Birth anthropometric measures, body mass index and allergic diseases in a birth cohort study (BAMSE)

Objective

We aimed to assess increased birth weight or birth length in relation to allergic diseases at 4 years of age, taking body mass index (BMI) at age 4 as a covariate in the adjustment.

Methods

The parents of a large prospective birth cohort answered questionnaires on environmental factors and allergic symptoms when their children were 2 months and 1, 2 and 4 years old. Perinatal data on weight and length at birth were received from the child care health centres. The children were clinically examined at 4 years of age and height and weight recorded. Blood was drawn for analysis of specific IgE antibodies to common inhalant allergens. Risk associations between birth anthropometric measures and wheeze, allergic diseases or sensitisation were estimated in multivariate logistic regression analyses (n = 2869).

Results

There were no clear overall associations between birth weight and allergic diseases at 4 years of age. Birth length ⩾90th percentile was inversely associated with any wheeze at age 4 (adjusted OR 0.64, 95% CI 0.44 to 0.92) but was significantly associated only with late‐onset wheeze (adjusted OR 0.40, 95% CI 0.21 to 0.77). No such associations were seen for persistent or transient wheeze, eczema, rhinitis or allergic sensitisation. Transient wheeze during the first 2 years of age tended to be associated with increased BMI at age 4.

Conclusion

Increased birth weight was not associated with wheeze or allergic disease. Increased birth length may play a protective role in late‐onset wheeze in early childhood.     

Enhanced thrombin generation and fibrinolytic activity in normal pregnancy and the puerperium.

Blood coagulation and fibrinolytic inhibitors and the balance between and within the two systems were investigated in 26 normal pregnant women during pregnancy and the puerperium. The concentration of the coagulation inhibitors antithrombin and protein C remained within normal levels, whereas the mean level of free protein S showed a significant decrease from 0.26 U/mL in early pregnancy to 0.14 U/mL in week 35. At the same time, soluble fibrin levels increased from 9.2 to 13.4 nmol/L and thrombin-antithrombin complexes increased from 3.1 to 7.1 micrograms/L; both are indicators of thrombin activity. A concurrent increase in the levels of the fibrinolytic inhibitors plasminogen activator inhibitor-1 and -2 from 7.4 to 37.8 AU/mL and 31 to 160 micrograms/L, respectively, suggests a decrease in fibrinolytic activity. However, the levels of fibrin D-dimer, ie, fibrin split products, also increased in parallel from 91 to 198 micrograms/L, suggesting that fibrinolysis is present. Thus, a balance normally exists, which is probably why thrombotic events are rare during pregnancy.     

Effect of the Choice of Primary Chemotherapy on the Cumulative Length of Stay in Hospital for Multiple Myeloma

The actual use of hospital beds for patients with multiple myeloma was calculated from a randomised trial of primary treatment with either melphalan and prednisone (MP, 66 patients) or intensive combination chemotherapy with vincristine, cyclophosphamide, lomustine, melphalan and methylprednisolone (MOCCA, 64 patients). The survival of the patients was similar in both arms, and the samples, 20 and 32 patients, respectively, were well representative for the whole arms. The average numbers of hospital days were similar fur both arms. For the first year MP 33.2 (SD 27.6) vs. MOCCA 32.1 (SD 19.0), and during the first to 4th years 78.5 (SD 45.9) vs. 67.8 (SD 34.1). For the year of death it was 50.4 (SD 33.1) vii. 36.3 (SD 27.0), respectivelly. Thus the choice of primary chemotherapy whether conventional or more aggressive had no influence on the actual number of in-patient hospital days concerned. When the combination chemotherapy schedule is well tolerated it can be administered just as well on an ambulatory basis or by using it with very short admissions. It seems that the need for inpatient care for patients with multiple myeloma is mostly related to the complications of the disease itself and to intercurrent disorders including infections.     

Psychiatric hospital treatment of young people

To develop and extend psychiatric work among the young, information is required on, e.g., the manner and extent to which young people have so far made use of psychiatric hospital services. In this study report, psychiatric hospital treatment from age 15-21 years is described epidemiologically. The percentage of young people treated in psychiatric institutions during the 7-year follow-up period was 2.7. Of all the young psychiatric patients in this cohort, only some 20% required institutional care. A small group of about 0.7% of the total young population accounted for some 70% of the total number of psychiatric hospital days involving young people.     

Effects of propiomazine on the EEG sleep of normal subjects

The effects of 25 mg propiomazine were examined in ten healthy volunteers in a sleep laboratory setting. A significant decrease in sleep latency and a corresponding decrement in subjectively assessed sleep latency was found during drug treatment. The distribution of the different sleep stages was affected to a relatively small extent. Some evidence for a suppression of REM-sleep in the early part of the treatment period was found. Based on subjective assessment, the subjects rated their sleep quality as significantly improved during treatment. Ratings of "drowsiness in the morning" were not different during baseline and drug treatment, but there was a significant decrease at withdrawal.     

Poor sleep and psychiatric symptoms at school: an epidemiological study

The objective of this study was to evaluate associations between sleep problems and psychiatric symptoms at school. A random sample consisting of 5813 eight- to nine-year-old children was selected from ordinary schools. Both parents' and children's reports of sleep problems were taken into account. The psychiatric symptoms were addressed according to the teachers' reports (the Rutter Scale B). Children with severe sleep problems were more likely to have a psychiatric disturbance according to the Rutter B Scale (OR 2.45, 95 % CI 1.85–3.25). Logistic regression models showed that severe sleep problems were highly associated with emotional problems (OR 2.74, 95 % CI 1.84–4.13), school attendance problems (OR 2.53, 95 % OR 1.45–4.41), behavioural problems (OR 2.44, 95 % CI 1.59–3.75) and hyperactivity (OR 2.02, 95 % CI 1.30–3.13). Over 95 % of severe sleep problems were reported only by the children themselves. In conclusion, children with severe sleep problems have substantially more teacher-reported psychiatric symptoms than those with no or mild sleep complaints. In diagnosing sleep disorders, it is important to include children as informants because relevant information may be overlooked when only parents are questioned. Accepted: 20 August 2001