Balanitis xerotica obliterans in children and its incidence under the age of 5 years.

PubMed

Jayakumar, S; Antao, B; Bevington, O; Furness, P; Ninan, G K

2012-06-01

To analyse the incidence of BXO among paediatric circumcisions for preputial pathology, in particular in children under the age of 5 years. Retrospective review revealed 1769 paediatric circumcisions performed between 1997 and 2008 at our institution. Data were collected on patient's age, date when sample received by pathology department and histological findings for all the foreskin samples received and examined during the study period. Epidemiological data were obtained from the Office for National Statistics, UK. A total of 346 foreskin samples were received and BXO was found in 182 (52.6%). There were 31 children under the age of 5 years circumcised for preputial pathology. BXO was reported in 6 (19.3%) and chronic inflammation in 16 (51.6%) of these patients. The foreskin was reported normal in 2 (6.5%) and the remaining 7 (22.6%) patients had preputial cysts or other pathology. Epidemiological population data analysis revealed the incidence of BXO per year to be 3.01 cases/1000 boys under 15 years of age and 0.322 cases/1000 boys under 5 years. The incidence of BXO in boys noted in our study is higher than previously reported. BXO can result in significant complications and should be considered in children even under 5 years. Copyright © 2011 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

A 5-year longitudinal analysis of modifiable predictors for outdoor play and screen-time of 2- to 5-year-olds.

PubMed

Xu, Huilan; Wen, Li Ming; Hardy, Louise L; Rissel, Chris

2016-08-26

Early childhood is a critical time for establishing physical activity and sedentary behaviours. Identifying modifiable predictors of physical activity and sedentary behaviours in the early life stages can inform the development of early intervention programs. The aim of this study was to identify modifiable predictors of outdoor play (a proxy of physical activity) and screen-time in 2- to 5-year-olds. A longitudinal data analysis was conducted using 5-year follow-up data from the Healthy Beginnings Trial undertaken in Sydney, Australia from 2007 to 2013. A total of 667 pregnant women were recruited for the study. Information on mothers' demographics, physical activity, screen-time, knowledge of child development, and awareness of childhood obesity during pregnancy (at baseline); children's tummy time (a colloquial term describing the time when a baby is placed on his or her stomach while awake and supervised) at 6 months old and screen-time at 1 year old was collected via interviews with participating mothers as potential modifiable predictors. Main outcomes were children's outdoor playtime and screen-time at ages 2, 3.5, and 5 years. Mixed linear and logistic regression models were built to determine these modifiable predictors. Mothers' screen-time during pregnancy (β = 2.1, 95 % CI 0.17-4.12; P = 0.030) and children's daily screen-time at age 1 year (β = 15.2, 95 % CI 7.28-23.11; P < 0.0001) predicted children's daily screen-time across ages 2 to 5 years after controlling for confounding factors. Practising tummy time daily (β = 13.4, 95 % CI 1.26-25.52; P = 0.030), mother's physical activity level (β = 3.9, 95 % CI 0.46-7.28; P = 0.026), and having been informed about playing with child at baseline (β = 11.6, 95 % CI 1.56-21.54; P = 0.023) predicted children's outdoor playtime across ages 2 to 5 years. Mothers played an important role in their children's outdoor play and screen-time in the first years of

Performance of an HRP-2 Rapid Diagnostic Test in Nigerian Children Less Than 5 Years of Age

PubMed Central

Ajumobi, Olufemi; Sabitu, Kabir; Nguku, Patrick; Kwaga, Jacob; Ntadom, Godwin; Gitta, Sheba; Elizeus, Rutebemberwa; Oyibo, Wellington; Nsubuga, Peter; Maire, Mark; Poggensee, Gabriele

2015-01-01

The diagnostic performance of histidine-rich protein 2 (HRP-2)–based malaria rapid diagnostic test (RDT) was evaluated in a mesoendemic area for malaria, Kaduna, Nigeria. We compared RDT results with expert microscopy results of blood samples from 295 febrile children under 5 years. Overall, 11.9% (35/295) tested positive with RDT compared with 10.5% (31/295) by microscopy: sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 100%, 98.5%, 88.6%, and 100%, respectively. The RDT sensitivity was not affected by transmission season, parasite density, and age. Specificity and positive PV decreased slightly during the high-transmission season (97.5% and 83.3%). The RDT test positivity rates in the low- and high-transmission seasons were 9.4% and 13.5%, respectively. Overall, the test performance of this RDT was satisfactory. The findings of a low proportion of RDT false positives, no invalid and no false-negative results should validate the performance of RDTs in this context. PMID:25711608

Prenatal Caffeine Exposure and Child IQ at Age 5.5 Years: The EDEN Mother-Child Cohort.

PubMed

Galéra, Cédric; Bernard, Jonathan Y; van der Waerden, Judith; Bouvard, Manuel-Pierre; Lioret, Sandrine; Forhan, Anne; De Agostini, Maria; Melchior, Maria; Heude, Barbara

2016-11-01

Evidence from animal studies suggests maternal caffeine intake during pregnancy has detrimental effects on subsequent brain development in offspring. However, human data in this area are limited. The aim of this study was to assess whether caffeine intake by women during pregnancy is associated with impaired cognitive development in offspring at age 5.5 years. Multivariate modeling was conducted using data of 1083 mother-child pairs from a population-based birth cohort in France followed from pregnancy to age 5.5 years of the children. Measures included an estimate of maternal caffeine intake during pregnancy, children's IQ at age 5.5, and individual and family characteristics. Prenatal caffeine exposure was common in the sample (91%) with 12% displaying an intake ≥200 mg/day (high). Multivariable modeling showed a significant negative relationship between caffeine intake and children's IQ at 5.5 years (-.94 [95% confidence interval = -1.70, -.17] full IQ unit per 100 mg daily caffeine intake). In particular, children of mothers consuming ≥200 mg/day were more likely to have borderline or lower IQ compared with children of mothers consuming <100 mg/day (13.5% vs. 7.3%; odds ratio = 2.30, 95% confidence interval = 1.13, 4.69). We found an association between caffeine intake during pregnancy and impaired cognitive development in offspring, a result in line with animal data. More epidemiologic and biologically grounded research is needed to determine whether this association is causal. This finding suggests that conservative guidelines regarding the maximum caffeine intake recommended in pregnancy (i.e., 200 mg/day) should be maintained. Copyright © 2015 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Etiology of viral gastroenteritis in children <5 years of age in the United States, 2008-2009.

PubMed

Chhabra, Preeti; Payne, Daniel C; Szilagyi, Peter G; Edwards, Kathryn M; Staat, Mary Allen; Shirley, S Hannah; Wikswo, Mary; Nix, W Allan; Lu, Xiaoyan; Parashar, Umesh D; Vinjé, Jan

2013-09-01

Although rotavirus and norovirus cause nearly 40% of severe endemic acute gastroenteritis (AGE) in children <5 years of age in the United States, there are limited data on the etiologic role of other enteric viruses in this age group. We conducted active population-based surveillance in children presenting with AGE to hospitals, emergency departments, and primary care clinics in 3 US counties. Stool specimens from these children and from age-matched healthy controls collected between October 2008 and September 2009 were tested for enteric adenovirus, astrovirus, sapovirus, parechovirus, bocavirus, and aichivirus. Typing was performed by sequencing and phylogenetic analysis. Adenovirus, astrovirus, sapovirus, parechovirus, bocavirus, and aichivirus were detected in the stool specimens of 11.8%, 4.9%, 5.4%, 4.8%, 1.4%, and 0.2% of patients with AGE and 1.8%, 3.0%, 4.2%, 4.4%, 2.4%, and 0% of healthy controls, respectively. Adenovirus (type 41), astrovirus (types 1, 2, 3, 4, and 8), sapovirus (genogroups I and II), parechovirus (types 1, 3, 4, and 5), and bocavirus (types 1, 2, and 3) were found cocirculating. Adenovirus, astrovirus, and sapovirus infections were detected in 22.1% of the specimens from children <5 years of age who had medical visits for AGE and tested negative for rotavirus and norovirus. No causal role for parechovirus and bocavirus was found.

Predicting severe motor impairment in preterm children at age 5 years.

PubMed

Synnes, Anne; Anderson, Peter J; Grunau, Ruth E; Dewey, Deborah; Moddemann, Diane; Tin, Win; Davis, Peter G; Doyle, Lex W; Foster, Gary; Khairy, May; Nwaesei, Chukwuma; Schmidt, Barbara

2015-08-01

To determine whether the ability to predict severe motor impairment at age 5 years improves between birth and 18 months. Ancillary study of the Caffeine for Apnea of Prematurity Trial. International cohort of very low birth weight children who were assessed sequentially from birth to 5 years. Severe motor impairment was defined as a score <5th percentile on the Movement Assessment Battery of Children (MABC), or inability to complete the MABC because of cerebral palsy. Multivariable logistic regression cumulative risk models used four sets of predictor variables: early neonatal risk factors, risk factors at 36 weeks' postmenstrual age, risk factors at a corrected age of 18 months, and sociodemographic variables. A receiver operating characteristic curve (ROC) was generated for each model, and the four ROC curves were compared to determine if the addition of the new set of predictors significantly increased the area under the curve (AUC). Of 1469 children, 291 (19.8%) had a severe motor impairment at 5 years. The AUC increased from 0.650 soon after birth, to 0.718 (p<0.001) at 36 weeks' postmenstrual age, and to 0.797 at 18 months (p<0.001). Sociodemographic variables did not significantly improve the AUC (AUC=0.806; p=0.07). Prediction of severe motor impairment at 5 years of age using a cumulative risk model improves significantly from birth to 18 months of age in children with birth weights between 500 g and 1250 g. ClinicalTrials.gov number NCT00182312. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Australian children with cleft palate achieve age-appropriate speech by 5 years of age.

PubMed

Chacon, Antonia; Parkin, Melissa; Broome, Kate; Purcell, Alison

2017-12-01

Children with cleft palate demonstrate atypical speech sound development, which can influence their intelligibility, literacy and learning. There is limited documentation regarding how speech sound errors change over time in cleft palate speech and the effect that these errors have upon mono-versus polysyllabic word production. The objective of this study was to examine the phonetic and phonological speech skills of children with cleft palate at ages 3 and 5. A cross-sectional observational design was used. Eligible participants were aged 3 or 5 years with a repaired cleft palate. The Diagnostic Evaluation of Articulation and Phonology (DEAP) Articulation subtest and a non-standardised list of mono- and polysyllabic words were administered once for each child. The Profile of Phonology (PROPH) was used to analyse each child's speech. N = 51 children with cleft palate participated in the study. Three-year-old children with cleft palate produced significantly more speech errors than their typically-developing peers, but no difference was apparent at 5 years. The 5-year-olds demonstrated greater phonetic and phonological accuracy than the 3-year-old children. Polysyllabic words were more affected by errors than monosyllables in the 3-year-old group only. Children with cleft palate are prone to phonetic and phonological speech errors in their preschool years. Most of these speech errors approximate typically-developing children by 5 years. At 3 years, word shape has an influence upon phonological speech accuracy. Speech pathology intervention is indicated to support the intelligibility of these children from their earliest stages of development. Copyright © 2017 Elsevier B.V. All rights reserved.

Oseltamivir Pharmacokinetics, Dosing, and Resistance Among Children Aged <2 Years With Influenza

PubMed Central

Kimberlin, David W.; Acosta, Edward P.; Prichard, Mark N.; Sánchez, Pablo J.; Ampofo, Krow; Lang, David; Ashouri, Negar; Vanchiere, John A.; Abzug, Mark J.; Abughali, Nazha; Caserta, Mary T.; Englund, Janet A.; Sood, Sunil K.; Spigarelli, Michael G.; Bradley, John S.; Lew, Judy; Michaels, Marian G.; Wan, Wen; Cloud, Gretchen; Jester, Penelope; Lakeman, Fred D.; Whitley, Richard J.; Giles, Dusty; Cotton, Bari; Judy, Sharon; Cowie, Margaret; Francis, Jeanne; Evans, Candice; O'Donnell, Nan; Shiraishi, Ofelia Vargas; Latiolais, Lisa; Aymami, Valeri; Dole, Ken; Gaultier, Julie; Lofthus, Gerry; Kinnunen, Diane; Lacombe, Kirsten; Stellato, Nancy; Denlinger, Julie; Hingtgen, Sara; Mason, Christina; Jeffrey, Noreen

2013-01-01

Background. Children <2 years of age are at high risk of influenza-related mortality and morbidity. However, the appropriate dose of oseltamivir for children <2 years of age is unknown. Methods. The National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group evaluated oseltamivir in infants aged <2 years in an age–de-escalation, adaptive design with a targeted systemic exposure. Results. From 2006 to 2010, 87 subjects enrolled. An oseltamivir dose of 3.0 mg/kg produced drug exposures within the target range in subjects 0–8 months of age, although there was a greater degree of variability in infants <3 months of age. In subjects 9–11 months of age, a dose of 3.5 mg/kg produced drug exposures within the target range. Six of 10 subjects aged 12–23 months receiving the Food and Drug Administration–approved unit dose for this age group (ie, 30 mg) had oseltamivir carboxylate exposures below the target range. Virus from 3 subjects developed oseltamivir resistance during antiviral treatment. Conclusions. The appropriate twice-daily oral oseltamivir dose for infants ≤8 months of age is 3.0 mg/kg, while the dose for infants 9–11 months old is 3.5 mg/kg. Clinical Trials Registration. NCT00391768. PMID:23230059

Laparoendoscopic single-site urologic surgery in children less than 5 years of age.

PubMed

Ganpule, Arvind; Sheladiya, Chetan; Mishra, Shashikant; Sabnis, Ravindra; Desai, Mahesh

2013-08-01

We report our experience with laparoendoscopic single-site (LESS) urological procedures in children less than 5 years of age. Ten patients (11 procedures) underwent LESS through the umbilicus. Seven patients underwent nephrectomy and three patients underwent pyeloplasty (one simultaneous bilateral). R-port port (Advanced Surgical Concepts, Ireland) was used in nine cases, in one case, the Gelpoint access port (Applied Medical, Rancho Santa Margarita, CA, USA) was used. The Olympus Endoeye camera with coaxial light cable was used. The hilum was secured in all cases with Hem-o-Lok clips (Teleflex Medical, Research Triangle Park, NC, USA) except in one case in which an Endo GIA stapler (Covidien Surgical, Norwalk, CT, USA) was used. All procedures were technically successful. Accessory port (3 mm) was used in 3 patients. Mean age in nephrectomized patients was 3.14±1.7 years, the mean operative room time (ORT) was 97.5±12.54 minutes. In the pyeloplasty group, mean ORT was 192±47.16 minutes and mean age was 2.43±2.3 years. Bilateral pyeloplasty was done in a 4-month-old infant. The ORT in this case was 180 minutes. A follow-up renogram done in the pyeloplasty patients (n=2) showed good drainage. Mean length of stay was 3.6 days (range, 3 to 6 days).The analgesic requirement was 23.86 mg (range, 12.5 to 50 mg) of diclofenac sodium. LESS is technically feasible in patients as young as 4 months of age. It has the potential to offer better cosmesis. This needs to be proved in further comparative studies. Development of miniature instruments will further the growth of LESS in this age group.

A hospital-based surveillance of rotavirus gastroenteritis in children <5 years of age in Singapore.

PubMed

Phua, Kong Boo; Tee, Nancy; Tan, Nancy; Ramakrishnan, Gunasekaran; Teoh, Yee-Leong; Bock, Hans; Liu, Yanfang

2013-12-01

In Singapore, 2 rotavirus vaccines were licensed in October 2005 and July 2007, respectively, for vaccinating infants aged ≥ 6 weeks against rotavirus gastroenteritis. These vaccines are optional and are not included in the National Childhood Immunization Program. This study aimed to determine the incidence of rotavirus gastroenteritis-associated hospitalizations among children <5 years of age. Children <5 years, who were hospitalized for acute gastro enteritis, were enrolled between September 2005 and April 2008. Stool samples were tested for the presence and serotyping of rotavirus. Incidence and proportion of gastroenteritis and rotavirus gastroenteritis cases were calculated with 95% confidence intervals. Among 1976 children included in the according-to-protocol cohort, 781 were rotavirus positive with a median age of 24 months (range: 0-59 months). The overall incidence of rotavirus gastroenteritis hospitalizations during the entire study period in children <5 years of age was 4.6 (95% confidence interval: 4.3-4.9) per 1000 person-years with the highest number of cases observed in children 13-24 months of age (26.5%). G1P[8] (18.3%) and G9P[8] (9.9%) were the most common rotavirus types. Rotavirus gastroenteritis hospitalizations peaked between January and March. Rotavirus infection was the primary cause of acute gastro enteritis hospitalizations among children <5 years of age, constituting nearly one-third of gastroenteritis hospitalizations in Singapore. The predominant strain observed in Singapore was G1P[8]. Results of this study suggest the need for implementation of rotavirus vaccination into National Childhood Immunization Program in Singapore.

Family characteristics and caries experience in preschool children. A longitudinal study from pregnancy to 5 years of age.

PubMed

Wigen, Tove I; Espelid, Ivar; Skaare, Anne B; Wang, Nina J

2011-08-01

The purpose of the study was to explore associations between family status, family income, family size, mother's age at child birth, mother's education and parents' national background and caries experience in 5-year-old children. This study is based on data from the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health and the Public Dental Services. A total of 1348 children were followed from pregnancy to the age of 5 years. Questionnaires were completed by mothers twice during pregnancy and when the children were 3 and 5 years of age. Clinical and radiographic examination of the children was performed at the age of 5 years. Caries experience in the 5-year-old children was low; 89% had no caries experience (d(3-5) mft = 0). In multiple logistic regression having one or both parents of non-western origin (OR 3.4, CI 1.6-7.3), having had a change in family status from pregnancy to 5 years of age (OR 2.0, CI 1.1-3.4) and having mother with low education (OR 1.9, CI 1.3-2.8) were statistically significant risk indicators for having caries experience at the age of five. Family characteristics in pregnancy and early life were associated with caries experience in 5-year-old children. Primary care personnel meeting young children with one or several of these characteristics should consider referring the child to dental personnel to enable early initiation of health-promoting activities. © 2010 John Wiley & Sons A/S.

[Trend of mortality of congenital malformation in children aged <5 years in Beijing, 2006-2015].

PubMed

Wang, J; Li, D Y; Zhang, W X; Li, Y C; Wang, J

2017-01-10

Objective: To investigate the change in mortality of congenital malformation in children aged <5 years in Beijing from 2006 to 2015. Methods: Using the death surveillance data in children aged <5 years in Beijing from 2006 to 2015, which was collected from the real-time surveillance network, we calculated the area and age distributions of the mortality of congenital malformation in children aged <5 years in Beijing. Meanwhile, the variations of age, time and space in the causes of deaths were discussed. Results: The mortality rate of congenital malformation in the children s decreased from 1.909‰ in 2006 to 0.703‰ in 2015, the decrease rate was 63.17 % . The decrease rate was highest in neonates (71.50 % ) ( χ (2)=57.993, P <0.01). Expect urban area ( χ (2)=3.384, P >0.05), the mortality rates of congenital malformation in the children showed a downward trend in outer suburban area and suburban area ( χ (2) =40.637 and 50.646, P <0.01). The proportion of the children died of congenital malformation decreased from 32.97 % in 2006 to 23.24 % in 2015, which mainly occurred in infancy and neonatal period ( χ (2)=9.395 and 4.354, P <0.05). The constituent ratios of the children died of neural tube defects, respiratory system abnormalities and other abnormalities decreased significantly ( χ (2)=13.478, 7.358, 7.912 and 10.074, P <0.01). The constituent ratios of children died of chromosomal abnormality, multiple malformations and digestive tract abnormality didn' t decreased significantly ( P >0.05). In the leading causes of deaths from congenital malformation, the mortality of congenital heart disease, neural tube defects and digestive tract atresia decreased obviously ( χ (2)=70.868, 18.431 and 9.225, P <0.01), except biliary atresia ( χ (2)= 1.407, P >0.05). There was an obvious area specific difference between the deaths of congenital heart disease and the deaths of neural tube defects, the mortality was higher in outer suburbs than in suburban and urban

Impact of Age on Change in Self-Image 5 Years After Complex Spinal Fusion (≥5 Levels).

PubMed

Elsamadicy, Aladine A; Adogwa, Owoicho; Sergesketter, Amanda; Behrens, Shay; Hobbs, Cassie; Bridwell, Keith H; Karikari, Isaac O

2017-01-01

Spinal deformities that require ≥5 fusion levels are difficult and challenging for both the surgeon and patient. Corrections of moderate to severe deformities have been shown to improve patient-reported outcomes (PROs), and provide patients with a better quality of life. Self-image is an important PRO because it sheds insight into the patient's perception of health, as well as serving as a proxy of satisfaction for patients with spine deformity undergoing corrective surgery. However, with an aging population, the impact of age on long-term change in self-image is unknown. The aim of this study is to determine the effects of age on self-image 5 years after undergoing an elective complex spinal fusion (≥5 levels). This was a retrospective analysis of prospectively collected data of 55 adult patients (≥18 years old) undergoing ≥5 levels of spinal fusion to the sacrum with iliac fixation from January 2002 to December 2008. Patients were grouped by age: young (<60 years old) and older (≥60 years old). Patient demographics, comorbidities, preoperative variables (sagittal and Cobb angles) and postoperative complication rates were collected. All patients had prospectively collected outcome measures and a minimum of 5 years follow-up. PRO instrument SRS-22r (function, self-image, mental health, and pain) was completed before surgery then at follow-up (at least 5 years after surgery). The primary outcome investigated in this study was the change in self-image after surgery. Baseline characteristics and preoperative variables were similar in both cohorts. There were no significant differences in intraoperative variables, including the mean ± standard deviation number of fusion levels between the cohorts (young, 11.2 ±4.3 vs. older, 12.1 ± 4.0; P = 0.42). Complication rates were similar between the cohorts, with no significant differences in the types of complications (young, 29.63% vs. older, 25.0%; P = 0.77). There were no significant differences in

Bayley-III motor scale and neurological examination at 2 years do not predict motor skills at 4.5 years.

PubMed

Burakevych, Nataliia; Mckinlay, Christopher Joel Dorman; Alsweiler, Jane Marie; Wouldes, Trecia Ann; Harding, Jane Elizabeth

2017-02-01

To determine whether Bayley Scales of Infant and Toddler Development (3rd edition) (Bayley-III) motor scores and neurological examination at 2 years corrected age predict motor difficulties at 4.5 years corrected age. A prospective cohort study of children born at risk of neonatal hypoglycaemia in Waikato Hospital, Hamilton, New Zealand. Assessment at 2 years was performed using the Bayley-III motor scale and neurological examination, and at 4.5 years using the Movement Assessment Battery for Children (2nd edition) (MABC-2). Of 333 children, 8 (2%) had Bayley-III motor scores below 85, and 50 (15%) had minor deficits on neurological assessment at 2 years; 89 (27%) scored less than or equal to the 15th centile, and 54 (16%) less than or equal to the 5th centile on MABC-2 at 4.5 years. Motor score, fine and gross motor subtest scores, and neurological assessments at 2 years were poorly predictive of motor difficulties at 4.5 years, explaining 0 to 7% of variance in MABC-2 scores. A Bayley-III motor score below 85 predicted MABC-2 scores less than or equal to the 15th centile with a positive predictive value of 30% and a negative predictive value of 74% (7% sensitivity and 94% specificity). Bayley-III motor scale and neurological examination at 2 years were poorly predictive of motor difficulties at 4.5 years. © 2016 Mac Keith Press.

Bayley-III motor scale and neurological examination at 2 years do not predict motor skills at 4.5 years

PubMed Central

Burakevych, Nataliia; Mckinlay, Christopher Joel Dorman; Alsweiler, Jane Marie; Wouldes, Trecia An; Harding, Jane Elizabeth

2016-01-01

Aim To determine whether Bayley Scales of Infant and Toddler Development (3rd edition) (Bayley-III) motor scores and neurological examination at 2 years' corrected age predict motor difficulties at 4.5 years' corrected age. Method A prospective cohort study of children born at risk of neonatal hypoglycaemia in Waikato Hospital, Hamilton, New Zealand. Assessment at 2 years was performed using the Bayley-III motor scale and neurological examination, and at 4.5 years using the Movement Assessment Battery for Children (2nd edition) (MABC-2). Results Of 333 children, 8 (2%) had Bayley-III motor scores below 85, and 50 (15%) had minor deficits on neurological assessment at 2 years; 89 (27%) scored less than or equal to the 15th centile, and 54 (16%) less than or equal to the 5th centile on MABC-2 at 4.5 years. Motor score, fine and gross motor subtest scores, and neurological assessments at 2 years were poorly predictive of motor difficulties at 4.5 years, explaining 0 to 7% of variance in MABC-2 scores. A Bayley-III motor score below 85 predicted MABC-2 scores less than or equal to the 15th centile with a positive predictive value of 30% and a negative predictive value of 74% (7% sensitivity and 94% specificity). Interpretation Bayley-III motor scale and neurological examination at 2 years were poorly predictive of motor difficulties at 4.5 years. PMID:27543144

Vitamin supplementation and related nutritional status in Thai children, aged 1-5 years.

PubMed

Ratanachu-ek, Suntaree

2014-06-01

To evaluate the prevalence of vitamin supplementation in Thai children aged 1-5 years at Queen Sirikit National Institute of Child Health (QSNICH), parental knowledge of vitamins, practices, and related factors such as nutritional status in vitamin supplementation. A cross-sectional study was performed at the Well Child Clinic, QSNICH, from 1-31 May 2005. Five hundred parents of young children, aged 1-5 years were interviewed by using the questionnaire to obtain information regarding knowledge and practices of vitamin supplementation. Weight and length/height were measured and nutritional status was assessed using the Thai growth reference. The relationships among vitamin supplement, nutritional status, and other related factors were analyzed using Chi-square test. The p-value < 0.05 was considered statistically significant. Prevalence of vitamin supplementation was 76%, including vitamin C 62%, multi-vitamin (MTV) 35%, and cod-liver oil 20%. Regarding parental knowledge of vitamins, 57% of them knew the health benefits but 74% did not know the toxic effects of vitamins. The reasons for vitamin supplementation were poor feeding 63%, under-weight 23% and unhealthy status 14%. Vitamins were obtained from over-the-counter 59%, health services 40%, and friends 1%. Vitamin supplementation was significantly higher in children over 2 years of age, whose parents knew the benefits of vitamins, and in those children with malnutrition. The prevalence of vitamin supplementation was high in malnourished children, over 2 years of age whose parents had knowledge about benefits of vitamins. Parents should be warned about the dangers of high dose of vitamin consumption.

Trends in asthma mortality in the 0- to 4-year and 5- to 34-year age groups in Brazil

PubMed Central

Graudenz, Gustavo Silveira; Carneiro, Dominique Piacenti; Vieira, Rodolfo de Paula

2017-01-01

ABSTRACT Objective: To provide an update on trends in asthma mortality in Brazil for two age groups: 0-4 years and 5-34 years. Methods: Data on mortality from asthma, as defined in the International Classification of Diseases, were obtained for the 1980-2014 period from the Mortality Database maintained by the Information Technology Department of the Brazilian Unified Health Care System. To analyze time trends in standardized asthma mortality rates, we conducted an ecological time-series study, using regression models for the 0- to 4-year and 5- to 34-year age groups. Results: There was a linear trend toward a decrease in asthma mortality in both age groups, whereas there was a third-order polynomial fit in the general population. Conclusions: Although asthma mortality showed a consistent, linear decrease in individuals ≤ 34 years of age, the rate of decline was greater in the 0- to 4-year age group. The 5- to 34-year group also showed a linear decline in mortality, and the rate of that decline increased after the year 2004, when treatment with inhaled corticosteroids became more widely available. The linear decrease in asthma mortality found in both age groups contrasts with the nonlinear trend observed in the general population of Brazil. The introduction of inhaled corticosteroid use through public policies to control asthma coincided with a significant decrease in asthma mortality rates in both subsets of individuals over 5 years of age. The causes of this decline in asthma-related mortality in younger age groups continue to constitute a matter of debate. PMID:28380185

Antibody persistence 5 years after vaccination at 2 to 10 years of age with Quadrivalent MenACWY-CRM conjugate vaccine, and responses to a booster vaccination.

PubMed

Block, Stan L; Christensen, Shane; Verma, Bikash; Xie, Fang; Keshavan, Pavitra; Dull, Peter M; Smolenov, Igor

2015-04-27

In a multi-center extension study, children 2-10 years of age, initially vaccinated with one or two doses (2-5 year-olds) or one dose (6-10 year-olds) of quadrivalent meningococcal CRM197-conjugate vaccine (MenACWY-CRM), were assessed five years later for antibody persistence and booster response using serum bactericidal assay with human complement (hSBA). Children 7-10 and 11-15 years of age, who received MenACWY-CRM in the original study, and age-matched vaccine-naïve children, were enrolled in this extension study. After an initial blood draw, children received one dose of MenACWY-CRM as booster or primary dose, with a second blood draw 28 days later. hSBA titers decreased five years after primary vaccination, but were higher than in non-vaccinated controls against serogroups C, W and Y, with substantial proportions having titers ≥8: 7-22% for A, 32-57% for C, 74-83% for W, and 48-54% for Y. Previously-vaccinated children demonstrated booster responses to revaccination against all four serogroups. Responses to primary vaccination in vaccine-naïve controls were lower and similar to primary responses observed in the original study. All vaccinations were generally well tolerated, with no safety concern raised. Approximately half the children vaccinated as 2-10 year-olds maintained protective antibodies against serogroups C, W and Y five years later, but fewer did against serogroup A. Declining titers five years after vaccination and robust booster responses suggest that five years may be an appropriate interval to revaccinate children, subject to epidemiology and delivery considerations. Copyright © 2015 Elsevier Ltd. All rights reserved.

Preschool Gender-Typed Play Behavior at Age 3.5 Years Predicts Physical Aggression at Age 13 Years.

PubMed

Kung, Karson T F; Li, Gu; Golding, Jean; Hines, Melissa

2018-05-01

Gender differences in play behavior and physical aggression have been consistently reported. Theoretical perspectives concerning evolutionary, social, and social-cognitive mechanisms suggest that male-typical play behavior during childhood increases subsequent physical aggression. The evidence supporting these connections is limited, however. The present study investigated the association between gender-typed play behavior in early childhood and physical aggression in early adolescence using a sample drawn from a longitudinal, population study, the Avon Longitudinal Study of Parents and Children. Based on gender-typed play behavior as measured by the Pre-School Activities Inventory at age 3.5 years, samples of masculine (64 boys, 60 girls), feminine (80 boys, 66 girls), and randomly selected control children (55 boys, 67 girls) were recruited at age 13 years and administered the Reinisch Aggression Inventory. After controlling for a range of sociodemographic variables, maternal characteristics, and behavioral problems, including hyperactivity and conduct problems at age 3.5, significant group differences in physical aggression at age 13 were found among children classified as masculine, control, and feminine at age 3.5. Masculine children exhibited significantly more physical aggression than control children or feminine children, and control children exhibited significantly more physical aggression than feminine children. The association between gender-typed play behavior and physical aggression was not moderated by sex. These results suggest that the degree of childhood gender-typed play behavior independently predicts the degree of physical aggression at adolescence in boys and in girls.

The Predictors of Diet Quality among Australian Children Aged 3.5 Years.

PubMed

Collins, Laura J; Lacy, Kathleen E; Campbell, Karen J; McNaughton, Sarah A

2016-07-01

It is critical to promote healthy eating early in life. The aim of this study was to examine diet quality and its predictors among Australian preschool-aged children. Diet was assessed at age 3.5 years using multiple 24-hour recalls. Diet quality was assessed using an adapted version of the Revised Children's Diet Quality Index (RC-DQI). Potential predictors of diet quality were from questionnaires at age 3, 9, and 18 months and informed by the ecologic model of childhood overweight. Potential predictors included child's sex, age of introduction to solid foods, breastfeeding status, food acceptance, maternal nutrition knowledge, modeling of healthy eating, self-efficacy, education, and home food availability. Data from 244 children participating in the Melbourne Infant Feeding, Activity, and Nutrition Trial in 2008-2010 and follow-up data collection in 2011-2013 were examined. Diet quality at age 3.5 years. Bivariate logistic regression was performed to assess the relationship between diet quality and each predictor. A multivariable logistic regression model accounting for influences of covariates, treatment arm, and clustering by group tested associations between diet quality and significant predictors from bivariate analyses. RC-DQI scores had a mean±standard deviation score of 62.8±8.3 points out of a maximum of 85 points. Breastfeeding status (odds ratio [OR] 2.34, 95% CI 1.33 to 4.10) and maternal modeling of healthy eating (OR 1.75, 95% CI 1.01 to 3.03) were positively associated with RC-DQI scores. Both breastfeeding status (OR 3.09, 95% CI 1.63 to 5.85) and modeling (OR 2.01, 95% CI 1.04 to 3.88) remained positively associated with diet quality after adjustment for child age, body mass index z score, energy intake, treatment arm, and clustering. Breastfeeding status and modeling of healthy eating were independently associated with children's diet quality. Early intervention could assist mothers to practice these behaviors to provide support for improving

Risk factors for atopic dermatitis in New Zealand children at 3.5 years of age.

PubMed

Purvis, D J; Thompson, J M D; Clark, P M; Robinson, E; Black, P N; Wild, C J; Mitchell, E A

2005-04-01

The prevalence of atopic dermatitis (AD) is increasing in Western societies. The hygiene hypothesis proposes that this is due to reduced exposure to environmental allergens and infections during early life. To examine factors associated with a diagnosis of AD at 3.5 years of age, especially those factors implicated by the hygiene hypothesis. The Auckland Birthweight Collaborative study is a case-control study of risk factors for small for gestational age babies. Cases were born at term with birthweight < or = 10th centile; controls were appropriate for gestational age, with birthweight > 10th centile. The infants were assessed at birth, 1 year and 3.5 years of age. Data were collected by parental interview and examination of the child. AD was defined as the presence of an itchy rash in the past 12 months with three or more of the following: history of flexural involvement; history of generally dry skin; history of atopic disease in parents or siblings; and visible flexural dermatitis as per photographic protocol. Statistical analyses took into account the disproportionate sampling of the study population. Analysis was restricted to European subjects. Eight hundred and seventy-one children were enrolled at birth, 744 (85.4%) participated at 1 year, and 550 (63.2%) at 3.5 years. AD was diagnosed in 87 (15.8%) children seen at 3.5 years. The prevalence of AD did not differ by birthweight. AD at 3.5 years was associated with raised serum IgE > 200 kU L(-1), and wheezing, asthma, rash or eczema at 1 year. In multivariate analysis, adjusted for parental atopy and breastfeeding, AD at 3.5 years was associated with atopic disease in the parents: maternal atopy only, adjusted odds ratio (OR) 3.83, 95% confidence interval (CI) 1.20-12.23; paternal atopy only, adjusted OR 3.59, 95% CI 1.09-11.75; both parents atopic, adjusted OR 6.12, 95% CI 2.02-18.50. There was a higher risk of AD with longer duration of breastfeeding: < 6 months, adjusted OR 6.13, 95% CI 1.45-25.86; > or

Stature-for-Age and Weight-for-Age Percentiles: Boys, 2 to 20 Years

MedlinePlus

2 to 20 years: Boys NAME Stature-for-age and Weight-for-age percentiles RECORD # Mother’s Stature Date Age in cm 160 62 S 155 60 T 150 ... 14 15 16 17 18 19 20 BMI* AGE (YEARS) cm 95 190 90 185 75 180 ...

The course of skull deformation from birth to 5 years of age: a prospective cohort study.

PubMed

van Vlimmeren, Leo A; Engelbert, Raoul Hh; Pelsma, Maaike; Groenewoud, Hans Mm; Boere-Boonekamp, Magda M; der Sanden, Maria Wg Nijhuis-van

2017-01-01

In a continuation of a prospective longitudinal cohort study in a healthy population on the course of skull shape from birth to 24 months, at 5 years of age, 248 children participated in a follow-up assessment using plagiocephalometry (ODDI-oblique diameter difference index, CPI-cranio proportional index). Data from the original study sampled at birth, 7 weeks, 6, 12, and 24 months were used in two linear mixed models. (1) if deformational plagiocephaly (ODDI <104%) and/or positional preference at 7 weeks of age are absent, normal skull shape can be predicted at 5 years of age; (2) if positional preference occurs, ODDI is the highest at 7 weeks and decreases to a stable lowest value at 2 and 5 years of age; and (3) regarding brachycephaly, all children showed the highest CPI at 6 months of age with a gradual decrease over time. The course of skull deformation is favourable in most of the children in The Netherlands; at 5 years of age, brachycephaly is within the normal range for all children, whereas the severity of plagiocephaly is within the normal range in 80%, within the mild range in 19%, and within the moderate/severe range in 1%. Medical consumption may be reduced by providing early tailored counselling. What is Known: • Skull deformation prevalence increased after recommendations against Sudden Infant Death Syndrome, little is known about the longitudinal course. • Paediatric physical therapy intervention between 2 and 6 months of age reduces deformational plagiocephaly at 6 and 12 months of age. What is New: • The course of skull deformation is favourable in most of the children in The Netherlands; at 5 years of age, deformational brachycephaly is within the normal range for all children, whereas the severity of deformational plagiocephaly is within the normal range in 80%, within the mild range in 19%, and within the moderate to severe range in only 1%. • Paediatric physical therapy intervention does not influence the long

Cohort Study of Severe Bronchiolitis during Infancy and Risk of Asthma by Age 5 Years.

PubMed

Balekian, Diana S; Linnemann, Rachel W; Hasegawa, Kohei; Thadhani, Ravi; Camargo, Carlos A

Severe bronchiolitis (ie, bronchiolitis requiring hospital admission) is thought to markedly increase asthma risk, with 30%-50% developing asthma by age 5 years. To date, studies of this association are small, and most are from outside the United States. The objective of this study was to investigate the association between severe bronchiolitis and risk of asthma in a US birth cohort. We studied a cohort nested within the Massachusetts General Hospital Obstetric Maternal Study (MOMS), a prospective cohort of pregnant women enrolled during 1998-2006. Children of mothers enrolled in MOMS were included in the analysis if they received care within our health system (n = 3653). Diagnoses and medications were extracted from the children's electronic health records; we also examined pregnancy and perinatal risk factors collected for the underlying pregnancy study. The birth cohort was 52% male, 49% white, and 105 infants (2.9%) had severe bronchiolitis. Overall, 421 children (11.5%) developed asthma by age 5 years. Among the children with severe bronchiolitis, 27.6% developed asthma by age 5 years. In multivariable logistic regression adjusting for 12 risk factors, severe bronchiolitis remained a strong risk factor for developing asthma by age 5 years (odds ratio 2.57; 95% confidence interval 1.61-4.09). In a large Boston birth cohort, the frequency of severe bronchiolitis and childhood asthma was similar to published data. Among children with severe bronchiolitis, the risk of developing asthma was lower than prior studies but still high (27.6%). This difference may be due to different study designs, populations, and outcome definitions studied. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Malnutrition among vaccinated children aged 0-5 years in Batouri, Republic of Cameroon.

PubMed

Nagahori, Chikako; Kinjo, Yoshihide; Tchuani, Jean Paul; Yamauchi, Taro

2017-12-01

Malnutrition continues to contribute to a high infant mortality rate. This study aimed to determine the prevalence of malnutrition and its potential association with the time at which complementary feeding was introduced among children aged 0-5 years in Batouri, Republic of Cameroon. Mothers (n=212) were interviewed using a structured questionnaire. Child height or length, and weight measurements were determined and the appropriate Z -scores calculated. Multiple regression analysis was performed with the values of all nutritional status indicators as dependent variables and the time of commencing complementary feeding, and the child's age and sex, as independent variables. The prevalence of stunting (height/length for age<-2 standard deviation [SD]), underweight (weight for age<-2SD), and wasting (weight for height/length<-2SD) was 45.8%, 30.2%, and 11.3%, respectively. Even taking into consideration the biological variables, there was a significant association in the effects of time of starting complementary foods on the nutritional status indicators. Furthermore, adding socio-economic variables did not produce a rise in adjusted R 2 values for all age group models concerned. Approximately 30% of the children in the study region were underweight, and approximately half of the children exhibited stunting, indicating chronic malnutrition. Commencing complementary feeding at an appropriate time had a positive effect on nutritional status from approximately 2 years of age.

Phenylalanine tolerance can already reliably be assessed at the age of 2 years in patients with PKU.

PubMed

van Spronsen, F J; van Rijn, M; Dorgelo, B; Hoeksma, M; Bosch, A M; Mulder, M F; de Klerk, J B C; de Koning, T; Rubio-Gozalbo, M Estela; de Vries, M; Verkerk, P H

2009-02-01

The clinical severity of phenylalanine hydroxylase deficiency is usually defined by either pre-treatment phenylalanine (Phe) concentration or Phe tolerance at 5 years of age. So far, little is known about the course of Phe tolerance or the ability of both pre-treatment Phe and Phe tolerance at early age to predict Phe tolerance at later age. This study was conducted to investigate the course of the individual Phe tolerance and to assess the predictive value of both the pre-treatment Phe concentration and Phe tolerance at 1 and 6 months and 1, 2, 3 and 5 years for Phe tolerance at 10 years of age. Data on blood Phe concentration, prescribed Phe intake and weight of 213 early and continuously treated Dutch PKU patients up to 10 years of age were collected. Data acquired under good metabolic control were used in the study. Tolerance was expressed in mg/day and mg/kg per day. Data at 1 and 6 months and at 1, 2, 3 and 5 years of 61, 58, 59, 57, 56 and 59 patients were included for comparison with the Phe tolerance at 10 years. Phe tolerances (mg/kg per day) at 2, 3 and 5 years showed a clear correlation with the tolerance at 10 years of age (r = 0.608, r = 0.725 and r = 0.661). Results for tolerance expressed as mg/day were comparable. Pre-treatment Phe concentrations did not correlate significantly with the tolerance. Pre-treatment Phe is unreliable but Phe tolerance is a reliable predictor of the tolerance at 10 years of age, starting at 2 years of age.

Randomised trial of LHRH analogue treatment on final height in girls with onset of puberty aged 7.5-8.5 years

PubMed Central

Cassio, A.; Cacciari, E.; Balsamo, A.; Bal, M.; Tassinari, D.

1999-01-01

OBJECTIVE—To study the effectiveness of luteinising hormone releasing hormone (LHRH) analogues in improving final height in girls affected by early puberty.
PATIENTS—Forty six consecutive girls with onset of puberty aged 7.5-8.5 years randomly divided into two groups: one treated with 3.75 mg triptorelin intramuscularly every four weeks (group 1); and the other with no treatment (group 2).
RESULTS—Mean (SD) chronological age at onset of menarche was significantly higher in group 1 than in group 2 (11.9 (1.0) v 10.8 (0.7) years). However, mean (SD) height at menarche (152.7 (7.2) v 152.5(5.7) cm) and mean (SD) growth after menarche (4.9 (3.0) v 5.4(2.2) cm) were similar in both groups. The mean (SD) final height was similar in the two groups (group 1, 158.1 (6.2) cm; group 2, 158.6 (6.0) cm) and not significantly different from target height. Fourteen of 20 patients in group 1 and 12 of 18 patients in group 2 showed final height equal to or higher than target height. Final heights of girls with poor initial height prognosis were significantly lower than those of girls with good prognosis, but in patients with the same initial height prognosis, both groups showed final heights similar and not significantly different from their target heights.
CONCLUSIONS—LHRH analogue has no apparent effect on final height in subjects with onset of puberty between 7.5 and 8.5years.

 PMID:10490438

Value of Tree Measurements Made at Age 5 Years for Predicting the Height and Diameter Growth at Age 25 Years in Loblolly Pine Plantations

Treesearch

Allan E. Tiarks; Calvin E. Meier; V. Clark Baldwin; James D. Haywood

1998-01-01

Early growth measurements Of pine plantations are often used to predict the productivity of the stand later in the rotation when assessing the effect Of management on productivity. A loblolly pine (Pinus taeda L.) study established at 35 locations (2 to 3 plots/location) was used to test the relationship between height measurements at age 5 years...

Cognitive functioning over 2 years after intracerebral hemorrhage in school-aged children.

PubMed

Murphy, Lexa K; Compas, Bruce E; Gindville, Melissa C; Reeslund, Kristen L; Jordan, Lori C

2017-11-01

Previous research investigating outcomes after pediatric intracerebral hemorrhage (ICH) has generally been limited to global and sensorimotor outcomes. This study examined cognitive outcomes after spontaneous ICH in school-aged children with serial assessments over 2 years after stroke. Seven children (age range 6-16y, median 13; six males, one female; 57% white, 43% black) presenting with spontaneous ICH (six arteriovenous malformations) were assessed at 3 months, 12 months, and 24 months after stroke. The Pediatric Stroke Outcome Measure (PSOM) quantified neurological outcome and Wechsler Intelligence Scales measured cognitive outcomes: verbal comprehension, perceptual reasoning, working memory, and processing speed. PSOM scales showed improved neurological function over the first 12 months, with mild to no sensorimotor deficits and moderate overall deficits at 1- and 2-year follow-ups (median 2-year sensorimotor PSOM=0.5, total PSOM=1.5). Changes in cognitive function indicated a different trajectory; verbal comprehension and perceptual reasoning improved over 24 months; low performance was sustained in processing speed and working memory. Age-normed centile scores decreased between 1- and 2-year follow-ups for working memory, suggesting emerging deficits compared with peers. Early and serial cognitive testing in children with ICH is needed to assess cognitive functioning and support children in school as they age and cognitive deficits become more apparent and important for function. In children with intracerebral hemorrhage (ICH), motor function improved between 3 months and 24 months. Improvements in cognitive function were variable between 3 months and 24 months. Working memory centiles declined, suggesting emerging deficits compared with peers. Processing speed improved but remained significantly below the 50th centile. Cognitive impact of ICH may increase with age in children. © 2017 Mac Keith Press.

Development of Distinct Body Mass Index Trajectories Among Children Before Age 5 Years: A Population-Based Study.

PubMed

Lynch, Brian A; Rutten, Lila J Finney; Ebbert, Jon O; Kumar, Seema; Yawn, Barbara P; Jacobson, Debra; Sauver, Jennifer St

2017-10-01

The prevalence of childhood obesity has increased over the past 3 decades. This study was designed to understand how childhood body mass index (BMI) influences later risk of obesity. We calculated BMIs for children residing in Olmsted County, Minnesota, between January 1, 2005 and December 31, 2012 using medical records data. We defined homogenous BMI trajectory clusters using a nonparametric hill-climbing algorithm. Overall, 16,538 (47%) children had >3 weight assessments at least 1 year apart and were included in the analyses. Within the 8-year follow-up period, children who were younger than 2 years and overweight had a 3- fold increase of obesity (adjusted hazard ratio [HR] = 3.24; 95% confidence interval [CI] = 2.69-3.89) and those aged 5 years and overweight had a 10-fold increased risk of obesity (adjusted HR = 9.97, 95% CI = 8.55-11.62). Three distinct BMI trajectories could be distinguished prior to 5 years of age. The risk of developing obesity in those who are overweight increased dramatically with increasing age. Interventions to prevent obesity need to occur prior to school age to prevent children from entering unhealthy BMI trajectories.

[Child malnutrition in children under 5 years of age in Peru: trends and determinants].

PubMed

Sobrino, Manuel; Gutiérrez, César; Cunha, Antonio J; Dávila, Miguel; Alarcón, Jorge

2014-02-01

Analyze malnutrition and anemia trends in Peruvian children under 5 years of age and their association with determinants in the 2000-2011 period. Nutritional indicators for children under 5 years of age from the 2011 Demographic and Family Health Survey (ENDES), and their evolution based on data from the 2000, 2005, and 2008 ENDES, were analyzed. Chronic malnutrition (CM) (height/age ≤ 2 SD), acute malnutrition (AM), (height/weight ≤ 2 SD), and anemia trends were estimated. Associations were found with factors such as sex, age, area of residence (urban or rural), region of residence, mother's education, wealth quintile, availability of public water system, sewer availability, altitude, presence of other children in household, birth order, presence of diarrhea in previous 15 days, and presence of cough in previous 15 days. AM, CM, and anemia in Peruvian children under 5 years of age decreased from 2000-2011. This reduction was not uniform for the three conditions, with decreases of 1.1% to 0.4% recorded for AM, 31.6% to 19.6% for CM, and 50.4% to 30.7% for anemia. Although the factors analyzed were related to the prevalence of these three illnesses, calculation of the adjusted odds ratios showed significant differences for CM (mother's education, Sierra region, altitude greater than 2 500 m above sea level, presence of two or more children in household, and being the third or successive child) and anemia (child sex [higher in males], children under 2 years of age, Resto de costa region and Selva region, altitude greater than 2 500 m above sea level, availability of public water system, sewer availability, presence of two or more children in household, and presence of diarrhea within 15 days prior to the survey). For AM, differences were observed according to some factors but they were not significant in the adjusted model. In the 2000-2011 period, Peru achieved reduction of its CM, AM, and anemia rates. AM rates decreased to almost one-third, with overall

Aetiology and clinical features of dysentery in children aged <5 years in rural Bangladesh.

PubMed

Ferdous, F; Ahmed, S; DAS, S K; Farzana, F D; Latham, J R; Chisti, M J; Faruque, A S G

2014-01-01

The study identified the common aetiological agents and prominent clinical features of dysentery cases in children aged <5 years and compared this to non-dysentery diarrhoeal cases from the same population. From January 2010 to December 2011, 2324 children aged <5 years received treatment at Kumudini Hospital, of which 682 (29%) presented with dysentery. Of the dysenteric children, aetiology could not be determined for over half (61%). Shigella spp. accounted for 32% of dysentery cases. Significant associations were found between presence of blood in stool and: child age (24-59 months) [odds ratio (OR) 2.21, 95% confidence interval (CI) 1.49-3.27], no treatment of drinking water at home (OR 2.00, 95% CI 1.09-3.67), vomiting (OR 0.19, 95% CI 0.14-0.25), abdominal pain (OR 4.68, 95% CI 3.24-6.77), straining (OR 16.45, 95% CI 11.92-22.69), wasting (OR 1.66, 95% CI 1.15-2.41), and presence of Shigella in stool (OR 6.25, 95% CI 4.20-9.29) after controlling for confounders. This study makes it clear that appropriate public health strategies are needed to reduce the burden of dysentery in Bangladesh.

Impact of rotavirus vaccination in Australian children below 5 years of age

PubMed Central

Pendleton, Annmarie; Galic, Maja; Clarke, Christopher; Ng, Su Peing; Ledesma, Emilio; Ramakrishnan, Gunasekaran; Liu, Yanfang

2013-01-01

This study was conducted to assess the impact of administration of two-dose rotavirus (RV) vaccine (RIX4414; GlaxoSmithKline Vaccines) among children aged less than 5 y in three states/territories of Australia. Aggregated and de-identified data on rotavirus gastroenteritis (RVGE) and all-cause gastroenteritis (AGE) from July 1998–June 2009 were obtained from the Australian Institute of Health and Welfare database. The baseline incidence (July 1998–June 2006) of RVGE hospitalizations before RV vaccine introduction in New South Wales (NSW), the Australian Capital Territory (ACT) and the Northern Territory (NT) were 33.75, 42.93 and 288.67 per 10 000 child-years, respectively among children aged 0–11 mo. Following RV vaccine introduction in NSW, the ACT and the NT, incidence of RVGE hospitalizations reduced to 13.06, 17.35 and 47.52 per 10 000 child-years, respectively, during July 2007–June 2008 and 3.87, 8.40 and 122.79 per 10,000 child-years, respectively, during July 2008–June 2009 among children aged 0–11 mo. Reductions in RVGE and AGE were also observed in all children below 5 y of age in NSW and the ACT. Overall reduction in hospitalizations due to RVGE and AGE was observed following RV vaccine introduction into the NIP in Australia. PMID:23733041

[Immunization coverage of children aged 0 to 5 years in Libreville (Gabon)].

PubMed

Ategbo, Simon; Ngoungou, Edgard Brice; Koko, Jean; Vierin, Yolande; Zang Ndong, Carine Eyi; Moussavou Mouyama, André

2010-01-01

monitoring. Parents were asked to explain the reasons for any delays in or absences of vaccinations. EPI vaccines administered to children aged 0 to 11 months include: BCG (Calmette-Guérin bacillus); DPT3 (3rd combination dose for Diphtheria-Tetanus-Pertussis); Hib3 (3rdd dose of Haemophilus influenza b); OPV3 (3rd dose of oral polio vaccine); IPV3 (3rd dose of injectable polio vaccine, often in combination); HEB3 (3rd dose of Hepatitis B); yellow fever vaccine; and measles vaccine. The non-EPV vaccines for children aged 12 to 59 months included: HiB4; DPT4; HEB4; IPV4; MMR (combined Measles-Mumps-Rubella); meningococcal vaccine A and C; Typhim Vi (typhoid polysaccharide vaccine); and Pneumo 23 (pneumococcal vaccine.) The study included 1001 children: 533 boys (53.2%) and 468 girls (46.8%), for a sex ratio of 1.1. The mean age of the sample was 12.0 ± 13.1 months, distributed as follows: 64.5% aged 0 to 11 months; 20.1% aged 12 to 24 months; and 15.4% aged 25 to 59 months. In all, 175 children (17.5%) came from the private sector, and 826 children (82.5%) from the public sector. Both parents lived with 696 children (69.5%), while the remaining 305 children (30.5%) lived with their mother. The mothers' mean age was 26 years (min/max: 15/49 years); 61.3% had completed secondary education, 19.1% superior level, 10.6% primary level and 9.0% had no education at all. Almost 37% of mothers had some sort of paid employment. Household income was distributed as follows: low income for 18.6%, average income for 47.2%, and high income for 34.3% of the families interviewed. The average number of children under the age of 15 in a household was 3 (±2). Among children aged 0 to 11 months, the EPI antigens had the highest vaccination coverage rates, and these rates were higher in the private sector (more than 80% to 99% for some). Overall, the BCG scar was seen in 98.5% of all children; in the private sector 90.2% had received the third dose of the DTC/VPO-IPV vaccine, and in the

Increase of body mass index (BMI) from 1.5 to 3 years of age augments the degree of insulin resistance corresponding to BMI at 12 years of age.

PubMed

Arisaka, Osamu; Sairenchi, Toshimi; Ichikawa, Go; Koyama, Satomi

2017-04-01

To elucidate the effect of early growth patterns on the metabolic sensitivity to adiposity, we examined the relationship between the homeostatic model assessment of insulin resistance (HOMA-IR) and body mass index (BMI) levels at 12 years of age in 101 boys and 91 girls in a birth cohort. Children with an increase in BMI from the ages of 1.5 to 3 years exhibited a greater increase of HOMA-IR per BMI increase at 12 years of age compared to those with a decrease in BMI or stable BMI from 1.5 to 3 years. This suggests that children who show an increase in BMI from 1.5 to 3 years, a period normally characterized by a decreased or stable BMI, are more prone to developing insulin resistance at 12 years of age.

Age-stratified 5-year risks of cervical precancer among women with enrollment and newly detected HPV infection.

PubMed

Gage, Julia C; Katki, Hormuzd A; Schiffman, Mark; Fetterman, Barbara; Poitras, Nancy E; Lorey, Thomas; Cheung, Li C; Castle, Philip E; Kinney, Walter K

2015-04-01

It is unclear whether a woman's age influences her risk of cervical intraepithelial neoplasia grade 3 or worse (CIN3+) upon detection of HPV. A large change in risk as women age would influence vaccination and screening policies. Among 972,029 women age 30-64 undergoing screening with Pap and HPV testing (Hybrid Capture 2, Qiagen, Germantown, MD) at Kaiser Permanente Northern California (KPNC), we calculated age-specific 5-year CIN3+ risks among women with HPV infections detected at enrollment, and among women with "newly detected" HPV infections at their second screening visit. Women (57,899, 6.0%) had an enrollment HPV infection. Among the women testing HPV negative at enrollment with a second screening visit, 16,724 (3.3%) had a newly detected HPV infection at their second visit. Both enrollment and newly detected HPV rates declined with age (p < 0.001). Women with enrollment versus newly detected HPV infection had higher 5-year CIN3+ risks: 8.5% versus 3.9%, (p < 0.0001). Risks did not increase with age but declined slightly from 30-34 years to 60-64 years: 9.4% versus 7.4% (p = 0.017) for enrollment HPV and 5.1% versus 3.5% (p = 0.014) for newly detected HPV. Among women age 30-64 in an established screening program, women with newly detected HPV infections were at lower risk than women with enrollment infections, suggesting reduced benefit vaccinating women at older ages. Although the rates of HPV infection declined dramatically with age, the subsequent CIN3+ risks associated with HPV infection declined only slightly. The CIN3+ risks among older women are sufficiently elevated to warrant continued screening through age 65. © 2014 UICC.

Age-Stratified 5-Year Risks of Cervical Precancer among Women with Enrollment and Newly Detected HPV Infection

PubMed Central

Gage, Julia C.; Katki, Hormuzd A.; Schiffman, Mark; Fetterman, Barbara; Poitras, Nancy E.; Lorey, Thomas; Cheung, Li C.; Castle, Philip E.; Kinney, Walter K.

2014-01-01

It is unclear whether a woman's age influences her risk of cervical intraepithelial neoplasia grade 3 or worse (CIN3+) upon detection of HPV. A large change in risk as women age would influence vaccination and screening policies. Among 972,029 women age 30-64 undergoing screening with Pap and HPV testing (Hybrid Capture 2, Qiagen, Germantown, MD, USA) at Kaiser Permanente Northern California (KPNC), we calculated age-specific 5-year CIN3+ risks among women with HPV infections detected at enrollment, and among women with “newly detected” HPV infections at their second screening visit. 57,899 women (6.0%) had an enrollment HPV infection. Among the women testing HPV negative at enrollment with a second screening visit, 16,724 (3.3%) had a newly detected HPV infection at their second visit. Both enrollment and newly detected HPV rates declined with age (p<.001). Women with enrollment vs. newly detected HPV infection had higher 5-year CIN3+ risks: 8.5% vs. 3.9%, (p<.0001). Risks did not increase with age but declined slightly from 30-34 years to 60-64 years: 9.4% vs. 7.4% (p=0.017) for enrollment HPV and 5.1% vs. 3.5% (p=0.014) for newly detected HPV. Among women age 30-64 in an established screening program, women with newly detected HPV infections were at lower risk than women with enrollment infections, suggesting reduced benefit vaccinating women at older ages. Although the rates of HPV infection declined dramatically with age, the subsequent CIN3+ risks associated with HPV infection declined only slightly. The CIN3+ risks among older women are sufficiently elevated to warrant continued screening through age 65. PMID:25136967

Corporal Punishment and Child Behavioural and Cognitive Outcomes through 5?Years of Age: Evidence from a Contemporary Urban Birth Cohort Study

ERIC Educational Resources Information Center

MacKenzie, Michael J.; Nicklas, Eric; Waldfogel, Jane; Brooks-Gunn, Jeanne

2012-01-01

This study examined the prevalence and determinants of spanking of children at 3?years of age and the associations between spanking and externalizing behaviour and receptive verbal ability at age 5?years. Overall, we find maternal spanking rates of 55.2% and paternal rates of 43.2% at age 3?years. Mothers facing greater stress and those who…

Longitudinal Evaluation of 100% Fruit Juice Consumption on BMI Status in 2–5 Year-Old Children

PubMed Central

Shefferly, Ann; Scharf, Rebecca J.; DeBoer, Mark D.

2015-01-01

Background Obesity in childhood is related to multiple lifestyle factors. Our objective was to evaluate the relationship between consumption of 100% fruit juice and weight status over time among preschool children. Methods We used linear and logistic multivariable regression to evaluate body mass index (BMI) z-score and overweight/obese status as a function of 100% fruit juice intake for 8,950 children examined at ages 2, 4, and 5 years as part of the Early Childhood Longitudinal Study–Birth Cohort, a representative sample of the United States. Results Cross-sectional analysis at ages 2, 4, and 5 years showed no difference in the prevalence of overweight and obesity between consistent juice drinkers and inconsistent/non-drinkers. Longitudinal analysis found that children who drank 100% juice consistently at age 2 years had greater increases in BMI z-score by age 4 years than infrequent/non-drinkers (p<0.0001), a difference driven by lesser increases in height z-score (p=0.0003) and slightly greater increases in weight z-score (p=0.0550) among consistent juice drinkers over the 2 to 4 year time period. Additionally, consistent juice drinkers at age 2 had higher odds of becoming overweight by age 4 (adjusted odds ratio 1.30; CI 1.06–1.60). These differences in growth parameters were not noted between ages 4 and 5 years. Conclusions Drinking 100% fruit juice regularly at age 2 is associated with higher odds of becoming overweight between 2 and 4 years. Pediatricians and parents can discourage excessive fruit juice consumption as part of a larger effort to avoid unhealthy gain in BMI in young children. PMID:26110996

Subcutaneous Immunoglobulin Replacement Therapy with Hizentra® is Safe and Effective in Children Less Than 5 Years of Age.

PubMed

Patel, Niraj C; Gallagher, Joel L; Ochs, Hans D; Prescott Atkinson, Thomas; Wahlstrom, Justin; Dorsey, Morna; Bonilla, Francisco A; Heimall, Jennifer; Kobrynski, Lisa; Morris, David; Haddad, Elie

2015-08-01

Hizentra® (IGSC 20%) is a 20% liquid IgG product approved for subcutaneous administration in adults and children 2 years of age and older who have primary immunodeficiency disease (PIDD). There is limited information about the use of IGSC 20 % in very young children including those less than 5 years of age. A retrospective chart review involved 88 PIDD infants and children less than 5 years of age who received Hizentra®. The mean age at the start of Hizentra® was 34 months (range 2 to 59 months). IGSC 20 % was administered weekly to 86 infants (two additional infants received twice weekly and three times weekly infusions, respectively) and included an average of 63 infusions (range 6-182) for an observation period up to 45.5 months. Infusion by manual delivery occurred in 15 patients. The mean dose was 674 mg/kg/4 weeks. The mean IgG level was 942 mg/dL while on IGSC 20 %, compared to a mean trough IgG level of 794 mg/dL (p < 0.0001) during intravenous or subcutaneous IgG administration prior to IGSC 20 %. Average infusion time was 47 (range 5-120) minutes, and the median number of infusion sites was 2 (range 1-4). Local reactions were mostly mild and observed in 36/88 (41%) children. No serious adverse events were reported. A significant increase in weight percentile (7 % ± 19.2, p = 0.0012) among subjects was observed during IGSC 20% administration. The rate of serious bacterial infections was 0.067 per patient-year while receiving IGSC 20%, similar to previously reported efficacy studies. Hizentra® is effective in preventing infections, and is well tolerated in children less than age 5 years.

Fetal exposure to propoxur and abnormal child neurodevelopment at 2 years of age

PubMed Central

Ostrea, Enrique M.; Reyes, Alexis; Villanueva-Uy, Esterlita; Pacifico, Rochelle; Benitez, Bernadette; Ramos, Essie; Bernardo, Rommel C.; Bielawski, Dawn M.; Delaney-Black, Virginia; Chiodo, Lisa; Janisse, James J.; Ager, Joel W.

2012-01-01

Objective Our aim was to determine the effects of fetal exposure to propoxur and pyrethroids, on child neurodevelopment at 2 years of age. Patients and Methods Mothers were prospectively recruited during mid-pregnancy in Bulacan, Philippines where multiple pesticides including propoxur, cyfluthrin, chlorpyrifos, cypermethrin, pretilachlor, bioallethrin, malathion, diazinon and transfluthrin are used. To detect prenatal exposure to these pesticides, maternal hair and blood, infant’s hair, cord blood, and meconium were analyzed for the pesticides by gas chromatography/mass spectrometry. Infants were examined at 2 years of age with 95.1% follow up rate and their neurodevelopment outcome was assessed by the Griffiths Mental Developmental Scale (N=754). Results Meconium analysis was the most sensitive method to detect fetal exposure to pesticides and exposure was highest for propoxur (21.3%) and the grouped pyrethroids (2.5% - bioallethrin, transfluthrin, cyfluthrin and cypermethrin). Path analysis modeling was performed to determine the effects of fetal exposure to propoxur and pyrethroids on the child’s neurodevelopment at 24 months of age while controlling for confounders. Only singletons and those with complete data for the path analysis were included (N=696). Using a path analysis model, there was a significant negative (β= −0.14, p<0.001) relationship between prenatal pesticide exposure to propoxur and motor development at 2 years of age after controlling for confounders, e.g., infant gender, socioeconomic status, maternal intelligence, home stimulation (HOME), postnatal exposure to propoxur and blood lead level at 2 years of age. Conclusion At 2 years of age, prenatal exposure to propoxur was associated with poorer motor development in children. PMID:22155319

Graves' disease in 2.5 years old girl - 6-years-long observation.

PubMed

Jonak, Olimpia; Połubok, Joanna; Barg, Ewa

2016-01-01

Pediatric Graves' disease is rare in young children, more frequent in children with other autoimmune diseases or with family history of autoimmune thyroid disease. The 2.5 year old girl was admitted to the hospital with tachycardia and subfebrile temperature. The girl presented symptoms of atopic dermatitis. Child's mother was diagnosed with Hashimoto disease two months after the child's diagnosis. In physical examination of the child, enlarged thyroid was found. At the admission, the laboratory tests revealed decreased TSH (0.001 uIU/ml), increased both FT3 (>30 pg/ml) and FT4 (3.43 ng/dl), but normal levels of anti-thyreoglobulin antibodies (ATG - 0.64 IU/ml) and anti-thyroid peroxidase antibodies (ATPO - 0 IU/ml); thyrotropin receptor antibodies (TRAb) were not identified. The Graves' disease was diagnosed. The girl started treatment with methimazole (2x5mg) and propranolol (due to tachycardia, 2x5mg). The thyroid function (TSH, FT4 and FT3) normalized 1 year after diagnosis and hormone levels remained within normal reference values, but she received methimazole for 18 months. At presen, the patient is 8 years old. She is not receiving any treatment and her thyroid function is correct. The girl still presents symptoms of atopy. In case of symptoms of tachycardia in children, the hyperthyroidism should be taken into consideration. Numerous methods of treatment provide a therapy appropriate to the age and condition of patients. Long remission after treatment with antithyroid drugs could also be achieved in younger (prepubertal) children. © Polish Society for Pediatric Endocrinology and Diabetology.

Prospective evaluation of respiratory exacerbations in children with cystic fibrosis from newborn screening to 5 years of age.

PubMed

Byrnes, Catherine Ann; Vidmar, Suzanna; Cheney, Joyce L; Carlin, John B; Armstrong, David S; Cooper, Peter J; Grimwood, Keith; Moodie, Marj; Robertson, Colin F; Rosenfeld, Margaret; Tiddens, Harm A; Wainwright, Claire E

2013-07-01

Newborn screening allows novel treatments for cystic fibrosis (CF) to be trialled in early childhood before irreversible lung injury occurs. As respiratory exacerbations are a potential trial outcome variable, we determined their rate, duration and clinical features in preschool children with CF; and whether they were associated with growth, lung structure and function at age 5 years. Respiratory exacerbations were recorded prospectively in Australasian CF Bronchoalveolar Lavage trial subjects from enrolment after newborn screening to age 5 years, when all participants underwent clinical assessment, chest CT scans and spirometry. 168 children (88 boys) experienced 2080 exacerbations, at an average rate of 3.66 exacerbations per person-year; 80.1% were community managed and 19.9% required hospital admission. There was an average increase in exacerbation rate of 9% (95% CI 4% to 14%; p<0.001) per year of age. Exacerbation rate differed by site (p<0.001) and was 26% lower (95% CI 12% to 38%) in children receiving 12 months of prophylactic antibiotics. The rate of exacerbations in the first 2 years was associated with reduced forced expiratory volume in 1 s z scores. Ever having a hospital-managed exacerbation was associated with bronchiectasis (OR 2.67, 95% CI 1.13 to 6.31) in chest CT scans, and lower weight z scores at 5 years of age (coefficient -0.39, 95% CI -0.74 to -0.05). Respiratory exacerbations in young children are markers for progressive CF lung disease and are potential trial outcome measures for novel treatments in this age group.

Prediction of outcome at 5 years from assessments at 2 years among extremely preterm children: a Norwegian national cohort study.

PubMed

Leversen, Katrine Tyborg; Sommerfelt, Kristian; Elgen, Irene Bircow; Eide, Geir Egil; Irgens, Lorentz M; Júlíusson, Pétur B; Markestad, Trond

2012-03-01

To examine the predictive value of early assessments on developmental outcome at 5 years in children born extremely preterm. This is a prospective observational study of all infants born in Norway in 1999-2000 with gestational age (GA) <28 weeks or birth weight (BW) <1000 g. At 2 years of age, paediatricians assessed mental and motor development from milestones. At 5 years, parents completed questionnaires on development and professional support before cognitive function was assessed with Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R) and motor function with the Movement Assessment Battery for children (ABC test). Twenty-six of 373 (7%) children had cerebral palsy at 2 and 29 of 306 (9%) children at 5 years. Of children without major impairments, 51% (95% CI 35-67) of those with and 22% (95% CI 16-28) without mental delay at 2 years had IQ <85 at 5 years, and 36% (95% CI 20-53 with and 16% (95% CI 11-21) without motor delay at 2 years had an ABC score >95th percentile (poor function). Approximately half of those without major impairments but IQ <85 or ABC score >95th percentile had received support or follow-up beyond routine primary care. Previous assessments had limited value in predicting cognitive and motor function at 5 years in these extremely preterm children without major impairments. © 2011 The Author(s)/Acta Paediatrica © 2011 Foundation Acta Paediatrica.

Survival without disability to age 5 years after neonatal caffeine therapy for apnea of prematurity.

PubMed

Schmidt, Barbara; Anderson, Peter J; Doyle, Lex W; Dewey, Deborah; Grunau, Ruth E; Asztalos, Elizabeth V; Davis, Peter G; Tin, Win; Moddemann, Diane; Solimano, Alfonso; Ohlsson, Arne; Barrington, Keith J; Roberts, Robin S

2012-01-18

Very preterm infants are prone to apnea and have an increased risk of death or disability. Caffeine therapy for apnea of prematurity reduces the rates of cerebral palsy and cognitive delay at 18 months of age. To determine whether neonatal caffeine therapy has lasting benefits or newly apparent risks at early school age. Five-year follow-up from 2005 to 2011 in 31 of 35 academic hospitals in Canada, Australia, Europe, and Israel, where 1932 of 2006 participants (96.3%) had been enrolled in the randomized, placebo-controlled Caffeine for Apnea of Prematurity trial between 1999 and 2004. A total of 1640 children (84.9%) with birth weights of 500 to 1250 g had adequate data for the main outcome at 5 years. Combined outcome of death or survival to 5 years with 1 or more of motor impairment (defined as a Gross Motor Function Classification System level of 3 to 5), cognitive impairment (defined as a Full Scale IQ<70), behavior problems, poor general health, deafness, and blindness. The combined outcome of death or disability was not significantly different for the 833 children assigned to caffeine from that for the 807 children assigned to placebo (21.1% vs 24.8%; odds ratio adjusted for center, 0.82; 95% CI, 0.65-1.03; P = .09). The rates of death, motor impairment, behavior problems, poor general health, deafness, and blindness did not differ significantly between the 2 groups. The incidence of cognitive impairment was lower at 5 years than at 18 months and similar in the 2 groups (4.9% vs 5.1%; odds ratio adjusted for center, 0.97; 95% CI, 0.61-1.55; P = .89). Neonatal caffeine therapy was no longer associated with a significantly improved rate of survival without disability in children with very low birth weights who were assessed at 5 years.

Increase in best practice child car restraint use for children aged 2-5 years in low socioeconomic areas after introduction of mandatory child restraint laws.

PubMed

Brown, Julie; Keay, Lisa; Hunter, Kate; Bilston, Lynne E; Simpson, Judy M; Ivers, Rebecca

2013-06-01

To examine changes in child car restraint practices in low socioeconomic areas following the introduction of mandatory child car restraint legislation in New South Wales (NSW), Australia. Data from two cross-sectional studies of child car restraint use at pre-schools, early childhood centres and primary schools before and after the introduction of legislating mandatory age-appropriate car restraint use for children up to the age of seven years was used in this analysis. All included observations were from local government areas with socioeconomic status in the lowest 30% of urban Sydney. Children aged 2-5 years were observed in their vehicles as they arrived at observation sites (107 pre-legislation, 360 post-legislation). Multilevel logistic regression was used to examine changes in observed age-appropriate and correct use of car restraints. Age-appropriate car restraint use was higher post-legislation than pre-legislation. After controlling for child's age, parental income, language spoken at home and adjusting for clustering, the odds of children being appropriately restrained post-legislation were 2.3 times higher than in the pre-legislation sample, and the odds of them being correctly restrained were 1.6 times greater. Results indicate an improvement in car restraint practices among children aged 2-5 in low socioeconomic areas after introduction of child restraint laws. Implications : Despite improvements observed with enhanced legislation, further efforts are required to increase optimal child car restraint use. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.

Child development at 5 years of age predicted mathematics ability and schooling outcomes in Malawian adolescents.

PubMed

Gandhi, Mihir; Teivaanmaki, Tiina; Maleta, Kenneth; Duan, Xiaolian; Ashorn, Per; Cheung, Yin Bun

2013-01-01

This study aimed to examine the association between child development at 5 years of age and mathematics ability and schooling outcomes at 12 years of age in Malawian children. A prospective cohort study looking at 609 rural Malawian children. Outcome measures were percentage of correctly answered mathematics questions, highest school grade completed and number of times repeating school grades at 12 years of age. A child development summary score obtained at 5 years of age was the main exposure variable. Regression analyses were used to estimate the association and adjust for confounders. Sensitivity analysis was performed by handling losses to follow-up with multiple imputation (MI) method. The summary score was positively associated with percentage of correctly answered mathematics questions (p = 0.057; p = 0.031 MI) and with highest school grade completed (p = 0.096; p = 0.070 MI), and negatively associated with number of times repeating school grades (p = 0.834; p = 0.339 MI). Fine motor score at 5 years was independently associated with the mathematic score (p = 0.032; p = 0.011 MI). The association between child development and mathematics ability did not depend on school attendance. Child development at 5 years of age showed signs of positive association with mathematics ability and possibly with highest school grade completed at 12 years of age. © 2012 The Author(s)/Acta Paediatrica © 2012 Foundation Acta Paediatrica.

Individual factors, neighborhood social context and asthma at age 5 years.

PubMed

Vo, Phuong; Bair-Merritt, Megan; Camargo, Carlos A; Eisenberg, Staci; Long, Webb

2017-04-01

Childhood asthma is a major public health problem and its development is multifactorial. We examined whether neighborhood cohesion and disorder were associated with caregiver-report of asthma at age 5 years. This study is a secondary data analysis of the 2011-2012 United States National Survey of Children's Health. Data were available for 4680 children, age 5 years old born at term or preterm with birthweight >2500 g. Neighborhood disorder and cohesion were assessed based on caregivers' responses to validated questionnaires. Child asthma diagnosis was reported by the caregiver. Multivariable logistic regression was used to examine the relationship between these neighborhood factors and caregiver-report of child asthma, while accounting for individual level covariates. Approximately two-thirds of the 4680 children were White and lived in households with income >400% of federal poverty line. Asthma was present in 399 (9%) children. Child female sex was associated with reduced risk of caregiver-reported asthma while non-Hispanic Black race and having smokers in the household were independently associated with increased risk in multivariable models. In these models, neighborhood disorder was significantly associated with asthma (adjusted Odds Ratio [aOR] 1.70, 95% Confidence Interval [CI] 1.04-2.78), while neighborhood cohesion was not (aOR 0.93, 95% CI 0.51-1.68). Even after adjustment for several individual level factors, neighborhood disorder was associated with caregiver-report of asthma in this nationally representative sample of 5-year-old children. Further research is needed to better understand how risk factors at different levels of the socio-ecological framework may interact to affect childhood asthma development.

Ages and Stages Questionnaire at 3 Years for Predicting IQ at 5-6 Years.

PubMed

Charkaluk, Marie-Laure; Rousseau, Jessica; Calderon, Johanna; Bernard, Jonathan Y; Forhan, Anne; Heude, Barbara; Kaminski, Monique

2017-04-01

To assess the predictive value of the 36-month Ages & Stages Questionnaire (ASQ) score for IQ score at age 5 to 6 years in the general population and to identify factors associated with IQ <85 once the ASQ score is taken into account. Data were collected from 939 children enrolled in a population-based prospective cohort study. Developmental outcomes at 36 months were assessed via the ASQ and at 5 to 6 years via the Wechsler Preschool and Primary Scale of Intelligence. The ASQ threshold was identified via the receiver operating characteristic curve. Additional predictive factors to obtain an IQ <85 were investigated, and their interaction with ASQ score was studied. Sixty-nine children (7.3%) had an IQ <85. A 36-month ASQ score threshold of 270 was optimal to identify children with an IQ <85 at 5 to 6 years, with a 0.77 ± 0.11 sensitivity and 0.68 ± 0.03 specificity. Maternal educational level and occupational activity at the time of ASQ completion were associated with the risk of an IQ <85 at a given ASQ level. In the multivariate model, no interaction between the studied factors and ASQ score reached significance. In the general pediatric population, 36-month ASQ parental reports could be used to identify children at later risk of cognitive delay. Low maternal education level should also be considered as a major risk factor for lower IQ in preschool children regardless of ASQ score. Copyright © 2017 by the American Academy of Pediatrics.

Feasibility of automated visual field examination in children between 5 and 8 years of age.

PubMed Central

Safran, A. B.; Laffi, G. L.; Bullinger, A.; Viviani, P.; de Weisse, C.; Désangles, D.; Tschopp, C.; Mermoud, C.

1996-01-01

AIMS--To investigate how young children develop the ability to undergo a visual field evaluation using regular automated perimetry. METHODS--The study included 42 normal girls aged 5, 6, 7, and 8 years. Twelve locations in the 15 degrees eccentricity were tested in one eye, using an Octopus 2000R perimeter with a two level strategy. False positive and false negative catch trials were presented. The examination was performed three times in succession. Before the examination procedure, a specially designed programme was conducted for progressive familiarisation. RESULTS--During the familiarisation procedure, it was found that all of the 5-year-old children, seven of the 6-year-old children, and three of the 7-year-old children were unable to perform immediately, and correctly, the instructions given during the familiarisation phase; these children took from 30 seconds to 3 minutes to comply with the examiner's requests. With the exception of one 5-year-old child, all tested subjects completed the planned procedure. The mean proportion of false negative answers in catch trials was 1.6%. The mean proportion of false positive answers was 12.2%. The quadratic dependency on age suggested by the averages was not significant (F(3,116) = 0.88; p = 0.45). Detection stimulus improved with age, as shown by the fact that probability of perceiving dim stimulus increases significantly (F(3,116) = 12.68; p < 0.0001). CONCLUSION--Children did remarkably well regarding both the duration of the examination and the reliability of the answers. A preliminary familiarisation phase with a specially designed adaptation programme was found to be mandatory with children aged 7 or under. To our knowledge, this is the first time that such an investigation has been performed. PMID:8759261

Predicting school readiness from neurodevelopmental assessments at age 2 years after respiratory distress syndrome in infants born preterm.

PubMed

Patrianakos-Hoobler, Athena I; Msall, Michael E; Huo, Dezheng; Marks, Jeremy D; Plesha-Troyke, Susan; Schreiber, Michael D

2010-04-01

To determine whether neurodevelopmental outcomes at the age of 2 years accurately predict school readiness in children who survived respiratory distress syndrome after preterm birth. Our cohort included 121 preterm infants who received surfactant and ventilation and were enrolled in a randomized controlled study of inhaled nitric oxide for respiratory distress syndrome. Abnormal outcomes at the age of 2 years were defined as neurosensory disability (cerebral palsy, blindness, or bilateral hearing loss) or delay (no neurosensory disability but Bayley Scales of Infant Development mental or performance developmental index scores <70). School readiness (assessed at a mean age of 5y 6mo, SD 1y) was determined using neurodevelopmental assessments of motor, sensory, receptive vocabulary, perceptual, conceptual, and adaptive skills. The mean birthweight of the cohort (57 males, 64 females) was 987g (SD 374), and the mean gestational age was 27.3 weeks (SD 2.6). At the age of 2 years, the neurodevelopmental classification was 'disabled' in 11% and 'delayed' in 23%. At the age of 5 years 6 months, intensive special education was required for 11% and some special education for 21%. Disability and delay at the age of 2 years were 92% and 50% predictive of lack of school readiness respectively, whereas only 15% of children who were normal at the age of 2 years were not school ready at the later assessment. Children with delay at 2 years were more likely to need special education if they were socially disadvantaged. Without preschool developmental supports, preterm survivors living in poverty will require more special education services.

Effectiveness of Pentavalent and Monovalent Rotavirus Vaccines in Concurrent Use Among US Children <5 Years of Age, 2009–2011

PubMed Central

Payne, Daniel C.; Boom, Julie A.; Staat, Mary Allen; Edwards, Kathryn M.; Szilagyi, Peter G.; Klein, Eileen J.; Selvarangan, Rangaraj; Azimi, Parvin H.; Harrison, Christopher; Moffatt, Mary; Johnston, Samantha H.; Sahni, Leila C.; Baker, Carol J.; Rench, Marcia A.; Donauer, Stephanie; McNeal, Monica; Chappell, James; Weinberg, Geoffrey A.; Tasslimi, Azadeh; Tate, Jacqueline E.; Wikswo, Mary; Curns, Aaron T.; Sulemana, Iddrisu; Mijatovic-Rustempasic, Slavica; Esona, Mathew D.; Bowen, Michael D.; Gentsch, Jon R.; Parashar, Umesh D.

2015-01-01

Background We assessed vaccine effectiveness (VE) for RotaTeq (RV5; 3 doses) and Rotarix (RV1; 2 doses) at reducing rotavirus acute gastroenteritis (AGE) inpatient and emergency department (ED) visits in US children. Methods We enrolled children <5 years of age hospitalized or visiting the ED with AGE symptoms from November 2009–June 2010 and from November 2010–June 2011 at 7 medical institutions. Fecal specimens were tested for rotavirus by enzyme immunoassay and genotyped. Vaccination among laboratory-confirmed rotavirus cases was compared with rotavirus-negative AGE controls. Regression models calculated VE estimates for each vaccine, age, ethnicity, genotype, and clinical setting. Results RV5-specific analyses included 359 rotavirus cases and 1811 rotavirus-negative AGE controls. RV1-specific analyses included 60 rotavirus cases and 155 rotavirus-negative AGE controls. RV5 and RV1 were 84% (95% confidence interval [CI], 78%–88%) and 70% (95% CI, 39%–86%) effective, respectively, against rotavirus-associated ED visits and hospitalizations combined. By clinical setting, RV5 VE against ED and inpatient rotavirus-associated visits was 81% (95% CI, 70%–84%) and 86% (95% CI, 74%–91%), respectively. RV1 was 78% (95% CI, 46%–91%) effective against ED rotavirus disease; study power was insufficient to evaluate inpatient RV1 VE. No waning of immunity was evident during the first 4 years of life for RV5, nor during the first 2 years of life for RV1. RV5 provided genotype-specific protection against each of the predominant strains (G1P[8], G2P[4], G3P[8], G12P[8]), while RV1 VE was statistically significant for the most common genotype, G3P[8]. Conclusions Both RV5 and RV1 significantly protected against medically attended rotavirus gastroenteritis in this real-world assessment. PMID:23487388

Drawings of very preterm-born children at 5 years of age: a first impression of cognitive and motor development?

PubMed

Schepers, Sasja; Deković, Maja; Feltzer, Max; de Kleine, Martin; van Baar, Anneloes

2012-01-01

The aim of this study was to examine differences in drawing skills between very preterm and term children, and to determine whether very preterm children's cognitive and motor development is reflected in the draw-a-person test (DAP) at age 5. Seventy-two very preterm children (birth weight <1,500 g and/or gestational age <32 weeks) and 60 term children at 5 years of age were compared on the DAP. Cognitive and motor skills of the very preterm children had been assessed four times, at 1/2, 1, 2, and 5 years of age. Very preterm children showed a developmental delay in drawing ability. Structural equation modeling revealed a positive relation between both cognitive as well as motor development and the DAP. The DAP could be a crude parameter for evaluating cognitive and motor deficits of very preterm children. A worrisome result should be followed by more standardized tests measuring cognitive and motor skills.

Gestational Age at Birth and 'Body-Mind' Health at 5 Years of Age: A Population Based Cohort Study.

PubMed

Cronin, Frances M; Segurado, Ricardo; McAuliffe, Fionnuala M; Kelleher, Cecily C; Tremblay, Richard E

2016-01-01

Numerous studies have identified the effects of prematurity on the neonate's physical health, however few studies have explored the effects of prematurity on both the physical and mental health of the child as they develop. Secondary analysis of data from the Millennium Cohort Study, a longitudinal study of infants (n = 18 818, born 2000-2002 in the United Kingdom) was performed. Effects of gestational age at birth on health outcomes at 5 years were measured using parental rating of their children's general health and severity of behavior problems. The association between parent's general health ratings and behavior problem ratings was low: 86% of those reporting serious behavior problems (5% of the sample, n = 764) rated their child as being in excellent, very good, or good health. Still, a gradient of increasing risk of poorer outcome with decreasing gestational age was observed for a composite health measure (poor/fair health and/or serious behavior problems), suggesting an association with prematurity for this composite assessment of health status. The greatest contribution to the childhood composite health measure at 5 years was for children born at 32-36 weeks gestation: population attributable fractions for having poor outcomes was 3.4% (Bonferroni-adjusted 95% confidence interval 1.1%-6.2%), compared to 1% (0.2-2.3) for birth at less than 32 weeks. Results suggest that preterm children, by school entry, are not only at high risk of physical health problems, but also of behavioral health problems. The recognition of, and response to comprehensive health and well-being outcomes related to prematurity are important in order to correctly plan and deliver adequate paediatric health services and policies.

Your Child's Development: 2.5 Years (30 Months)

MedlinePlus

... Safe Videos for Educators Search English Español Your Child’s Development: 2.5 Years (30 Months) KidsHealth / For Parents / Your Child’s Development: 2.5 Years (30 Months) Print en español ...

Longitudinal Relations Between Observed Parenting Behaviors and Dietary Quality of Meals From Ages 2 to 5

PubMed Central

Montaño, Zorash; Smith, Justin D.; Dishion, Thomas J.; Shaw, Daniel S.; Wilson, Melvin N.

2015-01-01

Objectives Parents influence a child’s diet by modeling food choices, selecting the food they will make available, and controlling the child’s intake. Few studies have examined the covariation between parent’s behavior management practices and their guidance and support for a young child’s nutritional environment in early childhood. We hypothesized that parents’ positive behavior support (PBS), characterized as skillful behavior management and proactive structuring of children’s activities, would predict dietary quality over the course of early childhood (age 2 to 5 years), a critical period for the development of a dietary lifestyle through the lifespan. Methods Participants included 731 culturally diverse, low-income families in a randomized, controlled trial of the Family Check-Up. Families participated in a yearly home visit videotaped assessment when children were 2 to 5 years. PBS and dietary quality of meals parents served to their children were assessed by coding videotapes of structured parent–child interactions, including a meal preparation task. A cross-lagged panel model was used to evaluate the longitudinal relation between PBS and the dietary quality of meals served during the meal preparation task. Results Analyses revealed that PBS repeatedly predicted meals’ dietary quality the following year: age 2–3 (β = .30), age 3–4 (β = 0.14), age 4–5 (β = 0.37). Dietary quality significantly predicted PBS 1 year later: age 3–4 (β = 0.16), age 4–5 (β = 0.14). As expected, the relative strength of the relationship from PBS to dietary quality was significantly stronger than the reverse, from dietary quality to PBS. Conclusions Positive behavior management and proactive parenting practices are an important foundation for establishing a healthy nutritional environment for young children. These findings suggest that family-centered prevention interventions for pediatric obesity may benefit from targeting PBS in service of promoting

Development of the Intrinsic Language Network in Preschool Children from Ages 3 to 5 Years.

PubMed

Xiao, Yaqiong; Brauer, Jens; Lauckner, Mark; Zhai, Hongchang; Jia, Fucang; Margulies, Daniel S; Friederici, Angela D

2016-01-01

Resting state studies of spontaneous fluctuations in the functional magnetic resonance imaging (fMRI) blood oxygen level dependent signal have shown great potential in mapping the intrinsic functional connectivity of the human brain underlying cognitive functions. The aim of the present study was to explore the developmental changes in functional networks of the developing human brain exemplified with the language network in typically developing preschool children. To this end, resting-sate fMRI data were obtained from native Chinese children at ages of 3 and 5 years, 15 in each age group. Resting-state functional connectivity (RSFC) was analyzed for four regions of interest; these are the left and right anterior superior temporal gyrus (aSTG), left posterior superior temporal gyrus (pSTG), and left inferior frontal gyrus (IFG). The comparison of these RSFC maps between 3- and 5-year-olds revealed that RSFC decreases in the right aSTG and increases in the left hemisphere between aSTG seed and IFG, between pSTG seed and IFG, as well as between IFG seed and posterior superior temporal sulcus. In a subsequent analysis, functional asymmetry of the language network seeding in aSTG, pSTG and IFG was further investigated. The results showed an increase of left lateralization in both RSFC of pSTG and of IFG from ages 3 to 5 years. The IFG showed a leftward lateralized trend in 3-year-olds, while pSTG demonstrated rightward asymmetry in 5-year-olds. These findings suggest clear developmental trajectories of the language network between 3- and 5-year-olds revealed as a function of age, characterized by increasing long-range connections and dynamic hemispheric lateralization with age. Our study provides new insights into the developmental changes of a well-established functional network in young children and also offers a basis for future cross-culture and cross-age studies of the resting-state language network.

The Acquisition of Questions in Texas Spanish: Age 2 - Age 5.

ERIC Educational Resources Information Center

Gonzalez, Gustavo

To determine the normal sequence of the development of Spanish phonology and Spanish grammatical patterns in the speech of native Spanish speakers, ages 2-5, a study of the acquisition of interrogative formation was undertaken. Two male and two females from each of nine age intervals between two and five were selected as informants; all were…

Estimated exposures to perfluorinated compounds in infancy predict attenuated vaccine antibody concentrations at age 5-years.

PubMed

Grandjean, Philippe; Heilmann, Carsten; Weihe, Pal; Nielsen, Flemming; Mogensen, Ulla B; Timmermann, Amalie; Budtz-Jørgensen, Esben

2017-12-01

Perfluorinated alkylate substances (PFASs) are highly persistent and may cause immunotoxic effects. PFAS-associated attenuated antibody responses to childhood vaccines may be affected by PFAS exposures during infancy, where breastfeeding adds to PFAS exposures. Of 490 members of a Faroese birth cohort, 275 and 349 participated in clinical examinations and provided blood samples at ages 18 months and 5 years. PFAS concentrations were measured at birth and at the clinical examinations. Using information on duration of breastfeeding, serum-PFAS concentration profiles during infancy were estimated. As outcomes, serum concentrations of antibodies against tetanus and diphtheria vaccines were determined at age 5. Data from a previous cohort born eight years earlier were available for pooled analyses. Pre-natal exposure showed inverse associations with the antibody concentrations five years later, with decreases by up to about 20% for each two-fold higher exposure, while associations for serum concentrations at ages 18 months and 5 years were weaker. Modeling of serum-PFAS concentration showed levels for age 18 months that were similar to those measured. Concentrations estimated for ages 3 and 6 months showed the strongest inverse associations with antibody concentrations at age 5 years, particularly for tetanus. Joint analyses showed statistically significant decreases in tetanus antibody concentrations by 19-29% at age 5 for each doubling of the PFAS exposure in early infancy. These findings support the notion that the developing adaptive immune system is particularly vulnerable to immunotoxicity during infancy. This vulnerability appears to be the greatest during the first 6 months after birth, where PFAS exposures are affected by breast-feeding.

Prospective evaluation of respiratory exacerbations in children with cystic fibrosis from newborn screening to 5 years of age

PubMed Central

Byrnes, Catherine Ann; Vidmar, Suzanna; Cheney, Joyce L; Carlin, John B; Armstrong, David S; Cooper, Peter J; Grimwood, Keith; Moodie, Marj; Robertson, Colin F; Rosenfeld, Margaret; Tiddens, Harm A; Wainwright, Claire E

2013-01-01

Background Newborn screening allows novel treatments for cystic fibrosis (CF) to be trialled in early childhood before irreversible lung injury occurs. As respiratory exacerbations are a potential trial outcome variable, we determined their rate, duration and clinical features in preschool children with CF; and whether they were associated with growth, lung structure and function at age 5 years. Methods Respiratory exacerbations were recorded prospectively in Australasian CF Bronchoalveolar Lavage trial subjects from enrolment after newborn screening to age 5 years, when all participants underwent clinical assessment, chest CT scans and spirometry. Results 168 children (88 boys) experienced 2080 exacerbations, at an average rate of 3.66 exacerbations per person-year; 80.1% were community managed and 19.9% required hospital admission. There was an average increase in exacerbation rate of 9% (95% CI 4% to 14%; p<0.001) per year of age. Exacerbation rate differed by site (p<0.001) and was 26% lower (95% CI 12% to 38%) in children receiving 12 months of prophylactic antibiotics. The rate of exacerbations in the first 2 years was associated with reduced forced expiratory volume in 1 s z scores. Ever having a hospital-managed exacerbation was associated with bronchiectasis (OR 2.67, 95% CI 1.13 to 6.31) in chest CT scans, and lower weight z scores at 5 years of age (coefficient −0.39, 95% CI −0.74 to −0.05). Conclusions Respiratory exacerbations in young children are markers for progressive CF lung disease and are potential trial outcome measures for novel treatments in this age group. PMID:23345574

Processes Linking Weight Status and Self-Concept Among Girls From Ages 5 to 7 Years

PubMed Central

Davison, Kirsten Krahnstoever; Birch, Leann Lipps

2008-01-01

This study assessed the relationship between girls’ weight status and self-concept and examined peer teasing and parent criticism as potential mediators of this relationship. Data were collected for 182 girls and their parents when the girls were 5 and 7 years old. At each age, girls’ body mass index, self-concept, peer weight-related teasing (child report), and parents’ criticism of girls’ weight status (spouse report) were assessed. At ages 5 and 7, girls who were more overweight reported lower self-concept. Peer teasing and parent criticism mediated the relationship between weight status and self-concept at age 7, but not at age 5. In addition, the duration and timing of parent criticism across ages 5 and 7 mediated the association between girls’ weight status at age 5 and perceived peer acceptance at age 7. PMID:12220051

Girl-child marriage and its association with morbidity and mortality of children under 5 years of age in a nationally-representative sample of Pakistan.

PubMed

Nasrullah, Muazzam; Zakar, Rubeena; Zakar, Muhammad Zakria; Krämer, Alexander

2014-03-01

To determine the relationship between child marriage (before age 18 years) and morbidity and mortality of children under 5 years of age in Pakistan beyond those attributed to social vulnerabilities. Nationally-representative cross-sectional observational survey data from Pakistan Demographic and Health Survey, 2006-2007 was limited to children from the past 5 years, reported by ever-married women aged 15-24 years (n = 2630 births of n = 2138 mothers) to identify differences in infectious diseases in past 2 weeks (diarrhea, acute respiratory infection [ARI], ARI with fever), under 5 years of age and infant mortality, and low birth weight by early (<18) vs adult (≥ 18) age at marriage. Associations between child marriage and mortality and morbidity of children under 5 years of age were assessed by calculating adjusted OR using logistic regression models after controlling for maternal and child demographics. Majority (74.5%) of births were from mothers aged <18 years. Marriage before age 18 years increased the likelihood of recent diarrhea among children born to young mothers (adjusted OR = 1.59; 95% CI: 1.18-2.14). Even though maternal child marriage was associated with infant mortality and mortality of children under 5 years of age in unadjusted models, association was lost in the adjusted models. We did not find a relation between girl-child marriage and low birth weight infants, and ARI. Girl-child marriage increases the likelihood of recent diarrhea among children born to young mothers. Further qualitative and prospective quantitative studies are needed to understand the factors that may drive child morbidity and mortality among those married as children vs adults in Pakistan. Copyright © 2014 Mosby, Inc. All rights reserved.

Adverse Childhood Experiences and ADHD Diagnosis at Age 9 Years in a National Urban Sample.

PubMed

Jimenez, Manuel E; Wade, Roy; Schwartz-Soicher, Ofira; Lin, Yong; Reichman, Nancy E

To examine associations between adverse childhood experiences (ACEs) and attention-deficit/hyperactivity disorder (ADHD) at age 9 years using longitudinal data and assess the extent to which ACEs during middle childhood are independently associated with ADHD at age 9 years. We conducted a secondary analysis of data from the Fragile Families urban birth cohort 5- and 9-year interviews. The sample was limited to children for whom mothers were the primary caregiver and mother-reported information on 8 ACEs and ADHD were available at age 5 and 9 years. We examined associations between ACEs and parent-reported ADHD at age 9 years using logistic regression and controlling for potential confounders. We included 1572 children; 48% were African American, 11% had parent-reported ADHD at age 9 years, 41% and 42% experienced ≥1 ACE by age 5 years and between the ages of 5 and 9 years, respectively. ACEs before age 5 years were associated with ADHD at age 9 years. One, 2, and ≥3 ACEs between age 5 and 9 years were associated with ADHD at age 9 years even after controlling for ACEs before age 5 years and ADHD at age 5 years (adjusted odds ratio [AOR], 1.9; 95% confidence interval [CI], 1.2-3; AOR, 2.1; 95% CI, 1.2-3.8; and AOR, 2.2; 95% CI, 1.1-4.3). In this study of urban children, ACEs occurring before age 5 years as well as between the ages of 5 and 9 years were associated with ADHD at age 9 years. Even after controlling for early childhood ACEs and ADHD at age 5 years, the association between ADHD and ACEs in middle childhood remained significant, highlighting the importance of screening and intervention throughout childhood. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

A National Profile of Attention-Deficit Hyperactivity Disorder Diagnosis and Treatment Among US Children Aged 2 to 5 Years.

PubMed

Danielson, Melissa L; Visser, Susanna N; Gleason, Mary Margaret; Peacock, Georgina; Claussen, Angelika H; Blumberg, Stephen J

2017-09-01

Clinical guidelines provide recommendations for diagnosis and treatment of attention-deficit hyperactivity disorder (ADHD), with specific guidance on caring for children younger than 6 years. This exploratory study describes ADHD diagnosis and treatment patterns among young children in the United States using 2 nationally representative parent surveys. The National Survey of Children's Health (2007-2008, 2011-2012) was used to produce weighted prevalence estimates of current ADHD and ADHD medication treatment among US children aged 2 to 5 years. The National Survey of Children with Special Health Care Needs (2009-2010) provided additional estimates on types of medication treatment and receipt of behavioral treatment among young children with special health care needs (CSHCN) with ADHD. In 2011 to 2012, 1.5% of young children (approximately 237,000) had current ADHD compared to 1.0% in 2007 to 2008. In 2011 to 2012, 43.7% of young children with current ADHD were taking medication for ADHD (approximately 104,000). In young CSHCN with ADHD, central nervous system stimulants were the most common medication type used to treat ADHD, and 52.8% of young CSHCN with current ADHD had received behavioral treatment for ADHD in the past year. Nearly a quarter million In young CSHCN have current ADHD, with a prevalence that has increased by 57% from 2007 to 2008 to 2011 to 2012. The demographic patterns of diagnosis and treatment described in this study can serve as a benchmark to monitor service use patterns of young children diagnosed with ADHD over time.

Prospective long-term follow up of children with anorectal malformation: growth and development until 5years of age.

PubMed

van den Hondel, Desiree; Sloots, Cornelius E J; Gischler, Saskia J; Meeussen, Conny J H M; Wijnen, Rene M H; IJsselstijn, Hanneke

2013-04-01

To evaluate growth and development in children with anorectal malformations and to analyze effects of type of malformation and comorbidities. Non-syndromal children with anorectal malformations were prospectively evaluated at 0.5, 1, 2, and 5 years. Biometrics were obtained at all visits. Mental and psychomotor function development was determined. 108 children (59% male) were included. 49% had a high malformation, and 46% had ≥ 1 additional major comorbidity. All growth parameters were below the norm at all ages (p<0.01), irrespective of type of malformation. Children with ≥ 1 additional major anomaly had lower height at all ages; at 5 years, mean (95% CI) height was -1.83 (-2.7 to -1.1) and -0.70 (-1.3 to -0.1) in children with and without comorbidities, respectively (p=0.019). Mental development was normal, irrespective of the type of malformation or comorbidities. Motor development was delayed at all ages. At 5 years, motor development (n=30) was normal in 70%, borderline in 23%, and 7% had definitive motor problems (p=0.043). Non-syndromal children with anorectal malformations are at risk for growth impairment, especially those with additional major comorbidity. Mental development is normal. Motor development is slightly impaired. Supportive care should focus on growth, dietary management, and motor development besides defecation problems. Copyright © 2013 Elsevier Inc. All rights reserved.

Transcatheter closure of atrial septal defects type 2 in children under 3 years of age.

PubMed

Knop, Mateusz T; Białkowski, Jacek; Szkutnik, Małgorzata; Fiszer, Roland; Smerdziński, Sebastian; Gałeczka, Michał; Litwin, Linda

2018-06-04

Atrial septal defect type II (ASD), according to current standards, is closed percutaneously usually after the child has reached the age of 4-5 years. There are limited data regarding such treatment in smaller infants. To evaluate feasibility, safety and efficacy of percutaneous ASD closure in children under 3 years of age. Overall group of 149 children < 3 years with hemodynamically significant ASD, who underwent effective transcatheter ASD closure in one tertiary center between 1999 and 2014 were included. Mean procedural age of treated children was 2,2 years and weight 12,5 kg. In all nitinol wire mesh devices were applied (mostly Amplatzer Septal Occluders). ASD was closed by standard technique (except few cases when left disc of implant was inserted initially into right pulmonary vein to prevent oblique position of the device). Complications related to the procedure were divided into major and minor ones. There were 97 children with a single ASD and 52 with double/multiple ASD. No death, no implant embolization, and one major complications occurred during procedure and in follow-up. ASD was completely closed in all but 8 patients with double/multiple ASD. Right ventricle diameter normalization occurred in all during 1 year follow-up. In majority of the patients in follow-up an acceleration of physical development and resolution of accompanying morbidity was observed. Percutaneous ASD device closure can be performer safely in children below 3 years of age with low risk of complication during and after the procedure.

Trends in asthma mortality in the 0- to 4-year and 5- to 34-year age groups in Brazil.

PubMed

Graudenz, Gustavo Silveira; Carneiro, Dominique Piacenti; Vieira, Rodolfo de Paula

2017-01-01

To provide an update on trends in asthma mortality in Brazil for two age groups: 0-4 years and 5-34 years. Data on mortality from asthma, as defined in the International Classification of Diseases, were obtained for the 1980-2014 period from the Mortality Database maintained by the Information Technology Department of the Brazilian Unified Health Care System. To analyze time trends in standardized asthma mortality rates, we conducted an ecological time-series study, using regression models for the 0- to 4-year and 5- to 34-year age groups. There was a linear trend toward a decrease in asthma mortality in both age groups, whereas there was a third-order polynomial fit in the general population. Although asthma mortality showed a consistent, linear decrease in individuals ≤ 34 years of age, the rate of decline was greater in the 0- to 4-year age group. The 5- to 34-year group also showed a linear decline in mortality, and the rate of that decline increased after the year 2004, when treatment with inhaled corticosteroids became more widely available. The linear decrease in asthma mortality found in both age groups contrasts with the nonlinear trend observed in the general population of Brazil. The introduction of inhaled corticosteroid use through public policies to control asthma coincided with a significant decrease in asthma mortality rates in both subsets of individuals over 5 years of age. The causes of this decline in asthma-related mortality in younger age groups continue to constitute a matter of debate. Apresentar uma atualização das tendências da mortalidade da asma no Brasil em duas faixas etárias: 0-4 anos e 5-34 anos. Dados relativos ao período de 1980 a 2014 referentes à mortalidade da asma, conforme se definiu na Classificação Internacional de Doenças, foram extraídos Sistema de Informação sobre Mortalidade do Departamento de Tecnologia da Informação do Sistema Único de Saúde. Para analisar as tendências temporais das taxas

Administration of Antibiotics to Children Before Age 2 Years Increases Risk for Childhood Obesity

PubMed Central

Scott, Frank I; Horton, Daniel B.; Mamtani, Ronac; Haynes, Kevin; Goldberg, David S; Lee, Dale Y.; Lewis, James D

2016-01-01

Background & Aims Childhood obesity is increasing and is associated with adult obesity. Antibiotics have been used to promote weight gain in livestock for several decades. Antibiotics are commonly prescribed for children, but it is not clear how exposure to antibiotics early in life affects risk for obesity. We performed a population-based cohort study to assess the association between antibiotic exposure before age 2 years and obesity at age 4 years. Methods We performed a retrospective cohort study of 21,714 children in The Health Improvement Network —a population-representative dataset of more than 10 million individuals derived from electronic medical records from 1995 through 2013 in the United Kingdom. Eligible subjects were registered within 3 months of birth with complete follow-up and height and weight were recorded within 12 months of their 4th birthday. Antibiotic exposure was assessed before age 2 years, and classified based on anti-anaerobic activity. The primary outcome was obesity at age 4 years. We performed logistic regression analyses, adjusting for maternal and sibling obesity, maternal diabetes, mode of delivery, socioeconomic status, year and country of birth, and urban dwelling. Results In the cohort, 1306 of the children (6.4%) were obese at 4 years of age. Antibiotic exposure was associated with an increased risk of obesity at 4 years (odds ratio [OR]=1.21; 95% confidence interval [CI], 1.07–1.38). Odds ratios increased with repeated exposures: for 1–2 prescriptions, OR=1.07 (95% CI, 0.91–1.23); for 3–5 prescriptions, OR=1.41 (95% CI, 1.20–1.65); for 6 or more prescriptions, OR=1.47 (95% CI, 1.19–1.82). Antifungal agents were not associated with obesity (OR=0.81; 95% CI, 0.59–1.11). Conclusions Administration of 3 or more courses of antibiotics before children reach an age of 2 years is associated with an increased risk of early childhood obesity. PMID:27003602

Administration of Antibiotics to Children Before Age 2 Years Increases Risk for Childhood Obesity.

PubMed

Scott, Frank I; Horton, Daniel B; Mamtani, Ronac; Haynes, Kevin; Goldberg, David S; Lee, Dale Y; Lewis, James D

2016-07-01

Childhood obesity is increasing and is associated with adult obesity. Antibiotics have been used to promote weight gain in livestock for several decades. Antibiotics are commonly prescribed for children, but it is not clear how exposure to antibiotics early in life affects risk for obesity. We performed a population-based cohort study to assess the association between antibiotic exposure before age 2 years and obesity at age 4 years. We performed a retrospective cohort study of 21,714 children in The Health Improvement Network-a population-representative dataset of >10 million individuals derived from electronic medical records from 1995 through 2013 in the United Kingdom. Eligible subjects were registered within 3 months of birth with complete follow-up and height and weight were recorded within 12 months of their 4th birthday. Antibiotic exposure was assessed before age 2 years, and classified based on anti-anaerobic activity. The primary outcome was obesity at age 4 years. We performed logistic regression analyses, adjusting for maternal and sibling obesity, maternal diabetes, mode of delivery, socioeconomic status, year and country of birth, and urban dwelling. In the cohort, 1306 of the children (6.4%) were obese at 4 years of age. Antibiotic exposure was associated with an increased risk of obesity at 4 years (odds ratio [OR] = 1.21; 95% confidence interval [CI]: 1.07-1.38). ORs increased with repeated exposures: for 1-2 prescriptions, OR = 1.07 (95% CI, 0.91-1.23); for 3-5 prescriptions, OR = 1.41 (95% CI, 1.20-1.65); and for 6 or more prescriptions, OR = 1.47 (95% CI, 1.19-1.82). Antifungal agents were not associated with obesity (OR = 0.81; 95% CI, 0.59-1.11). Administration of 3 or more courses of antibiotics before children reach an age of 2 years is associated with an increased risk of early childhood obesity. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

Plantar Pressures After Nonoperative Treatment for Clubfoot: Intermediate Follow-up at Age 5 Years.

PubMed

Jeans, Kelly A; Erdman, Ashley L; Karol, Lori A

2017-01-01

Worldwide, a nonoperative approach in the treatment of idiopathic clubfoot has been taken in an attempt to reduce the incidence of surgical outcomes. Although both the Ponseti casting (Ponseti) and the French physiotherapy (PT) methods have shown gait and pedobarograph differences at age 2 years, improved gait results have been reported by age 5 years. The purpose of this study was to assess plantar pressures in feet treated with the Ponseti versus the PT methods at this intermediate stage. Clubfoot patients treated nonoperatively (Ponseti or PT) underwent pedobarograph data collection at age 5 years. The foot was subdivided into the medial/lateral hindfoot, midfoot, and forefoot regions. Variables included Peak Pressure, Maximum Force, Contact Area%, Contact Time%, Pressure Time Integral, the hindfoot-forefoot angle, and displacement of the center of pressure (COP) line. Twenty controls were used for comparison. Pedobarograph data from 164 patients (238 feet; 122 Ponseti and 116 PT) showed no significant differences between the Ponseti and the PT feet, except the PT feet had a significantly less medial movement of the COP than the Ponseti feet (P=0.0379). Compared with controls, both groups had decreased plantar pressures in the hindfoot and first metatarsal regions, whereas the midfoot and lateral forefoot experienced significant increases compared with controls. This lateralization was also reflected in the hindfoot-forefoot angle and the COP. Feet that remain nonoperative and avoid surgical intervention are considered a good clinical result. However, pedobarograph results indicate mild residual deformity in these feet despite clinically successful outcomes. Level II-therapeutic.

Source Monitoring and Executive Function in 2.5- to 3-Year-Olds

ERIC Educational Resources Information Center

Hala, Suzanne; McKay, Lee-Ann; Brown, Alisha M. B.; San Juan, Valerie

2016-01-01

Hala, Brown, McKay, and San Juan (2013) found that children as young as 2.5 years of age demonstrated high levels of accuracy when asked to recall whether they or the experimenter had carried out a particular action. In the research reported here, we examined the relation of early-emerging source monitoring to executive function abilities.…

Intravitreal aflibercept for neovascular age-related macular degeneration in patients aged 90 years or older: 2-year visual acuity outcomes.

PubMed

Chatziralli, Irini; Regan, Shane O; Mohamed, Ryian; Talks, James; Sivaprasad, Sobha

2018-06-04

The purpose of this study was to investigate the efficacy of intravitreal aflibercept for neovascular age-related macular degeneration (nAMD) in very elderly patients aged 90 years or older at 2 years after treatment initiation. In this multicentre retrospective data analysis from electronic medical record, consecutive treatment-naive patients with nAMD treated with aflibercept with at least 2 years follow-up were stratified into those aged < 90 years (Group I) and an older cohort aged 90 and over (Group II). We compared the visual acuity (EDTRS letters) outcomes at 4 weekly intervals between the two groups over a 2-year period. The mean visual acuity of Group I at presentation was 56.3 ETDRS letters versus 52.8 letters in Group II. Maximal visual acuity was achieved in both the groups by 6 months after initiating treatment (4.7 vs. 4.0 letters gain). By 2 years, the mean visual acuity of the older cohort fell marginally below their baseline visual acuity (0.8 letter loss), while Group I presented +2.1 letters gain. The number of injections given and the retention rate of the older cohort were no different to the rest of the patients. Very old patients with nAMD benefited from aflibercept, but not to the same degree as the younger patients. The study showed that, on an average, the very elderly patients were able to adhere to the intensive anti-VEGF treatment regimens.

Longitudinal development of cognitive, visuomotor and adaptive behavior skills in HIV uninfected children, aged 3-5 years of age, exposed pre- and perinatally to anti-retroviral medications.

PubMed

Smith, Mary Lou; Puka, Klajdi; Sehra, Ramandeep; Read, Stanley E; Bitnun, Ari

2017-10-01

Little is known about the neurodevelopmental outcomes of children older than 3 years of age born to HIV infected mother but who are HIV-uninfected (HEU), and who have been exposed in utero and early in life to HIV and to antiretroviral medications (ARVs). We conducted a longitudinal study of cognitive, visuomotor and adaptive function of HEU children, who were assessed at two ages, 3.5 and 5.5 years. Sixty-four children (33 female) were assessed. In comparison with population norms for their age, at 3.5 years of age they had scores significantly below age expectations on aspects of adaptive behavior, but at age 5.5 years, their scores did not significantly diverge from the population norms on any of the measures. Verbal intelligence was lower at age 5.5 than at age 3.5 years, although there were also improvements in some features of adaptive behavior. Exposure to PI-based ARVs (compared to NNRTIs) was associated with higher Performance IQ, visuomotor and communication scores at age 5.5 years. Birth, early growth, and sociodemographic variables were predictive of outcomes. This study is important in tracking the trajectory of neurocognitive development across the pre-school and early school age years. The findings suggest that the full impact of early ARV exposure may not be evident until a considerable period of development has occurred. The results raise the possibility of negative effects of early ARV exposure on neurodevelopment that emerge over time, and reiterate the importance of sociodemographic and early health variables for optimal development.

A prospective observational cohort study to assess the incidence of acute otitis media among children 0-5 years of age in Southern Brazil.

PubMed

Lanzieri, Tatiana M; Cunha, Clóvis Arns da; Cunha, Rejane B; Arguello, D Fermin; Devadiga, Raghavendra; Sanchez, Nervo; Barria, Eduardo Ortega

To estimate acute otitis media incidence among young children and impact on quality of life of parents/caregivers in a southern Brazilian city. Prospective cohort study including children 0-5 years of age registered at a private pediatric practice. Acute otitis media episodes diagnosed by a pediatrician and impact on quality of life of parents/caregivers were assessed during a 12-month follow-up. During September 2008-March 2010, of 1,136 children enrolled in the study, 1074 (95%) were followed: 55.0% were ≤2 years of age, 52.3% males, 94.7% white, and 69.2% had previously received pneumococcal vaccine in private clinics. Acute otitis media incidence per 1000 person-years was 95.7 (95% confidence interval: 77.2-117.4) overall, 105.5 (95% confidence interval: 78.3-139.0) in children ≤2 years of age and 63.6 (95% confidence interval: 43.2-90.3) in children 3-5 years of age. Acute otitis media incidence per 1000 person-years was 86.3 (95% confidence interval: 65.5-111.5) and 117.1 (95% confidence interval: 80.1-165.3) among vaccinated and unvaccinated children, respectively. Nearly 68.9% of parents reported worsening of their overall quality of life. Acute otitis media incidence among unvaccinated children in our study may be useful as baseline data to assess impact of pneumococcal vaccine introduction in the Brazilian National Immunization Program in April 2010. Copyright © 2017 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda. All rights reserved.

Live Attenuated Influenza Vaccine, Trivalent, Is Safe in Healthy Children 18 Months to 4 Years, 5 to 9 Years, and 10 to 18 Years of Age in a Community-Based, Nonrandomized, Open-Label Trial

PubMed Central

Piedra, Pedro A.; Gaglani, Manjusha J.; Riggs, Mark; Herschler, Gayla; Fewlass, Charles; Watts, Matt; Kozinetz, Claudia; Hessel, Colin; Glezen, W. Paul

2006-01-01

the study, we administered 18 780 doses of LAIV-T to 11 096 children. A total of 4529, 7036, and 7215 doses of LAIV-T were administered to children who were 18 months to 4 years, 5 to 9 years, and 10 to 18 years of age, respectively. In vaccination years 1, 2, 3, and 4, we identified 10, 15, 11, and 6 SAEs, respectively. None of the SAEs was attributed to LAIV-T. In vaccination years 1, 2, 3, and 4, we identified 3, 2, 1, and 0 pregnancies, respectively, among adolescents. All delivered healthy infants. The RR for MAARI from 0 to 14 and 15 to 42 days after LAIV-T was assessed in vaccinees during the 4 vaccine years. Compared with the prevaccination period, there was no significant increase in risk in health care utilization attributed to MAARI from 0 to 14 and 15 to 42 days after vaccination in children who were 18 months to 4 years, 5 to 9 years, and 10 to 18 years of age in the 4 vaccine years. In children who were 18 months to 4 years of age, there was no significant increase in the risk in health care utilization for MAARI, MAARI subcategories (otitis media/sinusitis, upper respiratory tract illness, and lower respiratory tract illness), and asthma during the 0 to 14 days after vaccination compared with the prevaccination period. No significant increase in the risk in health care utilization for MAARI, MAARI subcategories, and asthma was detected when the risk period was extended to 15 to 42 days after vaccination, except for asthma events in vaccine year 1. A RR of 2.85 (95% confidence interval [CI]: 1.01–8.03) for asthma events was detected in children who were 18 months to 4 years of age but was not significantly increased for the other 3 vaccine years (vaccine year 2, RR: 1.42 [95% CI: 0.59–3.42]; vaccine year 3, RR: 0.47 [95% CI: 0.12–1.83]; vaccine year 4, RR: 0.20 [95% CI: 0.03–1.54]). No significant increase in the risk in health care utilization for MAARI or asthma was observed in children who were 18 months to 18 years of age and received 1, 2, 3

Rheumatic Heart Disease-Attributable Mortality at Ages 5-69 Years in Fiji: A Five-Year, National, Population-Based Record-Linkage Cohort Study.

PubMed

Parks, Tom; Kado, Joseph; Miller, Anne E; Ward, Brenton; Heenan, Rachel; Colquhoun, Samantha M; Bärnighausen, Till W; Mirabel, Mariana; Bloom, David E; Bailey, Robin L; Tukana, Isimeli N; Steer, Andrew C

2015-01-01

Rheumatic heart disease (RHD) is considered a major public health problem in developing countries, although scarce data are available to substantiate this. Here we quantify mortality from RHD in Fiji during 2008-2012 in people aged 5-69 years. Using 1,773,999 records derived from multiple sources of routine clinical and administrative data, we used probabilistic record-linkage to define a cohort of 2,619 persons diagnosed with RHD, observed for all-cause mortality over 11,538 person-years. Using relative survival methods, we estimated there were 378 RHD-attributable deaths, almost half of which occurred before age 40 years. Using census data as the denominator, we calculated there were 9.9 deaths (95% CI 9.8-10.0) and 331 years of life-lost (YLL, 95% CI 330.4-331.5) due to RHD per 100,000 person-years, standardised to the portion of the WHO World Standard Population aged 0-69 years. Valuing life using Fiji's per-capita gross domestic product, we estimated these deaths cost United States Dollar $6,077,431 annually. Compared to vital registration data for 2011-2012, we calculated there were 1.6-times more RHD-attributable deaths than the number reported, and found our estimate of RHD mortality exceeded all but the five leading reported causes of premature death, based on collapsed underlying cause-of-death diagnoses. Rheumatic heart disease is a leading cause of premature death as well as an important economic burden in this setting. Age-standardised death rates are more than twice those reported in current global estimates. Linkage of routine data provides an efficient tool to better define the epidemiology of neglected diseases.

The relationship between body mass index and gross motor development in children aged 3 to 5 years.

PubMed

Nervik, Deborah; Martin, Kathy; Rundquist, Peter; Cleland, Joshua

2011-01-01

To investigate the relationship between obesity and gross motor development in children who are developing typically and determine whether body mass index (BMI) predicts difficulty in gross motor skills. BMIs were calculated and gross motor skills examined in 50 children who were healthy aged 3 to 5 years using the Peabody Developmental Motor Scales, 2nd edition (PDMS-2). Pearson chi-square statistic and stepwise linear hierarchical regression were used for analysis. A total of 24% of the children were overweight/obese, whereas 76% were found not to be overweight/obese. Fifty-eight percent of the overweight/obese group scored below average on the PDMS-2 compared to 15% of the nonoverweight group. Association between BMI and gross motor quotients was identified with significance of less than 0.002. Regression results were nonsignificant with all 50 subjects, yet showed significance (P = 0.018) when an outlier was excluded. Children aged 3 to 5 years with high BMIs may have difficulty with their gross motor skills. Further research is needed.

Association between Infancy BMI Peak and Body Composition and Blood Pressure at Age 5–6 Years

PubMed Central

Hof, Michel H. P.; Vrijkotte, Tanja G. M.; de Hoog, Marieke L. A.; van Eijsden, Manon; Zwinderman, Aeilko H.

2013-01-01

Introduction The development of overweight is often measured with the body mass index (BMI). During childhood the BMI curve has two characteristic points: the adiposity rebound at 6 years and the BMI peak at 9 months of age. In this study, the associations between the BMI peak and body composition measures and blood pressure at age 5–6 years were investigated. Methods Measurements from the Amsterdam Born Children and their Development (ABCD) study were available for this study. Blood pressure (systolic and diastolic) and body composition measures (BMI, waist-to-height ratio, fat percentage) were gathered during a health check at about 6 years of age (n = 2822). All children had multiple BMI measurements between the 0–4 years of age. For boys and girls separately, child-specific BMI peaks were extracted from mixed effect models. Associations between the estimated BMI peak and the health check measurements were analysed with linear models. In addition, we investigated the potential use of the BMI at 9 months as a surrogate measure for the magnitude of the BMI peak. Results After correction for the confounding effect of fetal growth, both timing and magnitude of the BMI peak were significantly and positively associated (p<0.001) with all body composition measures at the age of 5–6 years. The BMI peak showed no direct association with blood pressure at the age 5–6 year, but was mediated by the current BMI. The correlation between the magnitude of the BMI peak and BMI at 9 months was approximately 0.93 and similar associations with the measures at 5–6 years were found. Conclusion The magnitude of the BMI peak was associated with body composition measures at 5–6 years of age. Moreover, the BMI at 9 months could be used as surrogate measure for the magnitude of the BMI peak. PMID:24324605

Treatment of rape-induced urogenital and lower gastrointestinal lesions among girls aged 5 years or younger.

PubMed

Mukwege, Denis; Alumeti, Desiré; Himpens, Jacques; Cadière, Guy-Bernard

2016-03-01

To evaluate outcomes after treatment of rape-induced urogenital and lower gastrointestinal lesions among young girls. In a retrospective study, data were assessed from girls aged 5 years or younger who were treated for sexual-assault-related injuries at the General Referral Hospital, Panzi, Bukavu, Democratic Republic of Congo, between 2004 and 2014. Data were obtained from review of charts, records of the mother's impressions and physical examinations, and photographic evidence. Elective surgery had been reserved for patients experiencing fecal and/or urinary incontinence. Overall, 205 girls aged 5 years or younger presented with rape injuries: 162 (79.1%) had only mucocutaneous lesions, 22 (10.7%) had musculocutaneous lesions, and 21 (10.2%) had musculocutaneous lesions complicated by fecal and/or urinary incontinence. Among the 21 girls who underwent perineal surgery, two with fecal and urinary incontinence and perforation of the peritoneum of Douglas pouch were additionally treated by laparoscopy. Among 16 patients with fecal incontinence, the continence score had improved significantly at 10.4 months after surgery (P<0.001). Concomitant urinary incontinence subsided for four of five patients but persisted for one who had a gunshot wound to the vagina. Cosmetic outcome was normal in 19 cases. For rape survivors aged 5 years or younger, a treatment strategy by which surgery is reserved for incontinent patients provided good cosmetic and functional outcomes. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Viral gastroenteritis in rotavirus negative hospitalized children <5 years of age from the independent states of the former Soviet Union.

PubMed

Chhabra, Preeti; Samoilovich, Elena; Yermalovich, Marina; Chernyshova, Liudmyla; Gheorghita, Stela; Cojocaru, Radu; Shugayev, Nazim; Sahakyan, Gayane; Lashkarashvili, Marina; Chubinidze, Marina; Zakhashvili, Khatuna; Videbaek, Dovile; Wasley, Annemarie; Vinjé, Jan

2014-12-01

Rotavirus causes nearly 40% of all hospitalizations for AGE among children <5 years of age in the NIS of the former Soviet Union. The etiologic role of other established gastroenteritis viruses in this age group is unknown. Laboratory-confirmed rotavirus negative fecal specimens (N=495) collected between January and December 2009 from children in 6 NIS (Armenia, Azerbaijan, Belarus, Georgia, Republic of Moldova and Ukraine) were tested for norovirus, sapovirus, enteric adenovirus and astrovirus by real-time RT-PCR. Genotyping was carried out by sequencing and phylogenetic analysis. Norovirus, enteric adenovirus, sapovirus and astrovirus were detected in 21.8%, 4.0%, 3.2%, and 1.4% of the rotavirus negative specimens, respectively. Mixed infections were identified in 4.1% of the specimens. Phylogenetic analysis showed co-circulation of several different genotypes with GII.4 Den Haag (2006b) norovirus, GI.2 sapovirus, adenovirus type 41, and astrovirus type 1 causing majority of the infections. Norovirus, enteric adenovirus, sapovirus and astrovirus account for a significant proportion (30.5%) of AGE in hospitalized children <5 years of age in 6 NIS. Copyright © 2014 Elsevier B.V. All rights reserved.

Growth and Mortality Outcomes for Different Antiretroviral Therapy Initiation Criteria in Children aged 1–5 Years: A Causal Modelling Analysis

PubMed Central

Schomaker, Michael; Davies, Mary-Ann; Malateste, Karen; Renner, Lorna; Sawry, Shobna; N’Gbeche, Sylvie; Technau, Karl-Günter; Eboua, François; Tanser, Frank; Sygnaté-Sy, Haby; Phiri, Sam; Amorissani-Folquet, Madeleine; Cox, Vivian; Koueta, Fla; Chimbete, Cleophas; Lawson-Evi, Annette; Giddy, Janet; Amani-Bosse, Clarisse; Wood, Robin; Egger, Matthias; Leroy, Valeriane

2017-01-01

Background There is limited evidence regarding the optimal timing of initiating antiretroviral therapy (ART) in children. We conducted a causal modelling analysis in children aged 1–5 years from the International Epidemiologic Databases to Evaluate AIDS West/Southern-Africa collaboration to determine growth and mortality differences related to different CD4-based treatment initiation criteria, age groups and regions. Methods ART-naïve children of age 12–59 months at enrollment with at least one visit before ART initiation and one follow-up visit were included. We estimated 3-year growth and cumulative mortality from the start of follow-up for different CD4 criteria using g-computation. Results About one quarter of the 5826 included children was from West Africa (24.6%). The median (first; third quartile) CD4% at the first visit was 16% (11%;23%), the median weight-for-age z-scores and height-for-age z-scores were −1.5 (−2.7; −0.6) and −2.5 (−3.5; −1.5), respectively. Estimated cumulative mortality was higher overall, and growth was slower, when initiating ART at lower CD4 thresholds. After 3 years of follow-up, the estimated mortality difference between starting ART routinely irrespective of CD4 count and starting ART if either CD4 count<750 cells/mm3 or CD4%<25% was 0.2% (95%CI: −0.2%;0.3%), and the difference in the mean height-for-age z-scores of those who survived was −0.02 (95%CI: −0.04;0.01). Younger children aged 1–2 and children in West Africa had worse outcomes. Conclusions Our results demonstrate that earlier treatment initiation yields overall better growth and mortality outcomes, though we could not show any differences in outcomes between immediate ART and delaying until CD4 count/% falls below750/25%. PMID:26479876

Clinical Characteristics of Adult Dogs More Than 5 Years of Age at Presentation for Patent Ductus Arteriosus.

PubMed

Boutet, B G; Saunders, A B; Gordon, S G

2017-05-01

The median age at presentation for dogs with patent ductus arteriosus (PDA) is <6 months of age, and closure is associated with a decrease in heart size and increased survival time, which are not well described in older dogs. To describe the clinical characteristics of dogs with PDA ≥5 years of age at the time of presentation to a veterinary referral hospital. 35 client-owned dogs. Retrospective case series. PDA was diagnosed at a median age of 7.4 years (range, 5.1-12.3 years). Females represented 23/35 (65.7%) of the patients. Concurrent heart disease included degenerative mitral valve disease (DMVD; 13), arrhythmias (11), pulmonary hypertension (7), and other congenital defects (2). Cardiomegaly was documented in the majority of dogs consisting of left ventricular enlargement (91%) and left atrial enlargement (86%). Median vertebral heart size in 24 dogs was 12.9 (range, 10.7-18.2). The PDA shunt direction was left-to-right in 33 and bidirectional in 2 dogs. Closure was performed in 26 dogs, including 4 with pulmonary hypertension. In 10 dogs receiving furosemide pre-operatively for management of heart failure, furosemide was discontinued (8) or the dosage decreased (2) at the time of discharge. Adult dogs can present with a left-to-right shunting PDA that results in cardiomegaly and clinical signs that can improve or resolve with PDA closure. This improvement is also apparent in dogs with PDA complicated by DMVD. Pulmonary hypertension that does not result in complete right-to-left shunting should not be considered a contraindication to closure. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Effect of Zinc Supplementation on Growth Outcomes in Children under 5 Years of Age.

PubMed

Liu, Enju; Pimpin, Laura; Shulkin, Masha; Kranz, Sarah; Duggan, Christopher P; Mozaffarian, Dariush; Fawzi, Wafaie W

2018-03-20

(1) Background: The effects of zinc supplementation on child growth, and prior reviews of these studies, have shown mixed results. We aim to systematically review and meta-analyze randomized controlled trials evaluating effects of preventive zinc supplementation for 3 months or longer during pregnancy or in children up to age 5 years on pregnancy outcomes and child growth; (2) Methods: We searched PubMed, EMBASE, Cochrane Library, Web of Science, and trial registries for eligible trials up to October 10, 2017. Inclusion selection and data extractions were performed independently and in duplicate. Study quality was evaluated by the Cochrane Risk of Bias tool. Findings were pooled using random effects meta-analysis, with heterogeneity assessed by I ² and τ² statistic, stratified analyses, and meta-regression, and publication bias by Egger's and Begg's tests; (3) Results: Seventy-eight trials with 34,352 unique participants were identified, including 24 during pregnancy and 54 in infancy/childhood. Maternal zinc supplementation did not significantly increase birth weight (weighted mean difference (WMD) = 0.08 kg, 95%CI: -0.05, 0.22) or decrease the risk of low birth weight (RR = 0.76, 95%CI: 0.52-1.11). Zinc supplementation after birth increased height (WMD = 0.23 cm, 95%CI: 0.09-0.38), weight (WMD = 0.14 kg, 95%CI: 0.07-0.21), and weight-for-age Z -score (WMD = 0.04, 95%CI: 0.001-0.087), but not height-for-age Z -score (WMD = 0.02, 95%CI: -0.01-0.06) or weight-for-height Z score (WMD = 0.02, 95%CI: -0.03-0.06). Child age at zinc supplementation appeared to modify the effects on height ( P -interaction = 0.002) and HAZ ( P -interaction = 0.06), with larger effects of supplementation starting at age ≥2 years (WMD for height = 1.37 cm, 95%CI: 0.50-2.25; WMD for HAZ = 0.12, 95%CI: 0.05-0.19). No significant effects of supplementation were found on the risk of stunting, underweight or wasting; (4) Conclusion: Although the possibility of publication bias and small

Influenza-associated outpatient visits among children less than 5 years of age in eastern China, 2011-2014.

PubMed

Zhang, Tao; Zhang, Jun; Hua, Jun; Wang, Dan; Chen, Liling; Ding, Yunfang; Zeng, Shanshan; Wu, Jing; Jiang, Yanwei; Geng, Qian; Zhou, Suizan; Song, Ying; Iuliano, A Danielle; Greene, Carolyn M; McFarland, Jeffrey; Zhao, Genming

2016-06-10

The disease burden of influenza in China has not been well described, especially among young children. The aim of this study was to estimate the incidence of outpatient visits associated with influenza in young children in Suzhou, a city of more than 11 million residents in Jiangsu Province in eastern China. Influenza-like illness (ILI) was defined as the presence of fever (axillary temperature ≥38 °C) and cough or sore throat. We collected throat swabs for children less than 5 years of age with ILI who visited Suzhou University Affiliated Children's Hospital (SCH) outpatient clinic or emergency room between April 2011 and March 2014. Suzhou CDC, a national influenza surveillance network laboratory, tested for influenza viruses by real-time reverse transcription-polymerase chain reaction assay (rRT-PCR). Influenza-associated ILI was defined as ILI with laboratory-confirmed influenza by rRT-PCR. To calculate the incidence of influenza-associated outpatient visits, we conducted community-based healthcare utilization surveys to determine the proportion of hospital catchment area residents who sought care at SCH. The estimated incidence of influenza-associated ILI outpatient visits among children aged <5 years in the catchment area of Suzhou was, per 100 population, 17.4 (95 % CI 11.0-25.3) during April 2011-March 2012, 14.6 (95 % CI 5.2-26.2) during April 2012-March 2013 and 21.4 (95 % CI: 10.9-33.5) during April 2013-March 2014. The age-specific outpatient visit rates of influenza-associated ILI were 4.9, 21.1 and 21.2 per 100 children aged 0- <6 months, 6- <24 months and 24- <60 months, respectively. Influenza virus infection causes a substantial burden of outpatient visits among young children in Suzhou, China. Targeted influenza prevention and control strategies for young children in Suzhou are needed to reduce influenza-associated outpatient visits in this age group.

Contribution of the priming paradigm to the understanding of the conceptual developmental shift from 5 to 9 years of age.

PubMed

Perraudin, Sandrine; Mounoud, Pierre

2009-11-01

We conducted three experiments to study the role of instrumental (e.g. knife-bread) and categorical (e.g. cake-bread) relations in the development of conceptual organization with a priming paradigm, by varying the nature of the task (naming--Experiment 1--or categorical decision--Experiments 2 and 3). The participants were 5-, 7- and 9-year-old children and adults. The results showed that on both types of task, adults and 9-year-old children presented instrumental and categorical priming effects, whereas 5-year-old children presented mainly instrumental priming effects, with categorical effects remaining marginal. Moreover, the magnitude of the instrumental priming effects decreased with age. Finally, the priming effects observed for 7-year-old children depended on the task, especially for the categorical effects. The theoretical implications of these results for our understanding of conceptual reorganization from 5 to 9 years of age are discussed.

Anticipating rotavirus vaccines--a pre-vaccine assessment of incidence and economic burden of rotavirus hospitalizations among children < 5 year of age in Libya, 2012-13.

PubMed

Alkoshi, Salem; Leshem, Eyal; Parashar, Umesh D; Dahlui, Maznah

2015-01-24

Libya introduced rotavirus vaccine in October 2013. We examined pre-vaccine incidence of rotavirus hospitalizations and associated economic burden among children < 5 years in Libya to provide baseline data for future vaccine impact evaluations. Prospective, hospital-based active surveillance for rotavirus was conducted at three public hospitals in two cities during August 2012 - April 2013. Clinical, demographic and estimated cost data were collected from children <5 hospitalized for diarrhea; stool specimens were tested for rotavirus with a commercial enzyme immunoassay. Annual rotavirus hospitalization incidence rate estimates included a conservative estimate based on the number of cases recorded during the nine months and an extrapolation to estimate 12 months incidence rate. National rotavirus disease and economic burden were estimated by extrapolating incidence and cost data to the national population of children aged < 5 years. A total of 410 children < 5 years of age with diarrhea were enrolled, of whom 239 (58%) tested positive rotavirus, yielding an incidence range of 418-557 rotavirus hospitalizations per 100,000 children < 5 years of age. Most (86%) rotavirus cases were below two years of age with a distinct seasonal peak in winter (December-March) months. The total cost of treatment for each rotavirus patient was estimated at US$ 679 (range: 200-5,423). By extrapolation, we estimated 2,948 rotavirus hospitalizations occur each year in Libyan children < 5 years of age, incurring total costs of US$ 2,001,662 (range: 1,931,726-2,094,005). Rotavirus incurs substantial morbidity and economic burden in Libya, highlighting the potential value of vaccination of Libyan children against rotavirus.

[Economical effectiveness of vaccination of cohort of children aged 2 years against chickenpox in the Russian Federation].

PubMed

Kostinov, M P; Zverev, V V

2012-01-01

Perform calculation of the economical effectiveness of realization of a program of vaccination of children aged 2 years against chickenpox (CP) in the Russian Federation. Data of Federal service on customers rights protection and human well-being surveillance on evaluation of morbidity and losses caused by CP in the Russian Federation in 2008 - 2010 were used. A cohort of children (1 760 000) aged 2 years subject to vaccination against CP in 2011, evaluation of cost of 1 case of the infection, the amount of losses per vaccination of 1 child were approximately determined; analysis of prevented losses by implementation ofvaccination program by using mathematical modeling methods was performed. Without vaccination program in the Russian Federation the cost of losses per 1 case of CP related to hospitalization and outpatient visits as well as temporary disability of one of the parent in various age groups was: for children aged 1 - 2 years--8 333 RUB (Russian rubles), 3 - 6 years--21 171 RUB, 7 - 14 years--21 295 RUB. The cost of vaccination against CP of 1 child including 2 doses of vaccines with physician examination and vaccination procedure would be 1600 RUB. In the case of realization of vaccination program against CP in 2011 of children aged 2 years its cost would be 2 488.9 million RUB. Cost prevention already exceeds the cost of vaccination in 1 age cohort of children at year 2 and in 5 years the amount of prevented losses would exceed 15 billion RUB per 1 vaccinated cohort and would continue to increase steadily. The performed calculations show that vaccination against CP in the Russian Federation is a highly efficient investment. Self-sufficiency of a program implemented in 2011 may be obtained already at the start of year 2 after the realization and by 2016 the net economical benefit would be around 8 milliards RUB.

Measles Humoral and Cell-Mediated Immunity in Children Aged 5–10 Years After Primary Measles Immunization Administered at 6 or 9 Months of Age

PubMed Central

Gans, Hayley A.; Yasukawa, Linda L.; Sung, Phillip; Sullivan, Barbara; DeHovitz, Ross; Audet, Susette; Beeler, Judy; Arvin, Ann M.

2013-01-01

Background. Given the high infant measles mortality rate, there is interest in whether a measles immunization regimen beginning at <12 months of age provides lasting immunity. Methods. Measles-specific immune responses were evaluated in 70 children aged 5–10 years after primary measles vaccine administered at 6, 9, or 12 months. Results. At 5–10 years of age, the stimulation index for measles T-cell proliferation was 11.4 (SE, 1.3), 10.9 (SE, 1.5), and 14.4 (SE 2.1) when the first measles dose was given at 6, 9, or 12 months, respectively. Neutralizing antibody concentration (geometric mean titer [GMT]) in those immunized at 6 months of age was 125 mIU/mL (95% confidence interval [CI], 42–377) in the presence of passive antibodies (PAs) and 335 mIU/mL (95% CI, 211–531) in those without PAs; in those immunized at 9 months, GMTs were 186 mIU/mL (95% CI, 103–335) and 1080 mIU/mL (95% CI, 642–1827) in the presence and absence of PAs, respectively. The GMT was 707 mIU/mL (95% CI, 456–1095) when vaccine was administered at 12 months (P ≤ .04). Conclusions. Measles-specific T-cell responses were sustained at 5–10 years of age regardless of age at time of primary measles immunization. Neutralizing antibody concentrations were lower in cohorts given the first vaccine dose at 6 months of age and in the presence of PAs; however, responses could be boosted by subsequent doses. Starting measles vaccination at <12 months of age may be beneficial during measles outbreaks or in endemic areas. PMID:23300162

Comparative Assessment of a Single Dose and a 2-dose Vaccination Series of a Quadrivalent Meningococcal CRM-conjugate Vaccine (MenACWY-CRM) in Children 2-10 Years of Age.

PubMed

Johnston, William; Essink, Brandon; Kirstein, Judith; Forleo-Neto, Eduardo; Percell, Sandra; Han, Linda; Keshavan, Pavitra; Smolenov, Igor

2016-01-01

We compared the immunogenicity, safety and 1-year antibody persistence of a single-dose and a 2-dose series of a licensed meningococcal ACWY-CRM conjugate vaccine (MenACWY-CRM) in 2- to 10-year-old children. In this phase III, multicenter, observer-blind study, children aged 2-5 years (n = 359) and 6-10 years (n = 356) were randomized 1:1 to receive 2 doses of MenACWY-CRM (ACWY2) or 1 dose of placebo followed by 1 dose of MenACWY-CRM (ACWY1), 2 months apart. Immunogenicity was measured using serum bactericidal activity with human complement (hSBA). Primary outcomes were to assess the immunologic noninferiority and superiority of ACWY2 versus ACWY1. One-month after the second dose, the hSBA seroresponse in ACWY2 was noninferior to ACWY1 for all 4 serogroups, in both age cohorts, and was superior for serogroups C and Y in the 2- to 5-year-old age cohort and for serogroup Y in the 6- to 10-year-old age cohort. Overall, 90%-99% of subjects in ACWY2 and 65%-96% in ACWY1 had hSBA titers ≥ 8; geometric mean titers were 1.8- to 6.4-fold higher in ACWY2 than ACWY1 across serogroups. At 1 year postvaccination, geometric mean titers declined, and the differences between ACWY2 and ACWY1 remained significant for serogroups A and C in the 2- to 5-year-old age cohort and for serogroups C and Y in the 6- to 10-year-old age cohort. The safety profile of MenACWY-CRM was similar in both groups. The single dose and 2-dose MenACWY-CRM series were immunogenic and well tolerated. Although antibody responses were greater after 2 doses, especially in the 2- to 5-year-old age cohort, this difference was less pronounced at 1 year postvaccination.

Global, Regional, and National Estimates of Rotavirus Mortality in Children <5 Years of Age, 2000-2013.

PubMed

Tate, Jacqueline E; Burton, Anthony H; Boschi-Pinto, Cynthia; Parashar, Umesh D

2016-05-01

Rotavirus vaccine is recommended for routine use in all countries globally. To facilitate decision making on rotavirus vaccine adoption by countries, help donors prioritize investments in health interventions, and monitor vaccine impact, we estimated rotavirus mortality for children <5 years of age from 2000 to 2013. We searched PubMed using the keyword "rotavirus" to identify studies that met each of the following criteria: data collection midpoint in year 1998 or later, study period of a 12-month increment, and detection of rotavirus infection by enzyme immunoassay in at least 100 children <5 years of age who were hospitalized with diarrhea and systematically enrolled through active surveillance. We also included data from countries that participated in the World Health Organization (WHO)-coordinated rotavirus surveillance network between 2008 and 2013 that met these criteria. To predict the proportion of diarrhea due to rotavirus, we constructed a multiple linear regression model. To determine the number of rotavirus deaths in children <5 years of age from 2000 to 2013, we multiplied annual, country-specific estimates of the proportion of diarrhea due to rotavirus from the regression model by the annual number of WHO-estimated child deaths caused by diarrhea in each country. Globally, we estimated that the number of rotavirus deaths in children <5 years of age declined from 528 000 (range, 465 000-591 000) in 2000 to 215 000 (range, 197 000-233 000) in 2013. The predicted annual rotavirus detection rate from these studies declined slightly over time from 42.5% (95% confidence interval [CI], 37.4%-47.5%) in 2000 to 37.3% (95% CI, 34.2%-40.5%) in 2013 globally. In 2013, an estimated 47 100 rotavirus deaths occurred in India, 22% of all rotavirus deaths that occurred globally. Four countries (India, Nigeria, Pakistan, and Democratic Republic of Congo) accounted for approximately half (49%) of all estimated rotavirus deaths in 2013. While rotavirus vaccine had been

Risk factors for long-bone fractures in children up to 5 years of age: a nested case-control study.

PubMed

Baker, Ruth; Orton, Elizabeth; Tata, Laila J; Kendrick, Denise

2015-05-01

To investigate risk factors for first long-bone fractures in children up to 5 years old in order to provide evidence about which families could benefit from injury prevention interventions. Population-based matched nested case-control study using The Health Improvement Network, a UK primary care research database, 1988-2004. Maternal, household and child risk factors for injury were assessed among 2456 children with long-bone fractures (cases). 23,661 controls were matched to cases on general practice. Adjusted ORs and 95% CIs were estimated using conditional logistic regression. Fractures of long-bones were independently associated with younger maternal age and higher birth order, with children who were the fourth-born in the family, or later, having a threefold greater odds of fracture compared to first-born children (adjusted OR 3.12, 95% CI 2.08 to 4.68). Children over the age of 1 year had a fourfold (13-24 months, adjusted OR 4.09 95% CI 3.51 to 4.76) to fivefold (37+ months, adjusted OR 4.88 95% CI 4.21 to 5.66) increase in the odds of a long-bone fracture compared to children aged 0-12 months. Children in families with a history of maternal alcohol misuse had a raised odds of long-bone fracture (adjusted OR 2.33, 95% CI 1.13 to 4.82) compared to those with no documented history. Risk factors for long-bone fractures in children less than 5 years old included age above 1 year, increasing birth order, younger maternal age and maternal alcohol misuse. These risk factors should be used to prioritise families and communities for injury prevention interventions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Longitudinal development of secondary sexual characteristics in girls and boys between ages 91/2 and 151/2 years.

PubMed

Susman, Elizabeth J; Houts, Renate M; Steinberg, Laurence; Belsky, Jay; Cauffman, Elizabeth; Dehart, Ganie; Friedman, Sarah L; Roisman, Glenn I; Halpern-Felsher, Bonnie L

2010-02-01

To identify ages when adolescents were in sexual maturity stages 2 through 5; to explain the relations between breast (girls), genital (boys), and pubic hair (girls and boys) development between ages 9(1/2) and 15(1/2) years; and to evaluate synchrony of pubertal development across characteristics. Annual pubertal assessments. Ten locations in the United States. A total of 859 adolescents (427 boys [49.7%] and 432 girls [50.3%]; 737 white [85.8%] and 122 black [14.2%]). Changes in the 5 stages of breast, genital, and pubic hair development. Girls were in breast maturity stages 2 and 3 earlier than comparable pubic hair stages. Although breast development in girls started earlier than pubic hair development, girls completed breast and pubic hair development at approximately the same age. Black girls were in all stages of breast and pubic hair development earlier than white girls. Boys were in stages 2, 3, 4, and 5 of genital development before the comparable pubic hair stage. In boys, genital development started earlier than pubic hair development, but pubic hair development was completed in less time. Black boys were in genital and pubic hair development about 7 months earlier than white boys. Black and white boys completed genital development in approximately 4(1/2) years, but black boys took approximately 6 months longer than white boys to complete pubic hair development. At stage 2, for 66.2% of girls, breast development preceded their pubic hair development; for 91.1% of boys, genital development preceded their pubic hair development. The results of this study are useful in understanding normative variation in the timing and change in the development of secondary sexual characteristics at puberty. They will help identify adolescents with atypical changes in sexual maturation and unusual progression of sexual maturation and growth disorders.

Depression subtypes and 5-year risk of dementia and Alzheimer disease in patients aged 70 years.

PubMed

Vilalta-Franch, Joan; López-Pousa, Secundino; Llinàs-Reglà, Jordi; Calvó-Perxas, Laia; Merino-Aguado, Javier; Garre-Olmo, Josep

2013-04-01

The objective of this study was to estimate several subtypes of depressive disorders as risk factors for dementia and Alzheimer disease (AD) specifically. This is a population-based cohort study using a sample of 451 non-demented older people. Adjusted Cox proportional hazard models were calculated to determine the association of depression with dementia or AD development after 5 years. Baseline evaluation included the Cambridge Mental Disorders of the Elderly Examination (CAMDEX). Depressive disorders (major episode [MD] and minor depressive disorders [MDDIS]) were assessed following DSM-IV criteria and further classified according to the age at onset (early versus late onset). In turn, all late-onset depressions were grouped as with or without depression-executive dysfunction syndrome (DEDS). Dementia (and dementia subtypes) diagnoses were made using the CAMDEX. When the patients were deceased, the Retrospective Collateral Dementia Interview was used. Late-onset depressions (both MD and MDDIS) were associated with increased dementia (hazard ratio [HR] = 2.635; 95% CI = 1.153-6.023; and HR = 2.517; 95% CI = 1.200-5.280, respectively), and AD (HR = 6.262; 95% CI = 2.017-19.446; and HR = 4.208; 95% CI = 1.828-9.685, respectively) after adjustment by age, gender, marital status, education, cognitive impairment, executive function and stroke history. A second model revealed that only late-onset depressions with DEDS increased the risk for both dementia (late-onset MD with DEDS: HR = 6.262; 95% CI = 2.017-19.446; late-onset MDDIS with DEDS: HR = 4.208; 95% CI = 1.828-9.685) and AD (late-onset MD with DEDS: HR = 7.807; 95% CI = 1.567-38.894; late-onset MDDIS with DEDS: HR = 6.099; 95% CI = 2.123-17.524). Late-onset depressive episodes with DEDS are risk factors for dementia and AD development, regardless of the severity of the depression. Copyright © 2012 John Wiley & Sons, Ltd.

[Xp11.2 translocation renal carcinoma in adults over 50 years of age: about four cases].

PubMed

Arnoux, V; Long, J-A; Fiard, G; Pasquier, D; Bensaadi, L; Terrier, N; Rambeaud, J-J; Descotes, J-L

2012-11-01

To describe demographic, therapeutic and follow-up data of four cases of renal cell carcinoma with Xp11.2 translocation in adults older than 50 years of age. Between January 2008 and December 2011, 170 patients underwent surgery for renal cell carcinoma in our center. Systematic histopathologic analysis of specimen removed was performed. Complementary immunohistochemical analysis was performed only in cases with uncertain diagnosis or in patients younger than 40 years of age. Among these 170 patients with a median age of 59years old (21-89), immunohistochemistry helped find a TFE3 translocation in four cases (2.4%). There were three women and one man of 53, 71, 75 and 86years old respectively. One patient was metastatic at diagnosis. Radical nephrectomy was first performed in all cases. TNM staging was T3aN2R0, T3bN0R0, T2N2R0 and T3aN2R2, with a Furhman grade of 4. Two patients progressed with metastasis 5 and 7months after surgery, and two with lymphatic invasion 2 and 9months after nephrectomy. One patient died during follow-up. Xp11.2 translocation renal cell carcinoma was uncommon after 50years of age in our series, but probably under estimated. It seemed to be associated with a poor prognosis. Larger studies must be performed to optimize its specific treatment. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Comparing self-reported health status and diagnosis-based risk adjustment to predict 1- and 2 to 5-year mortality.

PubMed

Pietz, Kenneth; Petersen, Laura A

2007-04-01

To compare the ability of two diagnosis-based risk adjustment systems and health self-report to predict short- and long-term mortality. Data were obtained from the Department of Veterans Affairs (VA) administrative databases. The study population was 78,164 VA beneficiaries at eight medical centers during fiscal year (FY) 1998, 35,337 of whom completed an 36-Item Short Form Health Survey for veterans (SF-36V) survey. We tested the ability of Diagnostic Cost Groups (DCGs), Adjusted Clinical Groups (ACGs), SF-36V Physical Component score (PCS) and Mental Component Score (MCS), and eight SF-36V scales to predict 1- and 2-5 year all-cause mortality. The additional predictive value of adding PCS and MCS to ACGs and DCGs was also evaluated. Logistic regression models were compared using Akaike's information criterion, the c-statistic, and the Hosmer-Lemeshow test. The c-statistics for the eight scales combined with age and gender were 0.766 for 1-year mortality and 0.771 for 2-5-year mortality. For DCGs with age and gender the c-statistics for 1- and 2-5-year mortality were 0.778 and 0.771, respectively. Adding PCS and MCS to the DCG model increased the c-statistics to 0.798 for 1-year and 0.784 for 2-5-year mortality. The DCG model showed slightly better performance than the eight-scale model in predicting 1-year mortality, but the two models showed similar performance for 2-5-year mortality. Health self-report may add health risk information in addition to age, gender, and diagnosis for predicting longer-term mortality.

Length and weight of very low birth weight infants in Germany at 2 years of age: does it matter at what age they start complementary food?

PubMed

Spiegler, J; Eisemann, N; Ehlers, S; Orlikowsky, T; Kannt, O; Herting, E; Göpel, W

2015-06-01

We analysed at what age parents start complementary food in very low birth weight infants, determined risk factors for early introduction of complementary food (post-term age) and analysed whether the age at introduction of complementary food influences height or weight at 2 years of age. Parents of premature infants born in 2009-2011 answered questionnaires regarding introduction of complementary food in the first year of life (N=2262) and were followed up at a post-term age of 2 years (N=981). Length and weight were compared with full-term infants from the KiGGs study. Logistic and linear regression analyses were conducted to study predictors for early introduction of complementary food and the influence of age at introduction of complementary food on later height and weight. Average age at introduction of complementary food was 3.5 months post-term age. The lower the gestational age at birth, the earlier (post-term age) vegetables and meat were introduced. Age at introduction of complementary food was influenced by intrauterine growth restriction, gestational age at birth, maternal education and a developmental delay perceived by the parents. Length and weight at a post-term age of 2 years was not negatively influenced by early introduction of complementary food. VLBW infants are introduced to complementary food on average before a post-term age of 4 months. There was no negative effect of early introduction of complementary food on height and weight at 2 years of age.

Etiology of Acute Otitis Media in Children Less Than 5 Years of Age

PubMed Central

Van Dyke, Melissa K.; Pirçon, Jean-Yves; Cohen, Robert; Madhi, Shabir A.; Rosenblüt, Andrés; Macias Parra, Mercedes; Al-Mazrou, Khalid; Grevers, Gerhard; Lopez, Pio; Naranjo, Laura; Pumarola, Felix; Sonsuwan, Nuntigar

2017-01-01

Background: Acute otitis media (AOM) is an important cause of childhood morbidity and antibiotic prescriptions. However, the relative importance of the well-known otopathogens, Streptococcus pneumoniae (Spn) and Haemophilus influenzae (Hflu), remains unclear because of a limited number of tympanocentesis-based studies that vary significantly in populations sampled, case definitions and heptavalent pneumococcal conjugate vaccine use. Methods: We conducted a pooled analysis of results from 10 AOM etiology studies of similar design, the protocols of which were derived from a common protocol and conducted in children 3 months to 5 years of age in different countries. Generalized estimating equations were used to account for within-study correlations. Results: The majority, 55.5% (95% confidence interval: 47.0%–65.7%) of 1124 AOM episodes, were bacterial pathogen positive: 29.1% (24.8%–34.1%) yielded Hflu and 23.6% (19.0%–29.2%) Spn. Proportions of Hflu and Spn were higher and lower, respectively, in heptavalent pneumococcal conjugate vaccine–vaccinated children. Hflu and Spn were each isolated from 20% to 35% of children in every 1-year age range. Hflu was less likely to be isolated from first (vs. subsequent) episodes [relative risk (RR): 0.71 (0.60–0.84)]. Spn was more often isolated from sporadic (vs. recurrent) cases [RR: 0.76 (0.61–0.97)]; the opposite was true for Hflu [RR: 1.4 (1.00–1.96)]. Spn cases were more likely to present with severe (vs. mild) symptoms [RR: 1.42 (1.01–2.01)] and Hflu cases with severe tympanic membrane inflammation [RR: 1.35 (1.06–1.71)]. Conclusions: Spn and Hflu remain the leading otopathogens in all populations examined. While associated with overlapping symptoms and severity, they exhibit some differences in their likelihood to cause disease in specific subpopulations. PMID:27918383

Longitudinal relations between observed parenting behaviors and dietary quality of meals from ages 2 to 5.

PubMed

Montaño, Zorash; Smith, Justin D; Dishion, Thomas J; Shaw, Daniel S; Wilson, Melvin N

2015-04-01

Parents influence a child's diet by modeling food choices, selecting the food they make available, and controlling the child's intake. Few studies have examined the covariation between parent's behavior management practices and their guidance and support for a young child's nutritional environment in early childhood. We hypothesized that parents' positive behavior support (PBS), characterized as skillful behavior management and proactive structuring of children's activities, would predict dietary quality over the course of early childhood (age 2 to 5 years), a critical period for the development of a dietary lifestyle. Participants included 731 culturally diverse, low-income families in a randomized, controlled trial of the Family Check-Up. Families participated in a yearly home visit videotaped assessment PBS and dietary quality of meals parents served to their children were assessed by coding videotapes of structured parent-child interactions. A cross-lagged panel model was used to evaluate the longitudinal relation between PBS and the dietary quality of meals served during a meal preparation task. Analyses revealed that PBS repeatedly predicted meals' dietary quality the following year: age 2-3 (β = .30), age 3-4 (β = 0.14), age 4-5 (β = 0.37). Dietary quality significantly predicted PBS 1 year later: age 3-4 (β = 0.16), age 4-5 (β = 0.14). As expected, the relative strength of the relationship from PBS to dietary quality was significantly stronger than the reverse, from dietary quality to PBS. Positive behavior management and proactive parenting practices are an important foundation for establishing a healthy nutritional environment for young children. These findings suggest that family-centered prevention interventions for pediatric obesity may benefit from targeting PBS in service of promoting better dietary quality. Copyright © 2014 Elsevier Ltd. All rights reserved.

Randomized Open Trial Comparing 2-Dose Regimens of the Human Papillomavirus 16/18 AS04-Adjuvanted Vaccine in Girls Aged 9-14 Years Versus a 3-Dose Regimen in Women Aged 15-25 Years.

PubMed

Puthanakit, Thanyawee; Huang, Li-Min; Chiu, Cheng-Hsun; Tang, Ren-Bin; Schwarz, Tino F; Esposito, Susanna; Frenette, Louise; Giaquinto, Carlo; McNeil, Shelly; Rheault, Paul; Durando, Paolo; Horn, Michael; Klar, Maximilian; Poncelet, Sylviane; De Simoni, Stéphanie; Friel, Damien; De Muynck, Benoit; Suryakiran, Pemmaraju V; Hezareh, Marjan; Descamps, Dominique; Thomas, Florence; Struyf, Frank

2016-08-15

This randomized, open trial compared regimens including 2 doses (2D) of human papillomavirus (HPV) 16/18 AS04-adjuvanted vaccine in girls aged 9-14 years with one including 3 doses (3D) in women aged 15-25 years. Girls aged 9-14 years were randomized to receive 2D at months 0 and 6 (M0,6; (n = 550) or months 0 and 12 (M0,12; n = 415), and women aged 15-25 years received 3D at months 0, 1, and 6 (n = 482). End points included noninferiority of HPV-16/18 antibodies by enzyme-linked immunosorbent assay for 2D (M0,6) versus 3D (primary), 2D (M0,12) versus 3D, and 2D (M0,6) versus 2D (M0,12); neutralizing antibodies; cell-mediated immunity; reactogenicity; and safety. Limits of noninferiority were predefined as <5% difference in seroconversion rate and <2-fold difference in geometric mean antibody titer ratio. One month after the last dose, both 2D regimens in girls aged 9-14 years were noninferior to 3D in women aged 15-25 years and 2D (M0,12) was noninferior to 2D (M0,6). Geometric mean antibody titer ratios (3D/2D) for HPV-16 and HPV-18 were 1.09 (95% confidence interval, .97-1.22) and 0.85 (.76-.95) for 2D (M0,6) versus 3D and 0.89 (.79-1.01) and 0.75 (.67-.85) for 2D (M0,12) versus 3D. The safety profile was clinically acceptable in all groups. The 2D regimens for the HPV-16/18 AS04-adjuvanted vaccine in girls aged 9-14 years (M0,6 or M0,12) elicited HPV-16/18 immune responses that were noninferior to 3D in women aged 15-25 years. NCT01381575. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America.

High-voltage electroencephalogram spindles in rats, aging and 5-HT2 antagonism.

PubMed

Moyanova, S; Kortenska, L; Kirov, R

1998-03-09

We examined the effects of serotonin-2 (5-hydroxytryptamine-2, 5-HT2) receptor antagonists on the so-called high-voltage spindles (HVS, electroencephalographic patterns, characterized by large amplitude rhythmic waves mainly in the alpha band), recorded from the frontal cortex of young, middle-aged and old freely-moving rats during waking immobility. The study was based on the assumption that the effects of 5-HT2 receptor antagonists on the HVS activity depend on the age of rats, because there is evidence for an age-related decrease in the 5-HT2 binding sites density. Four parameters of the electroencephalogram (EEG) were used to characterize the HVS activity: the square root-transformed EEG peak power in the alpha band, the frequency corresponding to this peak (both measured from the EEG power spectra using the fast Fourier transform), the HVS mean duration, and the HVS incidence (both measured from the EEG records). The EEG parameters were analyzed after i.p. administration of three 5-HT2 receptor antagonists: ketanserin, ritanserin and cyproheptadine. In young rats, the three drugs increased the alpha power, but did not change the alpha peak-corresponding frequency. Ketanserin and ritanserin did not change the HVS mean duration and HVS incidence, while cyproheptadine increased both these parameters in young rats. In middle-aged and old untreated rats, the HVS activity was significantly increased. The three 5-HT2 antagonists did not change the HVS activity in aged rats, which could be due to age-related suppression of the 5-HT2 receptor functions. Copyright 1998 Elsevier Science B.V.

Prevalence of Shigella among diarrheic children under-5 years of age attending at Mekelle health center, north Ethiopia.

PubMed

Kahsay, Atsebaha Gebrekidan; Teklemariam, Zelalem

2015-12-15

Shigellosis is recognized as a major global public health problem especially in developing countries particularly in children under-5 years of age. Therefore; the objective of this study was to determine the prevalence of Shigella among diarrheic children under-5 years of age attending at Mekelle health center, north Ethiopia. A cross-sectional study was conducted among diarrheic children under-5 years of age from March to May, 2012. Structured questionnaire was used to collect the data. Study participants were recruited by convenience sampling technique. Shigella was isolated and identified using standard bacteriological techniques. A total of 241 study participants were included in the study. The overall prevalence of Shigella in this study was 13.3% (32/241). High prevalence of Shigella (22.6%) was revealed from the age group of 12-23 months. No Shigella was isolated from the age group of 0-5 months. Majority of the isolates of Shigella were from bloody and mucoid diarrhea. There was high prevalence of Shigella infection in this study. Children among the age group of 12-23 months were highly affected. Therefore; responsible bodies should work hard on preventive measures to reduce or eradicate the problem occurred due to shigellosis.

Rheumatic Heart Disease-Attributable Mortality at Ages 5–69 Years in Fiji: A Five-Year, National, Population-Based Record-Linkage Cohort Study

PubMed Central

Parks, Tom; Kado, Joseph; Miller, Anne E.; Ward, Brenton; Heenan, Rachel; Colquhoun, Samantha M.; Bärnighausen, Till W.; Mirabel, Mariana; Bloom, David E.; Bailey, Robin L.; Tukana, Isimeli N.; Steer, Andrew C.

2015-01-01

Background Rheumatic heart disease (RHD) is considered a major public health problem in developing countries, although scarce data are available to substantiate this. Here we quantify mortality from RHD in Fiji during 2008–2012 in people aged 5–69 years. Methods and Findings Using 1,773,999 records derived from multiple sources of routine clinical and administrative data, we used probabilistic record-linkage to define a cohort of 2,619 persons diagnosed with RHD, observed for all-cause mortality over 11,538 person-years. Using relative survival methods, we estimated there were 378 RHD-attributable deaths, almost half of which occurred before age 40 years. Using census data as the denominator, we calculated there were 9.9 deaths (95% CI 9.8–10.0) and 331 years of life-lost (YLL, 95% CI 330.4–331.5) due to RHD per 100,000 person-years, standardised to the portion of the WHO World Standard Population aged 0–69 years. Valuing life using Fiji’s per-capita gross domestic product, we estimated these deaths cost United States Dollar $6,077,431 annually. Compared to vital registration data for 2011–2012, we calculated there were 1.6-times more RHD-attributable deaths than the number reported, and found our estimate of RHD mortality exceeded all but the five leading reported causes of premature death, based on collapsed underlying cause-of-death diagnoses. Conclusions Rheumatic heart disease is a leading cause of premature death as well as an important economic burden in this setting. Age-standardised death rates are more than twice those reported in current global estimates. Linkage of routine data provides an efficient tool to better define the epidemiology of neglected diseases. PMID:26371755

Increasing incidence of type 2 diabetes in New Zealand children <15 years of age in a regional-based diabetes service, Auckland, New Zealand.

PubMed

Sjardin, Natalia; Reed, Peter; Albert, Ben; Mouat, Fran; Carter, Phillipa J; Hofman, Paul; Cutfield, Wayne; Gunn, Alistair; Jefferies, Craig

2018-04-24

It is important to understand whether type 2 diabetes mellitus (T2DM) is increasing in childhood for health-care planning and clinical management. The aim of this study is to examine the incidence of T2DM in New Zealand children, aged <15 years from a paediatric diabetes centre, Auckland, New Zealand. Retrospective analysis of prospectively collected data from a population-based referral cohort from 1995 to 2015. Hundred and four children presented with T2DM over the 21-year period. The female:male ratio was 1.8:1, at mean (standard deviation) age 12.9 (1.9) years, body mass index standard deviation score +2.3 (0.5), blood sugar 15.3 (8.5) mmol/L, HbA1c 76 (28) mmol/mol. At diagnosis, 90% had acanthosis nigricans and 48% were symptomatic. In all, 33% were Maori, 46% Pacific Island, 15% Asian/Middle Eastern and 6% European. There was a progressive secular increase of 5% year on year in incidence. The overall annual incidence of T2DM <15 years of age was 1.5/100 000 (1.2-1.9) (95% confidence interval), with higher rates in Pacific Island (5.9/100 000) and Maori (4.1/100 000). The incidence of T2DM in children <15 years of age in New Zealand has increased progressively at 5%/year over the last 21 years. The risk was disproportionately associated with girls and children from high-risk ethnic groups. © 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Femoral head epiphysis growth and development among Chinese children aged 0-5 years.

PubMed

Luo, Jiayou; Tang, Jin; Zhou, Libo; Zeng, Rong; Mou, Jinsong; Zhang, Lingli

2009-05-01

The aim of this study was to examine the pattern of femoral head epiphysis growth and development among Chinese children. Between January and December, 2007, we randomly sampled 1,450 healthy Chinese children (0-5 years old) from Hunan Provincial Children's Hospital in Changsha, Hunan, China. The diameter of femoral head epiphysis was measured by pelvic X-ray photography and processed by medical image processing software. The growth of femoral head epiphysis in girls was 2-3 months earlier than that in boys. The diameter of femoral head epiphysis increased with advancing age in both girls and boys, but the diameter of femoral head epiphysis in 2, 3, 4, 6, and 10-month-old girls was significantly larger than that in boys. Cubic regression equations between the diameter of femoral head epiphysis and age were created for boys and girls that could be used to predict the diameter of femoral head epiphysis. In conclusion, there was gender difference in femoral head epiphysis growth and development among Chinese children, and our prediction models will provide the guidance for early diagnosis of diseases related to the growth and development of the femoral head epiphysis.

A Prospective Hospital-based Surveillance to Estimate Rotavirus Disease Burden in Bhutanese Children under 5 Years of Age.

PubMed

Wangchuk, Sonam; Dorji, Tshering; Tsheten; Tshering, Karchung; Zangmo, Sangay; Pem Tshering, Kunzang; Dorji, Tandin; Nishizono, Akira; Ahmed, Kamruddin

2015-03-01

As part of efforts to develop an informed policy for rotavirus vaccination, this prospective study was conducted to estimate the burden of rotavirus diarrhea among children less than 5 years old attended to the Department of Pediatrics, Jigme Dorji Wangchuk National Referral Hospital (JDWNRH), Thimphu, Bhutan. The duration of the study was three years, extending from February 2010 through December 2012. We estimated the frequency of hospitalization in the pediatric ward and dehydration treatment unit (DTU) for diarrhea and the number of events attributable to rotavirus infection among children under 5 years of age. During the study period, a total of 284 children (1 in 45) were hospitalized in the pediatric ward, and 2,220 (1 in 6) in the DTU with diarrhea among children residing in the Thimphu district. Group A rotavirus was detected in 32.5% and 18.8% of the stool samples from children hospitalized in the pediatric ward, respectively. Overall, 22.3% of the stool samples were rotavirus-positive, and the majority (90.8%) of them was detected in children under 2 years of age. From this study, we estimated that the annual incidence of hospitalization in the pediatric ward and DTU due to rotavirus diarrhea was 2.4/1000 (95% CI 1.7-3.4) and 10.8/1000 (95% CI 9.1-12.7) children, respectively. This study revealed that rotavirus is a major cause of diarrhea in Bhutanese children in Thimphu district and since no study has been performed previously, represents an important finding for policy discussions regarding the adoption of a rotavirus vaccine in Bhutan.

Beverage Consumption Patterns at Age 13 to 17 Years Are Associated with Weight, Height, and Body Mass Index at Age 17 Years.

PubMed

Marshall, Teresa A; Van Buren, John M; Warren, John J; Cavanaugh, Joseph E; Levy, Steven M

2017-05-01

Sugar-sweetened beverages (SSBs) have been associated with obesity in children and adults; however, associations between beverage patterns and obesity are not understood. Our aim was to describe beverage patterns during adolescence and associations between adolescent beverage patterns and anthropometric measures at age 17 years. We conducted a cross-sectional analyses of longitudinally collected data. Data from participants in the longitudinal Iowa Fluoride Study having at least one beverage questionnaire completed between ages 13.0 and 14.0 years, having a second questionnaire completed between 16.0 and 17.0 years, and attending clinic examination for weight and height measurements at age 17 years (n=369) were included. Beverages were collapsed into four categories (ie, 100% juice, milk, water and other sugar-free beverages, and SSBs) for the purpose of clustering. Five beverage clusters were identified from standardized age 13 to 17 years mean daily beverage intakes and named by the authors for the dominant beverage: juice, milk, water/sugar-free beverages, neutral, and SSB. Weight, height, and body mass index (BMI; calculated as kg/m 2 ) at age 17 years were analyzed. We used Ward's method for clustering of beverage variables, one-way analysis of variance and χ 2 tests for bivariable associations, and γ-regression for associations of weight or BMI (outcomes) with beverage clusters and demographic variables. Linear regression was used for associations of height (outcome) with beverage clusters and demographic variables. Participants with family incomes <$60,000 trended shorter (1.5±0.8 cm; P=0.070) and were heavier (2.0±0.7 BMI units; P=0.002) than participants with family incomes ≥$60,000/year. Adjusted mean weight, height, and BMI estimates differed by beverage cluster membership. For example, on average, male and female members of the neutral cluster were 4.5 cm (P=0.010) and 4.2 cm (P=0.034) shorter, respectively, than members of the milk cluster. For

Staging of third molar development in relation to chronological age of 5-16 year old Indian children.

PubMed

Hegde, Sapna; Patodia, Akash; Dixit, Uma

2016-12-01

The usefulness of the developmental status of the third molar has been studied in assessment of the chronological age of adolescents in whom the development of the other permanent teeth is nearly complete. However, little is known about the timing and pattern of third-molar development in the Indian population. This study aimed to stage the third molar development in relation to chronological age of 5-16year old Indian children. In this cross-sectional observational study, the status of third molar development in relation to chronological age of 1139 Indian children aged 5-16 years was evaluated radiographically, using Orhan's modification of Demirjian's method. The frequency of occurrence of the third molars varied from 47% to 70%. Crypt formation, crown completion and root completion occurred as early as 5.4, 8.7 and 15.0 years, respectively. No significant differences based on gender or side were observed in third-molar development (p>0.05). For most stages, maxillary third molars were slightly more advanced than their mandibular counterparts (p>0.05). Considering the high degree of variability observed in third molar genesis and development, the usefulness of this tooth in age determination studies may be very limited in the age group studied. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Intranasal Deposition of Accuspray™ Aerosol in Anatomically Correct Models of 2-, 5-, and 12-Year-Old Children.

PubMed

Laube, Beth L; Sharpless, Gail; Vikani, Ami R; Harrand, Vincent; Zinreich, Simeon J; Sedberry, Keith; Knaus, Darin; Barry, James; Papania, Mark

2015-10-01

To our knowledge, quantification of intranasal deposition of aerosol generated by Accuspray(™) (AS) in children has never been published. We hypothesized that deposition would vary significantly with age and with placement of the device within, or outside, of the nostril. We tested these hypotheses in anatomically-correct physical models based on CT scans of 2-, 5-, and 12-year-old children with normal, intranasal airways. Models included a removable anterior nose (AN) with exterior facial features and interior nasal vestibule and nasal valve area and a main nasal airway (MNA), subdivided into upper (superior turbinates and olfactory area), middle (middle turbinates), and lower (inferior turbinates and nasopharynx) thirds. Aerosol was generated from distilled water admixed with (99m)technetium pertechnetate and administered during static airflow by AS inserted inside the right nostril (eight runs/model), or outside the right nostril (six runs/model). Mean aerosol Dv(50) ± standard deviation was 67.8 ± 24.7 μm. Deposition was quantified by 2D gamma scintigraphy and expressed as percentage of the emitted dose. When placed inside the nostril, mean (± standard deviation) deposition within the MNA was significantly less in the 2-year-old, compared to the 5- and 12-year-old, averaging 46.8 ± 33.8% (AN:55.4 ± 29.9%), 75.4 ± 26.7% (AN:23.3 ± 13.6%), and 72.1 ± 18.5% (AN:25.8 ± 18.5%), respectively (p<0.05). When placed outside the nostril, MNA was significantly less in the 2- and 5-year-old compared to the 12-year-old, with 1.4 ± 2.5% (AN:69.7 ± 40.7%), 7.4 ± 9.0% (AN:77.8 ± 32.8%), and 21.1 ± 29.1% (AN:29.2 ± 19.3%), respectively (p<0.05). Deposition in the MNA of all age models was highest when AS was placed inside the nostril (p<0.05). Deposition in the lower third was significantly increased for the 5- and 12-year-old and in the middle third of the 5-year-old when AS was placed inside the nostril. These results indicate that age and device placement

Comparing Self-Reported Health Status and Diagnosis-Based Risk Adjustment to Predict 1- and 2 to 5-Year Mortality

PubMed Central

Pietz, Kenneth; Petersen, Laura A

2007-01-01

Objectives To compare the ability of two diagnosis-based risk adjustment systems and health self-report to predict short- and long-term mortality. Data Sources/Study Setting Data were obtained from the Department of Veterans Affairs (VA) administrative databases. The study population was 78,164 VA beneficiaries at eight medical centers during fiscal year (FY) 1998, 35,337 of whom completed an 36-Item Short Form Health Survey for veterans (SF-36V) survey. Study Design We tested the ability of Diagnostic Cost Groups (DCGs), Adjusted Clinical Groups (ACGs), SF-36V Physical Component score (PCS) and Mental Component Score (MCS), and eight SF-36V scales to predict 1- and 2–5 year all-cause mortality. The additional predictive value of adding PCS and MCS to ACGs and DCGs was also evaluated. Logistic regression models were compared using Akaike's information criterion, the c-statistic, and the Hosmer–Lemeshow test. Principal Findings The c-statistics for the eight scales combined with age and gender were 0.766 for 1-year mortality and 0.771 for 2–5-year mortality. For DCGs with age and gender the c-statistics for 1- and 2–5-year mortality were 0.778 and 0.771, respectively. Adding PCS and MCS to the DCG model increased the c-statistics to 0.798 for 1-year and 0.784 for 2–5-year mortality. Conclusions The DCG model showed slightly better performance than the eight-scale model in predicting 1-year mortality, but the two models showed similar performance for 2–5-year mortality. Health self-report may add health risk information in addition to age, gender, and diagnosis for predicting longer-term mortality. PMID:17362210

Pseudomonas aeruginosa genotypes acquired by children with cystic fibrosis by age 5-years.

PubMed

Kidd, Timothy J; Ramsay, Kay A; Vidmar, Suzanna; Carlin, John B; Bell, Scott C; Wainwright, Claire E; Grimwood, Keith

2015-05-01

We describe Pseudomonas aeruginosa acquisitions in children with cystic fibrosis (CF) aged ≤5-years, eradication treatment efficacy, and genotypic relationships between upper and lower airway isolates and strains from non-CF sources. Of 168 CF children aged ≤5-years in a bronchoalveolar lavage (BAL)-directed therapy trial, 155 had detailed microbiological results. Overall, 201/271 (74%) P. aeruginosa isolates from BAL and oropharyngeal cultures were available for genotyping, including those collected before and after eradication therapy. Eighty-two (53%) subjects acquired P. aeruginosa, of which most were unique strains. Initial eradication success rate was 90%, but 36 (44%) reacquired P. aeruginosa, with genotypic substitutions more common in BAL (12/14) than oropharyngeal (3/11) cultures. Moreover, oropharyngeal cultures did not predict BAL genotypes reliably. CF children acquire environmental P. aeruginosa strains frequently. However, discordance between BAL and oropharyngeal strains raises questions over upper airway reservoirs and how to best determine eradication in non-expectorating children. Copyright © 2014 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

HIV Diagnoses Among Persons Aged 13-29 Years - United States, 2010-2014.

PubMed

Ocfemia, M Cheryl Bañez; Dunville, Richard; Zhang, Tianchi; Barrios, Lisa C; Oster, Alexandra M

2018-02-23

In 2014, persons aged 13-29 years represented 23% of the U.S. population, yet accounted for 40% of diagnoses of human immunodeficiency virus (HIV) infection during the same year (1). During 2010-2014, the rates of diagnosis of HIV infection decreased among persons aged 15-19 years, were stable among persons aged 20-24 years, and increased among persons aged 25-29 years (1). However, these 5-year age groups encompass multiple developmental stages and potentially mask trends associated with the rapid psychosocial changes during adolescence through young adulthood. To better understand HIV infection among adolescents aged 13-17 years and young adults aged 18-29 years in the United States and identify ideal ages to target primary HIV prevention efforts, CDC analyzed data from the National HIV Surveillance System (NHSS)* using narrow age groups. During 2010-2014, rates of diagnosis of HIV infection per 100,000 population varied substantially among persons aged 13-15 years (0.7), 16-17 years (4.5), 18-19 years (16.5), and 20-21 years (28.6), and were higher, but less variable, among persons aged 22-23 years (34.0), 24-25 years (33.8), 26-27 years (31.3), and 28-29 years (28.7). In light of the remarkable increase in rates between ages 16-17, 18-19, and 20-21 years, and a recent study revealing that infection precedes diagnosis for young persons by an average of 2.7 years (2), these findings demonstrate the importance of targeting primary prevention efforts to persons aged <18 years and continuing through the period of elevated risk in their mid-twenties.

Longitudinal trajectories of mental health in Australian children aged 4-5 to 14-15 years.

PubMed

Christensen, Daniel; Fahey, Michael T; Giallo, Rebecca; Hancock, Kirsten J

2017-01-01

Mental health can affect young people's sense of wellbeing and life satisfaction, their ability to participate in employment and education, and their onward opportunities in life. This paper offers a rare opportunity to longitudinally examine mental health in a population-representative study of children aged 4-5 years to 14-15 years. Using data from the Longitudinal Study of Australian Children (LSAC), this study examined maternally-reported child mental health over a 10 year period, in order to understand their initial mental health status early in life and its change over time, as measured by the Strengths and Difficulties Questionnaire. Longitudinal models were fitted from ages 4-5 to 14-15 years. Results showed that child sex, maternal mental health, socio-economic status (family income, maternal education, neighbourhood disadvantage), maternal hostility, and child temperament (persistence, sociability, reactivity) are all independent contributors to child mental health at age 4. These effects largely persist over time, with the effects of maternal mental health increasing slightly over time. Persistence of these effects suggests the need for early intervention and supports. The independent contribution of these factors to child mental health suggests that multi-faceted approaches to child and maternal mental health are needed.

Risk factors for overweight and obesity in children aged 2-6 years.

PubMed

Kondolot, Meda; Poyrazoğlu, Serpil; Horoz, Duygu; Borlu, Arda; Altunay, Canan; Balcı, Elcin; Öztürk, Ahmet; Mazıcıoğlu, Mümtaz M; Kurtoğlu, Selim

2017-05-01

Understanding risk factors that may vary culturally can help improve preventive strategies for obesity. This is the first cross-sectional study aimed to determine the risk factors for overweight/obesity in children aged 2-6 years in a central Anatolian city in Turkey. A total of 1582 children (1351 healthy, 231 overweight/obese) aged 2-6 years were included from the Anthropometry of Turkish Children aged 0-6 years database. Age, gender, birth weight, birth order, mother's age, mother's body mass index (BMI), weight gain of mothers during pregnancy, presence of gestational diabetes, breastfeeding duration, history of formula feeding, mother's and father's education, mother's job, monthly income, smoking at home and physical activity, sleep duration and duration of television (TV) watching of the children were evaluated as independent risk factors. Logistic regression analyses were performed to investigate risk factors for overweight/obesity. Having a high family income compared to bad [odds ratio (OR)=1.96; 95% confidence interval (CI): 1.237-3.106], increased the time of watching TV during the weekend (OR=1.094; 95% CI: 1.032-1.159), and similar physical activity level according to their peers compared to less (OR=2.957; 95% CI: 1.056-8.282) were found to be significantly associated with a higher risk of overweight/obesity in children aged 2-6 years old. The early childhood period seems to be important in the establishment of healthy behavioral patterns, especially limitation of TV watching and encouragement of physical activity. Obesogenic environment in families with high incomes need to be revealed.

Comparison of contact lens and intraocular lens correction of monocular aphakia during infancy: a randomized clinical trial of HOTV optotype acuity at age 4.5 years and clinical findings at age 5 years.

PubMed

Lambert, Scott R; Lynn, Michael J; Hartmann, E Eugenie; DuBois, Lindreth; Drews-Botsch, Carolyn; Freedman, Sharon F; Plager, David A; Buckley, Edward G; Wilson, M Edward

2014-06-01

The efficacy and safety of primary intraocular lens (IOL) implantation during early infancy is unknown. To compare the visual outcomes of patients optically corrected with contact lenses vs IOLs following unilateral cataract surgery during early infancy. The Infant Aphakia Treatment Study is a randomized clinical trial with 5 years of follow-up that involved 114 infants with unilateral congenital cataracts at 12 sites. A traveling examiner assessed visual acuity at age 4.5 years. Cataract surgery with or without primary IOL implantation. Contact lenses were used to correct aphakia in patients who did not receive IOLs. Treatment was determined through random assignment. HOTV optotype visual acuity at 4.5 years of age. The median logMAR visual acuity was not significantly different between the treated eyes in the 2 treatment groups (both, 0.90 [20/159]; P = .54). About 50% of treated eyes in both groups had visual acuity less than or equal to 20/200. Significantly more patients in the IOL group had at least 1 adverse event after cataract surgery (contact lens, 56%; IOL, 81%; P = .02). The most common adverse events in the IOL group were lens reproliferation into the visual axis, pupillary membranes, and corectopia. Glaucoma/glaucoma suspect occurred in 35% of treated eyes in the contact lens group vs 28% of eyes in the IOL group (P = .55). Since the initial cataract surgery, significantly more patients in the IOL group have had at least 1 additional intraocular surgery (contact lens, 21%; IOL, 72%; P < .001). There was no significant difference between the median visual acuity of operated eyes in children who underwent primary IOL implantation and those left aphakic. However, there were significantly more adverse events and additional intraoperative procedures in the IOL group. When operating on an infant younger than 7 months of age with a unilateral cataract, we recommend leaving the eye aphakic and focusing the eye with a contact lens. Primary IOL

Association between depression in carers and malnutrition in children aged 6 months to 5 years

PubMed Central

Ganiyu, Adewale B.; Firth, Jacqueline A.

2017-01-01

Background Childhood malnutrition is an important risk factor for child mortality and underlies close to 50% of child deaths worldwide. Previous studies have found an association between maternal depression and child malnutrition, but it is not known whether this association exists in Botswana. In addition, previous studies excluded non-maternal primary caregivers (PCGs). It is unclear whether the association between primary caregiver depression and child malnutrition remains when non-maternal PCGs are included. Aim The aim of this study was to determine if there is an association between PCG depression and malnutrition in children aged between 6 months and 5 years in Mahalapye, Botswana. Setting The study was conducted in the child welfare clinics of Xhosa and Airstrip clinics, two primary health care facilities in Mahalapye, Botswana. Methods This was a case control study. Cases were malnourished children aged between 6 months and 5 years, and controls were non-malnourished children matched for age and gender. The outcome of interest was depression in the PCGs of the cases and controls, which was assessed using the Patient Health Questionnaire 9 (PHQ 9), a depression screening tool. Results From a sample of 171 children, 84 of whom were malnourished, we found that the malnourished children were significantly more likely to have depressed PCGs (odds ratio = 4.33; 95% CI: 1.89, 9.89) than non-malnourished children in the 6-month to 5-year age group; the PCGs of malnourished children also had lower educational status. Conclusion This study found a significant association between PCG depression and child malnutrition. PMID:28155288

Clinical Features of Human Metapneumovirus Infection in Ambulatory Children Aged 5-13 Years.

PubMed

Howard, Leigh M; Edwards, Kathryn M; Zhu, Yuwei; Griffin, Marie R; Weinberg, Geoffrey A; Szilagyi, Peter G; Staat, Mary A; Payne, Daniel C; Williams, John V

2018-05-15

We detected human metapneumovirus (HMPV) in 54 (5%) of 1055 children aged 5 to 13 years with acute respiratory illness (ARI) identified by outpatient and emergency department surveillance between November and May 2003-2009. Its clinical features were similar to those of HMPV-negative ARI, except a diagnosis of pneumonia was more likely (13% vs 4%, respectively; P = .005) and a diagnosis of pharyngitis (7% vs 24%, respectively; P = .005) was less likely in patients with HMPV- positive ARI than those with HMPV-negative ARI.

Pregnancy Outcome of Multiparous Women Aged over 40 Years

PubMed Central

Ates, Seda; Batmaz, Gonca; Sevket, Osman; Molla, Taner; Dane, Cem; Dane, Banu

2013-01-01

Objective. The aim of this study was to evaluate the effect of maternal age on prenatal and obstetric outcome in multiparaous women. Materials and Methods. A retrospective case control study was conducted, including women aged 40 years and over (study group, n = 97) who delivered at 20 week's gestation or beyond and women aged 20–29 years (control group, n = 97). Results. The mean age of women in the study group was 41.2 ± 1.7 years versus 25.4 ± 2.3 years in the control group. Advanced maternal age was associated with a significantly higher rate of hypertension, diabetes mellitus, fetal complication, and 5-minute Apgar scores <7 (P < 0.05). Caeserean section rate, incidence of placental abruption, preterm delivery, and neonatal intensive care unit admission were more common in the older group, but the differences were not statistically significant. Conclusions. Advanced maternal age is related to maternal and neonatal complications. PMID:25954770

Malnutrition at Age 3 Years and Lower Cognitive Ability at Age 11 Years

PubMed Central

Liu, Jianghong; Raine, Adrian; Venables, Peter H.; Dalais, Cyril; Mednick, Sarnoff A.

2014-01-01

Background Early malnutrition is linked to poor cognition, but long-term effects have not been extensively examined and psychosocial confounds have not always been controlled. Objective To test the hypothesis that malnutrition at age 3 years will be associated with poorer cognitive ability at age 11 years independent of psychosocial confounds. Design A prospective, longitudinal study of a birth cohort of 1559 children originally assessed at age 3 years for malnutrition (low hemoglobin level, angular stomatitis, kwashiorkor, and sparse, thin hair) and followed up to age 11 years. Setting and Participants A community sample of 1559 children (51.4% boys and 48.6% girls) born between September 1, 1969, and August 31, 1970, in 2 towns in the island of Mauritius, with 68.7% Indians and 25.7% Creoles (African origin). Main Outcome Measures Verbal and spatial ability measured at ages 3 and 11 years and reading, scholastic ability, and neuropsychologic performance measured at age 11 years. Results Malnourished children had poorer cognition at both ages. Deficits were stable across time, applied to all sex and ethnic groups, and remained after controlling for multiple measures of psychosocial adversity. Children with 3 indicators of malnutrition had a 15.3-point deficit in IQ at age 11 years. Conclusions Malnutrition at age 3 years is associated with poor cognition at age 11 years independent of psychosocial adversity. Promoting early childhood nutrition could enhance long-term cognitive development and school performance, especially in children with multiple nutritional deficits. PMID:12796242

Determinants of severe acute malnutrition among children under 5 years of age in Nepal: a community-based case-control study.

PubMed

Pravana, Nilesh Kumar; Piryani, Suneel; Chaurasiya, Surendra Prasad; Kawan, Rasmila; Thapa, Ram Krishna; Shrestha, Sumina

2017-08-28

Malnutrition is one of the leading causes of morbidity and mortality among children under the age of 5 years in low and middle income countries like Nepal. Children with severe acute malnutrition (SAM) are nine times more likely to die than children without malnutrition. The prevalence of SAM has increased in Nepal over the past 15 years; however, the determinants of SAM have not been clearly assessed in the country. To assess the determinants of SAM among children aged 6-59 months in the Bara district of Nepal. A community-based case-control study was conducted in 12 randomly selected Village Development Committees (VDCs) of the Bara district of Nepal. A random sample of 292 children aged 6-59 months (146 as cases and 146 as controls) from 12 VDCs were included in this study. The prevalence of SAM among children under the age of 5 years was 4.14%. The following factors were significantly associated with SAM: low socioeconomic status (adjusted odds ratio (AOR) 17.13, 95% CI 5.85 to 50.13); mother's age at birth <20 or >35 years (AOR 3.21, 95% CI 1.30 to 7.94); birth interval <24 months (AOR 4.09, 95% CI 1.87 to 8.97); illiterate father (AOR 3.65, 95% CI 1.62 to 8.20); bottle feeding (AOR 2.19, 95% CI 1.73 to 12.03); and not initiating complementary feeding at the age of 6 months (AOR 2.91, 95% CI 1.73 to 12.03). Mother's educational level, initiation of breastfeeding, colostrum feeding, and exclusive breastfeeding were not significantly associated with SAM. The mother's age at birth, birth interval, socioeconomic status, father's educational level and initiation of complementary feeding at the age of 6 months were important determinants of SAM among children. A multi-sector approach is essential to address SAM. There is a need for further studies not only focusing on SAM but also moderate acute malnutrition. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use

A Case Series of Marijuana Exposures in Pediatric Patients Less than 5 Years of Age

ERIC Educational Resources Information Center

Wang, George Sam; Narang, Sandeep K.; Wells, Kathryn; Chuang, Ryan

2011-01-01

Objective: In Colorado, there has been a large increase in medical marijuana dispensaries and licenses for the use of medical marijuana over the past year. This is a retrospective case series of marijuana exposures that have presented to the emergency department (ED) in children less than 5 years of age. Methods: We performed a retrospective chart…

Association of Bullying Behavior at 8 Years of Age and Use of Specialized Services for Psychiatric Disorders by 29 Years of Age.

PubMed

Sourander, Andre; Gyllenberg, David; Brunstein Klomek, Anat; Sillanmäki, Lauri; Ilola, Anna-Marja; Kumpulainen, Kirsti

2016-02-01

Bullying and being exposed to bullying among children is prevalent, especially among children with psychiatric symptoms, and constitutes a major concern worldwide. Whether childhood bullying or exposure to bullying in the absence of childhood psychiatric symptoms is associated with psychiatric outcomes in adulthood remains unclear. To study the associations between bullying behavior at 8 years of age and adult psychiatric outcomes by 29 years of age. Nationwide birth cohort study of 5034 Finnish children with complete information about childhood bullying behavior was followed up from 8 to 29 years of age. Follow-up was completed on December 31, 2009, and data were analyzed from January 15, 2013, to February 15, 2015. Information about bullying, exposure to bullying, and psychiatric symptoms were obtained from parents, teachers, and child self-reports when children were 8 years of age. Use of specialized services for psychiatric disorders from 16 to 29 years of age was obtained from a nationwide hospital register, including outpatient and inpatient treatment. Among the 5034 study participants, 4540 (90.2%) did not engage in bullying behavior; of these, 520 (11.5%) had received a psychiatric diagnosis at follow-up; 33 of 166 (19.9%) who engaged in frequent bullying, 58 of 251 (23.1%) frequently exposed to bullying, and 24 of 77 (31.2%) who both frequently engaged in and were frequently exposed to bullying had received psychiatric diagnoses at follow-up. When analyses were adjusted by sex, family factors, and child psychiatric symptoms at 8 years of age, we found independent associations of treatment of any psychiatric disorder with frequent exposure to bullying (hazard ratio [HR], 1.9; 95% CI, 1.4-2.5) and being a bully and exposed to bullying (HR, 2.1; 95% CI, 1.3-3.4). Exposure to bullying was specifically associated with depression (HR, 1.9; 95% CI, 1.2-2.9). Bullying was associated with psychiatric outcomes only in the presence of psychiatric problems at 8 years

Phenotypic and Genotypic Characterisation of Inflammatory Bowel Disease Presenting Before the Age of 2 years

PubMed Central

Dziubak, Robert; Pescarin, Matilde; Drury, Suzanne; Godwin, Heather; Reeve, Kate; Chadokufa, Sibongile; Huggett, Bonita; Sider, Sara; James, Chela; Acton, Nikki; Cernat, Elena; Gasparetto, Marco; Noble-Jamieson, Gabi; Kiparissi, Fevronia; Elawad, Mamoun; Beales, Phil L.; Sebire, Neil J.; Gilmour, Kimberly; Uhlig, Holm H.; Bacchelli, Chiara; Shah, Neil

2017-01-01

Abstract Objectives: Inflammatory bowel disease [IBD] presenting in early childhood is extremely rare. More recently, progress has been made to identify children with monogenic forms of IBD predominantly presenting very early in life. In this study, we describe the heterogeneous phenotypes and genotypes of patients with IBD presenting before the age of 2 years and establish phenotypic features associated with underlying monogenicity. Methods: Phenotype data of 62 children with disease onset before the age of 2 years presenting over the past 20 years were reviewed. Children without previously established genetic diagnosis were prospectively recruited for next-generation sequencing. Results: In all, 62 patients [55% male] were identified. The median disease onset was 3 months of age (interquartile range [IQR]: 1 to 11). Conventional IBD classification only applied to 15 patients with Crohn’s disease [CD]-like [24%] and three with ulcerative colitis [UC]-like [5%] phenotype; 44 patients [71%] were diagnosed with otherwise unclassifiable IBD. Patients frequently required parenteral nutrition [40%], extensive immunosuppression [31%], haematopoietic stem-cell transplantation [29%], and abdominal surgery [19%]. In 31% of patients, underlying monogenic diseases were established [EPCAM, IL10, IL10RA, IL10RB, FOXP3, LRBA, SKIV2L, TTC37, TTC7A]. Phenotypic features significantly more prevalent in monogenic IBD were: consanguinity, disease onset before the 6th month of life, stunting, extensive intestinal disease and histological evidence of epithelial abnormalities. Conclusions: IBD in children with disease onset before the age of 2 years is frequently unclassifiable into Crohn’s disease and ulcerative colitis, particularly treatment resistant, and can be indistinguishable from monogenic diseases with IBD-like phenotype. PMID:27302973

Rotavirus diarrhea in hospitalized children under 5 years of age in Vientiane, Lao PDR, 2009-2015.

PubMed

SoukAloun, Douangdao; Douangbouphaa, Vannida; Phetsouvanh, Rattanaphone; Sibounheuang, Bountoy; Vongsouvat, Manivanh; Chanmala, Keomany; Vongphachanh, Thonglay; Maniphonh, Soudalinh; Phouangsouvanh, Inhpanh; Fox, Kimberley; Logronio, Josephine; Grabovac, Varja; Heffelfinger, James; Jeong, Hyesook; Kim, Kisang; Nyambat, Batmunkh

2018-05-05

Diarrhea is a leading cause of death in children <5 years worldwide, causing an estimated 215,000 deaths in 2013. This evaluation tracks the epidemiologic patterns and most common rotavirus genotypes among hospitalized children in this age group with acute gastroenteritis in Lao PDR. Children <5 years in a central tertiary hospital in the capital city were prospectively enrolled into the surveillance platform during January 2009-December 2015. We collected information regarding clinical characteristics of enrolled children. Stool samples were obtained within 24 h of hospital admission and tested for rotavirus using rotavirus antigen detection enzyme immunoassay. Samples were sent to the regional reference laboratories in Australia and South Korea for genotyping. Bivariate analyses compared demographic and clinical characteristics between rotavirus positive and negative children using Chi-square statistical testing. Seasonality of rotavirus and annual genotype distribution are also described. We enrolled 1853 children <5 years with acute gastroenteritis during the surveillance period and collected 1772 fecal specimens, 982 (55%) of which tested positive for rotavirus. A higher proportion of rotavirus acute gastroenteritis was observed among children 12-23 months of age as compared to rotavirus negative children in the same age group, 41% vs 36%. Eighty-six percent of rotavirus positive children experienced vomiting, as compared to 65% of rotavirus negative children. Eighty-five percent (n = 830/982) of rotavirus positive specimens occurred during the dry season (January-April). The most common genotypes identified were G1, G2, G3 and P8 and P4. The most prevalent combined genotype differed annually during the surveillance period. Surveillance continues to be important in documenting the burden of rotavirus in children <5 years in Lao PDR as well as providing a baseline for determining the impact of rotavirus vaccine once it is introduced into Lao PDR

BMI at Age 17 Years and Diabetes Mortality in Midlife: A Nationwide Cohort of 2.3 Million Adolescents.

PubMed

Twig, Gilad; Tirosh, Amir; Leiba, Adi; Levine, Hagai; Ben-Ami Shor, Dana; Derazne, Estela; Haklai, Ziona; Goldberger, Nehama; Kasher-Meron, Michal; Yifrach, Dror; Gerstein, Hertzel C; Kark, Jeremy D

2016-11-01

The sequelae of increasing childhood obesity are of major concern. We assessed the association of BMI in late adolescence with diabetes mortality in midlife. The BMI values of 2,294,139 Israeli adolescents (age 17.4 ± 0.3 years), measured between 1967 and 2010, were grouped by U.S. Centers for Disease Control and Prevention age/sex percentiles and by ordinary BMI values. The outcome, obtained by linkage with official national records, was death attributed to diabetes mellitus (DM) as the underlying cause. Cox proportional hazards models were applied. During 42,297,007 person-years of follow-up (median, 18.4 years; range <1-44 years) there were 481 deaths from DM (mean age at death, 50.6 ± 6.6 years). There was a graded increase in DM mortality evident from the 25th to the 49th BMI percentile group onward and from a BMI of 20.0-22.4 kg/m 2 onward. Overweight (85th to 94th percentiles) and obesity (the 95th percentile or higher), compared with the 5th to 24th percentiles, were associated with hazard ratios (HRs) of 8.0 (95% CI 5.7-11.3) and 17.2 (11.9-24.8) for DM mortality, respectively, after adjusting for sex, age, birth year, height, and sociodemographic variables. The HR for the 50th through 74th percentiles was 1.6 (95% CI 1.1-2.3). Findings persisted in a series of sensitivity analyses. The estimated population-attributable fraction for DM mortality, 31.2% (95% CI 26.6-36.1%) for the 1967-1977 prevalence of overweight and obesity at age 17, rose to a projected 52.1% (95% CI 46.4-57.4%) for the 2012-2014 prevalence. Adolescent BMI, including values within the currently accepted "normal" range, strongly predicts DM mortality up to the seventh decade. The increasing prevalence of childhood and adolescent overweight and obesity points to a substantially increased future adult DM burden. © 2016 by the American Diabetes Association.

Association between depression in carers and malnutrition in children aged 6 months to 5 years.

PubMed

Motlhatlhedi, Keneilwe; Setlhare, Vincent; Ganiyu, Adewale; Firth, Jacqueline

2017-01-30

 Childhood malnutrition is an important risk factor for child mortality and underlies close to 50% of child deaths worldwide. Previous studies have found an association between maternal depression and child malnutrition, but it is not known whether this association exists in Botswana. In addition, previous studies excluded non-maternal primary caregivers (PCGs). It is unclear whether the association between primary caregiver depression and child malnutrition remains when non-maternal PCGs are included. The aim of this study was to determine if there is an association between PCG depression and malnutrition in children aged between 6 months and 5 years in Mahalapye, Botswana. The study was conducted in the child welfare clinics of Xhosa and Airstrip clinics, two primary health care facilities in Mahalapye, Botswana. This was a case control study. Cases were malnourished children aged between 6 months and 5 years, and controls were non-malnourished children matched for age and gender. The outcome of interest was depression in the PCGs of the cases and controls, which was assessed using the Patient Health Questionnaire 9 (PHQ 9), a depression screening tool. From a sample of 171 children, 84 of whom were malnourished, we found that the malnourished children were significantly more likely to have depressed PCGs (odds ratio = 4.33; 95% CI: 1.89, 9.89) than non-malnourished children in the 6-month to 5-year age group; the PCGs of malnourished children also had lower educational status. This study found a significant association between PCG depression and child malnutrition.

Incidence and survival of hematological cancers among adults ages ≥75 years.

PubMed

Krok-Schoen, Jessica L; Fisher, James L; Stephens, Julie A; Mims, Alice; Ayyappan, Sabarish; Woyach, Jennifer A; Rosko, Ashley E

2018-04-13

Evaluating population-based data of hematologic malignancies (HMs) in older adults provides prognostic information for this growing demographic. Incidence rates and one- and five-year relative survival rates were examined for specific HMs among adults ages ≥75 years using data from the Surveillance, Epidemiology and End Results (SEER) Program. Hematologic malignancy cases (Hodgkin lymphoma (HL), non-Hodgkin lymphoma (NHL), multiple myeloma (MM), acute lymphocytic leukemia (ALL), chronic lymphocytic leukemia (CLL), acute myeloid leukemia (AML), and chronic myeloid leukemia (CML)) were reported to one of 18 SEER registries. Recent average annual (2010-2014) incidence rates and incidence trends from 1973 to 2014 were examined for cases ages ≥75 years. One- and five-year relative cancer survival rates were examined for adults ages ≥75 years diagnosed 2007-2013, with follow-up into 2014. From 1973 to 2014, incidence rates increased for NHL, MM, and AML, decreased for HL, and remained relatively stable for ALL, CLL, and CML among adults ages ≥75 years. The highest one- and five-year relative survival rates were observed among adults with CLL ages 75-84 years (1 year: 91.8% (95% CI = 91.8-90.8)) and 5 years: 76.5% (95% CI = 74.2-78.6)). The lowest one- and five-year survival rates were observed among adults with AML ages 75-84 (1 year: 18.2% (95% CI = 74.2-78.6) and 5 years: 2.7% (95% CI = 2.0-3.6)). Survival for older adults ages ≥75 years with HMs is poor, particularly for acute leukemia. Understanding the heterogeneity in HM outcomes among older patients may help clinicians better address the hematological cancer burden and mortality in the aging population. © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Long-term safety and tolerability of saxagliptin add-on therapy in older patients (aged ≥65 years) with type 2 diabetes

PubMed Central

Iqbal, Nayyar; Allen, Elsie; Öhman, Peter

2014-01-01

Background Treatment decisions for older patients with type 2 diabetes mellitus must balance glycemic control and adverse event risk. The objective of this study was to evaluate the long-term safety and tolerability of saxagliptin 5 mg as add-on therapy to common antihyperglycemic drugs in patients aged ≥65 years and <65 years. Methods Pooled adverse event data from three placebo-controlled trials of 76–206 weeks’ duration in older (≥65 years) and younger (<65 years) patients receiving saxagliptin 5 mg or matching placebo added to metformin, glyburide, or a thiazolidinedione were analyzed. Measurements were calculated from day of first dose to specified event or last dose and included time at risk for adverse events, treatment-related adverse events, serious adverse events, adverse events leading to discontinuation, and events of special interest. Weighted incidence rates (number of events/total time) and incidence rate ratios (saxagliptin/placebo) with 95% confidence intervals were calculated (Mantel-Haenszel test). Results A total of 205 older (mean age 69 years; saxagliptin, n=99; placebo, n=106) and 1,055 younger (mean age 52 years; saxagliptin, n=531; placebo, n=524) patients were assessed. Regardless of age category, the adverse event incidence rates were generally similar between treatments, with confidence intervals for incidence rate ratios bridging 1. Treatment-related adverse events occurred in 36 older patients receiving saxagliptin versus 32 receiving placebo (incidence rate 34.1 versus 27.1 per 100 person-years) and in 150 younger patients in both treatment groups (incidence rate 24.0 versus 27.8 per 100 person-years). With saxagliptin versus placebo, serious adverse events occurred in eight versus 14 older (incidence rate 5.7 versus 9.9 per 100 person-years) and 49 versus 44 younger patients (incidence rate 6.5 versus 6.6 per 100 person-years). There were two deaths (one patient ≥65 years) with saxagliptin and six (none aged ≥65 years

Long-term safety and tolerability of saxagliptin add-on therapy in older patients (aged ≥ 65 years) with type 2 diabetes.

PubMed

Iqbal, Nayyar; Allen, Elsie; Öhman, Peter

2014-01-01

Treatment decisions for older patients with type 2 diabetes mellitus must balance glycemic control and adverse event risk. The objective of this study was to evaluate the long-term safety and tolerability of saxagliptin 5 mg as add-on therapy to common antihyperglycemic drugs in patients aged ≥ 65 years and <65 years. Pooled adverse event data from three placebo-controlled trials of 76-206 weeks' duration in older (≥ 65 years) and younger (<65 years) patients receiving saxagliptin 5 mg or matching placebo added to metformin, glyburide, or a thiazolidinedione were analyzed. Measurements were calculated from day of first dose to specified event or last dose and included time at risk for adverse events, treatment-related adverse events, serious adverse events, adverse events leading to discontinuation, and events of special interest. Weighted incidence rates (number of events/total time) and incidence rate ratios (saxagliptin/placebo) with 95% confidence intervals were calculated (Mantel-Haenszel test). A total of 205 older (mean age 69 years; saxagliptin, n=99; placebo, n=106) and 1,055 younger (mean age 52 years; saxagliptin, n=531; placebo, n=524) patients were assessed. Regardless of age category, the adverse event incidence rates were generally similar between treatments, with confidence intervals for incidence rate ratios bridging 1. Treatment-related adverse events occurred in 36 older patients receiving saxagliptin versus 32 receiving placebo (incidence rate 34.1 versus 27.1 per 100 person-years) and in 150 younger patients in both treatment groups (incidence rate 24.0 versus 27.8 per 100 person-years). With saxagliptin versus placebo, serious adverse events occurred in eight versus 14 older (incidence rate 5.7 versus 9.9 per 100 person-years) and 49 versus 44 younger patients (incidence rate 6.5 versus 6.6 per 100 person-years). There were two deaths (one patient ≥ 65 years) with saxagliptin and six (none aged ≥ 65 years) with placebo. Older patients

Vision screening in children: Is 7-9 years of age a threshold for visual impairment?

PubMed

Ertekin, Yusuf Haydar; Tekin, Murat; Uludag, Aysegul; Arikan, Sedat; Sahin, Erkan Melih

2016-01-01

The present study aimed to assess the prevalence of decreased visual acuity, strabismus, and spectacle wear in children aged 5 to 13 years. A cross-sectional study was performed in primary education schools. A total of 1938 participants, including 940 females (48.5%) and 998 males (51.5%) with a mean age 8.96 ± 2.31 (5-13 years old), were screened. The comparisons were performed with gender, age, and age groups. The children attended to vision screening were assigned to three age groups as 5-6 years, 7-9 years, and 10-13 years. The prevalence of the parameters was detected as decreased visual acuity 12.4%, strabismus 2.2%, and spectacle wear 6.9%. The prevalence of decreased visual acuity was significantly higher in girls and in children aged 7-9 years old (p = 0.013, p < 0.001). The prevalence of spectacle wear was significantly higher in girls and in children aged 7-9 years old (p = 0.019, p < 0.001). There was a visual acuity decrease in 33 of 106 (31.1%) children despite wearing own spectacle. There was no significant difference among three age groups for strabismus. Increased prevalence of decreased visual acuity, as well as the higher frequency of spectacle wear in children at ages of 7-9 years old may point out a threshold for visual impairment.

Obstacles to preventing obesity in children aged 2 to 5 years: Latino mothers' and fathers' experiences and perceptions of their urban environments.

PubMed

Penilla, Carlos; Tschann, Jeanne M; Sanchez-Vaznaugh, Emma V; Flores, Elena; Ozer, Emily J

2017-11-02

The prevalence of obesity among Latino children is alarmingly high, when compared to non-Latino White children. Low-income Latino parents living in urban areas, even if they are well-educated, face obstacles that shape familial health behaviors. This study used qualitative methods to explore parents' experiences in providing meals and opportunities to play to their children aged 2 to 5 years. In contrast to most prior studies, this study examined perceptions of familial behaviors among both mothers and fathers. An ecological framework for exploring the associations of parental feeding behaviors and children's weight informed this study. An interview guide was developed to explore parents' experiences and perceptions about children's eating and physical activity and administered to six focus groups in a community-based organization in the Mission District of San Francisco. Transcripts were coded and analyzed. Twenty seven mothers and 22 fathers of Latino children ages 2 to 5 participated. Mothers, fathers, and couples reported that employment, day care, neighborhood environments and community relationships were experienced, and perceived as obstacles to promoting health behavior among their children, including drinking water instead of soda and participating in organized playtime with other preschool-age children. Results from this study suggest that the parents' demographic, social and community characteristics influence what and how they feed their children, as well as how often and the types of opportunities they provide for physical activity, providing further evidence that an ecological framework is useful for guiding research with both mothers and fathers. Mothers and fathers identified numerous community and society-level constraints in their urban environments. The results point to the importance of standardized work hours, resources for day care providers, clean and safe streets and parks, strong community relationships, and reduced access to sugar

Influenza-related healthcare visits, hospital admissions, and direct medical costs for all children aged 2 to 17 years in a defined Swedish region, monitored for 7 years.

PubMed

Rahmqvist, Mikael; Gjessing, Kristian; Faresjö, Tomas

2016-08-01

The seasonal variation of influenza and influenza-like illness (ILI) is well known. However, studies assessing the factual direct costs of ILI for an entire population are rare. In this register study, we analyzed the seasonal variation of ILI-related healthcare visits and hospital admissions for children aged 2 to 17 years, and the resultant parental absence from work, for the period 2005 to 2012. The study population comprised an open cohort of about 78,000 children per year from a defined region. ILI was defined as ICD-10 codes: J00-J06; J09-J15, J20; H65-H67. Overall, the odds of visiting a primary care center for an ILI was 1.64-times higher during the peak influenza season, compared to the preinfluenza season. The corresponding OR among children aged 2 to 4 years was 1.96. On average, an estimated 20% of all healthcare visits for children aged 2 to 17 years, and 10% of the total healthcare costs, were attributable to seasonal ILI. In primary care, the costs per week and 10,000 person years for ILI varied - by season - from &OV0556;3500 to &OV0556;7400. The total ILI cost per year, including all physical healthcare forms, was &OV0556;400,400 per 10,000 children aged 2 to 17 years. The costs for prescribed and purchased drugs related to ILI symptoms constituted 52% of all medicine costs, and added 5.8% to the direct healthcare costs.The use of temporary parental employment benefits for caring of ill child followed the seasonal pattern of ILI (r = 0.91, P < 0.001). Parental absence from work was estimated to generate indirect costs, through loss of productivity of 5.2 to 6.2 times the direct costs. Direct healthcare costs increased significantly during the influenza season for children aged 2 to 17 years, both in primary and hospital outpatient care, but not in hospital inpatient care. Primary care manages the majority of visits for influenza and ILI. Children 2 to 4 years have a larger portion of their total healthcare encounters related to ILI compared

Age-Specific Prevalence of Visual Impairment and Refractive Error in Children Aged 3-10 Years in Shanghai, China.

PubMed

Ma, Yingyan; Qu, Xiaomei; Zhu, Xiaofeng; Xu, Xun; Zhu, Jianfeng; Sankaridurg, Padmaja; Lin, Senlin; Lu, Lina; Zhao, Rong; Wang, Ling; Shi, Huijing; Tan, Hui; You, Xiaofang; Yuan, Hong; Sun, Sifei; Wang, Mingjin; He, Xiangui; Zou, Haidong; Congdon, Nathan

2016-11-01

We assessed changes in age-specific prevalence of refractive error at the time of starting school, by comparing preschool and school age cohorts in Shanghai, China. A cross-sectional study was done in Jiading District, Shanghai during November and December 2013. We randomly selected 7 kindergartens and 7 primary schools, with probability proportionate to size. Chinese children (n = 8398) aged 3 to 10 years were enumerated, and 8267 (98.4%) were included. Children underwent distance visual acuity assessment and refraction measurement by cycloplegic autorefraction and subjective refraction. The prevalence of uncorrected visual acuity (UCVA), presenting visual acuity, and best-corrected visual acuity in the better eye of ≤20/40 was 19.8%, 15.5%, and 1.7%, respectively. Among those with UCVA ≤ 20/40, 93.2% could achieve visual acuity of ≥20/32 with refraction. Only 28.7% (n = 465) of children with UCVA in the better eye of ≤20/40 wore glasses. Prevalence of myopia (spherical equivalent ≤-0.5 diopters [D] in at least one eye) increased from 1.78% in 3-year-olds to 52.2% in 10-year-olds, while prevalence of hyperopia (spherical equivalent ≥+2.0 D) decreased from 17.8% among 3-year-olds to 2.6% by 10 years of age. After adjusting for age, attending elite "high-level" school was statistically associated with greater myopia prevalence. The prevalence of myopia was lower or comparable to that reported in other populations from age 3 to 5 years, but increased dramatically after 6 years, consistent with a strong environmental role of schooling on myopia development.

Phenotypic and Genotypic Characterisation of Inflammatory Bowel Disease Presenting Before the Age of 2 years.

PubMed

Kammermeier, Jochen; Dziubak, Robert; Pescarin, Matilde; Drury, Suzanne; Godwin, Heather; Reeve, Kate; Chadokufa, Sibongile; Huggett, Bonita; Sider, Sara; James, Chela; Acton, Nikki; Cernat, Elena; Gasparetto, Marco; Noble-Jamieson, Gabi; Kiparissi, Fevronia; Elawad, Mamoun; Beales, Phil L; Sebire, Neil J; Gilmour, Kimberly; Uhlig, Holm H; Bacchelli, Chiara; Shah, Neil

2017-01-01

Inflammatory bowel disease [IBD] presenting in early childhood is extremely rare. More recently, progress has been made to identify children with monogenic forms of IBD predominantly presenting very early in life. In this study, we describe the heterogeneous phenotypes and genotypes of patients with IBD presenting before the age of 2 years and establish phenotypic features associated with underlying monogenicity. Phenotype data of 62 children with disease onset before the age of 2 years presenting over the past 20 years were reviewed. Children without previously established genetic diagnosis were prospectively recruited for next-generation sequencing. In all, 62 patients [55% male] were identified. The median disease onset was 3 months of age (interquartile range [IQR]: 1 to 11). Conventional IBD classification only applied to 15 patients with Crohn's disease [CD]-like [24%] and three with ulcerative colitis [UC]-like [5%] phenotype; 44 patients [71%] were diagnosed with otherwise unclassifiable IBD. Patients frequently required parenteral nutrition [40%], extensive immunosuppression [31%], haematopoietic stem-cell transplantation [29%], and abdominal surgery [19%]. In 31% of patients, underlying monogenic diseases were established [EPCAM, IL10, IL10RA, IL10RB, FOXP3, LRBA, SKIV2L, TTC37, TTC7A]. Phenotypic features significantly more prevalent in monogenic IBD were: consanguinity, disease onset before the 6th month of life, stunting, extensive intestinal disease and histological evidence of epithelial abnormalities. IBD in children with disease onset before the age of 2 years is frequently unclassifiable into Crohn's disease and ulcerative colitis, particularly treatment resistant, and can be indistinguishable from monogenic diseases with IBD-like phenotype. Copyright © 2016 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Prevention of dental caries in children from birth through age 5 years: US Preventive Services Task Force recommendation statement.

PubMed

Moyer, Virginia A

2014-06-01

Update of the 2004 US Preventive Services Task Force (USPSTF) recommendation on prevention of dental caries in preschool-aged children. The USPSTF reviewed the evidence on prevention of dental caries by primary care clinicians in children 5 years and younger, focusing on screening for caries, assessment of risk for future caries, and the effectiveness of various interventions that have possible benefits in preventing caries. This recommendation applies to children age 5 years and younger. The USPSTF recommends that primary care clinicians prescribe oral fluoride supplementation starting at age 6 months for children whose water supply is deficient in fluoride. (B recommendation) The USPSTF recommends that primary care clinicians apply fluoride varnish to the primary teeth of all infants and children starting at the age of primary tooth eruption. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of routine screening examinations for dental caries performed by primary care clinicians in children from birth to age 5 years. (I Statement). Copyright © 2014 by the American Academy of Pediatrics.

Oxygen Saturation in Healthy Children Aged 5 to 16 Years Residing in Huayllay, Peru at 4340 m

PubMed Central

Schult, Sandra

2011-01-01

Abstract Schult, Sandra, and Carlos Canelo-Aybar. Oxygen saturation in healthy chidren aged 5 to 6 years residing in Huayllay, Peru, at 4340 m. High Alt. Med. Biol. 12:89–92, 2011.—Hypoxemia is a major life-threatening complication of childhood pneumonia. The threshold points for hypoxemia vary with altitude. However, few published data describe that normal range of variation. The purpose of this study was to establish reference values of normal mean Sao2 levels and an approximate cutoff point to define hypoxemia for clinical purposes above 4300 meters above sea level (masl). Children aged 5 to 16 yr were examined during primary care visits at the Huayllay Health Center. Huayllay is a rural community located at 4340 m in the province of Pasco in the Peruvian Andes. We collected basic sociodemographic data and evaluated three outcomes: arterial oxygen saturation (Sao2) with a pulse oximeter, heart rate, and respiratory rate. Comparisons of main outcomes among age groups (5–6, 7–8, 9–10, 11–12, 13–14, and 15–16 yr) and sex were performed using linear regression models. The correlation of Sao2 with heart rate and respiration rate was established by Pearson's correlation test. We evaluated 583 children, of whom 386 were included in the study. The average age was 10.3 yr; 55.7% were female. The average Sao2, heart rate, and respiratory rate were 85.7% (95% CI: 85.2–86.2), 80.4/min (95% CI: 79.0–81.9), and 19.9/min (95% CI: 19.6–20.2), respectively. Sao2 increased with age (p < 0.001). No differences by sex were observed. The mean minus two standard deviations of Sao2 (threshold point for hypoxemia) ranged from 73.8% to 81.8% by age group. At 4300 m, the reference values for hypoxemia may be 14.2% lower than at sea level. This difference must be considered when diagnosing hypoxemia or deciding oxygen supplementation at high altitude. Other studies are needed to determine whether this reference value is appropriate for clinical use. PMID

Safety and antibody response, including antibody persistence for 5 years, after primary vaccination or revaccination with pneumococcal polysaccharide vaccine in middle-aged and older adults.

PubMed

Musher, Daniel M; Manof, Susan B; Liss, Charlie; McFetridge, Richard D; Marchese, Rocio D; Bushnell, Bonnie; Alvarez, Frances; Painter, Carla; Blum, Michael D; Silber, Jeffrey L

2010-02-15

This study assessed antibody levels for 5 years after primary vaccination or revaccination with 23-valent pneumococcal polysaccharide vaccine (PN23). Subjects were enrolled into 4 study groups by age (50-64 or > or = 65 years) and prior vaccination status (no prior vaccination or 1 vaccination 3-5 years previously). Blood was obtained on day 0 (before primary vaccination or revaccination), day 30, day 60, and annually during years 2-5. Levels of immunoglobulin G (IgG) to 8 vaccine serotypes were measured by enzyme-linked immunosorbent assay. Of 1008 enrolled subjects, 551 completed year 5. For each serotype and age group, baseline geometric mean concentrations (GMCs) of IgG were higher in revaccination than primary vaccination subjects. Primary vaccination or revaccination with PN23 induced significant increases in levels of antibody to all serotypes tested. Although day 30 and 60 antibody levels tended to be modestly lower after revaccination, study groups had similar GMCs at later time points. For serotypes 4, 6B, 8, 9V, 12F, 14, and 23F, GMCs during years 2-5 after primary vaccination or revaccination remained higher than in vaccine-naive persons. Levels of antibody to serotype 3 returned to baseline by year 2. Both primary vaccination and revaccination with PN23 induce antibody responses that persist during 5 years of observation.

Challenges in the Estimation of the Annual Risk of Mycobacterium tuberculosis Infection in Children Aged Less Than 5 Years.

PubMed

Khan, P Y; Glynn, Judith R; Mzembe, T; Mulawa, D; Chiumya, R; Crampin, Amelia C; Kranzer, Katharina; Fielding, Katherine L

2017-10-15

Accurate estimates of Mycobacterium tuberculosis infection in young children provide a critical indicator of ongoing community transmission of M. tuberculosis. Cross-reactions due to infection with environmental mycobacteria and/or bacille Calmette-Guérin (BCG) vaccination compromise the estimates derived from population-level tuberculin skin-test surveys using traditional cutoff methods. Newer statistical approaches are prone to failure of model convergence, especially in settings where the prevalence of M. tuberculosis infection is low and environmental sensitization is high. We conducted a tuberculin skin-test survey in 5,119 preschool children in the general population and among household contacts of tuberculosis cases in 2012-2014 in a district in northern Malawi where sensitization to environmental mycobacteria is common and almost all children are BCG-vaccinated. We compared different proposed methods of estimating M. tuberculosis prevalence, including a method described by Rust and Thomas more than 40 years ago. With the different methods, estimated prevalence in the general population was 0.7%-11.5% at ages <2 years and 0.8%-3.3% at ages 2-4 years. The Rust and Thomas method was the only method to give a lower estimate in the younger age group (0.7% vs 0.8%), suggesting that it was the only method that adjusted appropriately for the marked effect of BCG-attributable induration in the very young. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

Back pain in children surveyed with weekly text messages - a 2.5 year prospective school cohort study.

PubMed

Franz, Claudia; Wedderkopp, Niels; Jespersen, Eva; Rexen, Christina T; Leboeuf-Yde, Charlotte

2014-01-01

Back pain is reported to occur already in childhood, but its development at that age is not well understood. The aims of this study were to describe BP in children aged 6-12 years, and to investigate any sex and age differences. Data on back pain (defined as pain in the neck, mid back and/or lower back) were collected once a week from parents replying to automated text-messages over 2.5 school years from 2008 till 2011. The prevalence estimates were presented as percentages and 95% confidence intervals. Differences between estimates were considered significant if confidence intervals did not overlap. A test for trend, using a multi-level mixed-effects logistic regression extended to the longitudinal and multilevel setting, was performed to see whether back pain reporting increased with age. Depending on the age group, 13-38% children reported back pain at least once per survey year, and 5-23% at least twice per survey year. The average weekly prevalence estimate ranged between 1% and 5%. In the final survey year more girls than boys reported back pain at least twice. The prevalence estimates did not increase monotonically with age but showed a greater increase in children younger than 9/10, after which they remained relatively stable up to the age of 12 years. We found that back pain was not a common problem in this age group and recommend health professionals be vigilant if a child presents with constant or recurring back pain. Our results need to be supplemented by a better understanding of the severity and consequences of back pain in childhood. It would be productive to study the circumstances surrounding the appearance of back pain in childhood, as well as, how various bio-psycho-social factors affect its onset and later recurrence. Knowledge about the causes of back pain in childhood might allow early prevention.

Vitamin D intake during the first 4 years and onset of asthma by age 5: A nested case-control study.

PubMed

Nwaru, Bright I; Hadkhale, Kishor; Hämäläinen, Niina; Takkinen, Hanna-Mari; Ahonen, Suvi; Ilonen, Jorma; Toppari, Jorma; Niemelä, Onni; Haapala, Anna-Maija; Veijola, Riitta; Knip, Mikael; Virtanen, Suvi M

2017-11-01

Early-life vitamin D intake has been linked to asthma risk in childhood, but the role of longitudinal vitamin D exposure has not been previously evaluated. We investigated the association between vitamin D intake during the first 4 years of life and asthma risk by age 5. Within a Finnish population-based birth cohort, 182 incident asthma cases were matched to 728 controls on sex, genetic risk for type 1 diabetes, delivery hospital, and time of birth. Vitamin D intake was assessed by age-specific 3 day food records. Parents completed a validated version of the International Study of Asthma and Allergies in Childhood questionnaire at 5 years. At 3 months, supplements were the main source of vitamin D intake; intake from foods increased from 3 months on, mainly from fortified milk products. Vitamin D intake at each specific age was associated with an increased risk of any asthma, atopic, and non-atopic asthma, but only intake at 1 and 2 years was statistically significantly associated with asthma. Longitudinal vitamin D intake was associated with an increased risk of asthma (OR 1.24; 95%CI 1.00-1.53). Increased vitamin D intake in childhood, particularly intake at 1 and 2 years of age, may increase risk of childhood asthma. This might reflect a true effect or residual confounding by lifestyle or environmental factors. Repeated assessment of vitamin D intake allowed evaluation of the longitudinal and age-dependent impact of vitamin D on the risk of asthma. Further longitudinal studies are required to confirm or question these findings. © 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

Problems of Children of School Age (5-9 Years): Report on a Working Group.

ERIC Educational Resources Information Center

World Health Organization, Copenhagen (Denmark). Regional Office for Europe.

This report presents the proceedings of a working group convened in Copenhagen in November 1975 by the World Health Organization to discuss the problems of children 5 to 9 years. The report focuses on a survey of the general problems of European children of this particular age, individual risk factors, and individual groups at risk, and suggests…

Effect of a Binocular iPad Game vs Part-time Patching in Children Aged 5 to 12 Years With Amblyopia: A Randomized Clinical Trial.

PubMed

Holmes, Jonathan M; Manh, Vivian M; Lazar, Elizabeth L; Beck, Roy W; Birch, Eileen E; Kraker, Raymond T; Crouch, Eric R; Erzurum, S Ayse; Khuddus, Nausheen; Summers, Allison I; Wallace, David K

2016-12-01

A binocular approach to treating anisometropic and strabismic amblyopia has recently been advocated. Initial studies have yielded promising results, suggesting that a larger randomized clinical trial is warranted. To compare visual acuity (VA) improvement in children with amblyopia treated with a binocular iPad game vs part-time patching. A multicenter, noninferiority randomized clinical trial was conducted in community and institutional practices from September 16, 2014, to August 28, 2015. Participants included 385 children aged 5 years to younger than 13 years with amblyopia (20/40 to 20/200, mean 20/63) resulting from strabismus, anisometropia, or both. Participants were randomly assigned to either 16 weeks of a binocular iPad game prescribed for 1 hour a day (190 participants; binocular group) or patching of the fellow eye prescribed for 2 hours a day (195 participants; patching group). Study follow-up visits were scheduled at 4, 8, 12, and 16 weeks. A modified intent-to-treat analysis was performed on participants who completed the 16-week trial. Binocular iPad game or patching of the fellow eye. Change in amblyopic-eye VA from baseline to 16 weeks. Of the 385 participants, 187 were female (48.6%); mean (SD) age was 8.5 (1.9) years. At 16 weeks, mean amblyopic-eye VA improved 1.05 lines (2-sided 95% CI, 0.85-1.24 lines) in the binocular group and 1.35 lines (2-sided 95% CI, 1.17-1.54 lines) in the patching group, with an adjusted treatment group difference of 0.31 lines favoring patching (upper limit of the 1-sided 95% CI, 0.53 lines). This upper limit exceeded the prespecified noninferiority limit of 0.5 lines. Only 39 of the 176 participants (22.2%) randomized to the binocular game and with log file data available performed more than 75% of the prescribed treatment (median, 46%; interquartile range, 20%-72%). In younger participants (aged 5 to <7 years) without prior amblyopia treatment, amblyopic-eye VA improved by a mean (SD) of 2.5 (1.5) lines in the

Changes in sleep duration in Spanish children aged 2-14 years from 1987 to 2011.

PubMed

de Ruiter, Ingrid; Olmedo-Requena, Rocío; Sánchez-Cruz, José-Juan; Jiménez-Moleón, José-Juan

2016-05-01

Historical decreases in sleep duration in children have been documented worldwide; however, there is sparse information on sleep duration in differing cultural regions. We assess sleep duration and its trends for children in Spain from 1987 to 2011 and associated sociodemographic characteristics. Data from eight Spanish National Health Surveys, from 1987 to 2011, were collected on parent-reported sleep duration and associated socio-demographic characteristics including age, sex, parental level of education, child body mass index (BMI), and physical activity. A total of 24,867 children aged 2-14 years were included in the final sample. Overall, short sleep duration increased to 44.7% from 29.8% in 1987. Decreasing sleep duration trends were found in all demographic groups, decreasing by around 20 minutes in 24 hours from 1987 to 2011; decreasing to 10 hours 16 minutes in 2- to 5-year olds, 9 hours 31 minutes in 6- to 9-year-olds, and 8 hours 52 minutes in 10- to 14-year-olds. No difference in sleep duration was found between girls and boys. Sleep duration was associated with year of survey, age, level of parental education, obesity, and exercise. Almost 45% of children in Spain are not sleeping the recommended amount. Regional differences in sleep attitudes and duration alongside a lack of consistency in cut-offs for age-appropriate ideal sleep in literature is a barrier for international comparison and highlights the need for research in physiological sleep requirements. With the association of short sleep duration with many different health outcomes, sleep should be considered as a modifiable lifestyle factor and a public health issue. Copyright © 2016 Elsevier B.V. All rights reserved.

Central nervous system medications and falls risk in men aged 60-75 years: the Study on Male Osteoporosis and Aging (SOMA).

PubMed

Masud, Tahir; Frost, Morten; Ryg, Jesper; Matzen, Lars; Ibsen, Marlene; Abrahamsen, Bo; Brixen, Kim

2013-01-01

drugs acting on the central nervous system (CNS) increase falls risk. Most data on CNS drugs and falls are in women/mixed-sex populations. This study assessed the relationship between CNS drugs and falls in men aged 60-75 years. a questionnaire was sent to randomly selected Danish men aged 60-75 years. Cross-sectional data on CNS drugs and falls in the previous year were available for 4,696 men. Logistic regression investigated the relationship between falls and CNS drugs. the median age was 66.3 (IQR = 63.1-70.0) years; 21.7% were fallers. The following were associated with fallers (OR; 95% CI): opiates (2.4; 1.5-3.7), other analgesics (1.7; 1.4-2.1), antiepileptics (2.8; 1.5-5.1), antidepressants (2.8; 1.9-4.1) and anxiolytics/hypnotics (1.5; 0.9-2.6). Effects of opiates interacted strongly and significantly with age, with a marked association with falls in the older half of the subjects only. No significant associations were found between antipsychotics and fallers. Selective serotonin reuptake inhibitors and tricyclics were significantly associated with fallers (3.1; 2.0-5.0 and 2.2; 1.0-4.7, respectively). several CNS drug classes are associated with an approximately 2-3-fold increase risk of falls in men aged 60-75 years randomly selected from the population. Further longitudinal data are now required to confirm and further investigate the role of CNS drugs in falls causation in men.

Dietary salt intake assessed by 24 h urinary sodium excretion in Australian schoolchildren aged 5-13 years.

PubMed

Grimes, Carley A; Riddell, Lynn J; Campbell, Karen J; Nowson, Caryl A

2013-10-01

To measure total daily salt intake using 24 h urinary Na excretion within a sample of Victorian schoolchildren aged 5-13 years and to assess discretionary salt use habits of children and parents. Cross-sectional study. Completed within a convenience sample of independent primary schools (n 9) located in Victoria, Australia. Two hundred and sixty children completed a 24 h urine collection over a school (34%) or non-school day (66%). Samples deemed incomplete (n 18), an over-collection (n 1) or that were incorrectly processed at the laboratory (n 3) were excluded. The sample comprised 120 boys and 118 girls with a mean age of 9.8 (SD 1.7) years. The average 24 h urinary Na excretion (n 238) was 103 (SD 43) mmol/24 h (salt equivalent 6.0 (SD 2.5) g/d). Daily Na excretion did not differ by sex; boys 105 (SD 46) mmol/24 h (salt equivalent 6.1 (SD 2.7) g/d) and girls 100 (SD 41) mmol/24 h (salt equivalent 5.9 (SD 2.4) g/d; P=0.38). Sixty-nine per cent of children (n 164) exceeded the recommended daily Upper Limit for Na. Reported discretionary salt use was common: two-thirds of parents reported adding salt during cooking and almost half of children reported adding salt at the table. The majority of children had salt intakes exceeding the recommended daily Upper Limit. Strategies to lower salt intake in children are urgently required, and should include product reformulation of lower-sodium food products combined with interventions targeting discretionary salt use within the home.

Vision screening in children: Is 7-9 years of age a threshold for visual impairment?

PubMed Central

Ertekin, Yusuf Haydar; Tekin, Murat; Uludag, Aysegul; Arikan, Sedat; Sahin, Erkan Melih

2016-01-01

Objective: The present study aimed to assess the prevalence of decreased visual acuity, strabismus, and spectacle wear in children aged 5 to 13 years. Methods: A cross-sectional study was performed in primary education schools. A total of 1938 participants, including 940 females (48.5%) and 998 males (51.5%) with a mean age 8.96 ± 2.31 (5-13 years old), were screened. The comparisons were performed with gender, age, and age groups. The children attended to vision screening were assigned to three age groups as 5-6 years, 7-9 years, and 10-13 years. Results: The prevalence of the parameters was detected as decreased visual acuity 12.4%, strabismus 2.2%, and spectacle wear 6.9%. The prevalence of decreased visual acuity was significantly higher in girls and in children aged 7-9 years old (p = 0.013, p < 0.001). The prevalence of spectacle wear was significantly higher in girls and in children aged 7-9 years old (p = 0.019, p < 0.001). There was a visual acuity decrease in 33 of 106 (31.1%) children despite wearing own spectacle. There was no significant difference among three age groups for strabismus. Conclusion: Increased prevalence of decreased visual acuity, as well as the higher frequency of spectacle wear in children at ages of 7-9 years old may point out a threshold for visual impairment. PMID:27882020

Pediatric data for dual X-ray absorptiometric measures of normal lumbar bone mineral density in children under 5 years of age using the lunar prodigy densitometer.

PubMed

Manousaki, D; Rauch, F; Chabot, G; Dubois, J; Fiscaletti, M; Alos, N

2016-09-07

Knowledge of physiological variations of bone mineral density (BMD) in newborns and infants is necessary to evaluate pathological changes associated with fractures. Limited reference data for children under 5 years old are available. This study provides normative data of lumbar BMD for the Lunar Prodigy in young children under 5 years old. We assessed cross-sectionally 155 healthy children (77 boys, 80% Caucasian), ranging in age from newborn to the age of 5 years. Lumbar bone mineral content (BMC) and areal BMD were measured by dual-energy X-ray absorptiometry using a Lunar Prodigy absorptiometer. Volumetric BMD was calculated using the Kroeger and Carter methods. BMC and areal BMD increased from birth to 5 years (p<0.001). Volumetric BMD did not change with age. BMD and BMC correlated with age, weight and height (R(2)≥0.85 for all), with a maximum gain between the ages of 1 and 4 years, which did not follow the same pattern as height velocity. We did not find significant sex difference for any of the three measured parameters. This study provides normative data for lumbar spine densitometry of infants and young children using the Lunar Prodigy DXA system.

Objectively Measured Physical Activity Predicts Hip and Spine Bone Mineral Content in Children and Adolescents Ages 5–15 Years: Iowa Bone Development Study

PubMed Central

Janz, Kathleen F.; Letuchy, Elena M.; Francis, Shelby L.; Metcalf, Kristen M.; Burns, Trudy L.; Levy, Steven M.

2014-01-01

This study examined the association between physical activity (PA) and bone mineral content (BMC; gram) from middle childhood to middle adolescence and compared the impact of vigorous-intensity PA (VPA) over moderate- to vigorous-intensity PA (MVPA). Participants from the Iowa bone development study were examined at ages 5, 8, 11, 13, and 15 years (n = 369, 449, 452, 410, and 307, respectively). MVPA and VPA (minutes per day) were measured using ActiGraph accelerometers. Anthropometry was used to measure body size and somatic maturity. Spine BMC and hip BMC were measured via dual-energy x-ray absorptiometry. Sex-specific multi-level linear models were fit for spine BMC and hip BMC, adjusted for weight (kilogram), height (centimeter), linear age (year), non-linear age (year2), and maturity (pre peak height velocity vs. at/post peak height velocity). The interaction effects of PA × maturity and PA × age were tested. We also examined differences in spine BMC and hip BMC between the least (10th percentile) and most (90th percentile) active participants at each examination period. Results indicated that PA added to prediction of BMC throughout the 10-year follow-up, except MVPA, did not predict spine BMC in females. Maturity and age neither modify the PA effect for males nor females. At age 5, the males at the 90th percentile for VPA had 8.5% more hip BMC than males in the 10th percentile for VPA. At age 15, this difference was 2.0%. Females at age 5 in the 90th percentile for VPA had 6.1% more hip BMC than those in the 10th percentile for VPA. The age 15 difference was 1.8%. VPA was associated with BMC at weight-bearing skeletal sites from childhood to adolescence, and the effect was not modified by maturity or age. Our findings indicate the importance of early and sustained interventions that focus on VPA. Approaches focused on MVPA may be inadequate for optimal bone health, particularly for females. PMID:25076937

Agreement between children aged 5-6 years and their mothers in rating child oral health-related quality of life.

PubMed

Abanto, Jenny; Tsakos, Georgios; Paiva, Saul Martins; Raggio, Daniela Prócida; Celiberti, Paula; Bönecker, Marcelo

2014-09-01

Studies have assessed parent-child agreement on ratings of school-aged children's OHRQoL. There are, however, no studies on children younger than 7 years of age. The aim was to assess the agreement between children aged 5-6 years and their mothers regarding child's oral health-related quality of life (OHRQoL). In this cross-sectional study, a total of 298 mother-child pairs (MCP), seeking the pediatric dental screening at the Dental School, University of São Paulo, completed the Brazilian version of the Scale of Oral Health Outcomes for 5-year-old children (SOHO-5), validated for children aged 5-6 years in Brazil. Agreement between total and items' scores was assessed using comparison and correlation analyses, by comparing the mean directional differences and by computing the intraclass correlation coefficient (ICC) values, respectively. The mean directional difference in the total scores was 0.13 (CI 95% -0.076; 0.338) and therefore not significant for MCP. The mean absolute difference for MCP was 1.26, representing 11% of the maximum possible score. The ICC for total score was 0.84 (CI 95% 0.798; 0.867) for MCP. Mothers do rate their young children's OHRQoL similarly to children's self-reports. When assessing OHRQoL of children aged 5-6 years, mothers may be reliable proxies for their young children. © 2013 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Surgical outcomes of the endoscopic transsphenoidal route to pituitary tumours in paediatric patients >10 years of age: 5 years of experience at a single institute

PubMed Central

Zhan, Rucai; Xu, Guangming; Wiebe, Timothy M; Li, Xingang

2015-01-01

Objective To evaluate the safety and effectiveness of the endoscopic endonasal transsphenoidal approach (EETA) for the management of pituitary adenomas in paediatric patients >10 years of age. Methods A retrospective chart review was performed to identify 56 paediatric patients between 10 and 18 years of age who underwent an endonasal endoscopic transsphenoidal approach for the resection of a pituitary adenoma during the last 5 years. The age, sex, symptoms, tumour size, extent of tumour resection, clinical outcome and surgical complications of patients were reviewed. Results Total resection was achieved in 49 (87.5%) cases, subtotal resection was achieved in 7 (12.5%) cases and no patient had a partial or insufficient resection. Of the 35 patients who experienced preoperative deterioration of vision, 33 (94.2%) achieved visual remission with rates of 34.2% and 60% for normalisation and improvement, respectively. Endocrinological normalisation was achieved in 13 (31.7%) of 41 patients who had preoperative hyperhormonal levels; hormone levels decreased in 25 (61.0%) patients, and 3 (7.3%) patients had no change in hormone level. Two (3.5%) patients incurred postoperative cerebrospinal fluid leakage, which was resolved after lumbar drainage. Four (7.1%) patients developed hypopituitarism, which required hormone therapy. Post-surgery, five (8.9%) patients incurred transient diabetes insipidus (DI), of which one (1.7%) patient developed persistent DI and was administered Minirin. Meningitis occurred in one (1.7%) patient who was cured by the administration of a third-generation antibiotic. There were no cases of intracranial haematoma, reoperation or death. Conclusions EETA allows neurosurgeons to safely and effectively remove paediatric pituitary adenomas with low morbidity and mortality. PMID:26006173

Outcomes of hip arthroscopy in patients aged 50 years or older compared with a matched-pair control of patients aged 30 years or younger.

PubMed

Domb, Benjamin G; Linder, Dror; Finley, Zachary; Botser, Itamar B; Chen, Austin; Williamson, Joseph; Gupta, Asheesh

2015-02-01

Age has been suggested as a negative prognostic factor for hip arthroscopy. The purpose of this study was to compare patient characteristics and outcomes after hip arthroscopy in patients aged 50 years or older with a matched control group of patients aged 30 years or younger at a minimum postoperative follow-up of 2 years. Between September 2008 and March 2010, data were prospectively collected on all patients aged 50 years or older undergoing primary hip arthroscopy. Fifty-two patients met our inclusion and matching criteria, of whom all 52 (100%) were available for follow-up at a minimum of 2 years. This cohort was compared with a matched-pair control group of patients aged 30 years or younger who underwent similar procedures. The mean age of the study group was 54.8 years (range, 50 to 69 years), and that of the control group was 20.3 years (range, 13 to 30 years). The groups were matched at a 1:1 ratio, including 18 male patients (34.6%) and 34 female patients (65.4%) in each group, with a mean follow-up period of 32 months (range, 24 to 54 months). In the younger control group, the score improvement from preoperatively to 2 years' follow-up was 62.9 to 84.2 for the modified Harris Hip Score, 60.5 to 84.2 for the Non-Arthritic Hip Score, 63.1 to 86.5 for the Hip Outcome Score-Activities of Daily Living, and 42.2 to 72.7 for the Hip Outcome Score-Sport-Specific Subscale. In the older study group, the score improvement from preoperatively to 2 years' follow-up was 61.2 to 82.2 for the modified Harris Hip Score, 59.9 to 80.4 for the Non-Arthritic Hip Score, 63.9 to 83 for the Hip Outcome Score-Activities of Daily Living, and 41.2 to 64.6 for the Hip Outcome Score-Sport-Specific Subscale. All improvements in both groups were statistically significant at the 2-year postoperative follow-up (P < .001). There was no significant difference for all patient-reported outcome (PRO) scores at final follow-up between both groups. When we compared the change in PRO scores (�

Validation of Accelerometer Cut-Points in Children With Cerebral Palsy Aged 4 to 5 Years.

PubMed

Keawutan, Piyapa; Bell, Kristie L; Oftedal, Stina; Davies, Peter S W; Boyd, Roslyn N

2016-01-01

To derive and validate triaxial accelerometer cut-points in children with cerebral palsy (CP) and compare these with previously established cut-points in children with typical development. Eighty-four children with CP aged 4 to 5 years wore the ActiGraph during a play-based gross motor function measure assessment that was video-taped for direct observation. Receiver operating characteristic and Bland-Altman plots were used for analyses. The ActiGraph had good classification accuracy in Gross Motor Function Classification System (GMFCS) levels III and V and fair classification accuracy in GMFCS levels I, II, and IV. These results support the use of the previously established cut-points for sedentary time of 820 counts per minute in children with CP aged 4 to 5 years across all functional abilities. The cut-point provides an objective measure of sedentary and active time in children with CP. The cut-point is applicable to group data but not for individual children.

Safety of quadrivalent live attenuated influenza vaccine in subjects aged 2-49years.

PubMed

Baxter, Roger; Eaton, Abigail; Hansen, John; Aukes, Laurie; Caspard, Herve; Ambrose, Christopher S

2017-03-01

Quadrivalent live attenuated influenza vaccine (Q/LAIV) was licensed in 2012 and replaced trivalent live attenuated influenza vaccine in the United States during the 2013-2014 influenza season. This study assessed the safety of Q/LAIV in children and adults aged 2-49years. This was a prospective observational cohort study using data collected from Kaiser Permanente Northern California. Post-vaccination events of interest were any hospitalization, hospitalization for lower respiratory tract infection, and the following medically attended events: hypersensitivity, seizures/convulsions, lower respiratory tract infection, wheezing, Guillain-Barré syndrome, Bell's palsy, encephalitis, neuritis, vasculitis, and narcolepsy/cataplexy. The rates of these events during the risk interval post-vaccination were compared with rates observed during reference periods later in the follow-up (within-cohort analysis) and with rates observed in frequency-matched unvaccinated controls and inactivated influenza vaccine (IIV) recipients. A total of 62,040 eligible Q/LAIV recipients were identified during the 2013-2014 influenza season. Within-cohort comparisons of all Q/LAIV recipients as well as comparisons between Q/LAIV recipients and unvaccinated controls or IIV recipients did not show any significantly higher risk of hospitalizations or medically attended events following administration of Q/LAIV. Additional analyses by setting (clinic visits, emergency department visits, and hospital admissions) and age group (2-4, 5-8, 9-17, and 18-49years) also did not reveal clinically consistent findings that suggested any increased risk after administration of Q/LAIV. In this large population study of individuals aged 2-49years, no safety signals associated with the administration of Q/LAIV were observed. A much larger study population would be needed to confidently reject any association between Q/LAIV and very rare events, specifically those with an incidence of <1 event/10,000 person-years

Predictors of outcome at 2 years of age after early intrauterine growth restriction.

PubMed

Torrance, H L; Bloemen, M C T; Mulder, E J H; Nikkels, P G J; Derks, J B; de Vries, L S; Visser, G H A

2010-08-01

To examine the relative importance of antenatal and perinatal variables on short- and long-term outcome of preterm growth restricted fetuses with umbilical artery (UA) Doppler abnormalities. This was a cohort study of 180 neonates with birth weight < 10(th) percentile, gestational age at delivery < 34 weeks and abnormal Doppler ultrasound examination of the UA. Various antenatal and perinatal variables were studied in relation to short- and long-term outcome. Neonatal and overall mortality (up to 2 years of age) were predicted by low gestational age at delivery. Neonatal mortality was additionally predicted by absent or reversed UA end-diastolic flow, while the presence of severe neonatal complications and placental villitis were additional predictors of both infant (between 28 days and 1 year of postnatal life) and overall mortality. Placental villitis was found to be the only predictor of necrotizing enterocolitis. Low gestational age at delivery, male sex, abnormal cardiotocography, absent or reversed UA end-diastolic flow and the HELLP syndrome predicted respiratory distress syndrome. Abnormal neurodevelopmental outcome at 2 years was predicted by low birth weight (< 2.3(rd) percentile), fetal acidosis (UA pH < 7.00), and placental villitis. Less advanced gestation at delivery remains an important predictor of short-term outcome in growth-restricted fetuses. In addition, the presence of placental villitis may aid neonatologists in the early identification of infants at increased risk of necrotizing enterocolitis, death and abnormal neurodevelopment at 2 years of age. Abnormal neurodevelopment was related to low weight and acidosis at birth, indicating that the severity of malnutrition and fetal acidosis affect long-term outcome.

Soccer Injuries in Players Aged 7 to 12 Years: A Descriptive Epidemiological Study Over 2 Seasons.

PubMed

Rössler, Roland; Junge, Astrid; Chomiak, Jiri; Dvorak, Jiri; Faude, Oliver

2016-02-01

As part of a risk-management approach, sound epidemiological data are needed to develop prevention programs. A recent review on soccer injuries of players younger than 19 years concluded that prospective data concerning children are lacking. To analyze the incidence and characteristics of soccer injuries in children aged 7 to 12 years. Descriptive epidemiological study. The present survey was a prospective descriptive epidemiological study on soccer injuries over 2 seasons in the Czech Republic and Switzerland. Exposure of players during training and match play (in hours) and injury data were reported by coaches via an Internet-based registration system. Location, type, and severity of injuries were classified according to an established consensus. Injury characteristics are presented as absolute numbers and injury incidence rates (injuries per 1000 hours of soccer exposure). An injury was defined as any physical complaint sustained during a scheduled training session or match play resulting in at least 1 of the following: (1) inability to complete the current match or training session, (2) absence from subsequent training sessions or matches, and (3) injury requiring medical attention. In total, 6038 player-seasons with 395,295 hours of soccer exposure were recorded. The mean (±SD) age of the players was 9.5 ± 2.0 years, and 3.9% of the participants were girls. A total of 417 injuries were reported. Most (76.3%) injuries were located in the lower limbs, with 15.6% located in the upper limbs. Joint and ligament injuries comprised 30.5%, contusions 22.5%, muscle and tendon injuries 18.5%, and fractures and bone injuries 15.4% of all injuries; 23.7% of injuries led to more than 28 days of absence from sport participation. The overall injury incidence was 0.61 (95% CI, 0.53-0.69) injuries per 1000 hours of soccer exposure during training sessions and 4.57 (95% CI, 4.00-5.23) during match play. Injury incidence rates increased with increasing age. The observed injury

Classification Rule for 5-year Cardiovascular Diseases Risk using decision tree in Primary Care Chinese Patients with Type 2 Diabetes Mellitus.

PubMed

Wan, Eric Yuk Fai; Fong, Daniel Yee Tak; Fung, Colman Siu Cheung; Yu, Esther Yee Tak; Chin, Weng Yee; Chan, Anca Ka Chun; Lam, Cindy Lo Kuen

2017-11-10

Cardiovascular disease(CVD) is the leading cause of mortality among patients with type 2 diabetes mellitus(T2DM), and a risk classification model for CVD among primary care diabetic patients is pivotal for risk-based interventions and patient information. This study developed a simple tool for a 5-year CVD risk prediction for primary care Chinese patients with T2DM. A retrospective cohort study was conducted on 137,935 primary care Chinese T2DM patients aged 18-79 years without history of CVD between 1 January 2010 and 31 December 2010. New events of CVD of the cohort over a median follow up of 5 years were extracted from the medical records. A classification rule of 5-year CVD risk was obtained from the derivation cohort and validated in the validation cohort. Significant risk factors included in decision tree were age, gender, smoking status, diagnosis duration, obesity, unsatisfactory control on haemoglobin A1c and cholesterol, albuminuria and stage of chronic kidney disease, which categorized patients into five 5-year CVD risk groups(<5%; 5-9%; 10-14%; 15-19% and ≥20%). Taking the group with the lowest CVD risk, the hazard ratios varied from 1.92(1.77,2.08) to 8.46(7.75,9.24). The present prediction model performed comparable discrimination and better calibration from the plot compared to other current existing models.

Forecasting the progress towards the target of Millennium Development Goal 1C in children under 5 years of age in Bangladesh.

PubMed

Hasan, Md Tanvir; Soares Magalhaes, Ricardo J; Williams, Gail M; Mamun, Abdullah A

2015-07-01

To estimate the average annual rates of reduction of stunting, underweight and wasting for the period 1996 to 2011, and to evaluate whether Bangladesh will be expected to achieve the target of Millennium Development Goal 1C of reducing the prevalence of underweight by half by 2015. We used five nationwide, cross-sectional, Demographic and Health Survey data sets to estimate prevalence of undernutrition defined by stunting, underweight and wasting among children under 5 years of age using the WHO child growth standards. We then computed the average annual rates of reduction of prevalence of undernutrition using the formula derived by UNICEF. Finally, we projected the prevalence of undernutrition for the year 2015 using the estimated average annual rates of reduction. Nationwide covering Bangladesh. Children under 5 years of age (n 28,941). The prevalence of stunting decreased by 18.8% (from 60.0% to 41.2%), underweight by 16.0% (from 52.2% to 36.2%) and wasting by 5.1% (from 20.6% to 15.5%) during 1996 to 2011. The overall average annual rates of reduction were 2.84%, 2.69 % and 2.47%, respectively, for stunting, underweight and wasting. We forecast that in 2015, the prevalence of stunting, underweight and wasting will be 36.7%, 32.5% and 14.0%, respectively, at the national level. The prevalence of undernutrition is likely to remain high in rural areas, in the Sylhet division and in the poorest wealth quintile. Bangladesh is likely to achieve the Millennium Development Goal 1C target of reducing the prevalence of underweight by half by 2015. However, it is falling behind in reducing stunting and further investment is needed to reduce individual, household and environmental determinants of stunting in Bangladesh.

Risk factors for mortality before age 18 years in cystic fibrosis.

PubMed

McColley, Susanna A; Schechter, Michael S; Morgan, Wayne J; Pasta, David J; Craib, Marcia L; Konstan, Michael W

2017-07-01

Understanding early-life risk factors for childhood death in cystic fibrosis (CF) is important for clinical care, including the identification of effective interventions. Data from the Epidemiologic Study of Cystic Fibrosis (ESCF) collected 1994-2005 were linked with the Cystic Fibrosis Foundation Patient Registry (CFFPR) demographic and mortality data from 2013. Inclusion criteria were ≥1 visit annually at age 3-5 years and ≥1 FEV 1 measurement at age 6-8 years. Demographic data, nutritional parameters, pulmonary signs and symptoms, microbiology, and FEV 1 were evaluated as risk factors for death before age 18 years. Multivariable Cox proportional hazards regression was used to model the simultaneous effects of risk factors associated with death before age 18 years. Among 5365 patients enrolled in ESCF who met inclusion criteria, 3880 (72%) were linked to the CFFPR. Among these, 191 (5.7%) died before age 18 years; median age at death was 13.4 ± 3.1 years. Multivariable regression showed clubbing, crackles, female sex, unknown CFTR genotype, minority race or ethnicity, Medicaid insurance (a proxy of low socioeconomic status), Pseudomonas aeruginosa on 2 or more cultures, and weight-for-age <50th percentile were significant risk factors for death regardless of inclusion of FEV 1 at age 6-8 years in the model. We identified multiple risk factors for childhood death of patients with CF, all of which remained important after incorporating FEV 1 at age 6-8 years. Among the factors identified were the presence of clubbing or crackles at age 3-5 years, signs which are not routinely collected in registries. © 2017 Wiley Periodicals, Inc.

Infliximab therapy in pediatric patients 7 years of age and younger.

PubMed

Kelsen, Judith R; Grossman, Andrew B; Pauly-Hubbard, Helen; Gupta, Kernika; Baldassano, Robert N; Mamula, Petar

2014-12-01

Infliximab (IFX) is efficacious for induction and maintenance of remission in pediatric patients with moderate-to-severe inflammatory bowel disease (IBD). It has, however, not been studied in patients 7 years old and younger. Our aim was to characterize efficacy and safety of IFX therapy in this cohort. This was a retrospective study of patients with IBD ages 7 years and younger, treated with IFX between 1999 and 2011. Medical records were reviewed for age of diagnosis, disease phenotype, therapy, surgery, IFX infusion dates, dose, and intervals. Outcome measures included physician global assessment, corticosteroid requirement, and adverse events. Thirty-three children (ages 2.4-7 years) were included. Twenty patients had Crohn disease, 4 had ulcerative colitis, and 9 had indeterminate colitis. Maintenance of IFX therapy at 1, 2, and 3 years was 36%, 18%, and 12%, respectively. Patients of age 5 years and younger had the lowest rates of maintenance of therapy at 25% at year 1, and 10% at years 2 and 3 combined. Nine percent of all of the patients demonstrated response measured by the physician global assessment and were steroid free at 1 year. There were 8 infusion reactions. There were no malignancies, serious infections, or deaths. IFX demonstrated a modest response rate and a low steroid-sparing effect in patients with IBD 7 years old and younger. Although this is a limited study, there appears to be a trend for decreased sustained efficacy with IFX in this age group, particularly in children 5 years old and younger, when compared with the previously published literature in older children.

Cardiovascular risk factors and carotid intima media thickness in young adults born small for gestational age after cessation of growth hormone treatment: a 5-year longitudinal study.

PubMed

van der Steen, Manouk; Kerkhof, Gerthe F; Smeets, Carolina C J; Hokken-Koelega, Anita C S

2017-12-01

Growth hormone treatment reduces blood pressure and lipid concentrations. We assessed long-term changes in blood pressure, lipid concentrations, and carotid intima media thickness over a 5-year period after cessation of growth hormone treatment in adults born small for gestational age. We did a longitudinal observational study at a medical centre in the Netherlands between April 1, 2004, and April 1, 2016. We included adults born small for gestational age who were treated with growth hormone (1 mg/m 2 per day); treatment started during childhood until adult height. Participants were evaluated at cessation of treatment, and 6 months, 2 years, and 5 years later. We compared cardiovascular risk factors with untreated controls from the PROGRAM study. We included 199 participants born small for gestational age and treated with growth hormone along with 285 controls: 51 untreated short adults born small for gestational age, 92 untreated adults born small for gestational age with spontaneous catch-up growth, and 142 adults born appropriate for gestational age. In the 6 months after treatment cessation, systolic blood pressure increased temporarily from 113·00 mm Hg (95% CI 111·18-114·82) to 116·92 mm Hg (115·07 to 118·77; p<0·001) and diastolic blood pressure increased temporarily from 62·19 mm Hg (60·99-63·38) to 66·51 mm Hg (65·14-67·89; p<0·001). At 5 years after treatment cessation, mean systolic blood pressure was 109·2 mm Hg (105·5-113·0) and mean diastolic blood pressure was 63·4 mm Hg (60·9-65·9), similar to the values at cessation. Lipid concentrations were non-significantly higher 5 years after treatment cessation (p values 0·09-0·21) than at treatment cessation. Cessation of growth hormone had no effect on carotid intima media thickness. At 5 years after cessation, total cholesterol was lower in adults treated with growth hormone (mean 4·21 mmol/L, 95% CI 4·04-4·38) than in untreated short adults born small for gestational age (4·66

Hyperinsulinemia and metabolic syndrome at mean age of 10 years in black and white schoolgirls and development of impaired fasting glucose and type 2 diabetes mellitus by mean age of 24 years.

PubMed

Morrison, John A; Glueck, Charles J; Umar, Muhammad; Daniels, Stephen; Dolan, Lawrence M; Wang, Ping

2011-01-01

The objective of the study was to evaluate preteen insulin and metabolic syndrome (MS) as independent predictors of impaired fasting glucose (IFG) and type 2 diabetes mellitus (T2DM) in black and white females by mean age of 24 years. This was a prospective cohort study. There were 8 measures of fasting glucose and insulin from mean age of 10 years through mean age of 24 years, and insulin also at mean age of 25 years. Childhood MS was defined by at least 3 abnormal values among waist circumference, triglyceride, high-density lipoprotein cholesterol, blood pressure, and glucose. Hyperinsulinemia was defined by insulin greater than or equal to race-specific 75th percentile. Patients with type 1 diabetes mellitus were excluded. The study was held in schools and in an outpatient clinical center. Participants were schoolgirls (260 white, 296 black). There was no intervention. The outcome measures were IFG (fasting glucose of at least 100 to 125 mg/dL) and T2DM (fasting glucose of at least 126 mg/dL). By the age of 24 years, there were 11 cases of T2DM (2%) and 108 cases of IFG (19%). By the age of 24 years, IFG + T2DM was present in 18% of women (73/412) who had normal insulin-no MS at the age of 10 years vs 28% (34/122) of those with high insulin-no MS at the age of 10 years (P = .014) and 67% (10/15) of those with high insulin + MS at the age of 10 years (P < .0001). By stepwise logistic regression, significant, independent, positive predictors of IFG + T2DM were first insulin measure in childhood, age at last sampling, childhood MS, change in body mass index over 15 years, and, separately, initial glucose of at least 100 mg/dL and average of all insulin quartile ranks over 15 years. The correlation between childhood insulin z score and insulin z score 15 years later was r = .30, P < .0001. Insulin and MS at a mean age of 10 years plus change in body mass index over 15 years, and 15-year average insulin rank independently predict IFG + T2DM by mean age of 24 years

Cost Effectiveness of Influenza Vaccine Choices in Children Aged 2–8 Years in the U.S.

PubMed Central

Smith, Kenneth J.; Raviotta, Jonathan M.; DePasse, Jay V.; Brown, Shawn T.; Shim, Eunha; Nowalk, Mary Patricia; Zimmerman, Richard K.

2015-01-01

Introduction Prior evidence found live attenuated influenza vaccine (LAIV) more effective than inactivated influenza vaccine (IIV) in children aged 2–8 years, leading CDC in 2014 to prefer LAIV use in this group. However, since 2013, LAIV has not proven superior, leading CDC in 2015 to rescind their LAIV preference statement. Here, the cost effectiveness of preferred LAIV use compared with IIV in children aged 2–8 years is estimated. Methods A Markov model estimated vaccination strategy cost effectiveness in terms of cost per quality-adjusted life year gained. Base case assumptions were: equal vaccine uptake, IIV use when LAIV was not indicated (in 11.7% of the cohort), and no indirect vaccination effects. Sensitivity analyses included estimates of indirect effects from both equation- and agent-based models. Analyses were performed in 2014–2015. Results Using prior effectiveness data in children aged 2–8 years (LAIV=83%, IIV=64%), preferred LAIV use was less costly and more effective than IIV (dominant), with results sensitive only to LAIV and IIV effectiveness variation. Using 2014–2015 U.S. effectiveness data (LAIV=0%, IIV=15%), IIV was dominant. In two-way sensitivity analyses, LAIV use was cost saving over the entire range of IIV effectiveness (0%–81%) when absolute LAIV effectiveness was >7.1% higher than IIV, but never cost saving when absolute LAIV effectiveness was <3.5% higher than IIV. Conclusions Results support CDC’s decision to no longer prefer LAIV use and provide guidance on effectiveness differences between influenza vaccines that might lead to preferential LAIV recommendation for children aged 2–8 years. PMID:26868283

Developmental tempo in children aged 0-5 years living under unfavourable environmental conditions.

PubMed

Lejarraga, Horacio; Kelmansky, Diana M; Nunes, Fernando

2018-04-01

To describe the dynamics of development along the early years of life among children living under unfavorable socioeconomic conditions. In 5401 children younger than 6 years old living in Florencio Varela and in the Matanza-Riachuelo River Basin (Matanza, Villa 21-24, Wilde, Villa Inflamable and Acuba), areas with a high proportion of families with unmet basic needs, a logistic regression analysis was used to estimate the median age at attainment of 13 psychomotor developmental milestones; differences between these ages and median age at attainment of milestones as per the national reference were plotted on the y-axis, while the median age as per the national reference was plotted on the x-axis. Three stages were observed: the first one between 0 and 270 days with normal development, in which the median age at attainment was similar to that of the national reference; a second one of progressive development delay; and a third one of recovery at 1260 days. Adjusted linear spline slopes were 0.06 (not significant), -0.26 (p < 0.0001) and 0.26 (p < 0.01) for stages 1, 2 and 3, respectively. The three slopes were statistically different from each other. The stage of normal development (stage 1) was attributed to the protective effect of the mother and the family environment; stage 2 of progressive delay, to the unfavorable impact of the environment, and stage 3 of partial recovery was attributed to attending a daycare center. These findings allow the implementation of effective interventions at each stage. Three periods with different developmental tempos were identified. Sociedad Argentina de Pediatría.

Single vs dual (en bloc) kidney transplants from donors ≤ 5 years of age: A single center experience

PubMed Central

Al-Shraideh, Yousef; Farooq, Umar; El-Hennawy, Hany; Farney, Alan C; Palanisamy, Amudha; Rogers, Jeffrey; Orlando, Giuseppe; Khan, Muhammad; Reeves-Daniel, Amber; Doares, William; Kaczmorski, Scott; Gautreaux, Michael D; Iskandar, Samy S; Hairston, Gloria; Brim, Elizabeth; Mangus, Margaret; Stratta, Robert J

2016-01-01

AIM: To compare outcomes between single and dual en bloc (EB) kidney transplants (KT) from small pediatric donors. METHODS: Monocentric nonprospective review of KTs from pediatric donors ≤ 5 years of age. Dual EB KT was defined as keeping both donor kidneys attached to the inferior vena cava and aorta, which were then used as venous and arterial conduits for the subsequent transplant into a single recipient. Donor age was less useful than either donor weight or kidney size in decision-making for kidney utilization as kidneys from donors < 8 kg or kidneys < 6 cm in length were not transplanted. Post-transplant management strategies were standardized in all patients. RESULTS: From 2002-2015, 59 KTs were performed including 34 dual EB and 25 single KTs. Mean age of donors (17 mo vs 38 mo, P < 0.001), mean weight (11.0 kg vs 17.4 kg, P = 0.046) and male donors (50% vs 84%, P = 0.01) were lower in the dual EB compared to the single KT group, respectively. Mean cold ischemia time (21 h), kidney donor profile index (KDPI; 73% vs 62%) and levels of serum creatinine (SCr, 0.37 mg/dL vs 0.49 mg/dL, all P = NS) were comparable in the dual EB and single KT groups, respectively. Actuarial graft and patient survival rates at 5-years follow-up were comparable. There was one case of thrombosis resulting in graft loss in each group. Delayed graft function incidence (12% dual EB vs 20% single KT, P = NS) was slightly lower in dual EB KT recipients. Initial duration of hospital stay (mean 5.4 d vs 5.6 d) and the one-year incidences of acute rejection (6% vs 16%), operative complications (3% vs 4%), and major infection were comparable in the dual EB and single KT groups, respectively (all P = NS). Mean 12 mo SCr and abbreviated MDRD levels were 1.17 mg/dL vs 1.35 mg/dL and 72.5 mL/min per 1.73 m2 vs 60.5 mL/min per 1.73 m2 (both P = NS) in the dual EB and single KT groups, respectively. CONCLUSION: By transplanting kidneys from young pediatric donors into adult recipients, one can

Change in health status (EQ-5D) over 5 years among individuals with and without type 2 diabetes mellitus in the SHIELD longitudinal study.

PubMed

Grandy, Susan; Fox, Kathleen M

2012-08-21

Health-related quality of life studies among adults with type 2 diabetes mellitus, using the EQ-5D, have been short term and have not assessed change over years. This study assessed the change in health status and health-related quality of life over 5 years among individuals with and without diabetes. Respondents to the US Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD) completed the EuroQol-5D (EQ-5D) at baseline (2004) and 5 years later (2009). Visual analog scale (VAS) score and health index score were computed at baseline and year 5, and the change over 5 years was measured for individuals with type 2 diabetes mellitus (T2DM) and those without diabetes, and T2DM adults with and without diabetic complications. Linear regression models were used to determine change in EQ-5D score, controlling for age, gender, race, education, household income, and body mass index (BMI). There was significantly greater decline in the EQ-5D index score in the T2DM group (-0.031 [SD 0.158]), compared with those without diabetes (-0.016 [0.141], p = 0.001). Compared with respondents without diabetes, those with T2DM had a larger reduction in EQ-5D index score, after controlling for demographics (p = 0.001). EQ-5D VAS score declined over 5 years for both groups: -1.42 (18.1) for the T2DM group, and -0.63 (15.8) for the group without diabetes, but the between-group difference was not significant either before (p = 0.09) or after (p = 0.12), controlling for demographics. T2DM respondents with diabetic complications had a greater decline in EQ-5D scores than T2DM respondents without complications (p < 0.05). Over a 5-year period, health status of respondents with T2DM declined significantly compared with those with no diabetes, indicating that the burden of the disease has a long-term detrimental impact. This decline in health status is likely to impact utility scores (fewer quality-adjusted life years) for economic

Developmental Trajectories of Sex-Typed Behavior in Boys and Girls: A Longitudinal General Population Study of Children Aged 2.5-8 Years

ERIC Educational Resources Information Center

Golombok, Susan; Rust, John; Zervoulis, Karyofyllis; Croudace, Tim; Golding, Jean; Hines, Melissa

2008-01-01

The stability of sex-typed behavior from the preschool to the middle school years was examined. The Preschool Activities Inventory, a measure of within-sex variation in sex-typed behavior, was completed by the primary caregiver when the child was 2.5, 3.5, and 5 years, and a modified version, the Child Activities Inventory, was completed by the…

Guaifenesin Pharmacokinetics Following Single‐Dose Oral Administration in Children Aged 2 to 17 Years

PubMed Central

Thompson, Gary A.; Solomon, Gail; Albrecht, Helmut H.; Reitberg, Donald P.

2016-01-01

Abstract This study characterized guaifenesin pharmacokinetics in children aged 2 to 17 years (n = 40) who received a single oral dose of guaifenesin (age‐based doses of 100‐400 mg) 2 hours after breakfast. Plasma samples were obtained before and for 8 hours after dosing and analyzed for guaifenesin using liquid chromatography‐tandem mass spectrometry. Pharmacokinetic parameters were estimated using noncompartmental methods, relationships with age were assessed using linear regression, and dose proportionality was assessed on 95% confidence intervals. Based on the upper dose recommended in the monograph (for both children and adolescents), area under the curve from time zero to infinity and maximum plasma concentration both increased with age. However, when comparing the upper dose for children aged 2 to 11 years with the lower dose for adolescents aged 12 to 17 years, similar systemic exposure was observed. As expected due to increasing body size, oral clearance (CLo) and terminal volume of distribution (Vz/F) increased with age. Due to a larger increase in Vz/F than CLo, an increase in terminal exponential half‐life was also observed. Allometric scaling indicated no maturation‐related changes in CLo and Vz/F. PMID:26632082

5 CFR 551.601 - Minimum age standards.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Minimum age standards. 551.601 Section... ADMINISTRATION UNDER THE FAIR LABOR STANDARDS ACT Child Labor § 551.601 Minimum age standards. (a) 16-year minimum age. The Act, in section 3(l), sets a general 16-year minimum age, which applies to all employment...

5 CFR 551.601 - Minimum age standards.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Minimum age standards. 551.601 Section... ADMINISTRATION UNDER THE FAIR LABOR STANDARDS ACT Child Labor § 551.601 Minimum age standards. (a) 16-year minimum age. The Act, in section 3(l), sets a general 16-year minimum age, which applies to all employment...

5 CFR 551.601 - Minimum age standards.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Minimum age standards. 551.601 Section... ADMINISTRATION UNDER THE FAIR LABOR STANDARDS ACT Child Labor § 551.601 Minimum age standards. (a) 16-year minimum age. The Act, in section 3(l), sets a general 16-year minimum age, which applies to all employment...

5 CFR 551.601 - Minimum age standards.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Minimum age standards. 551.601 Section... ADMINISTRATION UNDER THE FAIR LABOR STANDARDS ACT Child Labor § 551.601 Minimum age standards. (a) 16-year minimum age. The Act, in section 3(l), sets a general 16-year minimum age, which applies to all employment...

Speech outcomes at 5 and 10 years of age after one-stage palatal repair with muscle reconstruction in children born with isolated cleft palate.

PubMed

Nyberg, Jill; Neovius, Erik; Lohmander, Anette

2018-02-01

The aim of this study was to investigate speech outcomes in children with clefts in the hard and/or soft palate only (CPH/CPS), in order to determine the prevalence of cleft speech characteristics, the change between 5 and 10 years of age, and the difference in occurrence between CPH and CPS. A consecutive series of 88 children born with CPH or CPS were included in a retrospective cohort. All participants were treated with one-stage palatal repair using a minimal incision technique with muscle reconstruction (mean age 13 months). Twelve children (14%) received a velopharyngeal flap. Cleft speech variables were rated at 5 and 10 years of age independently by three experienced external speech-language pathologists. Inter- and intra-rater agreements were determined, and the prevalence of cleft speech characteristics was calculated. Moderate-to-severe hypernasality and weak pressure consonants were present in 5%-10% of the children at 5 years, with marginal but statistically significant improvement at 10 years of age. Frequently or always occurring audible nasal air leakage was detected in 20% of children at age 5, and increased to ∼35% of the children at 10 years. Ten per cent had compensatory articulation at age 5, and 25% demonstrated s-distortions, whereas few had these problems at age 10. The results demonstrate low occurrence of compensatory articulation problems in this cohort, even by 5 years of age. The high presence of symptoms of velopharyngeal insufficiency at 10 years of age suggests a need for additional secondary velopharyngeal surgery.

Iron deficiency and anemia are associated with low retinol levels in children aged 1 to 5 years.

PubMed

Saraiva, Bárbara C A; Soares, Michele C C; Santos, Luana C dos; Pereira, Simone C L; Horta, Paula M

2014-01-01

To analyze the occurrence of anemia and iron deficiency in children aged 1 to 5 years and the association of these events and retinol deficiency. This was an observational analytic cross-sectional study conducted in Vitoria, ES, Brazil, between April and August of 2008, with healthy children aged 1 to 5 years (n=692) that lived in areas covered by primary healthcare services. Sociodemographic and economic conditions, dietary intake (energy, protein, iron, and vitamin A ingestion), anthropometric data (body mass index-for-age and height-for-age), and biochemical parameters (ferritin, hemoglobin, and retinol serum) were collected. The prevalence of anemia, iron deficiency, and retinol deficiency was 15.7%, 28.1%, and 24.7%, respectively. Univariate analysis showed a higher prevalence of anemia (PR: 4.62, 95% CI: 3.36, 6.34, p<0.001) and iron deficiency (PR: 4.51, 95% CI: 3.30, 6.17, p<0.001) among children with retinol deficiency. The same results were obtained after adjusting for socioeconomic and demographic conditions, dietary intake, and anthropometric variables. There was a positive association between ferritin vs. retinol serum (r=0.597; p<0.001) and hemoglobin vs. retinol serum (r=0.770; p<0.001). Anemia and iron deficiency were associated with low levels of serum retinol in children aged 1 to 5 years, and a positive correlation was verified between serum retinol and serum ferritin and hemoglobin levels. These results indicate the importance of initiatives encouraging the development of new treatments and further research regarding retinol deficiency. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Guaifenesin Pharmacokinetics Following Single-Dose Oral Administration in Children Aged 2 to 17 Years.

PubMed

Thompson, Gary A; Solomon, Gail; Albrecht, Helmut H; Reitberg, Donald P; Guenin, Eric

2016-07-01

This study characterized guaifenesin pharmacokinetics in children aged 2 to 17 years (n = 40) who received a single oral dose of guaifenesin (age-based doses of 100-400 mg) 2 hours after breakfast. Plasma samples were obtained before and for 8 hours after dosing and analyzed for guaifenesin using liquid chromatography-tandem mass spectrometry. Pharmacokinetic parameters were estimated using noncompartmental methods, relationships with age were assessed using linear regression, and dose proportionality was assessed on 95% confidence intervals. Based on the upper dose recommended in the monograph (for both children and adolescents), area under the curve from time zero to infinity and maximum plasma concentration both increased with age. However, when comparing the upper dose for children aged 2 to 11 years with the lower dose for adolescents aged 12 to 17 years, similar systemic exposure was observed. As expected due to increasing body size, oral clearance (CLo ) and terminal volume of distribution (Vz /F) increased with age. Due to a larger increase in Vz /F than CLo , an increase in terminal exponential half-life was also observed. Allometric scaling indicated no maturation-related changes in CLo and Vz /F. © 2016, The Authors. The Journal of Clinical Pharmacology Published by Wiley Periodicals, Inc. on behalf of American College of Clinical Pharmacology.

Habitual Physical Activity in Children With Cerebral Palsy Aged 4 to 5 Years Across All Functional Abilities.

PubMed

Keawutan, Piyapa; Bell, Kristie L; Oftedal, Stina; Davies, Peter S W; Ware, Robert S; Boyd, Roslyn N

2017-01-01

To compare ambulatory status in children with cerebral palsy aged 4 to 5 years with their habitual physical activity and time spent sedentary, and to compare their activity with physical activity guidelines. Sixty-seven participants-independently ambulant, marginally ambulant, and nonambulant-wore accelerometers for 3 days. Time spent sedentary as a percentage of wear time and activity counts were compared between groups. There were significant differences in time spent sedentary and activity counts between groups. Children who were independently ambulant were more likely to meet physical activity guidelines. Children with cerebral palsy spent more than half of their waking hours in sedentary time. Interventions to reduce sedentary behavior and increase habitual physical activity are needed in children with cerebral palsy at age 4 to 5 years.

Genetic Counselling, BRCA1/2 Status and Clinico-pathologic Characteristics of Patients with Ovarian Cancer before 50 Years of Age

PubMed Central

Cvelbar, Mirjam; Hocevar, Marko; Novakovic, Srdjan; Stegel, Vida; Perhavec, Andraz

2017-01-01

Abstract Background In Slovenia like in other countries, till recently, personal history of epithelial ovarian cancer (EOC) has not been included among indications for genetic counselling. Recent studies reported up to 17% rate of germinal BRCA1/2 mutation (gBRCA1/2m) within the age group under 50 years at diagnosis. The original aim of this study was to invite to the genetic counselling still living patients with EOC under 45 years, to offer gBRCA1/2m testing and to perform analysis of gBRCA1/2m rate and of clinico-pathologic characteristics. Later, we added also the data of previously genetically tested patients with EOC aged 45 to 49 years. Patients and methods All clinical data have to be interpreted in the light of many changes happened in the field of EOC just in the last few years: new hystology stage classification (FIGO), new hystology types and differentiation grades classification, new therapeutic possibilities (PARP inhibitors available, also in Slovenia) and new guidelines for genetic counselling of EOC patients (National Comprehensive Cancer Network, NCCN), together with next-generation sequencing possibilities. Results Compliance rate at the invitation was 43.1%. In the group of 27 invited or previously tested patients with EOC diagnosed before the age of 45 years, five gBRCA1/2 mutations were found. The gBRCA1/2m detection rate within the group was 18.5%. There were 4 gBRCA1 and 1 gBRCA2 mutations detected. In the extended group of 42 tested patients with EOC diagnosed before the age of 50 years, 14 gBRCA1/2 mutations were found. The gBRCA1/2m detection rate within this extended, partially selected group was 33.3%. There were 11 gBRCA1 and 3 gBRCA2 mutations detected. Conclusions The rate of gBRCA1/2 mutation in tested unselected EOC patients under the age of 50 years was higher than 10%, namely 18.5%. Considering also a direct therapeuthic benefit of PARP inhibitors for BRCA positive patients, there is a double reason to offer genetic testing to

Mental health in low-to-moderate risk preterm, low birth weight, and small for gestational age children at 4 to 5 years: the role of early maternal parenting.

PubMed

Westrupp, Elizabeth M; Mensah, Fiona K; Giallo, Rebecca; Cooklin, Amanda; Nicholson, Jan M

2012-03-01

The majority of children born preterm, with low birth weight, or small for gestational age are born with low-to-moderate risk (LTM), yet most research focuses on the high-risk group. Little is known about whether children with LTM perinatal risk are at greater risk for mental health problems, or what the role of early maternal parenting is in determining these outcomes. Longitudinal data were from a large nationally representative Australian cohort of 5,000 children, aged 0 to 1, 2 to 3, and 4 to 5 years of age. Participants were 354 children with LTM perinatal risk born at 33 to 36 weeks, with birth weight 1,501 to 2,499 grams, or born between the first and 10th percentiles for gestational age; and 2,461 children in the normal birth weight, term comparison group. Child mental health was measured by mother-report on the Strengths and Difficulties Questionnaire (SDQ). Parenting irritability, warmth, self-efficacy, maternal separation anxiety, and overprotective parenting were measured when children were 0 to 1 and 2 to 3 years of age. Parents in the LTM perinatal risk group were more likely to experience parenting difficulties on one of eight parenting measures (irritable parenting at age 0-1 year) when adjusting for socio-demographic differences (odds ratio = 1.43; 95% confidence interval = 1.05, 1.95, p < .02). This group difference was no longer apparent by age 2 to 3 years. Compared with healthy-term peers, there were small increases in Emotional Symptoms and Total Difficulties on the SDQ for the LTM perinatal risk group at age 4 to 5 years. When accounting for maternal-specific and socio-demographic factors, LTM perinatal risk group continued to predict Emotional Symptoms but not Total Difficulties at age 4 to 5 years. Children with LTM perinatal risk were at a small increased risk for emotional difficulties but did not differ significantly from other children of similar social backgrounds in their risk for generalized mental health problems. These findings

Social determinants of malnutrition among Serbian children aged <5 years: ethnic and regional disparities.

PubMed

Brcanski, Jelena; Jović-Vraneš, Aleksandra; Marinković, Jelena; Favre, Dragana

2014-10-01

To assess the association between growth indicators of Serbian children aged <5 years of Roma and non-Roma populations and social determinants of health. This study used a cross-sectional secondary data analysis design to measure national and Roma population samples from the MICS 4 (UNICEF) performed in 2010 in Serbia. A total of 4,978 questionnaires were observed with children aged <5 years. Logistic regression analysis was performed to identify association between social determinants of health and growth indicators. Roma children were more than three times more likely to exhibit stunted and/or severely stunted than non-Roma children from the lowest wealth quintile. Non-Roma children residing outside of the Belgrade region had a lower risk of stunted compared to children residing within the Belgrade region, while the risk of stunted among Roma children was nearly twofold greater than those residing in southern and eastern Serbia than in the Belgrade region. Our findings clarified the necessity to establish ethnically and regionally sensitive programs to solve the malnutrition problems.

Managing the screen-viewing behaviours of children aged 5-6 years: a qualitative analysis of parental strategies.

PubMed

Jago, R; Zahra, J; Edwards, M J; Kesten, J M; Solomon-Moore, E; Thompson, J L; Sebire, S J

2016-03-01

The present study used qualitative methods to: (1) examine the strategies that were used by parents of children aged 5-6 years to manage screen viewing; (2) identify key factors that affect the implementation of the strategies and (3) develop suggestions for future intervention content. Telephone interviews were conducted with parents of children aged 5-6 years participating in a larger study. Interviews were transcribed verbatim and analysed using an inductive and deductive content analysis. Coding and theme generation was iterative and refined throughout. Parents were recruited through 57 primary schools located in the greater Bristol area (UK). 53 parents of children aged 5-6 years. Parents reported that for many children, screen viewing was a highly desirable behaviour that was difficult to manage, and that parents used the provision of screen viewing as a tool for reward and/or punishment. Parents managed screen viewing by setting limits in relation to daily events such as meals, before and after school, and bedtime. Screen-viewing rules were often altered depending on parental preferences and tasks. Inconsistent messaging within and between parents represented a source of conflict at times. Potential strategies to facilitate reducing screen viewing were identified, including setting screen-viewing limits in relation to specific events, collaborative rule setting, monitoring that involves mothers, fathers and the child, developing a family-specific set of alternative activities to screen viewing and developing a child's ability to self-monitor their own screen viewing. Managing screen viewing is a challenge for many parents and can often cause tension in the home. The data presented in this paper provide key suggestions of new approaches that could be incorporated into behaviour change programmes to reduce child screen viewing. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Emotion Dialogues between Mothers and Children at 4.5 and 7.5 Years: Relations with Children's Attachment at 1 Year

ERIC Educational Resources Information Center

Oppenheim, David; Koren-Karie, Nina; Sagi-Schwartz, Abraham

2007-01-01

It was examined whether secure infant-mother attachment contributes to emotionally congruent and organized mother-child dialogues about emotions in later years. The attachment of 99 children was assessed using the Strange Situation at the age of 1 year and their emotion dialogues with their mothers were assessed at the ages of 4.5 and 7.5 years.…

Ammonia Control in Children Ages 2 Months through 5 Years with Urea Cycle Disorders: Comparison of Sodium Phenylbutyrate and Glycerol Phenylbutyrate

PubMed Central

Smith, W; Diaz, GA; Lichter-Konecki, U; Berry, SA; Harding, CO; McCandless, SE; LeMons, C; Mauney, J; Dickinson, K; Coakley, DF; Moors, TL; Mokhtarani, M; Mokhtarani, M; Scharschmidt, BF; Lee, B

2014-01-01

Objectives To examine ammonia levels, pharmacokinetics (PK), and safety of glycerol phenylbutyrate (GPB, HPN-100) and sodium phenylbutyrate (NaPBA) in young children with urea cycle disorders (UCDs). Study design This open label switch-over study enrolled patients ages 29 days to under 6 years taking NaPBA. Patients underwent 24-hr blood and urine sampling on NaPBA and again on a PBA-equimolar dose of GPB and completed questionnaires regarding signs and symptoms associated with NaPBA and/or their UCD. Results 15 patients (8 ASL, 3 ASS, 3 OTC, 1 ARG) ages 2 months through 5 years enrolled in and completed the study. Daily ammonia exposure (24-hour AUC) was lower on GPB and met predefined non-inferiority criteria (ratio of means 0.79; 95% CI 0.593–1.055; p = 0.03 Wilcoxon; 0.07 t-test). Six patients experienced mild AEs on GPB; there were no SAEs or significant lab changes. Liver tests and ASA levels among patients with ASL were unchanged or improved on GPB. Eleven of 15 patients reported 35 symptoms on Day 1; 23 of these 35 symptoms improved or resolved on GPB. Mean systemic exposure to PBA, PAA and PAGN were similar and PAA exposure tended to be higher in the youngest children on both drugs. Urinary PAGN concentration was greater on morning voids and varied less over 24 hours on GPB versus NaPBA. Conclusions GPB results in more evenly distributed urinary output of PAGN over 24 hours, was associated with fewer symptoms and offers ammonia control comparable with that observed with NaPBA in young children with UCDs. PMID:23324524

5 CFR 875.212 - Is there a minimum application age?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Is there a minimum application age? 875.212 Section 875.212 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE... application age? Yes, there is a minimum application age. You must be at least 18 years old at the time you...

5 CFR 875.212 - Is there a minimum application age?

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Is there a minimum application age? 875.212 Section 875.212 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE... application age? Yes, there is a minimum application age. You must be at least 18 years old at the time you...

5 CFR 875.212 - Is there a minimum application age?

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Is there a minimum application age? 875.212 Section 875.212 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE... application age? Yes, there is a minimum application age. You must be at least 18 years old at the time you...

5 CFR 875.212 - Is there a minimum application age?

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Is there a minimum application age? 875.212 Section 875.212 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE... application age? Yes, there is a minimum application age. You must be at least 18 years old at the time you...

5 CFR 875.212 - Is there a minimum application age?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Is there a minimum application age? 875.212 Section 875.212 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE... application age? Yes, there is a minimum application age. You must be at least 18 years old at the time you...

Rotavirus diarrhoea hospitalizations among children under 5 years of age in Nigeria, 2011-2016.

PubMed

Tagbo, B N; Mwenda, J M; Eke, C B; Edelu, B O; Chukwubuike, C; Armah, G; Mapaseka, S L; Isiaka, A; Namadi, L; Okafor, H U; Ozumba, U C; Nnani, R O; Okafor, V; Njoku, R; Odume, C; Benjamin-Pujah, C; Azubuike, C; Umezinne, N; Ogude, N; Osarogborun, V O; Okwesili, M U; Ezebilo, S K; Udemba, O; Yusuf, K; Mahmud, Z; Ticha, J M; Obidike, E O; Mphahlele, J M

2018-05-22

The high burden of rotavirus acute gastroenteritis (AGE) is well documented among children under 5 years of age, with the majority of mortality occurring in developing countries. Nigeria ranked second worldwide in the number of rotavirus deaths in 2013. As Nigeria plans to introduce rotavirus vaccine soon, a pre-vaccine documentation of rotavirus disease burden is necessary to determine vaccine impact. Routine rotavirus surveillance was conducted during 2011-2016 in 3 sentinel sites in Nigeria using the standard WHO protocol. Children under 5 years of age hospitalized for acute gastroenteritis were enrolled and demographic, clinical and outcome data were collected. A stool sample was subsequently obtained and tested for human rotavirus antigen using the Enzyme-linked immunosorbent assay (ELISA). 2694 children with acute gastroenteritis were enrolled during January 2011 to December 2016; of these, 1242 (46%) tested positive for rotavirus. Among the rotavirus positive cases, 66% and 94% were younger than 12 months and 24 months respectively. Marked peaks in rotavirus positivity were seen in January of each year. Vomiting, and use of oral and intravenous fluids occurred more often in rotavirus positive cases as compared to rotavirus negative cases. The high prevalence of rotavirus disease highlights the need for urgent introduction of rotavirus vaccine in Nigeria. Additionally, this study provides pre-vaccine introduction disease-burden data that will serve as a baseline for rotavirus vaccine impact-assessment once vaccine has been introduced in the national immunization program. Copyright © 2018 Elsevier Ltd. All rights reserved.

Loblolly pine regeneration and competing vegetation 5 years after implementing uneven-aged silviculture

Treesearch

Michael G. Shelton; Paul A. Murphy

1994-01-01

Thc effects of three basal areas (9.2, 133, and 18.4 m2/ha), maximum diameters (30.5. 40.6, and 50.8 cm), and site indices (24.6, 24.7-27.4, and >27.5 m at 50 years) on establishment and development of loblolly pine (Pinus taeda L.) regeneration and competing vegetation were...

Bioaccumulation of polybrominated diphenyl ethers (PBDEs) in sediment aged for 2 years to carps (Cyprinus carpio)

NASA Astrophysics Data System (ADS)

Tian, S. Y.; Li, J. Y.; Jia, X. M.

2017-08-01

In order to understand the risk of polybrominated diphenyl ethers (PBDEs) existing in sediment for years, the accumulation of PBDEs in sediment aged for 2 years to fish was investigated. Simulated aquatic system microcosms were conducted with PBDE contaminated sediment aged for 2 years and carps were cultured in the microcosms for 20 days. PBDE concentrations in carp tissues were analyzed to estimate the bioavailability of aged PBDEs in carps. The main spiked PBDE congeners were detected in sediment even though the contaminated sediment was aged for 2 years. Similarly, the five PBDE (BDE-28, 47, 100, 153 and 154) congeners which probably were bioaccumulated by carp were detected in fish tissues, indicating that PBDEs could be bioaccumulated after aging for 2 years. The PBDEs distribution revealed that the concentrations of polybrominated diphenyl ethers in tissues of Cyprinus carpio is in this order of magnitude: gut > liver > gill > fillet. The PBDEs concentrations in fillet were as high as 67.9 ng/g dry wt, in which BDE-47 contributed almost 50% in profile.

Alcohol consumption at age 11-12 years and traumatic dental injuries at age 15-16 years in school children from East London.

PubMed

Baig Enver, Muneera; Marcenes, Wagner; Stansfeld, Stephen A; Bernabé, Eduardo

2016-10-01

To explore the association between alcohol consumption at age 11-12 years and traumatic dental injuries (TDI) at age 15-16 years. Data of 635 adolescents who participated in phases I and III of the Research with East London Adolescents Community Health Survey (RELACHS), a longitudinal school-based survey of a representative sample of adolescents from East London, were used for this study. Information on socio-demographic characteristics and alcohol consumption was obtained from questionnaires in phase I when adolescents were 11-12 years of age. Data on TDI and clinical characteristics (incisor overjet and lip coverage) were taken from clinical examination in phase III when adolescents were 15-16 years of age. The association between (lifetime and last month) alcohol consumption and TDI was assessed in crude and adjusted logistic regression models. Overall, 14.5% of adolescents had ever consumed alcohol and 3.5% had consumed alcohol the month before the baseline survey, whereas 17% of adolescents had experienced TDI by age 15-16 years. No significant association of alcohol consumption with TDI was seen in these adolescents for either lifetime (adjusted odds ratio [OR]: 0.87; 95% confidence interval [CI]: 0.45-1.67) or last month consumption of alcohol (adjusted OR: 0.86; 95% CI: 0.28-2.69). This study did not support the association between alcohol use and TDI in adolescents. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Growth and development of children aged 1-5 years in low-intensity armed conflict areas in Southern Thailand: a community-based survey.

PubMed

Jeharsae, Rohani; Sangthong, Rassamee; Wichaidit, Wit; Chongsuvivatwong, Virasakdi

2013-04-04

A low-intensity armed conflict has been occurring for nearly a decade in southernmost region of Thailand. However, its impact on child health has not yet been investigated. This study aimed to estimate the prevalence of delayed child growth and development in the affected areas and to determine the association between the violence and health among children aged 1-5 years. A total of 498 children aged 1-5 years were recruited. Intensity of conflict for each sub-district was calculated as the 6-year average number of incidents per 100,000 population per year and classified into quartiles. Growth indices were weight-for-age, height-for-age, and weight-for-height, while development was measured by the Denver Development Screening Test II (Thai version). Food insecurity, child-rearing practice, health service accessibility, household sanitation, and depression among the caregivers were assessed using screening scales and questionnaires. Contextual information such as average income and numbers of violent events in each sub-district was obtained from external sources. Growth retardation was highly prevalent in the area as reported by rates of underweight, stunting, and wasting at 19.3%, 27.6% and 7.4%, respectively. The prevalence of developmental delay was also substantially high (37.1%). Multi-level analysis found no evidence of association between insurgency and health outcomes. However, children in areas with higher intensity of violence had a lower risk of delay in personal-social development (OR = 0.4; 95% CI = 0.2 - 0.9; p-value = 0.05). Unlike war refugees and internally-displaced persons in camp-like settings, the relationship between level of armed conflict and growth and developmental delay among children aged 1-5 years could not be demonstrated in the community setting of this study where food supply had been minimally perturbed.

When to Start Antiretroviral Therapy in Children Aged 2–5 Years: A Collaborative Causal Modelling Analysis of Cohort Studies from Southern Africa

PubMed Central

Schomaker, Michael; Egger, Matthias; Ndirangu, James; Phiri, Sam; Moultrie, Harry; Technau, Karl; Cox, Vivian; Giddy, Janet; Chimbetete, Cleophas; Wood, Robin; Gsponer, Thomas; Bolton Moore, Carolyn; Rabie, Helena; Eley, Brian; Muhe, Lulu; Penazzato, Martina; Essajee, Shaffiq; Keiser, Olivia; Davies, Mary-Ann

2013-01-01

Background There is limited evidence on the optimal timing of antiretroviral therapy (ART) initiation in children 2–5 y of age. We conducted a causal modelling analysis using the International Epidemiologic Databases to Evaluate AIDS–Southern Africa (IeDEA-SA) collaborative dataset to determine the difference in mortality when starting ART in children aged 2–5 y immediately (irrespective of CD4 criteria), as recommended in the World Health Organization (WHO) 2013 guidelines, compared to deferring to lower CD4 thresholds, for example, the WHO 2010 recommended threshold of CD4 count <750 cells/mm3 or CD4 percentage (CD4%) <25%. Methods and Findings ART-naïve children enrolling in HIV care at IeDEA-SA sites who were between 24 and 59 mo of age at first visit and with ≥1 visit prior to ART initiation and ≥1 follow-up visit were included. We estimated mortality for ART initiation at different CD4 thresholds for up to 3 y using g-computation, adjusting for measured time-dependent confounding of CD4 percent, CD4 count, and weight-for-age z-score. Confidence intervals were constructed using bootstrapping. The median (first; third quartile) age at first visit of 2,934 children (51% male) included in the analysis was 3.3 y (2.6; 4.1), with a median (first; third quartile) CD4 count of 592 cells/mm3 (356; 895) and median (first; third quartile) CD4% of 16% (10%; 23%). The estimated cumulative mortality after 3 y for ART initiation at different CD4 thresholds ranged from 3.4% (95% CI: 2.1–6.5) (no ART) to 2.1% (95% CI: 1.3%–3.5%) (ART irrespective of CD4 value). Estimated mortality was overall higher when initiating ART at lower CD4 values or not at all. There was no mortality difference between starting ART immediately, irrespective of CD4 value, and ART initiation at the WHO 2010 recommended threshold of CD4 count <750 cells/mm3 or CD4% <25%, with mortality estimates of 2.1% (95% CI: 1.3%–3.5%) and 2.2% (95% CI: 1.4%–3.5%) after 3 y, respectively. The

Association Between Moderate and Late Preterm Birth and Neurodevelopment and Social-Emotional Development at Age 2 Years.

PubMed

Cheong, Jeanie L; Doyle, Lex W; Burnett, Alice C; Lee, Katherine J; Walsh, Jennifer M; Potter, Cody R; Treyvaud, Karli; Thompson, Deanne K; Olsen, Joy E; Anderson, Peter J; Spittle, Alicia J

2017-04-03

Moderate and late preterm (MLPT) births comprise most preterm infants. Therefore, long-term developmental concerns in this population potentially have a large public health influence. While there are increasing reports of developmental problems in MLPT children, detail is lacking on the precise domains that are affected. To compare neurodevelopment and social-emotional development between MLPT infants and term-born control infants at age 2 years. This investigation was a prospective longitudinal cohort study at a single tertiary hospital. Participants were MLPT infants (32-36 weeks' completed gestation) and healthy full-term controls (≥37 weeks' gestation) recruited at birth. During a 3-year period between December 7, 2009, and November 7, 2012, MLPT infants were recruited at birth from the neonatal unit and postnatal wards of the Royal Women's Hospital, Melbourne, Australia. The term control recruitment extended to March 26, 2014. The dates of the data developmental assessments were February 23, 2012, to April 8, 2016. Moderate and late preterm birth. Cerebral palsy, blindness, and deafness assessed by a pediatrician; cognitive, language, and motor development assessed using the Bayley Scales of Infant Development-Third Edition (developmental delay was defined as less than -1 SD relative to the mean in controls in any domain of the scales); and social-emotional and behavioral problems assessed by a parent questionnaire (Infant Toddler Social Emotional Assessment). Outcomes were compared between birth groups using linear and logistic regression, adjusted for social risk. In total, 198 MLPT infants (98.5% of 201 recruited) and 183 term-born controls (91.0% of 201 recruited) were assessed at 2 years' corrected age. Compared with controls, MLPT children had worse cognitive, language, and motor development at age 2 years, with adjusted composite score mean differences of -5.3 (95% CI, -8.2 to -2.4) for cognitive development, -11.4 (95% CI, -15.3 to -7.5) for language

Maternal obesity, gestational diabetes, breastfeeding and childhood overweight at age 2 years.

PubMed

Bider-Canfield, Z; Martinez, M P; Wang, X; Yu, W; Bautista, M P; Brookey, J; Page, K A; Buchanan, T A; Xiang, A H

2017-04-01

Maternal obesity, excessive gestational weight gain (EGWG), gestational diabetes mellitus (GDM) and breastfeeding are four important factors associated with childhood obesity. The objective of the study was to assess the interplay among these four factors and their independent contributions to childhood overweight in a cohort with standard clinical care. The cohort included 15 710 mother-offspring pairs delivered in 2011. Logistic regression was used to assess associations between maternal exposures and childhood overweight (body mass index >85th percentile) at age 2 years. Mothers with pre-pregnancy obesity or overweight were more likely to have EGWG, GDM and less likely to breastfeed ≥6 months. Mothers with GDM had 40-49% lower EGWG rates and similar breastfeeding rates compared with mothers without GDM. Analysis adjusted for exposures and covariates revealed an adjusted odds ratio (95% confidence interval) associated with childhood overweight at age 2 years of 2.34 (2.09-2.62), 1.50 (1.34-1.68), 1.23 (1.12-1.35), 0.95 (0.83-1.10) and 0.76 (0.69-0.83) for maternal obesity, overweight, EGWG, GDM and breastfeeding ≥6 months vs. <6 months, respectively. In this large clinical cohort, GDM was not associated with, but maternal pre-pregnancy obesity or overweight and EGWG were independently associated with an increased risk, and breastfeeding ≥6 months was associated with a decreased risk of childhood overweight at age 2 years. © 2016 World Obesity Federation.

Epidemiology of open-globe injuries in Iran: analysis of 2,340 cases in 5 years (report no. 1).

PubMed

Mansouri, Mohammadreza; Faghihi, Hooshang; Hajizadeh, Fedra; Rasoulinejad, Seyed Ahmed; Rajabi, Mohammad Taher; Tabatabaey, Ali; Shoaee, Shervan; Faghihi, Shaahin; Khabazkhoob, Mehdi

2009-09-01

To review characteristics of open-globe injuries presented to Farabi Eye Hospital, a large referral center for serious ocular injury in the capital city of Iran. A retrospective review of 2,340 open-globe injury patients during a 5-year period was performed. Data about any patient that was diagnosed as open-globe injury were collected from medical records. Of 2,340 patients, 1,904 (81.4%) were men. Mean age was 22.44 +/- 16.65 years (range, 4 months to 90 years). Seventy-five percent of cases were younger than 30 years, with a peak of 5 years. There were 561 patients who had an intraocular foreign body (24.7%). In patients younger than 16 years, a knife was the most prevalent cause (22%); in patients younger than 7 years, knives accounted for 33.6% of trauma etiology; and in patients more than 16 years, a projectile metallic foreign body was the most common cause, accounting for 27% of open-globe injuries. Endophthalmitis developed in 5.1% (117 cases). Factors that had a positive association with severity of ocular injury were visual acuity lower than 20/200 at admission, endophthalmitis, double perforation, and laceration length. According to Ocular Trauma Scoring, there was better visual prognosis in younger age groups, male sex, and intraocular foreign body groups. The rate of enucleation or evisceration was 5.3% (126 cases). We had a low sympathetic ophthalmia rate of 0.08%. The most prevalent trauma etiology is a projectile metallic foreign body in adults and a knife injury in children. Compared with other previous epidemiologic studies, we had younger patients, lower enucleations, and sympathetic ophthalmia.

[Rheumatic cardiopathy in children younger than 6 years of age].

PubMed

Vázquez-Antona, C; Calderón-Colmenero, J; Attié, F; Zabal, C; Buendía-Hernández, A; Díaz-Medina, L H; Bialkowski, J; García Arenal, F

1991-01-01

Most of the published papers on Rheumatic Fever (RF) have not included the younger population. We selected 211 cases of children with RF younger than 6 years of age from 9,471 clinical files from 1944 to 1982. These were followed retrospectively to identify the presence of rheumatic activity, subsequent attacks and penicillin profilaxis. From de 211 cases, 209 had carditis; 57% of them were girls and 43% boys. There were no previous infections of the upper respiratory tract in 36% of the patients. The number of cases with RF increased abruptly after 3 years of age and continued increasing until 5 years of age when 70.5% of the population had there first clinically recognized attack. Lesions were present in the mitral valve in 80% of the cases, in the aortic valve in 12%, in the tricuspid in 5% and in the pulmonary valve in 3%. The death rate during the first attack was 20% being refractory heart failure the main cause of death. Thirteen cases suffered rheumatic pneumonia, 9 of whom died (69.2%). 1) The incidence of acute rheumatic fever in children under 6 years of age has decreased with time. 2) The death rate as well as the valvular damage decreased with the parents cooperation with the treatment. 3) The changes in the clinical picture and the severity of valve sequelea may be due to penicillin profilaxis and the better understanding of the disease.

Antibody persistence and booster response 68 months after vaccination at 2-10 years of age with one dose of MenACWY-TT conjugate vaccine.

PubMed

Knuf, Markus; Helm, Klaus; Kolhe, Devayani; Van Der Wielen, Marie; Baine, Yaela

2018-05-31

We evaluated antibody persistence up to 68 months (M) post-vaccination with a quadrivalent meningococcal serogroups A, C, W and Y tetanus toxoid conjugate vaccine (MenACWY-TT) or a licensed monovalent MenC conjugate vaccine (MenC-CRM 197 ) and subsequent booster responses to MenACWY-TT in healthy European children. In the initial study (NCT00674583), healthy children, 2-10 years of age, were randomized to receive a single dose of either MenACWY-TT or MenC-CRM 197 . In the follow-up study, we present the persistence at 32, 44, 56, and 68 M post-vaccination, overall and stratified by age (2-5 and 6-10 years), and the immunogenicity and safety of MenACWY-TT administered to all study participants at M68 post-primary vaccination. At M68, 33.3% (age group 2-5 years) and 47.1% (age group 6-10 years) of the children vaccinated with MenACWY-TT, and 50.0% (age group 2-5 years) and 75.9% (age group 6-10 years) vaccinated with MenC-CRM 197 retained titers ≥1:8 for MenC, as assessed by a serum bactericidal assay using rabbit complement (rSBA). In the MenACWY-TT recipients, the percentages of children retaining rSBA titers ≥1:8 for MenA, MenW, and MenY were 81.7%, 47.3% and 66.7% in age group 2-5 years and 91.8%, 58,8% and 76.5% in age group 6-10 years, respectively. The booster dose induced robust responses (100% for all serogroups) and was well-tolerated. Antibody persistence (rSBA titers ≥ 1:8) for serogroups A, W and Y was observed in more than 50.0% of the children 68 M after receiving one dose of MenACWY-TT; for MenC, antibody persistence was observed in more than one third of MenACWY-TT and more than half of MenC-CRM 197 recipients. Vaccination with a booster dose of MenACWY-TT induced robust immune responses for all serogroups. Copyright © 2018. Published by Elsevier Ltd.

Prevalence and factors associated with preoperative anxiety in children aged 5-12 years.

PubMed

Moura, Louise Amália de; Dias, Iohanna Maria Guimarães; Pereira, Lilian Varanda

2016-06-14

to estimate the prevalence and factors associated with preoperative anxiety in children who wait for outpatient surgery. cross-sectional analysis of baseline data of a prospective cohort study that investigates the predictors of postoperative pain in children aged 5-12 years submitted to inguinal and umbilical hernia repair. It was selected 210 children, which were interviewed in the preoperative holding area of a general hospital. Anxiety was evaluated using the modified Yale Preoperative Anxiety Scale (mYPAS). Sociodemographic and clinical variables were analyzed as exposure and anxiety (mYPAS final score>30) as outcome. Logistic regression was used to identify factors associated with preoperative anxiety. forty-two percent (42.0%) of children presented preoperative anxiety (CI95%: 35.7%-48.6%), with mean scores equal to 30.1 (SD=8.4). Factors associated with preoperative anxiety were: age group of 5-6 years (OR=2.28; p=0.007) and socioeconomic status classified as class C (OR=2.39; p=0.016). the evaluation of children who wait for outpatient surgery should be multidimensional and comprise information on age and socioeconomic status, in order to help in the identification and early treatment of preoperative anxiety. estimar a prevalência e os fatores associados à ansiedade pré-operatória em crianças que aguardam cirurgia ambulatorial. análise transversal de dados da linha de base de um estudo de coorte prospectiva que investiga os preditores de dor pós-operatória em crianças de 5 a 12 anos, submetidas à herniorrafia inguinal e umbilical. Foram selecionadas 210 crianças, entrevistadas na sala de espera de um hospital geral. Avaliou-se a ansiedade por meio da Escala de Ansiedade Pré-operatória de Yale Modificada (EAPY-m). Variáveis sociodemográficas e clínicas foram analisadas, como exposição e ansiedade (soma dos escores da EAPY-m>30) como desfecho. A regressão logística foi utilizada para identificar fatores associados à ansiedade pr

Dietary patterns, anthropometric status, prevalence and risk factors for anaemia among school children aged 5-11 years in Central Uganda.

PubMed

Turyashemererwa, F M; Kikafunda, J; Annan, R; Tumuhimbise, G A

2013-07-01

To determine the dietary patterns, anthropometric status, prevalence and risk factors for anaemia among school children aged 5-11 years in a peri-urban area of Central Uganda. A cross-sectional study involving both qualitative and quantitative methods was used. Anthropometric data were taken using standardised equipment, whereas haemoglobin was assessed using a haemoglobin meter. Food intake was assessed using a food frequency questionnaire. One hundred and twenty-two primary school children, aged 5-11 years, and their carers were recruited in the study. The proportion of anaemic children (haemoglobin <12 g/dl) was 37.7%; 36.9% of these had mild and 0.8% had moderate anaemia. The unadjusted odds ratio (OR) showed that children who never consumed fish had a nine-fold increased odds of being anaemic [OR = 9.0, 95% confidence interval (CI) = 1.6-50.7; P = 0.018], whereas those who had fewer meals (1-2 per day) had a 27.0% increased risk (OR = 3.7, 95% CI = 1.1-12.6; P = 0.021). The adjusted OR showed number of meals per day as the only independent predictor of anaemia (OR = 3.5, 95% CI = 1.1-11.8; P = 0.031). The proportion of malnutrition (<-2 SD) for wasting (body mass index for age) was 3.3%, being underweight was 5.8% and stunting was 6.6%. Children aged >8 years were associated with wasting (P = 0.041) and stunting (P = 0.034). One main dietary pattern was identified explaining approximately 20.4% of the variability of intake in the population. However, scores of this pattern were not significantly associated with child haemoglobin levels. Anaemia but not macronutrient malnutrition in this cohort of school children is high. Patterns of the dietary intake observed did not explain nutritional status in this population. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Chronic renal disease in children aged 5-18 years: a population-based survey in Turkey, the CREDIT-C study.

PubMed

Soylemezoglu, Oguz; Duzova, Ali; Yalçinkaya, Fatos; Arinsoy, Turgay; Süleymanlar, Gültekin

2012-10-01

Data on the epidemiology of chronic kidney disease (CKD), which is a serious health problem and refers to a condition related to irreversible kidney damage that further progress to end-stage renal disease in children, are insufficient and data that are available were based on hospital records. The aim of this nationwide, population-based field study was to determine the prevalence of CKD in children in Turkey and to evaluate the association between CKD and possible risk factors such as obesity and hypertension. The study was the paediatric stratum (3622 children aged 5-18 years) of the previously published population-based survey of Chronic REnal Disease In Turkey (CREDIT study). Medical data were collected through home visits and interviews between November 2007 and July 2008; height, weight and blood pressure were also measured. Serum creatinine, total cholesterol, uric acid and complete blood count were determined from 12-h fasting blood samples, and spot urine tests were performed for subjects who gave consent to laboratory evaluation. Following adjustment according to gender, residence, age groups and geographical regions, the prevalence of children with estimated glomerular filtration rate (eGFR) <75 mL/min/1.73 m(2) was 0.94 [95% confidence interval (CI): 0.63-1.35], and the prevalence of children with CKD Stages 3-5 [National Kidney Foundation-Kidney Disease Outcomes Quality Initiative (K/DOQI)] was 2600 (95% CI 1100-5100) per million age related population. The mean eGFR was found to increase with age; the ratios of children with eGFR <90 and <75 mL/min/1.73 m(2) were higher in younger age groups. The frequencies of overweight and obese children were 9.3 and 8.9%, respectively, and the mean eGFR was lower in patients with higher body mass index. The prevalence of hypertension and hypercholesterolaemia was 6.1 and 5.8%, respectively; the mean eGFR was lower in children with hypercholesterolaemia. This is the first population-based CKD study performed in

Associations between the physical activity levels of fathers and their children at 20 months, 3.5 and five years of age.

PubMed

Walsh, Adam D; Crawford, David; Cameron, Adrian J; Campbell, Karen J; Hesketh, Kylie D

2017-07-05

Early childhood (under five years of age) is a critical developmental period when children's physical activity behaviours are shaped and when physical activity patterns begin to emerge. Physical activity levels track from early childhood through to adolescence with low levels of physical activity associated with poorer health. The aims of this study were to examine cross-sectional and longitudinal associations between the physical activity levels of fathers and their children at the ages of 20 months, 3.5 and 5 years, and to investigate whether these associations differed based on paternal body mass index (BMI) and education. The Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) Program was a cluster randomized-controlled trial delivered to pre-existing first-time parent groups. Physical activity levels of fathers and their first-born children were assessed using the Active Australia Survey and ActiGraph accelerometers respectively. Cross-sectional associations between father and child physical activity behaviours were assessed at each time point. Longitudinal associations between father and child physical activity were also investigated from child age 20 months to both 3.5 and 5 years. Additional stratified analyses were conducted based on paternal BMI and paternal education as a proxy for socioeconomic position (SEP). Data from the control and interventions groups were pooled and all analyses adjusted for intervention status, clustering by first-time parent group and accelerometer wear time. Physical activity levels of fathers and their children at child age 20 months were not associated cross-sectionally or longitudinally at child age 3.5 and 5 years. Positive associations were observed between light physical activity of healthy weight fathers and children at age 3.5 years. Inverse associations were observed for moderate/vigorous physical activity between fathers and children at age 5 years, including between overweight/obese fathers and their

Determination of Knowledge, Attitudes and Behaviors Regarding Factors Causing Home Accidents and Prevention in Mothers with a Child Aged 0-5 Years

ERIC Educational Resources Information Center

Akturk, Ümmühan; Erci, Behice

2016-01-01

Objective: In this study, it was aimed to determine knowledge, "attitudes" and "behaviors" in mothers with a child aged 0-5 years regarding factors causing "home accidents" and prevention. Method: The target population of the study consisted of mothers with a child aged 0-5 years who were admitted to pediatrics ward…

Evaluation of a regional German interdisciplinary oral health programme for children from birth to 5 years of age.

PubMed

Wagner, Y; Heinrich-Weltzien, R

2017-01-01

The aim of this prospective birth cohort study was to evaluate the effect of the interdisciplinary oral health programme (OHP) for early childhood caries (ECC) in 5-year-old German children. All parents of newborns (n = 1162; born 2009/2010) were visited after birth by the communal newborn visiting service of Jena, Thuringia, and advised on general and dental health. In the first year of life, children were invited to attend a dental examination in the Jena University Hospital. Participating children were included in a caries-risk-related recall system with continuous oral care over 5 years. The caries-risk assessment tool of the AAPD was used to determine the likelihood of carious lesion development and to categorize the children at low, moderate or high risk for caries. High-risk children received fluoride varnish. Families (n = 563) who gave their approval for final examination after 5 years were invited again and examined by a blinded clinician. Dental caries was scored using WHO diagnostic criteria expanded to d1-level without radiography. Children were allocated to prevention (PG) and control group (CG) and matched on the basis of age, sex, ethnicity and socio-economic status (SES). Two hundred and eighty-nine children (mean age 5.2 ± 0.7 years; 46.7 % female) were examined. Children in the PG (n = 174) showed significantly lower caries prevalence and experience (10.9 %, 0.2 ± 0.7 d 3-4 mft) than children in the CG (57.4 %, 2.9 ± 3.8 d 3-4 mft). Multivariate analysis found that low SES, early start of tooth brushing, supervision/regular second brush by parent, regular dental visits and duration of breast-/bottle-feeding >1 year were significantly related to d 3-4 mft. The OHP was an effective approach for preventing early childhood caries in preschool children. A programme consisting of early maternal counselling, establishment of a dental home, and inclusion of the children in a caries-risk-related recall system with continuous dental

Clubfoot Does Not Impair Gross Motor Development in 5-Year-Olds.

PubMed

Zapata, Karina A; Karol, Lori A; Jeans, Kelly A; Jo, Chan-Hee

2018-04-01

To evaluate the gross motor development of 5-year-olds using the Peabody Developmental Motor Scales, 2nd Edition (PDMS-2), test after initial nonoperative management of clubfoot as infants. The PDMS-2 Stationary, Locomotion, and Object Manipulation subtests were assessed on 128 children with idiopathic clubfeet at the age of 5 years. Children were categorized by their initial clubfoot severity as greater than 13, unilateral or bilateral involvement, and required surgery. Children with treated clubfeet had average gross motor scores (99 Gross Motor Quotient) compared with age-matched normative scores. Children with more severe clubfeet required surgery significantly more than children with less severe scores (P < .01). Peabody scores were not significantly different according to initial clubfoot severity, unilateral versus bilateral involvement, and surgical versus nonsurgical outcomes. Clubfoot does not significantly impair gross motor development in 5-year-olds.

Global burden of mental disorders among children aged 5-14 years.

PubMed

Baranne, Marie Laure; Falissard, Bruno

2018-01-01

The global burden of disease (GBD) study provides information about fatal and non-fatal health outcomes around the world. The objective of this work is to describe the burden of mental disorders among children aged 5-14 years in each of the six regions of the World Health Organisation. Data come from the GBD 2015 study. Outcomes: disability-adjusted life-years (DALYs) are the main indicator of GBD studies and are built from years of life lost (YLLs) and years of life lived with disability (YLDs). Mental disorders are among the leading causes of YLDs and of DALYs in Europe and the Americas. Because of the importance of infectious diseases, mental disorders appear marginal in Africa for YLLs although they play an important role in YLDs there. Because the epidemiological transition that has taken place in Europe and the Americas (i.e., a switch from acute and infectious conditions to chronic and mental health issues) is likely to happen sooner or later across the entire planet, mental health problems in youth are likely to become one of the main public health challenges of the twenty-first century. These results should improve health care if policy-makers use them to develop health policies to meet the real needs of populations (especially children) today.

Prevalence of Metabolically Healthy Obesity (MHO) and its relation with incidence of metabolic syndrome, hypertension and type 2 Diabetes amongst individuals aged over 20 years in Ahvaz: A 5 Year cohort Study (2009-2014).

PubMed

Latifi, Seyed Mahmoud; Karandish, Majid; Shahbazian, Hajieh; Taha, Jalaly Mohammad; Cheraghian, Bahman; Moradi, Mitra

2017-12-01

Today, obesity epidemic is one of the major health problems of the present century. One of the phenotypes of obesity is metabolically healthy obesity. It seems that these obese individuals suffer less from cardiovascular disease and metabolically unhealthy obesity. This study aimed to investigate the prevalence of metabolically healthy obesity (MHO) and its relationship with incidence of metabolic syndrome, diabetes and hypertension in individuals over 20 years in the city of Ahvaz. This study was a 5-year cohort study, which was conducted on adults between years 2009 to 2014.Participants who were randomly selected from individuals covered by the health centers in the city of Ahvaz in baseline population, were again recalled by these centers. The subjects completed the question aires, and anthropometric measurements and blood samples were prepared for performing tests based on Phase 1. A total of 591 individuals Participated in this study, 281 (47.5%) were males and 310 (52.5%) females with mean age of 42.2±13.3 years. The prevalence of MHO was 19.5% in the baseline population. The cumulative incidence of metabolic syndrome, diabetes and hypertension in MHO individuals were 29.6%, 24.3% and 13%, respectively. The prevalence of MHO was 19.5% in the baseline population. There was a specific relationship between MHO and incidence of metabolic syndrome and diabetes; however, there was a less significant relationship between MHO and hypertension. Copyright © 2017. Published by Elsevier Ltd.

Early Father Involvement and Subsequent Child Behaviour at Ages 3, 5 and 7 Years: Prospective Analysis of the UK Millennium Cohort Study.

PubMed

Kroll, Mary E; Carson, Claire; Redshaw, Maggie; Quigley, Maria A

Fathers are increasingly involved in care of their babies and young children. We assessed the association of resident fathers' involvement with subsequent behaviour of their children, examining boys and girls separately. We used longitudinal data from the UK Millennium Cohort Study for children born in 2000-2001, divided into three separate analysis periods: ages 9 months to 3 years, 3 to 5 years, and 5 to 7 years. By exploratory factor analysis of self-reported attitudes and engagement in caring activities, we derived composite measures of various types of father involvement at 9 months, 3 and 5 years. Where possible we created equivalent measures of mother involvement. Child behaviour was assessed by the Strengths and Difficulties Questionnaire (SDQ), which was completed by the mother when the child was aged 3, 5 and 7 years. We estimated gender-specific odds ratios for behaviour problems per quintile of father involvement, using separate logistic regression models for boys and girls in each analysis period. We controlled for a wide range of potential confounders: characteristics of the child (temperament and development at 9 months, and illness and exact age at outcome), equivalent mother involvement where appropriate, and factors related to socioeconomic status, household change, and parental well-being, where statistically significant. Paternal positive parenting beliefs at age 9 months and increased frequency of creative play at age 5 years were significantly associated with lower risk of subsequent behaviour problems (SDQ total difficulties) in both boys and girls (p<0.05), odds ratios ranging between 0.81 and 0.89 per quintile of involvement. No associations were observed for other composite measures of caring activity by the father at 9 months, 3 years or 5 years. Quality of parenting, rather than the division of routine care between parents, was associated with child behavioural outcomes.

Canadian Sedentary Behaviour Guidelines for the Early Years (aged 0-4 years).

PubMed

Tremblay, Mark S; Leblanc, Allana G; Carson, Valerie; Choquette, Louise; Connor Gorber, Sarah; Dillman, Carrie; Duggan, Mary; Gordon, Mary Jane; Hicks, Audrey; Janssen, Ian; Kho, Michelle E; Latimer-Cheung, Amy E; Leblanc, Claire; Murumets, Kelly; Okely, Anthony D; Reilly, John J; Stearns, Jodie A; Timmons, Brian W; Spence, John C

2012-04-01

The Canadian Society for Exercise Physiology (CSEP), with assistance from multiple partners, stakeholders, and researchers, developed the first Canadian Sedentary Behaviour Guidelines for the Early Years (aged 0-4 years). These national guidelines are in response to a call from health and health care professionals, child care providers, and fitness practitioners for guidance on sedentary behaviour in the early years. The guideline development process followed the Appraisal of Guidelines for Research Evaluation (AGREE) II framework. The recommendations are informed by evidence from a systematic review that examined the relationships between sedentary behaviour (predominantly screen time) and health indicators (healthy body weight, bone and skeletal health, motor skill development, psychosocial health, cognitive development, and cardio-metabolic disease risk factors) for three age groups (infants aged <1 year; toddlers aged 1-2 years; preschoolers aged 3-4 years). Evidence from the review was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The new guidelines include a preamble to provide context, followed by the specific recommendations. The final guidelines benefitted from extensive on-line consultations with input from >900 domestic and international stakeholders, end-users, and key informants. The final guidelines state: for healthy growth and development, caregivers should minimize the time infants (aged <1 year), toddlers (aged 1-2 years), and preschoolers (aged 3-4 years) spend being sedentary during waking hours. This includes prolonged sitting or being restrained (e.g., stroller, high chair) for more than 1 h at a time. For those under 2 years, screen time (e.g., TV, computer, electronic games) is not recommended. For children 2-4 years, screen time should be limited to under 1 h per day; less is better.

Safety and tolerability of fexofenadine for the treatment of allergic rhinitis in children 2 to 5 years old.

PubMed

Milgrom, Henry; Kittner, Barbara; Lanier, Robert; Hampel, Frank C

2007-10-01

The safety of fexofenadine has been examined extensively in adults and school-age children. However, the safety of fexofenadine in children younger than 6 years has not been reported to date. To compare the safety and tolerability of twice-daily fexofenadine hydrochloride, 30 mg, and placebo in preschool children aged 2 to 5 years with allergic rhinitis. This was a multicenter, double-blind, randomized, placebo-controlled, parallel-group study, conducted between February 29, 2000, and June 14, 2001. Participants were randomized to either fexofenadine hydrochloride, 30 mg, or placebo twice daily for a 2-week period. To facilitate dosing, capsule content was mixed with applesauce (approximately 10 mL). Safety assessments depended on date of entry into the study because of an amendment to the protocol. Before the amendment, assessments included physical examination, vital signs reporting (oral temperature, heart rate, and respiratory rate), and adverse event (AE) reporting. After the amendment, safety assessments included laboratory testing (blood chemistry and hematology profiles), physical examination, 12-lead electrocardiography, and vital signs (oral temperature, blood pressure, heart rate, and respiratory rate) and AE reporting. Treatment-emergent AEs were observed in 116 of 231 participants receiving placebo and 111 of 222 receiving fexofenadine. These AEs were possibly related to study medication in 19 (8.2%) and 21 (9.5%) of the participants receiving placebo and fexofenadine, respectively, and most frequently involved the digestive system. No clinically relevant differences in laboratory measures, vital signs, and physical examinations were observed. The findings show that fexofenadine hydrochloride, 30 mg, is well tolerated and has a good safety profile in children aged 2 to 5 years with allergic rhinitis.

Relationships among age, gender, anthropometric characteristics, and dynamic balance in children 5 to 12 years old.

PubMed

Butz, Sarah M; Sweeney, Jane K; Roberts, Pamela L; Rauh, Mitchell J

2015-01-01

To examine relationships among age, gender, anthropometrics, and dynamic balance. Height, weight, and arm and foot length were measured in 160 children with typical development aged 5 to 12 years. Dynamic balance was assessed using the Timed Up and Go (TUG) test, Pediatric Reach Test (PRT), and Pediatric Balance Scale (PBS). Moderate to good positive relationships (r = 0.61 and r = 0.56) were found between increasing age and PRT and PBS scores. A fair negative relationship (r = -0.49) was observed between age and TUG test. No significant gender-by-age group difference was observed. Age had the strongest influence on TUG and PBS scores; arm length had the strongest influence on PRT scores. Dynamic balance ability is directly related to chronological age. Age and arm length have the strongest relationships with balance scores. These findings may assist pediatric therapists in selecting dynamic balance tests according to age rather than specific diagnosis.

Concurrent and Predictive Validity of Parent Reports of Child Language at Ages 2 and 3 Years

PubMed Central

Campbell, Thomas F.; Kurs-Lasky, Marcia; Rockette, Howard E.; Dale, Philip S.; Colborn, D. Kathleen; Paradise, Jack L.

2005-01-01

The MacArthur–Bates Communicative Development Inventories (CDI; Dale, 1996; Fenson et al., 1994), parent reports about language skills, are being used increasingly in studies of theoretical and public health importance. This study (N = 113) correlated scores on the CDI at ages 2 and 3 years with scores at age 3 years on tests of cognition and receptive language and measures from parent–child conversation. Associations indicated reasonable concurrent and predictive validity. The findings suggest that satisfactory vocabulary scores at age 2 are likely to predict normal language skills at age 3, although some children with limited skills at age 3 will have had satisfactory scores at age 2. Many children with poor vocabulary scores at 2 will have normal skills at 3. PMID:16026501

Body composition during fetal development and infancy through the age of 5 years

PubMed Central

Toro-Ramos, T; Paley, C; Pi-Sunyer, FX; Gallagher, D

2015-01-01

Fetal body composition is an important determinant of body composition at birth, and it is likely to be an important determinant at later stages in life. The purpose of this work is to provide a comprehensive overview by presenting data from previously published studies that report on body composition during fetal development in newborns and the infant/child through 5 years of age. Understanding the changes in body composition that occur both in utero and during infancy and childhood, and how they may be related, may help inform evidence-based practice during pregnancy and childhood. We describe body composition measurement techniques from the in utero period to 5 years of age, and identify gaps in knowledge to direct future research efforts. Available literature on chemical and cadaver analyses of fetal studies during gestation is presented to show the timing and accretion rates of adipose and lean tissues. Quantitative and qualitative aspects of fetal lean and fat mass accretion could be especially useful in the clinical setting for diagnostic purposes. The practicality of different pediatric body composition measurement methods in the clinical setting is discussed by presenting the assumptions and limitations associated with each method that may assist the clinician in characterizing the health and nutritional status of the fetus, infant and child. It is our hope that this review will help guide future research efforts directed at increasing the understanding of how body composition in early development may be associated with chronic diseases in later life. PMID:26242725

Anxiety, depression, and psychological well-being 2 to 5 years poststroke.

PubMed

Bergersen, Hilde; Frøslie, Kathrine Frey; Stibrant Sunnerhagen, Katharina; Schanke, Anne-Kristine

2010-01-01

We sought to explore psychological well-being and the psychosocial situation in persons with stroke, 2 to 5 years after discharge from a specialized rehabilitation hospital. The Hospital Anxiety and Depression Scale; the 30-item General Health Questionnaire; and a questionnaire were mailed to 255 former patients. A total of 64% answered (36% women), and the average age was 58 years. The Hospital Anxiety and Depression Scale identified problems in 47% (anxiety in 36% and depression in 28%) and 30-item General Health Questionnaire in 54%. About half had experienced periods of anxiety, depression, or both since discharge. Most were satisfied with support by family/friends (88%), home ward (68%), and community therapy services (57%). Marital status was as in the general population. Long after stroke, almost half of the investigated patients with stroke had psychiatric problems according to the questionnaires. This is higher than in the general population but is comparable with some other chronic, somatic populations in Norway. Copyright (c) 2010 National Stroke Association. Published by Elsevier Inc. All rights reserved.

DIET, BODY MASS INDEX AND DENTAL CARIES AMONG THAI CHILDREN AGED 3 TO 5 YEARS.

PubMed

Mitrakul, Kemthong; Arunakul, Malee; Asvanund, Yuwadee; Laisirireoungrai, Tanai; Praneechotiros, Tharawut; Tevavichulada, Peerapol

2017-03-01

Early childhood caries (ECC) can cause pain and interfere with healthy nutrition affecting a child growth. The aim of this study was to determine if there is an association between dental caries and body mass index (BMI) among Thai children aged 3 to 5 years. We randomly selected 100 students attending Suan Missakawan School, Bangkok, Thailand. We examined each child to determine the number of decayed, missing and filled teeth (DMFT) giving a DMFT score. We also measured the height and weight for each subject and calculated their body mass index (BMI) as weight in kilograms divided by height in meter squared. Parents or guardians were asked to complete a questionnaire asking general information and the diet of the child. Data from the questionnaire were analyzed using the Kruskal-Wallis test. Associations between caries and variables were examined using the Spearman’s correlation with significance set at p<0.05. The mean (±SD) age of the subject, the mean (±SD) DMFT score of the subject and the mean (±SD) BMI for the subjects were 4.21(±0.71) years old, 5.27(±4.78) and 16.46(±2.56) kg/ m2, respectively. Seventy-one percent of subjects had a normal BMI, 25% were overweight and 4% were underweight. Eighteen percent had no caries (DMFT score=0), 32% had a few caries (DMFT score=0.1-3.0), 14% had many caries (DMFT scores=3.1-6.9), and 36% had very many caries (DMFT≥7). The DMFT score was not significantly associated with a history of sugar consumption or BMI. The DMFT score was significantly negatively associated with estimated fat consumption and estimated iron consumption based on the diet reported by the parents or guardians. Further studies are needed to determine if these reported diets reflect actual consumption and if the associations are still significant.

Ammonia control in children ages 2 months through 5 years with urea cycle disorders: comparison of sodium phenylbutyrate and glycerol phenylbutyrate.

PubMed

Smith, Wendy; Diaz, George A; Lichter-Konecki, Uta; Berry, Susan A; Harding, Cary O; McCandless, Shawn E; LeMons, Cindy; Mauney, Joe; Dickinson, Klara; Coakley, Dion F; Moors, Tristen; Mokhtarani, Masoud; Scharschmidt, Bruce F; Lee, Brendan

2013-06-01

To examine ammonia levels, pharmacokinetics, and safety of glycerol phenylbutyrate (GPB; also referred to as HPN-100) and sodium phenylbutyrate (NaPBA) in young children with urea cycle disorders (UCDs). This open label switch-over study enrolled patients ages 29 days to under 6 years taking NaPBA. Patients underwent 24-hour blood and urine sampling on NaPBA and again on a phenylbutyric acid-equimolar dose of GPB and completed questionnaires regarding signs and symptoms associated with NaPBA and/or their UCD. Fifteen patients (8 argininosuccinate lyase deficiency, 3 argininosuccinic acid synthetase deficiency, 3 ornithine transcarbamylase deficiency, 1 arginase deficiency) ages 2 months through 5 years enrolled in and completed the study. Daily ammonia exposure (24-hour area under the curve) was lower on GPB and met predefined noninferiority criteria (ratio of means 0.79; 95% CI 0.593-1.055; P=.03 Wilcoxon; 0.07 t test). Six patients experienced mild adverse events on GPB; there were no serious adverse events or significant laboratory changes. Liver tests and argininosuccinic acid levels among patients with argininosuccinate lyase deficiency were unchanged or improved on GPB. Eleven of 15 patients reported 35 symptoms on day 1; 23 of these 35 symptoms improved or resolved on GPB. Mean systemic exposure to phenylbutyric acid, phenylacetic acid, and phenylacetylglutamine (PAGN) were similar and phenylacetic acid exposure tended to be higher in the youngest children on both drugs. Urinary PAGN concentration was greater on morning voids and varied less over 24 hours on GPB versus NaPBA. GPB results in more evenly distributed urinary output of PAGN over 24 hours were associated with fewer symptoms and offers ammonia control comparable with that observed with NaPBA in young children with UCDs. Copyright © 2013 Mosby, Inc. All rights reserved.

Plasma endotoxin core antibody concentration and linear growth are unrelated in rural Malawian children aged 2-5 years.

PubMed

Benzoni, Nicole; Korpe, Poonum; Thakwalakwa, Chrissie; Maleta, Ken; Stephenson, Kevin; Manary, Micah; Manary, Mark

2015-06-24

Environmental enteropathy is subclinical inflammation of the upper gastrointestinal tract associated with reduced linear growth in developing countries. Usually investigators have used biopsy or a dual sugar absorption test to assess environmental enteropathy. Such tests are time and resource intensive, restricting their utility as screening methods. Serum endotoxin core antibody (EndoCab) concentration is a potential indicator of intestinal inflammation and integrity, and thus may be useful to predict environmental enteropathy. We analyzed the association of serum EndoCab levels versus linear growth and lactulose-mannitol assay results in 2-5 year old rural Malawian children. This was an observational study of 388 rural, asymptomatic Malawian children who had anthropometric measurements taken at least every 3 months since birth. In June and July 2011, dual sugar permeability tests were performed and serum samples were drawn for EndoCab assays. Pearson correlation, Student's t test and multivariable linear regression were used to compare ln EndoCab concentrations with height-for-age z scores (HAZ) at time of sampling and 3 months later. Identical analysis was also performed for ln EndoCab versus measurements from dual sugar permeability testing performed in conjunction with serum sampling. In a subgroup of children with anthropometric data in the months prior to serum sampling, Pearson correlation was used to estimate the relationship between ln EndoCab and recent linear growth. Ln EndoCab concentrations were not correlated with HAZ at time of measurement (B = -0.078, P = 0.14) nor change in HAZ over the subsequent 3 months HAZ (B = -0.018, P = 0.27). EndoCab concentration was not associated with %lactulose excretion (B < 0.001, P = 0.98) nor the lactulose:mannitol ratio (B = 0.021, P = 0.62). Subgroup analysis also did not reveal any significant association between EndoCab and recent growth. EndoCab titers were not correlated with measurements of growth or

Protective and risk factors for allergic diseases in high-risk children at the ages of two and five years.

PubMed

Sandini, Urpu; Kukkonen, Anna Kaarina; Poussa, Tuija; Sandini, Lorenzo; Savilahti, Erkki; Kuitunen, Mikael

2011-01-01

Environmental and lifestyle factors such as breast-feeding and pets seem to affect atopic disease prevalence. We identified risk factors for allergic diseases. We prospectively followed until the age of 5 years a cohort of 1,223 children born into allergic families, who participated in a randomized placebo-controlled trial of probiotics as preventive against allergic disease. We evaluated the cumulative incidence of allergic diseases with questionnaires and examined all children at the ages of 2 and 5 years. Compared to allergy in one parent only, allergy in both parents conferred an increased risk of allergic disease at the ages of 2 (OR 1.64; 95% CI 1.11-2.42, p = 0.013) and 5 (OR 1.83; 95% CI 1.24-2.70, p = 0.002) and at the age of 2 for eczema (OR 1.74; 95% CI 1.17-2.58, p = 0.006). Exclusive breast-feeding over 2 months elevated the risk of eczema at the ages of 2 (OR 1.73; 95% CI 1.15-2.61, p = 0.009) and 5 (OR 1.51; 95% CI 1.03-2.23, p = 0.036). Cat or dog exposure at 0-2 years and at 0-5 years protected against IgE sensitization until 5 years of age (OR 0.60; 95% CI 0.37-1.00, p = 0.048, and OR 0.61; 95% CI 0.39-0.96, p = 0.033), and exposure at the ages of 0-5 years protected against allergic rhinitis until the age of 5 (OR 0.46; 95% CI 0.25-0.85, p = 0.013) in the probiotic group. Allergy in both parents is an independent predictor of eczema and of allergic disease until the ages of 2 and 5. Long, exclusive breast-feeding was associated with increased eczema at the ages of 2 and 5, and cat or dog exposure was associated with decreased IgE sensitization and allergic rhinitis in the probiotic group. Copyright © 2011 S. Karger AG, Basel.

A follow-up survey on the knowledge of age-related macular degeneration and its risk factors among Singapore residents after 5 years of nation-wide awareness campaigns.

PubMed

Sanjay, Srinivasan; Chin, You Chuen; Teo, Hui Ting; Ong, Shu Xuan; Toh, Serene Hui Fang; Khong, Ming Hui; Yeo, Anna C H; Au Eong, Kah-Guan

2014-08-01

To re-evaluate the awareness of age-related macular degeneration (AMD) and knowledge of its risk factors among Singapore residents after 5 years of awareness campaigns. Cross-sectional, questionnaire-based telephone survey (modified from the AMD Alliance International Global Report), conducted in Singapore in 2011. Participants were randomly selected using the Global Yellow Pages Singapore residential listings 2009/2010. Awareness of AMD and its risk factors was assessed among participants. Of 1773 Singapore residents contacted over the telephone, 559 participated (31.5% response rate). The mean age of participants was 43.1 years (range 21-85 years). A total of 157 participants (28.1%) were familiar with AMD. Among these, the number who correctly identified the risk factors were: smoking, n = 132 (84.1%); ageing, n = 123 (78.3%); lack of vitamins/nutrients, n = 121 (77.1%); genetics, n = 101 (64.3%); unprotected light exposure, n = 100 (63.7%) and; sex, n = 62 (39.5%). Participants aged >50 years (prevalence rate ratio, PRR 2.23, confidence interval, CI, 1.31-3.81) or who had undergone an eye test within the previous year (PRR 2.61, 95% CI 1.79-3.82) were more familiar with AMD, while females (PRR 0.68, 95% CI 0.47-0.98) were less familiar. Self-reported awareness of AMD among Singapore residents increased four-fold from 7.3% in 2006 to 28.1% in 2011 following 5 years of awareness campaigns. Participants who were >50 years or had undergone an eye test within the previous year were more aware of AMD while female participants were less aware of AMD.

Seasonal variation of malaria cases in children aged less than 5 years old following weather change in Zomba district, Malawi.

PubMed

Hajison, Precious L; Mwakikunga, Bonex W; Mathanga, Don P; Feresu, Shingairai A

2017-07-03

Malaria is seasonal and this may influence the number of children being treated as outpatients in hospitals. The objective of this study was to investigate the degree of seasonality in malaria in lakeshore and highland areas of Zomba district Malawi, and influence of climatic factors on incidence of malaria. Secondary data on malaria surveillance numbers and dates of treatment of children <5 years of age (n = 374,246) were extracted from the Zomba health information system for the period 2012-2016, while data on climatic variables from 2012 to 2015 were obtained from meteorological department. STATA version 13 was used to analyse data using non-linear time series correlation test to suggest a predictor model of malaria epidemic over explanatory variable (rainfall, temperature and humidity). Malaria cases of children <5 years of age in Zomba district accounts for 45% of general morbidity. There was no difference in seasonality of malaria in highland compared to lakeshore in Zomba district. This study also found that an increase in average temperature and relative humidity was associated of malaria incidence in children <5 year of age in Zomba district. On the other hand, the difference of maximum and minimum temperature (diurnal temperature range), had a strong negative association (correlation coefficients of R 2  = 0.563 [All Zomba] β = -1295.57 95% CI -1683.38 to -907.75 p value <0.001, R 2  = 0.395 [Zomba Highlands] β = -137.74 95% CI -195.00 to -80.47 p value <0.001 and R 2  = 0.470 [Zomba Lakeshores] β = -263.05 95% CI -357.47 to -168.63 p value <0.001) with malaria incidence of children <5 year in Zomba district, Malawi. The diminishing of malaria seasonality, regardless of strong rainfall seasonality, and marginal drop of malaria incidence in Zomba can be explained by weather variation. Implementation of seasonal chemoprevention of malaria in Zomba could be questionable due to reduced seasonality of malaria. The lower diurnal

Prenatal stress and balance of the child's cardiac autonomic nervous system at age 5-6 years.

PubMed

van Dijk, Aimée E; van Eijsden, Manon; Stronks, Karien; Gemke, Reinoud J B J; Vrijkotte, Tanja G M

2012-01-01

Autonomic nervous system (ANS) misbalance is a potential causal factor in the development of cardiovascular disease. The ANS may be programmed during pregnancy due to various maternal factors. Our aim is to study maternal prenatal psychosocial stress as a potential disruptor of cardiac ANS balance in the child. Mothers from a prospective birth cohort (ABCD study) filled out a questionnaire at gestational week 16 [IQR 12-20], that included validated instruments for state anxiety, depressive symptoms, pregnancy-related anxiety, parenting daily hassles and job strain. A cumulative stress score was also calculated (based on 80(th) percentiles). Indicators of cardiac ANS in the offspring at age 5-6 years are: pre-ejection period (PEP), heart rate (HR), respiratory sinus arrhythmia (RSA) and cardiac autonomic balance (CAB), measured with electrocardiography and impedance cardiography in resting supine and sitting positions. 2,624 mother-child pairs, only single births, were available for analysis. The stress scales were not significantly associated with HR, PEP, RSA and CAB (p≥0.17). Accumulation of maternal stress was also not associated with HR, PEP, RSA and CAB (p≥0.07). Results did not support the hypothesis that prenatal maternal psychosocial stress deregulates cardiac ANS balance in the offspring, at least in rest, and at the age of five-six years.

Diffuse Lung Disease in Biopsied Children 2 to 18 Years of Age. Application of the chILD Classification Scheme.

PubMed

Fan, Leland L; Dishop, Megan K; Galambos, Csaba; Askin, Frederic B; White, Frances V; Langston, Claire; Liptzin, Deborah R; Kroehl, Miranda E; Deutsch, Gail H; Young, Lisa R; Kurland, Geoffrey; Hagood, James; Dell, Sharon; Trapnell, Bruce C; Deterding, Robin R

2015-10-01

Children's Interstitial and Diffuse Lung Disease (chILD) is a heterogeneous group of disorders that is challenging to categorize. In previous study, a classification scheme was successfully applied to children 0 to 2 years of age who underwent lung biopsies for chILD. This classification scheme has not been evaluated in children 2 to 18 years of age. This multicenter interdisciplinary study sought to describe the spectrum of biopsy-proven chILD in North America and to apply a previously reported classification scheme in children 2 to 18 years of age. Mortality and risk factors for mortality were also assessed. Patients 2 to 18 years of age who underwent lung biopsies for diffuse lung disease from 12 North American institutions were included. Demographic and clinical data were collected and described. The lung biopsies were reviewed by pediatric lung pathologists with expertise in diffuse lung disease and were classified by the chILD classification scheme. Logistic regression was used to determine risk factors for mortality. A total of 191 cases were included in the final analysis. Number of biopsies varied by center (5-49 biopsies; mean, 15.8) and by age (2-18 yr; mean, 10.6 yr). The most common classification category in this cohort was Disorders of the Immunocompromised Host (40.8%), and the least common was Disorders of Infancy (4.7%). Immunocompromised patients suffered the highest mortality (52.8%). Additional associations with mortality included mechanical ventilation, worse clinical status at time of biopsy, tachypnea, hemoptysis, and crackles. Pulmonary hypertension was found to be a risk factor for mortality but only in the immunocompetent patients. In patients 2 to 18 years of age who underwent lung biopsies for diffuse lung disease, there were far fewer diagnoses prevalent in infancy and more overlap with adult diagnoses. Immunocompromised patients with diffuse lung disease who underwent lung biopsies had less than 50% survival at time of last follow-up.

Etiology of acute otitis media and serotype distribution of Streptococcus pneumoniae and Haemophilus influenzae in Chilean children <5 years of age

PubMed Central

Rosenblut, Andres; Napolitano, Carla; Pereira, Angelica; Moreno, Camilo; Kolhe, Devayani; Lepetic, Alejandro; Ortega-Barria, Eduardo

2017-01-01

Abstract The impact of bacterial conjugate vaccines on acute otitis media (AOM) is affected by several factors including population characteristics, bacterial etiology and vaccine conjugation method, carrier, and coverage. This study estimated the baseline etiology, distribution, and antibiotic susceptibility of bacterial serotypes that causes AOM in children aged <5 years in a public setting in Santiago, Chile. Children aged ≥3 months and <5 years referred to the physician for treatment of AOM episodes (with an onset of symptoms <72 h) were enrolled between September 2009 and September 2010. Middle ear fluid (MEF) was collected by tympanocentesis or by otorrhea for identification and serotyping of bacteria. Antibacterial susceptibility was tested using E-test (etrack: 112671). Of 160 children (mean age 27.10 ± 15.83 months) with AOM episodes, 164 MEF samples (1 episode each from 156 children; 2 episodes each from 4 children) were collected. Nearly 30% of AOM episodes occurred in children aged 12 to 23 months. Streptococcus pneumoniae (41.7% [58/139]) and Haemophilus influenzae (40.3% [56/139]) were predominant among the cultures that showed bacterial growth (85% [139/164]). All Streptococcus pneumoniae positive episodes were serotyped, 19F (21%) and 14 (17%) were the predominant serotypes; all Haemophilus influenzae strains were nontypeable. Streptococcus pneumoniae were resistant to penicillin (5%) and erythromycin (33%); Haemophilus influenzae were resistant to ampicillin (14%) and cefuroxime and cefotaxime (2% each). AOM in Chilean children is predominantly caused by Streptococcus pneumoniae and nontypeable Haemophilus influenzae. Use of a broad spectrum vaccine against these pathogens might aid the reduction of AOM in Chile. PMID:28178138

Managing the screen-viewing behaviours of children aged 5–6 years: a qualitative analysis of parental strategies

PubMed Central

Jago, R; Zahra, J; Edwards, M J; Kesten, J M; Solomon-Moore, E; Thompson, J L; Sebire, S J

2016-01-01

Objectives The present study used qualitative methods to: (1) examine the strategies that were used by parents of children aged 5–6 years to manage screen viewing; (2) identify key factors that affect the implementation of the strategies and (3) develop suggestions for future intervention content. Design Telephone interviews were conducted with parents of children aged 5–6 years participating in a larger study. Interviews were transcribed verbatim and analysed using an inductive and deductive content analysis. Coding and theme generation was iterative and refined throughout. Setting Parents were recruited through 57 primary schools located in the greater Bristol area (UK). Participants 53 parents of children aged 5–6 years. Results Parents reported that for many children, screen viewing was a highly desirable behaviour that was difficult to manage, and that parents used the provision of screen viewing as a tool for reward and/or punishment. Parents managed screen viewing by setting limits in relation to daily events such as meals, before and after school, and bedtime. Screen-viewing rules were often altered depending on parental preferences and tasks. Inconsistent messaging within and between parents represented a source of conflict at times. Potential strategies to facilitate reducing screen viewing were identified, including setting screen-viewing limits in relation to specific events, collaborative rule setting, monitoring that involves mothers, fathers and the child, developing a family-specific set of alternative activities to screen viewing and developing a child's ability to self-monitor their own screen viewing. Conclusions Managing screen viewing is a challenge for many parents and can often cause tension in the home. The data presented in this paper provide key suggestions of new approaches that could be incorporated into behaviour change programmes to reduce child screen viewing. PMID:26932143

The Treatment of Parasomnias with Hypnosis: a 5-Year Follow-Up Study

PubMed Central

Hauri, Peter J.; Silber, Michael H.; Boeve, Bradley F.

2007-01-01

Study Objectives: This study involves a replication and extension of a previous one reported by Hurwitz et al (1991) on the treatment of certain parasomnias with hypnosis. Methods: Thirty-six patients (17 females), mean age 32.7 years (range 6–71). Four were children aged 6 to 16. All had chronic, “functionally autonomous” (self-sustaining) parasomnias. All underwent 1 or 2 hypnotherapy sessions and were then followed by questionnaire for 5 years. Results: Of the 36 patients, 45.4% were symptom-free or at least much improved at the 1-month follow-up, 42.2% at the 18-month follow-up, and 40.5% at the 5-year follow-up. Conclusions: One or 2 sessions of hypnotherapy might be an efficient first-line therapy for patients with certain types of parasomnias. Citation: Hauri PJ; Silber MH; Boeve BF. The treatment of parasomnias with hypnosis: a 5-year follow-up study. J Clin Sleep Med 2007;3(4):369-373. PMID:17694725

Corporal punishment and child behavioral and cognitive outcomes through 5 years-of-age: Evidence from a contemporary urban birth cohort study

PubMed Central

MacKenzie, Michael J.; Nicklas, Eric; Waldfogel, Jane; Brooks-Gunn, Jeanne

2013-01-01

This study examined the prevalence and determinants of spanking of children at 3 years-of-age, and the associations between spanking and externalizing behavior and receptive verbal ability at age 5. Overall, we find maternal spanking rates of 55.2% and paternal rates of 43.2% at age 3. Mothers facing greater stress and those who spanked earlier are more likely to spank at age 3, whereas those who report a supportive partner during pregnancy and those who were not U.S. born were less likely to spank. Mothers and fathers in communities where spanking was more normative were more likely to spank. Fathers were less likely to spank daughters at age 3. Frequent maternal spanking at age 3 was associated with externalizing behavior and receptive vocabulary at age 5, controlling for an array of ecological risks, earlier behavior, and verbal capacity. Taking advantage of the large and diverse sample we explored potential interactions and found no evidence that race, parental warmth, normativeness, or child gender moderated the association between spanking and externalizing or receptive vocabulary. These findings add to the literature on negative consequences associated with a widely endorsed parenting practice, and highlight the need for research that explores alternative effective discipline practices and addresses parent questions of what else they could, or even should, be doing. PMID:24839402

Corporal punishment and child behavioral and cognitive outcomes through 5 years-of-age: Evidence from a contemporary urban birth cohort study.

PubMed

MacKenzie, Michael J; Nicklas, Eric; Waldfogel, Jane; Brooks-Gunn, Jeanne

2012-01-01

This study examined the prevalence and determinants of spanking of children at 3 years-of-age, and the associations between spanking and externalizing behavior and receptive verbal ability at age 5. Overall, we find maternal spanking rates of 55.2% and paternal rates of 43.2% at age 3. Mothers facing greater stress and those who spanked earlier are more likely to spank at age 3, whereas those who report a supportive partner during pregnancy and those who were not U.S. born were less likely to spank. Mothers and fathers in communities where spanking was more normative were more likely to spank. Fathers were less likely to spank daughters at age 3. Frequent maternal spanking at age 3 was associated with externalizing behavior and receptive vocabulary at age 5, controlling for an array of ecological risks, earlier behavior, and verbal capacity. Taking advantage of the large and diverse sample we explored potential interactions and found no evidence that race, parental warmth, normativeness, or child gender moderated the association between spanking and externalizing or receptive vocabulary. These findings add to the literature on negative consequences associated with a widely endorsed parenting practice, and highlight the need for research that explores alternative effective discipline practices and addresses parent questions of what else they could, or even should, be doing.

Malnutrition at Age 3 Years and Externalizing Behavior Problems at Ages 8, 11, and 17 Years

PubMed Central

Liu, Jianghong; Raine, Adrian; Venables, Peter H.; Mednick, Sarnoff A.

2006-01-01

Objective Poor nutrition is thought to predispose to externalizing behavior problems, but to date there appear to have been no prospective longitudinal studies testing this hypothesis. This study assessed whether 1) poor nutrition at age 3 years predisposes to antisocial behavior at ages 8, 11, and 17 years, 2) such relationships are independent of psychosocial adversity, and 3) IQ mediates the relationship between nutrition and externalizing behavior problems. Method The participants were drawn from a birth cohort (N=1,795) in whom signs of malnutrition were assessed at age 3 years, cognitive measures were assessed at ages 3 and 11 years, and antisocial, aggressive, and hyperactive behavior was assessed at ages 8, 11, and 17 years. Results In relation to comparison subjects (N=1,206), the children with malnutrition signs at age 3 years (N=353) were more aggressive or hyperactive at age 8 years, had more externalizing problems at age 11, and had greater conduct disorder and excessive motor activity at age 17. The results were independent of psychosocial adversity and were not moderated by gender. There was a dose-response relationship between degree of malnutrition and degree of externalizing behavior at ages 8 and 17. Low IQ mediated the link between malnutrition and externalizing behavior at ages 8 and 11. Conclusions These results indicate that malnutrition predisposes to neurocognitive deficits, which in turn predispose to persistent externalizing behavior problems throughout childhood and adolescence. The findings suggest that reducing early malnutrition may help reduce later antisocial and aggressive behavior. PMID:15514400

Kidney Outcomes 5 Years After Pediatric Cardiac Surgery

PubMed Central

Greenberg, Jason H.; Zappitelli, Michael; Devarajan, Prasad; Thiessen-Philbrook, Heather R.; Krawczeski, Catherine; Li, Simon; Garg, Amit X.; Coca, Steve; Parikh, Chirag R.

2017-01-01

IMPORTANCE Acute kidney injury (AKI) after pediatric cardiac surgery is associated with high short-term morbidity and mortality; however, the long-term kidney outcomes are unclear. OBJECTIVE To assess long-term kidney outcomes after pediatric cardiac surgery and to determine if perioperative AKI is associated with worse long-term kidney outcomes. DESIGN, SETTING, AND PARTICIPANTS This prospective multicenter cohort study recruited children between ages 1 month to 18 years who underwent cardiopulmonary bypass for cardiac surgery and survived hospitalization from 3 North American pediatric centers between July 2007 and December 2009. Children were followed up with telephone calls and an in-person visit at 5 years after their surgery. EXPOSURES Acute kidney injury defined as a postoperative serum creatinine rise from preoperative baseline by 50% or 0.3 mg/dL or more during hospitalization for cardiac surgery. MAIN OUTCOMES AND MEASURES Hypertension (blood pressure ≥95th percentile for height, age, sex, or self-reported hypertension), microalbuminuria (urine albumin to creatinine ratio >30 mg/g), and chronic kidney disease (serum creatinine estimated glomerular filtration rate [eGFR] <90 mL/min/1.73 m2 or microalbuminuria). RESULTS Overall, 131 children (median [interquartile range] age, 7.7 [5.9–9.9] years) participated in the 5-year in-person follow-up visit; 68 children (52%) were male. Fifty-seven of 131 children (44%) had postoperative AKI. At follow-up, 22 children (17%) had hypertension (10 times higher than the published general pediatric population prevalence), while 9 (8%), 13 (13%), and 1 (1%) had microalbuminuria, an eGFR less than 90 mL/min/1.73 m2, and an eGFR less than 60 mL/min/1.73 m2, respectively. Twenty-one children (18%) had chronic kidney disease. Only 5 children (4%) had been seen by a nephrologist during follow-up. There was no significant difference in renal outcomes between children with and without postoperative AKI. CONCLUSIONS AND

9 CFR 71.18 - Individual identification of certain cattle 2 years of age or over for movement in interstate...

Code of Federal Regulations, 2011 CFR

2011-01-01

... cattle 2 years of age or over for movement in interstate commerce. 71.18 Section 71.18 Animals and Animal... certain cattle 2 years of age or over for movement in interstate commerce. (a) No cattle 2 years of age or over, except steers and spayed heifers and cattle of any age which are being moved interstate during...

9 CFR 71.18 - Individual identification of certain cattle 2 years of age or over for movement in interstate...

Code of Federal Regulations, 2012 CFR

2012-01-01

... cattle 2 years of age or over for movement in interstate commerce. 71.18 Section 71.18 Animals and Animal... certain cattle 2 years of age or over for movement in interstate commerce. (a) No cattle 2 years of age or over, except steers and spayed heifers and cattle of any age which are being moved interstate during...

9 CFR 71.18 - Individual identification of certain cattle 2 years of age or over for movement in interstate...

Code of Federal Regulations, 2013 CFR

2013-01-01

... cattle 2 years of age or over for movement in interstate commerce. 71.18 Section 71.18 Animals and Animal... certain cattle 2 years of age or over for movement in interstate commerce. (a) No cattle 2 years of age or over, except steers and spayed heifers and cattle of any age which are being moved interstate during...

Associations between regional brain volumes at term-equivalent age and development at 2 years of age in preterm children.

PubMed

Lind, Annika; Parkkola, Riitta; Lehtonen, Liisa; Munck, Petriina; Maunu, Jonna; Lapinleimu, Helena; Haataja, Leena

2011-08-01

Altered brain volumes and associations between volumes and developmental outcomes have been reported in prematurely born children. To assess which regional brain volumes are different in very low birth weight (VLBW) children without neurodevelopmental impairments ([NDI] cerebral palsy, hearing loss, blindness and significantly delayed cognitive performance) compared with VLBW children with NDI, and to evaluate the association between regional brain volumes at term-equivalent age and cognitive development and neurological performance at a corrected age of 2 years. The study group consisted of a regional cohort of 164 VLBW children, divided into one group of children without NDI (n = 148) and one group of children with NDI (n = 16). Brain (MRI) was performed at term-equivalent age, from which brain volumes were manually analysed. Cognitive development was assessed with the Bayley Scales of Infant Development II (BSID-II), and neurological performance with the Hammersmith Infant Neurological Examination at the corrected age of 2 years. The volumes of total brain tissue, cerebrum, frontal lobes, basal ganglia and thalami, and cerebellum were significantly smaller, and the volume of the ventricles significantly larger, in the children with NDI than in those without NDI. Even in children without NDI, a smaller cerebellar volume was significantly correlated with poor neurological performance at 2 years of corrected age. Volumetric analysis at brain MRI can provide an additional parameter for early prediction of outcome in VLBW children.

Mammography in asymptomatic women aged 40-49 years

PubMed Central

Silva, Flávio Xavier; Katz, Leila; Souza, Alex Sandro Rolland; Amorim, Melania Maria Ramos

2014-01-01

OBJECTIVE To assess findings of mammography of and interventions resulting from breast cancer screening in women aged 40-49 years with no increased risk (typical risk) of breast cancer. METHODS This cross-sectional study evaluated women aged 40-49 years who underwent mammography screening in a mastology reference center in Recife, PE, Northeastern Brazil, between January 2010 and October 2011. Women with breast-related complaints, positive findings in the physical examination, or high risk of breast cancer were excluded. RESULTS The 1,000 mammograms performed were classified into the following Breast Imaging-Reporting and Data System (BI-RADS) categories BI-RADS 0, 232; BI-RADS 1, 294; BI-RADS 2, 294; BI-RADS 3, 16; BI-RADS 4A, 2; BI-RADS 5, 1. There was one case of grade II invasive ductal carcinoma and various interventions, including 469 ultrasound scans, 53 referrals to mastologists, 11 cytological examinations, and 8 biopsies. CONCLUSIONS Mammography screening in women aged 40-49 years with typical risk of breast cancer led to the performance of other interventions. However, it also resulted in increased costs without demonstrable efficacy in decreasing mortality. PMID:26039396

Maternal Thyroid Function in Early Pregnancy and Neuropsychological Performance of the Child at 5 Years of Age.

PubMed

Andersen, Stine Linding; Andersen, Stig; Liew, Zeyan; Vestergaard, Peter; Olsen, Jørn

2018-02-01

Abnormal maternal thyroid function in pregnancy may impair fetal brain development, but more evidence is needed to refine and corroborate the hypothesis. To estimate the association between maternal thyroid function in early pregnancy and neuropsychological performance of the child at 5 years of age. Follow-up study. A cohort of 1153 women and their children sampled from the Danish National Birth Cohort. Maternal thyroid-stimulating hormone (TSH) and free thyroxine (fT4) were measured in stored biobank sera from early pregnancy. Child neuropsychological test results (Wechsler Intelligence Scale/Test of Everyday Attention), test of motor function (Movement Assessment Battery), and results of parent and teacher reports (Behavior Rating Inventory of Executive Function/Strengths and Difficulties Questionnaire). Altogether 145 children (12.6%) were born to mothers with abnormal thyroid function in the early pregnancy. High maternal TSH and low fT4 were associated with lower child verbal intelligence quotient (adjusted mean difference TSH ≥ 10 mIU/L vs 0.1 to 2.49 mIU/L, -8.9 [95% confidence interval (CI), -15 to -2.4]; fT4 < 10 pmol/l vs 12.0 to 18.99 pmol/l, -13 [95% CI, -19 to -7.3]). Abnormal maternal thyroid function was also associated with adverse motor function and teacher-reported problems of executive function and behavior, and these associations were dominated by exposure to maternal hypothyroxinemia. Maternal thyroid hormone abnormalities were associated with adverse neuropsychological function of the child at 5 years of age. For intelligence, marked hypothyroidism was important, whereas for motor function and executive and behavior problems, maternal hypothyroxinemia was predominant. Copyright © 2017 Endocrine Society

Malnutrition at age 3 years and lower cognitive ability at age 11 years: independence from psychosocial adversity.

PubMed

Liu, Jianghong; Raine, Adrian; Venables, Peter H; Dalais, Cyril; Mednick, Sarnoff A

2003-06-01

Early malnutrition is linked to poor cognition, but long-term effects have not been extensively examined and psychosocial confounds have not always been controlled. To test the hypothesis that malnutrition at age 3 years will be associated with poorer cognitive ability at age 11 years independent of psychosocial confounds. A prospective, longitudinal study of a birth cohort of 1559 children originally assessed at age 3 years for malnutrition (low hemoglobin level, angular stomatitis, kwashiorkor, and sparse, thin hair) and followed up to age 11 years. A community sample of 1559 children (51.4% boys and 48.6% girls) born between September 1, 1969, and August 31, 1970, in 2 towns in the island of Mauritius, with 68.7% Indians and 25.7% Creoles (African origin). Verbal and spatial ability measured at ages 3 and 11 years and reading, scholastic ability, and neuropsychologic performance measured at age 11 years. Malnourished children had poorer cognition at both ages. Deficits were stable across time, applied to all sex and ethnic groups, and remained after controlling for multiple measures of psychosocial adversity. Children with 3 indicators of malnutrition had a 15.3-point deficit in IQ at age 11 years. Malnutrition at age 3 years is associated with poor cognition at age 11 years independent of psychosocial adversity. Promoting early childhood nutrition could enhance long-term cognitive development and school performance, especially in children with multiple nutritional deficits.

Refractive surgery for accommodative esotropia: 5-year follow-up.

PubMed

Magli, Adriano; Forte, Raimondo; Gallo, Flavio; Carelli, Roberta

2014-02-01

To assess the long-term effectiveness and safety of refractive surgery with LASIK or photorefractive keratectomy (PRK) for treating accommodative esotropia in adults. All patients with accommodative esotropia treated with LASIK or PRK until December 2007 and with a minimum follow-up of 5 years were retrospectively included. LASIK was performed on 44 eyes of 22 patients (12 women, 10 men; mean age: 22.7 ± 2.9 years). Mean postoperative follow-up was 62.1 ± 3.2 months. PRK was performed on 16 eyes of 8 patients (4 women, 4 men; mean age: 23.7 ± 1.7 years). Mean postoperative follow-up was 61.3 ± 2.8 months. At the 5-year follow-up, the mean cycloplegic refraction was more hyperopic in the PRK group (0.3 ± 0.8 vs 0.06 ± 0.3 diopters, P = .01). Correction of esotropia to esophoria or orthotropia was present in 21 patients (95.4%) treated with LASIK and in all patients treated with PRK. Both LASIK and PRK were effective in the long-term reduction of accommodative esotropia. Copyright 2014, SLACK Incorporated.

Causes of death among children aged 5-14 years in the WHO European Region: a systematic analysis for the Global Burden of Disease Study 2016.

PubMed

Kyu, Hmwe H; Stein, Claudia E; Boschi Pinto, Cynthia; Rakovac, Ivo; Weber, Martin W; Dannemann Purnat, Tina; Amuah, Joseph E; Glenn, Scott D; Cercy, Kelly; Biryukov, Stan; Gold, Audra L; Chew, Adrienne; Mooney, Meghan D; O'Rourke, Kevin F; Sligar, Amber; Murray, Christopher J L; Mokdad, Ali H; Naghavi, Mohsen

2018-05-01

The mortality burden in children aged 5-14 years in the WHO European Region has not been comprehensively studied. We assessed the distribution and trends of the main causes of death among children aged 5-9 years and 10-14 years from 1990 to 2016, for 51 countries in the WHO European Region. We used data from vital registration systems, cancer registries, and police records from 1980 to 2016 to estimate cause-specific mortality using the Cause of Death Ensemble model. For children aged 5-9 years, all-cause mortality rates (per 100 000 population) were estimated to be 46·3 (95% uncertainty interval [UI] 45·1-47·5) in 1990 and 19·5 (18·1-20·9) in 2016, reflecting a 58·0% (54·7-61·1) decline. For children aged 10-14 years, all-cause mortality rates (per 100 000 population) were 37·9 (37·3-38·6) in 1990 and 20·1 (18·8-21·3) in 2016, reflecting a 47·1% (43·8-50·4) decline. In 2016, we estimated 10 740 deaths (95% UI 9970-11 542) in children aged 5-9 years and 10 279 deaths (9652-10 897) in those aged 10-14 years in the WHO European Region. Injuries (road injuries, drowning, and other injuries) caused 4163 deaths (3820-4540; 38·7% of total deaths) in children aged 5-9 years and 4468 deaths (4162-4812; 43·5% of total) in those aged 10-14 years in 2016. Neoplasms caused 2161 deaths (1872-2406; 20·1% of total deaths) in children aged 5-9 years and 1943 deaths (1749-2101; 18·9% of total deaths) in those aged 10-14 years in 2016. Notable differences existed in cause-specific mortality rates between the European subregions, from a two-times difference for leukaemia to a 20-times difference for lower respiratory infections between the Commonwealth of Independent States (CIS) and EU15 (the 15 member states that had joined the European Union before May, 2004). Marked progress has been made in reducing the mortality burden in children aged 5-14 years over the past 26 years in the WHO European Region. More deaths could be prevented, especially in

Midlife muscle strength and human longevity up to age 100 years: a 44-year prospective study among a decedent cohort.

PubMed

Rantanen, Taina; Masaki, Kamal; He, Qimei; Ross, G Webster; Willcox, Bradley J; White, Lon

2012-06-01

We studied prospectively the midlife handgrip strength, living habits, and parents' longevity as predictors of length of life up to becoming a centenarian. The participants were 2,239 men from the Honolulu Heart Program/Honolulu-Asia Aging Study who were born before the end of June 1909 and who took part in baseline physical assessment in 1965-1968, when they were 56-68 years old. Deaths were followed until the end of June 2009 for 44 years with complete ascertainment. Longevity was categorized as centenarian (≥100 years, n = 47), nonagenarian (90-99 years, n = 545), octogenarian (80-89 years, n = 847), and ≤79 years (n = 801, reference). The average survival after baseline was 20.8 years (SD = 9.62). Compared with people who died at the age of ≤79 years, centenarians belonged 2.5 times (odds ratio (OR) = 2.52, 95% confidence interval (CI) = 1.23-5.10) more often to the highest third of grip strength in midlife, were never smokers (OR = 5.75 95% CI = 3.06-10.80), had participated in physical activity outside work (OR = 1.13 per daily hour, 95% CI = 1.02-1.25), and had a long-lived mother (≥80 vs. ≤60 years, OR = 2.3, 95% CI = 1.06-5.01). Associations for nonagenarians and octogenarians were parallel, but weaker. Multivariate modeling showed that mother's longevity and offspring's grip strength operated through the same or overlapping pathway to longevity. High midlife grip strength and long-lived mother may indicate resilience to aging, which, combined with healthy lifestyle, increases the probability of extreme longevity.

Stereotactic radiosurgery for brain metastases: a case-matched study comparing treatment results for patients 80 years of age or older versus patients 65-79 years of age.

PubMed

Watanabe, Shinya; Yamamoto, Masaaki; Sato, Yasunori; Kawabe, Takuya; Higuchi, Yoshinori; Kasuya, Hidetoshi; Yamamoto, Tetsuya; Matsumura, Akira; Barfod, Bierta E

2014-11-01

Recently, an increasing number of patients with brain metastases, even patients over 80 years of age, have been treated with stereotactic radiosurgery (SRS). However, there is little information on SRS treatment results for patients with brain metastases 80 years of age and older. The authors undertook this study to reappraise whether SRS treatment results for patients 80 years of age or older differ from those of patients who are 65-79 years old. This was an institutional review board-approved, retrospective cohort study. Among 2552 consecutive brain metastasis patients who underwent SRS during the 1998-2011 period, we studied 165 who were 80 years of age or older (Group A) and 1181 who were age 65-79 years old (Group B). Because of the remarkable disproportion in patient numbers between the 2 groups and considerable differences in pre-SRS clinical factors, the authors conducted a case-matched study using the propensity score matching method. Ultimately, 330 patients (165 from each group, A and B) were selected. For time-to-event outcomes, the Kaplan-Meier method was used to estimate overall survival and competing risk analysis was used to estimate other study end points, as appropriate. Although the case-matched study showed that post-SRS median survival time (MST, months) was shorter in Group A patients (5.3 months, 95% CI 3.9-7.0 months) than in Group B patients (6.9 months, 95% CI 5.0-8.1 months), this difference was not statistically significant (HR 1.147, 95% CI 0.921-1.429, p = 0.22). Incidences of neurological death and deterioration were slightly lower in Group A than in Group B patients (6.3% vs 11.8% and 8.5% vs 13.9%), but these differences did not reach statistical significance (p = 0.11 and p = 0.16). Furthermore, competing risk analyses showed that the 2 groups did not differ significantly in cumulative incidence of local recurrence (HR 0.830, 95% CI 0.268-2.573, p = 0.75), rates of repeat SRS (HR 0.738, 95% CI 0.438-1.242, p = 0.25), or incidence

Deterioration of Speech Recognition Ability Over a Period of 5 Years in Adults Ages 18 to 70 Years: Results of the Dutch Online Speech-in-Noise Test.

PubMed

Stam, Mariska; Smits, Cas; Twisk, Jos W R; Lemke, Ulrike; Festen, Joost M; Kramer, Sophia E

2015-01-01

The first aim of the present study was to determine the change in speech recognition in noise over a period of 5 years in participants ages 18 to 70 years at baseline. The second aim was to investigate whether age, gender, educational level, the level of initial speech recognition in noise, and reported chronic conditions were associated with a change in speech recognition in noise. The baseline and 5-year follow-up data of 427 participants with and without hearing impairment participating in the National Longitudinal Study on Hearing (NL-SH) were analyzed. The ability to recognize speech in noise was measured twice with the online National Hearing Test, a digit-triplet speech-in-noise test. Speech-reception-threshold in noise (SRTn) scores were calculated, corresponding to 50% speech intelligibility. Unaided SRTn scores obtained with the same transducer (headphones or loudspeakers) at both test moments were included. Changes in SRTn were calculated as a raw shift (T1 - T0) and an adjusted shift for regression towards the mean. Paired t tests and multivariable linear regression analyses were applied. The mean increase (i.e., deterioration) in SRTn was 0.38-dB signal-to-noise ratio (SNR) over 5 years (p < 0.001). Results of the multivariable regression analyses showed that the age group of 50 to 59 years had a significantly larger deterioration in SRTn compared with the age group of 18 to 39 years (raw shift: beta: 0.64-dB SNR; 95% confidence interval: 0.07-1.22; p = 0.028, adjusted for initial speech recognition level - adjusted shift: beta: 0.82-dB SNR; 95% confidence interval: 0.27-1.34; p = 0.004). Gender, educational level, and the number of chronic conditions were not associated with a change in SRTn over time. No significant differences in increase of SRTn were found between the initial levels of speech recognition (i.e., good, insufficient, or poor) when taking into account the phenomenon regression towards the mean. The study results indicate that hearing

A spin-down clock for cool stars from observations of a 2.5-billion-year-old cluster.

PubMed

Meibom, Søren; Barnes, Sydney A; Platais, Imants; Gilliland, Ronald L; Latham, David W; Mathieu, Robert D

2015-01-29

The ages of the most common stars--low-mass (cool) stars like the Sun, and smaller--are difficult to derive because traditional dating methods use stellar properties that either change little as the stars age or are hard to measure. The rotation rates of all cool stars decrease substantially with time as the stars steadily lose their angular momenta. If properly calibrated, rotation therefore can act as a reliable determinant of their ages based on the method of gyrochronology. To calibrate gyrochronology, the relationship between rotation period and age must be determined for cool stars of different masses, which is best accomplished with rotation period measurements for stars in clusters with well-known ages. Hitherto, such measurements have been possible only in clusters with ages of less than about one billion years, and gyrochronology ages for older stars have been inferred from model predictions. Here we report rotation period measurements for 30 cool stars in the 2.5-billion-year-old cluster NGC 6819. The periods reveal a well-defined relationship between rotation period and stellar mass at the cluster age, suggesting that ages with a precision of order 10 per cent can be derived for large numbers of cool Galactic field stars.

Pulmonary hypertension in sickle cell disease children under 10 years of age.

PubMed

Colombatti, Raffaella; Maschietto, Nicola; Varotto, Elena; Grison, Alessandra; Grazzina, Nicoletta; Meneghello, Linda; Teso, Simone; Carli, Modesto; Milanesi, Ornella; Sainati, Laura

2010-09-01

Despite the finding of elevated Tricuspid Regurgitant Velocity (TRV) in children below 5 years of age, the prevalence and evolution of Pulmonary Hypertension (PH) in young children with sickle cell disease (SCD) are unclear. In order to identify predictive factors of precocious PH development, SCD children > or =3 years old, at steady state, underwent annual echocardiography and Tissue Doppler Imaging (TDI). Patients receiving chronic transfusion were excluded. Thirty-seven of seventy-five patients were > or =3 years, with measurable TRV. In our young population (mean age 6.2 years) of mainly African, HbS/HbS patients, 8/37 (21.6%) had TRV > or =2.5 m/s, 8% being only 3 years old. Significant correlation was found between precocious TRV elevation and high platelet and reticulocyte counts and frequent acute chest syndromes (ACS). In multivariate analysis, ACS was the only variable predicting TRV > or =2.5 m/s. TDI of the 37 patients showed signs of diastolic dysfunction of the left ventricle. At follow-up all eight patients with high TRV displayed further increase and seven more developed TRV > or =2.5 m/s. PH seems to begin in children earlier than expected. Factors involved in its early onset might be different from the ones causing its development in older children or adults. African children might benefit from early screening and re-assessment once a year.

Complications and 2-year valve survival following Ahmed valve implantation during the first 2 years of life.

PubMed

Almobarak, F; Al-Mobarak, F; Khan, A O

2009-06-01

To report complications and 2-year valve survival following Ahmed valve implantation during the first 2 years of life. Retrospective institutional case series. Forty-two eyes of 36 patients with Ahmed valve implantation (without prior drainage device surgery) during the first 2 years of life and 2 years' postsurgical follow-up were identified. Most eyes had primary congenital glaucoma (28/42, 66.7%), aphakic glaucoma (5/42, 11.9%) or Peters anomaly (5/42, 11.9%). All but three eyes had prior ocular surgery. Surgery was at a mean age of 11.83 months (m) (SD 5.63). The most common significant postoperative complications were tube malpositioning requiring intervention (11/42, 26.2%), endophthalmitis (3/42, 7.1%; one with tube exposure) and retinal detachment (3/42, 7.1%). Thirty-six eyes (85.8%) required resumption of antiglaucoma medications to maintain intraocular pressure (IOP) < or =22 mm Hg a mean of 7.2 m (SD 6.8) postoperatively. Cumulative probabilities of valve survival (IOP< or =22 mm Hg with or without medication) by Kaplan-Meier analysis were 73.8% and 63.3% at 12 months and 24 months, respectively. Postoperative tube malpositioning that required surgical revision was common in this age group. Infectious endophthalmitis and retinal detachment are known potential complications following any incisional surgery for advanced buphthalmos; however, tube exposure is a unique potential problem following aqueous shunt implantation that can lead to intraocular infection. Cumulative valve survival 2 years following implantation was 63.3%.

Etiology and Factors Associated with Pneumonia in Children under 5 Years of Age in Mali: A Prospective Case-Control Study

PubMed Central

Messaoudi, Mélina; Sánchez Picot, Valentina; Telles, Jean-Noël; Diakite, Abdoul-Aziz; Komurian-Pradel, Florence; Endtz, Hubert; Diallo, Souleymane; Paranhos-Baccalà, Gláucia; Vanhems, Philippe

2015-01-01

Background There are very limited data on children with pneumonia in Mali. The objective was to assess the etiology and factors associated with community-acquired pneumonia in hospitalized children <5 years of age in Mali. Methods A prospective hospital-based case-control study was implemented in the Pediatric department of Gabriel Touré University Hospital at Bamako, Mali, between July 2011-December 2012. Cases were children with radiologically-confirmed pneumonia; Controls were hospitalized children without respiratory features, matched for age and period. Respiratory specimens, were collected to identify 19 viruses and 5 bacteria. Whole blood was collected from cases only. Factors associated with pneumonia were assessed by multivariate logistic regression. Results Overall, 118 cases and 98 controls were analyzed; 44.1% were female, median age was 11 months. Among pneumonia cases, 30.5% were hypoxemic at admission, mortality was 4.2%. Pneumonia cases differed from the controls regarding clinical signs and symptoms but not in terms of past medical history. Multivariate analysis of nasal swab findings disclosed that S. pneumoniae (adjusted odds ratio [aOR] = 3.4, 95% confidence interval [95% CI]: 1.6–7.0), human metapneumovirus (aOR = 17.2, 95% CI: 2.0–151.4), respiratory syncytial virus [RSV] (aOR = 7.4, 95% CI: 2.3–23.3), and influenza A virus (aOR = 10.7, 95% CI: 1.0–112.2) were associated with pneumonia, independently of patient age, gender, period, and other pathogens. Distribution of S. pneumoniae and RSV differed by season with higher rates of S. pneumoniae in January-June and of RSV in July-September. Pneumococcal serotypes 1 and 5 were more frequent in pneumonia cases than in the controls (P = 0.009, and P = 0.04, respectively). Conclusions In this non-PCV population from Mali, pneumonia in children was mainly attributed to S. pneumoniae, RSV, human metapneumovirus, and influenza A virus. Increased pneumococcal conjugate vaccine coverage in

Dental erosion among South Brazilian adolescents: A 2.5-year longitudinal study.

PubMed

Brusius, C D; Alves, L S; Susin, C; Maltz, M

2018-02-01

This population-based longitudinal study investigated the incidence, progression and risk factors for dental erosion among South Brazilian adolescents. Eight hundred and one schoolchildren attending 42 public and private schools were clinically examined at 12 years of age; clinical examinations were repeated after 2.5 years (SD=0.3). After tooth cleaning and drying, permanent incisors and first molars were classified using the Basic Erosive Wear Examination (BEWE) scoring criteria. Questionnaires were used to collect data on socio-demographic characteristics, dietary habits, toothbrushing frequency and general health. Poisson regression analysis was used to assess the association between dental erosion incidence and explanatory variables, with adjusted incidence risk ratios (IRR) and 95% CI estimated. Among those who did not have dental erosion at baseline, 49 of 680 schoolchildren (7.1%; 95% CI=5.2-9.1) developed erosive lesions over the follow-up period. Among schoolchildren who had dental erosion at baseline, 31 of 121 (25.4%; 95% CI=17.6-33.3) had new or more severe lesions. Boys were more likely to develop dental erosion than girls (IRR=1.88; 95% CI=1.06-3.32). A moderate incidence of dental erosion was observed among South Brazilian adolescents, with boys being at higher risk. The high progression rate of 25% observed here is very concerning, and it should be taken in consideration when designing preventive strategies for dental erosion. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Metabolic health of young adults who were born small for gestational age and treated with growth hormone, after cessation of growth hormone treatment: a 5-year longitudinal study.

PubMed

van der Steen, Manouk; Smeets, Carolina C J; Kerkhof, Gerthe F; Hokken-Koelega, Anita C S

2017-02-01

Growth hormone treatment reduces fat mass and insulin sensitivity and increases lean body mass. Data are only available for short-term longitudinal changes after cessation of growth hormone treatment in young adults born small for gestational age. We aimed to assess long-term changes over a 5-year period following cessation of growth hormone treatment. We did a longitudinal study of young adults born small for gestational age and previously treated with growth hormone. Individuals were followed up for 5 years after attainment of adult height, when growth hormone treatment was discontinued: assessments were done at cessation of growth hormone treatment and at 6 months, 2 years, and 5 years thereafter. Data 5 years after cessation of growth hormone were compared with untreated age-matched controls. We used dual-energy x-ray absorptiometry to assess body composition, and did frequently sampled intravenous glucose tolerance tests to assess insulin sensitivity, acute insulin response, and the disposition index (a measure of β-cell function). This study is registered with ISRCTN, numbers ISRCTN96883876 and ISRCTN65230311. Between April, 2004, and April, 2016, we followed up 199 young adults born small for gestational age and previously treated with growth hormone, during the 5 years after cessation of growth hormone treatment. Data at 5 years for these individuals were compared with those for 51 untreated adults born small for gestational age with short stature, 92 untreated adults born small for gestational age with spontaneous catch-up growth, and 142 adults born appropriate for gestational age and unexposed to growth hormone treatment. In young adults born small for gestational age and previously treated with growth hormone, 5 years after cessation of growth hormone treatment, there were increases in fat mass (estimated marginal mean 10·73 kg [95% CI 9·95-11·50] at cessation of treatment vs 16·12 kg [14·77-17·46] at 5 years; p<0·0001), trunk fat (5·34 kg [4�

Effect of chlorhexidine pretreatment on bond strength durability of caries-affected dentin over 2-year aging in artificial saliva and under simulated intrapulpal pressure.

PubMed

Mobarak, E H

2011-01-01

To evaluate the influence of 2% and 5% chlorhexidine (CHX) pretreatment on bond durability of a self-etching adhesive to normal (ND) and caries-affected (AD) dentin after 2-years of aging in artificial saliva and under simulated intrapulpal pressure (IPP). One hundred twenty freshly extracted carious teeth were ground to expose ND and AD. Specimens were distributed into three equal groups (n=40) according to whether the dentin substrates were pretreated with 2% or 5% CHX or with water (control). Clearfil SE Bond (Kuraray) was applied to both substrates and composite cylinders (0.9 mm diameter and 0.7 mm height) were formed. Pretreatment and bonding were done while the specimens were subjected to 15 mm Hg IPP. After curing, specimens were aged in artificial saliva at 37°C and under IPP at 20 mm Hg until being tested after 24 hours or 2 years (n=20/group). Microshear bond strength was evaluated. Failure modes were determined using a scanning electron microscope (SEM) at 400× magnification. Data were statistically analyzed using three-way analysis of variance (ANOVA); one-way ANOVA tests, and t-test (p<0.05). Additional specimens (n=5/group) were prepared to evaluate interfacial silver precipitation. For the 24-hour groups, there were no significant differences among the ND groups and AD groups. For ND aged specimens, the 5% CHX group had the highest value followed by the 2% CHX and control groups, although the difference was statistically insignificant. For AD aged specimens, the 5% CHX group revealed statistically higher bond values compared to the 2% CHX and control groups. Fracture modes were predominately adhesive and mixed. Different interfacial silver depositions were recorded. Two percent or 5% CHX pretreatment has no adverse effect on the 24-hour bonding to ND and AD. Five percent CHX was able to diminish the loss in bonding to AD after 2years of aging in artificial saliva and under simulated IPP.

Cardiac Mortality Among 200 000 Five-Year Survivors of Cancer Diagnosed at 15 to 39 Years of Age

PubMed Central

Henson, Katherine E.; Reulen, Raoul C.; Winter, David L.; Bright, Chloe J.; Fidler, Miranda M.; Frobisher, Clare; Guha, Joyeeta; Wong, Kwok F.; Kelly, Julie; Edgar, Angela B.; McCabe, Martin G.; Whelan, Jeremy; Cutter, David J.; Darby, Sarah C.

2016-01-01

Background: Survivors of teenage and young adult cancer are acknowledged as understudied. Little is known about their long-term adverse health risks, particularly of cardiac disease that is increased in other cancer populations where cardiotoxic treatments have been used. Methods: The Teenage and Young Adult Cancer Survivor Study cohort comprises 200 945 5-year survivors of cancer diagnosed at 15 to 39 years of age in England and Wales from 1971 to 2006, and followed to 2014. Standardized mortality ratios, absolute excess risks, and cumulative risks were calculated. Results: Two thousand sixteen survivors died of cardiac disease. For all cancers combined, the standardized mortality ratios for all cardiac diseases combined was greatest for individuals diagnosed at 15 to 19 years of age (4.2; 95% confidence interval, 3.4–5.2) decreasing to 1.2 (95% confidence interval, 1.1–1.3) for individuals aged 35 to 39 years (2P for trend <0.0001). Similar patterns were observed for both standardized mortality ratios and absolute excess risks for ischemic heart disease, valvular heart disease, and cardiomyopathy. Survivors of Hodgkin lymphoma, acute myeloid leukaemia, genitourinary cancers other than bladder cancer, non-Hodgkin lymphoma, lung cancer, leukaemia other than acute myeloid, central nervous system tumour, cervical cancer, and breast cancer experienced 3.8, 2.7, 2.0, 1.7, 1.7, 1.6, 1.4, 1.3 and 1.2 times the number of cardiac deaths expected from the general population, respectively. Among survivors of Hodgkin lymphoma aged over 60 years, almost 30% of the total excess number of deaths observed were due to heart disease. Conclusions: This study of over 200 000 cancer survivors shows that age at cancer diagnosis was critical in determining subsequent cardiac mortality risk. For the first time, risk estimates of cardiac death after each cancer diagnosed between the ages of 15 and 39 years have been derived from a large population-based cohort with prolonged

Psychiatric disorders in Danish children aged 5-7 years: A general population study of prevalence and risk factors from the Copenhagen Child Cohort (CCC 2000).

PubMed

Elberling, Hanne; Linneberg, Allan; Rask, Charlotte Ulrikka; Houman, Tine; Goodman, Robert; Mette Skovgaard, Anne

2016-01-01

Knowledge about the presentation of psychopathology in preschool age and associated risk factors is fundamental to preventive intervention before schooling. To investigate the full spectrum of psychiatric diagnoses in general population children at the period of transition from preschool to school. A sample of 1585 children from the Copenhagen Child Cohort, CCC2000 aged 5-7 years was assessed using the Development and Well-Being Assessment (DAWBA) with diagnostic classification by experienced clinicians. Perinatal, sociodemographic and socio-economic data was obtained from Danish national registries. The prevalence of any ICD-10 psychiatric disorder was 5.7% (95%CI: 4.4-7.1). Pervasive developmental disorders (PDD) were found in 1.3% (95%CI: 0.8-1.8) and behavioural and hyperkinetic disorders were found in 1.5% (95%CI: 0.9-2.1) and 1.0% (95%CI: 0.4-1.6), respectively. Emotional disorders were found in 2.9% (95%CI: 1.9-40). More boys were diagnosed with PDD, behavioural disorders and tics. No gender differences were found in hyperactivity disorders (HD) and emotional disorders. Co-morbidity was frequent, in particular between HD and PDD, but also between HD and emotional disorder and behavioural disorder. Teenage mothers, single parents and low household income the first two years after the child's birth were associated with a three-to fourfold increased risk of psychiatric disorder in the child at age 5-7 years. The study results point to two "windows of opportunity" for prevention. In the earliest postnatal years, prevention should target families at socio-economic risk; and in the years before schooling, intervention should focus on children with symptoms of PDD, HD, and behavioural disorders.

Choline intake during pregnancy and child cognition at age 7 years.

PubMed

Boeke, Caroline E; Gillman, Matthew W; Hughes, Michael D; Rifas-Shiman, Sheryl L; Villamor, Eduardo; Oken, Emily

2013-06-15

Animal models indicate that exposure to choline in utero improves visual memory through cholinergic transmission and/or epigenetic mechanisms. Among 895 mothers in Project Viva (eastern Massachusetts, 1999-2002 to 2008-2011), we estimated the associations between intakes of choline, vitamin B12, betaine, and folate during the first and second trimesters of pregnancy and offspring visual memory (measured by the Wide Range Assessment of Memory and Learning, Second Edition (WRAML2), Design and Picture Memory subtests) and intelligence (measured using the Kaufman Brief Intelligence Test, Second Edition (KBIT-2)) at age 7 years. Mean second-trimester intakes were 328 (standard deviation (SD), 63) mg/day for choline, 10.5 (SD, 5.1) µg/day for vitamin B12, 240 (SD, 104) mg/day for betaine, and 1,268 (SD, 381) µg/day for folate. Mean age 7 test scores were 17.2 (SD, 4.4) points on the WRAML 2 Design and Picture Memory subtests, 114.3 (SD, 13.9) points on the verbal KBIT-2, and 107.8 (SD, 16.5) points on the nonverbal KBIT-2. In a model adjusting for maternal characteristics, the other nutrients, and child's age and sex, the top quartile of second-trimester choline intake was associated with a child WRAML2 score 1.4 points higher (95% confidence interval: 0.5, 2.4) than the bottom quartile (P-trend = 0.003). Results for first-trimester intake were in the same direction but weaker. Intake of the other nutrients was not associated with the cognitive tests administered. Higher gestational choline intake was associated with modestly better child visual memory at age 7 years.

Choline Intake During Pregnancy and Child Cognition at Age 7 Years

PubMed Central

Boeke, Caroline E.; Gillman, Matthew W.; Hughes, Michael D.; Rifas-Shiman, Sheryl L.; Villamor, Eduardo; Oken, Emily

2013-01-01

Animal models indicate that exposure to choline in utero improves visual memory through cholinergic transmission and/or epigenetic mechanisms. Among 895 mothers in Project Viva (eastern Massachusetts, 1999–2002 to 2008–2011), we estimated the associations between intakes of choline, vitamin B12, betaine, and folate during the first and second trimesters of pregnancy and offspring visual memory (measured by the Wide Range Assessment of Memory and Learning, Second Edition (WRAML2), Design and Picture Memory subtests) and intelligence (measured using the Kaufman Brief Intelligence Test, Second Edition (KBIT-2)) at age 7 years. Mean second-trimester intakes were 328 (standard deviation (SD), 63) mg/day for choline, 10.5 (SD, 5.1) µg/day for vitamin B12, 240 (SD, 104) mg/day for betaine, and 1,268 (SD, 381) µg/day for folate. Mean age 7 test scores were 17.2 (SD, 4.4) points on the WRAML 2 Design and Picture Memory subtests, 114.3 (SD, 13.9) points on the verbal KBIT-2, and 107.8 (SD, 16.5) points on the nonverbal KBIT-2. In a model adjusting for maternal characteristics, the other nutrients, and child's age and sex, the top quartile of second-trimester choline intake was associated with a child WRAML2 score 1.4 points higher (95% confidence interval: 0.5, 2.4) than the bottom quartile (P-trend = 0.003). Results for first-trimester intake were in the same direction but weaker. Intake of the other nutrients was not associated with the cognitive tests administered. Higher gestational choline intake was associated with modestly better child visual memory at age 7 years. PMID:23425631

Prevalence and factors associated with stunting and excess weight in children aged 0-5 years from the Brazilian semi-arid region.

PubMed

Ramos, Clariana V; Dumith, Samuel C; César, Juraci A

2015-01-01

To analyze the prevalence of excess weight and low height, and identify associated factors among children younger than five years. Cross-census study. A total of 1,640 children from two municipalities in Piauí, Brazil were included. The prevalence of low height was 10.9% (95% CI: 9.3 to 12.4), inversely associated with mother's younger age and low level of education, lower socioeconomic status, mothers who had fewer than six prenatal consultations, and households that had more than one child younger than 5 years. Excess weight prevalence was 19.1% (95% CI: 17.2 to 21.0), and remained inversely associated with lower maternal age, low maternal education, and cesarean delivery. Stunting was greater in children aged between 12 and 23 months, while excess weight decreased with age. It is noteworthy that the stunting rate, although decreasing, is still high, while the prevalence of excess weight, even in this very poor area, already exceeds the expected percentage for a population with better socioeconomic level. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Sustained impact of rotavirus vaccine introduction on rotavirus gastroenteritis hospitalizations in children <5 years of age, Ghana, 2009-2016.

PubMed

Enweronu-Laryea, Christabel C; Armah, George; Sagoe, Kwamena W; Ansong, Daniel; Addo-Yobo, Emmanuel; Diamenu, Stanley K; Mwenda, Jason M; Parashar, Umesh D; Tate, Jacqueline E