scholarly journals Pubarche and gonadarche onset and progression are differently associated to birth weight and infancy growth patterns

2021 ◽  
Author(s):  
Christine Wohlfahrt-Veje ◽  
Jeanette Tinggaard ◽  
Anders Juul ◽  
Jorma Toppari ◽  
Niels E Skakkebæk ◽  
...  
Keyword(s):  
Birth Weight ◽  
Growth Patterns ◽  
Survival Models ◽  
Childhood And Adolescence ◽  
Testis Size ◽  
Weight Changes ◽  
Pubertal Stages ◽  
Catch Up ◽  
Parametric Survival

Abstract Context Controversy exists regarding associations between early life growth patterns and timing of puberty. Objective To investigate associations between birth anthropometry, early growth patterns and onset/progression of pubertal milestones in boys and girls. Design and Participants Among children examined at birth (1997-2003) and at 36 months of age in a mother child cohort, pubertal Tanner stages (B1-5, PH1-5, G1-5) and testicular volume were examined by trained physicians at 1-5 follow-up examinations during childhood and adolescence (672 girls and 846 boys, 2006-2013). Main Outcome Measures With parametric survival models we analyzed associations between birth weight, changes in standard deviation scores (SDS) from birth to 36 months (Δ SDS 0-36 >0.67 SD defining catch up growth), and age at pubertal onset/attainment of late pubertal stages /menarche. Results A 1 kg higher birth weight was associated with earlier onset of B2+ (thelarche): -3.9 months (CI: -6.7; -1.1), G2+ (gonadarche): -2.7 months (-5.3;-0.1), Tvol3+ (testis size > 3ml):-2.8 months (-4.9; -0.7), but with later G4+ and PH4+ in boys, and a slower progression from B2 to menarche (5.3 months (1.2; 9.4)) in girls. Catch up growth was associated with earlier PH2+ (pubarche) in girls (-4.1 months (-7.6;-0.6)), earlier PH2+ in boys (-3.4 months (-6.6;-0.2)), faster progression from B2 to menarche in girls (-9.1 months (14.6; 3.5)) and earlier G4+ and PH4+ in boys. Conclusions Associations between birthweight and infancy catch up growth differed for gonadarche and pubarche, and for early and late pubertal markers, with similar patterns in both sexes.

Primary Follow-up Care in a Multidisciplinary Setting Enhances Catch-up Growth of Very-low-birth-weight Infants

1997 ◽  
Vol 97 (4) ◽  
pp. 386-390 ◽  
Author(s):  
STEPHANIE R. BRYSON ◽  
LEA THERIOT ◽  
NELL J. RYAN ◽  
JANET POPE ◽  
NANCY TOLMAN ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Follow Up Care ◽  
Catch Up

scholarly journals GROWTH, NEURODEVELOPMENT IN EXTREMELY LOWBIRTH BABIES AT TWO YEAR OF CORRECTED AGE

2019 ◽  
Vol 3 (5) ◽  
Author(s):  
Dr. Ashok Kumar ◽  
Dr. Kanya Mukhopadhyay ◽  
Dr. Prabhjot Malhi ◽  
Dr. Anil Kumar Bhalla
Keyword(s):  
Birth Weight ◽  
Neurological Examination ◽  
Gestational Age ◽  
Head Circumference ◽  
Control Group ◽  
Case Group ◽  
Significant Difference ◽  
Catch Up

According to national neonatal perinatal data (NNPD) the survival of ELBW babies has improved from 37% in 2000 to 45% in 2002-3 reports. In our neonatal unit in PGIMER the survival of ELBW babies has been 54-56% in last 5 years, however unfortunately there is very scanty reports of long term outcome of ELBW babies from India. There is very scanty report of long term growth outcome of VLBW and ELBW Babies in our country, we reported VLBW and ELBW babies in our follow up had poor catch up growth, though some catch-up was observed at 6 month but subsequent lag in growth probably reflects poor weaning at 1 year.  Infants with extremely low birth weights (ELBWs) are more susceptible to all of the possible complications of premature birth, both in the immediate neonatal period and after discharge from the nursery. These babies are at risk of poor growth and developmental. in the present study a total of 39 cases of ELBW Babies were enrolled during one year study period from July 2011- June2012 attending the neonatal follow up clinic attained 2year±3month of corrected age. Their detail birth data and postnatal illnesses retrieved from their initial hospital files and unit discharge record. A similar number of babies enrolled at 2yrs±3months of age in the control group. In the presence study, we assessed the growth, and neurological out come in extremely low birth baby attained 2yrs±3 months of corrected age. The study population consisted of 39 children of ELBW baby born during 2009 -10 at PGIMER & same number of normal birth weight children at 2yr±3 months of corrected age who satisfied the inclusion and exclusion criteria. These children were enrolled from neonatal follow up clinic who were already undergoing long term follow up. For growth outcome, we used weight, height & head circumference measurement of child, for neurological and developmental outcome used clinical neurological examination and DP-III .Base line demographic characteristics of our ELBW babies (Cases) where as follows.   Mean (S.D) gestational age of  ELBW babies was 29.87±2.3 week. Mean (S.D) birth weight 867±71.1 grams, Mean (S.D) lenght35±2.1cm & head circumference was 25.76±1.9 cm. Mean hospital stay in the ELBW babies was 48.6±19.9 days. Mean birth weight and gestational age of control group where 2684±166.2grm and 39.03±0.9 weeks. At 2year of corrected age we found  - Weight was similar in both in case group & control group. (10.04±1.4 Vs 10.75±1.1). Height and head circumference were smaller in cases than control group. (81.4±4.3 Vs 84.4±3.3 and 45.9±1.6 Vs 46.8±1.5. 5% Babies had cerebral palsy in case group (N=2/39) and none in control group. Gross development score(GDS) in Development profile-III in both study group (cases & controls) was  similar  (72.49±8.08 Vs 73.54±9.3,p=0.596). Significant difference in domains physical (84.5±7.8 Vs.90±3.5, p=0.000) and domains adaptive (81±6.7 Vs. 85.3±5.4,p= 0.003) in cases as compared to controls. There was no difference between SGA and AGA among cases in growth and neurological development. There was no difference between male and female in case group in any parameter .There is very scanty data from our country on longterm follow up of ELBW babies. Our data shows that our ELBW cohort remained small in height and had smaller head circumference though weight was similar as compared to normal control babies.  Key words: ELBW, VLBW, birth weight, neurological examination.

scholarly journals Extrapolating Parametric Survival Models in Health Technology Assessment: A Simulation Study

2020 ◽  
Vol 41 (1) ◽  
pp. 37-50
Author(s):  
Daniel Gallacher ◽  
Peter Kimani ◽  
Nigel Stallard
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Goodness Of Fit ◽  
Information Criterion ◽  
Health Technology ◽  
Survival Models ◽  
Fit Statistics ◽  
Long Term Treatment ◽  
Parametric Survival

Extrapolations of parametric survival models fitted to censored data are routinely used in the assessment of health technologies to estimate mean survival, particularly in diseases that potentially reduce the life expectancy of patients. Akaike’s information criterion (AIC) and Bayesian information criterion (BIC) are commonly used in health technology assessment alongside an assessment of plausibility to determine which statistical model best fits the data and should be used for prediction of long-term treatment effects. We compare fit and estimates of restricted mean survival time (RMST) from 8 parametric models and contrast models preferred in terms of AIC, BIC, and log-likelihood, without considering model plausibility. We assess the methods’ suitability for selecting a parametric model through simulation of data replicating the follow-up of intervention arms for various time-to-event outcomes from 4 clinical trials. Follow-up was replicated through the consideration of recruitment duration and minimum and maximum follow-up times. Ten thousand simulations of each scenario were performed. We demonstrate that the different methods can result in disagreement over the best model and that it is inappropriate to base model selection solely on goodness-of-fit statistics without consideration of hazard behavior and plausibility of extrapolations. We show that typical trial follow-up can be unsuitable for extrapolation, resulting in unreliable estimation of multiple parameter models, and infer that selecting survival models based only on goodness-of-fit statistics is unsuitable due to the high level of uncertainty in a cost-effectiveness analysis. This article demonstrates the potential problems of overreliance on goodness-of-fit statistics when selecting a model for extrapolation. When follow-up is more mature, BIC appears superior to the other selection methods, selecting models with the most accurate and least biased estimates of RMST.

Follow-up Study of Physical Growth of Monozygous Twins With Discordant Within-Pair Birth Weights

PEDIATRICS ◽  
1986 ◽  
Vol 77 (3) ◽  
pp. 336-344
Author(s):  
Marie P. Keet ◽  
Alina M. Jaroszewicz ◽  
Carl J. Lombard
Keyword(s):  
Birth Weight ◽  
Head Circumference ◽  
Normal Growth ◽  
Ponderal Index ◽  
Physical Growth ◽  
Child Rearing ◽  
Catch Up ◽  
Monozygous Twins ◽  
Future Growth

In an attempt to determine the future growth of intrauterine growth-retarded babies, 14 pairs of monozygous twins, showing within-pair birth weight differences of 11% to 48% (median 28%), were followed prospectively for 3 to 9 years. Weight, length, and head circumference were measured biannually for the first 3 years of life and thereafter annually. At birth, the median within-pair percentage differences of weight (28%), length (6.2%), and head circumference (5.2%) were all significant (P < .01). At 12, 24, and 30 months of age, these median within-pair percentage differences became insignificant for head circumference, length, and weight, respectively. The most rapid catch-up growth of the lighter twins occurred during the first 2 years of life. Analysis of individual pairs, however, showed suboptimal growth in both members of two pairs, although growth became concordant. In four other pairs, the lighter birth weight member remained growth retarded in comparison with the cotwin and showed within-pair differences in weight varying between 8% and 19%, in height between 1% and 6%, and in head circumference between 1.9% and 7%. All children with birth weights above the tenth percentile grew up normally, regardless of the extent of within-pair birth weight differences, with one exception. This exception was a pair in whom there were withinpair differences in child rearing. In the six pairs in which the smaller twin's birth weight was below the tenth percentile, only three pairs showed normal growth. In these six pairs a normal ponderal index in the lighter twin members was associated with poorer growth than a low ponderal index. It is concluded that monozygous twins will grow up normally, despite large within-pair birth weight differences, provided that both twins' birth weights are above the tenth percentile. Should the birth weight of the smaller member be below the tenth percentile, the prognosis has to be guarded, but the ponderal index may prove to be a valuable indicator of future growth.

Estimating long-term survival of previously untreated patients with EGFR mutation-positive (EGFRm) advanced non-small cell lung cancer (NSCLC) who received osimertinib in the FLAURA study.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e20560-e20560
Author(s):  
Matthew Dyer ◽  
Matthew Green ◽  
simon jones ◽  
Rachel Hodge
Keyword(s):  
Advanced Nsclc ◽  
Survival Rates ◽  
Survival Model ◽  
Survival Models ◽  
Term Survival ◽  
Parametric Survival Model ◽  
Best Fitting ◽  
Parametric Survival

e20560 Background: In the Phase III FLAURA trial (NCT02296125), osimertinib, a third-generation EGFR-TKI, provided clinically and statistically significantly longer progression-free survival versus gefitinib/erlotinib as first-line treatment for patients with EGFRm advanced NSCLC. At the time of analysis, data on overall survival (OS) were immature (25% maturity). To better understand the long-term survival potential of osimertinib beyond the observed trial follow-up period, mathematical parametric survival models were used to estimate clinically plausible survival rates up to 5 years from FLAURA. Methods: Following published best-practice guidelines, candidate parametric survival models were evaluated based on both statistical and visual goodness-of-fit to the observed FLAURA OS data. Two modeling approaches were considered: single models with treatment included as a covariate; and separate models fitted to the osimertinib and gefitinib/erlotinib arms. Point estimates of 5-year survival rates with 95% confidence intervals (CIs) are reported for the best fitting model. Results: The best fitting parametric survival model to the FLAURA OS data was the Weibull model with treatment included as a covariate. Based on this model, estimated median OS was longer with osimertinib than with gefitinib/erlotinib (41.4 months vs 30.6 months). The estimated 3- and 5-year survival rates with osimertinib were 57.3% (95% CI 46.6%, 69.2%) and 31.1% (95% CI 23.7%, 41.8%), respectively. In comparison, the estimated 3- and 5-year survival rates with gefitinib/erlotinib were 41.1% (95% CI 31.9%, 52.9%) and 15.5% (95% CI 11.6%, 22.1%), respectively. Conclusions: Based on the best fitting parametric survival model to FLAURA OS data, the estimated 5-year survival rate with osimertinib was double that with gefitinib/erlotinib (31.1% vs 15.5%) in patients with EGFRm advanced NSCLC. Long-term follow-up data from FLAURA (60% OS maturity) will further validate this finding. Clinical trial information: NCT02296125.

scholarly journals Work-unit organisational changes and subsequent prescriptions for psychotropic medication: a longitudinal study among public healthcare employees

2019 ◽  
Vol 76 (3) ◽  
pp. 143-150 ◽  
Author(s):  
Johan Høy Jensen ◽  
Jens Peter Bonde ◽  
Esben Meulengracht Flachs ◽  
Janne Skakon ◽  
Naja Hulvej Rod ◽  
...  
Keyword(s):  
Psychotropic Medication ◽  
Organisational Change ◽  
Survival Models ◽  
Public Healthcare ◽  
Budget Cuts ◽  
Work Unit ◽  
Increased Risk ◽  
Parametric Survival ◽  
Healthcare Employees

ObjectivesWe examined exposure to different types of organisational changes at work as risk factors for subsequent prescription for psychotropic medication among employees.MethodsThe study population included 15 038 public healthcare employees nested within 1284 work units in the Capital Region of Denmark. Multilevel mixed-effects parametric survival models were developed to examine time to prescription for psychotropic medications (anxiolytics/hypnotics/sedatives/antidepressants) during the 12-month interval following exposure to organisational changes relative to no change from January to December 2013. Data on work-unit level organisational changes (including mergers, split-ups, relocation, change in management, employee lay-offs and budget cuts) were collected from work-unit managers (59% response).ResultsAny organisational change versus no change was associated with a higher risk of psychotropic prescription (HR: 1.14, 95% CI: 1.02 to 1.26), especially change in management (HR: 1.23, 95% CI: 1.07 to 1.41). Splitting the 12-month follow-up period into two halves yielded particularly high rates of psychotropic prescription in the latter half of the follow-up, for example, any change (HR: 1.25, 95% CI: 1.11 to 1.41), change in management (HR: 1.42, 95% CI: 1.22 to 1.65), mergers (HR: 1.26, 95% CI: 1.06 to 1.50), employee lay-off (HR: 1.23, 95% CI: 1.03 to 1.46) and budget cuts (HR: 1.13, 95% CI: 1.00 to 1.41). The associations did not vary by sex.ConclusionsOrganisational changes in the workplace, especially change in management, may be associated with increased risk of psychotropic prescription among employees regardless of sex.

STRUCTURAL AND DYNAMIC FEATURES OF EAR-LY DISABILITY DUE TO MENTAL DISEASES

2020 ◽  
pp. 62-67
Author(s):  
Shmakova O.P.
Keyword(s):  
People With Disabilities ◽  
Child And Adolescent Psychiatry ◽  
Child Psychiatrist ◽  
Childhood And Adolescence ◽  
Disabled Children ◽  
Dynamic Features ◽  
Factors Affecting ◽  
Number Of Children ◽  
Number Of Patients

Prevention of disability is one of the most significant tasks of child and adolescent psychiatry. Obtaining data on the dynamics of the number of people with disabilities and the factors affecting this indicator seems to be one of the relevant aspects. Aim: to trace the dynamics of the number of children with disabili-ties and to assess the change in the structure of early disability over the past decades. Materials and Meth-ods. A comparative analysis of two cohorts of patients was carried out: 1st - patients born in 1990-1992. (1203 patients (men - 914, 76%; women - 289, 24%)) who applied to the district neuropsychiatric dispensa-ry for outpatient care in childhood and adolescence; II - children and adolescents born in 2005 - 2018 (602 patients (male - 410, 68%; female - 192, 32%), ob-served at the time of the study by a child psychiatrist in the neuropsychiatric dispensary. Research methods: clinical and psychopathological; follow-up; statisti-cal. Results. Comparison of the number and nosologi-cal distribution of disabled children in two cohorts showed that over the 15th year there has been a shift towards an increase in the proportion of disabled children among patients observed by child and ado-lescent psychiatrists. The increase in the number of children with disabilities was due to those suffering from childhood autism and other disorders of general development. There were no statistically significant differences in the number of people with disabilities who received benefits before the age of 7, as well as differences in gender ratios among disabled people in the two cohorts. Conclusion. Early disability is a mul-tifactorial phenomenon, prevalence, dynamics, the structure of which depends not only on clinical, but also on socio-administrative realities. Children with autism require increased attention, since there has been a multiple increase in the number of patients with this diagnosis.

Sign in / Sign up

Export Citation Format

Share Document