Effect of asthma intervention on children with undiagnosed asthma

OBJECTIVE: To measure the effect of an asthma intervention on the functional status and morbidity of children with undiagnosed asthma. STUDY DESIGN: Data from a randomized trial were used to compare outcomes at baseline and follow-up for children with undiagnosed and diagnosed asthma. We studied 510 symptomatic children with diagnosed asthma (diagnosed) and 299 children with symptoms but no diagnosis (undiagnosed). Baseline functioning and morbidity were similar for undiagnosed and diagnosed patients classified as moderate-severe. RESULTS: There were fewer undiagnosed reported allergies, seasonal symptoms, and other respiratory diagnoses (all P < 0.01). Among the moderate-severe, functional status, for example, symptom-days ( P = .02), symptom-nights ( P < .01), and days of restricted activity ( P < .01), was significantly reduced at follow-up for the undiagnosed in the intervention group but not for undiagnosed control subjects. Findings were similar for children with diagnosed asthma. CONCLUSIONS: Children with undiagnosed asthma were generally nonatopic, although some had symptoms at a level comparable to children with a diagnosis. The intervention successfully improved functional status for children with undiagnosed asthma as well as for children with diagnosed asthma. These results can be applied to ongoing discussions related to case detection.     

The NCl's cancer centers program: Past,present, and future

Since passage of the National Cancer Act in 1971, the NCI Centers Program has promoted the establishment and the development of cancer centers of many types throughout the nation. These now include 20 comprehensive cancer centers, as well as a number of clinical and basic science centers that are supported through NCI core grants. Scientific productivity at NCI-supported centers has been high. While cancer center core grants usually represent only a small proportion of the total extramural research support for a given institution, they are essential in providing shared resources and in pulling together the various component research programs of a center into a unified program. The future directions of the NCI centers program as a whole, as well as the role of cancer research centers within their communities and regions, are discussed.     

Storage and use of residual dried blood spots from state newborn screening programs

OBJECTIVES: To provide current data for policy discussions and to assess future needs among newborn screening programs regarding the storage and use of residual dried blood spots (DBS) in the United States. STUDY DESIGN: An electronic questionnaire was administered to U.S. state health department laboratory directors in 2003. RESULTS: Responses were received from 49 of the 50 states. Approximately half of them stored residual DBS for more than 6 months, 57% did not have a written policy that determines how residual DBS can or cannot be used, and 16% informed parents that DBS might be retained. Residual DBS were used by 74% of respondents for evaluation of newborn screening tests, by 52% for clinical or forensic testing, and by 28% for epidemiologic studies. Use of DBS was reported more frequently by states with extended storage. When asked if they might participate in an anonymous multistate epidemiologic study by contributing unlinked DBS, 41% responded affirmatively. CONCLUSIONS: More states have used residual DBS for evaluating newborn screening tests than for epidemiologic studies. There is potential interest among states in using unlinked DBS for multistate studies and a need for written policies addressing all uses of residual DBS.     

Prevalence of overweight in children with developmental disorders in the continuous national health and nutrition examination survey (NHANES) 1999-2002

OBJECTIVE: To estimate the prevalence of overweight in children identified with developmental disorders on the basis of nationally representative survey data. STUDY DESIGN: We estimated the prevalence of overweight in children with developmental disorders on the basis of a recent large nationally representative survey. The continuous National Health and Nutrition Examination Survey (NHANES) 1999-2002 included 4 questions to identify children with developmental disorders. Height and weight were used to calculate body mass index (BMI). BMI percentiles were estimated relative to the age- and sex-specific Centers for Disease Control and Prevention growth reference. The 85th percentile BMI defined at-risk-for-overweight and the 95th percentile BMI defined overweight. RESULTS: We found a higher prevalence of at-risk-for overweight and overweight among children with limitations in physical activity and a higher prevalence of overweight in girls with learning disabilities, compared with children without these conditions, after adjustment for age and race-ethnicity. CONCLUSION: To the extent that children with developmental disorders are included in large representative surveys, the data suggest that children with developmental disorders have a risk for overweight that is at least as great as that of typically developing children.