Distribución espacial y tendencia secular (1991-2014) de nacidos pequeños para la edad gestacional en Jujuy / Spatial distribution and secular trend (1991­2014) of small for gestational age infants born in Jujuy

Introducción. El feto que no alcanza el potencial de crecimiento esperado en el útero se considera pequeño para la edad gestacional (PEG). Esta restricción depende de factores genéticos y/o ambientales; la altura geográfica es uno muy relevante. Este trabajo analiza la distribución espacial de las prevalencias de PEG y su tendencia secular en Jujuy (1991-2014). Materiales y métodos. Se analizaron los registros de 308 469 nacidos vivos de Jujuy (Dirección de Estadísticas e Información de Salud). Se estimaron prevalencias de PEG (peso/edad gestacional

Introduction. A fetus that does not reach the expected growth potential in utero is considered small for gestational age (SGA). Such restriction depends on genetic and/or environmental factors, being altitude a very relevant factor. This study analyzes the spatial distribution of the prevalence of SGA and its secular trend in Jujuy (1991­2014). Materials and methods. The records of 308 469 live births in Jujuy (Health Statistics and Information Department) were analyzed. The prevalence of SGA (weight/gestational age < P10 and < P3) was estimated for sex according to the INTERGROWTH-21 st standard in the ecoregions of Jujuy (Valle and Ramal ­less than 2000 MASL­, Puna, and Quebrada) across 3 periods (1991­2000, 2001­2009, 2010­2014) and proportions were compared. The secular trend was assessed using the Joinpoint regression analysis. Results. The overall prevalence of SGA was 2.3% (< P3) and 7% (< P10). Significantly higher values were observed in Puna and Quebrada in both SGA categories and across all periods. Only in Valle, significant differences were observed between sexes across all periods. The prevalence of SGA showed a significant downward secular trend at a provincial and regional level, and this was greater in Quebrada (5.2% < P3 and 3.5% < P10). Conclusions. A consistent and significant decrease in the prevalence of SGA has been observed since the 1990s in Jujuy, where altitude is itself a determining factor of size at birth, since the Puna and Quebrada regions showed the highest prevalence of SGA during the entire period.

Predictive Performance Of Different Diagnostic Criteria For Overweight And Obesity Between 2008-2015 In Adolescents

Background: The reference cut-offs for overweight and obesity have evolved from the use of International obesity task force (IOTF) to extended IOTF and revised Indian Academy of Pediatrics (IAP) growth charts. Methods: Secondary analysis of anthropometric data of school-going children from Delhi in the year 2008, 2013 and 2015 was performed. The proportions of children with overweight, obesity, and undernutrition were checked for agreement using different diagnostic cutoffs, and compared at three-time points. Results: Among 8417 adolescents, weighted Kappa statistics showed good agreement between extended IOTF and IAP cutoffs (k=0.933; 95% CI 0.93-0.94), between eIOTF and IOTF (k=0.624; 95% CI 0.619 - 0.629) and between IAP and IOTF (k=0.654; 95% CI 0.645-0.662). A higher proportion of adolescents were diagnosed with obesity with extended IOTF and IAP charts than IOTF charts (P<0.001 for both genders). The mean (SD) BMI showed a rising trend for adolescents overall from 19.61 (3.89) kg/m2 in 2008, 20.44 (4.37) kg/m2 in 2013 and 20.88 (4.60) kg/m2 in 2015 (P<0.001). 158 adolescent (97 girls) were undernourished using combined IAP and extended IOTF criteria. Conclusion: Both extended IOTF and IAP charts showed good agreement for diagnosing overweight and obesity in adolescents. A secular trend in malnutrition was observed in adolescent girls.

Trends in body height, body weight, BMI, and nutrition status from 1979 to 1987: a measurement-based analysis of 10, 954 male adolescents from the municipality of Bijelo Polje / Tendencias en la altura corporal, el peso corporal, el IMC y el estado nutricional de 1979 a 1987: un análisis basado en mediciones de 10. 954 adolescentes varones del municipio de Bijelo Polje

SUMMARY: This study aimed to consolidate data regarding body height, body weight, body mass index, and nutrition status of the entire young male population from the Municipality of Bijelo Polje in order to estimate trends from 1979 to 1987. The sample of respondents includes 10,954 young males divided into nine groups. The measurement sample includes body height, body weight, and body mass index based on two previous measures. The descriptive statistics were expressed as a mean and standard deviation for each variable, while the analysis of nutrition status was done based on body mass index (underweight, normal weight, pre-obese, obese). The results showed that a secular trend in the observed study period is not visible regarding body height, body weight, and body mass index. The contribution of this study is reflected in the fact that there were no previously published data for this period and this municipality; the data can significantly aid in monitoring the secular trends throughout Montenegro.

RESUMEN: Este estudio tuvo como objetivo consolidar los datos sobre la altura corporal, el peso corporal, índice de masa corporal y el estado nutricional de toda la población masculina joven del Municipio de Bijelo Polje con el fin de estimar las tendencias de 1979 a 1987. La muestra de encuestados incluyó 10.954 hombres jóvenes divididos en nueve grupos. Las mediciones incluyeron la altura corporal, el peso corporal y el índice de masa corporal basado en dos medidas anteriores. Las estadísticas descriptivas se expresaron como media y desviación estándar para cada variable, mientras que el análisis del estado nutricional se realizó con base en el índice de masa corporal (bajo peso, peso normal, pre-obesidad, obesidad). Los resultados mostraron que una tendencia secular en el período de estudio observado no es visible con respecto a la altura corporal, el peso corporal y el índice de masa corporal. La contribución de este estudio está basada en que no existían datos publicados previamente para este período y en este municipio; los datos pueden ayudar significativamente a monitorear las tendencias seculares en todo Montenegro.

Hokkaido birth cohort study on environment and children's health: cohort profile 2021

BACKGROUND@#The Hokkaido Study on Environment and Children's Health is an ongoing study consisting of two birth cohorts of different population sizes: the Sapporo cohort and the Hokkaido cohort. Our primary objectives are to (1) examine the effects that low-level environmental chemical exposures have on birth outcomes, including birth defects and growth retardation; (2) follow the development of allergies, infectious diseases, and neurobehavioral developmental disorders, as well as perform a longitudinal observation of child development; (3) identify high-risk groups based on genetic susceptibility to environmental chemicals; and (4) identify the additive effects of various chemicals, including tobacco.@*METHODS@#The purpose of this report is to provide an update on the progress of the Hokkaido Study, summarize recent results, and suggest future directions. In particular, this report provides the latest details from questionnaire surveys, face-to-face examinations, and a collection of biological specimens from children and measurements of their chemical exposures.@*RESULTS@#The latest findings indicate different risk factors of parental characteristics on birth outcomes and the mediating effect between socioeconomic status and children that are small for the gestational age. Maternal serum folate was not associated with birth defects. Prenatal chemical exposure and smoking were associated with birth size and growth, as well as cord blood biomarkers, such as adiponectin, leptin, thyroid, and reproductive hormones. We also found significant associations between the chemical levels and neuro development, asthma, and allergies.@*CONCLUSIONS@#Chemical exposure to children can occur both before and after birth. Longer follow-up for children is crucial in birth cohort studies to reinforce the Developmental Origins of Health and Disease hypothesis. In contrast, considering shifts in the exposure levels due to regulation is also essential, which may also change the association to health outcomes. This study found that individual susceptibility to adverse health effects depends on the genotype. Epigenome modification of DNA methylation was also discovered, indicating the necessity of examining molecular biology perspectives. International collaborations can add a new dimension to the current knowledge and provide novel discoveries in the future.

Secular trends in suicidal ideation and associated factors among adolescents

Objectives: Suicide is one of the leading causes of death in adolescence, and the second most common cause of death among young people. The objective of this study was to identify trends in suicidal ideation by sex and ascertain factors associated with this outcome. Methods: Secular trend study with statewide coverage conducted at 5-year intervals, with 4,207 adolescents (2006), 6,264 adolescents (2011) and 6,026 adolescents (2016). Logistic regression was used to evaluate the secular trend of suicidal ideation. Multilevel logistic regressions evaluated the factors associated with suicidal ideation in the survey conducted in 2016. Results: There was a positive trend in suicidal ideation prevalence in 2016 compared to the prevalence in 2006 and 2011, in both boys and girls. Low social support, poor sleep quality, and low parental supervision were associated with suicidal ideation in boys and girls. Exposure to violence and bullying was associated with suicidal ideation only in girls. TV time and computer and videogame time were not associated with suicidal ideation in boys or girls. Conclusion: There is an alarming trend of increased suicidal ideation in adolescents. Several dimensions were associated with suicidal ideation in adolescents, especially social support, sleep quality, and parental supervision.

Epidemiología de las muertes súbitas infantiles inesperadas en Argentina: tendencia secular y variación espacial / Epidemiology of sudden unexpected death in infancy in Argentina: secular trend and spatial variation

Introducción. La mortalidad infantil incluye defunciones de menores de un año. La proporción de muerte súbita inesperada infantil (MSII) varía entre países y según las causas de muerte consideradas. Objetivo. Describir la variación espacial y temporal de MSII en Argentina entre 1991 y 2014 utilizando la Clasificación Internacional de Enfermedades, décima revisión. Materiales y métodos. A partir de la información de defunciones infantiles (Dirección de Estadísticas e Información de Salud), se calculó el porcentaje de MSII sobre el total de muertes infantiles y la frecuencia de las causas que la componían a nivel nacional, regional y provincial. El riesgo de muerte y la tendencia secular se calcularon con regresión de Poisson. Para detectar agrupamientos departamentales con porcentajes de MSII significativamente diferentes a los nacionales, se utilizó el programa SaTScan v9.1.1. Resultados. En Argentina, entre 1991 y 2014, fallecieron 267 552 menores de un año; el 7 % fueron MSII; la tendencia secular de estas causas fue negativa y estadísticamente significativa; el riesgo de MSII fue de 0,86, y se observó una gran heterogeneidad espacial. A nivel nacional, la causa más frecuente fue síndrome de la muerte súbita del lactante, con diferencias interregionales. Nueve agrupamientos departamentales tuvieron riesgo de MSII entre 4,36 y 1,24, significativamente diferentes al resto del país. Conclusiones. La proporción de MSII y de las causas que la componen presenta heterogeneidad interregional con predominio de códigos relacionados con diagnósticos imprecisos en las regiones más desfavorecidas y de síndrome de muerte súbita del lactante en las más desarrolladas.

Introduction. Infant mortality comprises deaths among infants younger than one year old. The proportion of sudden unexpected death in infancy (SUDI) varies by country and based on the cause of death. Objective. To describe the spatial and temporal variation of SUDI in Argentina between 1991 and 2014 according to the International Classification of Diseases, tenth revision. Materials and methods. Based on infant death data (provided by the Health Statistics and Information Department), we estimated the percentage of SUDI over the total number of infant deaths and the frequency of causes of death at a provincial, regional, and national level. The risk for death and the secular trend were estimated using a Poisson regression. The SaTScan software, v9.1.1, was used to detect clusters of districts where the percentage of SUDI was significantly different from the national percentage. Results. In Argentina, between 1991 and 2014, 267 552 infants younger than 1 year died; 7 % corresponded to SUDI; the secular trend of causes was negative and statistically significant; the risk for SUDI was 0.86, and a great spatial heterogeneity was observed. At a national level, the most common cause was sudden infant death syndrome, with inter-regional differences. In nine district clusters, the risk for SUDI ranged between 4.36 and 1.24, which is significantly different from the rest of the country. Conclusions. The proportion of SUDI and its causes show inter-regional heterogeneity; codes related to inaccurate diagnoses predominated in more unfavorable regions, while sudden infant death syndrome was prevalent in the more developed regions.

A study of anthropometric parameters of school children: a cross sectional study in Rajasthan

Background: The ongoing research in the school health domain is necessary to understand the secular trends in anthropometric parameters. Our study is an attempt to analyze the cross sectional findings and comparison with national reference studies to draw a conclusion on changing attributes of anthropometric parameters with time.Methods: The present study was adapted as a school based, cross sectional, observational epidemiological study design. We have analyzed the data generated out of assessment of height and weight (anthropometric analysis) along with other evaluation as a part of comprehensive health examination.Results: We evaluated, a total of 995 students, aged 5-16 years of which, 569 (57.2%) were boys and 426 (42.8%) were girls. BMI percentiles were calculated for both schoolboys and schoolgirls. Comparisons of the present height and weight curves with earlier data from India and multi country data from WHO was done. In this study prevalence of overweight was 10.35% which indicates the rising trends of childhood overweight and obesity.Conclusions: The trends of changing anthropometric measurements as evident in our study indicate the schoolchildren are growing taller and heavier. With increase in BMI, the prevalence of childhood overweight is on high level but level of underweight and under nutrition per say is low, probably due to quality food availability and increased buying capacity of families.

Secular Trends of Multiple Birth Rate in Korea: 1981–2017

PURPOSE: To determine the secular trend of the multiple birth rate in Korea from 1981 to 2017. METHODS: This study used birth certificate data covering the years 1981–2017 (20,948,901 births), provided by Statistics Korea. The impact of assisted reproductive technologies (ART) on multiple birth was analyzed by examining data prior to and after the introduction of ART and the national support program for infertile couples in South Korea. The odds ratio (OR) and 95% confidence intervals were calculated to describe the secular trend in the multiple birth rate per 100 births. RESULTS: During this period, the multiple birth rate per 100 births increased by 277 percent from 1.031 to 3.891, the twin birth rate increased from 1.013 to 3.807 (275%), and the triplet birth rate increased from 0.018 to 0.084 (363%). The secular trend of the multiple birth rate remained in the 1.000 level during 1981–1991, but has been rising steadily since 1992. The average increment of the multiple birth rate was 3.9% annually from 1981 through 2017 (peaking at more than 10 percent during 2006–2007). Prior to the introduction of ART in Korea (1981–1984), the multiple birth rate was 1.007, but after its introduction, the multiple birth rate was 1.005 in 1985–1989 (OR, 0.998; 95% confidence interval, 0.982–1.014), 1.084 in 1990–1994 (1.007; 1.060–1.094), 1.891 in 2000–2004 (1.894; 1.866–1.922), 3.127 in 2010–2014 (3.173; 3.129–3.217), and 3.811 in 2015–2017 (3.893; 3.835–3.952). CONCLUSION: Over the past three decades, multiple births have risen dramatically in Korea, primarily due to the increasingly widespread use of fertility therapies, and the delayed age of childbearing. There is a need for more research to understand the factors contributing to multiple births, and the national birth registration systems ought to be reformed to monitor whether multiple births originated spontaneously or from assisted-conception.

Early-life exposure to endocrine-disrupting chemicals and pubertal development in girls

Over the last decades, the onset of puberty in girls has occurred earlier, but the tempo of pubertal progression has been relatively slower, resulting in a younger age at puberty onset without a change in age at menarche. Sufficient energy availability and adiposity contribute to early pubertal development, and environmental factors, such as endocrine-disrupting chemicals (EDCs), may affect not only the control of energy balance, but also puberty and reproduction. EDCs are hormonally active substances that can perturb puberty by acting both peripherally on target organs, such as adipose tissue or adrenal glands, and/or centrally on the hypothalamic-pituitary-gonadal (HPG) axis. Depending on whether the exposure takes place earlier during fetal and neonatal life or later during early childhood, EDCs can lead to different outcomes through different mechanisms. Evidence of associations between exposures to EDCs and altered pubertal timing makes it reasonable to support their relationship. However, human epidemiologic data are limited or inconsistent and cannot provide sufficient evidence for a causal relationship between EDC exposure and changes in pubertal timing. Further investigation is warranted to determine the overall or different effects of EDCs exposure during prenatal or childhood windows on pubertal milestones and to reveal the underlying mechanisms, including epigenetic marks, whereby early-life exposure to EDCs affect the HPG-peripheral tissue axis.

Variabilidad del crecimiento y la maduración física en venezuela entre 1939 y 2016 / Variability of growth and physical maturation in venezuela between 1939 and 2016

La variabilidad del crecimiento y la maduración física de los venezolanos entre 1939 y 2016 es el producto de una revisión histórica-antropológica, no-sistemática ni exhaustiva, que se focaliza en la auxología epidemiológica. Como marco conceptual, se presentan los aspectos fundamentales de la variabilidad genética-biológica del crecimiento: dimorfismo sexual, variabilidad de acuerdo al ritmo de maduración y los grupos étnicos en Venezuela, país de mestizaje. En el aspecto fundamental de la variabilidad ambiental se incluye el crecimiento y desarrollo en las alturas, pero la visión se focaliza en las diferencias urbano-rurales, de acuerdo al estrato social y en los procesos dinámicos poblacionales tal como la tendencia secular en crecimiento y maduración, indicador del progreso o retroceso de una población y la transición alimentaria y nutricional y sus consecuencias, tal como la doble carga nutricional. El mestizaje, de amerindio, descendientes de africanos y de europeos, no es homogéneo, existen diferencias significativas entre regiones y entre estratos sociales. El área metropolitana de Caracas resultó diferente al resto del país, debido a: composición genética distinta, estructura demográfica y social urbana y predominio de estratos altos y medio altos. Las diferencias urbano rurales en crecimiento fueron menores que entre estratos sociales, debido a ritmos de maduración distintas. La crisis alimentaria actual puede modificar la tendencia secular, disminuir la obesidad y aumentar el déficit nutricional. Se recomienda sistematizar la información documental la cual se encuentra dispersa y no digitalizada y utilizar cualquier estudio de población para realizar proyecciones y analizar tendencias con métodos estadísticos apropiados(AU)

Variability in growth and development in Venezuela between 1939 and 2016 is the result of an historic-anthropological non-systematic, non-exhaustive review, with a focus on auxologic epidemiology. As a conceptual framework, the fundamental aspects of biological and genetic variability of growth are discussed: sexual dimorphism, variability according to the tempo of growth, the worldwide variation according to the different ethnic groups and their admixture in Venezuela. The fundamental aspects of the environment include growth differences according to altitude, yet the focus lies in auxologic epidemiology : urban-rural differences, differences according to social strata, as well as the dynamic processes such as the secular trend in growth and maturation-an indicator of the progress or recession of a population--and the Food and Nutrition Transition and its consequences, specially the double burden of nutrition. The latter could be modified by the actual food crisis: diminishing overweight and obesity and increasing current and past malnutrition, eventually affecting negatively the secular trend. Documents and sources of information should be systematized and made available in digital formats and any growth and development survey could be used in analyzing trends and outcomes if the proper statistical methods are used(AU)

A national survey on physical growth and development of children under seven years of age in nine cities of China in 2015 / 中华儿科杂志

To investigate and analyze the status of physical growth and its change in children under 7 years of age in 9 cities of China, and to provide scientific data for renewing and developing the new growth reference of Chinese children. Data of healthy children under 7 years of age were collected by stratified cluster sampling method in Beijing, Harbin, Xi'an, Shanghai, Nanjing, Wuhan, Guangzhou, Fuzhou and Kunming during the period from June to November in 2015. They were divided into 22 age groups. The sample size of boys or girls, urban or suburban was 150-200 in each age group in each city, and the total sample size in the 9 cities was 161 774. Weight, length/height, head circumference, sitting height, chest circumference and waist circumference were measured by the trained investigators using standard methods. There were strict quality control measures during investigation process. The test was used to compare the difference of physical growth between two groups and one-way ANOVA was used to compare the difference of physical growth among three groups. (1) The level of physical growth of children under 7 years were different between boys and girls, urban and suburban, as well as different regions of China in 2015. The urban-suburban difference was more significant in children older than 8 months, that is, the weight and height of urban children were greater than those of suburban children (0.01-0.48 kg and 0.1-1.1 cm respectively). (2) Weight and height of children in the 9 cities, whether urban or suburban areas, had been greater than WHO growth standards, for example, the Z-scores of height values of urban and suburban children were 0.43 ±0.99 (130.551, 0.05) and 0.30 ±1.01 (87.407, 0.05) higher than the WHO standards. (3) The physical growth of children in the 9 cities was improved in varying degrees during the past 10 years. For example, the changes of weight and height in urban children under 3 years were not significant, while there was significant improvement among children older than 3 years and the increasing trend became apparent along with the increasing of age (0.05-1.18 kg in weight and 0.5-1.8 cm in height). The urban-suburban difference of physical growth in each age group of boys and girls narrowed significantly during the past 10 years, which was clearly shown from the narrowing urban-suburban differences of weight and height in boys aged 5.5-<6.0 years (1.58 kg in 2005 . 0.44 kg in 2015 and 2.8 cm in 2005 . 0.9 cm in 2015) . (4) From the increments of each decade during 1975-2015, a rapid increments of physical growth during 1975-2005 were found, while the increments after 2005 had slowed comparing with that of the previous period in urban areas, for example, the increments of height in boys aged 5.5-<6.0 years were 1.5, 2.1, 2.7, 0.7 cm respectively in the 1(st), 2(nd), 3(rd) and 4(th) decade (1975-1985, 1985-1995, 1995-2005, 2005-2015) . In suburban areas, the trends of the previous 3 decades were similar with that of urban children, while the increments of the 4(th) decade were still bigger though they were slightly smaller than those of the 3(rd) decade, for example, the increments of height in boys aged 5.5-<6.0 years were 2.4, 2.3, 3.2, 2.6 cm in the 1(st), 2(nd), 3(rd) and 4(th) decade respectively. Physical growth of children under 7 years of age showed a slow positive secular trend during the last decade after a rapid increase. The increments of suburban children's physical growth were greater than those of urban children. The physical growth of children under 7 years in 9 Chinese cities exceeded the WHO standards.

Relación de la mortalidad infantil con la altura geográfica en el Noroeste Argentino / Relationship between infant mortality and altitude in the Northwest region of Argentina

Introducción. Por su localización sobre los Andes, el Noroeste Argentino presenta una heterogeneidad geográfica, socioeconómica, cultural y biológica reflejada en tasas de mortalidad infantil (TMI) superiores a casi todas las regiones argentinas. Objetivo. Calcular la TMI, tasa de mortalidad neonatal (TMN) y la tasa de mortalidad posneonatal (TMP) para analizar su variación temporal y espacial, a través de la tendencia secular y el riesgo relativo de acuerdo con el nivel altitudinal. Población y método. En un estudio retrospectivo, descriptivo y de correlación basado en datos de nacimientos y defunciones infantiles sucedidos en el Noroeste Argentino (1998-2010), se calcularon por departamentos y nivel altitudinal (departamentos a < 2000metros sobre el nivel del mar, tierras bajas y > 2000 msnm, tierras altas) TMI, TMN y TMP, tendencia secular y riesgo relativo de muerte, realizando un análisis de agrupamiento. Resultados y conclusiones. Las tasas fueron más elevadas en tierras altas, la TMI fue de 29,8%o (en tierras bajas, 15,6%); la TMP en tierras altas fue de 17,7% y 5,2% en tierras bajas. Las tierras altas mostraron un descenso promedio anual del 3,9% para la TMI y del 4,1% para la TMP; en tierras bajas, el descenso fue de 7,0% para la TMI y del 9,3% para la TMP. El riesgo relativo fue significativamente mayor a grandes alturas para TMI y TMP. La TMN, su tendencia secular y riesgo relativo no mostraron diferencias estadísticamente significativas entre niveles de altura.

Introduction. Given its location on the Andes, the Northwest region of Argentina is geographically, socioeconomically, culturally, and biologically heterogeneous, and this is reflected on an infant mortality rate (IMR) that is higher than in any other Argentine region. Objective. To estimate IMR, neonatal mortality rate (NMR), and post-neonatal mortality rate (PNMR), and to analyze their spatial and temporal variations using secular trends and the relative risk based on altitudinal zones. Population and method. This was a retrospective, descriptive, correlational study based on birth and death data recorded in the Northwest region of Argentina (1998-2010); IMR, NMR, PNMR, secular trends, and the relative risk of death were calculated by district and altitudinal zone (districts at < 2000 meters above sea level, lowlands; at > 2000 meters above sea level, highlands) by means of a cluster analysis. Results and conclusions. Rates were higher in the highlands; IMR was 29.8%o (versus 15.6%o in the lowlands); PNMR was 17.7% in the highlands (versus 5.2% in the lowlands). In the highlands, there was an annual average reduction of 3.9% in IMR and of 4.1% in PNMR; in the lowlands, such reduction was of 7.0% in IMR and of 9.3% in PNMR. The relative risk of IMR and PNMR was significantly higher at high-altitude zones. NMR, its secular trend, and the relative risk did not show statistically significant differences between both altitudinal zones.

Changes in morphological characteristics during the period 2005 ­ 2014 in a sample of Serbian 7 - year-old children / Cambios en las características morfológicas durante el período 2005 - 2014 en una muestra de niños serbios de 7 años de edad

Morphological characteristics of children commonly imply the processes of growth and development. Information on children's growth in height and their body weight is often used as the indicator of the children's health and nutritional status. As the parameters are changeable both temporally and spatially, it is important to provide their continual assessment. The aim of the study is to investigate the changes in morphological characteristics in a sample of Serbian 7-year-old children in the period 2005 ­ 2014. The data was gathered from medical documentation recorded in the period 2005-2014 in the local health-care centre "Dr Dusan Savic­ Doda" in Beocin, which is situated in the central part of the province Vojvodina, the north-west part of Serbia. Most of the population consists of Serbs (69.7 %), and the second largest group are Roma (9 %) who came to this region in the 1990s as refugees from Kosovo. The categorization of the participants was based on their decimal age ranging from 6.50 to 7.49 years. Body height and weight were measured, and nutritional status categories were set in relation to the cut off values of body mass index (BMI) of the age of 7 (kg/m2) as proposed by IOTF- International Obesity Task Force. The study has pointed to an increasing trend in height and a decrease of BMI. Analysing the period of ten years, the height, weight and BMI in seven-year-olds living on the territory on Beocin municipality have proven to be slightly lower than in the children of the same age in other parts of Vojvodina and Serbia. The obtained results point to the need of further investigations of children living in this region in order to provide a better insight into the changes of the morphological parameters.

Las características morfológicas de los niños suelen implicar los procesos de crecimiento y desarrollo. La información sobre el crecimiento de los niños en altura y peso corporal se utiliza a menudo como el indicador de su salud y de su estado nutricional. Como los parámetros son cambiantes tanto temporalmente como espacialmente, es importante realizar una evaluación continua. El objetivo del estudio fue investigar los cambios en las características morfológicas en una muestra de niños serbios de 7 años en el período 2005-2014. Los datos se obtuvieron de la documentación médica registrada en el período 2005-2014 en el Centro de Atención de Salud "Dr Dusan Savic - Doda" en Beocin, situado en la region central de la provincia Vojvodina, al Noroeste de Serbia. La mayor parte de la población se compone de serbios (69,7 %) y el segundo grupo más grande son los romaníes (9 %) que llegaron a esta región en la década de 1990 como refugiados de Kosovo. Los participantes fueron clasificados en base a su edad decimal de 6,50 a 7,49 años. Se midió la estatura y el peso corporal y se establecieron las categorías de estado nutricional en relación con los valores de corte del índice de masa corporal (IMC) de 7 años de edad (kg / m2), según lo propuesto por IOTF International Obesity Task Force. El estudio ha señalado una tendencia creciente en altura y una disminución del IMC. Analizando el período de diez años, la altura, el peso y el IMC en niños de siete años que viven en el territorio del municipio de Beocin han demostrado ser ligeramente más bajos que en los niños de la misma edad en otras areas de Vojvodina y Serbia. Los resultados obtenidos apuntan a la necesidad de nuevas investigaciones de los niños que viven en esta región con el fin de proporcionar una mejor visión de los cambios en los parámetros morfológicos.

Development of anterior fontanelle in Chinese children in 2015 / 中华儿科杂志

Objective@#To observe the development of the anterior fontanel (AF) in healthy Chinese children from 1 to 36 months, and to assess the relationship between the closure of the AF and physical development in Chinese children.@*Method@#This was a cross-sectional evaluation of the AF in a series of 104 147 healthy children between June 2015 and October 2015 from nine cities in China. The size and closure of AF of the children were measured and recorded, and the age for the closure of AF was calculated using probit analysis. The data in 2015 were compared with the data from the same surveys in 1985, 1995 and 2005 respectively.@*Result@#(1) Totally, 104 147 healthy children (52 216 boys and 51 931 girls; range 1 month to 36 months) from nine cities enrolled in this cross-sectional study. (2)The size of AF gradually decreased with age, and the mean size of AF was 2.0(95% confidence interval (CI)2.0-2.1) cm at the age of 1 month, 0.6(95% CI 0.5-0.6) cm at the ages of 12-14 months, and 0.0(95% CI 0.0-0.0) cm at the ages of 21-23 months, respectively. (3) The percentage for the closure of AF was 0.1% at the age of 3 months, 67.5% at the ages of 15-17 months. The oldestt age for closure was 35 months. The mean age for the closure of AF was 14.5 months (95% CI 14.4-14.6), and the 3rd and 97th centiles of the age for the closure of AF were 6.6 and 22.4 months. (4) Over the past 30 years from 1985 to 2015, no significant change was found regarding the mean age for the closure of AF in children from urban area, contrarily, the mean age was 1.1 months earlier in suburban area. (5) The height and weight of children in the closed AF group were significantly higher than those of children in unclosed AF group(all P<0.01), but no significant difference was found regarding the head circumference between the two groups.@*Conclusion@#The size of AF at 1 month was maximum, then decreases gradually with age, and the mean age for the closure of AF was 14.5 (95% CI 14.4-14.6) months. No significant correlation was found between the development of AF and the head circumference, but there was a positive correlation between the development of AF and the height and weight. There was no significant change regarding the secular trend of the age for the closure of AF.

Trends of meningococcal meningitis with Neisseria meningitidis in Shijiazhuang, 1949-2014 / 中华传染病杂志

Objective To study the trends over time in meningococcal meningitis with Neisseria meningitidis .Methods Routine reported data on Meningococcal meningitis with Neisseria meningitidis in Shijiazhuang from 1949 to 2014 were used to study the trends of disease severity,disease distribution and serogroup switching of Neisseria meningitidis strains over time.The qualitative description and the quantitative evaluation was performed by the annual percent change (APC)in incidence to demonstrate the secular trends.The t test and χ2 test were performed when appropriate.Results From 1949 to 2014, 53 779 meningococcal meningitis cases were reported in Shijiazhuang.Of the 53 779 cases,36 170 were male and 17 609 were female,which was significantly different (χ2 =581 .04,P =0.000).It occurred all the year round,with an increased incidence between February and April,accounting for 81 .44%.The epidemic peak occurred about every 10 years.The range of annual incidence rate was from 0.01/lakh to 387.21/lakh.APC was -4.65 (t=-11 .72,P =0.000).The significant decline of APC were found in the age group of 0—1 year (t=-10.56,P =0.000),1 —5 year (t =-14.32,P =0.000),5 —10 year (t=-11 .01 ,P =0.003 ),10—15 year (t = -8.34,P =0.033 )and 40—50 year (t = -7.42,P =0.045).The risk population was those under 5 years old during 1949 to 2002 period and the serogroup was dominated by A strains.Whereas during 2003 to 2014,that was those of 5 —15 years old,and the dominant serogroup was C strains. Conclusions There is a remarkable decline in incidence of meningococcal meningitis in Shijiazhuang.The serogroup changes from A strains to C strains and the risk population of cases shifts to older children.

The relationship between malocclusion and menarcheal age, and its secular trend for Korean women / 대한치과교정학회지

OBJECTIVE: This study aimed to evaluate the mean age of menarche, its secular trend in Korean women, and the relationship between malocclusion and the rate of skeletal maturation, as defined by menarcheal age. METHODS: We retrospectively collected data on menarcheal age from 931 Korean women born during 1961 - 1997. Subjects were divided by the malocclusion type and birth-year decade into 3 and 4 groups, respectively. The mean menarcheal age for each group was determined, and one-way ANOVA was performed for intergroup comparison (p = 0.05). Two-way ANOVA was also performed to compare all the 12 subgroups (p = 0.05). RESULTS: The mean age of menarche was 12.82 years for Korean women born during 1961 - 1997. A distinct downward secular trend of menarcheal age was noticed (p 0.05). CONCLUSIONS: A positive secular trend towards earlier menarche exists among Korean women. Malocclusion does not show any significant relationship with the rate of skeletal maturation, as defined by menarcheal age.

Thyroid cancer incidence in the city of Tianjin during 2002 -2006 and its secular trend in recent 26 year / 中华普通外科杂志

Objective To conduct a descriptive epidemiological study on thyroid cancer incidence in the urbanarea of Tianjin during 2002 - 2006 and to analyze the secular trend of incidences based on previous data of 26 years and those from Shanghai and the United States. Methods Annual percent change (APC%) of thyroid cancer incidence and the rank of all-site cancer profiles were estimated. The secular trend of different histological incidences and the proportion changes were analyzed. Results The incidence of female thyroid cancer was 6. 55/100000 in 2006, ranking the eighth in the female cancer profile. The incidence of thyroid cancer showed an increased secular trend in recent 26 years, especially a 5.7-fold increase in the papillary thyroid cancer (PTC). The incidence for female increased by 267% in 2006 compared to that in 1981, APC% was 3. 1%. The variation ranked second among all the female tumors. The incidences of thyroid cancer in Shanghai and the United States also elevated with time.Conclusions Thyroid cancer has been one of female common tumors from a once less common tumor,especially the proportion of PTC is expanding. It suggests that further study on the risk factors and preventive efforts should be made.

Secular Trend in Dietary Patterns in a Korean Adult Population, Using the 1998, 2001, and 2005 Korean National Health and Nutrition Examination Survey

Koreans have undergone many changes in dietary patterns with economic growth. The purpose of this research was to examine changes in dietary patterns using data from the 1998, 2001, and 2005 Korean National Health and Nutrition Examination Survey. The study included 21,525 subjects (8,295 from 1998, 6,880 from 2001, and 6,350 from 2005) who were 20 years or older and who participated in a 24-h diet recall. The percentage energy intake from 22 food groups was calculated, and a cluster analysis was applied to identify dietary patterns. Two dietary patterns emerged; the first pattern was characterized by high intake of white rice, legumes, vegetables, kimchi, and seaweeds, the so-called "traditional" pattern (53%), whereas the other pattern was characterized by high intake of other grains, noodle dumplings, floured bread, pizza, hamburgers, cereals and snacks, potatoes, sugared sweets, nuts, fruits, meat.its products, eggs, fish, milk and dairy products, oils, beverages and seasoning, or the so-called "modified" pattern. The modified pattern comprised a higher proportion of younger aged, metropolitan residents with more education and higher incomes. However, the gender distribution was not significantly different. The modified pattern had a significantly higher intake of all nutrients except carbohydrates and had a higher proportion of energy from fat and protein. No association with a risk for metabolic syndrome was found for either dietary pattern. After age was standardized, the traditional pattern included 52% of the respondents in 1998, 54% in 2001, and 50% in 2005. However, the modified pattern was significantly more prevalent in the younger age group (20-29 yr), whereas the traditional pattern increased significantly in the older age group (> or = 65 yr). In conclusion, a secular trend was found for dietary pattern by age group, suggesting that it is necessary to monitor the changes in dietary pattern by age group and to develop appropriate dietary education and guidelines.

Tendência secular de crescimento em pré-escolares, Brasil / Secular trend of growth of preschool, Brazil

INTRODUÇÃO: a análise da distribuição temporal de eventos do processo saúde-doença é uma das estratégias de investigação mais antigas e valiosas para a epidemiologia e para a saúde pública. OBJETIVO: analisar a evolução do perfil antropométrico de pré-escolares, que frequentavam creches municipais da cidade de Taubaté em 1997 e 2007. MÉTODO: foram analisadas variáveis do banco de dados de 2 estudos transversais: um realizado em 1997, com 755 crianças, e outro de 2007, com 1448 crianças. Os dados analisados foram: idade da criança, sexo, peso, estatura e índice de massa corporal (IMC). A transformação dos valores antropométricos em escores Z foi realizada pelo referencial do CDC/NCHS (2000). As comparações entre os dois momentos foram feitas pelo χ-quadrado e pelo teste t-Student, (α = 0,05). RESULTADOS: evidenciou-se tendência de crescimento positiva entre 1997 e 2007 com um aumento significante nos valores médios de escore Z de estatura em ambos os sexos, meninos: 0,04 para 0,39 e meninas: 0,05 para 0,33, e de peso, meninos; -0,03 para 0,26 e meninas: 0,03 para 0,21. As médias de IMC não revelaram diferença significante (meninos de - 0,02 para 0,07 e meninas de 0,09 para 0,12). Observou-se também, entre 1997 e 2007, um aumento na prevalência de crianças emagrecidas, de 9,8 para 12,6 por cento e de crianças com excesso de peso, de 17,0 para 20,9 por cento. CONCLUSÃO: os pré-escolares da cidade de Taubaté tiveram uma tendência secular de crescimento bastante significativa entre 1997 e 2007, mais de estatura do que de peso, que se acompanhou de um aumento na prevalência de crianças emagrecidas e, principalmente, com excesso de peso. Isso indica que, possivelmente, a melhoria das condições de bem estar da população, além de repercutir positivamente no crescimento estatural dos pré-escolares, também pode resultar na instalação de um intenso e precoce processo de transição nutricional, inclusive fora das grandes regiões metropolitanas

Observed Trends for an Earlier Onset of Puberty: When is the Need for Treatment Indicated?

Globally, there is a secular trend toward earlier puberty and an increased final height at adulthood. In Korea, there is a trend toward an earlier menarche in girls but insufficient data to evaluate secular trends in boys. A significant increase in height was observed in Koreans aged 0~20 years during 1965~2005. This trend has diminished, but growth maturation has accelerated in infants and young children. Genetic and environmental factors including nutritional status (e.g., obesity) contribute to these changes. Central precocious puberty results from the accelerated activation of the hypothalamic-pituitary-gonadal axis. Although the cut-off age is controversial, clinical evaluations should be conducted on girls with pubertal onset occurring younger than 8 years, and on boys younger than 9 years at least until further prospective studies define the norms for Korea. Management of precocious puberty depends on the underlying etiology, as accelerated puberty can lead to a reduced final adult height. Depot forms of GnRH agonists (GnRHas) are the standard treatment for some patients with central precocious puberty. These agents can help restore the normal adult height in both girls and boys when it might be compromised by rapidly progressive precocious puberty. However, in girls with slowly progressive precocious puberty or with the onset of puberty at 8~9.9 years of age (early normal puberty), GnRHa treatment might offer no benefit for attaining normal height. There is little evidence on whether psychosocial problems are associated with precocious puberty or are improved by GnRHa treatment.