ABSTRACT
Pediatric environmental medicine in Central Eastern Europe needs support and development on national, institutional and individual basis. This situation is quantitatively, but not fundamentally different from what is to be found in Central Europe.
Subject(s)
Environmental Exposure/statistics & numerical data , Environmental Medicine/trends , Pediatrics/trends , Air Pollution/statistics & numerical data , Child , Environmental Medicine/statistics & numerical data , Europe, Eastern/epidemiology , Female , Humans , Lead/blood , Life Style/ethnology , Male , Pediatrics/statistics & numerical data , Smoking/epidemiology , Smoking/ethnology , Water Supply/standardsSubject(s)
Congenital Abnormalities/epidemiology , Congenital Abnormalities/etiology , Environmental Exposure/adverse effects , Hazardous Waste/adverse effects , Case-Control Studies , Female , Health Surveys , Humans , Incidence , Infant, Newborn , Male , Risk Assessment , World Health OrganizationSubject(s)
Breast Neoplasms/chemically induced , Dieldrin/adverse effects , Environmental Exposure/adverse effects , Insecticides/adverse effects , Adult , Aged , Breast Neoplasms/blood , Breast Neoplasms/epidemiology , Case-Control Studies , Cohort Studies , Confidence Intervals , Dieldrin/blood , Environmental Exposure/analysis , Environmental Monitoring , Epidemiological Monitoring , Female , Germany/epidemiology , Humans , Incidence , Insecticides/blood , Middle Aged , Odds Ratio , Risk AssessmentSubject(s)
Leukemia, Radiation-Induced , Power Plants , Radioactive Fallout , Radioactive Hazard Release , Child , France , Germany , Humans , UkraineABSTRACT
Catch-up growth was analyzed in 20 prepubertal children with primary hypothyroidism (PH) starting treatment at an age of 4.4 (1.2-10.1) years and a height (HT) SD score (HT SDS) of -3.1 (+/-0.8). All patients were followed for at least 3 prepubertal years. HT velocity was 12.3 +/- 2.3, 9.0 +/- 1.8 and 7.5 +/- 2.2 cm/year, and change in HT SDS was 1.60 +/- 0.56, 0.57 +/- 0.33 and 0.28 +/- 0.38 during the 1st, 2nd and 3rd year, respectively. The 11 children followed to adult height reached a HT SDS of -0.11 +/- 1.1, all within their target HT range. HT gain (DeltaHT SDS) during the 1st year was correlated with the degree of catch-up growth (r2 = 0.78, p < 0.001). While catch-up growth in childhood-onset PH is complete, this is not the case in GH deficiency (GHD). Based on the auxological characteristics of the patients with PH, HT velocities during the first 2 years were predicted applying prediction models devised for prepubertal children with idiopathic GHD. The modalities of GH treatment observed in the models were used to calculate predicted HT velocities of the PH patients. Observed HT velocities in PH were higher than predicted HT velocities during the 1st (10.67 +/- 1.37 cm/year, p < 0.01) and 2nd (8.35 +/- 0.86 cm/year, p = 0.128) year. The data show that catch-up potential in idiopathic GHD of childhood onset is reduced compared to PH. Since early catch-up as well as total HT recovery in children with GHD are often not reached by present treatment modalities, catch-up growth in PH may serve as a model towards optimizing GH treatment. The data suggest that initial GH doses of 1.0 IU/kg/week, rather than the presently recommended 0. 6 IU/kg/week, need to be given in GHD in order to achieve the degree of early catch-up observed in PH and to consequently improve the final outcome.
Subject(s)
Growth Disorders/drug therapy , Growth/drug effects , Human Growth Hormone/therapeutic use , Hypothyroidism/drug therapy , Body Height , Child , Child, Preschool , Female , Growth Disorders/complications , Growth Disorders/physiopathology , Human Growth Hormone/administration & dosage , Human Growth Hormone/deficiency , Humans , Hypothyroidism/complications , Hypothyroidism/physiopathology , Infant , MaleSubject(s)
Air Pollutants/toxicity , Ozone/toxicity , Air Pollutants/analysis , Child , Europe , Humans , Maximum Allowable Concentration , Ozone/analysis , United StatesSubject(s)
Cattle , Dermatitis, Atopic/etiology , Hair , Allergens/adverse effects , Animals , Bronchitis/etiology , Humans , Infant , Male , Milk/adverse effects , Skin TestsSubject(s)
Child Welfare/trends , Blast Injuries/prevention & control , Child , Female , Humans , Infant, Newborn , MaleSubject(s)
Abnormalities, Radiation-Induced/epidemiology , Down Syndrome/epidemiology , Power Plants , Radioactive Hazard Release , Abnormalities, Radiation-Induced/genetics , Down Syndrome/genetics , Humans , Incidence , Infant, Newborn , Meiosis/radiation effects , Nondisjunction, Genetic , Ukraine/epidemiologySubject(s)
Food Contamination , Infant Food , Pesticide Residues , Europe , Humans , Infant , Public PolicySubject(s)
Abstracting and Indexing/standards , Environmental Health , Neoplasms/classification , Neoplasms/epidemiology , Pesticides/adverse effects , Publishing , Child , Colorado/epidemiology , Data Collection/methods , Data Collection/standards , Data Interpretation, Statistical , Humans , JudgmentABSTRACT
BACKGROUND: Neonatal diabetes mellitus--defined here as hyperglycemia occurring within the first month of life that lasts for at least two weeks and requires insulin therapy--is a very rare form of the disease. Little is known about it, particularly with respect to its long-term course. METHODS: We studied two brothers who had neonatal diabetes and obtained follow-up information on 34 patients described in the literature as well as information on 21 additional patients. Forty-seven of the patients had neonatal diabetes, as defined above, and in 10 others the onset was between the first and third month of life. RESULTS: Twenty-six of the 57 infants had permanent diabetes, 18 had transient diabetes, and 13 had transient diabetes that recurred when they were 7 to 20 years old. Neonatal diabetes was associated with the Wolcott-Rallison syndrome in six infants, hyperuricemia due to phosphoribosyl-ATP pyrophosphatase hyperactivity in two, and celiac disease in two. Forty-one of 45 neonates in whom the duration of gestation and birth weight were known were small for their gestational ages. There were two pairs of affected twins and four other families with two or more infants with neonatal diabetes, but only three parents had diabetes. The incidence of neonatal diabetes mellitus in Germany has been estimated to be 1 in 500,000 neonates. CONCLUSIONS: Neonatal diabetes differs from insulin-dependent diabetes in that its course is highly variable. Some patients have permanent diabetes, but others have transient or lasting remissions.