Background: Newer and more agressive forms of chemotherapy and newer protocols in the treatment have increased the survival rate of children with malignancies. Improved survival rates in children ...treated for acute lymphoblastic leukemia have focused attention on late effects including disorders of growth and puberty, and development of overweight or obesity.Methods: The height and weight expressed as body mass index (BMI) of 47 patients (29 girls, 18 boys) long-term survivors of childhood lymphoblastic leukemia was retrospectively analyzed. Height standard deviation score (HSDS) according to Tanner and body mass index standard deviation scores (BMISDS) before treatment and at follow-up were calculated. At the time of analysis all patients remained in first remission. Twenty-eight patients had cranial radiation with 12–18 Gy and 15 with 20–30 Gy. Four patients had no radiotherapy. All patients were treated with standard chemotherapy including intrathecal Methotrexat. Mean age (SD) at the diagnosis was 5 5/12 (3 2/12) years, range (5/12 – 12 5/12) and at the time of evaluation 17 11/12 (3 9/12) years, range (10 1/12 – 31 6/12).Results: We observed significant decrease in HSDS from diagnosis to the final height in both radiation groups (p < 0.01) but the decrement in final height was similar with both radiation dose regimens. The decrement in final height SDS was greater in patients treated at a younger age (Pearson, p < 0.01). Girls treated with higher radiation dose (20–30 Gy) were more severely affected than boys. In both radiation dose treatment groups there was a significant increase in BMISDS between diagnosis and final height (p < 0.0001) with no significant difference between treatment groups. Menarche occurred earlier in girls than normal with no significant difference between both radiation dose regimens.Conclusions: We observed significant deterioration in HSDS and increment in BMISDS regardless to the radiation dose.
Background. Graves disease is the most common cause of hyperthyrosis in children and adolescents. The optimal treatment for children with AH remains controversial. The patients are usually treated ...with antithyroid drugs in combination with thyroxine, followed by definitive treatment with either surgery or radio-iodine if stable remission with antithyroid drug can not be achieved.Patients and methods. Between 1991 and 2000, 45 children (41 girls) from 0.5 to 17.5 years were treated at the University Childrens Hospital Ljubljana.Results and conclusions. Fourteen (31.1%) patients achieved long-term remission with antithyroid drugs alone. 12 (26.7%) of children needed further therapy. Surgery was carried out in 6 (50%), ablation therapy with J131 was successfully used in other six patients.
Background. Cardiovascular diseases represent the most frequent cause of morbidity and mortality in developed countries. Blood cholesterol concentration influences the progression of atherosclerosis ...and most developed countries started programs for early detection of hypercholesterolemia. The study presents data analysis related to the total cholesterol concentrations obtained from 5-year old children. Additionally, guidelines for improving the follow-up work with children having hypercholesterolemia are presented.Methods. Values of total cholesterol concentration of 2742 children born 1995 or 1996 were obtained from 17 pediatric primary care facilities in Slovenia. Data analysis included values of body mass index (BMI). The study was approved by the State Committee for Medical Ethics (103/02/02).Results. Values of total cholesterol concentration were not distributed according to the normal distribution. Total cholesterol concentration was significantly higher in girls (median 4.41 mmol/L, 5th percentile 3.3 mmol/l and 95th percentile 5.8 mmol/L) compared to boys (median 4.3 mmol/L, 5th percentile 3.2 mmol/l and 95th percentile 5.6 mmol/L) (p < 0.0001). Twenty-one percent of values were above 5 mmol/L, 15% above 5.2 mmol/L and 2.8% above 6 mmol/L. Total cholesterol concentration did not correlate with the BMI.Conclusions. The results of the present study are in accordance with other similar published studies. General screening for hypercholesterolemia in childhood is feasible and medically indicated. Twenty-one percent of Slovenia population has total cholesterol concentration above 5 mmol/L. The follow-up work with these children must be structured and well planned. The main advantage of early detection of hypercholesterolemia is in the possibility of starting the changes of eating habits and life-style early in childhood. Namely, these changes are easier to perform and more successful if started early.
