Recommended body mass index cutoff values for overweight screening programmes in Australian children and adolescents: Comparisons with North American values

Objectives: Guidelines for screening children and adolescents for overweight have recently been published by a North American Expert Committee. As Australian clinicians might uncritically adopt these recommendations, we explore the consequences of applying North American body mass index (BMI) cutoff values to an Australian population. Methodology The Australian BMI cutoffs were calculated using the methods recommended from height and weight data for 8492 schoolchildren aged 7-15 years old. Results Smoothed Australian BMI cutoffs were similar to those derived from the first United States National Health and Nutrition Examination Survey (NHANES-I) values for whites. However, the NHANES-I cutoffs would result in systematic misclassification. Among 7 year olds, the NHANES-I 85th percentile cutoff would wrongly classify 4.6% of normal males and 9.1% of normal females as ‘at risk of overweight’. At age 14 years, the NHANES-I 95th percentile cutoff would misclassify 3.5% of children as ‘overweight’ instead of ‘at risk of overweight’. Conclusion Australian screening programmes should use BMI cutoffs appropriately derived from local measurements, and these are given for Australian children.     

A child with xeroderma pigmentosum and bone marrow failure

The case of a child with both xeroderma pigmentosum and bone marrow failure is reported. It is suggested that this is not a chance association, and that the bone marrow hypoplasia may reflect an increased susceptibility of this patient's haemopoietic stem cells to non-UV mutagens.     

People with cancer have the right to expect the best possible treatment and care *

Planning care for the patient who has cancer in his own home is at the same time similar, yet profoundly different from planning care for the patient in hospital. The similarity arises out of the diagnosis and prognosis. The difference lies in the intermittent nature of home nursing as opposed to the continuity of hospital care. Although professional care is enlisted, the bulk of the care will be given by non-professionals, such as the patient's family and friends. Hospital doctors do not identify the same sort of goals for terminally ill patients as their hospice and their nursing colleagues in general hospitals (Lunt, 1985). They rarely include the needs of relatives in their plans and have a much smaller range of goals. Therefore, they need to be encouraged to participate with other team members and to listen to the views of their multi-disciplinary colleagues. Everyone who is responsible for discharging a patient into the community must be aware of the appropriate services that can be provided.     

Cardioverter Discharges Following Sensing of Electrical Artifact Due to Fluid Penetration in the Connector Port

We report a unique case of fluid penetration, 3 months after implantation, in the connector port of an automatic implantable Cardioverter defibrillator (ICD) with transvenous subcutaneous lead system. The patient had coronary artery disease and recurrent episodes of ventricular fibrillation, the fluid caused electrical signals interpreted as ventricular fibrillation by the device, which triggered shock delivery .     

The Distribution of Alcohol Dependence Severity among In-patient Problem Drinkers

One hundred and sixty problem drinkers admitted to in-patient care were rated according to the severity of their alcohol dependence by means of two standardized questionnaires (SADQ and SADD). A bimodal distribution of scores previously reported with the SADQ was not reproduced with either questionnaire, bat there was a highly significant correlation (r=0.806) between the SADQ and SADD scores. There was 59% agreement between the two questionnaires in their placing of scores within three categories of dependence severity. The results suggest a degree of caution in equating current estimates of minimal, mild to moderate and severe dependence on the SADQ with low, medium and high dependence, respectively, on the SADD. Some difficulties experienced by subjects in completing the two questionnaires are discussed.     

The Heterogeneity of the High Molecular Weight B12 Binder in Serum

The binding of vitamin B₁₂ by serum proteins was studied by separatingCo⁵⁷B₁₂-enriched serum by Sephadex gel filtration, column chromatographywith DEAE-cellulose, and paper electrophoresis. Each method of separationyielded two discrete B₁₂-binding fractions. However, the analysis of each serumby all three separation technics indicated that one of the fractions was, ineach case, bipartite.

The "high" molecular weight B₁₂-binding fraction defined by Sephadex gelfiltration consisted of transcobalamin I and just part of the transcobalamin IIfraction. The remaining portion of transcobalamin II was eluted from Sephadexgel in a "low" molecular weight fraction. Thus, transcobalamin II, equivalentto the -globulin B₁₂-binder, consisted of both "high" and "low" molecularweight components.

This suggests that there are at least three serum proteins that can bindvitamin B₁₂: two -globulins, together comprising the transcobalamin II fraction and differing in molecular weight; and transcobalamin I.

Submitted on November 4, 1968 Accepted on January 28, 1969