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Longitudinal data on adolescent growth in height and skeletal development of the hand and wrist were collected as part of a prospective study of the growth and development of 212 randomly selected Swedish urban children. The onset, peak and end of the pubertal growth spurt were defined on the unsmoothed incremental curve of height. The skeletal development was evaluated by studying the attainment of specified stages of the ulnar sesamoid of the metacarpophalangeal joint of the first finger, the epiphyses of the middle and distal phalanges of the third finger and the distal epihysis of the radius. All growth events and skeletal stages occurred earlier in girls than in boys. At the peak of the pubertal growth spurt the skeletal development was more advanced in girls than in boys, but at the end of the spurt the girls had a less mature skeletal development than the boys. The analysis of the relationship in time between the growth events and the skeletal stages showed that these stages can be used to indicate which period of adolescent growth an individual has reached.

A pharmacologically inert, acellular pertussis-toxoid vaccine that is easily standardized is safe and confers substantial protection against pertussis.

All acellular pertussis vaccines contain pertussis toxoid and induce protection against pertussis. This study investigated the relation between the postvaccination levels of pertussis toxin (PT) serum IgG and protection against pertussis. PT IgG was determined in sera obtained 21-77 days after the third vaccination from 813 children who received 3 doses of pertussis toxoid. The children were followed for 21-33 months after vaccination for the occurrence of pertussis. Of the children, 126 were exposed to pertussis in their households. The median PT IgG concentration was 79 U/mL in those who developed severe pertussis (>/=21 day of paroxysmal cough), 156 U/mL with mild pertussis (<21 days of paroxysmal cough), and 246 U/mL in those who did not develop pertussis (79 vs. 246, P<.0001). Corresponding values in the 687 children with no household exposure were 99, 124, and 155 U/mL, respectively (99 vs. 155, P<.0001). Thus, there is a highly significant correlation between the level of vaccine-induced serum PT IgG and protection against pertussis.