Biomedical subjects

J Karlberg

Publications and source records attributed to J Karlberg.

136 records · Page 8Linked to original sources

PubMed1981

Infants with low rate of weight gain. I. A study of organic factors and growth patterns.

To evaluate the clinical significance of low rate of weight gain 81 infants wer investigated with a deviation of weight corresponding to a decrease of at least one S.D.-score of weight attained in the current Swedish growth chart. In 28 patients this decrease was of organic origin, notably intestinal disease. Three different growth variables were compared: attained weight (transformed to S.D.-score), change in S.D.-score of attained weight per time unit (= rate of change of deviation in S.D.-score/year) and rate of weight gain in kg/year (transformed to S.D.-score). Twenty-two of 28 infants with organic diseases had a subnormal rate of weight gain whereas only 12 attained subnormal weight for age. The use of rate of weight gain is the most sensitive growth variable and is far better than the use of attained weight as an indicator of ill-health. Change in S.D.-score of attained weight for screening purposes give good agreement with rate of weight gain, provided that age is taken into account.

Body Weight↗

PubMed1976

I. physical growth from birth to 16 years and longitudinal outcome of the study during the same age period.

Physical growth of 212 randomly selected Swedish urban children has been investigated from birth to sixteen years as part of a prospective longitudinal study of growth and development. Twenty body measurements have been taken at specified ages. In all, about 66,000 values of measurement have been recorded. At sixteen years 179 (84.4%) ofthe original children were still regularly being followed. Thirty-three (15.6%) of the 212 children left the study at various ages. A comparison between the children who left the study and those remaining did not show any significant differences in physical growth. All recorded data have been scrutinized in order to detect errors of measurement or administrative errors. Such values have been corrected or excluded. The editorial procedures also included the adjustment of each measurement to exact target age, interpolation of missing examinations and exclusion of children with an aberrant growth pattern. When comparing the present study with older Swedish investigations a secular trend was established, while there was good agreement with other contemporary Swedish investigations. Growth charts of distance values of various body measurements are presented. In the charts standard deviation lines (+/- 1, 2, 3 SD) and mean values are plotted. A logarithmic time scale (logarithmic conceptional age) has been used for both practical and theoretical reasons. When evaluating individual values in comparison with reference values standard deviations should be used rather than centiles. With this approach even grossly deviating values can be evaluated. Longitudinal follow-up of individual children and comparison of children of different ages will also be facilitated by this approach.

Adolescent↗

PubMedDate not supplied

Distribution of symptomatic congenital heart disease in Hong Kong.

Racial group studies have identified differences in the occurrence of congenital heart disease (CHD) among ethnic populations. The aim of this study was to characterize the proportionate frequency and clinical profile of children with symptomatic cardiac abnormalities in Hong Kong. The hospital records of 666, mainly Southern Chinese children with symptomatic CHD, who were 4 years of age or younger and who were admitted to Grantham Hospital, Hong Kong, in 1994 and 1995 were analyzed retrospectively. Left-to-right shunting (45.0%) and pulmonary outflow obstruction (34.4%) were the most frequently diagnosed categories, followed by left ventricular outflow obstruction (8.3%), transposition of the great arteries (4.2%), conditions with intracardiac mixing (3.9%), and other cardiac lesions (4.2%). Compared with Western studies, pulmonary outflow obstruction (p<0.0001), particularly tetralogy of Fallot and critical pulmonary stenosis, were more frequent in Chinese children. In contrast with previous reports, coarctation of the aorta (5%) does not seem to be uncommon in Chinese patients. Conversely, aortic stenosis and hypoplastic left ventricle may be rare in these children (1% vs 3% and 3-7%). Other cardiac lesions showed no consistent racial difference in the frequency of occurrence. Chinese patients with Down's syndrome had ventricular septal defect (38%) as the predominant lesion followed by atrioventricular septal defect (25%). Western studies usually report a reverse pattern for these two lesions. The mortality rate for the total cohort was 7.5%. However, of those with conditions with intracardiac mixing and left ventricular outflow tract obstruction many did not survive childhood (20% and 21%, respectively).

Analysis of Variance↗

PubMedDate not supplied

Gaucher disease (type III): intellectual profile.

In 20 patients with Gaucher disease type III (Norrbottnian variant), long-term intellectual prognoses were analyzed on the basis of psychometric tests which were performed on an average of five tests per patient. Intellectual delay was not found to be characteristic of the early stages of the disease. Slow regression occurred through childhood and adolescence. Patients splenectomized at an early stage averaged lower IQ scores in the long-term than those in whom the spleen had been spared as long as possible. These data added to other evidence of increased neurologic and other organ impairment after splenectomy, support the view that the spleen should not be removed in other than emergent situations.

Adolescent↗

PubMedDate not supplied

Standard deviation score charts of skeletal maturity and its velocity in Swedish children assessed by the Tanner-Whitehouse method (TW2-20).

Reference values, means and standard deviations for skeletal maturity of Swedish children, evaluated in terms of the Tanner-Whitehouse method (TW2-20), have been expressed in mathematical functions. Almost 4000 radiograms have been assessed. The radiograms were taken on 212 children aged between one month and 18 years as part of a longitudinal study of growth and development. Up to the age of 10 years, the Swedish children had a more advanced skeletal maturation (about 0.5 SD) than the British children. Means and standard deviations have been used in preference to medians and centiles, since this makes it possible to use the results in the assessment of children with grossly deviating maturation. The selected functions were chosen in order to give a good description of the empirical distributions and no biological implications of the estimated parameters were sought. This method improves the assessment of skeletal maturity in several respects; reference values are given parametrically, which facilitates the computing of the individual standard deviation scores, and reference charts are presented for both attained scores and velocity scores (for boys between one and 13 years and for girls between one and 11 years).

Adolescent↗

PubMedDate not supplied

An update of the Swedish reference standards for weight, length and head circumference at birth for given gestational age (1977-1981).

An update of the Swedish reference standards for weight, length, and head circumference at birth, for each week of gestational age, is presented. It is based on the total Swedish cohorts of infants born 1977-1981 (n = 475,588). A "healthy population" (79%) was extracted, using prospectively collected data. Weekly (28-42 weeks) grouped data for length and head circumference were well approximated by the normal distribution, but the distributions for birthweight were positively skewed. The original skewed distributions for birthweight were transformed, using the square root, resulting in distributions close to the Gaussian. For smoothing purposes, the weakly values for the mean and the standard deviation were both fitted by a third degree polynomial function. These functions also make possible the calculation of the continuous variable, standard deviation score, for individual newborn infants as well as a comparison of distributions between groups of infants. The reference values and charts presented here have two major advantages over the current Swedish ones: the sample size used is now sufficiently large at the lower gestational ages, so that empirically found variations can be used, and the skewness of the birth weight distribution has been taken into account. The use of the reference standards presented here improves and facilitates evaluation of size deviation at birth.

Birth Weight↗

PubMedDate not supplied

Immobilization related to early linear growth.

This study shows that children with late-diagnosed congenital dislocation of the hip (CDH) have close to normal height development during the initial 6.0 years of life. The treatment consisted of immobilization for 0.5 to 1.3 years starting between 0.2 and 0.7 years of age. The present work addresses one specific issue that is related to the age at onset of the childhood component of the ICP growth model. The onset normally appears between 0.5 and 1.0 year of age, and is recognized as an increase in length/height velocity. The onset is thus found during a period of increasing motor activity. The normal successive change from sitting to walking position may have some influence on the onset of this tempo change in early linear growth. The present documentation implies that there is no such influence. In all 14 children with CDH, the onset manifested during the period of immobilization, and the average age at onset was found to be virtually equivalent with that of the controls. Our conclusion is that immobilization has no significant influence on the age at onset of the childhood phase of growth. The onset is accomplished independent of body position, be it lying down or normal for the age.

Age Factors↗

PubMedDate not supplied

A partial transient effect of short-term growth hormone (GH) treatment in short non-GH deficient prepubertal children.

This study reports the growth of 11 short non-GH deficient children before, during short-term GH therapy for 1 year and for 2 years after the cessation of treatment. The mean growth velocity increased significantly (p < 0.0001) from the pretreatment mean of 4.6 (SD = 0.95) cm/year to 8.4 (SD = 1.1) cm/year after 1 year of GH treatment without accelerated advancement of skeletal maturation. The serum IGF-1 levels also increased significantly with treatment. In nine children who remained prepubertal followed for one year after GH treatment, the mean growth velocity increased from 4.5 (SD = 0.69) cm/year before treatment to 8.7 (SD = 1.28) cm/year after 1 year of GH treatment (p < 0.0001). After stopping GH treatment, the growth velocity decreased significantly (p < 0.001) to 2.4 (SD = 0.68) cm/year during the first year of follow-up. In the six prepubertal children followed up for 2 years after treatment, the mean growth velocity was 4.1 (SD = 1.04) cm/year which was not significantly different from the pretreatment growth velocity. The significant decrease in growth velocity during the first post-treatment year could not be explained by the usual fall of growth velocity with increasing age in prepubertal children. Our results indicate that the effect of one year of GH treatment on height gain is partly transient and cast doubt on the efficacy of short-term GH therapy in short non-GH deficient patients.

Age Determination by Skeleton↗

PubMedDate not supplied

Growth stunting in early life in relation to the onset of the childhood component of growth.

AIMS: Growth stunting is prevalent in developing countries. The prevalence of stunting ranges from 10-80% or more. The critical period for growth faltering in length is between six and 18 months. The aims of this study were 1) to investigate the association between the age at onset of the childhood component and growth stunting in early life; 2) to develop a screening method for identifying any individual infant subject to stunting in early life. MATERIALS & METHODS: This community-based longitudinal study was carried out in Lahore, Pakistan. Three studied areas and one local control group were included in the study. There were 425 subjects for whom data were available for determining the age at onset of the childhood component. The onset was defined as an abrupt increase in length velocity. It was determined individually using the infancy-childhood-puberty growth model. RESULTS: The medians of the age at onset of childhood component were 15, 13, 10 and 9 months in the periurban, village, urban and control groups, respectively. The onset was significantly related to both length and length velocity during the critical period of stunting. Based on the distribution of individual length increment from 12 to 15 months, 2.0 and 3.0 cm were chosen as the cut-off points to identify a stunting infant. In the normal onset group, 84% of the children were identified as growing normally; in the delayed onset group, 61% were identified as stunting. Using this screening method, 97% of children have a delayed onset if their length increase is below 2 cm from 12 to 15 months; 99% of them have a normal onset if the increase is above 3 cm over the same period. CONCLUSIONS: The age at onset of the childhood component can significantly explain the variations in both length and length velocity in early life. The stunting screening method reported here is simple. It can be used in almost any situation, such as a pediatric clinic or community-based survey.

Age of Onset↗

PubMedDate not supplied

Benn Index at birth is associated with postnatal linear growth.

While previous research has suggested that body thinness is related to subsequent linear growth in children, it is unclear whether thinness at birth is related to linear growth in newborns and catch-up growth in small-forgestational age newborns. Drawing on data from a longitudinal growth study of 3,650 full-term Swedish babies, this study examines linear growth from birth to 6 months of age in three groups of newborns with short (< -2 SDS), appropriate (-2 to 2 SDS) and long (> 2 SDS) body length for gestational age. Among infants short at birth, the Benn Index (kg/m2.69) at birth was not related to the odds of short stature (< -2 SDS) at age 6 months (odds ratio = 1.03; p > 0.10). Nonetheless, the Benn Index was positively related to growth velocity in the first 6 months of life in the short (p = 0.060), appropriate (p < 0.05), and tall (p < 0.05) for gestational age newborns. Use of the Ponderal Index (kg/m3) would give similar results. The findings suggest that nutritional status at birth is related to linear growth velocity in newborns.

Birth Weight↗