dysfunctional social threat processing in this illness.

STUDY DESIGN: This is a prospective observational study of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) in a cohort of patients undergoing spinal surgery. OBJECTIVE: We sought to characterize the normal kinetics of ESR and CRP after spinal surgery and compare their usefulness as predictors of infectious complications in the early postoperative period. SUMMARY OF BACKGROUND DATA: ESR and CRP are nonspecific markers of inflammation used to evaluate postoperative infection. CRP is a quantitative test that exhibits predictable kinetics consisting of a postoperative rise and a peak followed by a decrease toward the normal value. Deviation from normal kinetics may be an indicator of infection. METHODS: ESR and CRP were collected before surgery and daily after surgery in consecutive patients. All infectious complications were recorded. RESULTS: One hundred forty-nine patients met inclusion criteria. Infectious complications occurred in 20 patients. A postoperative peak, which is necessary to apply the test, was observed in 78% of patients for CRP and 48% for ESR. Multiple linear regression analysis revealed preoperative CRP, number of levels, and lumbar region as significant predictors of greater CRP peak value (r = 0.435, P = 0.001). After the peak, CRP showed an exponential decrease with a half-life of 2.6 days (r = 0.701, P < 0.001). No trend could be determined for ESR. A second rise or failure to decrease as expected had a sensitivity, specificity, positive predictive value, and negative predictive value of 82%, 48%, 41%, and 86% for infectious complications, respectively. Of 8 cases of deep wound infection, 7 exhibited substantial deviations from expected CRP values. CONCLUSION: CRP is more applicable, predictable, and responsive in the early postoperative period compared with ESR. The postoperative kinetics of CRP derived in this study seems to be conserved regardless of operation, magnitude, or region. Knowledge of the kinetics allows assessment of the degree of difference between actual and expected values. Using a second rise or failure to decrease as expected for CRP is sensitive for infection. A negative test is reassuring that infection is unlikely.