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To date, studies using cross-sectional methodologies make up a majority of the literature surrounding children with autism spectrum disorders and participation in physical activity and screen time. Longitudinal studies are needed to examine how physical activity and screen time behaviors co-develop for children with and without an autism spectrum disorder. To address this research gap, this study compared how physical activity and screen time levels changed over time (9 to 18 years of age) between youth with autism spectrum disorder and youth with neurotypical development. Data on the levels of moderate-to-vigorous physical activity, light physical activity, television-, and video game-based screen time, collected as a part of the "Growing up in Ireland" study, were compared between youth with autism spectrum disorder and a propensity-matched sample of youth with neurotypical development (n = 88 per group; 176 in total). Robust regression analyses indicated that children with autism spectrum disorder became less active over time compared to children with neurotypical development and that video game screen time also differed significantly between the groups when children were 9 years old. These findings elucidate important disparities present between these groups of children during pivotal developmental times. To date, studies using cross-sectional methodologies make up a majority of the literature surrounding children with autism spectrum disorders and participation in physical activity and screen time. Longitudinal studies are needed to examine how physical activity and screen time behaviors co-develop for children with and without an autism spectrum disorder. To address this research gap, this study compared how physical activity and screen time levels changed over time (from 9 to 18 years of age) between youth with autism spectrum disorder and youth with neurotypical development. Data on the levels of moderate-to-vigorous physical activity, light physical activity, television-, and video game-based screen time, collected as a part of the "Growing up in Ireland" study, were compared between youth with autism spectrum disorder and a propensity-matched sample of youth with neurotypical development (n = 88 per group; 176 in total). Robust regression analyses indicated that children with autism spectrum disorder became less active over time compared to children with neurotypical development and that video game screen time also differed significantly between the groups when children were 9 years old. These findings elucidate important disparities present between these groups of children during pivotal developmental times. [ABSTRACT FROM AUTHOR]

Background Laparoscopic Roux-en-Y gastric bypass (RYGB) causes changes in body composition and bone metabolism, yet little is known about effects in adolescents. Objectives The objective of this study was to report dual-energy X-ray absorptiometry measures and serum bone markers, hypothesizing that bone turnover increases after surgery. Methods Inclusion criteria included the following: age 13-18 years and body mass index (BMI) >35 kg/m2. Seventy-two adolescents (22 boys; mean age 16.5 years; BMI 44.8 kg/m2) undergoing RYGB underwent dual-energy X-ray absorptiometry and serum bone marker analyses preoperatively and annually for 2 years. Results Mean BMI reduction at 2 years was 15.1 kg/m2. Body composition changes included a reduction in fat mass (51.8% to 39.6%, p < 0.001) and relative increase in lean mass (47.0% to 58.1%, p < 0.001). In contrast to previous studies in adults, adolescent boys lost a greater percentage of their body fat than girls (−17.3% vs. −9.5%, p < 0.001). Individual bone mineral density Z-scores (BMD-Z) at baseline were within or above the normal range. The mean (SD) BMD-Z was 2.02 (1.2) at baseline, decreasing to 0.52 (1.19) at 2 years. Higher concentrations of serum CTX ( p < 0.001) and osteocalcin ( p < 0.001) were observed in boys throughout the study period. Levels rose in the first year, before decreasing modestly in the second. Levels of serum markers of bone synthesis and resorption were higher in boys, whose skeletal maturity occurs later than girls'. Conclusions Differences in body fat and lean mass proportions were observed according to sex following RYGB. Bone turnover increased, and BMD decreased to levels approaching a norm for age. Long-term outcome will determine the clinical relevance. [ABSTRACT FROM AUTHOR]

Objective: To measure the user acceptance of a electronic auto-injector device (easypod) for recombinant human growth hormone (r-hGH) administration.Study Design and Methods: This was an open-label, uncontrolled study in which participants (n = 61) were trained to use the device to administer subcutaneous recombinant human growth hormone (r-hGH). Participants' opinions on the device were recorded by questionnaire and/or telephone interview during training and after 15 and 60 days of use. Opinions on the device were also collected from nurses or physicians who trained the participants in device use.Results: After 60 days, 98% (54/55) of responders reported a 'good' or 'very good' overall impression of the device. The pre-programmed dose feature, skin sensor, on-screen instructions, display of remaining dose, confirmation of injected dose and automatic needle attachment were identified by the majority of participants as 'very useful'. Participants were reported to have easily understood the injection process, and 87% (48/55) expressed a preference to continue use of the device. The device had a good safety profile, and no adverse events were reported during the study or follow-up periods.Conclusions: Participants had a good overall impression of the device and the majority expressed a preference to continue its use. The combination of features offered by the device make it user-friendly, and such ease of use may facilitate greater adherence to treatment, in turn improving therapy outcomes. [ABSTRACT FROM AUTHOR]

Aim To find predictors of abnormal retinal vascularisation in moderately to late preterm newborn infants considered to have no risk of developing retinopathy of prematurity. Methods Seventy-eight infants (34 girls) were recruited from a longitudinal study of otherwise healthy premature children born at a gestational age of 32 + 0-36 + 6 weeks. Retinal vessel morphology was evaluated at mean postnatal age 7 days. Insulin-like growth factor-I ( IGF-I) levels were analysed in umbilical cord blood. Results Of the 78 infants, 21 (27%) had abnormal retinal vessel morphology; they had significantly lower median (range) birth weight [1850 g, (1190-3260), vs. 2320, (1330-3580), p < 0.0001], shorter birth length [43.0 cm, (38-49), vs. 46.0, (40-50), p < 0.0001] and smaller head circumference [31.0 cm, (27.7-34.0), vs. 32.0, (27.5-36.5), p = 0.003]. They also had significantly lower gestational age [34 + 1 weeks, (32 + 2-35 + 3), vs. 34 + 6, (32 + 2-36 + 6), p = 0.004] and mean ± SD IGF-I levels (24.6 ± 17.0 μg/L vs. 46.7 ± 21.5, p < 0.0001). A higher percentage of these infants were small for gestational age (57.1% vs. 15.8%, p = 0.001), and maternal hypertension/preeclampsia rates were also higher (47.6% vs. 19.3%, p = 0.03). Step-wise logistic regression showed that birth weight was the strongest predictor of abnormal retinal vascularisation (p < 0.0001, odds ratio 0.040, 95% confidence interval 0.007-0.216). Conclusion In this population of moderately to late preterm newborns, birth weight appeared to affect the retinal vascular system. [ABSTRACT FROM AUTHOR]

The goal of growth hormone (GH) treatment in a short child is to attain a fast catch-up growth toward the target height (TH) standard deviation score (SDS), followed by a maintenance phase, a proper pubertal height gain, and an adult height close to TH. The short-term response variable of GH treatment, first-year height velocity (HV) (cm/year or change in height SDS), can either be compared with GH response charts for diagnosis, age and gender, or with predicted HV based on prediction models. Three types of prediction models have been described: the Kabi International Growth Hormone Study models, the Gothenburg models and the Cologne model. With these models, 50-80% of the variance could be explained. When used prospectively, individualized dosing reduces the variation in growth response in comparison with a fixed dose per body weight. Insulin-like growth factor-I-based dose titration also led to a decrease in the variation. It is uncertain whether adding biochemical, genetic or proteomic markers may improve the accuracy of the prediction. Prediction models may lead to a more evidence-based approach to determine the GH dose regimen and may reduce the drug costs for GH treatment. There is a need for user-friendly software programs to make prediction models easily available in the clinic. Copyright © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

What is already known about this subject Lifestyle intervention is the most common treatment strategy for children with obesity., Specialized units for the care of children with obesity report significant effects of lifestyle treatment., In children, the physical activity component in lifestyle treatment is often well accepted., What this study adds Two lifestyle treatment programmes in primary care for children with obesity both gave a reduction of body mass index significantly greater than the change observed in a non-intervention comparison group of children with obesity., Substituting one-third of nurse-led treatment sessions with sessions led by physiotherapists in one of the programmes did not improve the outcome., The efficacy of treatment in primary care seems to be comparable to that reported in the literature., Objective To evaluate the efficacy of lifestyle treatment in primary care for children with obesity. Methods In a multicentre study, sixty-four 9- to 13-year-old children with obesity were randomized to one of two 12-month lifestyle treatment programmes. The only difference between the programmes was that a physiotherapist substituted the nurse in one-third of the sessions in an attempt to stimulate physical activity. For comparison, children with normal weight and overweight, and an age-, sex- and body mass index-matched non-intervention group of children with obesity were used. Results Anthropometry and laboratory data differed significantly between children with obesity and normal weight at baseline. The follow-up at the end of treatment was attended by 55 children with obesity, 28 and 27 in each treatment arm. The mean (standard deviation) body mass standard deviation score changed by −0.36 (0.3) in the arm involving a physiotherapist and by −0.33 (0.2) in the other arm. These outcomes were not significantly different. Both reductions were significantly greater than the change of −0.14 (0.3) observed in the non-intervention comparison group of children with obesity Conclusion The efficacy of treatment in primary care for children with obesity seems to be comparable to that reported in the literature. ISRCTN44919688. [ABSTRACT FROM AUTHOR]

Aim: To investigate the development of waist circumference (WC) in preschool children born preterm compared with a population-based reference. Background: Children born preterm are reported to be insulin resistant, despite being lean during early childhood. We hypothesize that the mechanism is through increased visceral adiposity. Methods: Data from 4446 preschool children (2169 girls/2277 boys) born in 2001-2006 from a population-based study were compared with longitudinal measurements of body mass index (BMI) and WC from a cohort of 152 children (64 girls/88 boys) born moderately preterm in 2002-2004 (gestational age, 32-37 weeks). Results: In the preterm children, the mean WC was 2.8 cm larger compared with the reference group (p < 0.001) at 2 years of age but not at 5 years of age. There was no significant difference in the mean BMI at 2 years of age. The preterm group was significantly leaner at 5 years of age, with a mean BMI of 15.13 compared with 15.98 in the reference group (p < 0.001). Conclusion: Children born moderately preterm present as lean during early childhood but have an increased waist circumference in infancy, pointing towards a change in fat distribution with more abdominal fat. This may have implications for their metabolic status. [ABSTRACT FROM AUTHOR]

CONTEXT:The prevalence of obesity among adolescents has increased and we lack effective treatments.OBJECTIVE:To determine if gastric bypass is safe and effective for an unselected cohort of adolescents with morbid obesity in specialized health care.DESIGN, SETTING AND PATIENTS:Intervention study for 81 adolescents (13-18 years) with a body mass index (BMI) range 36-69 kg m−2 undergoing laparoscopic gastric bypass surgery in a university hospital setting in Sweden between April 2006 and May 2009. For weight change comparisons, we identified an adult group undergoing gastric bypass surgery (n=81) and an adolescent group (n=81) receiving conventional care.MAIN OUTCOME MEASUREMENTS:Two-year outcome regarding BMI in all groups, and metabolic risk factors and quality of life in the adolescent surgery group.RESULTS:Two-year follow-up rate was 100% in both surgery groups and 73% in the adolescent comparison group. In adolescents undergoing surgery, BMI was 45.5±6.1 (mean ±s.d.) at baseline and 30.2 (confidence interval 29.1-31.3) after 2 years (P<0.001) corresponding to a 32% weight loss and a 76% loss of excess BMI. The 2-year weight loss was 31% in adult surgery patients, whereas 3% weight gain was seen in conventionally treated adolescents. At baseline, hyperinsulinemia (>20 mU l−1) was present in 70% of the adolescent surgery patients, which was reduced to 0% at 1 year and 3% at 2 years. Other cardiovascular risk factors were also improved. Two-thirds of adolescents undergoing surgery had a history of psychopathology. Nevertheless, the treatment was generally well tolerated and, overall, quality of life increased significantly. Adverse events were seen in 33% of patients.CONCLUSIONS:Adolescents with severe obesity demonstrated similar weight loss as adults following gastric bypass surgery yet demonstrating high prevalence of psychopathology at baseline. There were associated benefits for health and quality of life. Surgical and psychological challenges during follow-up require careful attention. [ABSTRACT FROM AUTHOR]

AIM: To evaluate ophthalmological findings in children with Silver–Russell syndrome (SRS). METHODS: An ophthalmological evaluation including visual acuity (VA), refraction, strabismus, near point of convergence (NPC), slit-lamp examination, ophthalmoscopy, axial length measurements and full-field electroretinogram was performed on 18 children with SRS (8 girls, 10 boys; mean age 11.6 years). Fundus photographs were taken for digital image analysis. Data were compared with data on an age- and gender-matched reference group (ref) of school children (n=99). RESULTS: Seventeen out of 18 children with SRS had ophthalmological abnormalities. Best corrected VA of the best eye was <0.1 log of the minimal angle of resolution in 11 children (ref n=98) (p<0.0001), and 11 children had refractive errors (ref n=33) (p=0.05). Anisometropia (≥1 dioptre) was noted in three of the children (ref n=3) (p=0.046). Subnormal stereo acuity and NPC were found in 2/16 (ref=0) (p=0.02). The total axial length in both eyes was shorter compared with that in controls (p<0.006 and p<0.001). Small optic discs were found in 3/16, large cup in 3/16 and increased tortuosity of retinal vessels in 4/13 children with SRS. CONCLUSION: Children with SRS, who are severely intrauterine growth retarded, show significant ophthalmological abnormalities. Based on the present findings, ophthalmological examination is recommended in children with SRS. [ABSTRACT FROM AUTHOR]

This report examines the prevalence rate of Hodgkin's disease in an American mid-west town located directly south of a non-operational oil refinery. The refinery has a history of benzenecontaining gasoline leaks dating back to the early 1900s. Exposure data were assessed through the Toxic Release Inventory (TRI) data as published by the Environmental Protection Agency (EPA) and supplemented by exposure simulations using variations of residential exposure times and odour levels and the benzene content of the gasoline. Prevalence rates depended on the size of the population in question. The population size varied greatly between sources, with the more conservative and consistent estimates being reported by the local government and United States Census Bureau and the highest population figure being reported by the Agency for Toxic Substances Disease Registry. The prevalence of Hodgkin's disease for the residents within 1 mile from the refinery was found to be elevated for every population figure, ranging from 72.11 cases per 100,000 using the ATSDR's population to 182.34 per 100,000, whereas the prevalence for Hodgkin's disease in all the United States is only 22 cases of Hodgkin's disease per 100,000 people. The prevalence value reported in this report should be given greater weight than what would have been calculated using data from the ATSDR. Because of its significantly increased value compared with the rest of the United States, it provides evidence of benzene's role as a causative agent in the etiology of Hodgkin's disease. [ABSTRACT FROM AUTHOR]

Serious health effects due to perfluorooctanoate (PFOA) exposure are suspected. The aim of this study was to evaluate the health status of nearby residents, with prolonged exposure to PFOA in their drinking water. A population of 566 white residents who were plaintiffs or potential plaintiffs in a lawsuit was evaluated by questionnaire for health history and symptoms. Standardized Prevalence Ratios were estimated using National Health and Examination Survey (NHANES) data files for comparison rates. The exposed subjects reported statistically significant greater prevalence of angina, myocardial infarction, and stroke (SPR = 8.07, 95% C.I. = 6.54 - 9.95; SPR = 1.91, 95% C.I. = 1.40 - 2.62, and SPR = 2.17, 95% C.I. =1.47 - 3.21, respectively), chronic bronchitis, shortness of breath on stairs, asthma (SPR = 3.60, 95% C.I. = 2.92 - 4.44; SPR = 2.05, 95% C.I. = 1.70 - 2.46; SPR = 1.82, 95% C.I. = 1.47 - 2.25, respectively), and other serious health problems. The increased prevalence of adverse health effects may be due to PFOA. Further study is needed. [ABSTRACT FROM AUTHOR]

There is increasing evidence of permanent sequalae from acute organophosphate poisoning. We report on accidental diazinon overexposure with acute organophosphate poisoning through cutaneous absorption and inhalation followed by persistent neurological effects. In addition, we observed skeletal and endocrine effects likely attributable to the diazinon poisoning. A family of seven was exposed to diazinon in June 1999 over a two-day period. The pesticide company mistakenly used diazinon to heavily spray the inside of the home instead of permethrin. The applicator applied the pesticide over the entire surface of the floor, carpeting, furniture, and clothing in closets to eradicate an infestation of fleas. Acute symptoms in the family members included headaches, nausea, skin irritation, runny nose, and vomiting. The family was first evaluated at 3 months and then 3 years after the acute poisoning. There were persisting neurological symptoms of memory loss, decreased concentration, irritability, and personality changes of varying degrees in all family members. Objective neurological findings of impaired balance, reaction time, color vision, slotted pegboards and trials making were present in the three older children who could be tested. Neuropsychological evaluation revealed evidence of organic brain dysfunction in all seven family members. Bone growth difficulties are present in four of five children. One child has delayed menarche. [ABSTRACT FROM AUTHOR]

Objectives: This investigation is a part of a multidisciplinary descriptive evaluation of the Silver-Russell syndrome (SRS). The aim of this study was to describe the craniofacial morphology, occlusion and dental age in children with the SRS.Design: A descriptive literature-controlled study.Setting and Sample Population: Sixteen children diagnosed as having SRS, 10 boys and six girls, aged 4.4-14.5 years, were referred from different parts of Sweden to the Queen Silvia Children's Hospital, Göteborg University.Experimental Variable: Facial morphology was measured on lateral and postero-anterior radiographs. Occlusion, tooth eruption and palatal height were measured on casts, and dental maturity was evaluated on orthopantomograms.Outcome Measure: Linear and angular measurements were obtained from lateral radiographs and the ratios of the linear measurements from the postero-anterior radiographs. The degree of tooth calcification shown on orthopantomograms was taken as a measure of dental maturity. Biometric measurements were taken and the degree of tooth eruption was recorded from the dental casts. The SRS children were compared with reference groups with t-test and z-scores.Results: Overall, SRS children were found to have smaller linear facial dimensions and deviations in the facial proportions, such as a small retropositioned, and steeply inclined maxilla and mandible, and a proportionally larger anterior facial height in relation to the posterior facial height. In 40% of them a smaller facial height or length on one side (facial asymmetry) was correlated to the smaller side of the body. The frequency of malocclusions was higher, and the palatal height showed a tendency towards an increase. Dental maturity was within normal limits, while the time of tooth eruption was slightly delayed.Conclusions: The deviating facial morphology described above is a part of the syndrome, which is characterized by short stature, growth hormone deficiency and asymmetries of the body. The higher percentage of malocclusions in the SRS children might lead to a greater need of orthodontic treatment. [ABSTRACT FROM AUTHOR]

Hydrocortisone produced choleresis in anesthetized dogs receiving taurocholate and ampicillin. There was an increase in mean concentration of ampicillin in serum after infusion of hydrocortisone with no change in mean rate of biliary excretion of ampicillin. In dogs receiving creatinine in addition to taurocholate and ampicillin, hydrocortisone also produced an increase in mean levels of ampicillin in serum. The mean rate of biliary excretion and the rate of renal clearance of ampicillin were constant in these dogs. In dogs receiving creatinine, taurocholate, and ampicillin without infusion of hydrocortisone, mean concentration of ampicillin in serum, minute biliary weight, and renal clearance rate of ampicillin remained constant throughout the 150 min of study, while mean biliary concentration of ampicillin and rate of excretion decreased during the last 40 min. The increased concentrations of ampicillin in serum of dogs during and after infusion. of hydrocortisone seems due to decreased diffusion of ampicillin from plasma into the hepatocyte. Preliminary chromatographic studies of rat liver supernate on Sephadex G-75 indicate that bioactivity of ampicillin appears at a position in the elution pattern where Y protein should be eluted. Y protein binds anoinic metabolites of cortisol. Competitive or noncompetitive inhibition by hydrocortisone of binding of ampicillin to Y protein could explain the increased concentrations in serum during and after infusion of hydrocortisone. [ABSTRACT FROM PUBLISHER]

Aim: To evaluate whether intrauterine growth retardation (IUGR) protects against the development of allergy.Methods: A case-control study of 1515 subjects (15-25 y), of whom 430 were cases (birthweight/length below -2 SD for gestational age). Birth data were from the national birth register. The frequencies of allergic diseases were evaluated by questionnaire.Results: For the 950 who replied, the frequencies of allergic diseases were similar in cases and controls.Conclusion: IUGR does not protect against the development of allergy. [ABSTRACT FROM AUTHOR]