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Q: Stunted or small arms and hands ( Answered,   0 Comments )
Question  
Subject: Stunted or small arms and hands
Category: Health > Conditions and Diseases
Asked by: stumpy77-ga
List Price: $40.00
Posted: 28 Jun 2006 18:53 PDT
Expires: 28 Jul 2006 18:53 PDT
Question ID: 741914
What are some possible environmental causes of stunted arm and hands
growth?  What are the normal ranges for hand and arm length for a 6'0
adult caucasian male?  What can be done to remedy small or short arms
and hands?
Answer  
Subject: Re: Stunted or small arms and hands
Answered By: crabcakes-ga on 29 Jun 2006 21:17 PDT
 
Hello Stumpy77,


   There are numerous possible causes of stunted growth, and the list
of possibilities I have posted is not comprehensive ? nor are they in
any particular order.

There is really no good treatment for short arms and hands. Some
doctors my try human growth hormone, but it also has side effects, and
does not work for all causes of short arms and hands. I would discuss
your concerns with your doctor, as s/he will know your medical
history.


?These defects can be severe with incomplete formation of one or both
kidneys or urologic abnormalities such as obstruction of outflow of
urine from the kidneys or severe reflux (backflow) of urine into the
kidneys from the bladder.
These problems can cause kidney failure early in life and may require
kidney transplant. Many of these problems can be corrected surgically
before any damage can occur.
Limb defects occur in up to 70 percent of babies with VACTERL
association and include absent or displaced thumbs, extra digits
(polydactyly), fusion of digits (syndactyly) and forearm defects.
Babies with limb defects on both sides tend to have kidney or urologic
defects on both sides, while babies with limb defects on only one side
of the body tend to have kidney problems on that same side.
Many babies with VACTERL are born small and have difficulty with
gaining weight. Babies with VACTERL association, however, do tend to
have normal development and normal intelligence.?
No specific genetic or chromosome problem has been identified with
VACTERL association. VACTERL can be seen with some chromosomal defects
such as Trisomy 18 and is more frequently seen in babies of diabetic
mothers. VACTERL association, however, is most likely caused by
multiple factors.?
http://www.cincinnatichildrens.org/health/heart-encyclopedia/disease/syndrome/vacterl.htm

?In addition, to the above mentioned features, affected children may
also exhibit less frequent abnormalities including growth deficiencies
and failure to gain weight and grow at the expected rate (failure to
thrive). In some cases, the acronym VATER association is used. Some
researchers have added an (S) to the VACTERL or VATER acronym to
represent a single umbilical artery instead of the normal two. Mental
functioning and intelligence is usually unaffected. The exact cause of
VACTERL association is unknown. Most cases occur randomly, for no
apparent reason (sporadic).?
http://www.webmd.com/hw/raising_a_family/nord486.asp

?A teratogen is a chemical that causes a fetus to develop 
incorrectly, there are many examples of these.  Perhaps one of the
most common is alcohol.  When a pregnant woman drinks excessively the
baby is born with Fetal Alcohol Syndrome which includes a combination
of physical and mental problems.?

?Teratogen means, in Greek, "monster forming".  Teratogens are 
chemicals that cause abnormalities in embryos.  Alcohol certainly is one.  
Perhaps the most famous is thalidomide, a drug originally designed to
combat morning sickness is pregnant women.  It caused the long bones
in the arms or legs to be absent, resulting in babies with severely
stunted arms or legs.  Rarely, a microorganism such as a bacterium can
be teratogenic.  One is Toxoplasma, which causes toxoplasmosis.  It is
carried by rabbits and cats and can be common in your yard, which is
why doctors often advise pregnant women to wear latex gloves when
gardening.?

http://www.newton.dep.anl.gov/newton/askasci/1993/biology/bio085.htm



?The mother's nutrition, drinking (see fetal alcohol syndrome),
smoking, and drug abuse, as well as exposure to toxic chemicals and
radiation, can also affect the developing fetus. Smoking, drugs, toxic
chemicals, and the like can also damage the father's sperm, which may
pass on the defect to the embryo in fertilization.?
http://www.answers.com/main/ntquery;jsessionid=1qpbjni775euv?tname=congenital-disorder&sbid=lc05b


?Thalidomide was marketed in the 1950s as a cure for morning sickness. 
But it was withdrawn in 1961 after around 10,000 babies had been born
with disabilities such as the characteristic stunted arms or legs.
Some babies were born with no limbs at all.?
http://news.bbc.co.uk/1/hi/health/4325335.stm

?Perhaps the only drug more infamous than DES is thalidomide, a
compound that caused severe birth defects in thousands of infants when
prescribed to pregnant women as a sedative and nausea medication in
the late 1950s and early 1960s. Thalidomide-affected babies were born
with stunted legs or arms or even with rudimentary flippers in place
of hands or feet. Remarkably, as in the case of DES, scientists have
yet to unravel the details of how thalidomide interferes with the
growth of an embryo.?
http://www.sciencenews.org/pages/sn_arc99/2_20_99/bob2.htm

Bendectin is known to cause some birth defects too: ?In fact, Benadryl
was associated with an increase in oral clefts in an epidemiological
study published in The Lancet in 1974.32 Comparable malformations were
also noted in the offspring of test animals exposed to Benadryl in a
1977 study published in the Archives of Pharmacology and Toxicology.

An unpublished survey of 50,282 pregnancies in the Collaborative
Perinatal Project showed a statistically significant increase in
diaphragmatic defects in infants whose mothers were exposed to the
ethanolamines, doxylamine and diphenhydramine (Benadryl) during the
first three months of pregnancy.
Research dating back to 1971 (Kahison and Rosengren) has shown that
elevated levels of histamine can be detected in tissue undergoing
rapid growth or repair such as healing wounds or developing embryonic
tissue. Inhibition of histamine arrests fetal development in test
animals.

Since ethanolamine antihistamines have both histamine and
cholinergic-blocking action, 35 their use during pregnancy has the
potential to disrupt the levels of these chemicals that are necessary
for normal growth at different stages of fetal development.?
http://www.birthdefects.org/information/env_bendectin2.htm

?Rubella:  Rubella is transmitted by contact with nasal secretions of
infected individuals.  Infected pregnancies are at increased risk for
miscarriage.  Infection during the first trimester results in a high
rate of birth defects in the baby.  This risk decreases sharply with
infection in the second and third trimesters.  The birth defects
associated with congenital rubella syndrome include eye defects,
hearing loss, heart defects, mental retardation, and growth
retardation.?

?Varicella:  Varicella is transmitted by airborne respiratory droplets
and direct contact with an infected individual's rash.  Babies
infected before 20 weeks of pregnancy have an approximate 2% risk of
being affected with congenital varicella syndrome.  This syndrome can
include skin scarring, defects of the muscle and limbs, a smaller
head, blindness, seizures, and mental retardation.?

?Anticonvulsants:  Exposure to antiseizure medications is associated
with fetal anticonvulsant syndrome.  Approximately 10% of children
exposed to Dilantin and other seizure medications will have some
growth and mental retardation, digit hypoplasia (shortening), and a
characteristic face.  Use of valproic acid and carbamazepine in early
pregnancy are associated with a 1% risk for spina bifida.
http://www.gbmc.org/genetics/harveygenetics/prenataldx/PatientInformation/teratogens.cfm


?Some prescription drugs cause birth defects and should never be taken
if there is any chance that a woman is pregnant or could become
pregnant while taking the drug. Drugs that are used to treat a serious
or life threatening illness should be avoided if possible.
Prescription drugs known to cause birth defects include thalidomide
(Thalomid) and isotretinoin (Accutane). A pregnant woman should always
talk with her doctor about the risks and benefits of any drugs before
taking them.?
http://pediatrics.about.com/od/birthdefects/f/medicines.htm


Depleted Uranium is written "DU" in this article: ?Over 200,000 US
troops who returned from the 1991 war are now invalided out with
ailments officially attributed to service in Iraq ? that?s 1 in 3. In
contrast, the British government?s failure to fully assess the health
of returning troops, or to monitor their health, means no one even
knows how many have died or become gravely ill since their return.
However, Gulf veterans? associations say that, of 40,000 or so
fighting fit men and women who saw active service, at least 572 have
died prematurely since coming home and 5000 may be ill. An alarming
number are thought to have taken their own lives, unable to bear the
torment of the innumerable ailments which have combined to take away
their career, their sexuality, their ability to have normal children,
and even their ability to breathe or walk normally. As one veteran
puts it, they are ?on DU death row, waiting to die?.


Whatever other factors there may be, some of their illnesses are
strikingly similar to those of Iraqis exposed to DU dust. For example,
soldiers have also fathered children without eyes. And, in a group of
eight servicemen whose babies lack eyes seven are known to have been
directly exposed to DU dust. They too have fathered children with
stunted arms, and rare abnormalities classically associated with
radiation damage. They too seem prone to cancer and leukaemia.
Tellingly, so are EU soldiers who served as peacekeepers in the
Balkans, where DU was also used. Indeed their leukaemia rate has been
so high that several EU governments have protested at the use of DU.?
http://www.oilcrash.com/articles/du.htm


?To our knowledge, there are few intervention studies in young stunted
children that support this statement. In fact, stunted young children
are those who are very likely to suffer from multiple micronutrient
deficiency and also those who are likely to have a poor appetite
because of infections, malnutrition and monotonous diet.?
http://jn.nutrition.org/cgi/content/full/131/11/2874


?The word achondroplasia is derived from Greek and means "without
cartilage formation," although individuals with achondroplasia do have
cartilage. During fetal development and childhood, cartilage normally
develops into bone, except in a few places, such as the nose and ears.
In individuals with achondroplasia, something goes wrong during this
process, especially in the long bones (such as those of the upper arms
and thighs). The rate at which cartilage cells in the growth plates of
the long bones turn into bone is slow, leading to short bones and
reduced height.?

?Hands are short with stubby fingers. There is a separation between
the middle and ring fingers (trident hand). Most individuals with
achondroplasia eventually reach an adult height of about 4 feet.?

?How is achondroplasia treated?
There currently is no way to normalize skeletal development of
children with the disorder. Several medical centers are evaluating the
use of human growth hormone for children with the disorder. To date,
some children have achieved modest increases in growth; however, it is
not yet known whether treatment will significantly increase their
eventual adult height. Leg-lengthening surgeries can increase the
height of someone with achondroplasia by up to 12 inches. These
procedures require a long duration of treatment, however, and are
associated with many complications. They should only be done in a
center that is well- experienced in the procedure.?
http://www.marchofdimes.com/professionals/681_1204.asp



What Is the Growth Plate?
?The growth plate, also known as the epiphyseal plate or physis, is
the area of growing tissue near the end of the long bones in children
and adolescents. Each long bone has at least two growth plates: one at
each end. The growth plate determines the future length and shape of
the mature bone. When growth is complete--sometime during
adolescence--the growth plates close and are replaced by solid bone.

?Radiation, which is used to treat certain cancers in children, can
damage the growth plate. Moreover, a recent study has suggested that
chemotherapy given for childhood cancers may also negatively affect
bone growth. The same is true of the prolonged use of steroids for
rheumatoid arthritis.?

?The growth plates are the site of many inherited disorders that
affect the musculoskeletal system. Scientists are just beginning to
understand the genes and gene mutations involved in skeletal
formation, growth, and development. This new information is raising
hopes for improving treatment of children who are born with poorly
formed or improperly functioning growth plates.?
http://www.niams.nih.gov/hi/topics/growth_plate/growth.htm#2


?Amniotic Band Syndrome is a set of congenital birth defects believed
to be caused by entrapment of fetal parts (usually a limb or digits)
in fibrous amniotic bands while in utero.   In other words:  Before
the baby was born the body parts that shows signs of ABS (arm,
fingers, toes, etc.,) were caught up and entangled in string-like
bands.  This caused abnormalities that were present at birth.

?With Amniotic Banding no two cases are exactly alike. There are
several features that are relatively consistent:  syndactyly (webbed
digits),  distal ring constrictions, deformity of the nails, stunted
growth of the small bones in the digits, limb length discrepancy,
distal lymphedema (swelling), and congenital band indentations.?
http://www.amnioticbandsyndrome.com/aboutABS.htm


?Congenital hypothyroidism (CH) is caused by a deficiency in the
circulating thyroid hormone thyroxine. Left untreated, this congenital
deficiency of thyroid hormone can result in mental retardation and
stunted growth. Affected newborns may appear normal up to three months
of age. If detected early and maintained on treatment (hormone
replacement medication), infants with CH should have normal growth and
development?
http://www.dhss.mo.gov/Lab/Newborn/CongenitalHypothyroidism.html


Cori's Disease ?Autosomal Recessive. Debranching enzyme deficiency
(can only break down linear chains of glycogen, not at branch points)
------> accumulate glycogen in liver, heart, skeletal muscle.? Causes
stunted growth,
http://www.aippg.com/ppg_lists_genetic_disorders_selected.html


You may find this site interesting:
http://www.mediaent.net/kidhealth_episodes.htm



?the length of a man's outspread arms is equal to his height?
http://en.wikipedia.org/wiki/Vitruvian_Man


?From Greek times the fathom (orguia), was defined as the distance
between fingertip to fingertip of a man's outstretched arms. About
1.83m in antiquity, the fathom transferred to Nueva Espaņa as a
shorter 1.67m or 5.485 SAE feet.?
http://www.ca-missions.org/pauley.html


Lengths of men?s arms vary by several inches. See this chart 
http://www.yarnstandards.com/mansize.html


?Size of the average guy's biceps: 13 inches (flexed, at around 175 pounds)
Size of his chest: 40 inches (inhaled, exhaled closer to 38 inches, at
around 175 pounds)
Size of his waist: 34 inches (at around 175 pounds)?
Men?s sizes:
?  Head Circumference / Hat Size 22.05 .68 21.65 .66 .321 .337 
?  Head Breadth 6.00 .25 5.73 .24 .087 .089 
?  Ear Length(Height) 2.45 .17 2.06 .17 .036 .032 
?  Neck Circ/Size 14.80 .79 13.10 .79 .216 .204 
?  Palm Length 4.19 .26 3.90 .21 .061 .061 
?  Hand Length 7.49 .39 7.10 .48 .109 .111 
?  Finger Length 3.30 .32 3.20 .35 .048 .050 
?  Hand Breadth 3.52 .19 3.03 .19 .051 .047 
?  Hand Circumference/Glove Size 8.48(XL) .49 7.22(M) .36 .124 .112 
?  Heel\Ankle Circumference/Sandal Strap size 13.45 .68 12.16 .58 .196 .189 
?  Foot Circumference @ ball/Vamp "length" 9.83 .59 8.91 .45 .143 .139 
?  Foot Breadth/Shoe Width 3.91 .23 3.50 .21 .057 .054 
?  Foot Length/Shoe Size [Size 10.5] [Size 8] 10.53 .53 9.58 .51 .153 .149
http://www.pipeline.com/~dada3zen/average.htm

I hope this has helped you! Please request an Answer Clarification if
any part is unclear, and allow me to respond, before you rate. I'll be
happy to assist you further, before you rate this answer.

Sincerely, Crabcakes



Search Terms
============
stunted extremities
stunted growth + arms + hands
teratogens  + stunted arms
birth defects + teratogens
congenital malformations

Request for Answer Clarification by stumpy77-ga on 30 Jun 2006 22:46 PDT
Thanks for this info.  I am especially interested in the averages for
various body dimensions and I am still trying to digest what you have
provided.

However, I was much more interested in any agents (such as toxins, or
nutritional problems) that would arrest the development of an
otherwise normal person.  Is there any such thing?

Thanks.

Clarification of Answer by crabcakes-ga on 02 Jul 2006 19:26 PDT
Hi again Stumpy,


   In my answer, I did include nutritional and toxic elements that can
cause stunted growth. Hopefully, you have read all the sites now.
Please elaborate on exactly what you are seeking, as I must be
misunderstanding you.

   Are you concerened with overall stunted growth as well? As in head
and body? I also have provided you with some overall dimensions in one
or two of the sites I posted. I'll be happy to cintinue searching for
you, if you give me a bit more detail.

  Sincerely, Crabcakes

Request for Answer Clarification by stumpy77-ga on 03 Jul 2006 21:28 PDT
Thanks for the followup CC.

Sorry for the confusion.   I was not clear enough, my area of interest
lies in stunted growth in a child who was born normal but then
suffered some kind of accident which caused stunted extremities at
some point in the growth process, be it 8, 10, 12, 14, etc. years of
age.   As far as I can tell from what you have provided and my own
studies, they are generally caused by fractures or infections of the
growth plate.  So there are no chemical  agents that could cause
arrested development spefically in the limbs at this stage?  In other
words, the torso and the limbs grow at the same rate?

Thanks,
Stumpy

Clarification of Answer by crabcakes-ga on 03 Jul 2006 22:26 PDT
Hi again, and thank you for the clarification!

Here's what I have found:
"Crimmins and Finch propose that even when they grew into apparently
healthy adults, survivors of high-infection generations carried a
heavier lifetime burden of inflammation. This in turn accelerated the
progress of cardiovascular disease.

The authors also cited contemporary studies showing that respiratory
infections, childhood diarrhea, dysentery and other common infectious
diseases reduce growth.

When rates of infection dropped due to improved public health
practices, adult survivors grew taller and lived longer.

"Our model implies that the reduction in lifelong levels of infections
and inflammation reduced and delayed the progression of cardiovascular
disease and mortality due to heart disease and allowed for increased
height," said Crimmins, the study's lead author.

Other obvious beneficial factors, such as improved nutrition and
higher standards of living, did not explain all the mortality data.
Crimmins and Finch found that increases in height did not always
follow improvements in income and nutrition. In addition, height
decreased during some periods of improving income in early industrial
cities."
http://www.sciencedaily.com/releases/2005/12/051227102639.htm


?The long-term effects of lead poisoning in children can be very
severe. Children can suffer from lower intelligence, learning
disabilities, Attention Deficit Disorder (ADD), decreased physical
growth, hyperactivity, impaired hearing, motor problems, behavioral
problems, speech and language problems and even brain damage. These
can be serious, lifelong disabilities. As in many other types of
poisoning, the earlier that treatment is sought, the greater the
possibility of reducing the severity of injury.?
http://lead.legalview.com/Default.aspx



Precocious Puberty
?Dr. Pescovitz has doubts about these studies but also has concerns
about substances in the environment that may trigger abnormal growth
in girls and boys. Pescovitz discusses 100 years of data about puberty
and the role nutrition plays in its onset. The normal range for girls
entering puberty is between 8 and 13 years old, and she says that
obesity or "overnutrition" may be a factor for girls developing in the
lower range. Pescovitz differentiates between early-normal and
"precocious" puberty, a condition which may occur in 2- to 5-year olds
and which has pathological causes. Left untreated, precocious puberty
can cause the fusion of bones and result in stunted growth.

Environmental toxins called "endocrine disrupters" may also affect
human reproductive system functions and are currently under
investigation by the EPA and other American health organizations.?
http://www.soundmedicine.iu.edu/archive/2002/041302.html



?Yet today, decades after being banned, DDT is linked to cancer and
stunted childhood growth. ?DDT came to menace us in the future because
it seemed so safe in the present,? wrote Tenner.?
http://mercuryexposure.org/index.php?article_id=271


?Smoking during pregnancy deprives your child of the nutrients and
oxygen he needs to develop properly. If you smoke during your
pregnancy, you are putting yourself at an increased risk for placenta
previa, placental abruption, ectopic pregnancy, preterm labor, and
miscarriage or stillbirth. Your baby will also have an increased
chance of being born with a low birth weight and is more likely to
develop respiratory diseases along with other health problems as he
gets older.?

?Pesticides and insecticides have been linked to birth defects,
especially if exposure to these chemicals occurred during the first
trimester. However, it is important to note that these problems were
most prevalent in children whose mothers had had prolonged exposure to
the chemicals. If your garden absolutely must look fantastic this
year, you may be better off hiring someone to do the work for you.?
http://www.epigee.org/pregnancy/risks.html


Interesting, but not likely in developed countries:
http://content.nejm.org/cgi/content/full/354/3/221


?Background: Aflatoxins are produced by molds that contaminate food
products such as nuts and corn in hot and humid climates with poor
food storage conditions. Consumption of aflatoxin is known to increase
the risk of liver cancer in humans. This risk is amplified when
aflatoxin exposure occurs in conjunction with hepatitis infection.
Laboratory animal studies have also demonstrated that aflatoxins are
immunotoxic and cause growth retardation, but there is little evidence
of these effects in exposed human populations.

Aflatoxin exposure of West African children is known to be high. To
assess the effects of aflatoxin exposure on growth in children, these
researchers conducted an epidemiologic study on 200 children 16-37
months of age in four African villages.?
http://64.233.161.104/search?q=cache:2fVnzW25tawJ:www.niehs.nih.gov/dert/profiles/hilites/2004/aflatox.htm+aflatoxins+%2B+stunted+childhood+growth&hl=en&gl=us&ct=clnk&cd=2


?The extremities grow at a faster rate than the trunk, leading to a
gradual change in relative proportions. The
crown-to-pubis/pubis-to-heel ratio is 1.7 at birth, 1.5 at 1 yr, 1.2
at 5 yr, and 1 at 10 yr.?
http://www.merck.com/mrkshared/mmanual/section19/chapter256/256d.jsp


?Body proportions are substantially different from birth to adulthood.
The head is disproportionally large at birth, with a ratio of head
height to total height of 1: 4. At adulthood, the ratio is 1: 7 1/ 2.
The lower limbs account for 15% of total height at birth, and about 30
% in the adult. There is thus a downward shift in the center of
gravity, from about T12 in the infant to about L5 in the adult.

In the adolescent growth spurt, the feet and hands initially
accelerate, then the calf and forearm, then hips and chest, and then
the shoulders. Last of all is the trunk and depth of the chest; there
is about a year between the peak height velocity of the lower limbs
and that of the trunk. The spurt in trunk
length is greater than the spurt in lower limb growth, so the increase
in height in the adolescent growth spurt is more derived from the
trunk than the limbs.
Gender differences in growth become evident during adolescence with
proportionally greater growth of the male shoulders and the female
pelvis.?
http://www.posna.org/index?service=page/coreCurriculum&article=growth.html


Genetics and growth hormone play a role in growth and size
http://www.hormone.org/pdf/GHIssuesinChildrenandAdults.pdf

http://healthsciences.columbia.edu/dept/ps/2007/pathophys2/endocrine/GrowthPRL.pdf



Additional Reading:
===================

http://radiographics.rsnajnls.org/cgi/content/full/23/4/871

I hope this has helped!

Sincerely, Crabcakes
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