Our data suggest that homozygosity for the d3-GHR polymorphism is associated with a unique GH responsiveness and a weight regulation towards a lower BMI in girls with Turner syndrome.

No abstract

Children born with very low birth weight (VLBW) are at risk of impaired growth. We aimed to study VLBW survivors (90.8%) born in 1998/1999 in the state of Baden-Württemberg (n ϭ 2103) for whom growth data were available up to age six. Classification as appropriate for gestational age (AGA) or small for gestational age (SGA) depended on size at birth. Models to predict height SDS at 5 y were developed using data for 1 yr (Model 1) and 2 yrs (Model 2). The data of 1320 (63%) children were available: SGA: n ϭ 730, AGA: n ϭ 590. At 6 yrs, 8.3% AGA and 13.4% SGA children were short (ϽϪ2.0 SDS). The following factors explained Ht SDS at 5 (and 6) yrs (order of importance): (a) Model 1 (n ϭ 1033; R 2 ϭ 0. A lthough the frequency of premature births has risen during the last decades, the number of surviving babies has risen due to improved perinatal care. This holds particularly true for children with very low birth weight (VLBW; BW Ͻ 1500 g), as their survival rate has reached about 90% (1). Several reports have shown more frequent impairments in growth development in this group in comparison to other prematurely born children with higher birth weights (2-9). After Barker and colleagues established that low birth weight was a major determinant of mortality and morbidity in adult life (10), overwhelming evidence became available from epidemiologic studies which show that impaired birth weight is associated with a higher prevalence of the metabolic syndrome. It has therefore been hypothesized that an impairment in prenatal growth influences the long-term "metabolic programme" of an individual. Several authors have reported that children born small for gestational age (SGA) showed impaired growth in contrast to children whose birth length was appropriate for gestational age (AGA). However the main group studied in these reports involved either children with birth weights higher than 1500 g (11-14) or VLBW children born earlier than 1990 (3,5,6,15,16). Our study of VLBW children was aimed at investigating growth development from birth until early school age and at identifying the factors to predict their height development during childhood. The two birth cohorts we studied derived from the state birth register in Baden-Württemberg in Germany for the years 1998 and 1999, respectively. METHODS Population.The state of Baden-Wuerttemberg represents about 10% of Germany's geographical area and approximately 13% of its population. According to the state birth register, there were 108,000 births in 1998 and 111,000 in 1999 (17). Of these, 2316 VLBW babies were born and 2103 (90.8%) of them survived (1). There are 30 neonatal intensive care units (NICU) in Baden-Wuerttemberg, including four university hospitals; and all excepting two small units participated in our study (see Acknowledgements).Data collection. In 2004, birth and follow-up data were available for 2040 (97%) surviving children born VLBW. Parents were sent a questionnaire and a description of the study by post. 1322 (62.9%) families returned the questionnai...

Zusammenfassung Zielsetzung Über die aktuell immer größer werdende Gruppe angestellter Ärztinnen und Ärzte im ambulanten Sektor liegen derzeit nur wenige gesicherte Befunde vor. Daher sollen hier einige Ergebnisse einer bundesweiten quantitativen Befragung von Personen dieser Berufsgruppe dargestellt und diskutiert werden. Methode Bei der Studie handelt es sich um eine standardisierte quantitative Befragung von angestellten Ärztinnen und Ärzten im ambulanten Sektor. Da die angestrebte Grundgesamtheit eine disproportional geschichtete Stichprobe aus den Datenbanken der Kassenärztlichen Vereinigungen der Bundesländer darstellte und insgesamt 10 580 Ärztinnen und Ärzte angeschrieben wurden, beträgt die Responsequote 21,8%. Das Stichprobendesign erlaubt es nicht nur deskriptive Analysen für kleine Subpopulationen durchzuführen, sondern auch regionale Disparitäten in den Blick zu nehmen. Ergebnisse Es lässt sich zeigen, dass es sich v. a. um junge Ärztinnen handelt, die eine Anstellung im ambulanten Sektor aufnehmen. 59% der angestellten Ärztinnen und Ärzte arbeiten in Teilzeit, die durchschnittliche Wochenarbeitszeit beträgt 28,9 Stunden. Eine durchschnittliche Praxis beschäftigt insgesamt 4 Ärzte oder Ärztinnen und es werden im Mittel (Median) circa 30 Personen am Tag behandelt. Schlussfolgerung Ein wichtiger Grund für das stetige Wachstum dieser Berufsgruppe ist womöglich die Flexibilität der Arbeitszeitgestaltung und die Möglichkeit zur Teilzeitarbeit, welche sich wiederum positiv auf die Vereinbarkeit von Familie und Beruf auswirken. Nicht zuletzt scheint diese Berufsgruppe auch deshalb überwiegend aus jungen Ärztinnen zu bestehen. Oftmals stellt die Angestelltentätigkeit aber auch ein Übergangsmodell hin zu einer Niederlassung oder – für ehemalige Praxisinhaber – in den Ruhestand dar. Generell scheint die Angestelltentätigkeit in der Ambulanten Versorgung allerdings für viele das angestrebte „Normalarbeitsmodell“ zu sein.

Conventional analyses of growth hormone (GH) treatment in children focus mainly on height development. We aimed to investigate the complex effects of GH on three components of the body, namely, muscle, fat and bone, by means of peripheral quantitative computed tomography. This method, in which a component of the body is taken to represent the whole, is non-invasive and suitable for children. Our study group comprised 74 pre-pubertal children with GH deficiency (mean age, 7.2 years; height standard deviation score [SDS], –2.9) who received recombinant human GH treatment (30 µg/kg/day [0.03 mg/kg/day]) for 12 months (55 of the children received treatment for up to 24 months). Within 2 years, mean height SDS increased from –2.9 to –1.5, muscle surface area SDS rose from –2.4 to 1.0, while fat surface area SDS decreased from 0.1 to –1.0. Grip strength SDS increased from –1.0 to –0.3, whereas the ratio of strength to muscle area did not change. We thus observed that changes in body compartments (including bone) occur during GH treatment; we also found evidence showing a specific pattern of dynamics over time. In view of the limited literature available on muscle development during GH therapy in children, we explore the potential role and significance of these response variables in the assessment of GH therapy.