SUMMARY This prospective 20‐year follow‐up study contrasts the development of a group of 20 children grossly undernourished during infancy (index group) with that of a matched control group. There were significant differences between two groups in head circumference, height, weight, full‐scale IQ, verbal quotient, non‐verbal quotient and in visuo‐motor perceptual function. Despite their disadvantages, the index group have integrated effectively into the community, and their children have not experienced the nutritional deprivation they suffered during their own childhoods. RÉSUMÉ Etude de développement sur vingt ans du devenir psychosocial et des données de tomodensitométrie cérébrale de sujets sévérement sous‐nutrits durant la premiére enfance Cette étude longitudinale prospective sur 20 ans oppose le développement d'un groupe de 20 enfants sévérement sous‐nutrits durant la premiére enfance (groupe index) avec celui d'un groupe contrôle apparié. Les différences significatives entre les groupes index et contrôle en tour de tête, taille, poids, quotients intellectuels généraux, verbaux et non verbaux, en fonction perceptive visuomotrice mesurée au test de Bender et au dessin du Bonhomme sont discutées. L'étude montre qu'en dépit de leurs désavantages, les sujets du groupe index se sont intégrés plus efficacement dans la communauté et que leurs enfants n'ont pas eu á souffrir de la déprivation nutritionnelle qu'ils avaient subie durant leur propre enfance. ZUSAMMENFASSUNG Eine zwanzigjährige Entwicklungsstudie über die psychosozialen Ergebnisse und Befunde der Hirntomogramme von Patienten, die in ihrer Kindheit schwer unterernährt waren Diese zwanzigjährige Verlaufsstudie stellt die Entwicklung einer Gruppe von 20 in ihrer Kindheit schwer unterernährten Kindern (Index‐Gruppe) der einer entsprechenden Kontrollgruppe gegenüber. Die signifikanten Unterschiede zwischen der Index‐Gruppe und der Kontrollgruppe hinsichtlich Kopfumfang, Größe, Gewicht, Gesamtquotients, Verbalquotient, Nicht‐Verbal‐quotient und visuell motorischem Perzeptionsvermögen, was anhand des Bender Tests und anhand von Zeichnungen von Menschen beurteilt wurde, werden diskutiert. Die Studie zeigt, daß die Index‐Gruppe sich trotz ihrer Nachteile besser in die Gesellschaft integriert hat und daß ihre Kinder keine Unterernährung erfahren, die sie in ihrer eigenen Kindheit erlitten haben. RESUMEN Estudio del desarrollo en veinte anos de la situacion psicosocial conseguida y los hallazgos con la TAC en sujetos que habian sufrido una desnutricion importante en la lactancia Este estudio prospectivo de 20 años compara el desarrollo de un grupo de 20 niños con marcada desnutricion durante su lactancia (grupo indice) con el de un grupo control. Se discuten las diferencias significativas entre los dos grupos en el perimetro craneal, peso, estatura, cocientes verbal y no verbal y función perseptiva viso‐motora en el test de Bender y en los dibujos de figura humana. El estudio muestra que, a pesar de sus desventajas, el grupo indice se habia integrado más efectiv...
This report describes the secondary sexual development of 45 'Cape Coloured' female ex-kwashiorkor patients and 43 female controls. All patients were originally seen between five months and four years four months of age, treated and then followed up for 15 years after discharge. Age at menarche was available on 42 ex-patients and 33 controls, and age at peak height velocity (PHV) was available for 30 ex-patients and 15 controls. Maximum likelihood estimates of the mean age at entry to each pubertal stage were made, age at menarche was obtained directly from the subject records and age at PHV was obtained by fitting a non-linear growth function to the data for each subject. All subjects passed through the sequence of pubertal events in the normal order, i.e., no reversals were observed. Ex-patients were generally delayed in relation to controls but there were no significant differences for ages at entry to any of the pubertal stages. The subjects were combined for comparison to equivalent data on British girls. The South African girls were significantly delayed in the development of pubic hair and menarche but showed no significant differences for age at entry or duration of breast development and PHV. It is suggested that lack of delay in breast development may have selective advantages to females living in situations of chronic malnutrition.
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