CSF levels of carnitine in children with meningitis, neurologic disorders, acute gastroenteritis, and seizure

Carnitine concentrations in CSF, serum, and urine in normal febrile children and children with meningitis, neurologic disorders, and dehydration were studied. Carnitine levels in CSF were 1/10 compared with serum in normal febrile children. These levels increased two- to three-fold in the pathologic conditions studied. Since damage to the blood-brain barrier occurs in these conditions, higher blood-brain barrier permeability might explain CNS carnitine accumulation.     

Effects of adenosine, ATP, and UTP on chloride secretion by epithelia explanted from fetal rat lung

To determine the role of intensive chemotherapy and allogeneic bone marrow transplantation (BMT) in treatment of refractory anemia with excess of blasts (RAEB) or RAEB-t (in transformation), the outcome of 37 consecutive children, 12 with RAEB and 25 with RAEB-t, diagnosed between 1985 and 1995 was analyzed. Fourteen patients received intensive chemotherapy according to the AML-BFM protocols 83, 87, or 93 (group 1). Seven patients were treated less intensively with the 6-week consolidation phase as induction (group 2). Allogeneic BMT was performed in 10 children of group 1 and 2 after, and in eight (group 3) without prior chemotherapy. Eight children received minimal or no chemotherapy (group 4). Of 21 children (groups 1 and 2) 17 (81%) achieved complete or partial remission after chemotherapy, 12 of them (10 of group 1) remained in remission, eight after BMT. Five-year survival in 29 children treated intensively (groups 1-3) was 46%, SE 12%. Two of the other eight children (group 4) remained alive, one after spontaneous remission. Outcome after BMT was related to the blast count in the bone marrow prior to BMT. None of 10 children (including two with minimal or no chemotherapy) with < or = 12% blasts before BMT relapsed, in contrast to five of eight patients with a higher blast count (P log rank 0.02). We conclude that a substantial number of children with RAEB or RAEB-t can achieve remission with intensive AML-specific chemotherapy. In patients responding to intensive chemotherapy an increase in long-term survival after allogeneic BMT can be expected.     

Audience stress, personality, and speech.

"Forty-eight children, aged 10 to 12 years, told two stories to the experimenter alone and two to an audience of six adults… . Almost every subject told a longer story in the private compared to the audience situation. Highly exhibitionistic children were least influenced in this respect whereas self-conscious children reduced the length of their stories drastically before the six observers. Children who were both highly exhibitionistic and self-conscious made the most speech errors." From Psyc Abstracts 36:02:2FC69L. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Caries prevalence and salt fluoridation among 9-year-old schoolchildren in Strasbourg, France

The 9-year-old group (236 children) of an epidemiological study carried out in 1991 in Strasbourg on children aged 6 to 15 years was selected with the aim of determining if the caries prevalence reduction observed could be related to the use of salt fluoridation (FS) introduced in France in 1987. From these 236 children, 143 answered a questionnaire which showed that 36 of them were fluoridated salt users and 107 were not. The dft index was significantly lower in the FS consumers which showed 35.5% dft reduction compared to the non-FS-consuming children. When using the Generalized Linear Model, this reduction was significant (P = 0.03). Although lower in the FS group, the DMFT and DMFS indices showed no statistical significant difference. It appeared that 72.2% of the users took simultaneously fluoride tablets but no dental fluorosis was observed. The use of fluoride tablets had a significant effect on the DMFS (P = 10(-2)). The children who consumed FS used more frequently fluoridated mouthrinses (P = 10(-3)) and had more frequent professional application of fluoridated gel and varnishes than non-consumers (P = 0.02). The DMFS index increased with the number of meals (P = 10(-6)), which was the most significant variable entered into the Generalized Linear Model. The children who brushed their teeth once a day had a DMFS value 2.6 times higher than those who brushed regularly three times a day (P = 10(-3)). The DMFS value was 4.4 times higher among the children who brushed their teeth irregularly when compared with those who brushed three times a day (P = 10(-2)).     

Intellectual ability and achievement in psychiatrically hospitalized children with conduct, anxiety, and affective disorders.

The IQ and academic achievement of psychiatrically hospitalized children were studied. The sample consisted of 76 children, with a mean age of 10 years, who received diagnoses of conduct, oppositional, anxiety, and affective disorders on the basis of a structured diagnostic interview. A relative deficit in verbal abilities was observed for conduct-disordered children, extending to preadolescents the findings previously obtained for adolescent delinquents. Depressed children were characterized by underachievement, which is consistent with the learned helplessness literature. Contrary to expectations, children with an anxiety disorder had a lower IQ than children without the disorder. No cognitive deficits were observed for children diagnosed as oppositional. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Classroom-related behavior problems: Counsel parents, teachers, or children?

Compared the effectiveness of group counseling with significant adults (parents or teachers) and of group counseling with elementary school children in reducing classroom behavior problems. Ss were 372 children of average socioeconomic backgrounds. Results of an analysis of variance following a 10-wk treatment period indicate that the indirect approach (Adlerian group counseling with significant adults) was more effective than the direct approach (eclectic group counseling with the children), regardless of grade level. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluation of two live, cold-passaged, temperature-sensitive respiratory syncytial virus vaccines in chimpanzees and in human adults, infants, and children

Two live-attenuated, cold-passaged (cp), temperature-sensitive (ts) candidate vaccines, designated cpts530/1009 and cpts248/955, were attenuated, genetically stable, and immunogenic in chimpanzees and were highly attenuated for human adults. In respiratory syncytial virus (RSV)-seropositive children, cpts530/1009 was more restricted in replication than cpts248/955. In seronegative children, 10(4) pfu of cpts248/955 was insufficiently attenuated, and a high titer of vaccine virus was shed (mean peak titer, 10(4.4) pfu/mL), whereas 10(4) pfu of cpts530/1009 was relatively attenuated and restricted in replication (mean peak titer, 10(2.0) pfu/mL). At a dose of 10(5) pfu, cpts530/1009 was immunogenic in seronegative children (geometric mean titer of RSV neutralizing antibodies, 1:724). Transmission of either vaccine to seronegative placebo recipients occurred at a frequency of 20%-25%. Of importance, vaccine viruses recovered from chimpanzees and humans were ts. In contrast to previous studies, this study indicates that live attenuated RSV vaccines that are immunogenic and phenotypically stable can be developed. Additional studies are being conducted to identify a live RSV vaccine that is slightly more attenuated and less transmissible than cpts530/1009.     

Filial therapy with single parents: Effects on parental acceptance, empathy, and stress.

Determined the effectiveness of 10-wk filial therapy with parent–child play sessions as a method of prevention and intervention for single parents and their children. The experimental group was comprised of 20 mothers and 2 fathers. There were 19 mothers and 2 fathers in the control group. Parents ranged in age from 19 to 47 yrs. There were 10 girls and 12 boys in the experimental group and 9 girls and 12 boys in the control group. The children in both groups ranged in ages from 3 to 7 yrs. Results of the analysis of covariance (ANCOVA) revealed that single parents in the experimental group significantly increased both their attitude of acceptance and their empathic behavior toward their children, significantly reduced their level of stress related to parenting, and reported significantly fewer problems with their children's behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Competence, reticence, and helping by children and adolescents.

Examined the relation between age and helping in an experimental study in which 256 1st-, 4th-, 7th-, and 10th-grade children and adolescents directly observed an emergency and had the opportunity to intervene. A 2nd study was then conducted, using 256 1st-, 4th-, 7th-, and 10th-grade children and adolescents as Ss, in which an emergency was clearly staged, in order to elicit comments about factors that may inhibit helping. Results of Study 1 were consistent with earlier findings of a curvilinear relationship between age and helping among children and early adolescents, with 4th and 10th graders helping the victim of an injury significantly more than 1st and 7th graders. Significantly more help was given to a toddler than to an age peer and to a person whose injury appeared serious enough so that he or she could not get up unaided. Results obtained from Study 2 suggest that helping by younger Ss was inhibited by fear of possible inadequacy, and helping by adolescents was inhibited by fear of disapproval and/or sensitivity to the possible embarrassment felt by potential recipients. Reticence was expressed least where the potential recipient was a toddler. (40 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Driveway crush injuries in young children: a highly lethal, devastating, and potentially preventable event

BACKGROUND/PURPOSE: The aim of this study was to investigate driveway-related injuries in children, identify associated risk factors, and evaluate outcome compared with other mechanisms of blunt trauma. METHODS: A 6-year review (1991 to 1996) of pediatric (age less than 18 years) pedestrian injuries treated at two urban trauma centers was conducted: one regional pediatric trauma center and one level I trauma center with pediatric commitment. Five hundred twenty-seven children injured in pedestrian accidents were identified from the trauma registry; 51 children (10%) sustained traumatic injuries as a result of being struck in their driveway. Data are reported as mean +/- SEM. RESULTS: Children less than 5 years of age (n = 41) had an injury severity score (ISS) of 12.3+/-2.3, 15 (37%) sustained closed head injury, 13 (37%) had torso trauma, 19 (46%) skeletal trauma, and eight (20%) died. Children > or = 5 years old (n = 10) had an ISS of 10.7+/-2.4, three (30%) sustained closed head injury, four (40%) torso trauma, six (60%) skeletal trauma, and none died. In contrast, all other pediatric pedestrian accidents analyzed over the same time period had a mortality rate of only 2% (11 of 476). CONCLUSIONS: Pediatric driveway trauma carries a significant risk of head injury and a 10-fold increase in mortality in children under 5 years of age when compared with all other pediatric pedestrian accidents. More emphasis must be placed on injury prevention and public education to prevent this devastating mechanism of injury in these young, vulnerable children.     

Intramedullary spinal cord ependymomas in children: treatment, results and follow-up

A retrospective review of 20 pediatric patients with intramedullary spinal cord ependymomas, all of whom underwent operative resection between 1985 and 1996, was undertaken to determine surgical results, long-term follow-up and tumor recurrence. Twelve children operated on in the same period with filum or cauda equina ependymomas were not included in this study. Nine children had had previous treatment before referral. Gross total resection was achieved in 14 patients and subtotal in 6. None of these had a post-operative radiation therapy. The median follow-up period was 67 months (range 25-177 months). All children were clinically evaluated before and after operation and at the last follow-up. The clinical grade at the last follow-up showed improvement in 8 patients (40%), was unchanged in 10 (50%) and deteriorated in 2 (10%). Three patients had a recurrence, 2 at the primary site (2 and 3 years after our surgery) and 1 at a distant site (3 years after). The actuarial 5- and 10-year survival rates were both 90%; 5- and 10-year progression-free survival rates were 93 and 70%, respectively. We conclude that a complete removal can be achieved in almost all cases of intramedullary spinal cord ependymomas in children, and that the long survival rates justify avoiding post-operative radiation therapy.     

Residential mobility, well-being, and mortality.

We tested the relation between residential mobility and well-being in a sample of 7,108 American adults who were followed for 10 years. The more residential moves participants had experienced as children, the lower the levels of well-being as adults. As predicted, however, the negative association between the number of residential moves and well-being was observed among introverts but not among extraverts. We further demonstrated that the negative association between residential mobility and well-being among introverts was explained by the relative lack of close social relationships. Finally, we found that introverts who had moved frequently as children were more likely to have died during the 10-year follow-up. Among extraverts, childhood residential mobility was unrelated to their mortality risk as adults. These findings indicate that residential moves can be a risk factor for introverts and that extraversion can be an interpersonal resource for social relationships and well-being in mobile societies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changing criteria of autistic disorders: a comparison of the ICD-10 research criteria and DSM-IV with DSM-III-R, CARS, and ABC

Revised versions of diagnostic manuals, the International Classification of Diseases (ICD-10), and the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) all operate with several subgroups in the autistic spectrum. Five of the subgroups are identical in the two manuals, but ICD-10 contains five in addition. 132 children were diagnosed using ICD-10, DSM-IV, DSM-III-R, the Childhood Autism Rating Scale (CARS), and the Autistic Behavior Checklist (ABC). Five out of ten alternative subgroups of Pervasive Developmental Disorders (PDD) were identified in a population of developmentally impaired children. These subgroups were the same in the two manuals; the additional ones in ICD-10 were not identified. With the exception of the groups Disintegrative Disorder and Rett syndrome, significant differences were found between all the subgroups within the PDD spectrum and between the PDD group and the non-PDD group. Some problems connected with the guidelines in the ICD-10 manual are discussed.     

National trends in the mortality of children with sickle cell disease, 1968 through 1992

OBJECTIVES: This paper describes national trends in mortality of children with sickle cell disease and the settings in which death occurred. METHODS: United States death certificate data from 1968 through 1992 were used to calculate mortality rates of Black children with sickle cell disease 1 to 14 years old. Deaths from trauma, congenital anomalies, and perinatal conditions were excluded. RESULTS: Between 1968 and 1992, mortality rates of Black children with sickle cell disease decreased 41% for 1- to 4-year-olds, 47% for 5- to 9-year-olds, and 53% for 10- to 14-year-olds. During 1986 through 1992, children who died before hospital admission accounted for 41% of deaths among 1- to 4-year-olds, 27% among 5- to 9-year-olds, and 12% among 10- to 14-year-olds. CONCLUSIONS: Survival of Black children with sickle cell disease has improved markedly since 1968. A substantial proportion of deaths continue to occur prior to hospital admission. Trends in sickle cell mortality can be monitored inexpensively with death-certificate data.     

Prematurity, incubator noise and hearing disturbances (author's transl)

1. An audiologic follow-up study was done on 62 children, ages 10-11 years. All children had been pre-term infants, with a gestational age between 29 and 35 weeks. They had been maintained in an incubator for a period of 21-61 days. The children had frequently received ototoxic antibiotics in the newborn period, and had been subject to many perinatal risk factors with a high "non-optimal score." 2. 44 children (71%) were found to be audiologically normal, whereas 8 (13%) had minor auditory defects and 10 (16%) had major hearing defects. 3. There was a significant correlation between hearing defects and the "non-optimal score": children with the most difficult perinatal course were more likely to develop hearing difficulties. 4. This study was unable to support the assumption that the hearing loss found was due to high incubator noise levels: (a) The incubator noise level was slightly below the probably dangerous limit for noise exposure. (b) There was no correlation between the hearing impairment and the length of incubator stay. (c) The type of hearing defect was not generally consistent with that associated with noise pollution.     

Differential expression of p53, c-kit, and CD34 in prepubertal and postpubertal testicular germ cell tumors

BACKGROUND: The origin of testicular germ cell tumors (TGCTs) in children is poorly understood. There are clear differences between tumors in young children and those in adolescents and adults, which may suggest that they follow different pathways of tumorigenesis. METHODS: Tissue sections from 25 TGCTs (15 from patients age 4 years or younger and 10 from adolescents or adults) were stained immunohistochemically with anti-p53 (DO-1), CD34, and c-kit proto-oncogene protein product. RESULTS: CD34 expression was noted only in 5 prepubertal tumors. Expression of c-kit was observed in 9 of the 15 prepubertal tumors versus 2 of the 10 postpubertal cases. The intensity of expression was equal to that of the adjacent normal tubules in the prepubertal tumors, whereas the intensity was less in the postpubertal tumors. Expression of p53 was strong in 8 of the 10 tumors in adolescents or adults, with a 40-70% positivity, whereas only 6 of 15 prepubertal tumors expressed p53, with < 10% positivity. CONCLUSIONS: CD34 expression in tumors in the group of young children suggests a possible link to teratomas and further provides insight into the fundamental differences between this group and the adolescent/adult group. The expression of c-kit and p53 provides further evidence that c-kit/SCF signaling and p53 play potentially different roles in the initiation and progression of these tumors. Future studies will be required to clarify this issue.     

Comparative efficacy of terfenadine, loratadine, and astemizole in perennial allergic rhinitis

BACKGROUND: It is not known how many children with epilepsy may not need treatment with antiepileptic drugs (AEDs), how many respond unsatisfactorily to subsequent treatment regimens, and how many achieve "acceptable control" despite lack of remission. METHODS: In a prospective multicenter hospital-based study, 494 children with a broad range of seizure types and types of epilepsy were followed up for at least 2 years. There was no standard treatment protocol. We describe the treatment strategies applied to these children by the neurologists in charge and outcome with respect to remission from seizures. RESULTS: Treatment was initially withheld in 29% of the children, and after 2 years 17% still had not received any AEDs. There were no serious complications caused by withholding treatment. Of the children treated with AEDs, 60% were still using the first AED after 2 years; 80% received monotherapy and 20%, polytherapy. Children with severe symptomatic epilepsies, such as the West or Lennox-Gastaut syndrome, received polytherapy early on in the course of treatment. When 3 regimens had failed, the chance of achieving a remission of more than 1 year with subsequent regimens was 10%. Nevertheless, 15 of 50 children receiving AEDs in whom the "longest remission ever" was less than 6 months did achieve acceptable seizure control according to the neurologist in charge of treatment. Hence, of 494 children, only 35 (7%) developed an intractable form of epilepsy, defined as failure to bring seizures under acceptable control. CONCLUSIONS: A substantial percentage of children with new-onset epilepsy did not need treatment with AEDs. Chances of achieving a good outcome declined with subsequent treatment regimens. Not all children with recurrent seizures were suffering from intractable epilepsy; some had achieved acceptable control of seizures.     

Aggression, emotional maladjustment, and empathy in the abused child.

19 abused children between 5 and 10 yrs old were compared with 19 nonabused children on measures of aggression, emotional maladjustment, and empathy. The 2 groups were matched for age, sex, socioeconomic status, developmental age, IQ, language, and race. The abused Ss were found to be significantly lower than the controls on the measure of empathy and higher on measures of emotional maladjustment. They did not differ on the aggression measures. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-esteem, need for approval, and cheating behavior in children.

We investigated the effects of personality and situational variables on children's cheating behavior. Two hundred twenty-eight 10- to 12-year-old boys and girls completed the Children's Social Desirability Questionnaire and the Coopersmith Self-Esteem Inventory and were given unsolvable problems at which they could "succeed" only by cheating. One group was offered a tangible prize for success, the second group was told that its performance would be made public, and the third group served as a control group. The children with high self-esteem and low need for approval cheated significantly less than the children with high self-esteem and high need for approval, who behaved similarly to the children with low self-esteem. In addition, boys cheated more than girls, and all children cheated most when they expected a tangible prize. We discuss two kinds of high self-esteem: "true" high self-esteem and defensive high-esteem. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Studies of blood pressures in children, ages 5-14 years, in a total biracial community: the Bogalusa Heart Study

Blood pressure, height, weight, maturation, triceps skinfold thickness, serum lipids, and hemoglobin were measured as risk factors for coronary artery disease in 3,524 children (93% of the eligible population) in Bogalusa, Louisiana. Nine blood pressures were taken on each child by trained observers with mercury sphygmomanometers (Baumanometer) and Physiometrics automatic recorders in a rigid randomized design in a relaxed atmosphere with other children present. The pressures observed were low compared to reported data. Black children had significantly higher blood pressures than white children. This difference, starting before age 10, was largest in the children in the upper five percent of the pressure ranks. Stepwise multiple regression analysis revealed that this racial differnce was significant when measured by an automatic recorder. Body size, expressed by height and by weight/height3 index, was a strong determinant of blood pressure level. Other positive determinants were blood hemoglobin and external maturation.