Adult outcome of normal children who are short or underweight at age 7 years.

OBJECTIVES--To evaluate the adult growth outcome (at age 23) of children who are short or underweight at age 7 years in whom no identifiable pathological cause exists for their poor growth. DESIGN--Longitudinal follow up of a birth cohort. SETTING--The national child development study (1958 birth cohort) of Great Britain. SUBJECTS--523 children with a height or a weight below the fifth centile at age 7. Of these, 70 (13.4%) were excluded because they had a longstanding illness that could account for their poor growth. The remaining 453 subjects, who were followed to age 23, provided the base group from which those with additional data, such as parental height, were obtained. RESULTS--55/174 (31.6%) boys who were short at age 7 became short men; 60/211 (28.4%) girls who were short at age 7 became short women. Among boys who were underweight at age 7, 46/160 (28.7%) were still underweight at age 23, while 61/200 (30.5%) girls underweight at age 7 became underweight women. Having short parents did not increase the probability of being small as an adult. Children with delayed puberty were as likely to remain small as those in whom puberty was not delayed. CONCLUSIONS--One in three normal children who was short or underweight at age 7 became a short or underweight adult. This informs the management of short children and may be valuable when prolonged growth hormone treatment for short stature is being considered.     

Measles in children who have malignant disease.

A review study examined the clinical course of measles diagnosed in children being treated for malignant disease in Newcastle upon Tyne during 1973-86. Of the 17 cases diagnosed, five were fatal. Factors associated with a favourable outcome were a typical rash and Koplik''s spots, which were accompanied by a detectable serum antibody response and the disappearance of measles giant cells from nasopharyngeal secretions. Pneumonitis severe enough to require assisted ventilation was invariably fatal. Pneumonitis and encephalitis were the main complications. Treatment included immunoglobulin, interferon, and ribavirin, but none could clearly be shown to be effective. The comparatively low mortality in this series may have been due to the extensive use of the fluorescent antibody technique in Newcastle during the study period and therefore detection of less severe cases as compared with other reports.     

Biological age versus physical fitness age in women

The purpose of this study was to determine whether adult women who are in a state of high physical fitness are in a good state biologically, in terms of biological and physical fitness ages as estimated by statistical means. The subjects were 65 healthy Japanese women (aged 20-64 years). Biological and physical fitness ages were estimated from the data for 18 physiological function tests and 5 physical fitness tests, respectively, by a principal component model. The correlation coefficient between biological and physical fitness ages was 0.70 (P less than 0.01), which was generally regarded as a high correlation. Therefore, those who were in a state of high physical fitness were considered to be in good biological condition. This result is in good agreement with the results (r = 0.72) from adult men, on whom we reported previously. A statistical analysis to ascertain the relative importance of each contributory variable associated with the variance in biological age suggested that routine clinical evaluation of blood pressure and lipid metabolism might play an important role in determining not only the presence and severity of vascular disease but also the rate of biological aging in women.     

Biological age versus physical fitness age

A population of healthy middle-aged (n = 69) and elderly men (n = 12), who participated in a health promotion program, was studied to determine whether really physically fit individuals are in good biological condition, and also whether improvement of physical fitness in the middle-aged and the elderly reduces their "rate of aging". Biological and physical fitness ages of the individuals studied were estimated from the data for 18 physiological function tests and 5 physical fitness tests, respectively, by a principal component model. The correlation coefficient between the estimated biological and physical fitness ages was 0.72 (p less than 0.01). Detailed analyses of the relationship between the estimated biological and physical fitness ages revealed that those who manifested a higher ("older") physical fitness age did not necessarily have a higher biological age, but those who manifested a lower ("younger") physical fitness age were also found to have a lower biological age. These results suggested that there were considerable individual variations in the relationship between biological condition and physical fitness among individuals with an old physical fitness age, but those who were in a state of high physical fitness maintained a relatively good biological condition. The data regarding the elderly men who had maintained a regular exercise program indicated that their estimated biological ages were considerably younger than the expected values. This might suggest that in older individuals regular physical activity may provide physiological improvements which in turn might reduce "the rate of aging".     

Electrocardiographic signs of pulmonary hypertension in children who snore.

Two children presented with sleep disturbances due to enlarged tonsils and adenoids. One child died during induction of anaesthesia, and postmortem examination showed hypertrophy of the right ventricle and atrium. As a result a prospective survey was carried out of children undergoing tonsillectomy or adenoidectomy, or both. During a nine-month period an electrocardiogram was taken in 92 children. Three electrocardiograms (3.3%) showed evidence of right heart strain. The children with abnormal electrocardiograms had symptoms of sleep disturbance with apnoea, snoring, and daytime somnolence. These symptoms and the electrocardiographic changes were reserved by adenotonsillectomy. The prevalence of pulmonary hypertension in children with enlarged tonsils and adenoids is still underestimated. When signs and symptoms of sleep disturbance, particularly snoring, are present an electrocardiogram should be obtained and a cardiologist''s opinion sought before embarking on routine surgery in view of the potentially fatal consequences.     

Stress in families of children who have ingested poisons.

One hundred families of children under 5 years admitted to Cardiff Hospitals after accidentally ingesting poisons were compared with 100 control families matched for socioeconomic class and age and sex of the child. Questioning about five major stress factors (serious family illness, pregnancy, recent family moves, one parent away from home, anxiety or depression in one or both parents) disclosed significantly more stress in the affected families than in the controls. Thirty of the affected families had more than one major stress factor compared with four of the controls, while 63 of the controls had no major stress factor compared with 24 of the affected families (P less than 0.001). In only four of the affected families was there no stress factor. Fifteen children took poisons in homes other than their own. Unemployment was significantly more prevalent in the affected families than in the general population, though apart from this the socioeconomic backgrounds were similar. There were significantly more accidents and childhood poisonings in the parents and siblings of affected children than in the control families. In 25% of the cases poisoning was with Angiers Junior Aspirin.     

Declines in physiological functional capacity with age: a longitudinal study in peak swimming performance.

We followed up swimming performance times of 321 women and 319 men who participated in the US Masters Swimming Championships over a 12-yr period. All swimmers placed in the top 10 in their age group over 3 yr (mean = 5 yr). A random coefficients model for repeated measures was used to derive a line of best fit from a group of regression lines for each subject. Both 50- and 1,500-m swimming performance declined modestly until approximately 70 yr of age, where a more rapid decline was observed in both men and women. Compared with 1,500-m swimming, the 50-m freestyle declined more modestly and slowly with age. The rate and magnitude of declines in swimming performance with age were greater in women than in men in 50-m freestyle; such sex-related differences were not observed in 1,500-m freestyle. Overall, the variability along a population regression line increased markedly with advancing age. The present longitudinal findings indicate that 1) swimming performance declines progressively until age 70, where the decrease becomes quadratic; 2) the rates of the decline in swimming performance with age are greater in a long-duration than in a short-duration event, suggesting a relatively smaller loss of anaerobic muscular power with age compared with cardiovascular endurance; 3) the age-related rates of decline are greater in women than in men only in a short-duration event; and 4) the variability of the age-related decline in performance increases markedly with advancing age.     

Drag characteristics of competitive swimming children and adults

The aims of this study were to compare drag in swimming children and adults, quantify technique using the technique drag index (TDI), and use the Froude number (Fr) to study whether children or adults reach hull speed at maximal velocity (vmax). Active and passive drag was measured by the perturbation method and a velocity decay method, respectively, including 9 children aged 11.7+/-0.8 and 13 adults aged 21.4+/-3.7. The children had significantly lower active (kAD) and passive drag factor (kPD) compared with the adults. TDI (kAD/kPD) could not detect any differences in swimming technique between the two groups, owing to the adults swimming maximally at a higher Fr, increasing the wave drag component, and masking the effect of better technique. The children were found not to reach hull speed at vmax, and their Fr were 0.37+/-0.01 vs. the adults 0.42+/-0.01, indicating adults' larger wave-making component of resistance at vmax compared with children. Fr is proposed as an evaluation tool for competitive swimmers.