Growth charts for Chinese Down syndrome children from birth to 14 years.

OBJECTIVE: To establish Down syndrome (DS)-specific growth charts for Hong Kong Chinese children. DESIGN AND SETTING: Growth data were collected from (1) members of the Hong Kong Down Syndrome Association (cross-sectional); (2) DS children attending special schools or living in residential homes (cross-sectional); and (3) the paediatric departments of seven public hospitals (retrospective). PATIENTS: 425 DS children (57% males and 43% females) born in 1977-2000, yielding 4987 observations. MAIN OUTCOME MEASURES: The LMS method was used to construct reference centile curves of weight, height, body mass index (BMI) from birth until 14 years and head circumference for the first 4 years. RESULTS: The median birth length was 49.8 cm and height at age 14 was 146.7 cm for DS boys. Corresponding figures for DS girls were 49.5 and 142.1 cm. The median birth weight was 3.0 kg for DS boys and 2.9 kg for DS girls. At age 14, 26% DS boys (BMI >22.6 kg/m(2)) and 12% DS girls (BMI >23.3 kg/m(2)) were overweight. The median head circumference at birth was 32.8 cm for boys and 32.0 cm for girls. CONCLUSIONS: Chinese DS children had a shorter stature, lower weight and tendency to be overweight than local non-DS children. Their growth patterns differed from those of Chinese DS children in Taiwan, and DS children in the USA and Sweden. Growth retardation was most salient during the first year of life.

Medical issues among children and teenagers with Down syndrome in Hong Kong.

UNLABELLED: We examined the prevalence of medical problems in children and teenagers with Down syndrome in Hong Kong. METHODS: Children with Down syndrome receiving care from seven regional hospitals were included and their hospital records were reviewed. A total of 407 patients, aged between 0.06 and 17.16 years were included. Cardiovascular problems were observed in 216 (53%), endocrine problems in 111 (27%), gastrointestinal problems in 46 (11%), haematological problems in 18 (4%), neurological problems in 27 (7%), sleep problems in 36 (9%), skeletal problems in 56 (14%), visual problems in 195 (48%) and auditory problems in 137 (34%). CONCLUSIONS: The prevalence of medical problems was high in children and teenagers with Down syndrome in Hong Kong and similar to previous findings elsewhere. Future studies on the local prevalence of medical problems in the adult population with Down syndrome would help to define their medical needs.

Automated peritoneal dialysis in children and adolescents--benefits: a survey of patients and parents on health-related quality of life.

Automated peritoneal dialysis (APD) benefits children on dialysis and their parents by allowing for more daytime freedom and a more normal life. We carried out a survey on health-related quality of life (HRQOL) in children and adolescents from our end-stage renal disease program, including those on APD and hemodialysis (HD), and those who had received a kidney transplant (TX). Parents of patients under 18 years of age were also interviewed. The questionnaire on QOL was adapted from the Pediatric Quality of Life Inventory and grouped into seven aspects for which patients and parents were asked to assess the frequency of related problems during the preceding 3 months. We surveyed eligible children among the APD, HD, and TX patients enrolled in our program, and we surveyed the parents of the patients under 18 years of age. For APD, patients and parents both gave their most favorable scores to the peer activities and relationships and family activities and relationships aspects. In the TX group, the family activities and relationships aspect was also scored most favorably of all aspects. Notably, we observed no significant difference between the total scores for the APD and TX groups among patients and parents alike. Although the survey provided only a "snapshot" of HRQOL, the assessment by APD patients and their parents seems to be comparable to that by TX patients and their parents.

Severe acute respiratory syndrome among children.

OBJECTIVE: To study the epidemiologic, clinical, laboratory, and radiologic features, prognostic indicators, and short-term to medium-term outcomes for children with severe acute respiratory syndrome (SARS) and to validate the performance characteristics of a clinical case definition, calculated with respect to SARS-associated coronavirus (SARS-CoV) seroconversion. METHODS: Children <18 years of age, from a single-site outbreak, who satisfied a clinical case definition for SARS, with subsequent serologic confirmation, were treated according to a standard protocol and prospectively monitored. RESULTS: Forty-four children were included. The median age was 12 years. Forty-two children (95.5%) demonstrated an epidemiologic link. Fever, cough, malaise, coryza, sputum production, headache, myalgia, lymphopenia, and elevated lactate dehydrogenase levels were common presenting features. Radiographic findings were nonspecific, but high-resolution computed tomography of the thorax was an early diagnostic aid. A specific reverse transcription-polymerase chain reaction assay for SARS-CoV yielded positive results for <50% of children. Of 9 children who developed hypoxemia, 8 were treated with methylprednisolone. Of 5 children who received intensive care, 3 required assisted ventilation. All children recovered, and serious adverse events in response to treatment were not observed. The outcomes at 3 to 6 months after disease onset, including exercise tolerance, pulmonary functions, and psychologic status, were favorable. An age of >12 years was associated with methylprednisolone therapy for severe illness. After exclusion of the only infant, an age of >12 years was associated with oxygen requirements. Sore throat, high neutrophil count at presentation, and peak neutrophilia were independent factors predicting severe illness. The clinical case definition demonstrated good sensitivity, specificity, and positive and negative predictive values (97.8%, 92.7%, 88%, and 98.7%, respectively) for diagnostic accuracy. CONCLUSIONS: Children are susceptible to SARS-CoV infection. Teenagers resemble adults with respect to disease progression and may develop severe illness. The short-term to medium-term outcomes are good. Sore throat and initial and peak neutrophilia seem to be predictors of severe illness. Our clinical case definition performed well in the epidemic.