Months In Boys Research Articles

Brief Exposure to a Self-Paced Computer-Based Reading Programme and How It Impacts Reading Ability and Behaviour Problems

Basic literacy skills underlie much future adult functioning, and are targeted in children through a variety of means. Children with reading problems were exposed either to a self-paced computer programme that focused on improving phonetic ability, or underwent a classroom-based reading intervention. Exposure was limited to 3 40-min sessions a week, for six weeks. The children were assessed in terms of their reading, spelling, and mathematics abilities, as well as for their externalising and internalising behaviour problems, before the programme commenced, and immediately after the programme terminated. Relative to the control group, the computer-programme improved reading by about seven months in boys (but not in girls), but had no impact on either spelling or mathematics. Children on the programme also demonstrated fewer externalising and internalising behaviour problems than the control group. The results suggest that brief exposure to a self-paced phonetic computer-teaching programme had some benefits for the sample.

Analysis of the relationship of insulin-like growth factor-1 to the growth velocity and feeding of healthy infants

ContextInfancy is the fastest growth period in a child's development after birth, but little is known about hormonal regulation mechanism for the growth and development of this period. ObjectiveThe objective of this study is to analyze the trend of serum IGF-1 levels in healthy infants and the relationship of IGF-1 to the growth velocity and feeding method of infants. DesignPopulation-based birth cohort study. SettingThe study was conducted in the Third Hospital of Peking University. ParticipantsStudy participants were 484 healthy infants, all of whom were full-term and appropriate for gestational age (238 boys and 246 girls). InterventionsInterventions were anthropometrical measurements, feeding methods recorded every 1 to 2months and serum samples (2, 4, 6, 8, 10,12months). Main outcome measuresHeight, weight, feeding methods and serum IGF-1 were the main outcome measures. ResultsSerum IGF-1 levels decreased in the following 2months in boys but in females levels remained relatively high between 2 to 3months after birth and then started to decrease. It reached the lowest point at Months 7–8, and was on a slow rise in both male infants and female infants thereafter. Serum IGF-1 levels were significantly higher in female infants [112.65ng/ml (CI 91.82, 133.89)] than in male infants [74.38ng/ml (CI 53.14, 95.61)] at early infancy. Infants fed with human milk had lower serum IGF-1 levels than infants fed with formula milk or human milk plus formula milk (66.94±45.85ng/ml, 72.56±36.55ng/ml, 79.89±51.79ng/ml, respectively; P=0.019). IGF-1 levels were positively correlated to the growth velocity of body length (P<0.01). ConclusionThis study provides the trend for IGF-1 levels at infancy. It is highly possible that IGF-1 plays an important role in the regulation and control of length increases in infants, and feeding method influences serum IGF-1 levels.

Could a brief assessment of negative emotions and self-esteem identify adolescents at current and future risk of self-harm in the community? A prospective cohort analysis

BackgroundSelf-harm is common in adolescents, but it is often unreported and undetected. Available screening tools typically ask directly about self-harm and suicidal ideation. Although in an ideal world, direct enquiry and open discussion around self-harm would be advocated, non-psychiatric professionals in community settings are often reluctant to ask about this directly and disclosure can be met with feeling of intense anxiety. Training non-specialist staff to directly ask about self-harm has limited effects suggesting that alternative approaches are required. This study investigated whether a targeted analysis of negative emotions and self-esteem could identify young adolescents at risk of self-harm in community settings.MethodsData were collected as part of a clinical trial from young people in school years 8–11 (aged 12–16) at eight UK secondary schools (N = 4503 at baseline, N = 3263 in prospective analysis). The Short Mood and Feelings Questionnaire, Revised Child Anxiety and Depression Scale, Rosenberg Self-Esteem Scale, personal failure (Children’s Automatic Thoughts Scale), and two items on self-harm were completed at baseline, 6 and 12 months.ResultsFollowing a process of Principal Components Analysis, item reduction, and logistic regression analysis, three internally reliable factors were identified from the original measures that were independently associated with current and future self-harm; personal failure (3 items), physical symptoms of depression/anxiety (6 items), positive self-esteem (5 items). The summed score of these 14 items had good accuracy in identifying current self-harm (AUC 0.87 girls, 0.81 boys) and at six months for girls (0.81), and fair accuracy at six months for boys (AUC 0.74) and 12 months for girls (AUC 0.77).ConclusionsA brief and targeted assessment of negative emotions and self-esteem, focusing on factors that are strongly associated with current and future self-harm, could potentially be used to help identify adolescents who are at risk in community settings. Further research should assess the psychometric properties of the items identified and test this approach in more diverse community contexts.

Quantitative measurement of the androgen receptor in prepuces of boys with and without hypospadias

WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Despite diverse anatomical and histological trials in humans and animal models, the aetiology of hypospadias remains unknown and currently there is no clear molecular explanation about the emergence of this disease; however, genetic, endocrine and environmental mechanisms have been suggested. The aim of the present study was to quantify and compare the androgen receptor (AR; mRNA and protein) levels in 40 prepuces of boys with and without hypospadias using quantitative real-time polymerase chain reaction, Western Blot and standardised, automated immunohistochemistry. AR mRNA (P = 0.013) and AR protein (P = 0.014) was significantly elevated in the prepuces of boys with hypospadias compared with boys without hypospadias. Altogether our data indicate that elevated AR mRNA and protein levels can be considered as a biochemical response of an AR signalling defect as an identified cause in boys with hypospadias. Additionally, nuclear staining intensity for AR-protein in specimens of boys with hypospadias was higher than in boys with phimosis. To address the role of the androgen receptor (AR) on mRNA and protein levels in prepuces of boys with and without hypospadias. Data from 40 foreskin specimens of consecutive circumcised boys (20 with vs 20 without hypospadias) were enrolled in this prospective study. After surgery, samples were fixed in formaldehyde and frozen in liquid nitrogen. Total RNA was isolated from frozen tissue and transcribed to complementary DNA. The amount of AR mRNA was measured by quantitative real-time polymerase chain reaction and Western Blot and standardised, automated immunohistochemistry were used to assess AR protein levels. The mean age at time of surgery was 61.8 and 30.9 months in boys without and with hypospadias, respectively. There was penile, coronal and sine hypospadias in seven (35%), nine (45%), and four (20%) boys, respectively. AR mRNA was significantly elevated in the prepuces of boys with hypospadias compared with boys without hypospadias, at a mean (sd) of 28.33 (5.39) vs 15.31 (1.85) (P = 0.013). Furthermore, the amount of AR protein was higher in boys with, compared with boys without hypospadias, at a mean (sd) of 133.25 (6.17) vs 100 (4.45) (P = 0.014). Different AR mRNA expression and protein levels seem to be an indication of an AR signalling defect as a cause in boys with hypospadias. Decreased AR DNA binding and functional capability may result in a compensatory up-regulation of both AR mRNA and protein. Further studies are necessary to perform structural analysis of the AR and to corroborate these preliminary findings.

Quantitative muscle strength assessment in duchenne muscular dystrophy: longitudinal study and correlation with functional measures

BackgroundThe aim of this study was to perform a longitudinal assessment using Quantitative Muscle Testing (QMT) in a cohort of ambulant boys affected by Duchenne muscular dystrophy (DMD) and to correlate the results of QMT with functional measures. This study is to date the most thorough long-term evaluation of QMT in a cohort of DMD patients correlated with other measures, such as the North Star Ambulatory Assessment (NSAA) or thee 6-min walk test (6MWT).MethodsThis is a single centre, prospective, non-randomised, study assessing QMT using the Kin Com® 125 machine in a study cohort of 28 ambulant DMD boys, aged 5 to 12 years. This cohort was assessed longitudinally over a 12 months period of time with 3 monthly assessments for QMT and with assessment of functional abilities, using the NSAA and the 6MWT at baseline and at 12 months only. QMT was also used in a control group of 13 healthy age-matched boys examined at baseline and at 12 months.ResultsThere was an increase in QMT over 12 months in boys below the age of 7.5 years while in boys above the age of 7.5 years, QMT showed a significant decrease. All the average one-year changes were significantly different than those experienced by healthy controls. We also found a good correlation between quantitative tests and the other measures that was more obvious in the stronger children.ConclusionOur longitudinal data using QMT in a cohort of DMD patients suggest that this could be used as an additional tool to monitor changes, providing additional information on segmental strength.

Relationship between the clinical findings and radiographic severity in Osgood-Schlatter disease.

BackgroundOsgood–Schlatter disease (OSD) is one of the common causes of knee pain in active adolescents who play sports. The common age for boys to have OSD is between 12 and 15 years and for girls, between 8 and 12 years. Radiographic studies are helpful in diagnosis and treatment of OSD.PurposeWe examine the age at onset of OSD in detail and investigate the relationship between clinical findings, radiographic bone morphology, and the severity of OSD in adolescents.ResultsThe average age at onset of knee pain was 12 years and 6 months – 12 years and 9 months in boys, and 12 years and 1 month in girls. Boys were significantly older than girls at onset. In addition, there were significant relationships between duration from first onset to visit to the clinic, radiographic bone stage, body morphology, and radiographic severity. The patients who delayed their visit to the clinic from the first onset of pain and who were older showed a later bone stage and more radiographic severity grade of OSD. There was significant differences concerning weight and body mass index between severity grade I and III.ConclusionFor the age at the onset of OSD, the mean age of boys was significantly older than that of girls. The patients at a later bony stage had a higher severity grade. The boys and girls with OSD who had less weight or body mass index showed less severity.

The efficiency and stability of maxillary expansion with Quadhelix; a longitudinal study

Transverse maxillary deficiencies constitute a routine clinical problem in orthodontics, Quadhelixis one of the slow maxillary expanders which used to solve these problems. The purpose of this study was to investigate the long-term clinical responses of Quadhelixas slow maxillary expander; a treatment performed for early permanent dentition in Class I malocclusion. Subjects and methods: A study sample of 30 patients (13 males and 17 females) were selected on the criteria of having Class I permanent dentition with transverse maxillary deficiency, and mild or no crowding mandibular dental arch, treated with Quadhelix expander without extraction, with active mechanotherapy for teeth alignment (as needed). The mean age of the sample was 12 years and 2 months for girls and 12 years and 11 months for boys at treatment initiation. Cast and cephalometric measurements outcomes were evaluated at pretreatment phase A 0, post- activeexpansion phase A 1, post-retentive phaseA2 (one year after A 1), and at the end of long term follow-up A3(three years after A1). The results were compared to a control group of 30 subjects (15 males and 15 females) of Class I with normal occlusions of the same age group. Simple training to withdraw bad oral habitswas carried out all over the study. Results: Casts and cephalometric x-rays measurements were quantified and compared among phase A0, A1, A2, and A3. Using Student's t-test, the study group demonstrated a significant increase in the arch width values during the activeexpanding phase (P, .001) and less significant increaseduring the long-term follow-up (P, .01). Stable arch length and no increase in the lower facial height were beneficial results. Conclusions: The long-term clinical response demonstrated the efficiency and stability of this type of treatment in achieving maxillary arch width with no threatening of mandibular downward rotation. The follow-up evaluation confirmed the validity of overtreatment.

Effects of prenatal food and micronutrient supplementation on child growth from birth to 54 months of age: a randomized trial in Bangladesh

BackgroundThere is a lack of information on the optimal timing of food supplementation to malnourished pregnant women and possible combined effects of food and multiple micronutrient supplementations (MMS) on their offspring's growth. We evaluated the effects of prenatal food and micronutrient interventions on postnatal child growth. The hypothesis was that prenatal MMS and early invitation to food supplementation would increase physical growth in the offspring during 0-54 months and a combination of these interventions would further improve these outcomes.MethodsIn the large, randomized MINIMat trial (Maternal and Infant Nutrition Interventions in Matlab), Bangladesh, 4436 pregnant women were enrolled between November 2001 and October 2003 and their children were followed until March 2009. Participants were randomized into six groups comprising 30 mg Fe and 400 μg folic acid (Fe30F), 60 mg Fe and 400 μg folic acid (Fe60F) or MMS combined with either an early (immediately after identification of pregnancy) or a later usual (at the time of their choosing, i.e., usual care in this community) program invitation to food supplementation. The anthropometry of 3267 children was followed from birth to 54 months, and 2735 children were available for analysis at 54 months.ResultsThere were no differences in characteristics of mothers and households among the different intervention groups. The average birth weight was 2694 g and birth length was 47.7 cm, with no difference among intervention groups. Early invitation to food supplementation (in comparison with usual invitation) reduced the proportion of stunting from early infancy up to 54 months for boys (p = 0.01), but not for girls (p = 0.31). MMS resulted in more stunting than standard Fe60F (p = 0.02). There was no interaction between the food and micronutrient supplementation on the growth outcome.ConclusionsEarly food supplementation in pregnancy reduced the occurrence of stunting during 0-54 months in boys, but not in girls, and prenatal MMS increased the proportion of stunting in boys. These effects on postnatal growth suggest programming effects in early fetal life.Trial registration numberISRCTN: ISRCTN16581394

Timing of deciduous teeth emergence in Egyptian children

The existing eruption schedules for permanent and deciduous dentition are based on studies in industrialized countries. This study determined the dates of emergence of deciduous teeth in a cross-sectional sample of 1132 Egyptian infants aged 4-36 months selected from different governorates of Egypt. The dates of emergence of individual teeth were calculated using Probit analysis. The mandibular left and right incisors were the earliest teeth to emerge at a mean of 8.0 months in boys and 7.9 months in girls. The sequence of eruption followed a typical pattern. The average time from emergence of the first tooth to the last tooth was 17.8 months in the mandible and 15.8 months in the maxilla for boys and 22.1 and 20.1 months respectively for girls. Four active phases of emergence were identified and compared with data from other countries.

Study of Acute Alcohol Poisoning in Children Admitted to a Emergency Hospital Pirogov in Sofia, Bulgaria

Aim: The aim of the current study is to analyze the medical and social dimensions of acute alcohol poisoning in children with regard of improving prevention of addictive habitis and develop effective preventative strategies for reducing underage alcohol consumption. Material and Methods: We have studied the patients at the age up to 18 years with acute alcohol poisoning hospitalized in the Children Toxicology Department of Emergency Hospital Pirogov, Sofia, Bulgaria, from January 1, 2007 to June 31, 2008. All of them were at teen years – between 12 and 17 years old. Data on children were retrived from hospital medical records (age, sex, level of consciousness, blood ethanol level). The initial blood ethanol level was measured on admission by thin-layer chromatography for each patient. We have used the inquiry method - specially created for the purpose of the survey questionnaire comprising 39 questions (location and the reason for drinking, type of alcoholic beverage, age at first drink, combination alcohol-illicit drug, type of family, education and employment of parents, frequency of alcohol consumption by parents, consecutiveness of the children in family, presence of siblings, presence of children in a single room, interests etc.). Psychiatric interview was used. Results: We have studied 137 children with acute alcohol poisoning. Average age of children intoxicated by alcohol was 14.91±1.45 years. 77 (56.2%) are boys and 60 (43.8%) girls. The results demonstrate tendency of increase of the poisonings in weekends and in late afternoon and evening. On admission to hospital most of them had different levels of depressed consciousness: 61.3% were somnolent, 28.5% were soporous and 5.1% were comatose. Blood ethanol level was over 2.00 mg/ml in 40.2%. In the 21 (15.3%) cases children have been poisoned at the first alcohol consumption. No repeated hospitalization for acute alcohol poisoning in the study group for that period has been registered. Combination alcohol-illicit drug was observed in 13 children (9.5%). Children most often used one type of alcoholic beverage. The most frequent alcoholic beverage leading to intoxication is the vodka (63.1%). 64% of the children come from complete families. Both parents have secondary education in 79.7% and in 53.3% both parents are employed. 60% were the first born child in the family. First alcohol consuption was at the12 years and 10 months for boys, and at 13 years for girls. The most frequent reason for alcohol consumption was meeting and communicing with friends. The students have approximately 1.20 euro daily. Conlusion: Influence of “the group” is the main cause of alcohol consumption in adolescence. There is no increasing tendency for combining alcohol with other psychoactive drugs. We consider the brief intervention prior to hospital discharge as a preventive factor for repeated poisonings.

High-Dose Docosahexaenoic Acid Supplementation of Preterm Infants: Respiratory and Allergy Outcomes

Docosahexaenoic acid (DHA) has been associated with downregulation of inflammatory responses. To report the effect of DHA supplementation on long-term atopic and respiratory outcomes in preterm infants. This study is a multicenter, randomized controlled trial comparing the outcomes for preterm infants <33 weeks' gestation who consumed expressed breast milk from mothers taking either tuna oil (high-DHA diet) or soy oil (standard-DHA) capsules. Data collected included incidence of bronchopulmonary dysplasia (BPD) and parental reporting of atopic conditions over the first 18 months of life. Six hundred fifty-seven infants were enrolled (322 to high-DHA diet, 335 to standard), and 93.5% completed the 18-month follow-up. There was a reduction in BPD in boys (relative risk [RR]: 0.67 [95% confidence interval (CI): 0.47-0.96]; P=.03) and in all infants with a birth weight of <1250 g (RR: 0.75 [95% CI: 0.57-0.98]; P=.04). There was no effect on duration of respiratory support, admission length, or home oxygen requirement. There was a reduction in reported hay fever in all infants in the high-DHA group at either 12 or 18 months (RR: 0.41 [95% CI: 0.18-0.91]; P=.03) and at either 12 or 18 months in boys (RR: 0.15 [0.03-0.64]; P=.01). There was no effect on asthma, eczema, or food allergy. DHA supplementation for infants of <33 weeks' gestation reduced the incidence of BPD in boys and in all infants with a birth weight of <1250 g and reduced the incidence of reported hay fever in boys at either 12 or 18 months.

Aleitamento materno exclusivo e adiposidade

OBJETIVO: Associar o tempo de amamentação exclusiva da criança à adiposidade central e periférica, por meio do índice de massa corporal, dos perímetros da cintura e do braço, e das dobras cutâneas triciptal, subescapular e a somatória destas em pré-escolares. MÉTODOS: Pesquisa de delineamento transversal, em que 134 pré-escolares entre três e cinco anos de idade de uma escola par-ticular de Brasília, DF, foram avaliados quanto a: massa corporal, estatura, perímetros do braço e da cintura, dobras cutâneas triciptal e subescapular. Os pais das crianças responderam a um questionário sobre tempo de amamentação. O diagnóstico de sobrepeso e obe-sidade foi realizado de acordo com a classificação da Organização Mundial da Saúde para o índice de massa corporal por idade. RESULTADOS: As meninas tiveram maior concentração adiposa na dobra cutânea triciptal (p=0,001), subescapular (p=0,044) e na somatória destas (p=0,003) em relação aos meninos. A prevalência de sobrepeso e obesidade foi similar nos dois sexos (25,4% nos meninos e 22,6% nas meninas), assim como o tempo médio de amamentação exclusiva (4,3 meses para meninos e 4,6 meses para meninas). Notou-se correlação inversa significativa entre tempo de amamentação exclusiva e perímetro da cintura (r=-0,166; p=0,05). As demais variáveis também mostraram tendência de correlação inversa com o tempo de aleitamento materno exclusivo, porém sem valores significativos. CONCLUSÕES: A associação inversa entre o tempo de ama-mentação e o perímetro da cintura mostra um possível efeito do aleitamento materno sobre a distribuição de gordura corporal no pré-escolar.

Cerebral biometry at birth and at 4 and 8 months of age. A prospective study using US

Although longitudinal reference intervals for ventricular size are crucial for the diagnosis of dilated ventricles, such data are sparse. To establish references for ventricular measurements at birth, and at 4 and 8 months follow-up, and to examine the inter-observer variation of the measurements. This prospective, longitudinal study included 120 term newborns (boys 65, girls 55), mean age 1.5 days on initial scans, with re-examination at 4 months and 8 months of age. One examiner performed all the examinations, measuring: ventricular index, frontal horn width, third ventricle width, frontal subarachnoid space depth, optic nerve sheath diameter and resistive index. One hundred eight (90%) and 90 (75%) of the infants, respectively, attended for follow-up at 4 and 8 months of age. All measures increased with age, except for the depth of the subarachnoid spaces that showed an initial rise, followed by a mild drop at 8 months, and for the resistive index that remained stable at 0.6. The increase was particularly significant for frontal horn width with an increase from 2.2 mm at birth to 6.5 mm at 4 months in boys, and 2.1-5.8 mm in girls. The agreement between two observers was fair to moderate for most of the measurements. The increase in the width of the frontal horns between birth and 4 months of age, as well as the wide normal range found among all three age groups are noteworthy and should inform future diagnostics.

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Epidemiology and Demographics of Slipped Capital Femoral Epiphysis in Korea: A Multicenter Study by the Korean Pediatric Orthopedic Society

In 1979, slipped capital femoral epiphysis (SCFE) was rarely reported in Korea, although it is the most common hip disorder of adolescence in Western nations. However, because the number of reported cases of SCFE in Korea has increased a great deal since then, we performed a nationwide survey to ascertain its epidemiology and demographics in Korea. We reviewed the discharge databases for the period between January 1989 and December 2003 from 19 university hospitals across Korea. Recorded data included age at onset, sex, past medical history, height, weight, and type of slippage. We compared those data with national census data. The incidence data are reported as cases per 100,000 children between the ages of 10 and 14 years. Data for 231 patients (175 boys and 56 girls) were included in our survey. The average age at onset was 12 years 10 months in boys and 12 years in girls. The average annual incidence was estimated to be at least 0.499 for boys and 0.142 for girls for every 100,000 children between the ages of 10 and 14 years, which was lower than that of Western nations and Japan. The incidence showed a pattern of increments across each period. The mean body mass index was significantly higher in Korean patients with SCFE than in the population of the same age group without it. The incidence of SCFE in preadolescents in Korea has increased markedly since 1979, which may be related to increasing rates of obesity. Therapeutic, level 4.

Predictive validity of Bayley scale in language development of children at 6–36 months

The aim of the present study was to investigate the prediction of development among 6-, 18-, and 36-month-old infants on the Bayley Scale of Infant Development (BSID). One hundred infants were assessed using the BSID at 6 months; of these, 70 completed the 18 and 36 month assessment at follow up. Multivariate regression and structural equation modeling were used to determine predictive validity in the mental and psychomotor developmental scales. Structural equation analysis also confirmed the conceptual scheme of the stability of development from 6 to 36 months for boys. Boys had a steadier overall developmental trajectory compared to girls. The validity of BSID was consistent with previous studies. The language spurt in girls, however, from 6 to 18 months affected the stability of the BSID. Thus, the gender difference in language development should be considered in clinical assessment.

Social cognitive predictors of peer acceptance at age 5 and the moderating effects of gender

In this study we examined the effects of social intelligence, empathy, verbal ability and appearance-reality distinction on the level of peer acceptance, as well as the moderating role of gender. Participants were 98 five-year-old children (43 boys and 55 girls; mean age 5 years 3 months for boys and girls). Our results showed a main effect of social intelligence on peer acceptance, as well as several other effects that were moderated by gender: a significant and positive effect of verbal ability on social acceptance was found for boys; appearance-reality distinction was found to have a positive effect on social acceptance in the case of girls; and although empathy had a significant positive effect on social acceptance for both boys and girls, this effect was more pronounced among boys. Our results suggest that abilities promoting peer acceptance are different for boys and girls.

Symphysis pubis width and unaffected hip joint width in patients with slipped upper femoral epiphysis: widening compared with normal values

The exact pathomechanism of slipped upper femoral epiphysis (SUFE) remains elusive. This paper suggests a generalised abnormality of the development or maturation of cartilage as a possible cause. It is proposed that SUFE is part of a generalised abnormality of the cartilage formation or maturation resulting in abnormal measurements of cartilaginous joint structures. Radiographs of SUFE patients were assessed for the width of the unaffected hip joint and the symphysis pubis. Comparison with previously published normal values was made. Fifty-one patients were assessed, 35 male, 16 female. The average age was 12 years and 11 months combined for both sexes, 13 years 8 months for boys, 11 years 4 months for girls. Width of the symphysis pubis was assessed on 46 datasets, and comparison with normal values was performed using the Wilcoxon paired rank test. Statistical significance was set as p < 0.05. The average expected width was 5.8 mm (5.4-6.2 mm), the average measured width was 7.3 mm (3.5-12 mm), median value 7.0 mm, and the difference is statistically significant. Cartilage thickness of the uninvolved hip joint could be assessed in 46 cases, and comparison using the Wilcoxon paired rank test resulted in a statistically significant difference (significance set as p < 0.05). The average expected width was 4.9 mm (3.6-6.5 mm), the average measured width was 5.5 mm (4-8 mm), and median 5.3 mm. The results indicate that SUFE patients display a generalised increased width of joint cartilage for their age. This could be due to increased cartilage formation or decreased maturation or a combination of the two, and could explain the increased mechanical vulnerability of these children to normal or abnormal stresses, despite histologically normal organisation of the physis as shown in previous studies.

Return to Basketball and Soccer After Anterior Cruciate Ligament Reconstruction in Competitive School-Aged Athletes

Background:Little is known about the return to sports after anterior cruciate ligament reconstruction and whether sex differences exist regarding the level and timing at which athletes return.Hypotheses:Compared to school-aged girls, boys return to full sports earlier and at a higher frequency after surgery (1). Athletes who return to sports earlier will not have a higher incidence of subsequent injury to either knee after surgery (2).Study Design:Cohort.Methods:The patient population comprised 413 consecutive school-aged athletes who were injured while competing in basketball or soccer. Patients were enrolled prospectively, and activity levels were obtained through follow-up visits, surveys, phone calls, and e-mail.Results:Follow-up was obtained for 402 patients (basketball: 58 boys, 242 girls; soccer: 25 boys, 77 girls). Eighty-seven percent of girls and boys returned to high school basketball after surgery: the mean time to return to full participation in basketball was 5.2 ± 2.1 months for girls and 5.3 ± 2.2 months for boys (P = .92). Similarly, 93% of girls and 80% of boys returned to compete in high school soccer after surgery (P = .13); the mean time to return to full participation in soccer was 5.1 ± 1.9 months for girls and 5.1 ± 2.0 for boys (P = 1.00). About 20% of athletes went on to compete in their sport in college. The time of return to sports was not a statistically significant factor for the incidence of subsequent anterior cruciate ligament injury.Conclusion:Of 402 athletes competing in basketball and soccer, women and men returned at the same rate and same level of sport after surgery. Athletes who returned to sports at earlier times after surgery did not have a higher incidence of subsequent anterior cruciate ligament injury than patients who returned at later times.

Reproducibility of DXA measurements of bone mineral density and body composition in children

The technique of X-ray-based dual photon absorptiometry (DXA) is frequently used in children for the detection of changes in bone mass or body composition. Such changes can only be considered real if the uncertainties arising from the measurement technique are exceeded. Our objectives were twofold: (1) to determine the reproducibility of bone mineral density (BMD) measurements in children at the spine and the hip and from the whole body, as well as of whole-body measurements of mineral mass, lean body mass and fat mass in children; and (2) to estimate, from the measured precision, the time interval that needs to elapse before a statistically significant change in a DXA variable can be detected. The reproducibility of techniques for the measurement of BMD and body composition using DXA was measured in 15 young children (9 girls and 6 boys) and 17 older children (9 girls and 8 boys). Reproducibility was derived from the standard deviation of three repeated measurements of spine BMD, total hip BMD, whole-body BMD (WBBMD), whole-body bone mineral content (WBBMC), lean mass and fat mass. Technique precision was better than 0.01 g cm(-2) for spine BMD and for WBBMD. Hip BMD measurements were slightly less precise, particularly in younger children (0.013 g cm(-2)). For body composition variables, technique precision was 13 g for WBBMC, 201 g for lean body mass and 172 g for fat mass in younger children. Technique precision for older children was 18 g, 251 g and 189 g for the corresponding variables. Predictions showed that the absence of a normal increase in WBBMC in a small-for-age girl could be established after 12 months. For spine BMD, a significant increase should be observable after 6 months for boys over the age of 11 years. For younger boys, more than 12 months has to elapse before anticipated changes can be detected with confidence. The time intervals required to elapse before decisions can be made concerning the significance of observed differences between successive measurements of BMD or body composition in children depend upon the age of the child.