Follow-up of a cohort of 422 children aged 6 to 13 years conceived by in vitro fertilization

OBJECTIVE: To contact the total cohort of children conceived by IVF-ET consecutively in our center between June 1981 and December 1988. DESIGN: Retrospective study. SETTING: Infertility unit of the department of Obstetrics and Gynecology, Antoine Béclère Hospital, Clamart, France. PATIENT(S): Complete information was obtained on 370 children. The percentage lost for follow-up was 9%. INTERVENTION(S): To assess the children's well-being, telephone interviews of the parents and questionnaires sent to the parents and/or pediatrician were used. MAIN OUTCOME MEASURE(S): Surgical procedures, malformation, height and weight, school performance. RESULT(S): The physical growth of these children showed no major pathological features, with only 2.2% of them being below 2 SD for weight and 0.3% for height. The rates of malformation were not significantly different between these children and the general population. School performance was good, with 92.2% presenting encouraging outcome. Fifty-eight percent of the parents of children aged 6 to 10 years old did not inform their children about the IVF nor did 34% of the parents of children aged 11 to 13. Subsequent to the birth of the IVF child, 30 patients (8.9%) had a spontaneous pregnancy. However, five of them (15.1%) were ectopic. CONCLUSION(S): This study reports, for the first time, reassuring data on the long-term assessment of a large group of older IVF-ET children conceived consecutively, with a low percentage of subjects lost for follow-up.     

Standards of hourly excretion of B group vitamins with urine for children aged 9 to 13 years

Values of hour excretion of vitamins B1, B2, B6 and PP with urine in children of 9-13 years, studied under conditions of normal consumption of these vitamins, were estimated considering the correlation between the vitamins B concentration in blood and excretion of their metabolites with urine as well as using these parameters dependence on content of the vitamins in daily ration; for this purpose 35 adult persons and 31 children of both sexes were examined. Normal rate of riboflavin excretion with urine constituted 10-11 micrograms/h in children of this age, while of thiamine-11-12 micrograms/h. Under conditions of normal thiamine consumption, activity of erythrocyte transketolase, measured after preinactivation of transaldolase, exceeded 35 mumol/h/I ml of erythrocytes. Rates of excretion with urine of 4-pyridoxic acid and I-methyl nicotinamide were similar both in children and in adult persons and were equal to more than 40 micrograms/h and 400-600 micrograms/h, respectively.     

Automated visual field examination in children aged 5-8 years. Part II: Normative values

We determined normative values for the visual sensitivity threshold in 118 children aged 5-8 years, using automated static perimetry (Octopus 2000R, program 32). In addition, 17 normal adults were tested. The children first underwent a familiarization procedure. One week later, quantitative examination was performed according to a specially designed schedule divided into three phases. For each of the 76 points tested, mean thresholds and standard deviations were calculated as a function of age. In contrast to previous studies, sensitivity difference between adults and children over the central 30 degrees of the visual field emerged only for the youngest age groups (5- and 6-year olds). Both the response rate in false-negative trials, and values of a within-subject threshold variability index, suggested that 5- and 6-year-olds' higher thresholds were inflated by non physiological factors, such as vigilance and cognitive processes. For these ages, the data reported here should therefore be considered as an approximation of the upper level of the thresholds. In contrast, our results for 7- and 8 year-old children provided reliable normative values for light sensitivity across the visual field.     

Immunogenicity and tolerability of a trivalent influenza subunit vaccine (Influvac) in high-risk children aged 6 months to 4 years

The authors carried out an epidemiological survey from october 12 to december 4, 1995, at Medina's mother and Child care centre (MCC) in Dakar in order to assess chemoprophylaxis among pregnant women in Dakar. The midwife/pregnant women ratio is 0.08 The mentioned diagnosis criteria were relevant regards to the references established for most of the answers because since the latter base malaria diagnosis on the following signs: fever, chills, headaches and vomiting. 64.6% of them assume compliance to antimalarial chemoporphylaxis. Education level seems to be the main determining factor in this trend. Although chloroquine is the most widely used drug, nevertheless 11.9% of pregnant women assuming compliance use it at inappropriate posology. Besides, pyrimethamine is used by 12.3% of them. 34% of pregnant women do show chloroquine in urine. The plasmodial index is 1.4%. Only 8.1% of these women are supplied by health centres where shortages are noted.     

Sale of cigarettes to school children aged 14 and 15 years in New Zealand

AIMS: To determine the sources of cigarettes and extent of illegal sales to 14 and 15 year old children, and to examine associated risk factors in order to more effectively reduce tobacco access to children. METHOD: Nationwide cross sectional survey of fourth form school children in New Zealand by means of an anonymous self administered questionnaire. RESULTS: Questionnaires from 14,097 fourteen and fifteen years olds were analysed, with over one third smokers. Twenty four percent of the whole group (3432) had bought cigarettes in the last year. Of smokers, 59.9% bought their own, with the great majority (68.9%) from dairies, particularly females. Ninety five percent said it was "easy" or "very easy" to buy cigarettes, and this was a major risk factor for this behaviour (relative risk (RR) = 2.01, 95% confidence interval (CI) 1.74, 2.32, RR = 2.54, CI 2.28, 2.83, respectively). Only 24.6% children had ever been refused cigarettes because of age and all points of sale were comparable in this respect. Heavy smokers and males were more likely to have been refused. While refusal was associated with a fourfold increase in the perception that it was difficult to buy cigarettes, there was only a minimal reduction in the risk of children buying their own cigarettes (RR = 0.95, CI 0.91, 1.00). CONCLUSION: We have shown that the illegal sale of cigarettes to children is unacceptably easy and accurately perceived as such by children who smoke. The active enforcement of existing or future legislation is essential, with prosecution of offending retailers, if we are to make any progress to reduce the high prevalence of smoking in New Zealand children.     

The control of instrumental action following outcome devaluation in young children aged between 1 and 4 years.

To determine the role of action-outcome learning in the control of young children's instrumental behavior, the authors trained 18- to 48-month-olds to manipulate visual icons on a touch-sensitive display to obtain different types of video clips as outcomes. Subsequently, one of the outcomes was devalued by repeated exposure, and children's propensity to perform the trained actions was tested in extinction. On test, children with a mean age greater than 2.5 years performed the action trained with the devalued outcome less than those trained with the still-valued outcome, thereby demonstrating that their actions were mediated by action-outcome learning. By contrast, the instrumental responses of younger children (mean age     

Ability of caregivers to recognise signs of pneumonia in coughing children aged below five years

OBJECTIVES: This survey was carried out to determine: 1. The ability of caregivers to recognise signs of pneumonia in children aged below five years who are coughing. 2. The proportion of caregivers who possess a watch and are able to use that watch to count respiratory rates in children. 3. The home remedies used for cough. DESIGN: A cross sectional study. SETTING: Three Primary Health Care Clinics and a tertiary level hospital in Harare. MATERIALS AND METHODS: 413 children aged less than five years attending a health care centre for cough were studied. Socio-demographic and personal characteristics of both mother and child were documented. An inventory of home remedies that were being used since onset of cough was taken. The child was also examined for signs of pneumonia by both caregiver and research nurse. The sensitivity and specificity of the caregiver's ability to recognise signs of pneumonia compared to the research nurse was calculated. RESULTS: The ability of caregivers to recognise signs of pneumonia was high (sensitivity 95pc for hospitalized cases and 85pc for the clinic cases). Sensitivity tended to drop with increase in child's age. The caregiver's ability to recognise signs of pneumonia was not significantly related to the number of children she had or her level of education. Only 19.5pc of caregivers owned a watch and could use a watch to count respiratory rates correctly. Those who owned a watch were more likely to count respiratory rates correctly. Those who claimed ability to use a watch actually counted respiratory rates correctly. Sixty six pc had used some remedy to treat the cough at home. CONCLUSIONS: Caregivers were able to recognise signs of pneumonia without a watch. Only a small proportion of caregivers own watches and are able to use them correctly to count respiratory rates. National ARI control programmes should emphasize caregivers observing breathing when a child has a cough and encourage seeking early and appropriate health care when pneumonia is detected. Watches or timers should be made available and be recommended for use by trained health workers in health centres only. Use of potentially harmful remedies should be discouraged.     

Specific airway resistance, interrupter resistance, and respiratory impedance in healthy children aged 2-7 years

We report data on respiratory function in healthy children aged 2-7 years in whom we measured respiratory resistance by the interrupter technique (Rint); total respiratory impedance (Zrs), respiratory resistance (Rrs), and reactance (Xrs) by the impulse oscillation technique; and specific airway resistance (sRaw) by a modified procedure method in the whole body plethysmograph. Measurements were attempted in 151 children and were successfully obtained in 121 children with a mean (SD) age of 5.3 (1.5) years; no measurements were possible in 30 children (mean age 3 (0.9) years). The repeatability of measurements was independent of the age of the subjects, and the within-subject coefficient of variation was 11.1%, 8.1%, 10.8%, and 10.2% for sRaw, Rint, Zrs, and Rrs at 5 Hz (Rrs5), respectively. All lung function indices were linearly related to age, height, and weight. A significant negative correlation with age, height, and weight was found for Rint, Zrs, and Rrs5. Xrs5 was positively correlated to age and body size. The mean values of Rint, Rrs5, Xrs5, and Zrs in children younger and older than 5 years were 1.04, 1.38, -0.5, and 1.48 kPa x L(-1) x s and 0.9, 1.18, -0.37, and 1.23 kPa x L(-1) x s, respectively. sRaw showed no significant correlation with body size or age and the mean sRaw in children younger and older than 5 years was 1.09 and 1.13 kPa x s, respectively. None of the indices of respiratory function differed between boys and girls. Xrs and Rrs exhibited a significant frequency dependence in the range of 5-35 Hz. The techniques applied in this study require minimal cooperation and allow measurement of lung function in 80% of our population of awake young children. Further studies are needed to evaluate the potentials of the presently established reference values for clinical and epidemiological purposes.     

Environmental urban lead exposure and blood lead levels in children of Mexico City

Lead contamination is now a leading public health problem in Mexico. However, there are few data on the lead content of various environmental sources, and little is known about the contribution of these sources to the total lead exposure in the population of children residing in Mexico City. We conducted a cross-sectional study in a random sample of 200 children younger than 5 years of age who lived in one of two areas of Mexico City. Environmental samples of floor, window, and street dust, paint, soil, water, and glazed ceramics were obtained from the participants' households, as well as blood samples and dirt from the hands of the children. Blood lead levels ranged from 1 to 31 micrograms/dl with a mean of 9.9 micrograms/dl (SD 5.8 micrograms/dl). Forty-four percent of the children 18 months of age or older had blood lead levels exceeding 10 micrograms/dl. The lead content of environmental samples was low, except in glazed ceramic. The major predictors of blood lead levels were the lead content of the glazed ceramics used to prepare children's food, exposure to airborne lead due to vehicular emission, and the lead content of the dirt from the children's hands. We conclude that the major sources of lead exposure in Mexico City could be controlled by adequate public health programs to reinforce the use of unleaded gasoline and to encourage production and use of unleaded cookware instead of lead-glazed ceramics.     

Formulas expressing relationship among age, height and weight, and percentile in Saudi and US children aged 6-16 years

A microcomputer program in BASIC for predicting percentile of height and weight by age for Saudi and US children aged 6-16 years is designed. The formulas used in this program are derived from the data reported by Magbool et al. (Ann Saudi Med 13 (1993) 344-349) and the data of the National Center for Health Statistics (NCHS). Magbool et al. reported measurements of height and weight of 21,638 Saudi boys and girls aged 6-16 years from the Eastern Province. A mathematical model and a computer program previously published by the author are employed in this study. Analysis of the computer-assisted, predicted values and the data reported by Magbool et al. (Saudi) and the NCHS (USA) indicates that the program is accurate and reliable with a close agreement in expressing percentile as a function of age and height or weight. The computer-assisted predictive formulas can determine the relationship among the age, the height and weight, and the percentile, and as a supplement to the clinically useful reference standards of the tables and figures of Magbool et al. and the NCHS may be of value for growth evaluation of Saudi and US children.     

Long-term results of fasting. Results from 132 consecutive patients after 1-6 1/2 years

132 consecutive patients were reexamined 1-6.5 years (m = 2.8) after total fasting in hospital. 37 patients had continued to lose weight, 20 patients had maintained their fasting result (+/-2 kg) and 7 patients had slightly regained (less than 1/3 of their weight loss during fast). These 3 groups, totalling 64 patients (48%), were considered successful. Their mean overweight was diminished from 57 to 29%, corresponding to a 60% reduction of mortality in certain age groups. On the other hand, 63 patients (48%) had regained more than 1/3 of their original weight loss. Five patients (4%) were lost to follow-up. Selection of patients and long-term follow-up appeared to have a decisive bearing on long-term results of fasting, whereas factors such as age, sex, degree of overweight, onset of overweight in childhood and sports were without significant effect. From the long-term results presented, it is concluded that under certain conditions fasting in hospital is warranted. Behaviour therapy is a possible alternative in the treatment of obesity.     

Measles, polio and tetanus toxoid antibody levels in Gambian children aged 3 to 4 years following routine vaccination

A nation-wide cross-sectional survey of 816 children 3-4 years old was carried out in The Gambia between September 1990 and July 1991 to assess the seroprevalence of antibodies against 3 diseases included in the expanded programme on immunization: measles, poliomyelitis and tetanus. Among 689 children whose records were available, 94.5% were fully immunized. Measles vaccine was administered to 97% of the children and 91% of these had detectable antibodies at the time of the survey. Antibodies against type 1 and type 3 polioviruses, after up to 6 doses of oral polio vaccine, were present in 88.1% and 89.3% of the children respectively. Ninety-seven percent of the children who had received 4 doses of diphtheria-pertussis-tetanus vaccine (DPT) and 91% of those who received 3 doses had detectable tetanus toxoid antibodies at the age of 3-4 years. This study shows that serological responses to EPI vaccines given in infancy persist at very satisfactory levels throughout early childhood.     

APE/Ref-1 responses to oxidative stress in aged rats

OBJECTIVE: To compare iridocorneal angle grading systems on the basis of gonioscopy and ultrasound biomicroscopy (UBM). DESIGN: Original cross-sectional observational study. ANIMALS: 22 dogs. PROCEDURE: Gonioscopy, goniophotography, and UBM were performed on 38 eyes from dogs without clinical evidence of glaucoma in the eyes examined. RESULTS: Predominant gonioscopic grades derived from goniophotographs were considered normal (n = 26) and mild (12). Ultrasound biomicroscopy angle measurements ranged from 16 to 38 degrees (mean +/- SD, 26.2 +/- 4.5 degrees). Ciliary clefts depicted on UBM images were graded as open (n = 4), compact/narrow (23), and closed (11). Significant differences were not found between UBM-derived ciliary cleft grades and goniophotography-derived dysgenesis grades, nor between UBM-derived ciliary cleft grades and subjective gonioscopic grades. CLINICAL IMPLICATIONS: Because gonioscopy allows evaluation of the anterior face of the ciliary cleft, whereas UBM provides cross-sectional information of the iridocorneal filtration angle, UBM may yield more information regarding pathogenesis and prognosis of, and preferred management approaches to, glaucoma. Ultrasound biomicroscopy may also be useful as a predictor of glaucoma or to diagnose early stages of glaucoma.     

Current standards for body height and weight of Swiss children and adolescents 4 to 19 1/2 years old (Geneva 1972)]

New tables have recently been published containing (1) the usual percentiles of body weight and stature in each of the successive 6 months age groups, (2) two different age independent estimates of weight percentiles related to height, and (3) 50%, 80%, and 95% contours for the bivariate joint distribution of height and weight in each age group. All of the tables and charts are given for boys and girls separately. In view of the randomness of the sampling and the characteristic heterogeneity of the population concerned, these new normal limits may be declared valid not only for the entire Swiss area, but even for adjacent regions.     

Behavioral symptoms among children and adolescents. Screening with the help of a questionnaire in a group of children aged 4 to 17 years

A Danish translation of "The Child Behavior Checklist" (CBCL), developed by Achenbach and Edelbrock in Vermont, was standardized on 1,300 children aged between four and 17 years in the county of Fyn. The response rate was 61.4% and lowest among boys. Responders were compared to non-responders on different variables generated by the Danish Statistical Institute. No significant differences emerged across the two groups with respect to analysed confounders. We found a mean total CBCL score of 15-20 out of 232 possible points with considerable variation. The 95 percentile reflects a possible cut-off score for behavioural deviance or "psychiatric abnormality". This varied from 35 points in four to five years old girls to 58 points in six to ten years old boys. Parents reported hyperactivity and restlessness in 6.8% of six to ten year-old boys. Depression and sadness were reported in about 2% of all children six years or older. Six point three percent of all girls of 11-16 years selfreported obsessions. The 11-16 year-olds generally reported more symptomatic behaviour than their parents and teachers did about them.