April 24, 2003
April 24, 2003
Overweight, Obesity, and Death from Cancer |
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Childhood Cardiomyopathy in Australia Cardiomyopathy often has devastating consequences in children. This Australian study found an incidence of 1.24 cases per 100,000 person-years at risk from 1987 to 1996 among children under 10. Among cases of dilated cardiomyopathy, lymphocytic myocarditis was an important cause. Hypertrophic cardiomyopathy was about half as common as dilated cardiomyopathy. A myocardial disorder known as left ventricular noncompaction was also found. This study, along with one from the United States in this issue, provides an important calibration of the incidence of pediatric cardiomyopathy. The incidence data from the two countries are remarkably similar and together advance our understanding of the epidemiology of childhood cardiomyopathy.
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Pediatric Cardiomyopathy in the United States Cardiomyopathy in children is a serious disorder that often results in cardiac transplantation or death. This study was based on a 1996–1999 registry of cases in New England and in Texas, Oklahoma, and Arkansas. The overall annual incidence was 1.13 cases per 100,000 children, but the incidence was much higher among infants than in other age groups. Dilated and hypertrophic cardiomyopathies predominated. The incidence was higher in boys than in girls and in blacks than in whites. Along with the data from the Australian study in this issue, these epidemiologic data are valuable in defining the magnitude of the problem of pediatric cardiomyopathy, quantifying different types of cardiomyopathy, and identifying groups of children at risk.
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Fibroblast Growth Factor 23 in Oncogenic Osteomalacia and X-linked Hypophosphatemia Fibroblast growth factor 23 (FGF-23) appears to be involved in phosphate regulation by the kidney. It has been hypothesized that this factor is elevated in oncogenic osteomalacia and X-linked hypophosphatemia, and the authors developed an immunometric assay to study this issue. FGF-23 was readily detectable in healthy persons but markedly elevated in patients with oncogenic osteomalacia or hypophosphatemic rickets, suggesting that FGF-23 may have a role in phosphate homeostasis.
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Brief Report: The Usher Syndrome: A Prevalent Founder Mutation The Usher syndrome, the most frequent cause of deafness and concurrent blindness, occurs with increased frequency in Ashkenazi Jews. The authors of this study demonstrated a founder mutation for the most common form of the type 1 Usher syndrome that probably occurred 350 years ago. Prelingual deafness precedes retinitis pigmentosa in this condition. Therefore, deaf children of Ashkenazi extraction would benefit from early genetic testing for the type 1 Usher syndrome, since appropriate training and rehabilitation are crucial for learning and independence.
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Breast-Cancer Screening A 44-year-old woman in good health, who has no family history of breast or ovarian cancer, asks about mammography. She had a normal screening mammogram 18 months ago but has recently read that mammograms may not be useful. What should her physician advise?
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Medical Progress: Skin Cancers after Organ Transplantation Skin cancers are the most common tumors in patients who have received organ transplants. This review discusses the epidemiology, pathogenesis, and management of squamous-cell and basal-cell carcinomas, cancers of the anogenital region, Kaposi's sarcoma, melanoma, neuroendocrine skin carcinoma, and cutaneous manifestations of lymphoma in transplant recipients.
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