RESUMO
OBJECTIVES: The purpose was to demonstrate that an objective, multivariate case definition of fetal alcohol syndrome (FAS) and partial fetal alcohol syndrome (PFAS) can be derived by means of craniofacial anthropometry. STUDY DESIGN: Craniofacial measurements (n = 21) were taken of 100 individuals who had been exposed to alcohol before birth (41 FAS, 59 PFAS) and 31 members of a control group. Multivariate discriminant analysis was used to identify craniofacial measurements that best differentiated the 3 groups (FAS, PFAS, and control). RESULTS: Both the FAS and PFAS groups had a unique craniofacial phenotype that could be accurately discriminated from that of the control group. Stepwise discriminant analysis identified 6 craniofacial measurements that could differentiate individuals with and without prenatal alcohol exposure with 96% accuracy, 98% sensitivity, and 90% specificity. CONCLUSIONS: Individuals with FAS and PFAS have a distinctive facial phenotype that can be characterized anthropometrically. The phenotypic case definition could be used as a screening tool to identify individuals prenatally exposed to alcohol who do not exhibit a "classic" FAS phenotype but exhibit a more subtle craniofacial dysmorphia.
Assuntos
Antropometria , Anormalidades Craniofaciais , Transtornos do Espectro Alcoólico Fetal/diagnóstico , Adolescente , Estudos de Casos e Controles , Criança , Análise Discriminante , Feminino , Humanos , Masculino , Gravidez , Efeitos Tardios da Exposição Pré-Natal , Reprodutibilidade dos TestesRESUMO
The objective of this study was to determine age-specific reference values for urinary calcium/creatinine ratios (UCa/Cr) of children in southern Thailand. Non-fasting urine samples were collected from a random population of 488 healthy children (282 males, 206 females) ranging in age from 17 days to 15 years. Samples were divided into six groups by age. Subjects whose calcium levels exceeded the 95th percentile within each age group were classified as having hypercalciuria. Pyuria, hematuria, proteinuria, urinary sodium, and potassium levels in children with normal UCa/Cr were compared with levels in children with high UCa/Cr. The 95th percentiles for UCa/Cr (mg/mg) by age were: <6 months, 0.75; 6 months to <12 months, 0.64; 12 months to <2 years, 0.40; 2 years to <5 years, 0.38; 5 years to <10 years, 0.29; and 10 years to <15 years, 0.26. Pyuria, hematuria, and proteinuria were no more prevalent in the 22 children with hypercalciuria than in children with normal urinary calcium levels. Urinary sodium/creatinine ratios (UNa/Cr) and urinary sodium/potassium ratios (UNa/K) were correlated with UCa/Cr (r=0.41, P<0.0001 and r=0.24, P<0.0001, respectively). Urinary potassium/creatinine ratios (UK/Cr) were not (r=0.05, P>0.1)). Children with high UCa/Cr ratios also had higher UNa/Cr and UNa/K (5.6+/-7.1 vs. 2.6+/-1.5, P<0.001 and 5.4+/-2.3 vs. 2.5+/-0.23, P<0.05, respectively). The study established reference values for random, non-fasting UCa/Cr for healthy Thai children and indicated that urinalysis is not a good indicator of hypercalciuria.
Assuntos
Cálcio/urina , Creatinina/urina , Adolescente , Fatores Etários , Argentina , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Valores de Referência , Suécia , Taiwan , Tailândia , Estados UnidosAssuntos
Falência Renal Crônica/metabolismo , Laboratórios/normas , Manejo de Espécimes/normas , Alumínio/análise , Criança , Distúrbio Mineral e Ósseo na Doença Renal Crônica/metabolismo , Creatinina/sangue , Transtornos do Crescimento/etiologia , Humanos , Falência Renal Crônica/complicações , Magnésio/sangue , Estudos Multicêntricos como Assunto , Hormônio Paratireóideo/sangue , Controle de Qualidade , Ensaios Clínicos Controlados Aleatórios como Assunto , Zinco/sangueAssuntos
Cistinose/genética , Falência Renal Crônica/genética , Adolescente , Fatores Etários , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Fatores de TempoAssuntos
Distúrbios do Metabolismo do Cálcio/complicações , Cálcio/urina , Hiperparatireoidismo Secundário/etiologia , Adolescente , Distúrbios do Metabolismo do Cálcio/urina , Criança , Pré-Escolar , Feminino , Humanos , Hiperparatireoidismo Secundário/urina , Cálculos Renais/etiologia , Masculino , Hormônio Paratireóideo/sangueRESUMO
A group of 273 children with minor complaints was screened for idiopathic hypercalciuria by measurement of the urine Ca/Cr. Borderline or definitely high levels were noted in 17 of these children, 11 of whom were boys. More intensive metabolic studies were completed on four of these children and on three children who were noted to have symptomatic renal stones associated with idiopathic hypercalciuria. These studies suggest that IH, well recognized in adults, may have its origins in childhood and that appropriate management, if initiated in childhood, may have significant long-term benefits.