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Biomedical subjects

Y Hofvander

Publications and source records attributed to Y Hofvander.

At least 37 records · Page 2Linked to original sources

Pubertal linear growth of Indian girls adopted in Sweden.

Pubertal linear growth in 66 adopted Indian girls was studied. The infancy-childhood-puberty standard was used, since it is applicable to Indian girls, and enables determination of the onset and height gain of the pubertal growth phase in an individual. At arrival in Sweden, mean height was -2.8 SDS. Despite rapid catch-up growth, the girls were still below the reference mean (-0.8 SDS) at the onset of the pubertal growth spurt, which occurred approximately 1.5 years earlier than in Swedish girls and also earlier than in Indian girls. The pubertal height gain, however, was equivalent to that in Swedish girls with similar timing of puberty. The short final height found in some of these girls appears to be related to shortness prior to puberty and to very early onset of an otherwise normal pubertal growth component.

Adolescent↗

Sickle cell anaemia in Sudan: clinical findings, haematological and serum variables.

Ninety homozygous patients with Hb S haemoglobinopathy from Sudan were reported with respect to clinical findings, haematological and serum parameters. For comparison, 27 Hb AS heterozygous subjects and 28 Hb AA controls were investigated also. The patients showed an extreme type of illness presenting with severe clinical signs such as dactylitis, liver enlargement and cardiac complications. There was marked haemolytic anaemia (mean haemoglobin 66 g/l). Some patients also presented with low serum (S)-iron levels, indicating iron deficiency. S-bilirubin, S-ASAT, S-ALAT, S-GT and S-urate were notably raised, most probably as a consequence of haemolysis with liver involvement. The patients had lower S-calcium levels when compared with the AS and AA subjects. This may suggest a possible role of HB S in the production of this feature.

Adolescent↗

A longitudinal study on anthropometric and clinical development of Indian children adopted in Sweden. I. Clinical and anthropometric condition at arrival.

One hundred and fourteen children (60% girls) adopted from India through five major adoption organizations, were recruited consecutively. This paper describes the environment of the children in India and in Sweden, discusses the certainty of the ages and reports their condition at arrival in Sweden. The median age at arrival was 9.3 months, 62% being below one year of age (range 3-72 months). Infectious diseases similar in kind and frequency to those noted in child populations in developing countries, were found. Height/age and weight/age mean values were approximately -2 standard deviation scores (SDS) of the NCHS/WHO standard, which is similar to the anthropometric status of Indian average children. There were no significant sex differences. Thirty-seven birth weights were known, the majority below 2,500 g. Psychomotor retardation was found in 29% of the children. In the children with stunting and in those with weight/age less than -3 SDS at arrival there were high percentages of psychomotor retardation, anaemia and combined wasting and stunting. Therefore these children should be regarded as a risk group and be followed up with special care.

Adoption↗

A longitudinal study on anthropometric and clinical development of Indian children adopted in Sweden. II. Growth, morbidity and development during two years after arrival in Sweden.

One hundred and fourteen consecutively recruited children adopted from India (60% girls) to Sweden were studied during 2 years after arrival, with examinations monthly the first 6 months and thereafter every 3 months. Sixty-two percent were below 1 year of age at arrival. There was a mean increase from -2.2 standard deviation scores (SDS) height/age to -0.7 SDS during the two years, and a similar development for weight/age, with no significant difference between boys and girls. The weight/height remained at around -0.8 throughout the study period. Those who had lowest height/age at arrival had the most marked catch-up, but remained smaller throughout the 2 years. The psychomotor development was initially delayed in nearly 30% of the children, mainly among those stunted and/or with very low weight at arrival. After 2 years the rate was at a level similar to Swedish children. In a sub-sample, birth weight was found to be correlated to subsequent height and weight development. Hepatitis B, salmonella, giardia lamblia, trichuris trichiura, ascaris and hymenolepis nana were still found in a small percentage after 2 years. Other morbidity was at the same level as in Swedish children. Adopted children who are stunted and/or have a very low weight at arrival should be followed up with special care, and infectious diseases found at arrival should be kept in mind for differential diagnosis at subsequent disease episodes.

Adoption↗

Minor and trace elements in human milk from Guatemala, Hungary, Nigeria, Philippines, Sweden, and Zaire. Results from a WHO/IAEA joint project.

Concentrations of As, Ca, Cd, Cl, Co, Cr, Cu, F, Fe, Hg, I, K, Mg, Mn, Mo, Na, Ni, P, Pb, Sb, Se, Sn, V, and Zn were determined in human whole milk samples from Guatemala, Hungary, Nigeria, Philippines, Sweden, and Zaire; in most of these countries, three groups of subjects representing different socioeconomic conditions were studied. Analytical quality control was a primary consideration throughout. The analytical techniques used were atomic absorption spectrophotometry, atomic emission spectrometry with an inductively coupled plasma, colorimetry, electrochemistry, using an ion-selective electrode and neutron activation analysis. The differences between median concentrations of Ca, Cl, Mg, K, Na, and P (minor elements) were lower than 20% among the six countries. Among trace elements, concentrations observed in Filipino milk for As, Cd, Co, Cr, Cu, F, Fe, Mn, Mo, Ni, Pb, Sb, Se, and V were higher than for milk samples from other countries. The remaining five countries showed a mixed picture of high and low values. In the case of at least some elements, such as, F, I, Hg, Mn, Pb, and Se, the environment appears to play a major role in determining their concentrations in human milk. The nutritional status of the mother, as reflected by her socioeconomic status, does not appear to influence significantly the breast milk concentrations of minor and trace elements. Significant differences exist between the actual daily intakes observed in this study and current dietary recommendations made by, for example, WHO and the US National Academy of Sciences. These differences are particularly large (an order of magnitude or more!) for Cr, F, Fe, Mn, and Mo; for other elements, such as, Ca, Cu, Mg, P, and Zn, they amount to at least a factor 2. In the opinion of the present authors, these findings point to the need for a possible reassessment of the dietary requirements of young infants with respect to minor and trace elements, particularly for the elements Ca, Cr, Cu, F, Fe, Mg, Mn, Mo, P, and Zn.

Democratic Republic of the Congo↗

Patterns of breast feeding and weaning in the United Arab Emirate.

Two-hundred urban high and urban average mothers and 86 rural mothers in Dubai were interviewed to obtain baseline data about the duration of breast feeding and weaning patterns. The median duration of breast feeding was 4.5, 5, 9 months in urban high, urban average and rural groups, respectively.

Adult↗

Studies on perceived breast milk insufficiency. III. Consequences for breast milk consumption and growth.

Fifty-one mother-infant pairs were followed prospectively during the period 3 days to 18 months after delivery. In total 54.9% of the mothers experienced transient lactation crises, emanating mostly from a perception of breast milk insufficiency. Within the crisis group no significant difference in the infants' intake of breast milk during the crises compared with control measurements 1 week later was found. Nor had the crises any immediate impact on growth of the infants. A comparison between the crisis and the non-crisis group, revealed that the breast milk consumption in the crisis group was throughout lower with significant differences at 3 and 5 months. The infants in the crisis group also had a significantly lower weight at 2, 3, 4 and 9 months and were significantly thinner for their height at 1-6 months and at 9 months, although both groups were above the NCHS mean. We conclude that even if the infants in the crisis group had a lower consumption and a slower growth development, the differences were comparatively small. Furthermore, evidence was provided that the breast milk insufficiency occasionally perceived as acute by the mothers was in most cases not real.

Adult↗

Long term sequelae of childhood acute bacterial meningitis in a developing country. A study from the Sudan.

35 survivors of acute bacterial meningitis (ABM) from a group of 44 Sudanese children--seen during 18 months (April 1985-November 1986)--were prospectively followed to ascertain the long-term sequelae of the disease. 30 (17 with Haemophilus influenzae, 8 Neisseria meningitidis, 4 Streptococcus pneumoniae and one child with Enterobacter cloacae meningitis) could be followed during the surveillance period (3-4 years). Three (10%), including 2 with hemiplegia, died after 11-12 months. The association between motor deficit on discharge from hospital and subsequent death was significant (p = 0.04). Of the remaining 27, neuropsychologic sequelae were recorded in 9 (33%). Sensorineural hearing loss was observed in 6 (22%) patients and improved in one during surveillance. Motor deficits were found to improve with time but were replaced by the development of epilepsy about 3 years later in 11% of the survivors. The mean IQ (+/- SD) score for a subgroup of 19 post-meningitic children (92.3 +/- 13.9) was found to be significantly lower than in their nearest-age sibling controls (100.7 +/- 10.2; p = less than 0.01). Younger age at admission and longer duration of ABM symptoms before treatment were significantly associated with poorer outcome (respectively, r = 0.63, p = less than 0.01, r = 0.67, p = less than 0.01). The potential impact of vaccination against the commonest organisms causing ABM in developing countries is discussed.

Acute Disease↗