THE AGE OF MENARCHE IN SYDNEY SCHOOLGIRLS IN 1973 WITH COMMENT ON THE SECULAR TREND

The age of menarche was investigated in a cross-sectional sample of 840 girls aged 9 to 17 years attending state schools in Sydney in 1973. A probit analysis yielded a mean of 13.26 ± 0.069 yr with a standard deviation of 1.10 yr. Norms for onset of menstruation were estimated for girls 9 to 18 years in 6-monthly intervals. The results were in close agreement with Melbourne data from Towns et al. (1966). A retrospective mean was also found (12.76 yr) which did not differ significantly from a recent similar analysis on Sydney schoolgirls by Harper and Collins (1972). A survey of recent overseas studies using probit analyses found a consensus in Western Europe of 13.0 to 13.4 yr although older and younger means are in evidence elsewhere. An examination of the evidence on a secular trend in menarche in Australia suggested the evidence was not sound enough to allow any positive statement.     

Secular trend in the sexual maturation of southern Chinese boys

A random sample of 3872 southern Chinese boys ranging from 7 to 21 years of age were selected from primary and secondary schools in Hong Kong for the assessment of sexual maturation. The median ages of onset of puberty and pubic hair development were 11.4 and 12.7 years, respectively. The advancement of sexual maturation coincides with the secular increase in height and weight for Chinese children in Hong Kong.     

THE INCIDENCE OF DIABETES MELLITUS IN SWEDISH CHILDREN 0–14 YEARS OF AGE

ABSTRACT. This is a prospective study of the incidence of insulin-dependent diabetes mellitus (IDDM) in children 0–14 years of age, including all newly diagnosed cases in the whole of Sweden from July 1, 1977 until June 90, 1980. All 45 Swedish departments of paediatrics participated. During the three-year-period studied, 1108 Swedish children, 0–14 years of age had their onset of diabetes. That means around 369 new diabetics yearly in the age groups studied. The mean yearly incidences in the years 1977–80 were 22.6, 22.8 and 22.6 per 100000 children, respectively. Mean prevalence on June 30, 1980 was 1.48 per 1000 children 0–14 years with a wide range of 0.71-2.65. The age distribution at onset showed a gradual increase and peak incidences at 11 years of age for the girls and 4 and 13 years of age for the boys. There was a consistently higher incidence for boys in the younger age groups during the three-year-period studied. Peak incidences of new cases were reached in January, March and July through October for the age groups 5–9 and 10–14 years of age. No such seasonal variation was seen for children 0–4 years of age. The cumulative incidence of IDDM at 14 years of age was 3.2 per 1000 for the boys and 2.9 per 1000 for the girls. The degree of ascertainment in this study was 93.4 %.     

The relationship between early age of onset of initial substance use and engaging in multiple health risk behaviors among young adolescents

BACKGROUND: Previous research based on problem-behavior theory has found that early age of onset of substance use is associated with engaging in multiple health risk behaviors among high school students. It is unknown whether these relationships begin during early adolescence. OBJECTIVE: To examine the relationships between early age of onset of cigarette, alcohol, marijuana, and cocaine use and engaging in multiple risk behaviors among middle school students. METHODS: A modified version of the Centers for Disease Control and Prevention Youth Risk Behavior Survey was administered to 2227 sixth through eighth grade students attending 53 randomly selected middle schools in North Carolina. A Health Risk Behavior Scale was constructed from 16 behaviors, including indicators of violence and weapon carrying; current substance use; nonuse of helmets when biking, in-line skating or skateboarding; not wearing a seat belt; riding with a driver who had been drinking; and suicide plans. Among this sample of middle school students, the scale had a mean (SD) of 4.1 (2.7) (range=O-15), and had a high internal reliability coefficient (alpha(=0.74). The independent variables included first time use of cigarettes, alcohol, marijuana, and cocaine at age 11 years or earlier; actual age of onset of each substance; race and ethnicity; family composition; sex; school grade; academic ranking; and older age for school grade. These data were analyzed with analysis of variance, Spearman r, and multiple linear regression. RESULTS: All the independent variables were found to be associated (P<.005) with the Health Risk Behavior Scale during the bivariate analyses. When each of these significant variables were entered into a multiple regression model, having smoked at age 11 years or younger accounted for 21.9% of the variation in the Health Risk Behavior Scale. Male sex, early marijuana or cocaine use, older age, lower academic rank, white race, and living in a 1-parent family explained an additional 19.1% of variation in the model (adjusted R2=0.41, P<.001). When the actual ages of onset of the use of substances were analyzed, in order of magnitude; age of onset of smoking; male sex; age of onset of alcohol and marijuana use; age; lower academic ranking; age of onset of cocaine use; white race; and lower academic rating accounted for 52.8% (P<.001) of the variation in the Health Risk Behavior Scale. CONCLUSION: Even when considering sociodemographic factors, early age of onset of cigarette use was the strongest correlate of the number of health risk behaviors in which these young adolescents had engaged. Early onset of use of other substances was also associated with a clustering of health risk behaviors among this sample of middle school students. The findings suggest that screening for early experimentation with tobacco and other substance use will help identify young adolescents at increased risk for engaging in multiple health risk behaviors.     

COURSE OF RENAL FUNCTION IN IgA GLOMERULONEPHRITIS IN CHILDREN AND ADOLESCENTS

ABSTRACT. The pathophysiology of IgA GN was investigated in different stages of the disease. Seventeen patients who were between 3.5 and 16.5 years of age at the onset were included in the study. Clearance studies were performed repeatedly in 6 patients (in 5 of them over a period extending from the onset to 5-9.5 years) and only once in 9 patients (10-23 years after the onset). Two patients (one with uremia) were only evaluated clinically. C_In, C_PAH and U_NaV were studied during hydropenia (HP) and 3% isotonic saline volume expansion (VE). Shortly after the onset C_In, C_PAH and U_NaV were depressed. Renal function was essentially normal 1 and 2 years after the onset in spite of signs of active disease. A supernormal GFR was found in 7 patients after they had had the condition between 5 and 17 years. After a duration of IgA GN for >9 years 3 of 12 patients had developed hypertension and uremia and 2 had hypertension or labile BP. Three of 10 patients had a normal GFR and BP, but had increased natriuresis during VE. Only 2 of 10 patients were normotensive and had normal renal function. Disturbancies in the renal function are thus frequent in all stages of IgA GN and the changes seem to be related to the duration of the disease. Exaggerated natriuresis may indicate progressive disease.     

石家庄市儿童Ⅰ型糖尿病发病率调查

目的 了解石家庄市儿童I型糖尿病(IDDM)发病情况。方法 对石家庄市(包括郊县)1985～1997年间新发病的0～14岁的IDDM患者进行了回顾性调查。所有病例均来自医院、中小学及幼儿园。结果 共调查出51例,男23例,女28例。1985～1997年平均年粗发病率为0.60/10万,95%可信限(CI): 0.44～0.77,调整率为0.64/10万,95% CI: 0.35～0.93,校正率为0.71/10万,95% CI: 0.53～0.88。1985年为发病高峰,春秋季节发病较多,10～14岁组发病率高于0～4岁及5～9岁组。其中又以4岁和14岁为发病高峰,男女发病率无显著差异。结论 儿童Ⅰ型糖尿病的发病率与年龄组及季节有关。     

C-PEPTIDE IN JUVENILE DIABETICS BEYOND THE POSTINITIAL REMISSION PERIOD Relation to Clinical Manifestations at Onset of Diabetes, Remission and Diabetic Control

Abstract Ludvigsson, J., Heeling, L. G., Larsson, Y. and Leander, E. (Department of Paediatrics, Linköping University, Sweden, Novo Research Institute, Copenhagen, Denmark, Department of Mathematics, Linköping University, Sweden). C-peptide in juvenile diabetics beyond the postinitial remission period.—Relation to clinical manifestations at onset of diabetes, remission and diabetic control. Acta Paediatr Scand, 66:177, 1977.—A group of 58 diabetics, age 6–17 years and with a duration of diabetes of 3–14 years was studied in order to show whether the nature of the clinical manifestations and the treatment at the onset of the disease are related to the subsequent C-peptide production and also whether remaining C-peptide production is related to better diabetic control. The relations between a number of clinical and laboratory variables were analysed including the degree of ketosis and the insulin dose given at onset of diabetes, the incidence of postinitial remission period, the fasting C-peptide level after the remission period, the level of insulin antibodies and the actual diabetic control expressed as the degree of glucosuria in the patients' urine tests at home. Multiple regression analysis was the main method used. Postinitial remission was positively correlated to initial insulin dose and negatively correlated to duration of ketonuria at onset. C-peptide, which was found in 24.1% of the patients was positively correlated to age at onset and initial insulin dose, but negatively correlated to ketonuria at onset. Diabetic control was positively correlated to insulin dose at onset and to C-peptide level, but negatively correlated to insulin antibodies. It could further be shown that patients who had received a more vigorous treatment immediately at onset had both a higher incidence of postinitial remission and a better diabetic control. The results suggest that an early diagnosis followed by rapid normalization of the metabolism at the onset of juvenile diabetes increase the possibility of preservation of some of the endogenous insulin production, which seems to facilitate diabetic control.     

THE SEX VARIABLE IN CHILDHOOD URINARY-TRACT INFECTION

ABSTRACT: Bahna, S. L. and Torp, K. H. (Department of Paediatrics, County Hospital of Troms, Tromsö, Norway). The sex variable in childhood urinary-tract infection. Acta Paediatr Scand, 64:581, 1975.–Sex differences in childhood urinary-tract infection have been looked for by reviewing the medical records of all patients who were admitted to one medical centre during a certain time period. There were 240 patients; 26 males and 214 females, all under 14 years of age. The disease in boys–as compared with that in girls–was found to be characterized by an earlier onset, a shorter delay in diagnosis, and a shorter duration; but a higher frequency of malformations, a greater number of ^hospitalizations, and a greater need for surgical intervention. Proteus infection was found more frequently in boys, while Enterococcus and Staphylococcus were more frequent in girls. The initial symptomatology did not show any significant sex difference except in late childhood where the non-specific symptoms were more common in females. No sex difference was noted with respect to the frequency of vesicoureteric reflux or of bacteriuria without pyuria. It seems that the sex variable in this disease is worth considering in dealing with individual patients as well as in presenting data on a series of patients.     

Validity of BMI based on self-reported weight and height in adolescents

Aim:  To assess in a subset of a nationally representative sample of Portuguese adolescents, the validity of Body Mass Index (BMI) based on self-reported weight and height.
Methods:  This study included 462 students in grades 6, 8 and 10 (mean age 14.0 ± 1.9 years) from 12 public schools randomly selected from the list of schools which took part in the 2006 Health Behaviour in School Aged Children Portuguese survey, corresponding to approximately 10% of the sample. Self-reported weight and height were recorded and then measured.
Results:  Prevalence of normal weight, overweight and obesity based on self-report compared with that of measured values was not significantly different for boys and girls, and among age groups. BMI based on measured weight and height was underestimated compared with BMI based on self-reported data, both among girls and boys. Larger limits of agreement were found for boys, indicating a higher variability of self-reported BMI in estimating measured BMI, specifically below the age of 14 years.
Conclusion:  These data suggest that BMI based on self-reported weight and height is not accurate for BMI prediction at an individual level. However, self-reported BMI may be used as a simple and valid tool for BMI estimates of overweight and obesity in epidemiological studies.     

THE PREVALENCE OF NOCTURNAL ENURESIS: DO DSM III CRITERIA NEED TO BE CHANGED? A BRIEF RESEARCH REPORT

In this study the prevalence of nocturnal enuresis defined according to the DSM III criteria was determined in a random sample of 2070 children aged from 4 to 16 years. Nocturnal enuresis declines in prevalence with age and is more frequent in boys than in girls. Moreover, the decline in prevalence with age was found to take place earlier in girls than in boys. It is therefore argued that the DSM III age limit for enuresis should be raised to 8 years for boys.     

The natural history of night terrors

Night terrors are a sleep disorder, resulting from a partial arousal during slow-wave sleep. They usually occur within 2 hours of sleep onset and are characterized by agitation and unresponsiveness to external stimuli. Nineteen children (ten males, nine females) with onset of night terrors before age 7.5 years were studied by means of a questionnaire. Mean observation time (time from onset age to age at survey) was 8.5 years, but longer than 10 years in nine subjects. Seventy percent of the children had their initial frequency of night terrors as their peak frequency, with a tendency for shorter duration of the parasomnia in this group. Children with onset age less than 3.5 years may be expected to attain a peak frequency of at least one episode per week. Children with onset after 3.5 years, but before 7.5 years, may expect to attain a peak frequency of 1-2 episodes per month. There was a mean duration of 3.9 years, with a tendency for longer duration in children with positive family histories of sleep walking. Fifty percent stopped by age 8 years; 36 percent continued into adolescence. No common abnormal behavioral profile or psychopathology was found. Common precipitants of attacks were not identified.     

Immobilization Related to Early Linear Growth

ABSTRACT. 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.     

Prevalence of primary headaches in children from Belgrade, Serbia.

The aim of our study is to estimate the prevalence of migraine and tension-type headaches in 7-12-year-old school children from Belgrade. The sample was drawn from a total of 1259 school children from randomly selected primary schools. The diagnosis was made on the basis of a clinical interview combined with the neurological examination. The prevalence of migraine increases with age from 0.5% at the age of seven, to 6.8% at the age of 12. Female to male ratio inverts with age: males predominate at age 7-9, but females predominate at age 10-12. The estimated prevalence of tension-type headache increases with age from 0.5% in 7-year olds to 2.4% in 12-year olds. Statistically, the onset of migraine occurs significantly earlier than that of tension-type headache. Migraine and tension-type headache are frequent headache types and have different demographic characteristics among children.     

PSYCHIATRIC CARE AND COURSE OF PSYCHIATRIC DISORDERS FROM CHILDHOOD TO EARLY ADULTHOOD IN A REPRESENTATIVE SAMPLE

The incidence and prevalence of registered and psychiatric disorders were studied from birth to 24 years of age in a total population. The cumulative incidence of psychiatric disorders (meeting DSM III criteria) below 25 years was 13.9% for boys and 14.2% for girls. The outcomes of psychiatric disorders during childhood were generally good. Only 11% of children with an onset before age 10 remained in psychiatric care as young adults. Psychiatric disorders were more common among boys who had attended special classes. Low intelligence was related to psychiatric disorders with an onset before 15 years of age in males, but after 15 in females.     

TUMOR SUPPRESSOR GENES ON THE SHORT ARM OF CHROMOSOME 1 IN NEUROBLASTOMA

Iron-induced heart failure is the primary cause of death in thalassemia major patients who receive continuous transfusions. Recent studies have suggested that diastolic function is impaired prior to systolic function in process of hemochromatosis, but they did not come to agreement on the first impaired diastolic index. Additionally, serum ferritin concentration is not a reliable indicator of body iron storage since it increases in any simple inflammation. Accordingly, the authors undertook this study to assess any association between left ventricular diastolic indices and serum ferritin in thalassemic patients with normal systolic function to estimate the true amount of body iron storage and correct it in earlier stages. Serum ferritin concentration and diastolic indices were measured in 29 patients with normal left ventricular systolic function. Linear regression test was used to find any association between hematological and cardiac factors. No significant association was found between diastolic indices and serum ferritin concentration. But the results were quite different in patients above and below 15 years of age; standardized coefficients (r) for peak of E and A were increased in patients above 15, and the significance was close to. 05, unlike those of younger group. Although no correlation was found between serum ferritin and diastolic indices, the results were noteworthy in patients above 15. To appropriately judge this relation, the study must be continued with a bigger sample size and having patients' mean serum ferritin concentration during the 2 past years.     

SOMNAMBULISM IN CHILDHOOD-PREVALENCE, COURSE AND BEHAVIORAL CORRELATIONS

ABSTRACT. prevalence, course and behavioral correlations. Acta Paediatr Scand, 71: 495, 1982.–The occurrence and course of somnambulism and its correlations with behavioral variables have been investigated annually from 6 to 16 years of age in a sample recruited by random means. The prevalence was highest at 11-12 years. No sex difference was found. Apart from sporadic occurrences, the longitudinal data reveal a group of children for whom somnambulism is rather persistent. But even in this group the somnambulism is usually unrelated to other sleep disturbances (apart from "bad" dreams), deviant behavior or known environmental factors. These children have more inhibited aggression and a more developed mental defence against anxiety as determined by Rorschach tests. At school they appear to be more popular than other children.     

CONGENITAL HYPOTHYROIDISM IN SWEDEN Psychomotor Development in Patients Detected by Clinical Signs and Symptoms

Abstract. Aim, J., Larsson, A. and Zetterström, R. (Department of Paediatrics, Karolinska Institute, St. Göran's Children's Hospital, Stockholm, Sweden). Congenital hypothyroidism in Sweden: Psychomotor development in patients detected by clinical signs and symptoms. Acta Paediatr Scand, 70: 907, 1981. Thirty-nine children at 7 to 9 years of age with congenital hypothyroidism have been studied with respect to their intellectual, neurological and social functions. Their intellectual achievement as assessed by the WISC test, was significantly lower than in a reference population (mean IQ88, range 50–113). In children who showed signs and symptoms of hypothyroidism during their first four weeks of life, there was a negative correlation between the age when therapy was started and intellectual development. No such correlation was found in children who showed signs and symptoms after the first four weeks of life. Nine children of 26 with signs of hypothyroidism in the neonatal period, were found to have neurological abnormalities consisting of fine and gross motor disturbances. The neurological abnormalities seriously affected daily life in only the two most severely mentally retarded. No correlation was found between the age when the therapy was started and neurological abnormalities. Three children attended special schools because of mental retardation and six attended normal schools but required additional teaching assistance for learning disabilities. Our results suggest that the risk of future intellectual handicaps may be reduced by early treatment in children with hypothyroidism presenting during the neonatal period.     

A clinical study of 77 patients with mucopolysaccharidosis type II

AIM: This study aims to assess the clinical features of 77 South American patients (73 Brazilian) with mucopolysaccharidosis type II (MPS II). METHODS: Details of the patients and their disease manifestations were obtained from a review of medical records, interviews with the patients and/or their families, and physical examination of the patients. RESULTS: Mean birth weight was 3360 g, median age at onset of symptoms was 18 months and median age at diagnosis was 6 years. For the whole sample (median age, 8.2 years; range, 2.8-53.0 years), neurological degeneration, typical pebbly skin lesions, seizures and extensive dermal melanocytosis were found in 23.3, 13.0, 13.0 and 1.3% of the cases, respectively. The most frequently reported echocardiogram abnormality was mitral valve regurgitation. Refraction errors were the most common ophthalmological manifestation. The following characteristics were found to be associated with the severe form of MPS II: earlier age at biochemical diagnosis, higher levels of urinary glycosaminoglycans, language development delay, behavioural disturbances, poor school performance and mental retardation. CONCLUSION: Our results suggest that there is a considerable delay between the onset of signs and symptoms and the diagnosis of MPS II in Brazil (and probably in South America as well), and that many complications of this disease are underdiagnosed and undertreated. Therefore, the implementation of programmes aiming to increase the awareness of the disease, the availability of biochemical diagnostic tests and the provision of better support to affected patients is urgently needed.     

INCIDENCE, AGE AT ONSET AND SEASONAL VARIATION OF DIABETES MELLITUS IN NORWEGIAN CHILDREN, 1973–1977

ABSTRACT. Joner, G. and Søvik, O. (Department of Paediatrics, University of Bergen, Norway). Incidence, age at onset and seasonal variation of diabetes mellitus in Norwegian children, 1973–1977. Acta Paediatr Scand, 70:329, 1980.–A retrospective study was undertaken to estimate the incidence of diabetes mellitus in Norwegian children. Data were collected from all hospitals in the country and from a central insurance register. Eight hundred and forty-five new cases in the age group 0–14 years and with onset in the five-year study period 1973–1977 were detected. The calculated mean annual incidence was 17.6 per 100000 children, with a year-to-year variation of IS.4–19.3 per 100 000. The geographic variation in incidence was considerable with the lowest rate in the North (6.8/100 000/year) and the highest rates in the South-Eastern part of the country (approx. 20/100000/year). There was a significantly higher incidence for boys (18.8/100 000/year) than for girls (16.4/100 000/year). The age variation in the incidence rates showed rising values towards a peak at 12 years for girls and a plateau at 12–14 years for boys, with an abrupt decline after 12 and 14 years, respectively. There were more cases with onset in the winter and autumn, with significant peaks in February and October. From these data the prevalence of diabetes mellitus in the age group 0–14 years can be calculated to 1.2 per 1 000 children. In the whole of Norway, about 170 new cases of diabetes mellitus below the age of 15 years can be expected every year. Compared with previous studies, the present data suggest an increasing incidence of childhood diabetes in Norway.     

PANCREATIC B-CELL FUNCTION AND ABNORMAL URINARY PEPTIDES IN A BOY WITH LIPOATROPHIC DIABETES AND STENOSIS OF THE AQUEDUCT OF SYLVIUS

Abstract. Häger, A., Heding, L. G., Larsson, Y., Ludvigsson, J. and Trygstad, O. (Department of Paediatrics, University Hospital, Linköping, Sweden, Novo Research Institute Bagsvaerd, Denmark, and Department of Paediatrics, Rikshopitalet, Oslo, Norway). Pancreatic B-cell function and abnormal urinary peptides in a boy with lipoatrophic diabetes and stenosis of the aqueduct of Sylvius. Acta Paediatr Scand, 69:537, 1980. A boy with the classical clinical manifestations of acquired lipoatrophic diabetes has been studied for 5 years from the onset of diabetes at age 13. At the age of 15 a ventriculo-cisternal shunt operation was performed because of stenosis of the aqueduct of Sylvius, followed by a dramatic improvement in his diabetic state with a decrease of the 24 hr insulin requirement from 130 to 32 units. After 12 months there was a relapse with increased insulin requirement up to the preoperative level. Pimozide treatment was given for 7 months with no effect on the metabolic derangements. Extremely high basal levels of serum C-peptide and pro-insulin were found throughout the period of observation. A further increase occurred after i.v. arginine infusion tests, indicating hyperfunctioning B-cells. Repeated screenings of peptides in the urine by sephadex chromatography revealed pathological patterns similar to those observed in patients with other hypothalamic disorders, but different from that found in the urine of patients with congenital generalized lipodystrophy. Injection into mice of peptides extracted from the preoperative urine produced an acute hyperglycemia. The mechanisms behind this hypothalamic syndrome are unknown, but it is postulated that the abnormal urinary polypeptides originate from disorganized hypothalamic centres and that these peptides may be responsible for the disturbed carbohydrate and lipid metabolism.