Percentile distributions of waist circumference for 7–19‐year‐old Polish children and adolescents

The aim of the study was to develop waist circumference (WC) percentiles in Polish children and youth and to compare these with the results obtained in other countries. The study comprised a random group of 5663 Polish children aged 7–18 years. Smoothed WC percentile curves were computed using the LMS method. The curves displaying the values of the 50th (WC₅₀) and the 90th (WC₉₀) percentile were then compared with the results of similar studies carried out in children from the UK, Spain, Germany, Turkey, Cyprus, Canada and the USA. WC increased with age in both boys and girls and in all observed age periods the boys were seen to dominate. For 18‐year‐old Polish boys and girls the values of WC₉₀ were 86.5 and 78.2, respectively, and were lower than the current criteria developed by the International Diabetes Federation. Both WC₅₀ and WC₉₀ were higher in Polish boys and girls compared with their counterparts in the UK, Turkey and Canada and significantly lower than in children from the USA, Cyprus and Spain. The percentile curves for Polish children and youth, which were developed here for the first time, are base curves that can be applied in analysing trends as well as making comparisons with results of similar studies performed in other countries.     

Acceptability and repeatability of spirometry in children using updated ATS/ERS criteria

Spirometry in pediatrics can be limited by the child's development which is usually related to age. In 2005 the American Thoracic Society (ATS) and European Respiratory Society (ERS) published updated quality control criteria for spirometry. In 2007 the ATS/ERS published specific criteria for spirometry in preschool children 6 years of age and younger. Our primary objective was to determine the influence of age on the ability of children to meet updated spirometry criteria for acceptable and repeatable tests. Our second objective was to determine which criteria are associated with unacceptable tests. Data was prospectively collected over 12 months for children 4-17 years of age performing spirometry for the first time. Unsuccessful tests were analyzed to determine specific criteria not achieved. Three hundred ninety-three studies were collected and 292 (74%) met recently revised ATS/ERS criteria for acceptable and repeatable tests. Acceptable and repeatable test success was not correlated to the gender or race of the children. The percentage of acceptable and repeatable spirometry increased with age rising above 50% by age 6 and reached a plateau with approximately 85% success at age 10. The most common unmet criteria for an unacceptable study among preschool children was glottic closure and non-maximal efforts, while in school-age children was failure to plateau. These data demonstrate most children are able to perform acceptable/repeatable spirometry with their first effort based on revised ATS/ERS criteria.     

Spirometry in 3-5-year-old children with asthma

Spirometry with incentive games was applied to 207 2-5-year-old preschool children (PSC) with asthma in order to refine the quality-control criteria proposed by Aurora et al. (Am J Respir Crit Care Med 2004;169:1152-159). The data set in our study was much larger compared to that in Aurora et al. (Am J Respir Crit Care Med 2004;169:1152-159), where 42 children with cystic fibrosis and 37 healthy control were studied. At least two acceptable maneuvers were obtained in 178 (86%) children. Data were focused on 3-5-year-old children (n = 171). The proportion of children achieving a larger number of thresholds for each quality-control criterion (backward-extrapolated volume (Vbe), Vbe in percent of forced vital capacity (FVC, Vbe/FVC), time-to-peak expiratory flow (time-to-PEF), and difference (Delta) between the two FVCs (DeltaFVC), forced expiratory volume in 1 sec (DeltaFEV(1)), and forced expiratory volume in 0.5 sec (DeltaFEV(0.5)) from the two "best" curves) was calculated, and cumulative plots were obtained. The optimal threshold was determined for all ages by derivative function of rate of success-threshold curves, close to the inflexion point. The following thresholds were defined for acceptability: Vbe 相似文献   

Changes and analysis of anti‐HBs titres after primary immunization in 1‐ to 16‐year‐old Chinese children: A hospital‐based study

Immunization with the hepatitis B vaccine is the most effective measure to prevent Hepatitis B Virus (HBV) infection. The aim of this study was to investigate the change in antibody levels induced by administration of the hepatitis B vaccine in children aged 1‐16 year old in a large sample sized investigation. HBV markers were determined in 93 326 1‐ to 16‐year‐old hospitalized children who completed primary immunization as infants from south‐west China, Chongqing. Analyses were performed on anti‐HBs titre changes with increasing age, and the revaccination effect was evaluated in children aged 7‐14. The percentage of protective antibody was between 45.29% and 63.33% in all age groups, but was higher in the 1‐, 2‐ and 3‐year‐old groups (90.31%, 83.95% and 71.82%, respectively), and the rate of high‐responder was 5.03%‐10.56%, except in the 1‐year‐old group (23.33%). Additionally, 3.33%‐25.79% of subjects had not seroconverted. There was no significant difference in antibody levels between girls and boys (P > .05). The Geometric Mean Titers in children with confirmed revaccination history were significantly higher than those with unknown or no revaccination history (P < .0001). In conclusion, the overall rate of protective anti‐HBs was 67.10% with consecutive age groups from 1 to 16, it decreased from 90.31% to 45.29% for 1‐ to 8‐year‐old individuals, and interestingly, the rate increased from 45.46% to 63.33% for subjects aged 9‐15. Anti‐HBs titres were significantly improved after revaccination. Booster doses are recommended for those without seroconversion, especially children who live in school with other students or have family members with positive HBsAg.     

The “worth” of routine spirometry in a cystic fibrosis clinic

In our cystic fibrosis clinic, all patients older than 6 years perform spirometry at each visit just before being seen by the health care team. Upon review, we determined that our perceived rationale for this practice was that the medical history fails to detect deterioration in a sizable minority of patients whose pulmonary decline can be detected by spirometry. Furthermore, the literature and our own experience indicates that physical examination frequently will not detect changes in pulmonary status until the changes are advanced. As part of an ongoing quality/cost assessment, we decided to challenge our rationale for performing routine spirometry. Using standard methodology, we developed a six-item Likert style questionnaire, the purpose of which was to assess perceived changes in pulmonary symptoms since the last clinic visit. The questionnaire had an acceptable degree of internal consistency (Cronbach's alpha = 0.92), although the question about sputum production showed the least correlation with responses to other items. We administered the questionnaire to 103 consecutive different patients and examined the association between reported changes in symptoms and actual changes in spirometric outcomes. Overall, there was a statistically significant, but clinically weak association between symptom scores and change in FEV₁, r² = 0.16, P < 0.001. Twenty-three patients had a decline in FEV₁ of ⩾10% from one clinic visit to the next. Depending on the method used to place symptom scores into categories indicating that pulmonary symptoms were “worse,” “same,” or “better” than at the last clinic visit, 40–60% of these 23 patients indicated they felt the “same” or “better.” We conclude that spirometry is a justifiable part of all clinic visits for patients with cystic fibrosis, assuming that one would want to detect and treat declines in pulmonary status before they become advanced. Pediatr Pulmonol. 1998; 25:231–237. © 1998 Wiley-Liss, Inc.