Effect of Zinc Intake on Growth in Infants: A Meta-analysis

A systematic review and meta-analysis of available randomized controlled trials (RCTs) was conducted to evaluate the effect of zinc (Zn) intake on growth in infants. Out of 5500 studies identified through electronic searches and reference lists, 19 RCTs were selected after applying the exclusion/inclusion criteria. The influence of Zn intake on growth was considered in the overall meta-analysis. Other variables were also taken into account as possible effect modifiers: doses of Zn intake, intervention duration, nutritional status, and risk of bias. From each select growth study, final measures of weight, length, mid upper arm circumference (MUAC), head circumference, weight for age z-score (WAZ), length for age z-score (LAZ), and weight for length z-score (WLZ) were assessed. Pooled β and 95% confidence interval (CI) were calculated. Additionally, we carried out a sensitivity analysis. Zn intake was not associated with weight, length, MUAC, head circumference, and LAZ in the pooled analyses. However, Zn intake had a positive and statistically effect on WAZ (β = 0.06; 95%CI 0.02 to 0.10) and WLZ (β = 0.05; 95%CI 0.01 to 0.08). The dose-response relationship between Zn intake and these parameters indicated that a doubling of Zn intake increased WAZ and WLZ by approximately 4%. Substantial heterogeneity was present only in length analyses (I(2) = 45%; p = 0.03). Zn intake was positively associated with length values at short time (four to 20 weeks) (β = 0.01; CI 95% 0 to 0.02) and at medium doses of Zn (4.1 to 8 mg/day) (β = 0.003; CI 95% 0 to 0.01). Nevertheless, the effect magnitude was small. Our results indicate that Zn intake increases growth parameters of infants. Nonetheless, interpretation of these results should be carefully considered.

Three-dimensional display techniques in radiation therapy treatment planning

Good radiation treatment planning requires that the target volume be treated with a high and uniform dose of radiation while irradiating normal tissue as little as possible. Even if the merits of a given treatment plan are judged only on the appearance of isodose lines in one or a few planes it can sometimes be difficult for the experienced radiation oncologist to select the best of several alternative plans. If consideration is given to the entire spatial distribution of dose, however, the problem becomes far more difficult because of the enormous amount of data that must be evaluated. We believe that the lack of suitable methods to display these data has greatly contributed to the slow incorporation of 3D considerations into routine radiation treatment planning. In the past few years there have been great advances in both the theory of how to produce effective 3D displays and in the display hardware itself. In this paper we survey some of the methods used at the University of North Carolina, and show specific examples of how these displays can be used in radiation therapy treatment planning.

Shifting linear growth during infancy: illustration of genetic factors in growth from fetal life through infancy

A percentile linear growth chart, from the third to ninety-seven percentiles, was derived from longitudinal data on 90 normal full-term infants of middle class suburban families, and the individual growth curves of each infant was contrasted to the growth chart for the entire group. Individual shifting in growth rate was noted in two thirds of the infants. To better determine the timing and nature of these shifts in linear growth, a search was made for otherwise normal full-term infants who were at or below the tenth percentile for length at birth and who moved up to the fiftieth percentile or better by age 2 years and those who were at or above the ninetieth percentile at birth and moved down to the fiftieth percentile or less by 2 years of age. Those shifting upward had accelerated linear growth soon after birth; they achieved a new "channel" at a mean age of 11.5 months. Those shifting downward did not decelerate until after the first three to six months; they achieved a new channel by the mean age of 13 months. These findings plus the correlation coefficients relating parental size to the length of the infant at birth, one year, and two years of age are compatible with the following statements: Birth length relates predominantly to maternal size whereas by 2 years of age the length correlates best to mean parental height, reflecting the genetic growth factors of both parents. Those infants "catching-up" after birth usually do so in early infancy, whereas those "lagging-down" tend to do so in midinfancy.