In the present study, pure-tone audiometry was used in 687 Finnish school children, aged 6-15 years, to determine the prevalence of a 6 kHz acoustic dip and related factors among three age groups. Trained audiometricians tested air conduction thresholds in a sound-proof room. A total of 57 children (8.3%) had a clear-cut dip of at least 20 dB at 6 kHz. This dip was more pronounced in older children and in boys. A thorough case history was obtained by questionnaire, with logistic regression analysis showing that low birth weight (
504 overweight children admitted to hospital between 1921 and 1947 were followed up for 40 years by questionnaires at 10 year intervals. The mean weight for height (W/H) standard deviation score (SDS) reached a maximum in puberty (+3.5). The SDS fell to about +1 in adulthood. 47% patients were still obese (SDS greater than +1) in adulthood; 84.6% of these had SDS more than +2 in childhood. The degree of obesity in the family (parents and grandparents) and the degree of overweight in puberty were the most important factors for weight level in adulthood. Even when their food intake was in accordance with recommended levels, obese children had higher than normal weight as adults. Excessive overweight in puberty (SDS greater than +3) was associated with higher than expected morbidity and mortality in adult life. Weight-reducing measures should be started early in life to improve the unfavourable long-term prognosis for very obese children.
The increased survival of preterm and very low birth weight infants in recent years has been well documented but continued surveillance is required in order to monitor the effects of new therapeutic interventions. Gestation and birth weight specific survival rates most accurately reflect the outcome of perinatal care. Our aims were to determine survival to discharge for a large Canadian cohort of preterm infants admitted to the neonatal intensive care unit (NICU), and to examine the effect of gender on survival and the effect of increasing postnatal age on predicted survival.
Outcomes for all 19,507 infants admitted to 17 NICUs throughout Canada between January 1996 and October 1997 were collected prospectively. Babies with congenital anomalies were excluded from the study population. Gestation and birth weight specific survival for all infants with birth weight
In this paper we discuss the Russian adult health crisis and its implications. Although some hope that economic growth will trigger improvements in health, we argue that a scenario is more likely in which the unfavorable health status would become a barrier to economic growth. We also show that ill health is negatively affecting the economic well-being of individuals and households. We provide suggestions on interventions to improve health conditions in the Russian Federation, and we show that if health improvements are achieved, this will result in substantial economic gains in the future.
To determine whether seeking advice prior to an unscheduled visit to a pediatric emergency department (PED) influences appropriate use of this setting for minor illnesses.
Cross-sectional questionnaire survey.
The medical emergency department of the Montreal (Quebec) Children's Hospital, a major referral and urban teaching hospital.
Four hundred eighty-nine of 562 consecutive parents visiting the PED over two periods, one in February and the other in July 1989.
Parents of children between 0 and 18 years of age visiting the PED were asked whether they had previously sought advice from family, friends, or a physician. Other factors possibly related to the decision to seek care were also measured. Appropriateness was rated, blind to discharge diagnosis, by two pediatricians using a structured series of questions incorporating the child's age, time of the visit, clinical state, and problem at presentation. Thirty-four percent of visits among respondents were judged appropriate. In bivariate analysis, appropriate visits occurred significantly more often when a parent spoke to both a physician and a nonphysician (47%) prior to visiting the PED than when no advice was sought (29%; P
Identification of abnormalities in the developmental trajectory during infancy of future schizophrenia cases offers the potential to reveal pathogenic mechanisms of this disorder. Previous studies of head circumference in pre-schizophrenia were limited to measures at birth. The use of growth acceleration of head circumference (defined as the rate of change in head circumference) provides a more informative representation of the maturational landscape of this measure compared to studies based on static head circumference measures. To date, however, no study has examined whether HC growth acceleration differs between pre-schizophrenia cases and controls. In the present study, we employed a nested case control design of a national birth cohort in Finland. Cases with schizophrenia or schizoaffective disorder (N=375) and controls (N=375) drawn from the birth cohort were matched 1:1 on date of birth (within 1month), sex, and residence in Finland at case diagnosis. Longitudinal data were obtained on head circumference from birth through age 1. Data were analyzed using a new nonparametric Bayesian inversion method which allows for a detailed understanding of growth dynamics. Adjusting for growth velocity of height and weight, and gestational age, there was significantly accelerated growth of head circumference in females with schizophrenia from birth to 2months; the findings remained significant following Bonferroni correction (p
Birth-weight-gestational-age standards help to identify infants in need of special care and to determine causes and means for preventing retardation of intrauterine growth. Previously published standards either were based on small samples, data several decades old or characteristics of subpopulations in the United States or they were not specific for type of birth and sex. We compared the data for live births in 1972 with those in 1986 to develop current Canadian standards for type of birth (singleton or twin) and sex. We found that the 10th, 50th and 90th percentile figures for weight were slightly higher in 1986 than in 1972 for term deliveries (at 37 weeks' gestation or later), but the figures were virtually unchanged for preterm deliveries. The availability of reliable population-based standards should enhance the clinician's ability to identify true cases of retardation or acceleration of intrauterine growth.
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Cites: Can Med Assoc J. 1969 May 10;100(18):842-55770707
To explore the possible effect of metformin on maternal and fetal androgens and antim?llerian hormone (AMH) levels at birth and to study the predictors of maternal and fetal AMH levels.
Substudy of a randomized controlled trial (the PregMet study).
Women with polycystic ovary syndrome (PCOS) and their newborns (n = 132).
Metformin, 2,000 mg/daily, or placebo from the first trimester until delivery.
Androgens and AMH levels in maternal venous serum and in umbilical vein and artery serum.
Except for the increased free testosterone index (FTI) in the umbilical artery in boys, metformin did not influence maternal or fetal androgens, or AMH levels. The maternal body mass index (BMI) was a negative and FTI a strong positive predictor of maternal AMH levels. Maternal androgens and AMH levels did not correlate to fetal gender. In girls, gestational age, birth weight, or maternal androgens did not correlate to the AMH levels. In boys, birth weight was negatively correlated to the AMH levels.
Except for FTI, which was higher in boys, metformin had no impact on maternal or fetal androgen levels or the level of AMH. Fetal AMH, as a surrogate marker for ovarian development, was unaffected by maternal androgens. Birth weight and gestational age had no impact on AMH levels in girls; in boys, AMH probably reflects the physiologic variations due to birth weight.