Health Issues In Adults Research Articles

Groundwater Quality Assessment at East El Minia Middle Eocene Carbonate Aquifer: Water Quality Index (WQI) and Health Risk Assessment (HRA)

Around the world, groundwater supply is critical for vital needs such as drinking and irrigation. This work investigates groundwater in the carbonate aquifer of the Middle Miocene in the east El Minia area, Egypt. In this regard, thirty-two groundwater samples were collected. The water samples were analyzed for Ca2+, Mg2+, Na+, K+, Cl−, SO42−, NO3−, CO2−, HCO3−, Fe, Mn, Cd, As, Cr, Cu, and Pb. Groundwater has been evaluated using two methods, which are water quality index (WQI) and health risk assessment (HRA). The predominant groundwater is soft water, and the samples range in salinity from fresh to slightly salty. The groundwater mostly falls into the alkaline water type. All the groundwater samples under study are deemed low quality for human consumption due to water contamination. Fe, Mn, Cd, Cu, and Pb have high HQnc values, which can result in non-carcinogenic health issues in adults, while Mn, Cu, and Pb can give rise to non-carcinogenic health issues in children.

A TECHNOLOGY SUPPORTED FALL PREVENTION INTERVENTION FOR OLDER ADULTS WITH MILD COGNITIVE IMPAIRMENT

Abstract Falls and fall-related injuries are significant public health issues for adults 65 years of age and older. Over a third of older adults (OA) fall each year and 10-20% of falls result in serious injuries. Cognitive impairment has been identified as a leading risk factor with over 60% of OA living with mild cognitive impairment (MCI) falling annually. Housing conditions are also a risk factor for falls. We have developed Sense4Safety, a technology-enhanced intervention that includes multiple components: 1) in-home assessment and action; 2) education and regular communication with a coach; 3) passive monitoring facilitated by depth sensors in the home; and 4) alerts. The goal of this study was to access the feasibility of Sense4Safety and its acceptability. We recruited 10 low-income OA with MCI; each participant received the intervention for 3 months. All participants completed all study procedures. The Short Physical Performance Battery (SPPB) scores which provide an objective assessment of lower extremity functioning based on clinical experts’ observation showed high correlation to the sensor system assessment (r=0.94, p< 0.01). Two fall alerts were generated during the study period that triggered a timely response. Participants and their family members found the intervention to provide peace of mind and empower OA to proactively address changes in fall risk through exercise and home modifications. The combination of passive sensing and personalized coaching offers an innovative ecological approach to continuously assess functional mobility and gait in the home and captures changes that provide an early warning for fall risk.

Providing effective care and support for autistic adults with mental health issues.

Autism is a neurodevelopmental condition that is characterised by features such as persistent differences in social interaction and communication, specialised interests and sensory processing issues. It has been identified that autistic people are increasingly likely to experience various mental health issues, and often encounter challenges in accessing appropriate healthcare and a lack of understanding from healthcare professionals. This article explores the co-occurrence of autism and mental health issues in adults, and explains the role of nurses in providing care and support for this population.

Prevalence of anxiety and depression in adult patients with CHD.

CHD are among the most common congenital defects. Due to the chronic nature of CHD, patients face various risk factors that threaten their mental health. However, a comprehensive understanding of the medical and social predictors of mental health issues in adults with CHD is lacking. This study aims to investigate the prevalence of anxiety and depression in adults with CHD. This cross-sectional descriptive study focused on adults with CHD in Kerman, Iran. The participants completed demographic information alongside two psychological assessment tools: the Beck Anxiety Inventory (BAI) and the Depression Anxiety Stress Scales (DASS)-21. The data were analyzed using SPSS 26. The mean age of the participants was 29.94 ± 12.36 years, and 63.8% were female. According to the DASS, 73.4% did not have depression, 61% did not have anxiety, and 76.2% did not have stress. In total, 19% had mild stress, and 4.8% had moderate stress. According to the BAI, 27.6% did not have anxiety. Individual characteristics were not significantly associated with depression. However, gender, age, and type of surgery were significantly associated with anxiety. Cyanosis was significantly associated with stress. The results show that mental disorders like depression, anxiety, and stress are highly prevalent in adults with CHD. The prevalence depends on individual factors such as age, gender, and disease severity. Therefore, it is recommended that mental disorders in this population be evaluated and treated accurately.

Using depth sensors for a fall risk prediction system for socially vulnerable older adults with cognitive impairment

AbstractFalls and fall‐related injuries are significant public health issues for adults 65 years of age and older. Over a third of older adults (OA) fall each year and 10‐20% of falls result in serious injuries such as fractures and head trauma. Cognitive impairment is a leading risk factor for falls in OA. Over 60% of OA with MCI fall annually – two to three times the rate of those without cognitive impairment. OA living in low‐resource neighborhoods with poor housing conditions have twice the risk of falling. We have developed a technology‐based intervention called Sense4Safety that facilitates fall risk management and fall risk reduction for older adults (OA) with cognitive impairment living in low‐resource communities. Specifically, the intervention is designed to to 1) identify escalating risk for falls real‐time through in‐home passive sensor monitoring using depth sensors; 2) employ machine learning to inform individualized alerts for fall risk; and 3) link OA with a nurse tele‐coach who guides them in implementing evidence‐based individualized plans to reduce fall‐risk. The nurse coach is accessible via video‐conferencing or phone to discuss fall prevention and risk reduction strategies with the OA and their trusted other depending on the patterns identified in sensor‐detected changes in functional mobility and gait. The measurable primary outcomes include number of fall and near‐fall events, number of fall‐related hospitalizations, functional mobility, self‐reports of fear of falling and perceived independence. We have conducted an initial feasibility study of the intervention with 10 older adults in low income housing settings for a period of 3 months. The Sense4Safety intervention has the potential to become a feasible and cost‐effective approach to increase safety and quality of life for community dwelling low income OA with cognitive impairment and prevent or reduce falls. Currently, in most cases fall risk is addressed only after an adverse event has occurred or cognitive decline has progressed significantly. This intervention changes that paradigm to maximize safety and promote aging in place.

Cardiometabolic profiles in adolescents in the Pollution and Asthma Risk: an Infant Study cohort

Abstract Background Metabolic syndrome (MetS) is known as a risk factor for cardiovascular disease and diabetes but its definition is not yet consensual for teenagers. Thus, we aimed to identify cardiometabolic health profiles in adolescents from the PARIS birth cohort. Methods At 15/16 years old, PARIS participants underwent a health check-up including a blood test, handgrip strength measure, self-administered and parent-filled questionnaires. Cardiometabolic profiles, in the whole population and by gender, were identified by K-means partitioning. A MetS risk score was also calculated. Characteristics of cardiometabolic profiles were compared using Chi2/Fisher exact test or Student's t-test. Results This study included 529 adolescents (49% females) with a mean BMI of 20.2±3.2 kg/m2. MetS prevalence ranged from 0.2% to 1.3%. Two profiles were identified in the whole population and by gender: ‘healthy’ (67.1%) and ‘cardiometabolic risk’ (32.9%) profiles. The main predictive factors of profiles were weight and either waist-to-height ratio or waist circumference (R2>87%). Compared to “healthy” profiles, adolescents from ‘cardiometabolic risk’ lived more with obesity and pre-hypertension, had most frequently waist-to-height ratio over 0.5 and hypertriglyceridemia (unobserved in females). They also had higher cardiometabolic risk score and their parents were more often overweight. They had higher birth weight, earlier rebound age and puberty, and lower relative handgrip strength. Conclusions The identified cardiometabolic profiles were linked to early signals and handgrip strength, a marker of overall health, emphasizing the importance of early monitoring. The waist-to-height ratio appears to be easy to use and a useful clinical tool for screening adolescents at risk of cardiometabolic pathologies, and thus requiring a clinical follow-up. Key messages • We innovatively classified adolescents based on their cardiometabolic health into two groups, with one group potentially requiring monitoring to prevent adult health issues. • The waist-to-height ratio is a simple clinical tool usable for screening adolescents at cardiometabolic risk.

Weight-adjusted waist as an integrated index for fat, muscle and bone health in adults.

Unhealthy body composition, including high fat mass, low muscle mass and low bone mass, is a critical health issue in adults. The weight-adjusted waist index (WWI) estimates fat and muscle mass and may have implications for bone health. We examined its association with body composition outcomes in a large Korean adult cohort. This study used data from the Korean National Health and Nutrition Examination Survey (2008-2011). WWI was calculated as waist circumference (cm) divided by the square root of body weight (kg). Dual-energy X-ray absorptiometry was used to measure bone mineral density (BMD), appendicular lean mass (ALM) and total body fat percentage. Unhealthy body composition was defined as combined presence of high fat mass, low bone mass and low muscle mass. A total of 5983 individuals (3034 men [50.7%] and 2949 women [49.3%]; mean age: 63.5±8.7years) were included. WWI was positively correlated with total body fat percentage (r=0.478, P<0.001) and inversely with ALM/weight (r=-0.485, P<0.001) and BMD at the lumbar spine (r=-0.187, P<0.001), femoral neck (r=-0.269, P<0.001) and total hip (r=-0.255, P<0.001). Higher WWI quartiles correlated with lower BMD, T-scores and ALM/weight, along with increased total body fat, evident in both genders and more pronounced in women, even after adjusting for confounders. This trend remained statistically significant across WWI quartiles for all analyses (P<0.001). Higher WWI quartiles were also significantly associated with higher odds of unhealthy body composition, with adjusted odds ratio in the highest WWI group of 18.08 (95% CI, 4.32-75.61) in men and 6.36 (95% CI, 3.65-11.07) in women. The optimal cutoff values of WWI for unhealthy body composition were 10.4cm/√kg in men and 10.5cm/√kg in women. In community-dwelling adults, high WWI values are associated with unfavourable body composition outcomes, indicating high fat mass, low muscle mass and low bone mass. WWI can potentially serve as an integrated index of body composition, underscoring the need for further research to validate its use in clinical settings.

Impairments and comorbidities in adults with cerebral palsy and spina bifida: a meta-analysis.

Aging with a childhood-onset disability, such as cerebral palsy (CP), spina bifida (SB), and muscular diseases (MD), comes along with significant impairments and comorbidities. Despite the increasing evidence an overall picture is lacking. This study aimed to review the literature about adults with CP/SB/MD and impairments and comorbidities to perform a meta-analysis. Embase, PubMed, Cinahl, and Google Scholar were searched (2000-2020). Search terms included adults with one of the aforementioned disabilities combined with impairments and comorbidities. If specific impairments or comorbidities were reported by at least four studies, these were included in the study. Pooled prevalence (95% Confidence Interval) of impairments/comorbidities were calculated. The search yielded 7,054 studies of which 95 were included in the meta-analysis (64 CP, 31 SB, 0 MD). In total estimates were calculated for 26 (CP) and 11 (SB) outcomes. In adults with CP, pain [56.4% (95%CI 48.8-63.8)], deformities [44.2% (95%CI 12.9-78.4)], intellectual disability [37.2% (95%CI 26.7-48.3)], and fatigue [36.9% (95%CI 24.6-50.1)] were most prevalent; renal disease [3.0% (95%CI 2.1-4.2)] and stroke/rheumatic diseases {4.8% (95%CI 3.4-6.5; 4.8% (95%CI 1.5-9.9)] respectively} were least prevalent. For adults with SB, bladder incontinence [60.0% (95%CI 50.5-69.2)], bowel incontinence [49.2% (95%CI 34.5-64.0)], pain [44.1% (95%CI 27.4-61.5)], and sleeping problems [30.3% (95%CI 4.7-65.8)] were most prevalent; diabetes [4.8% (95%CI 2.8-7.3)] and renal disease [8.7% (95%CI 2.0-19.9)] were least prevalent. The included studies showed large heterogeneity. More research is needed to study health issues in adults with MD. Adults with CP or SB deal with a variety of health issues. More attention for the mental health of these adults is needed. There also is a need for accessible and adequate screening, preventive measures and clinical follow-up.

The age-related association between serum creatinine and cardiorespiratory morbidity and mortality and fractures among adults with cerebral palsy

PurposeSerum creatinine may be an objective biomarker of salient health issues in adults with cerebral palsy (CP). The objective was to assess the age-related association between serum creatinine with 3-year risk of cardiorespiratory morbidity/mortality and fracture among adults with CP. Patients and methodsThis retrospective cohort study used medical records between Jan. 1, 2012 and Oct. 2, 2022 from adults ≥18 years old with CP. The association between baseline serum creatinine with the 3-year risk of all-cause mortality, respiratory/cardiovascular morbidity/mortality, and fracture was assessed by age and sex using logistic regression. The discriminative ability of serum creatinine alone and in conjunction with other variables was assessed. ResultsOver the 3-year follow-up, 8.3% of 1368 adults with CP had all-cause mortality, 25.6% had respiratory morbidity/mortality, 12.4% had cardiovascular morbidity/mortality, and 8.9% sustained a fracture. The association between serum creatinine with outcomes was dependent on age. For younger adults, lower creatinine had a higher odds ratio (OR) for all-cause mortality, respiratory morbidity/mortality, and fracture. For 51–60 year olds, higher creatinine had a higher OR for cardiovascular morbidity/mortality. Serum creatinine alone had modest prediction of outcomes, and generally improved prediction when added to models that included sex and co-occurring intellectual disabilities and epilepsy (c-statistic range, 0.54–0.84). ConclusionsLower serum creatinine may reflect frailty while higher levels may reflect kidney dysfunction, helping to explain the differential associations by age. Serum creatinine may be a useful biomarker as part of risk prediction models for these salient health issues for adults with CP.

Nutritional Status Assessment among Adult Santals of East Singhbhum District in Jharkhand State, India

Currently, malnutrition and undernutrition are comprehensible health issues for adults in India. This condition also affects children. The prevalence of such situations developed in India is primarily due to socio-economic variation, especially in the case of socio-economically disadvantaged communities like Scheduled Tribes (STs) and Scheduled Castes (SCs) over others. For the last two to three decades, there has been no inspiring progress regarding the nutritional status of such a population. Studies on the assessment of nutritional status among both male and female Santals are almost lacking, hence the importance of conducting such a study. The present study tries to determine nutritional status prevalence among Santal adults in East Singhbhum District, Jharkhand, India. It was a community-based cross-sectional study carried out in tribal areas of East Singhbhum District, Jharkhand, India. A total of 211 adult (male = 101 and female = 110) schedule tribes (Santals) aged over 20 years in those village areas (Bela, Malua, Dighi Mura, Majhipara, Teghori and Raj bandh) were included in this study. Body Mass Index (BMI) and Mid Upper Arm Circumference (MUAC) were the major indicators used here to assess the studied participants' nutritional status. It was observed that most young adults, age group 20-40 years, are mainly affected. Further study revealed that 5.9 % of males, 8.1 % of females, and 7.1% of the total population were suffering from Chronic Energy Deficiency (CED), and 52.5 % of males, 58.1 % of females and 55.5 % of the total population became overweight. The overall sex-combined prevalence of undernutrition was 7.1%. The prevalence of undernutrition was significantly (p &lt; 0.05) higher (8.1%) in females compared to males (5.9%). Nutritional status assessment through MUAC also revealed more or less similar results. It may be suggested that nearly three fourth of the population (69.67 %) was nutritionally normal, whereas the rest (30.33 %) was found to be underweight and malnourished. So, from this study, it may be concluded that females were in the more concerning situation for undernutrition according to MUAC and overweight according to BMI.

A MULTIPLE REGRESSION MODEL FOR IDENTIFYING SOME RISK FACTORS AFFECTING THE CARDIOVASCULAR HEALTH ISSUES IN ADULTS

Multiple Regression analysis is one of the most critical and widely used statistical techniques in medical and applied research. It is dened as a multivariate technique for determining the correlation between a response variable and some combination of two or more predictor variables. Moreover, it is well-known in medical sciences that the obesity, high blood pressure and high cholesterol are major risk factors for cardiovascular health issues. The body mass index is a measure of body size, and combines a person's weight with their height, and therefore can affect their obesity, high blood pressure, high cholesterol and type 2 diabetes mellitus significantly, which are major risk factors for cardiovascular health issues in adults. Motivated by these facts, in this paper, a multiple linear regression model is developed to analyze the obesity in adults, based on a sample data of adult's age, height, weight, waist, diastolic blood pressure, systolic blood pressure, pulse, cholesterol, and the body mass index measurements. The use of multiple linear regression is illustrated in the prediction study of adult's obesity based on their body mass index. It is observed that in the presence of adult's age, weight, waist, diastolic blood pressure, systolic blood pressure, pulse, and cholesterol levels, height is a good predictor of the body mass index. Moreover, in the presence of age, height, waist, diastolic blood pressure, systolic blood pressure, pulse, and cholesterol levels, weight is a good predictor of the body mass index. Some concluding remarks are given in the end.

STAKEHOLDER ENGAGEMENT IN THE DESIGN OF A FALL RISK PREDICTION SYSTEM FOR SOCIALLY VULNERABLE OLDER ADULTS

Abstract Falls and fall-related injuries are significant public health issues for adults 65 years of age and older. Fall-related injuries are among the most expensive medical conditions. Mild cognitive impairment (MCI) and housing conditions are each independent risk factors for multiple falls among older adults and there is increasing evidence of the adverse effect of MCI on balance, stride, gait speed and increasing fall risk. We developed an innovative technology-supported intervention called Sense4Safety to 1) identify escalating risk for falls through real-time in-home passive sensor monitoring (using depth sensors); 2) employ machine learning to inform individualized alerts for fall risk; and 3) link ‘at risk’ socially vulnerable older adults with a tele-coach who guides them in implementing evidence-based individualized plans to reduce fall-risk. The purpose of this study was a) to examine preferences and attitudes of low-income older adults towards an in-home sensor-based system to inform fall prevention strategies; and b) solicit feedback from and validate the intervention protocols by clinical experts in fall prevention, fall risk assessment and geriatrics. We conducted one hour interview sessions with a total of 10 older adults and 10 clinical experts. Sessions were transcribed and analyzed. Findings included perceived benefits and challenges, recommendations for refinement of the intervention (including educational components and different visualization approaches for sensor data) and the role of family members or trusted others in addressing fall risk. We highlight clinical and ethical implications resulting from the use of passive monitoring for socially vulnerable older adults with MCI.

Development of psychopathology in adults with congenital heart disease: A 40–53 years follow-up study

BackgroundNowadays, more than 90% of patients with congenital heart disease (CHD) reach adulthood. Their long-term psychopathological development is not well known. Material and methodsOur unique, single center, longitudinal cohort-study evaluates a series of consecutive patients who underwent cardiac surgery in their childhood between 1968 and 1980 every ten years. Standardized questionnaires were used to measure psychopathology at 4 follow-up time points (1991, 2001, 2011 and 2021) and outcomes were compared with normative data. Results in the current evaluation were corrected for the Covid-19 stringency index. ResultsAt the current (4th) evaluation in 2021 (n = 204, 46.1% female, age: 49.9 ± 5.2), female patients with CHD reported more internalizing problems than the normative group. More specifically, they reported significantly more somatic complaints. Proxy-reports showed significantly less externalizing problems for males. No significant difference was found between mild and moderate/severe CHD in terms of psychopathology. Correction for Covid-19 stringency showed no significant effect.Over time, the percentage of patients scoring in the psychopathological range decreased from the first (1991, 25.4%) to the third follow-up (2011, 1.8%). However, the current study showed a significant increase (9.6%) of the psychopathology levels in comparison with 2011. ConclusionsCompared to normative data, female CHD patients reported significantly more internalizing problems, particularly more somatic complaints. Initially, the level of psychopathology decreased over time. However, in the last decade, there was a significant increase in psychopathology, warranting continuous attention to the psychological health issues of adults with CHD.

Understanding How Receptors and Genetic Mutations Promote Hypertension

Hypertension (high blood pressure) is a common health issue in adults that can lead to numerous co-morbidities. For hypertension to develop, a pathway called the renin-angiotensin-aldosterone system needs to be activated, and a vital part of this system involves the angiotensin 1 receptor. Dr Sudhir Jain from New York Medical College studies this receptor and how specific groups of genetic mutations, known as haplotypes, promote hypertension under different conditions.

Bone Mineral Density in Adults With Cerebral Palsy.

Low bone mineral density (BMD) is an emerging health issue in adults with cerebral palsy (CP). This cross-sectional study aimed to describe the characteristics of BMD in adults with CP, and to elucidate the risk factors for low BMD in this population. People aged ≥20 years and diagnosed with CP were recruited from February 2014 to November 2014. We assessed BMD using dual-energy X-ray absorptiometry (DXA) for the lumbar spine, femoral neck, and total femur. Moreover, the body composition was assessed using DXA. We included a total of 87 adults with CP (mean age 42.01 years; 52 men). The prevalence of low BMD was 25.3%. Male sex and age were associated with lower BMD. BMD was significantly lower in the non-ambulatory group than that in the ambulatory group for both lumbar spine and femoral neck. The total fat mass demonstrated a positive correlation with the Z-score and BMD for the femur neck and total femur. Body mass index (BMI) and total fat mass were positively correlated with BMD in the lumbar spine, femoral neck, and total femur. However, the Gross Motor Function Classification Scale levels were negatively correlated with BMD at the aforementioned three sites. In conclusion, adults with CP revealed decreased BMD, which was associated with male sex, age, decreased gross motor function, loss of ambulatory function, low BMI, decreased total fat mass, and decreased total fat-free mass.

Correlation of anemia to body mass index among adult population in a rural region of Malwa in Madhya Pradesh

Background: Anemia and obesity are the markers of imminent health issues in adults because malnutrition shows two extreme ends, decreased hemoglobin (Hb) and increased body mass index (BMI), caused due to undernutrition and overnutrition, respectively. Aims and Objectives: This study was done to compare the effect of a BMI on anemia in India as very few of these studies have been done in rural India and none in the rural Malwa region of Central India. Materials and Methods: The study was conducted at a rural mission hospital in a remote village Hatpipliya of district Dewas, Madhya Pradesh, beginning from September 2020 to November 2020 with a sample size of 152 subjects. Hb was assessed on the basis of the World Health Organization standards and BMI was calculated as per Quetelet’s index. The collected data were tabulated and analyzed. Results: A total of 152 people in the age group of >20 years were included in the study. Seventy-one (47%) were male and 81 (53%) were female. The prevalence of anemia among underweight population was 38.8%, which was almost closed to those with normal BMI (38.5%). The overweight category showed 21% to be anemic and interestingly, 50% of obese individuals were anemic. Conclusion: No significant difference (P > 0.05) was found in the prevalence of anemia among all BMI groups. Frequent screening for the prevalence of anemia and its association with BMI should be done among the target group.

Foot care needs for children and young people with intellectual and developmental disabilities

Accessible Summary We asked parents of children with intellectual and developmental disabilities to complete a survey to help us understand more about the foot problems their children have experienced. Parents told us that foot problems were common in their children, 75% of the parents raised this as a concern. Less than half of the parents felt confident with managing these problems. Buying shoes was considered difficult. The results from this survey tell us that foot problems in children and young people with intellectual and developmental disabilities are a concern. It is important to ensure that children have access to foot care services. AbstractBackgroundFoot problems have been reported to be a very common health issue in adults with intellectual disabilities; foot problems in children and young people are, however, poorly understood. The aim of this study was to explore foot care needs of children and young people with intellectual and developmental disability.MethodsAn exploratory, cross‐sectional online survey was undertaken across a four‐month period. A purposive snowball sampling approach was adopted. The survey tool was piloted before launch and comprised three sections. The first section elicited information relating to parent/caregiver status, diagnosis, secondary diagnoses and age of child/young person. The second domain explored foot care and sought to obtain information about foot problems, access to health services and existing knowledge about foot health. The third domain focussed on footwear. Ethical approval was granted from the host institution, and all participants provided electronic consent before completing the survey.ResultsData were collected from 49 parents/parental caregivers reporting on behalf of their children (mean age 7 years of age; SD 4.5 years of age). Parents reported foot problems to be very common (75%), and pes planus was the most frequent concern (51%). Twenty‐four parents reported difficulties with finding shoes (48%). A mismatch between foot shape and the shoe (30%) or complications with orthotic devices (14%) within the shoe were highlighted.ConclusionThe results demonstrated that the burden of foot problems in children and young people with intellectual and developmental disabilities is considerable. The findings highlight the importance of access to foot care services for these children.

Cover Image, Volume 179A, Number 9, September 2019

The cover image is based on the Genetic Syndromes in Adults Phenotype evolution and health issues of adults with Beckwith-Wiedemann Syndrome by Alessandro Mussa et al., DOI: 10.1002/ajmg.a.61301.

Phenotype evolution and health issues of adults with Beckwith‐Wiedemann syndrome

Beckwith-Wiedemann syndrome (BWS) phenotype usually mitigates with age and data on adulthood are limited. Our study aims at reporting phenotype evolution and health issues in adulthood. 34 patients (16 males), aged 18-58 years (mean 28.5) with BWS were enrolled. 26 patients were molecularly confirmed, 5 tested negative, and 3 were not tested. Final tall stature was present in 44%. Four patients developed Wilms' Tumor (2, 3, 5, and 10 years, respectively); one hepatoblastoma (22 years); one acute lymphoblastic leukemia (21 years); one adrenal adenoma and testicular Sertoli cell tumor (22 and 24 years, respectively); and three benign tumors (hepatic haemangioma, uterine myoma, and mammary fibroepithelioma). Surgery for BWS-related features was required in 85%. Despite surgical correction several patients presented morbidity and sequelae of BWS pediatric issues: pronunciation/swallow difficulties (n = 9) due to macroglossia, painful scoliosis (n = 4) consistent with lateralized overgrowth, recurrent urolithiasis (n = 4), azoospermia (n = 4) likely consequent to cryptorchidism, severe intellectual disability (n = 2) likely related to neonatal asphyxia and diabetes mellitus (n = 1) due to subtotal pancreatectomy for intractable hyperinsulinism. Four patients (two males) had healthy children (three physiologically conceived and one through assisted reproductive technology). Adult health conditions in BWS are mostly consequent to pediatric issues, underlying the preventive role of follow-up strategies in childhood. Malignancy rate observed in early adulthood in this small cohort matches that observed in the first decade of life, cumulatively raising tumor rate in BWS to 20% during the observation period. Further studies are warranted in this direction.

Cerebral palsy prevalence, subtypes, and associated impairments: a population‐based comparison study of adults and children

To describe the prevalence of cerebral palsy (CP), subtype distribution, motor and intellectual impairment, and epilepsy in adults with CP compared with children with CP. CP subtype and impairment data from the population-based CP register of western Sweden and population data from Statistics Sweden were used to compare surviving adults (n=581; 244 females, 337 males) born between 1959 and 1978, with the same cohort as children (n=723; 307 females, 416 males), andwiththe most recent cohort, born from 2007 to 2010 (n=205; 84 females, 121 males). Prevalence of CP in adults born between 1959 and 1978 was 1.14 per 1000. The occurrence of impairments differed between CP subtypes. Motor and intellectual impairment were closely related, regardless of subtype. Subtype distribution among survivors differed significantly from the original cohorts (p=0.002), and the most recent cohort (p<0.01), tetraplegia and dyskinetic CP being less common in survivors. Severe motor impairment, intellectual disability, and epilepsy were less common among survivors than in the original cohorts (p=0.004, p=0.002, p=0.037) and the most recent cohort (p=0.004, p=0.008, p<0.01). Data on prevalence, subtype distribution, and impairments in children with CP are not applicable to adults with CP. Population-based studies of adults with CP are needed. Cerebral palsy (CP) subtypes are differently distributed in adults compared to children. The prevalence of impairments in adults with CP is related to CP subtype. Spastic tetraplegia and dyskinetic CP are less common in adults than children. Severe motor impairment, intellectual disability, and epilepsy are less common in adults.