Secular trends in head growth.

In Dr Moell's series of cases there was no increase in weight velocity when steroids were omitted from reinduc-tion therapy. Their attained height (-0.06 standard deviation score) and weight (-0.03 standard deviation score) at diagnosis were comparable. Weight velocity remained normal during maintenance therapy, whereas height velocity was reduced. Consequently, by the stopping of treatment there was some evidence of increased weight-for-height (height-0-86 standard deviation score; weight-0*33 standard deviation score). This trend concurs with our findings in a larger group of patients where portraying the results as changes in percentage weight adjusted for height clearly shows the excessive weight gain starting during treatment. Although prednisolone reinduction almost certainly has an influence on weight gain, this may not account for all the changes observed. A prolonged interval before weight returned to normal and no adverse effect of spinal irradiation on final height attained are further examples of similar results obtained in both studies. References Sainsbury CPQ, Newcombe RG, Hughes IA. Weight gain and height velocity during prolonged first remission from acute lymphoblastic leukaemia. Landberg T. Height, weight and growth hormone secretion in children treated for acute leukemia. The reduced mortality seen in ventilated very low birth-weight infants has led to an increase in the incidence of chronic lung disease and the need for prolonged supplemental oxygen. Such infants require lengthy hospital stays, leading to inhibition of their physical and emotional development. Recently, the administration of low flow oxygen through a nasal catheter has been shown to be effective in the home management of these babies, but such a system is dependent on oxygen cylinders.' The use of an oxygen concentrator is established in adult practice but has not been described in the management of the chronically oxygen dependent infant. A survivor of a twin pregnancy born at 25 weeks' gestation was discharged from hospital after a prolonged and complicated stay, assisted ventilation having been necessary for a number of months. Low flow continuous oxygen was begun through a size 6FG feeding catheter, and after a period of adjustment based on clinical and transcutaneous oxygen monitoring he was discharged home on 0 5 I/minute. No hospital admissions have been necessary for the last five months and developmental catch up is being achieved. Supplemental oxygen was stopped after 161 days. As the 'Concentrator' (DeVilbiss DeVo/44 Oxygen Con-centrator, DeVilbiss Health Care Division, Feltham, Middlesex) is on wheels it could be moved easily about the …