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Sample records for childhood craniopharyngioma treatment

  1. Treatment Strategies in Childhood Craniopharyngioma

    Directory of Open Access Journals (Sweden)

    StephaniePuget

    2012-06-01

    Full Text Available The surgical management of craniopharyngioma in children has been one of the most controversial topics in pediatric neurosurgery. In theory, based on its benign histology total surgical excision could provide a cure. However, the therapeutic goals for pediatric craniopharyngioma are not only the cure of the disease but also the preservation of function. It has been widely established that in some particular cases total excision could leads to inacceptable damages, especially those linked to hypothalamic functions. During the last 15 years, we observed worldwide a growing advocacy for less-invasive pediatric craniopharyngioma resection supported by international consensus conferences. The state-of-the-art in the surgical management of some craniopharyngioma is now turning to multi-modality treatment strategies (combination surgery and radiotherapy aiming to limit morbidiy. Recent literature and our own experience helped to develop risk-adapted treatment strategies at initial diagnosis, respecting hypothalamic structures to provide optimal quality of life for these children. Following new algorithms of treatment, preliminary results with intention to spare the hypothalamus seem to be encouraging but the long-term clinical outcome in terms of post irradiation complications and relapse management is currently unknown.

  2. Risk-adapted treatment and follow-up management in childhood-onset craniopharyngioma.

    Science.gov (United States)

    Müller, Hermann L

    2016-05-01

    Craniopharyngiomas are rare embryonic malformations of the sellar/parasellar region with low histological grade. Here, we review findings on the diagnosis, treatment, clinical course, follow-up, and prognosis of craniopharyngioma patients. Clinical manifestations develop from increased intracranial pressure, anterior visual pathway damage, and hypothalamic/pituitary deficiencies. If the tumor is favorably localized (no anatomical involvement with the hypothalamic and optical structures) therapy of choice is complete resection, meticulously performed to preserve hypothalamic and optic functions. In patients with unfavorable tumor involvement, optimal therapy is limited hypothalamus-sparing surgical strategy, followed by judicious irradiation dosage to minimize recurrences and progression. Surgical lesions and/or anatomical involvement of posterior hypothalamic areas result in serious sequelae, mainly hypothalamic syndrome. Craniopharyngioma is a chronic disease and must be managed as such, providing ongoing care of pediatric and adult patients by experienced multidisciplinary teams in the context of multicenter trials. PMID:26982163

  3. Eating behavior, weight problems and eating disorders in 101 long-term survivors of childhood-onset craniopharyngioma

    NARCIS (Netherlands)

    Hoffmann, Anika; Postma, Frank P.; Sterkenburg, Anthe S.; Gebhardt, Ursel; Mueller, Hermann L.

    2015-01-01

    Background: As a result of hypothalamic involvement and/or treatment-related hypothalamic damage, up to 75% of childhood craniopharyngioma patients develop hypothalamic obesity. Methods: Eating behavior was analyzed in 101 survivors of childhood craniopharyngioma, recruited from 1980 to 2001 in the

  4. TREATMENT OF SODIUM DISORDERS AFTER SURGERY OF CRANIOPHARYNGIOMA

    Institute of Scientific and Technical Information of China (English)

    黄文宇; 石祥恩

    2000-01-01

    Objective. To study the treatment of the patients with blood sodium disorder after craniopharyngioma surgery. Method. The blood sodium in 44 patients with craniopharyngiomas was daily examined from operative to post-op erative days. Hypernatremia is defined as [Na] > 145 mmol/1, and hyponatremia as [Na] < 135 mmol/L. Results. Of the 44 patients, 36 developed sodium disorder. Among them, simple hyponatremia was 16 patients, simple hypernatremia was 9 patients, and alternative sodiu m disorder was 11 patients. Conclusion. The blood sodium disorder in patients with craniopharyngiomas after surgery appears to present com plicated changes. Three types of blood sodium disorder could be determined as simple hyponatremia, simple hyperna tremia, and alternative sodium disorder. Treatment of the sodium disorder in patients with craniopharyngiomas after surgery could be carried in accordance with the above three types.

  5. Treatment Option Overview (Childhood Craniopharyngioma)

    Science.gov (United States)

    ... cause less damage to healthy tissue in the brain and other parts of the body. Proton radiation is different from x-ray radiation. Surgery with cyst drainage Surgery may be done to drain tumors that are mostly fluid-filled cysts. This ...

  6. Treatment Options for Childhood Craniopharyngioma

    Science.gov (United States)

    ... cause less damage to healthy tissue in the brain and other parts of the body. Proton radiation is different from x-ray radiation. Surgery with cyst drainage Surgery may be done to drain tumors that are mostly fluid-filled cysts. This ...

  7. Craniopharyngioma

    Science.gov (United States)

    ... alone, radiation therapy is usually necessary. If the tumor has a classic appearance on CT scan, a biopsy may not be necessary if treatment with radiation alone is planned. ... centers. This tumor is best treated at a center with experience ...

  8. TREATMENT OF SODIUM DISORDERS AFTER SURGERY OF CRANIOPHARYNGIOMA

    Institute of Scientific and Technical Information of China (English)

    黄文宇; 石祥恩

    2000-01-01

    Objective. To study the treatment of the patients with blood sodium disorder after cramophatyrgioma stagery.Method. The blood sodium in 44 patients with craniopharyngiomas was daily examined from operative to post-op-erative days. Hypematremia is defined as [Na] > 145 mmol/l, and hyponatremia as [Na] < 135 nmml/L.Results. Of the 44 patients, 36 developed sodium disorder. Among them, simple hyponatremia was 16 patients,simple hypematremia was 9 patients, and alternative sodium disorder was 11 patients. Condusion. The blood sodium disorder in patients with craniopharyngiomas after surgery appears to present com-plicated changes. Three types of blood sodium disorder could be determined as simple hyponatremia, simple hyperna-tremia, and alternative sodium disorder. Treatment of the sodium disorder in patients with craniopharyngiomas after surgery could be carried in accordance with the above three types.

  9. Diagnostics, treatment, and follow-up in craniopharyngioma

    Directory of Open Access Journals (Sweden)

    HermannL.Müller

    2011-11-01

    Full Text Available Craniopharyngiomas (CP are partly cystic embryogenic malformations of the sellar and parasellar region. With an overall incidence of 0.5 to 2.0 new cases / million population / year, approximately 30 to 50% of all cases represent childhood CP. Typical manifestations at diagnosis are headache, visual impairment, polyuria/polydypsia, growth retardation, and significant weight gain. Therapy of choice in patients with favorable tumor localization is complete resection with the intention to maintain optical nerve and hypothalamic-pituitary functions. In patients with unfavorable tumor localization (hypothalamic involvement, a limited resection followed by local irradiation is recommended. The overall survival rates are high (92%. Recurrences after complete resection and progressions of residual tumor after incomplete resection are frequent post-surgical events. Accordingly, the appropriate time point of irradiation after incomplete resection is currently under investigation in a randomized multinational trial (KRANIOPHARYNGEOM 2007. Quality of life is substantially reduced in approximately 50% of long-term survivors due to sequelae, notably morbid hypothalamic obesity. Both, childhood CP and adult onset CP should be recognized as chronic diseases requiring constant monitoring of the consequences and appropriate medical resources for treatment in order to provide optimal quality of survival for patients.

  10. Childhood craniopharyngioma: survival, local control, endocrine and neurologic function following radiotherapy

    International Nuclear Information System (INIS)

    Between 1961 and 1978, 19 patients with a diagnosis of childhood or teenage craniopharyngioma received supervoltage radiotherapy. All patients had previously undergone either partial surgical resection (10 patients), total gross resection (3 patients), or aspiration and biopsy (6 patients). Fourteen patients were treated primarily and five were treated for recurrence. The five-year survival was 73% with a 10-year survival of 64%. Sixteen percent developed a recurrence following radiotherapy. Long term effects were assesed in terms of neurologic, intellectual, psychological and endocrine function. Seventy-nine percent had none or minimal neurologic disability. The mean full scale IQ for the group was 90. There were no additional endocrine deficiencies that could be directly attributed to radiation. Behavioral disorders occurred in 50%. These results are at least comparable, if not superior, to those of surgery

  11. Simultaneous development of craniopharyngioma and choroid plexus carcinoma in the childhood -a clinical case

    International Nuclear Information System (INIS)

    We present a clinical case of 9 years old girl with concomitant brain tumors - choroid plexus carcinoma and craniopharyngioma diagnosed in 2009. After three operations, cranio-spinal irradiation with boost for the remaining tumor located in left ventricular trigonum to a total dose of 55 Gy and 7 courses chemotherapy, local tumor control was achieved for the choroid plexus carcinoma. Four years following the achievement of local tumor control of the choroid plexus carcinoma, an increase of the tumor formation located in the left side of the pituitary was reported. The diagnosis cystic craniopharyngeoma was found during the surgical operation. With this clinical case we would like to stress on the achieved local tumor control following the complex treatment of carcinoma of the choroid plexus, as well as on the slow growth of simultaneously diagnosed craniopharyngeoma. This case report raises the question of the genetic predisposition of the brain tumors in children, as well as possibility of malignant transformation of craniopharyngeoma following radiotherapy. The differential diagnosis of neuroectodermal brain tumors requires immunohistochemical analysis and if necessary genetic analysis. Key words: Complex treatment. Choroid plexus carcinoma. Craniopharyngioma. Radiotherapy. Malignant transformation. Simultaneity

  12. Childhood Craniopharyngioma

    Science.gov (United States)

    ... cause less damage to healthy tissue in the brain and other parts of the body. Proton radiation is different from x-ray radiation. Surgery with cyst drainage Surgery may be done to drain tumors that are mostly fluid-filled cysts. This ...

  13. The anesthetic, critical care and surgical challenges in the management of craniopharyngioma

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2011-01-01

    Full Text Available Among the childhood brain neoplasms, craniopharyngioma constitutes about 2-6% of all primary intracranial tumors. Craniopharyngioma poses a multitude of challenges to the neurosurgeon, endocrinologist, oncologist, intensivist and the anesthesiologist. The morbidity and mortality due to radical surgical treatment is quite high, to the extent of 40-50%. The conservative approach with limited surgical intervention and radiotherapy assistance is taken by some neurosurgeons, but its usefulness is very doubtful. We are reporting a case of craniopharyngioma in an 18-year-old female who had progressive loss of vision and was successfully managed with combined radical surgery and medical therapy.

  14. [Craniopharyngioma in children: importance of a multidisciplinary approach and therapeutic strategies in the treatment of relapsing].

    Science.gov (United States)

    Fiorito, C M M; Giglione, E; Bellone, S; Peretta, P; Bertin, D; Basso, M E; Bona, G

    2013-12-01

    The craniopharyngioma is a benign intracranial nonglial tumor derived from a malformation of the embryonic tissue. Represents approximately 6-9% of brain tumors in children. It grows close to the optic nerve, hypothalamus and pituitary. The most frequent histological variety in children is adamantinomatous. The initial symptoms of intracranial hypertension is headache and nausea, followed by visual disturbances, impaired hormonal changes such as the secretion of GH, gonadotropins, TSH and ACTH and central diabetes insipidus. We present the clinical case of MD, 5yrs at age, which shows signs of intracranial hypertension syndrome: neuroradiological findings raise the diagnosis of adamantinomatous craniopharyngioma for which the child underwent to sub-total surgical removal of the lesion and radiosurgery treatment. During the disease develops visual impairment, and secondary diabetes insipidus, hypothyroidism hipocotisolism that takes therapy with desmopressin (Minirin), Cortone acetate and L-tiroxine. For the failure of previous therapies, the child has performed chemotherapy with cisplatin (30 mg/sqm/day) and Etoposide (150 mg/mq/day). A year after the end of the last cycle of chemotherapy was detected new progression of the lesion with the appearance of worsening headache and vomiting in the upright position. TC notes the expansion of the third ventricle and the patient undergoes surgery craniotomy. This clinical case underlines the difficulties in treatment of recurrent craniopharyngioma in situations where the anatomical location do not permit aggressive radical surgery. Anyway, new studies are needed to evaluate the effectiveness of systemic chemotherapy as a method of experimental treatment that could reduce the progression of disease. PMID:24217636

  15. Surgical strategies and modern therapeutic options in the treatment of craniopharyngiomas.

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    Mortini, Pietro; Gagliardi, Filippo; Boari, Nicola; Losa, Marco

    2013-12-01

    The optimal treatment of patients with craniopharyngioma remains controversial. In particular, the role of aggressive treatment compared to less aggressive therapeutic options is poorly understood. Radical resection is the therapy of choice at any age, because it is associated with the best outcome in terms of survival. Nevertheless, aggressive behaviour, location, involvement of critical structures, tumour size, calcifications, and patient age may limit the extent of resection. Surgery can also carry significant morbidity in terms of visual, hypothalamic, and endocrinological disturbances. Long term sequelae reduce the quality of life in 50% of long-term survivors, notably obesity and neurobehavioral impairment due to hypthalamic involvement and iatrogenic induced lesions. The quality of life should be considered as a clinically important endpoint in patients, who currently experience good overall survival rates, regardless of the degree of surgical resection. Tendency to recur despite negative postoperative imaging led many authors to advocate a less aggressive surgical treatment followed by radiation therapy. We review the data reported in the literature, especially early outcome after surgical treatment and factors affecting the risk of tumour recurrence, to elucidate the role of attempted radical resection in the treatment of craniopharyngioma and to identify the clinical and morphological characteristics predictive for the best surgical prognosis. PMID:23932582

  16. Treatment of alternated water-electrolyte balance and endocrine status after removal of craniopharyngioma in adults

    Institute of Scientific and Technical Information of China (English)

    WANG Lei; ZHAO Shang-feng; ZHANG Wei; ZHANG Mao-zhi

    2006-01-01

    Background Water-electrolyte disturbance and endocrine alterations are common complications of adult patients with craniopharygioma in the postoperative period and may affect their recovery and prognosis. Some of these complications even lead to death. Appropriate remedy based upon the status of water-electrolyte balance and the endocrine system is essential to good therapeutic results of adult patients with craniopharyngioma.Methods The alterations in water-electrolyte balance (117 patients) and endocrine status (42) of adult patients with craniopharyngioma after surgery were analyzed retrospectively.Results Most patients with craniopharyngioma experienced postoperative water-electrolyte disturbances and hypotonic dehydration. Moreover, the incidences of hypothyroidism and hypoadrenocorticism were relatively high.Conclusion It is critical to deal with dehydration and endocrine disorders for a sound outcome of craniopharyngioma surgery.

  17. Hypothalamic obesity after treatment for craniopharyngioma: the importance of the home environment.

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    Meijneke, Ruud W H; Schouten-van Meeteren, Antoinette Y N; de Boer, Nienke Y; van Zundert, Suzanne; van Trotsenburg, Paul A S; Stoelinga, Femke; van Santen, Hanneke M

    2015-01-01

    Hypothalamic obesity after treatment for craniopharyngioma is a well-recognized, severe problem. Treatment of hypothalamic obesity is difficult and often frustrating for the patient, the parents and the professional care-giver. Because hypothalamic obesity is caused by an underlying medical disorder, it is often assumed that regular diet and exercise are not beneficial to reduce the extraordinarily high body mass index, and in fact, lifestyle interventions have been shown to be insufficient in case of extreme hypothalamic obesity. Nevertheless, it is important to realize that also in this situation, informal care delivered by the family and appropriate parenting styles are required to minimize the obesity problem. We present a case in which weight gain in the home situation was considered unstoppable, and a very early mortality due to complications of the severe increasing obesity was considered inevitable. A permissive approach toward food intake became leading with rapid weight increase since a restrictive lifestyle was considered a senseless burden for the child. By admission to our hospital for a longer period of time, weight reduction was realized, and the merely permissive approach could be changed into active purposeful care by adequate information, instruction, guidance and encouragement of the affected child and her parents. This case illustrates that, although this type of obesity has a pathological origin, parental and environmental influences remain of extreme importance. PMID:25381948

  18. Dosimetry for the treatment of cystic craniopharyngioma through radiocolloids with 186 Re

    International Nuclear Information System (INIS)

    The cystic craniopharyngioma (CQ) are histologically benign tumors that can affect important organs, as the hypothalamus or the optic nerve. They are treated introducing, inside the cyst, a radioactive colloid. The wall constitutes the white volume and the dosimetry is usually carried out starting from analytic formulas that only are valid in the case of an homogeneous media, uniform and infinite. In this work it is studied the dosimetry of the CQ by means of Monte Carlo simulation (MC), taking in account the different materials and interfaces that conform them. We present the obtained results for the radionuclide 186 Re. We have used the Monte Carlo code Penelope and we follow 5x106 histories in each simulation. We supposed a size of CQ of 1.75 cm of radio and a wall thickness of 1 mm and we have varied the constituent materials of the interior of the cyst and of the wall. The analytic calculations that we carry out show an excellent agreement with the MC results for an unique media (water), as much for the beta radiation as for those originated of the Rhenium disintegration. However, when it takes in account the gel that is introduced in the tumor for the treatment and we vary the constituent material of the wall, we find important differences. Of the analysis of our results we can conclude that the dosimetry for the treatment of CQ based in the usual analytic formulas overestimates the doses really deposited in the wall of the CQ. (Author)

  19. Infrasellar craniopharyngioma

    International Nuclear Information System (INIS)

    A rare case of infrasellar craniopharyngioma mainly occupying the paranasal sinuses, the infratemporal fossa and the skull base is presented. The patient had been treated by an otolaryngologist as a case of mucocele of the sphenoid and ethmoid sinuses because the biopsy specimens obtained at endonasal surgery failed to confirm the true diagnosis. Computed tomography (CT) scan showed multilobulated lowdensity cysts in the paranasal sinuses, infratemporal fossa and skull base, and the cyst wall was enhanced. Magnetic resonance Imaging (MRI) revealed the cysts to have high intensity in both T1- and T2-weighted images, and excellent three-dimensional visualization was obtained. Characteristic motor-oil-like fluid was aspirated during transnasal surgery and the diagnosis of craniopharyngioma was confirmed by histological examination. (orig.)

  20. Infrasellar craniopharyngioma

    Energy Technology Data Exchange (ETDEWEB)

    Akimura, T.; Kameda, H.; Abiko, S.; Aoki, H.; Kido, T.

    1989-05-01

    A rare case of infrasellar craniopharyngioma mainly occupying the paranasal sinuses, the infratemporal fossa and the skull base is presented. The patient had been treated by an otolaryngologist as a case of mucocele of the sphenoid and ethmoid sinuses because the biopsy specimens obtained at endonasal surgery failed to confirm the true diagnosis. Computed tomography (CT) scan showed multilobulated lowdensity cysts in the paranasal sinuses, infratemporal fossa and skull base, and the cyst wall was enhanced. Magnetic resonance Imaging (MRI) revealed the cysts to have high intensity in both T1- and T2-weighted images, and excellent three-dimensional visualization was obtained. Characteristic motor-oil-like fluid was aspirated during transnasal surgery and the diagnosis of craniopharyngioma was confirmed by histological examination.

  1. Secondary neutron doses in proton therapy treatments of ocular melanoma and craniopharyngioma

    International Nuclear Information System (INIS)

    Monte Carlo simulations were used to assess secondary neutron doses received by patients treated with proton therapy for ocular melanoma and craniopharyngioma. MCNPX calculations of out-of-field doses were done for ∼20 different organs considering realistic treatment plans and using computational phantoms representative of an adult male individual. Simulations showed higher secondary neutron doses for intracranial treatments, ∼14 mGy to the salivary glands, when compared with ocular treatments, ∼0.6 mGy to the non-treated eye. This secondary dose increase is mainly due to the higher proton beam energy (178 vs. 75 MeV) as well as to the impact of the different beam parameters (modulation, collimation, field size etc.). Moreover, when compared with published data, the assessed secondary neutron doses showed similar trends, but sometimes with sensitive differences. This confirms secondary neutrons to be directly dependent on beam energy, modulation technique, treatment configuration and methodology. The MC approach was considered to assess the secondary neutron dose to organs located outside the treatment volume for patients treated with protons for ocular or intracranial tumours. The work involved the use of computational phantoms with realistic clinical treatment configurations (number of beams, incidence, modulation, dose prescription etc.). The secondary neutron doses were calculated to ∼20 organs in each phantom. MC simulations showed non-negligible neutron equivalent doses at healthy organs located outside the clinical target volume. For the ocular tumour treatments, the highest secondary neutron dose (∼0.6 mGy) was registered at the level of the non-treated eye. Meanwhile, for the intracranial tumour treatment, the salivary glands received a maximum secondary neutron dose of nearly 14 mGy. In both cases, the dose was found to decrease as organ's distance to the treatment volume increases. Moreover, simulations showed up to 160 times higher secondary

  2. SU-E-J-122: Detecting Treatment-Induced Metabolic Abnormalities in Craniopharyngioma Patients Undergoing Surgery and Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Hua, C; Shulkin, B; Li, Y; LI, X; Merchant, T [St. Jude Children' s Research Hospital, Memphis, TN (United States); Indelicato, D [University of Florida Proton Therapy Institute, Jacksonville, FL (United States); Boop, F [Semmes-Murphey Neurologic and Spine Institute, Memphis, TN (United States)

    2014-06-01

    Purpose: To identify treatment-induced defects in the brain of children with craniopharyngioma receiving surgery and proton therapy using fluorodeoxyglucose positron emission tomography (FDG PET). Methods: Forty seven patients were enrolled on a clinical trial for craniopharyngioma with serial imaging and functional evaluations. Proton therapy was delivered using the double-scattered beams with a prescribed dose of 54 Cobalt Gray Equivalent. FDG tracer uptake in each of 63 anatomical regions was computed after warping PET images to a 3D reference template in Talairach coordinates. Regional uptake was deemed significantly low or high if exceeding two standard deviations of normal population from the mean. For establishing the normal ranges, 132 children aged 1–20 years with noncentral nervous system related diseases and normal-appearing cerebral PET scans were analyzed. Age- and gender-dependent regional uptake models were developed by linear regression and confidence intervals were calculated. Results: Most common PET abnormality before proton therapy was significantly low uptake in the frontal lobe, the occipital lobe (particularly in cuneus), the medial and ventral temporal lobe, cingulate gyrus, caudate nuclei, and thalamus. They were related to injury from surgical corridors, tumor mass effect, insertion of a ventricular catheter, and the placement of an Ommaya reservoir. Surprisingly a significantly high uptake was observed in temporal gyri and the parietal lobe. In 13 patients who already completed 18-month PET scans, metabolic abnormalities improved in 11 patients from baseline. One patient had persistent abnormalities. Only one revealed new uptake abnormalities in thalamus, brainstem, cerebellum, and insula. Conclusion: Postoperative FDG PET of craniopharyngioma patients revealed metabolic abnormalities in specific regions of the brain. Proton therapy did not appear to exacerbate these surgery- and tumor-induced defects. In patients with persistent and

  3. Disease Control After Reduced Volume Conformal and Intensity Modulated Radiation Therapy for Childhood Craniopharyngioma

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    Merchant, Thomas E., E-mail: thomas.merchant@stjude.org [St Jude Children' s Research Hospital, Radiological Sciences, Memphis, Tennessee (United States); Kun, Larry E.; Hua, Chia-Ho [St Jude Children' s Research Hospital, Radiological Sciences, Memphis, Tennessee (United States); Wu, Shengjie; Xiong, Xiaoping [St Jude Children' s Research Hospital, Biostatistics, Memphis, Tennessee (United States); Sanford, Robert A.; Boop, Frederick A. [Semmes Murphey Neurologic and Spine Institute, Neurosurgery, Memphis, Tennessee (United States)

    2013-03-15

    Purpose: To estimate the rate of disease control after conformal radiation therapy using reduced clinical target volume (CTV) margins and to determine factors that predict for tumor progression. Methods and Materials: Eighty-eight children (median age, 8.5 years; range, 3.2-17.6 years) received conformal or intensity modulated radiation therapy between 1998 and 2009. The study group included those prospectively treated from 1998 to 2003, using a 10-mm CTV, defined as the margin surrounding the solid and cystic tumor targeted to receive the prescription dose of 54 Gy. The CTV margin was subsequently reduced after 2003, yielding 2 groups of patients: those treated with a CTV margin greater than 5 mm (n=26) and those treated with a CTV margin less than or equal to 5 mm (n=62). Disease progression was estimated on the basis of additional variables including sex, race, extent of resection, tumor interventions, target volume margins, and frequency of weekly surveillance magnetic resonance (MR) imaging during radiation therapy. Median follow-up was 5 years. Results: There was no difference between progression-free survival rates based on CTV margins (>5 mm vs ≤5 mm) at 5 years (88.1% ± 6.3% vs 96.2% ± 4.4% [P=.6386]). There were no differences based on planning target volume (PTV) margins (or combined CTV plus PTV margins). The PTV was systematically reduced from 5 to 3 mm during the time period of the study. Factors predictive of superior progression-free survival included Caucasian race (P=.0175), no requirement for cerebrospinal fluid shunting (P=.0066), and number of surveillance imaging studies during treatment (P=.0216). Patients whose treatment protocol included a higher number of weekly surveillance MR imaging evaluations had a lower rate of tumor progression. Conclusions: These results suggest that targeted volume reductions for radiation therapy using smaller margins are feasible and safe but require careful monitoring. We are currently investigating

  4. Stages of Childhood Craniopharyngioma

    Science.gov (United States)

    ... cause less damage to healthy tissue in the brain and other parts of the body. Proton radiation is different from x-ray radiation. Surgery with cyst drainage Surgery may be done to drain tumors that are mostly fluid-filled cysts. This ...

  5. Childhood vitiligo: Treatment paradigms

    Directory of Open Access Journals (Sweden)

    Amrinder Jit Kanwar

    2012-01-01

    Full Text Available Childhood vitiligo differs from the adults by showing a higher incidence in females, segmental vitiligo being more common and less frequent association with other systemic autoimmune and endocrine disorders.Childhood vitiligo is often associated with a marked psychosocial and long lasting effect on the self-esteem of the affected children and their parents, hence an adequate treatment is very essential. Treatment of vitiligo is indeed a tough challenge for the dermatologists′ more so in the background of childhood vitiligo. Although multiple therapeutic modalities are available in the therapeutic armamentarium, not all can be used in children. This brief report updates regarding various therapies available in the treatment of childhood vitiligo.

  6. Craniopharyngioma in children

    International Nuclear Information System (INIS)

    Purpose: The treatment regimens at presentation and recurrence, the related morbidity, and survival rates were studied for children with craniopharyngioma who were treated at King Faisal Specialist Hospital and Research Center (KFSH and RC). Methods and Materials: From 1975 to 1996, a total of 56 children younger than 18-years-old at diagnosis underwent treatment with surgery and/or radiotherapy for craniopharyngiomas at KFSH and RC. There was evidence that these patients had advanced disease at diagnosis; 36% of 51 patients whose visual status pretreatment was known were either blind or had major bilateral visual defects prior to treatment, and 36% of the 56 patients had diabetes insipidus. This report concentrates on 44 patients who had first definitive resection at KFSH and RC. Treatment policy was total resection if possible (17 patients), if not, subtotal resection (17 patients) or lesser procedures (10 patients). Five patients received postoperative irradiation after first definitive resection. Results: Ten-year-survival, and progression-free and event-free survival rates were 65%, 39%, and 29%, respectively. There were 9 postoperative deaths; 7 following the first procedure and 2 following resection for relapse, and 3 early deaths at home prior to relapse, following the first resection. None of the 22 patients who underwent less than total resection without postoperative radiation treatment were progression-free at 5 years, whereas the 5 patients who were irradiated remain progression-free. Conclusion: A more selective approach to total resection, and the routine use of postoperative irradiation following lesser surgical procedures requires evaluation

  7. Treatment Option Overview (Childhood Ependymoma)

    Science.gov (United States)

    ... without radiation therapy . Childhood ependymoma, anaplastic ependymoma, or RELA fusion–positive ependymoma Treatment of newly diagnosed childhood ... Grade II), anaplastic ependymoma (WHO Grade III), or RELA fusion–positive ependymoma is: Surgery . After surgery, the ...

  8. Craniopharyngioma and hypothalamic injury: latest insights into consequent eating disorders and obesity

    Science.gov (United States)

    Müller, Hermann L.

    2016-01-01

    Purpose of review Hypothalamic alterations, pathological or treatment induced, have major impact on prognosis in craniopharyngioma patients mainly because of consequent hypothalamic obesity. Recent insight in molecular genetics, treatment strategies, risk factors and outcomes associated with hypothalamic obesity provide novel therapeutic perspectives. This review includes relevant publications since 2013. Recent findings Recent findings confirm that alterations in posterior hypothalamic areas because of tumour location and/or treatment-related injuries are associated with severe hypothalamic obesity, reduced overall survival and impaired quality of life in long-term survivors of childhood-onset craniopharyngioma. However, eating disorders are observed because of hypothalamic obesity without clear disease-specific patterns. Treatment options for hypothalamic obesity are very limited. Treatment with invasive, nonreversible bariatric methods such as Roux-en-Y gastric bypass is most efficient in weight reduction, but controversial in the paediatric population because of medical, ethical, and legal considerations. Accordingly, treatment in craniopharyngioma should focus on prevention of (further) hypothalamic injury. Presurgical imaging for grading of hypothalamic involvement should be the basis for hypothalamus-sparing strategies conducted by experienced multidisciplinary teams. Summary Until a nonsurgical therapeutic option for hypothalamic obesity for paediatric patients is found, prevention of hypothalamic injury should be the preferred treatment strategy, conducted exclusively by experienced multidisciplinary teams. PMID:26574645

  9. Proton Beam Therapy Versus Conformal Photon Radiation Therapy for Childhood Craniopharyngioma: Multi-institutional Analysis of Outcomes, Cyst Dynamics, and Toxicity

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    Bishop, Andrew J. [Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Greenfield, Brad [Department of Radiation Oncology, Baylor College of Medicine, Houston, Texas (United States); Mahajan, Anita [Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Paulino, Arnold C. [Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Department of Radiation Oncology, Baylor College of Medicine, Houston, Texas (United States); Okcu, M. Fatih [Department of Pediatrics, Texas Children' s Cancer and Hematology Center, Baylor College of Medicine, Houston, Texas (United States); Allen, Pamela K. [Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Chintagumpala, Murali [Department of Pediatrics, Texas Children' s Cancer and Hematology Center, Baylor College of Medicine, Houston, Texas (United States); Kahalley, Lisa S. [Section of Psychology, Texas Children' s Cancer and Hematology Center, Baylor College of Medicine, Houston, Texas (United States); McAleer, Mary F.; McGovern, Susan L. [Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Whitehead, William E. [Department of Neurosurgery, Texas Children' s Cancer and Hematology Center, Baylor College of Medicine, Houston, Texas (United States); Grosshans, David R., E-mail: dgrossha@mdanderson.org [Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States)

    2014-10-01

    Purpose: We compared proton beam therapy (PBT) with intensity modulated radiation therapy (IMRT) for pediatric craniopharyngioma in terms of disease control, cyst dynamics, and toxicity. Methods and Materials: We reviewed records from 52 children treated with PBT (n=21) or IMRT (n=31) at 2 institutions from 1996-2012. Endpoints were overall survival (OS), disease control, cyst dynamics, and toxicity. Results: At 59.6 months' median follow-up (PBT 33 mo vs IMRT 106 mo; P<.001), the 3-year outcomes were 96% for OS, 95% for nodular failure-free survival and 76% for cystic failure-free survival. Neither OS nor disease control differed between treatment groups (OS P=.742; nodular failure-free survival P=.546; cystic failure-free survival P=.994). During therapy, 40% of patients had cyst growth (20% requiring intervention); immediately after therapy, 17 patients (33%) had cyst growth (transient in 14), more commonly in the IMRT group (42% vs 19% PBT; P=.082); and 27% experienced late cyst growth (32% IMRT, 19% PBT; P=.353), with intervention required in 40%. Toxicity did not differ between groups. On multivariate analysis, cyst growth was related to visual and hypothalamic toxicity (P=.009 and .04, respectively). Patients given radiation as salvage therapy (for recurrence) rather than adjuvant therapy had higher rates of visual and endocrine (P=.017 and .024, respectively) dysfunction. Conclusions: Survival and disease-control outcomes were equivalent for PBT and IMRT. Cyst growth is common, unpredictable, and should be followed during and after therapy, because it contributes to late toxicity. Delaying radiation therapy until recurrence may result in worse visual and endocrine function.

  10. Proton Beam Therapy Versus Conformal Photon Radiation Therapy for Childhood Craniopharyngioma: Multi-institutional Analysis of Outcomes, Cyst Dynamics, and Toxicity

    International Nuclear Information System (INIS)

    Purpose: We compared proton beam therapy (PBT) with intensity modulated radiation therapy (IMRT) for pediatric craniopharyngioma in terms of disease control, cyst dynamics, and toxicity. Methods and Materials: We reviewed records from 52 children treated with PBT (n=21) or IMRT (n=31) at 2 institutions from 1996-2012. Endpoints were overall survival (OS), disease control, cyst dynamics, and toxicity. Results: At 59.6 months' median follow-up (PBT 33 mo vs IMRT 106 mo; P<.001), the 3-year outcomes were 96% for OS, 95% for nodular failure-free survival and 76% for cystic failure-free survival. Neither OS nor disease control differed between treatment groups (OS P=.742; nodular failure-free survival P=.546; cystic failure-free survival P=.994). During therapy, 40% of patients had cyst growth (20% requiring intervention); immediately after therapy, 17 patients (33%) had cyst growth (transient in 14), more commonly in the IMRT group (42% vs 19% PBT; P=.082); and 27% experienced late cyst growth (32% IMRT, 19% PBT; P=.353), with intervention required in 40%. Toxicity did not differ between groups. On multivariate analysis, cyst growth was related to visual and hypothalamic toxicity (P=.009 and .04, respectively). Patients given radiation as salvage therapy (for recurrence) rather than adjuvant therapy had higher rates of visual and endocrine (P=.017 and .024, respectively) dysfunction. Conclusions: Survival and disease-control outcomes were equivalent for PBT and IMRT. Cyst growth is common, unpredictable, and should be followed during and after therapy, because it contributes to late toxicity. Delaying radiation therapy until recurrence may result in worse visual and endocrine function

  11. Longitudinal Investigation of Adaptive Functioning Following Conformal Irradiation for Pediatric Craniopharyngioma and Low-Grade Glioma

    International Nuclear Information System (INIS)

    Purpose: Children treated for brain tumors with conformal radiation therapy experience preserved cognitive outcomes. Early evidence suggests that adaptive functions or independent-living skills may be spared. This longitudinal investigation prospectively examined intellectual and adaptive functioning during the first 5 years following irradiation for childhood craniopharyngioma and low-grade glioma (LGG). The effect of visual impairment on adaptive outcomes was investigated. Methods and Materials: Children with craniopharyngioma (n=62) and LGG (n=77) were treated using conformal or intensity modulated radiation therapy. The median age was 8.05 years (3.21-17.64 years) and 8.09 years (2.20-19.27 years), respectively. Serial cognitive evaluations including measures of intelligence quotient (IQ) and the Vineland Adaptive Behavior Scales (VABS) were conducted at preirradiation baseline, 6 months after treatment, and annually through 5 years. Five hundred eighty-eight evaluations were completed during the follow-up period. Results: Baseline assessment revealed no deficits in IQ and VABS indices for children with craniopharyngioma, with significant (P<.05) longitudinal decline in VABS Communication and Socialization indices. Clinical factors associated with more rapid decline included females and preirradiation chemotherapy (interferon). The only change in VABS Daily Living Skills correlated with IQ change (r=0.34; P=.01) in children with craniopharyngioma. Children with LGG performed below population norms (P<.05) at baseline on VABS Communication, Daily Living Indices, and the Adaptive Behavior Composite, with significant (P<.05) longitudinal decline limited to VABS Communication. Older age at irradiation was a protective factor against longitudinal decline. Severe visual impairment did not independently correlate with poorer adaptive outcomes for either tumor group. Conclusions: There was relative sparing of postirradiation functional outcomes over time in this sample

  12. Longitudinal Investigation of Adaptive Functioning Following Conformal Irradiation for Pediatric Craniopharyngioma and Low-Grade Glioma

    Energy Technology Data Exchange (ETDEWEB)

    Netson, Kelli L. [Department of Psychiatry and Behavioral Sciences, Kansas University School of Medicine—Wichita, Kansas (United States); Conklin, Heather M. [Department of Psychology, St Jude Children' s Research Hospital, Memphis, Tennessee (United States); Wu, Shengjie; Xiong, Xiaoping [Department of Biostatistics, St Jude Children' s Research Hospital, Memphis, Tennessee (United States); Merchant, Thomas E., E-mail: thomas.merchant@stjude.org [Division of Radiation Oncology, St Jude Children' s Research Hospital, Memphis, Tennessee (United States)

    2013-04-01

    Purpose: Children treated for brain tumors with conformal radiation therapy experience preserved cognitive outcomes. Early evidence suggests that adaptive functions or independent-living skills may be spared. This longitudinal investigation prospectively examined intellectual and adaptive functioning during the first 5 years following irradiation for childhood craniopharyngioma and low-grade glioma (LGG). The effect of visual impairment on adaptive outcomes was investigated. Methods and Materials: Children with craniopharyngioma (n=62) and LGG (n=77) were treated using conformal or intensity modulated radiation therapy. The median age was 8.05 years (3.21-17.64 years) and 8.09 years (2.20-19.27 years), respectively. Serial cognitive evaluations including measures of intelligence quotient (IQ) and the Vineland Adaptive Behavior Scales (VABS) were conducted at preirradiation baseline, 6 months after treatment, and annually through 5 years. Five hundred eighty-eight evaluations were completed during the follow-up period. Results: Baseline assessment revealed no deficits in IQ and VABS indices for children with craniopharyngioma, with significant (P<.05) longitudinal decline in VABS Communication and Socialization indices. Clinical factors associated with more rapid decline included females and preirradiation chemotherapy (interferon). The only change in VABS Daily Living Skills correlated with IQ change (r=0.34; P=.01) in children with craniopharyngioma. Children with LGG performed below population norms (P<.05) at baseline on VABS Communication, Daily Living Indices, and the Adaptive Behavior Composite, with significant (P<.05) longitudinal decline limited to VABS Communication. Older age at irradiation was a protective factor against longitudinal decline. Severe visual impairment did not independently correlate with poorer adaptive outcomes for either tumor group. Conclusions: There was relative sparing of postirradiation functional outcomes over time in this sample

  13. Intracavitary therapy of craniopharyngiomas

    International Nuclear Information System (INIS)

    Craniopharyngiomas are benign cystic para-hypophyseal tumors often associated with hypopituitarism and visual-field abnormalities. Their therapy by surgery and external beam radiotherapy is imperfect. The intracavitary instillation of beta-emitting colloid radiopharmaceuticals into the cysts permits the delivery of far higher radiation doses to the cyst lining than is possible by external beam radiotherapy. This technique permits destruction of the lining epithelium with resultant elimination of cyst fluid formation and cyst shrinkage in up to 80% of cases

  14. Intracapsular irradiation therapy of craniopharyngiomas with radioactive gold

    International Nuclear Information System (INIS)

    Sixteen cases out of 27 patients with craniopharyngiomas were arbitrarily subjected to combined treatment of simple surgical evacuation and intracapsular irradiation with 198-Au. Follow-up studies were performed on 15 cases and they ranged from 6 months to 11 years. One patient was omitted from the study because of a short postoperative period. Immediate postoperative morbidity and the endocrine functions at the end of the follow-up study were compared with those of the patients who underwent extensive surgical resection of the tumors. Intracapsular irradiation with 198-Au was found to have satisfactory effects in the treatment of cystic craniopharyngioma, especially in recurrent cases of initially solid tumors, with respect to the preservation of the endocrine functions and the daily activity of the patients. The immediate postoperative hazards in the patients' care were also much less and they were found to be easily manageable. The patients, who had been followed up for over 5 years, maintained an occupational IQ score in the normal range and the patients under school age were all able to continue their school lives. One of the female patients, who had been married after the treatment, could have two children without any specific replacement therapy, and another patient in childhood who had shown physical retardation due to HGH deficiency, showed favorable results with crescormon administration in comparison with cases of extensive resection. Although the dosimetric value of 198-Au should be varied according to the size and thickness of the capsule, it was found that 15 to 30 mCi of 198-Au was the appropriate dosis for treatment. (author)

  15. Somnolence in adult craniopharyngioma patients is a common, heterogeneous condition that is potentially treatable.

    LENUS (Irish Health Repository)

    Crowley, R K

    2012-02-01

    CONTEXT AND OBJECTIVE: Somnolence and obesity are prevalent in craniopharyngioma patients. We hypothesized that somnolence was because of obstructive sleep apnoea in craniopharyngioma patients. DESIGN, PATIENTS AND MEASUREMENTS: We assessed prevalence of somnolence and sleep apnoea in 28 craniopharyngioma and 23 obese controls attending a tertiary referral centre, by means of the Epworth Sleepiness Score (ESS) and polysomnography. All subjects with sleep apnoea were offered continuous positive airway pressure therapy (CPAP) or modafinil. All craniopharyngioma patients, with unexplained somnolence, were offered modafinil. RESULTS: Somnolence was reported by 20\\/28 (71.5%) craniopharyngioma patients and 4\\/23 (17%) obese subjects (P < 0.001). Median ESS was 7.5 (IQR 6, 10.7) in craniopharyngioma patients and 4.0 (4,8) in controls, P < 0.01. Eleven somnolent craniopharyngioma patients had obstructive sleep apnoea, in whom treatment led to a reduction in ESS by 6.4 +\\/- 1.4, P = 0.01. Among the remaining nine patients, five were offered modafinil therapy, of whom four had benefit, three were not compliant with hormone replacement, and one died before intervention. There was no difference in the prevalence of obstructive sleep apnoea between craniopharyngioma (n = 13, 46%) and obese subjects (n = 14, 61%, P = 0.4). Body mass index (BMI) does not correlate with apnoea hypopnoea index [apnoea - hypopnoea index (AHI), r = 0.25, P = 0.08], which suggests that obesity alone does not explain the prevalence of sleep apnoea in craniopharyngioma patients. CONCLUSIONS: Somnolence is common in craniopharyngioma patients and in the majority is because of obstructive sleep apnoea. An additional group of somnolent craniopharyngioma patients benefits from modafinil.

  16. Treatment of Childhood Obesity: A Systematic Review

    Science.gov (United States)

    Staniford, Leanne J.; Breckon, Jeff D.; Copeland, Robert J.

    2012-01-01

    Childhood obesity trends have increased dramatically over the past three decade's. The purpose of this quantitative systematic review is to provide an update of the evidence, illustrating the efficacy of childhood obesity treatment, considering whether treatment fidelity has been measured and/or reported and whether this related to the treatment…

  17. Dosimetry for the treatment of cystic craniopharyngioma through radiocolloids with {sup 186} Re; Dosimetria para el tratamiento de craneofaringiomas quisticos mediante radiocoloide con {sup 186} Re

    Energy Technology Data Exchange (ETDEWEB)

    Rojas, E.L.; Al-dweri, F.M.O.; Lallena, A.M. [Depto. de Fisica Moderna, Universidad de Granada (Spain); Bodineau, C.; Galan, P. [Servicio de Radiofisica Hospitalaria, Hospital Regional Universitario ' Carlos Haya' , 29010 Malaga (Spain)

    2003-07-01

    The cystic craniopharyngioma (CQ) are histologically benign tumors that can affect important organs, as the hypothalamus or the optic nerve. They are treated introducing, inside the cyst, a radioactive colloid. The wall constitutes the white volume and the dosimetry is usually carried out starting from analytic formulas that only are valid in the case of an homogeneous media, uniform and infinite. In this work it is studied the dosimetry of the CQ by means of Monte Carlo simulation (MC), taking in account the different materials and interfaces that conform them. We present the obtained results for the radionuclide {sup 186} Re. We have used the Monte Carlo code Penelope and we follow 5x10{sup 6} histories in each simulation. We supposed a size of CQ of 1.75 cm of radio and a wall thickness of 1 mm and we have varied the constituent materials of the interior of the cyst and of the wall. The analytic calculations that we carry out show an excellent agreement with the MC results for an unique media (water), as much for the beta radiation as for those originated of the Rhenium disintegration. However, when it takes in account the gel that is introduced in the tumor for the treatment and we vary the constituent material of the wall, we find important differences. Of the analysis of our results we can conclude that the dosimetry for the treatment of CQ based in the usual analytic formulas overestimates the doses really deposited in the wall of the CQ. (Author)

  18. Nonpharmacologic Treatments for Childhood Constipation : Systematic Review

    NARCIS (Netherlands)

    Tabbers, Merit M.; Boluyt, Nicole; Berger, Marjolein Y.; Benninga, Marc A.

    2011-01-01

    OBJECTIVE: To summarize the evidence and assess the reported quality of studies concerning nonpharmacologic treatments for childhood constipation, including fiber, fluid, physical movement, prebiotics, probiotics, behavioral therapy, multidisciplinary treatment, and forms of alternative medicine. ME

  19. Brachytherapy in childhood rhabdomyosarcoma treatment

    International Nuclear Information System (INIS)

    A retrospective study of 21 children with rhabdomyosarcoma treated by brachytherapy to the primary site of the tumor at the Radiotherapy Department of the A.C.Camargo Hospital between january/1980 to june/1993 was undertaken. The main objectives were to comprove the utility of brachytherapy in childhood rhabdomyosarcoma, to evaluate the local control and survival, in association with chemotherapy, to analyze the late effects of the treatment and to determinate the preferential technique to each clinical situation. All patients received brachytherapy to the tumor site. The radioactive isotopes employed were Gold198, Cesium137 and Iridium192. The brachytherapy techniques depended on the tumor site, period of treatment, availability of the radioactive material and stage of the disease. Patients treated exclusively by brachytherapy received 40 Gy to 60 Gy. When brachytherapy was associated with external radiotherapy the dose ranged from 20 Gy to 40 Gy. Local control was achieved in 18 of 20 patients (90%). The global survival and local control survival rates were 61.9% (13/21 patients) and 72,2% (13/18 patients) respectively. (author)

  20. Sequential pathological changes during malignant transformation of a craniopharyngioma: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Tetsuya Negoto

    2015-01-01

    Full Text Available Background: Malignant transformation of craniopharyngiomas is quite rare, and the etiology of transformation remains unclear. The prognosis of malignantly transformed craniopharyngiomas is very poor. Case Description: A 36-year-old male had five craniotomies, five transsphenoidal surgeries, and two radiation treatments until 31 years of age after diagnosis of craniopharyngioma at 12 years of age. All serial pathological findings indicated adamantinomatous craniopharyngioma including those of a surgery performed for tumor regrowth at 31 years of age. However, when the tumor recurred approximately 5 years later, the pathological findings showed squamous metaplasia. The patient received CyberKnife surgery, but the tumor rapidly regrew within 4 months. The tumor was resected with the cavernous sinus via a dual approach: Transcranial and transsphenoidal surgery with an extracranial-intracranial bypass using the radial artery. Pathologic examination of a surgical specimen showed that it consisted primarily of squamous cells; the lamina propria was collapsed, and the tumor cells had enlarged nuclei and clarification of the nucleolus. The tumor was ultimately diagnosed as malignant transformation of craniopharyngioma. After surgery, he received combination chemotherapy (docetaxel, cisplatin, and fluorouracil. The tumor has been well controlled for more than 12 months. Conclusion: Serial pathological changes of the craniopharyngioma and a review of the 20 cases reported in the literature suggest that radiation of the squamous epithelial cell component of the craniopharyngioma led to malignant transformation via squamous metaplasia. We recommend aggressive surgical removal of craniopharyngiomas and avoidance of radiotherapy if possible.

  1. Treatment of Newly Diagnosed and Recurrent Childhood Brain Tumors

    Science.gov (United States)

    ... Treatment of Newly Diagnosed and Recurrent Childhood Brain Tumors The brain is made of different kinds of cells . Childhood ... following: What You Need To Know About™ Brain Tumors Pediatric Brain Tumor Consortium (PBTC) For more childhood cancer information ...

  2. Craniopharyngioma with hyperprolactinaemia due to a prolactinoma.

    OpenAIRE

    Wheatley, T; Clark, J D; Stewart, S.

    1986-01-01

    A case is presented in which a histologically proven prolactin secreting pituitary macroadenoma was associated with a large suprasellar craniopharyngioma. The pre-operative prolactin concentration was 8180 mU/l. Although hyperprolactinaemia up to 3000 mU/l in patients with a craniopharyngioma is usually due to stalk compression, greater values may indicate an associated prolactinoma.

  3. Late deaths after treatment for childhood cancer.

    OpenAIRE

    Hawkins, M M; Kingston, J. E.; Kinnier Wilson, L. M.

    1990-01-01

    An investigation of 749 deaths occurring among 4082 patients surviving at least five years after the diagnosis of childhood cancer in Britain before 1971 has been undertaken. Of the 738 with sufficient information the numbers of deaths attributable to the following causes were: recurrent tumour, 550 (74%), a second primary tumour, 61 (8%), a medical condition related to treatment of the tumour, 49 (7%), an traumatic death unrelated to the tumour or its treatment, 34 (5%), finally, any other c...

  4. Childhood obesity treatment and prevention. Psychological perspectives of clinical approaches

    OpenAIRE

    Maria Catena Quattropani; Teresa Buccheri

    2013-01-01

    Objective: This work focuses on clinical psychologist’ presence within childhood obesity prevention programmes in several countries. Method: The Authors collected articles considering psychological, biological and social aspects linked to childhood obesity. Results: Studies reveal that childhood obesity prevention programmes are based on biological, medical and educational aspects; clinical psychologists up until now have been engaged almost exclusively in the treatment of obesity. Conclusion...

  5. Childhood obesity treatment and prevention. Psychological perspectives of clinical approaches

    Directory of Open Access Journals (Sweden)

    Maria Catena Quattropani

    2013-05-01

    Full Text Available Objective: This work focuses on clinical psychologist’ presence within childhood obesity prevention programmes in several countries. Method: The Authors collected articles considering psychological, biological and social aspects linked to childhood obesity. Results: Studies reveal that childhood obesity prevention programmes are based on biological, medical and educational aspects; clinical psychologists up until now have been engaged almost exclusively in the treatment of obesity. Conclusions: There is a clear need to consider psychological aspects (emotional, cognitive and relational related to the childhood obesity’s causes and involve psychologists in its prevention projects. Keywords: childhood obesity, overweight, multidisciplinary approach, clinical psychology, prevention, treatment

  6. Craniopharyngioma

    Science.gov (United States)

    ... Tumors Oligoastrocytoma Oligodendroglioma Pineal Tumor Pituitary Tumor PNET Schwannoma Risk Factors Brain Tumor Facts Brain Tumor Dictionary ... Tumors Oligoastrocytoma Oligodendroglioma Pineal Tumor Pituitary Tumor PNET Schwannoma Risk Factors Brain Tumor Facts Brain Tumor Dictionary ...

  7. Incidence of craniopharyngioma in Denmark (n = 189) and estimated world incidence of craniopharyngioma in children and adults

    DEFF Research Database (Denmark)

    Nielsen, E H; Feldt-Rasmussen, U; Poulsgaard, L;

    2011-01-01

    We studied the incidence of craniopharyngioma in Denmark during the period 1985-2004 and estimated worldwide incidence rates (IR) of craniopharyngioma based on a literature review. Craniopharyngioma patients diagnosed during the period 1985-2004 were identified from the Danish National Patient...... PubMed and, if appropriate, were included in a weighted analysis estimating overall and children's IRs of craniopharyngioma. IRs are given as new cases per million per year. We identified 189 patients with new verified (162) or probable craniopharyngioma. The overall WHO World-standardised incidence...

  8. Dosimetric Comparison of Three-Dimensional Conformal Proton Radiotherapy, Intensity-Modulated Proton Therapy, and Intensity-Modulated Radiotherapy for Treatment of Pediatric Craniopharyngiomas

    International Nuclear Information System (INIS)

    Purpose: Cranial irradiation in pediatric patients is associated with serious long-term adverse effects. We sought to determine whether both three-dimensional conformal proton radiotherapy (3D-PRT) and intensity-modulated proton therapy (IMPT) compared with intensity-modulated radiotherapy (IMRT) decrease integral dose to brain areas known to harbor neuronal stem cells, major blood vessels, and other normal brain structures for pediatric patients with craniopharyngiomas. Methods and Materials: IMRT, forward planned, passive scattering proton, and IMPT plans were generated and optimized for 10 pediatric patients. The dose was 50.4 Gy (or cobalt Gy equivalent) delivered in 28 fractions with the requirement for planning target volume (PTV) coverage of 95% or better. Integral dose data were calculated from differential dose–volume histograms. Results: The PTV target coverage was adequate for all modalities. IMRT and IMPT yielded the most conformal plans in comparison to 3D-PRT. Compared with IMRT, 3D-PRT and IMPT plans had a relative reduction of integral dose to the hippocampus (3D-PRT, 20.4; IMPT, 51.3%∗), dentate gyrus (27.3, 75.0%∗), and subventricular zone (4.5, 57.8%∗). Vascular organs at risk also had reduced integral dose with the use of proton therapy (anterior cerebral arteries, 33.3∗, 100.0%∗; middle cerebral arteries, 25.9%∗, 100%∗; anterior communicating arteries, 30.8∗, 41.7%∗; and carotid arteries, 51.5∗, 77.6∗). Relative reduction of integral dose to the infratentorial brain (190.7∗, 109.7%∗), supratentorial brain without PTV (9.6, 26.8%∗), brainstem (45.6, 22.4%∗), and whole brain without PTV (19.4∗, 34.4%∗) were recorded with the use of proton therapy. (∗Differences were significant based on Friedman’s test with Bonferroni-Dunn correction, α = 0.05) Conclusions: The current study found that proton therapy was able to avoid excess integral radiation dose to a variety of normal structures at all dose levels while

  9. Osteonecrosis - complication at oncological treatment in childhood

    International Nuclear Information System (INIS)

    Osteonecrosis is one of serious complications at oncological treatment of children. The etiopathogenesis has not been completely elucidated, mostly it has a multifactorial character. The incidence is in 1,5 - 9,3 % range. ON affects predominantly the weight bearing joints. It affects mostly the patients with acute lymphoblastic leukemia and those at adolescent age. The course of disease is unpredictable. The changes at early stages can be reversible, but at some patients the disease progresses and can lead to a disability. At Children oncology clinic of Children teaching hospital in Bratislava during the years 1992 - 2008 we identified 12 patients affected by ON out of 146 children with ALL (8,2 %), 1 out of 42 with NHL (2,4 %) and 1 out of 42 with HL (2,4 %). The age at diagnosis of malignity: 4y7m - 17y, the age at diagnosis ON: 10y5m - 19y. Further course: regression - 2 patients, stabilised state - 6 patients, progression - 3 patients. 3 patients were lost from our follow up. The treatment was conservative, with the exception of one patient, who had to undergo surgery due to the progression of disease. To avoid the risk of inducing ON during the treatment of oncological patient in childhood it is important to optimalize the therapeutical protocols and to diagnose this complication early. (author)

  10. Brachytherapy on treatment of childhood rhabdomyosarcoma

    International Nuclear Information System (INIS)

    A retrospective study of 21 children with rhabdomyosarcoma treated by brachytherapy to the primary site of the tumor between january/1980 to june/1993 was undertaken. The main objectives were: to comprove the utility of brachytherapy in childhood rhabdomyosarcoma, to evaluate the local control and survival in association with chemotherapy, to analyze the late effects of the treatment and to determinate the preferencial technique to each clinical situation. Seventeen patients were female and four male with a median age of five years (range of 3 months to 15 years). Seven children showed head and neck tumors, seven in extremities, five genital, one perineal and one in trunk. Four patients were group II, fifteen group III and two group IV according the Intergroup Rhabdomyosarcoma Study (IRS) classification. The histologic type presented eighteen embryonary rhabdomyosarcoma, one alveolar rhabdomyosarcoma and in two patients was not possible to be determined. The therapeutic approach included induction chemotherapy followed by radiotherapy to the primary site in association or not with surgical ressection and maintenance chemotherapy. All patients received brachytherapy to the tumor site. The radioactive isotopes employed were: Gold198, Cesium137 and Iridium192. The brachytherapy techniques depended on the tumor site, period of treatment, availability of the radioactive material and stage of the disease. Patients treated exclusively by brachytherapy received 40Gy to 60Gy. When brachytherapy was associated with external radiotherapy the dose ranged from 20Gy to 40Gy. Local control was achieved in 18 of 20 patients (90%). The global survival and local control survival rates were 61.9% ((13(21)) patients) and 72.2% ((13(18)) patients) respectively. Staging and age showed statistic significance for survival. Distant metastasis occurred in seven patients (33.3%), mainly to the lungs. Patients treated with total radiation dose higher than 45Gy showed more incidence of

  11. Improving childhood obesity treatment using new technologies: the ETIOBE System

    OpenAIRE

    Baños Rivera, Rosa María; Cebolla i Martí, Ausiàs Josep; Botella Arbona, Cristina; García Palacios, Azucena; Oliver, Elia; Zaragozá, Irene; Alcañiz, Mariano

    2011-01-01

    Childhood obesity is an increasing public health problem in western culture. Sedentary lifestyles and an “obesogenic environment” are the main influences on children leading to an increase in obesity. The objective of this paper is to describe an e-health platform for the treatment and prevention of childhood obesity called ETIOBE. This e-health platform is an e-therapy system for the treatment of obesity, aimed at improving treatment adherence and promoting the mechanisms of self-control...

  12. Long term sequelae of pediatric craniopharyngioma - literature review and 20 years of experience

    Directory of Open Access Journals (Sweden)

    MichalCohen

    2011-11-01

    Full Text Available Craniopharyngioma are rare histologically benign brain tumors that develop in the pituitary- hypothalamic area. They may invade nearby anatomical structures causing significant rates of neurological, neurocognitive and endocrinological complications including remarkable hypothalamic damage. Information regarding long term implications of the tumors and treatment in the pediatric population is accumulating, and treatment goals appear to be changing accordingly. In this review we aim to present data regarding long term complications of craniopharyngioma in children and adolescents and our experience from a large tertiary center. Hypothalamic dysfunction was noted to be the most significant complication, adversely affecting quality of life in survivors. Obesity, fatigue and sleep disorders are the most notable manifestations of this dysfunction, and treatment is extremely difficult. Changes in management in recent years show a potential for improved long term outcomes; we found a trend towards less aggressive surgical management and increasing use of adjuvant treatment, accompanied by a decrease in complication rates.

  13. NFC as a Childhood Obesity Treatment Tool.

    Science.gov (United States)

    Díaz-Hellín, P; Fontecha, J; Hervás, R; Bravo, J

    2015-09-01

    Childhood Obesity is associated with a wide range of serious health complications and constitutes an increased risk of premature syndromes, including diabetes or heart diseases. Its treatment seems to be complicated. So, in order to help parents we have developed a system that will try to make easier the process of choosing foodstuff for overweight and obese children at the supermarket. To interact with the system, Near Field Communication mobile phones and tags are used. Those tags would have nutritional information such as energy or fat contain of each product. When the interaction takes place, the system will generate an alert determining if the product is adequate for the user diet or not. Decision will be influenced by specific prescript diets, which would have been previously generated by the system based on user profile parameters. At the same time the diet is established, the shopping list would be generated automatically. Therefore, the user could download and print both things at home easily by the PC application. The system also takes into account physical activity of the user. Children mobile phone includes an accelerometer that will detect and collect user activities in order to modify calorical requirements and, if necessary, to change physical activity too. In the future, it would be possible to extend this project system for adults, managing diets not just for obese and overweight, but also to diabetic or celiac people. PMID:26254253

  14. Cholelithiasis after treatment for childhood cancer

    Energy Technology Data Exchange (ETDEWEB)

    Mahmoud, H.; Schell, M.; Pui, C.H. (St. Jude Children' s Research Hospital, Memphis, TN (USA))

    1991-03-01

    The authors evaluated the risk of development of cholelithiasis in 6050 patients treated at a single hospital for various childhood cancers with different therapeutic modalities, including chemotherapy, surgery, radiation therapy, and bone marrow transplantation, from 1963 to 1989. Patients with underlying chronic hemolytic anemia or preexisting gallstones were excluded. Nine female and seven male patients with a median age of 12.4 years (range, 1.2 to 22.8 years) at diagnosis of primary cancer had gallstones develop 3 months to 17.3 years (median, 3.1 years) after therapy was initiated. Cumulative risks of 0.42% at 10 years and 1.03% at 18 years after diagnosis substantially exceed those reported for the general population of this age group. Treatment-related factors significantly associated with an increased risk of cholelithiasis were ileal conduit, parenteral nutrition, abdominal surgery, and abdominal radiation therapy (relative risks and 95% confidence intervals = 61.6 (27.9-135.9), 23.0 (9.8-54.1), 15.1 (7.1-32.2), and 7.4 (3.2-17.0), respectively). There was no correlation with the type of cancer, nor was the frequency of conventional predisposing features (e.g., family history, obesity, use of oral contraceptives, and pregnancy) any higher among the affected patients in this study than in the general population. Patients with cancer who have risk factors identified here should be monitored for the development of gallstones.

  15. Cholelithiasis after treatment for childhood cancer

    International Nuclear Information System (INIS)

    The authors evaluated the risk of development of cholelithiasis in 6050 patients treated at a single hospital for various childhood cancers with different therapeutic modalities, including chemotherapy, surgery, radiation therapy, and bone marrow transplantation, from 1963 to 1989. Patients with underlying chronic hemolytic anemia or preexisting gallstones were excluded. Nine female and seven male patients with a median age of 12.4 years (range, 1.2 to 22.8 years) at diagnosis of primary cancer had gallstones develop 3 months to 17.3 years (median, 3.1 years) after therapy was initiated. Cumulative risks of 0.42% at 10 years and 1.03% at 18 years after diagnosis substantially exceed those reported for the general population of this age group. Treatment-related factors significantly associated with an increased risk of cholelithiasis were ileal conduit, parenteral nutrition, abdominal surgery, and abdominal radiation therapy (relative risks and 95% confidence intervals = 61.6 [27.9-135.9], 23.0 [9.8-54.1], 15.1 [7.1-32.2], and 7.4 [3.2-17.0], respectively). There was no correlation with the type of cancer, nor was the frequency of conventional predisposing features (e.g., family history, obesity, use of oral contraceptives, and pregnancy) any higher among the affected patients in this study than in the general population. Patients with cancer who have risk factors identified here should be monitored for the development of gallstones

  16. Management of craniopharyngiomas: Role of conservative strategies

    Directory of Open Access Journals (Sweden)

    Shibu Pillai

    2013-01-01

    Full Text Available Craniopharyngiomas are uncommon tumors and their management remains controversial. Despite gross total resection, recurrences can occur in 15-43% during long-term follow-up of more than 10 years. Furthermore, radical surgery can be associated with complications associated with hypothalamic damage, which can lead to a poor quality-of-life. Limited surgery followed by adjuvant radiotherapy (RT can provide excellent long-term tumor control with minimum complications and good functional outcome. RT can however, produce insidious onset of hypopituitarism and vasculopathy. Secondary malignancies are a rare complication of RT. Modern radiation techniques and intracystic radiation can reduce these complications. Intracystic radiation is highly effective for cystic craniopharyngiomas. Intracystic bleomycin (ICB and interferon alpha (IFN are rarely curative, but can produce long lasting control of tumor cysts and this is very useful in very young children who may not tolerate radical surgery or RT. IFN has fewer toxicity issues compared to ICB.

  17. Role of gamma knife radiosurgery in craniopharyngioma

    OpenAIRE

    Ashis Patnaik; Ashok Kumar Mahapatra

    2013-01-01

    Craniopharyngiomas continue to be a challenge to manage, due to difficulty in complete excision and frequent recurrences. The management protocol remains controversial. They have a tendency to invade the normal brain tissues around them and due to their position in suprasellar region in close relationship with vital structures like optic apparatus, pituitary-hypothalamic axis, complete removal is often not feasible without causing serious morbidity and mortality. In this scenario, sub-total e...

  18. Childhood Soft Tissue Sarcoma: Treatment Information

    Science.gov (United States)

    ... Kidney/Wilms Tumor Liver Cancer Lymphoma (Non-Hodgkin) Lymphoma (Hodgkin) Neuroblastoma Osteosarcoma Retinoblastoma Rhabdomyosarcoma Skin Cancer Soft Tissue Sarcoma Thyroid Cancer Understanding Children's Cancer Anxiety Around Procedures Childhood Cancer Statistics Late ...

  19. Childhood trauma and treatment outcome in bipolar disorder.

    Science.gov (United States)

    Cakir, Sibel; Tasdelen Durak, Rumeysa; Ozyildirim, Ilker; Ince, Ezgi; Sar, Vedat

    2016-01-01

    The aim of the present study was to investigate the potential influence of childhood trauma on clinical presentation, psychiatric comorbidity, and long-term treatment outcome of bipolar disorder. A total of 135 consecutive patients with bipolar disorder type I were recruited from an ongoing prospective follow-up project. The Childhood Trauma Questionnaire and the Structured Clinical Interview for DSM-IV Axis I Disorders were administered to all participants. Response to long-term treatment was determined from the records of life charts of the prospective follow-up project. There were no significant differences in childhood trauma scores between groups with good and poor responses to long-term lithium treatment. Poor responders to long-term anticonvulsant treatment, however, had elevated emotional and physical abuse scores. Lifetime diagnosis of posttraumatic stress disorder (PTSD) was associated with poor response to lithium treatment and antidepressant use but not with response to treatment with anticonvulsants. Total childhood trauma scores were related to the total number of lifetime comorbid psychiatric disorders, antidepressant use, and the presence of psychotic features. There were significant correlations between all types of childhood abuse and the total number of lifetime comorbid psychiatric diagnoses. Whereas physical neglect was related to the mean severity of the mood episodes and psychotic features, emotional neglect was related to suicide attempts. A history of childhood trauma or PTSD may be a poor prognostic factor in the long-term treatment of bipolar disorder. Whereas abusive experiences in childhood seem to lead to nosological fragmentation (comorbidity), childhood neglect tends to contribute to the severity of the mood episodes. PMID:26683845

  20. The superiority of conservative resection and adjuvant radiation for craniopharyngiomas.

    Science.gov (United States)

    Schoenfeld, Adam; Pekmezci, Melike; Barnes, Michael J; Tihan, Tarik; Gupta, Nalin; Lamborn, Kathleen R; Banerjee, Anu; Mueller, Sabine; Chang, Susan; Berger, Mitchel S; Haas-Kogan, Daphne

    2012-05-01

    The purpose of this study is to evaluate the roles of resection extent and adjuvant radiation in the treatment of craniopharyngiomas. We reviewed the records of 122 patients ages 11-52 years who received primary treatment for craniopharyngioma between 1980 and 2009 at the University of California, San Francisco (UCSF). Primary endpoints were progression free survival (PFS) and overall survival (OS). Secondary endpoints were development of panhypopituitarism, diabetes insipidus (DI), and visual field defects. Of 122 patients, 30 (24%) were treated with gross total resection (GTR) without radiation therapy (RT), 3 (3%) with GTR + RT, 41 (33.6%) with subtotal resection (STR) without RT, and 48 (39.3%) with STR + RT. Median age at diagnosis was 30 years, with 46 patients 18 years or younger. Median follow-up for all patients was 56.4 months (interquartile range 18.9-144.2 months) and 47 months (interquartile range 12.3-121.8 months) for the 60 patients without progression. Fifty six patients progressed, 10 have died, 6 without progression. Median PFS was 61.1 months for all patients. PFS rate at 2 years was 61.5% (95% CI: 52.1-70.9). OS rate at 10 years was 91.1% (95% CI 84.3-97.9). There was no significant difference in PFS and OS between patients treated with GTR vs. STR + XRT (PFS; p = 0.544, OS; p = 0.735), but STR alone resulted in significantly shortened PFS compared to STR + RT or GTR (p < 0.001 for both). STR was associated with significantly shortened OS compared to STR + RT (p = 0.050) and trended to shorter OS compared to GTR (p = 0.066). GTR was associated with significantly greater risk of developing DI (56.3 vs. 13.3% with STR + XRT, p < 0.001) and panhypopituitarism (54.8 vs. 26.7% with STR + XRT, p = 0.014). In conclusion, for patients with craniopharyngioma, STR + RT may provide superior clinical outcome, achieving better disease control than STR and limiting side effects associated with aggressive surgical resection. PMID:22350375

  1. Intracavitary Irradiation as a Safe Alternative for Cystic Craniopharyngiomas: Case Report and Review of the Literature

    Science.gov (United States)

    Enriquez-Marulanda, Alejandro; Sierra-Ruiz, Melibea; Pabón, Luz Maritza; Lobato-Polo, Javier

    2016-01-01

    Craniopharyngioma treatment remains a challenge for clinicians and patients. There are many treatment alternatives; however one of them (intracavitary irradiation) seeks to control this type of benign brain tumor using minimally invasive techniques, with the specific aim of avoiding causing significant damage to important structures surrounding the sellar/suprasellar region. We present the case of a 3-year-old patient with a predominantly cystic craniopharyngioma who underwent intracavitary irradiation by stereotactic placement. Using this approach, the patient showed a successful response with remission of headaches and hydrocephalus. A reduction in the size of the cyst was achieved, without deterioration of visual fields, with no hormonal supplementation being needed, and with no evidence of focal neurological signs. PMID:27366151

  2. Salmeterol in the treatment of childhood asthma

    NARCIS (Netherlands)

    A.A.P.H. Vaessen-Verberne (Anja)

    1997-01-01

    textabstractAsthma is the most common chronic disease of childhood. Although mortality rates in the Netherlands and other Western European countries are low, astlmm causes a great deal of morbidity and school absence. Incidence rates in our country are about 10% and recent epidemiologic studies show

  3. Pubertas praecox in craniopharyngioma. Case report.

    Science.gov (United States)

    Cabezudo, J M; Perez, C; Vaquero, J; Garcia-de-Sola, R; Bravo, G

    1981-07-01

    A case of craniopharyngioma associated with true precocious puberty is reported in a child operated on when she was 2 years and 8 months of age. Precocity was noted 10 months after operation and was fully documented 1 year later. A pneumoencephalogram showed a recurrence of tumor in the hypothalamic area. Hormonal therapy was instituted to stop sexual maturation. Reoperation was undertaken only when her visual symptoms reappeared. She received a postoperative course of radiotherapy. On last examination, she was neurologically well, and computerized tomography did not show further growth of the residual tumor. The diagnosis of precocious puberty and its etiology in this patient are discussed. PMID:7241202

  4. Hypothalamic Obesity in Craniopharyngioma Patients: Disturbed Energy Homeostasis Related to Extent of Hypothalamic Damage and Its Implication for Obesity Intervention

    Directory of Open Access Journals (Sweden)

    Christian L. Roth

    2015-09-01

    Full Text Available Hypothalamic obesity (HO occurs in patients with tumors and lesions in the medial hypothalamic region. Hypothalamic dysfunction can lead to hyperinsulinemia and leptin resistance. This review is focused on HO caused by craniopharyngiomas (CP, which are the most common childhood brain tumors of nonglial origin. Despite excellent overall survival rates, CP patients have substantially reduced quality of life because of significant long-term sequelae, notably severe obesity in about 50% of patients, leading to a high rate of cardiovascular mortality. Recent studies reported that both hyperphagia and decreased energy expenditure can contribute to severe obesity in HO patients. Recognized risk factors for severe obesity include large hypothalamic tumors or lesions affecting several medial and posterior hypothalamic nuclei that impact satiety signaling pathways. Structural damage in these nuclei often lead to hyperphagia, rapid weight gain, central insulin and leptin resistance, decreased sympathetic activity, low energy expenditure, and increased energy storage in adipose tissue. To date, most efforts to treat HO have shown disappointing long-term success rates. However, treatments based on the distinct pathophysiology of disturbed energy homeostasis related to CP may offer options for successful interventions in the future.

  5. [Dietetic indications for obesity treatment in childhood].

    Science.gov (United States)

    Miggiano, G A D; Santoro, C

    2004-10-01

    A growing organism needs to have a steady availability of nutrients, in suitable quantities and in correct ratios, in order to achieve its genetic potential. Overweight and obesity in growing individuals may conceal lack of one or more nutrients. Obesity in childhood is the consequence of an excess of calories compared with the energetic waste because of the interlacing of genetic factors, metabolic factors (cellularity of the adipose tissue, deficit of thermogenesis), excessive food intake, alteration of some neuro-endocrine mechanisms which regulate bodily weight (set point theory), lack of suitable physical exercise; therefore a complicity of endogenous, exogenous, biological, psychological and social factors to which we cannot ascribe singularly a primary role. It is however necessary to start, since the first year of a child's life, a food education program as the latest acquisition shows that degenerative pathologies of metabolism start in a very precocious age and unbalanced nutrition starts since childhood. The most suitable therapeutic approach is that which takes in consideration all the aspects of obesity. This requires an intervention on several aspects: food, psychological mechanisms which sometimes are the cause of hypernutrition, attitude towards physical exercise, and also family and social behaviors concerning the patient. The traditional diet approach towards childhood obesity is based on balanced hypochaloric diets which provide about 1200-1800 kcal per day, distributed in 4 or 5 daily meals. The correct meal division educates the child to self-control and it is advantageous from a metabolic point of view because it avoids both high instability of glyco-insulin, caused by an excess of food, and because improving thermogenesis, induced by the diet, the result will consist in an increase of energetic waste. For the main meals it is advantageous to apply to a main course. PMID:15702660

  6. Parkinsonism: a rare manifestation of craniopharyngioma.

    Science.gov (United States)

    Parvaresh, Mansour; Azar, Maziar; Ghalaenovi, Hossein; Fattahi, Arash

    2015-01-01

    Craniopharyngioma is a non-glial, non-malignant intracranial tumor of ectodermal origin, which arises from a remnant of Rathke's pouch. This tumor accounts for 5.6 to 13% of intracranial tumors in children. This paper discusses a case of craniopharyngioma in a five-year-old boy. An MRI scan of his brain showed a huge sella and supra sella cystic-solid lesion that had invaded the prepontine and interpeduncular cisterns, filling of 3rd ventricle and hydrocephalus. The patient operated via interhemispheric subfrontal through lamina terminalis and the tumor dissected from all part of brain stem and total resection achieved. After surgery Parkinsonism was worse for 3 days and levodopa started for 3 days. Parkinsonism was gone and after one week levodopa discontinued. This case practically implied that decompression of mass effect of tumor on brain stem and short-term management with levodopa can improve Parkinsonism due to midline compressive brain tumors without basal ganglia involvement. PMID:26120410

  7. Long-term disease control and toxicity outcomes following surgery and intensity modulated radiation therapy (IMRT) in pediatric craniopharyngioma

    International Nuclear Information System (INIS)

    Purpose: To report long-term progression-free survival (PFS) and late-toxicity outcomes in pediatric craniopharyngioma patients treated with IMRT. Patients and methods: Twenty-four children were treated with IMRT to a median dose of 50.4 Gy (range, 49.8–54 Gy). The clinical target volume (CTV) was the gross tumor volume (GTV) with a 1 cm margin. The planning target volume (PTV) was the CTV with a 3–5 mm margin. Median follow-up was 107.3 months. Results: The 5- and 10-year PFS rates were 65.8% and 60.7%. The 5- and 10-year cystic PFS rates were 70.2% and 65.2% while the 5- and 10-year solid PFS were the same at 90.7%. Endocrinopathy was seen in 42% at initial diagnosis and in 74% after surgical intervention, prior to IMRT. Hypothalamic dysfunction and visual deficits were associated with increasing PTV and number of surgical interventions. Conclusions: IMRT is a viable treatment option for pediatric craniopharyngioma. Despite the use of IMRT, majority of the craniopharyngioma patients experienced long-term toxicity, many of which present prior to radiotherapy. Limitations of retrospective analyses on small patient cohort elicit the need for a prospective multi-institutional study to determine the absolute benefit of IMRT in pediatric craniopharyngioma

  8. Improving Childhood Obesity Treatment Using New Technologies: The ETIOBE System.

    Science.gov (United States)

    Baños, Rosa M; Cebolla, Ausias; Botella, Cristina; García-Palacios, Azucena; Oliver, Elia; Zaragoza, Irene; Alcaniz, Mariano

    2011-01-01

    Childhood obesity is an increasing public health problem in western culture. Sedentary lifestyles and an "obesogenic environment" are the main influences on children leading to an increase in obesity. The objective of this paper is to describe an e-health platform for the treatment and prevention of childhood obesity called ETIOBE. This e-health platform is an e-therapy system for the treatment of obesity, aimed at improving treatment adherence and promoting the mechanisms of self-control in patients, to obtain weight loss maintenance and to prevent relapse by establishing healthy lifestyle habits. ETIOBE is composed of three different applications, the Clinician Support System (CSS), the Home Support System (HSS) and the Mobile Support System (MSS). The use of new Information and Communication (ICT) technologies can help clinicians to improve the effectiveness of weight loss treatments, especially in the case of children, and to achieve designated treatment goals. PMID:21559232

  9. Long term results after fractionated stereotactic radiotherapy (FSRT) in patients with craniopharyngioma: maximal tumor control with minimal side effects

    International Nuclear Information System (INIS)

    There are already numerous reports about high local control rates in patients with craniopharyngioma but there are only few studies with follow up times of more than 10 years. This study is an analysis of long term control, tumor response and side effects after fractionated stereotactic radiotherapy (FSRT) for patients with craniopharyngioma. 55 patients who were treated with FSRT for craniopharyngioma were analyzed. Median age was 37 years (range 6–70 years), among them eight children < 18 years. Radiotherapy (RT) was indicated for progressive disease after neurosurgical resection or postoperatively after repeated resection or partial resection. A median dose of 52.2 Gy (50 – 57.6 Gy) was applied with typical dose per fraction of 1.8 Gy five times per week. The regular follow up examinations comprised in addition to contrast enhanced MRI scans thorough physical examinations and clinical evaluation. During median follow up of 128 months (2 – 276 months) local control rate was 95.3% after 5 years, 92.1% after 10 years and 88.1% after 20 years. Overall survival after 10 years was 83.3% and after 20 years 67.8% whereby none of the deaths were directly attributed to craniopharyngioma. Overall treatment was tolerated well with almost no severe acute or chronic side effects. One patient developed complete anosmia, another one’s initially impaired vision deteriorated further. In 83.6% of the cases with radiological follow up a regression of irradiated tumor residues was monitored, in 7 cases complete response was achieved. 44 patients presented themselves initially with endocrinologic dysfunction none of them showed signs of further deterioration during follow up. No secondary malignancies were observed. Long term results for patients with craniopharyngioma after stereotactic radiotherapy are with respect to low treatment related side effects as well as to local control and overall survival excellent

  10. Glucocorticoid Treatment in Childhood Nephrotic Syndrome : weighting the cornerstone

    NARCIS (Netherlands)

    N. Teeninga (Nynke)

    2013-01-01

    textabstractUnderstanding which factors influence relapse patterns in childhood nephrotic syndrome is clinically very relevant and could aid in developing new treatment strategies. Clinicians are continuously challenged to reduce relapse rates and at the same time to avoid glucocorticoid toxicity. B

  11. Second Malignant Neoplasms After Treatment of Childhood Acute Lymphoblastic Leukemia

    DEFF Research Database (Denmark)

    Schmiegelow, K.; Levinsen, Mette Frandsen; Attarbaschi, Andishe;

    2013-01-01

    PURPOSE: Second malignant neoplasms (SMNs) after diagnosis of childhood acute lymphoblastic leukemia (ALL) are rare events. PATIENTS AND METHODS: We analyzed data on risk factors and outcomes of 642 children with SMNs occurring after treatment for ALL from 18 collaborative study groups between 1980...

  12. Secondary osteosarcoma arising after treatment for childhood hematologic malignancies

    OpenAIRE

    Okada, Atsushi; Hatori, Masahito; Hosaka, Masami; Watanuki, Munenori; Itoi, Eiji

    2009-01-01

    Secondary osteosarcoma arising after the treatment of hematologic malignancies other than Hodgkin's lymphoma is rare. We report two cases of secondary osteosarcoma arising after treatment for childhood hematologic malignancies (non-Hodgkin's lymphoma and lymphoblastic leukemia). A 10-year-old boy, at the age of 3, was diagnosed with non-Hodgkin's lymphoma. He received chemotherapy, radiation, and bone-marrow transplantation and then was in complete remission. At 6 years, he complained of incr...

  13. Radiotherapeutic results in the management of craniopharyngioma

    International Nuclear Information System (INIS)

    From 1974 to 1985, twelve patients (seven children and five adults) with craniopharyngioma received megavoltage external beam radiation therapy at the University of Heidelberg. All patients had biopsy proven diagnosis. Nine patients received irradiation after incomplete surgical removal. Three patients were irradiated primary because of inoperability. In all cases irradiation was applied by a rotation technique with 42 MeV photons. A mean dose of 52.2 Gy (ranged from 46 yo 60 Gy) was administered at 2.0 Gy per fraction. In one case radiotherapy was broken off on account of the development of a hyperglycemic coma of unknown genesis. The mean follow-up period amounts nine years up to now. Local tumor control was achieved in nine patients. Two deaths occurred from tumor progression, after temporary improvement. In all cases no radiation related neurological, ophthalmological or endocrine side ffects were observed. (orig.)

  14. Stroke in Childhood and New Treatment Modalities

    OpenAIRE

    Ozlem Herguner

    2003-01-01

    The risk factors for stroke in chidren are very different from those leading to stroke in adults. In recent years, several potential treatments for various specific stroke syndromes have been made. In this article, the risk factors and new treatment modalities for stroke in children and adolescents are reviewed. [Archives Medical Review Journal 2003; 12(3.000): 177-198

  15. Stroke in Childhood and New Treatment Modalities

    OpenAIRE

    Hergüner, Özlem

    2003-01-01

    The risk factors for stroke in chidren are very different from those leading to stroke in adults. In recent years, several potential treatments for various specific stroke syndromes have been made. In this article, the risk factors and new treatment modalities for stroke in children and adolescents are reviewed.

  16. Parental Infertility, Fertility Treatment, and Childhood Epilepsy

    DEFF Research Database (Denmark)

    Kettner, Laura O; Ramlau-Hansen, Cecilia H; Kesmodel, Ulrik S;

    2016-01-01

    BACKGROUND: A few studies have indicated an increased risk of epilepsy in children conceived by fertility treatment possibly due to characteristics of the infertile couple rather than the treatment. We therefore aimed to investigate the association between parental infertility, fertility treatment......, and epilepsy in the offspring, including the subtypes of epilepsy; idiopathic generalised epilepsy and focal epilepsy. METHODS: This cohort included all pregnancies resulting in liveborn singletons from the Aarhus Birth Cohort, Denmark (1995-2013). Information on time to pregnancy and fertility...... treatment was obtained from pregnancy questionnaires in early pregnancy. Children developing epilepsy were identified from the Danish National Patient Register and the Danish National Prescription Registry until 2013. Data were analysed using Cox proportional hazards regression adjusted for potential...

  17. Treatment Option Overview (Childhood Soft Tissue Sarcoma)

    Science.gov (United States)

    ... Stage I Stage I is divided into stages IA and IB: In stage IA , the tumor is low grade (likely to grow ... tumor does not place any vital organs in danger. Hormone therapy Hormone therapy is a cancer treatment ...

  18. Treatment Options for Childhood Soft Tissue Sarcoma

    Science.gov (United States)

    ... Stage I Stage I is divided into stages IA and IB: In stage IA , the tumor is low grade (likely to grow ... tumor does not place any vital organs in danger. Hormone therapy Hormone therapy is a cancer treatment ...

  19. Behavioral Treatment for Common Childhood Problems

    OpenAIRE

    Hodson, Gary; Mathews, Judith R.; MacDonald, G. Wayne; McNeill, Gillian; Grantmyre, Jane

    1984-01-01

    Parents often consult family physicians about child rearing, child development, and school-related problems. Behavioral treatment is one method of dealing with such concerns. It involves identifying problems with a child's behavior, working to resolve them by rewarding desirable behavior and withholding rewards for undesirable behavior, and evaluating the outcome. Before treatment begins, it is necessary to establish that the parents feel the child's behavior is a problem; that the child can ...

  20. Long-Term Outcomes and Complications in Patients With Craniopharyngioma: The British Columbia Cancer Agency Experience

    Energy Technology Data Exchange (ETDEWEB)

    Lo, Andrea C., E-mail: andrealo@gmail.com [Department of Radiation Oncology, British Columbia Cancer Agency Vancouver Centre, Vancouver, British Columbia (Canada); Department of Surgery, University of British Columbia, Vancouver, British Columbia (Canada); Howard, A. Fuchsia [School of Population and Public Health, University of British Columbia, Vancouver, British Columbia (Canada); Nichol, Alan; Sidhu, Keerat; Abdulsatar, Farah [Department of Radiation Oncology, British Columbia Cancer Agency Vancouver Centre, Vancouver, British Columbia (Canada); Department of Surgery, University of British Columbia, Vancouver, British Columbia (Canada); Hasan, Haroon [Department of Radiation Oncology, British Columbia Cancer Agency Vancouver Centre, Vancouver, British Columbia (Canada); Goddard, Karen [Department of Radiation Oncology, British Columbia Cancer Agency Vancouver Centre, Vancouver, British Columbia (Canada); Department of Surgery, University of British Columbia, Vancouver, British Columbia (Canada)

    2014-04-01

    Purpose: We report long-term outcomes and complications of craniopharyngioma patients referred to our institution. Methods and Materials: Between 1971 and 2010, 123 consecutive patients received primary treatment for craniopharyngioma in British Columbia and were referred to our institution. The median age was 30 years (range, 2-80 years). Thirty-nine percent of patients were treated primarily with subtotal resection (STR) and radiation therapy (RT), 28% with STR alone, 15% with gross total resection, 11% with cyst drainage (CD) alone, 5% with CD+RT, and 2% with RT alone. Eight percent of patients received intracystic bleomycin (ICB) therapy. Results: Median follow-up was 8.9 years, and study endpoints were reported at 10 years. Ten-year Kaplan-Meier progression-free survival (PFS) was 46%. Patients treated with STR+RT or CD+RT had the highest PFS (82% and 83%, respectively). There were no significant differences between PFS after adjuvant versus salvage RT (84% vs 74%, respectively; P=.6). Disease-specific survival (DSS) was 88%, and overall survival (OS) was 80%. Primary treatment modality did not affect DSS or OS, while older age was a negative prognostic factor for OS but not DSS. Kaplan-Meier rates for visual deterioration, anterior pituitary hormone deficiency, diabetes insipidus, seizure disorder, and cerebrovascular events (CVE) due to treatment, not tumor progression, were 27%, 76%, 45%, 16%, and 11%, respectively. The CVE rate was 29% in patients who received ICB compared to 10% in those who did not (P=.07). Conclusions: We report favorable PFS in patients with craniopharyngioma, especially in those who received RT after surgery. DSS and OS rates were excellent regardless of primary treatment modality. We observed a high incidence of hypopituitarism, visual deterioration, and seizure disorder. Eleven percent of patients experienced CVEs after treatment. There was a suggestion of increased CVE risk in patients treated with ICB.

  1. Long-Term Outcomes and Complications in Patients With Craniopharyngioma: The British Columbia Cancer Agency Experience

    International Nuclear Information System (INIS)

    Purpose: We report long-term outcomes and complications of craniopharyngioma patients referred to our institution. Methods and Materials: Between 1971 and 2010, 123 consecutive patients received primary treatment for craniopharyngioma in British Columbia and were referred to our institution. The median age was 30 years (range, 2-80 years). Thirty-nine percent of patients were treated primarily with subtotal resection (STR) and radiation therapy (RT), 28% with STR alone, 15% with gross total resection, 11% with cyst drainage (CD) alone, 5% with CD+RT, and 2% with RT alone. Eight percent of patients received intracystic bleomycin (ICB) therapy. Results: Median follow-up was 8.9 years, and study endpoints were reported at 10 years. Ten-year Kaplan-Meier progression-free survival (PFS) was 46%. Patients treated with STR+RT or CD+RT had the highest PFS (82% and 83%, respectively). There were no significant differences between PFS after adjuvant versus salvage RT (84% vs 74%, respectively; P=.6). Disease-specific survival (DSS) was 88%, and overall survival (OS) was 80%. Primary treatment modality did not affect DSS or OS, while older age was a negative prognostic factor for OS but not DSS. Kaplan-Meier rates for visual deterioration, anterior pituitary hormone deficiency, diabetes insipidus, seizure disorder, and cerebrovascular events (CVE) due to treatment, not tumor progression, were 27%, 76%, 45%, 16%, and 11%, respectively. The CVE rate was 29% in patients who received ICB compared to 10% in those who did not (P=.07). Conclusions: We report favorable PFS in patients with craniopharyngioma, especially in those who received RT after surgery. DSS and OS rates were excellent regardless of primary treatment modality. We observed a high incidence of hypopituitarism, visual deterioration, and seizure disorder. Eleven percent of patients experienced CVEs after treatment. There was a suggestion of increased CVE risk in patients treated with ICB

  2. Recommendations for treatment of childhood non-severe pneumonia.

    Science.gov (United States)

    Grant, Gavin B; Campbell, Harry; Dowell, Scott F; Graham, Stephen M; Klugman, Keith P; Mulholland, E Kim; Steinhoff, Mark; Weber, Martin W; Qazi, Shamim

    2009-03-01

    WHO recommendations for early antimicrobial treatment of childhood pneumonia have been effective in reducing childhood mortality, but the last major revision was over 10 years ago. The emergence of antimicrobial resistance, new pneumonia pathogens, and new drugs have prompted WHO to assemble an international panel to review the literature on childhood pneumonia and to develop evidence-based recommendations for the empirical treatment of non-severe pneumonia among children managed by first-level health providers. Treatment should target the bacterial causes most likely to lead to severe disease, including Streptoccocus pneumoniae and Haemophilus influenzae. The best first-line agent is amoxicillin, given twice daily for 3-5 days, although co-trimoxazole may be an alternative in some settings. Treatment failure should be defined in a child who develops signs warranting immediate referral or who does not have a decrease in respiratory rate after 48-72 h of therapy. If failure occurs, and no indication for immediate referral exists, possible explanations for failure should be systematically determined, including non-adherence to therapy and alternative diagnoses. If failure of the first-line agent remains a possible explanation, suitable second-line agents include high-dose amoxicillin-clavulanic acid with or without an affordable macrolide for children over 3 years of age. PMID:19246022

  3. Factors contributing to poor treatment outcomes in childhood atopic dermatitis.

    Science.gov (United States)

    Sokolova, Anna; Smith, Saxon D

    2015-11-01

    Atopic dermatitis (AD) is a chronic relapsing inflammatory disease of the skin and is the most common paediatric dermatological condition. While no cure is available, it can be treated effectively if adherence to a therapeutic plan is maintained. Poor adherence to treatment is common in AD and can lead to treatment failure, which has significant impacts on the patient, family and society. A comprehensive literature search was conducted to identify factors that contribute to poor treatment adherence in childhood AD and to identify possible strategies to remedy these. Identified factors leading to poor treatment adherence include: complexity of treatment regimen, lack of knowledge, impaired quality of life, dissatisfaction with treatment strategies, infrequent follow up, corticosteroid phobia and the use of complementary and alternative medicine. Effective strategies to increase treatment adherence include: caregiver education and utilisation of education adjuncts, optimisation of the patient/caregiver-clinician relationship, early and frequent follow up and improvement of patient and caregiver quality of life. PMID:25817780

  4. Clonazepam Treatment of Pathologic Childhood Aerophagia with Psychological Stresses

    OpenAIRE

    Hwang, Jin-Bok; Kim, Jun Sik; Ahn, Byung Hoon; Jung, Chul-Ho; Lee, Young Hwan; Kam, Sin

    2007-01-01

    The treatment of pathologic aerophagia has rarely been discussed in the literature. In this retrospective study, the authors investigated the effects of clonazepam on the management of pathologic childhood aerophagia (PCA) with psychological stresses (PS), but not with mental retardation. Data from 22 consecutive PCA patients with PS (aged 2 to 10 yr), who had been followed up for over 1 yr, were reviewed. On the basis of videolaryngoscopic views, the authors observed that the pathologyof aer...

  5. Early childhood educators' recognition and treatment of violence against children

    OpenAIRE

    Pogačar, Monika

    2015-01-01

    The thesis analyses violence against children and early childhood educators' recognition of violence against children and their treatment. The theoretical part defines different types of violence which are: physical, mental, and sexual violence, child neglect, and economic violence. Definitions as well as signs of a certain type of violence are presented. The author also describes the role of practitioners in recognition of violence against children and the legislation that defines their ...

  6. The Behavioral Treatment of Childhood Nocturnal Enuresis.

    Science.gov (United States)

    Wagner, William G.

    1987-01-01

    Notes that of the treatments attempted for nocturnal enuresis, pharmacotherapy, individual psychotherapy, and behavioral conditioning, the most effective is behavioral conditioning with a urine alarm. Reviews the enuresis literature and provides recommendations for use of the urine alarm approach. (Author/ABB)

  7. Challenges and New Treatment in Childhood Constipation

    Directory of Open Access Journals (Sweden)

    M Sobhani Shahmirzadi

    2014-04-01

    Full Text Available Chronic Constipation is a debilitating condition that is often associated with different abdominal problem. It can cause distress for the child and family and can result in emotional disturbance and family problem. Based on the current algorhytm, the treatment of chronic constipation consists of 4 important phases, 1: education, 2: disimpaction, 3: prevention of re-accumulation of feces and 4: follow up. Challenges in treatment are related to many issues: a    Discussing the importance of problem for parents, b    Family concern about safety and side effects of drugs, c    Adherence to long term treatment, which is often crucial but unacceptable by family, d    Amelioration of withdrawal behavior in toddlers group which don’t understand the facts, e    Planning a appropriate diet for constipation which is again unacceptable by children, f     Cost of treatment g    Anismus Besides of known treatment consist of various drugs:   Biofeedback is one of the approaches that have proven benefits but with less emphasis and introduction, so application of this obsolete method needs further works. Tegaserod, a selective agonist that acts at 5-HT4 receptors and increases small bowel transit, stimulates intestinal secretion and inhibits visceral afferent responses has proven effective in the treatment of chronic constipation in adults.  In children with hard stools, 5-HT4 agonist might benefit children with constipation and tendency to form hard stools, and large rectal masses. The role of this promising new agent in pediatric constipation has to be established in future studies. Pre and Probiotics:  Non-digestible oligosaccharides consist mainly of fructooligosaccharides (FOS. FOS reduces fecal pH, increases the water, holding capacity of stool and fecal weight and decreases intestinal transit time. Furthermore, it has prebiotic effects by selectively stimulating the growth of probiotics bacteria, such as bifidobacteria. Surgery

  8. Behavioral treatment for common childhood problems.

    Science.gov (United States)

    Hodson, G; Mathews, J R; Macdonald, G W; McNeill, G; Grantmyre, J

    1984-01-01

    Parents often consult family physicians about child rearing, child development, and school-related problems. Behavioral treatment is one method of dealing with such concerns. It involves identifying problems with a child's behavior, working to resolve them by rewarding desirable behavior and withholding rewards for undesirable behavior, and evaluating the outcome. Before treatment begins, it is necessary to establish that the parents feel the child's behavior is a problem; that the child can voluntarily control the behavior; that at least one parent or primary caretaker can benefit from instruction in how to modify behavior, and that the behavior to be changed is not just one facet of a larger family problem. Both parents and physicians may find self-help books and printed handouts very useful. Referral to specialized services may be appropriate for complex or recalcitrant problems. PMID:21283501

  9. On the Benefits and Risks of Proton Therapy in Pediatric Craniopharyngioma

    International Nuclear Information System (INIS)

    Purpose: Craniopharyngioma is a pediatric brain tumor whose volume is prone to change during radiation therapy. We compared photon- and proton-based irradiation methods to determine the effect of tumor volume change on target coverage and normal tissue irradiation in these patients. Methods and Materials: For this retrospective study, we acquired imaging and treatment-planning data from 14 children with craniopharyngioma (mean age, 5.1 years) irradiated with photons (54 Gy) and monitored by weekly magnetic resonance imaging (MRI) examinations during radiation therapy. Photon intensity-modulated radiation therapy (IMRT), double-scatter proton (DSP) therapy, and intensity-modulated proton therapy (IMPT) plans were created for each patient based on his or her pre-irradiation MRI. Target volumes were contoured on each weekly MRI scan for adaptive modeling. The measured differences in conformity index (CI) and normal tissue doses, including functional sub-volumes of the brain, were compared across the planning methods, as was target coverage based on changes in target volumes during treatment. Results: CI and normal tissue dose values of IMPT plans were significantly better than those of the IMRT and DSP plans (p 3, and the mean increase in PTV was 11.3% over the course of treatment. The dose to 95% of the PTV was correlated with a change in the PTV; the R2 values for all models, 0.73 (IMRT), 0.38 (DSP), and 0.62 (IMPT), were significant (p < 0.01). Conclusions: Compared with photon IMRT, proton therapy has the potential to significantly reduce whole-brain and -body irradiation in pediatric patients with craniopharyngioma. IMPT is the most conformal method and spares the most normal tissue; however, it is highly sensitive to target volume changes, whereas the DSP method is not.

  10. Radium treatment for hemangioma in early childhood

    International Nuclear Information System (INIS)

    Between 1920 and 1959, a total of 14 647 children younger than 18 months were treated at Radiumhemmet with ionizing radiation for skin hemangioma. Seventy-two percent of the children were treated with radium needles or tubes, which were put into glass capsules and then applied to the hemangioma. The absorbed doses to different organs have been measured in a tissue equivalent phantom, representing a 6-month-old child. For a standard treatment of 8 Gy to the hemangioma the mean absorbed doses to the brain, eye lens, parotid gland, thyroid, breast anlage and gonads from 28 different treatment areas were 0.03-0.2 Gy. The mean absorbed dose to the organs in younger (<2 months) and older (14-18 months) children were up to 50% higher (0.04-0.1 Gy) and 33% lower (0.02-0.06 Gy) respectively, than for a 6-month-old child. The uncertainty in organ absorbed doses for each patient depended mostly on the estimation of the distance between the applicator and the site. (orig.)

  11. Early loss of teeth after treatment for childhood leukemia

    International Nuclear Information System (INIS)

    Background: only few reports of effects of radiotherapy in childhood on the dental apparatus are available in the literature. The basis for early loss of teeth appears to be a reduction of the root surface area after radiation exposure. These effects in the periodontium are a consequence of combined radiochemotherapy usually applied for treatment of childhood neoplasia. Chemotherapy alone also results in changes of periodontal development. Case report: a 33-year-old patient is reported, who, at the age of 11 years, received high-dose chemotherapy and radiotherapy of neuroaxis and cranium for acute lymphatic leukemia with relapse. The patient consulted the Implant Section of the Department of Oral and Maxillofacial Surgery because of severe dental changes and tooth loss despite adequate dental care and oral hygiene. Radiation doses given to the superior maxilla and mandible at the age of 11 were estimated to be in the range of 8-25 Gy. Conclusion: intense, life-long dental care and follow-up of patients cured from malignant disease in childhood must hence be postulated in order to minimize dental treatment sequelae by supportive measures, but also to initiate timely adequate dental and prosthetic management. (orig.)

  12. Late Effects of Treatment for Childhood Cancer (PDQ)

    Science.gov (United States)

    ... healthy liver are important for survivors of childhood cancer. Pancreas Radiation therapy increases the risk of pancreatic late ... are important for survivors of childhood cancer. Childhood cancer survivors with liver ... Pancreas Radiation therapy increases the risk of pancreatic late ...

  13. Learning and Memory Following Conformal Radiation Therapy for Pediatric Craniopharyngioma and Low-Grade Glioma

    International Nuclear Information System (INIS)

    Purpose: The primary objective of this study was to examine whether children with low-grade glioma (LGG) or craniopharyngioma had impaired learning and memory after conformal radiation therapy (CRT). A secondary objective was to determine whether children who received chemotherapy before CRT, a treatment often used to delay radiation therapy in younger children with LGG, received any protective benefit with respect to learning. Methods and Materials: Learning and memory in 57 children with LGG and 44 children with craniopharyngioma were assessed with the California Verbal Learning Test–Children's Version and the Visual-Auditory Learning tests. Learning measures were administered before CRT, 6 months later, and then yearly for a total of 5 years. Results: No decline in learning scores after CRT was observed when patients were grouped by diagnosis. For children with LGG, chemotherapy before CRT did not provide a protective effect on learning. Multiple regression analyses, which accounted for age and tumor volume and location, found that children treated with chemotherapy before CRT were at greater risk of decline on learning measures than those treated with CRT alone. Variables predictive of learning and memory decline included hydrocephalus, shunt insertion, younger age at time of treatment, female gender, and pre-CRT chemotherapy. Conclusions: This study did not reveal any impairment or decline in learning after CRT in overall aggregate learning scores. However, several important variables were found to have a significant effect on neurocognitive outcome. Specifically, chemotherapy before CRT was predictive of worse outcome on verbal learning in LGG patients. In addition, hydrocephalus and shunt insertion in craniopharyngioma were found to be predictive of worse neurocognitive outcome, suggesting a more aggressive natural history for those patients.

  14. Learning and Memory Following Conformal Radiation Therapy for Pediatric Craniopharyngioma and Low-Grade Glioma

    Energy Technology Data Exchange (ETDEWEB)

    Di Pinto, Marcos [Department of Pediatric Psychology, Children' s Hospital of Orange County, Orange, California (United States); Conklin, Heather M. [Department of Psychology, St. Jude Children' s Research Hospital, Memphis, Tennessee (United States); Li, Chenghong [Department of Biostatistics, St. Jude Children' s Research Hospital, Memphis, Tennessee (United States); Merchant, Thomas E., E-mail: thomas.merchant@stjude.org [Division of Radiation Oncology, St. Jude Children' s Research Hospital, Memphis, Tennessee (United States)

    2012-11-01

    Purpose: The primary objective of this study was to examine whether children with low-grade glioma (LGG) or craniopharyngioma had impaired learning and memory after conformal radiation therapy (CRT). A secondary objective was to determine whether children who received chemotherapy before CRT, a treatment often used to delay radiation therapy in younger children with LGG, received any protective benefit with respect to learning. Methods and Materials: Learning and memory in 57 children with LGG and 44 children with craniopharyngioma were assessed with the California Verbal Learning Test-Children's Version and the Visual-Auditory Learning tests. Learning measures were administered before CRT, 6 months later, and then yearly for a total of 5 years. Results: No decline in learning scores after CRT was observed when patients were grouped by diagnosis. For children with LGG, chemotherapy before CRT did not provide a protective effect on learning. Multiple regression analyses, which accounted for age and tumor volume and location, found that children treated with chemotherapy before CRT were at greater risk of decline on learning measures than those treated with CRT alone. Variables predictive of learning and memory decline included hydrocephalus, shunt insertion, younger age at time of treatment, female gender, and pre-CRT chemotherapy. Conclusions: This study did not reveal any impairment or decline in learning after CRT in overall aggregate learning scores. However, several important variables were found to have a significant effect on neurocognitive outcome. Specifically, chemotherapy before CRT was predictive of worse outcome on verbal learning in LGG patients. In addition, hydrocephalus and shunt insertion in craniopharyngioma were found to be predictive of worse neurocognitive outcome, suggesting a more aggressive natural history for those patients.

  15. Incidence of craniopharyngioma in Denmark (n = 189) and estimated world incidence of craniopharyngioma in children and adults

    DEFF Research Database (Denmark)

    Nielsen, Eigil Husted; Feldt-Rasmussen, Ulla; Poulsgaard, Lars;

    2011-01-01

    Registry, the Danish Cancer Registry and regional registries. Medical records were reviewed. Danish population data were obtained from Statistics Denmark. European and World population data were obtained from EU and WHO homepages. Prior studies providing data on craniopharyngioma IRs were identified via...... PubMed and, if appropriate, were included in a weighted analysis estimating overall and children's IRs of craniopharyngioma. IRs are given as new cases per million per year. We identified 189 patients with new verified (162) or probable craniopharyngioma. The overall WHO World-standardised incidence...... rate was 1.86 (1.60-2.14) for all ages and 2.14 (1.53-2.92) for children (age...

  16. Pharmacogenetics Influence Treatment Efficacy in Childhood Acute Lymphoblastic Leukemia

    DEFF Research Database (Denmark)

    Devidsen, M.L.; Dalhoff, K.; Schmiegelow, K.

    2008-01-01

    Pharmacogenetics covers the genetic variation affecting pharmacokinetics and pharmacodynamics. and their influence on drug-response phenotypes. The genetic variation includes an estimated 15 million single nucleotide polymorphisms (SNP) and is a key determinator for the interindividual differences...... treatment response. In the future, high-throughput, low-cost, genetic platforms will allow screening of hundreds or thousands of targeted SNPs to give a combined gene-dosage effect ( = individual SNP risk profile), which may allow pharmacogenetic-based individualization of treatment Udgivelsesdato: 2008/11...... in treatment resistance and toxic side effects. As most childhood acute lymphoblastic leukemia treatment protocols include up to 13 different chemotherapeutic agents, the impact of individual SNPs has been difficult to evaluate. So far Focus has mainly been on the widely used glucocorticosteroids...

  17. External beam irradiation of craniopharyngiomas: long-term analysis of tumor control and morbidity

    International Nuclear Information System (INIS)

    Purpose: To delineate the long-term control and morbidity with external beam radiotherapy (EBRT) of craniopharyngiomas. Methods and Materials: Between 1971 and 1992, 24 craniopharyngioma patients underwent EBRT at the University of Pittsburgh. Most (19 of 24) were treated within 1-3 months after subtotal resection. The other prior surgical procedures were biopsy (n = 2) and gross total resection (n = 1); 2 patients did not undergo any surgical procedure. The median follow-up was 12.1 years. The median patient age was 29 years (range 5-69). The total radiation doses varied from 36 to 70 Gy (median 59.75). The normalized total dose (NTD, biologically equivalent dose given in 2 Gy/fraction [α/β ratio = 2]) varied from 28 to 83 Gy (median 55.35). Results: The actuarial survival rate at 10 and 20 years was 100% and 92.3%, respectively. The actuarial local control rate at 10 and 20 years was 89.1% and 54.0%, respectively. No local failures occurred with doses ≥60 Gy (n=12) or NTDs ≥55 Gy. The complication-free survival rate at 10 and 20 years was 80.1% and 72.1%, respectively. No complications were noted with an NTD of ≤55 Gy. The actuarial survival free from any adverse outcome (recurrence or complication) was 70.1% and 31.8% at 10 and 20 years, respectively. The adverse outcome-free survival appeared optimized (at 73%) with an NTD of 55-63 Gy. Multivariate analysis found that tumor control correlated significantly with the total dose (p=0.02), treatment complications with NTD (p=0.008), and adverse outcome with hypopituitarism on presentation (p=0.03). Conclusion: We recommend treating craniopharyngioma with 1.6-1.7-Gy dose fractions to 60 Gy to optimize outcome from EBRT

  18. Effects of Surgery and Proton Therapy on Cerebral White Matter of Craniopharyngioma Patients

    International Nuclear Information System (INIS)

    Purpose: The purpose of this study was to determine radiation dose effect on the structural integrity of cerebral white matter in craniopharyngioma patients receiving surgery and proton therapy. Methods and Materials: Fifty-one patients (2.1-19.3 years of age) with craniopharyngioma underwent surgery and proton therapy in a prospective therapeutic trial. Anatomical magnetic resonance images acquired after surgery but before proton therapy were inspected to identify white matter structures intersected by surgical corridors and catheter tracks. Longitudinal diffusion tensor imaging (DTI) was performed to measure microstructural integrity changes in cerebral white matter. Fractional anisotropy (FA) derived from DTI was statistically analyzed for 51 atlas-based white matter structures of the brain to determine radiation dose effect. FA in surgery-affected regions in the corpus callosum was compared to that in its intact counterpart to determine whether surgical defects affect radiation dose effect. Results: Surgical defects were seen most frequently in the corpus callosum because of transcallosal resection of tumors and insertion of ventricular or cyst catheters. Longitudinal DTI data indicated reductions in FA 3 months after therapy, which was followed by a recovery in most white matter structures. A greater FA reduction was correlated with a higher radiation dose in 20 white matter structures, indicating a radiation dose effect. The average FA in the surgery-affected regions before proton therapy was smaller (P=.0001) than that in their non–surgery-affected counterparts with more intensified subsequent reduction of FA (P=.0083) after therapy, suggesting that surgery accentuated the radiation dose effect. Conclusions: DTI data suggest that mild radiation dose effects occur in patients with craniopharyngioma receiving surgery and proton therapy. Surgical defects present at the time of proton therapy appear to accentuate the radiation dose effect longitudinally

  19. Effects of Surgery and Proton Therapy on Cerebral White Matter of Craniopharyngioma Patients

    Energy Technology Data Exchange (ETDEWEB)

    Uh, Jinsoo, E-mail: jinsoo.uh@stjude.org [Department of Radiological Sciences, St Jude Children' s Research Hospital, Memphis, Tennessee (United States); Merchant, Thomas E. [Department of Radiological Sciences, St Jude Children' s Research Hospital, Memphis, Tennessee (United States); Li, Yimei; Li, Xingyu [Department of Biostatistics, St Jude Children' s Research Hospital, Memphis, Tennessee (United States); Sabin, Noah D. [Department of Radiological Sciences, St Jude Children' s Research Hospital, Memphis, Tennessee (United States); Indelicato, Daniel J. [Department of Radiation Oncology, University of Florida, Jacksonville, Florida (United States); Ogg, Robert J. [Department of Radiological Sciences, St Jude Children' s Research Hospital, Memphis, Tennessee (United States); Boop, Frederick A. [Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee (United States); Jane, John A. [Department of Neurosurgery, University of Virginia, Charlottesville, Virginia (United States); Hua, Chiaho [Department of Radiological Sciences, St Jude Children' s Research Hospital, Memphis, Tennessee (United States)

    2015-09-01

    Purpose: The purpose of this study was to determine radiation dose effect on the structural integrity of cerebral white matter in craniopharyngioma patients receiving surgery and proton therapy. Methods and Materials: Fifty-one patients (2.1-19.3 years of age) with craniopharyngioma underwent surgery and proton therapy in a prospective therapeutic trial. Anatomical magnetic resonance images acquired after surgery but before proton therapy were inspected to identify white matter structures intersected by surgical corridors and catheter tracks. Longitudinal diffusion tensor imaging (DTI) was performed to measure microstructural integrity changes in cerebral white matter. Fractional anisotropy (FA) derived from DTI was statistically analyzed for 51 atlas-based white matter structures of the brain to determine radiation dose effect. FA in surgery-affected regions in the corpus callosum was compared to that in its intact counterpart to determine whether surgical defects affect radiation dose effect. Results: Surgical defects were seen most frequently in the corpus callosum because of transcallosal resection of tumors and insertion of ventricular or cyst catheters. Longitudinal DTI data indicated reductions in FA 3 months after therapy, which was followed by a recovery in most white matter structures. A greater FA reduction was correlated with a higher radiation dose in 20 white matter structures, indicating a radiation dose effect. The average FA in the surgery-affected regions before proton therapy was smaller (P=.0001) than that in their non–surgery-affected counterparts with more intensified subsequent reduction of FA (P=.0083) after therapy, suggesting that surgery accentuated the radiation dose effect. Conclusions: DTI data suggest that mild radiation dose effects occur in patients with craniopharyngioma receiving surgery and proton therapy. Surgical defects present at the time of proton therapy appear to accentuate the radiation dose effect longitudinally

  20. Food Allergy in childhood: phenotypes, prevention and treatment.

    Science.gov (United States)

    Sánchez-García, Silvia; Cipriani, Francesca; Ricci, Giampaolo

    2015-12-01

    The prevalence of food allergy in childhood increased in the last decades, especially in Westernized countries where this phenomenon has been indicated as a second wave of the allergic epidemic. In parallel, scientific interest also increased with the effort to explain the reasons of this sudden rise and to identify potential protective and risk factors. A great attention has been focused on early exposures to allergenic foods, as well as on other nutritional factors or supplements that may influence the immune system in a positive direction. Both interventions on maternal diet before birth or during breastfeeding and then directly on infant nutrition have been investigated. Furthermore, the natural history of food allergy also seems to be changing over time; IgE-mediated cow's milk allergy and egg allergy seem to be more frequently a persistent rather than a transient disease in childhood, as described in the last years. Food avoidance and the emergency drugs in case of an adverse event, such as epinephrine self-injector, are currently the first-line treatment in patients with food allergies, with a resulting impairment in the quality of life and social behaviour. During the last decade, oral immunotherapy emerged as an optional treatment with remarkable results, offering a novel perspective in the treatment for and management of food allergy. PMID:26595763

  1. Randomized controlled trial of a good practice approach to treatment of childhood obesity in Malaysia: Malaysian childhood obesity treatment trial (MASCOT)

    OpenAIRE

    Wafa, S.W.; Talib, R.A.; Hamzaid, N.H.; McColl, J. H.; Rajikan, R.; Ng, L.O.; Ramli, A.H.; Reilly, J J

    2011-01-01

    Context. Few randomized controlled trials (RCTs) of interventions for the treatment of childhood obesity have taken place outside the Western world. Aim. To test whether a good practice intervention for the treatment of childhood obesity would have a greater impact on weight status and other outcomes than a control condition in Kuala Lumpur, Malaysia. Methods. Assessor-blinded RCT of a treatment intervention in 107 obese 7- to 11-year olds. The intervention was relatively low intensity (8 hou...

  2. Experiences with radiation treatment of soft tissue tumours in childhood

    International Nuclear Information System (INIS)

    The authors review the trends in the treatment of soft tissue tumours in childhood mainly after radiation treatment which is an integral part of the combined therapy. During the last 9 years 23 children with soft tissue tumours were treated with radiotherapy. It was found that in this type of tumours only moderate results could be achieved. This necessitates the early diagnosis and the early start of the combined treatment method. In the authors' material the 2 years survival was 16,6%. The radiotherapy improves the results only if it is based on adequate radiobiological and radiophysical planning ensuring the use of adequate doses and radiation sources. (author) 18 refs.; 3 figs.; 3 tables

  3. Side effects of treatment in childhood acute leukemia, 2

    International Nuclear Information System (INIS)

    We evaluated delayed neurotoxicities in treatment of childhood acute leukemia. Of 28 patients treated over 2 years who were examined on computed tomography of brain scans, 7 patients had abnormal findings. These abnormalities included two cases of leukoencephalopathy, three cases of intracranial calcifications, and two of ventricular dilatation. These patients were under 6 years old at the onset of disease, especially under 3 years old. Also, delayed neurotoxicities developed after relapse of leukemia, especially CNS relapse. It was considered that these were caused by cranial irradiation, intravenous methotrexate injection, intrathecal methotrexate, and sometimes high-dose Ara-C therapy, etc. Most of the cases of leukoencephalopathy were associated with treatment of intermediate-dose or high-dose methotrexate after relapse. These abnormalities must be carefully considered in the treatment of younger children with leukemia and patients with relapse. (author)

  4. Morbidity and mortality in patients with craniopharyngioma after surgery.

    LENUS (Irish Health Repository)

    Crowley, R K

    2010-10-01

    Craniopharyngioma (CP) is a benign tumour of the suprasellar region that is associated with increased morbidity and mortality in comparison with other causes of hypopituitarism. We aimed to establish the rate and causes of mortality and morbidity in patients with CP who attended our centre.

  5. Assessment and treatment of childhood topographical disorientation: a case study.

    Science.gov (United States)

    Brunsdon, Ruth; Nickels, Lyndsey; Coltheart, Max; Joy, Pamela

    2007-01-01

    Topographical disorientation refers to individuals who are unable to find their way around large-scale environments in a normal manner. Childhood topographical disorientation is rarely investigated or reported. Treatment of topographical disorientation is also rare with only one reported treatment study in an adult (Davis & Coltheart, 1999) and no known description of treatment in a child. This paper reports a detailed case analysis of CA, a 6-year-old child with topographical disorientation, and a description of a treatment programme focused on training orientation in the school environment. Assessment of CA revealed mild to moderate visual agnosia in conjunction with severe impairments in general spatial learning and memory, topographical new learning and memory, and a total inability to learn new topographical routes. CA was also unable to use a mental image of his environment, a simple visual plan of his environment or a simple visual map, but was able to follow verbally mediated topographical instructions. The treatment programme focused on improving CA's topographical orientation in the school environment. The programme first involved training in recognition of major school buildings and landmarks and then focused on practical training in route finding along commonly used routes in the school environment. Clear benefits from treatment were evident. The assessment and treatment methods employed provide practical and useful ideas for management of this condition in other children. PMID:17178605

  6. Immunity and infectious morbidity in childhood ALL treatment : the benefits of intensity reduction

    OpenAIRE

    van Tilburg, C M

    2011-01-01

    With current childhood acute lymphoblastic leukemia (ALL) treatment protocols the cure rate approaches 90%. In the 10 percent of case fatalities, 2 major challenges stand out: incurable relapses of ALL and (infectious) deaths-in-remission. Thus, reducing toxicity is becoming an important goal to further improve childhood ALL survival. The Dutch Childhood Oncology Group (DCOG) ALL 10 protocol was designed to investigate whether a reduction of chemotherapeutic treatment intensity after a standa...

  7. Family involvement in the treatment of childhood obesity

    DEFF Research Database (Denmark)

    Grønbæk, Helle Nergaard; Madsen, Svend Aage Lykke; Michaelsen, Kim F.

    2009-01-01

    INTRODUCTION: The objective of this study was to assess the impacts of a family-based childhood obesity treatment on anthropometry and predictors of dropout and successful weight loss. MATERIALS AND METHODS: The 18-month treatment consisted of a intensive period (IP) including physical exercise......, nutritional guidance, family psychotherapy, child group sessions and a 1-year follow-up (FU). RESULTS: One hundred children (10-12 years old, >140% of median weight-for-height) participated. The 81 children completing the IP decreased significantly from 2.9 to 2.6 body mass index (BMI) standard deviation...... score (SDS) units (p children completing the FU had a further decrease of 0.2 BMI SDS units (p = 0.003). Weight loss was less in children from immigrant families. Drop-out was higher if the mother...

  8. Botulinum Toxin Treatment for Limb Spasticity in Childhood Cerebral Palsy

    Science.gov (United States)

    Pavone, Vito; Testa, Gianluca; Restivo, Domenico A.; Cannavò, Luca; Condorelli, Giuseppe; Portinaro, Nicola M.; Sessa, Giuseppe

    2016-01-01

    CP is the most common cause of chronic disability in childhood occurring in 2–2.5/1000 births. It is a severe disorder and a significant number of patients present cognitive delay and difficulty in walking. The use of botulinum toxin (BTX) has become a popular treatment for CP especially for spastic and dystonic muscles while avoiding deformity and pain. Moreover, the combination of physiotherapy, casting, orthotics and injection of BTX may delay or decrease the need for surgical intervention while reserving single-event, multi-level surgery for fixed musculotendinous contractures and bony deformities in older children. This report highlights the utility of BTX in the treatment of cerebral palsy in children. We include techniques for administration, side effects, and possible resistance as well as specific use in the upper and lower limbs muscles. PMID:26924985

  9. Impact of Childhood Trauma on Treatment Outcome in the Treatment for Adolescents with Depression Study (TADS)

    Science.gov (United States)

    Lewis, Cara C.; Simons, Anne D.; Nguyen, Lananh J.; Murakami, Jessica L.; Reid, Mark W.; Silva, Susan G.; March, John S.

    2010-01-01

    Objective: The impact of childhood trauma was examined in 427 adolescents (54% girls, 74% Caucasian, mean = 14.6, SD = 1.5) with major depressive disorder participating in the Treatment for Adolescents with Depression Study (TADS). Method: TADS compared the efficacy of cognitive behavioral therapy (CBT), fluoxetine (FLX), their combination (COMB),…

  10. Infrasellar craniopharyngioma: case report Craniofaringioma infra-selar: relato de caso

    OpenAIRE

    Asdrubal Falavigna; Jorge Luiz Kraemer

    2001-01-01

    We report a case of infrasellar craniopharyngioma in a 34 year-old woman who presented with progressive headache and diplopia. Computed tomographic and magnetic resonance images showed a heterogeneous tumor originating from the sphenoid bone with ethmoid sinus and sella turcica extension. A sublabial rhinoseptal transsphenoidal surgery was performed. Craniopharyngiomas with infrasellar development are very rare. Infrasellar craniopharyngioma is uncommon, thirty-five cases has been reported in...

  11. Meningioma as second malignant neoplasm after oncological treatment during childhood

    International Nuclear Information System (INIS)

    A total of 38 patients (18 female/20 male) with childhood meningioma were recruited from the German registry HIT-Endo (1989-2009). In 5 cases meningioma occurred as second malignant neoplasm (SMN). Histologies were confirmed by reference assessment in all cases (SMN: 2 WHO I, 1 WHO II, 2 WHO III). The SMNs were diagnosed at a median age of 12.4 years with a median latency of 10.2 years after primary malignancy (PMN; 4 brain tumors, 1 lymphoblastic leukemia; median age at diagnosis 2.7 years). Meningioma occurred as SMN in the irradiated field of PMN (range 12-54 Gy). The outcome after treatment of SMN meningioma (surgery/irradiation) was favorable in terms of psychosocial status and functional capacity in 4 of 5 patients (1 death). We conclude that survivors of childhood cancer who were exposed to radiation therapy at young age harbor the risk of developing meningioma as a SMN at a particularly short latency period in case of high dose exposure. (orig.)

  12. Parent-Only Treatment for Childhood Obesity: A Randomized Controlled Trial

    OpenAIRE

    Boutelle, Kerri N.; Cafri, Guy; Crow, Scott J.

    2010-01-01

    Parent-only (PO) treatments for childhood obesity are feasible, more cost-effective and potentially easier to disseminate. The objective of this study was to determine whether a PO treatment is not inferior to a parent + child (PC) treatment for childhood obesity. Eighty parent–child dyads with an 8–12 year old overweight or obese child (>85th BMI-P) were recruited and randomized into PO or PC treatment for childhood obesity. Parents or parent–child dyads attended 5-month treatment groups. Ch...

  13. Childhood opsoclonus-myoclonus syndrome: diagnosis and treatment.

    Science.gov (United States)

    Blaes, Franz; Dharmalingam, Backialakshmi

    2016-06-01

    Opsoclonus-myoclonus syndrome (OMS) is a rare and primarily immune-mediated disease in children and adults. The main symptoms include opsoclonus, myoclonus and ataxia. In children, the symptoms also include irritability, and, over a long-term course, learning and behavioural disturbances. OMS can be idiopathic, parainfectious or occur as a paraneoplastic (tumour-associated) syndrome. Paraneoplastic OMS in children is almost exclusively associated with neuroblastoma, whereas in adults, small cell lung cancer and breast cancer are the main underlying tumours. An autoimmune pathophysiology is suspected because childhood OMS patients have functionally active autoantibodies, proinflammatory changes in the cytokine network and immunotherapy responses. Children appear to respond regularly to immunosuppressive treatment. However, although the neurological symptoms show a good response, most children continue to show neuropsychological disturbances. PMID:27095464

  14. Sleep–wake and melatonin pattern in craniopharyngioma patients

    DEFF Research Database (Denmark)

    Pickering, Line; Jennum, Poul; Gammeltoft, Steen;

    2014-01-01

    OBJECTIVE: To assess the influence of craniopharyngioma or consequent surgery on melatonin secretion, and the association with fatigue, sleepiness, sleep pattern and sleep quality. DESIGN: Cross-sectional study. METHODS: A total of 15 craniopharyngioma patients were individually matched to healthy...... controls. In this study, 24-h salivary melatonin and cortisol were measured. Sleep-wake patterns were characterised by actigraphy and sleep diaries recorded for 2 weeks. Sleepiness, fatigue, sleep quality and general health were assessed by Multidimensional Fatigue Inventory, Pittsburgh Sleep Quality Index......, Epworth Sleepiness Scale and Short-Form 36. RESULTS: Patients had increased mental fatigue, daytime dysfunction, sleep latency and lower general health (all, P≤0.05), and they tended to have increased daytime sleepiness, general fatigue and impaired sleep quality compared with controls. The degree of...

  15. Malignant transformation of craniopharyngioma with detailed follow-up.

    Science.gov (United States)

    Wang, Wei; Chen, Xiao-Dong; Bai, Hong-Min; Liao, Qiu-Lin; Dai, Xue-Jun; Peng, Da-Yun; Cao, Hui-Xia

    2015-02-01

    A 29-year-old male patient was admitted into hospital with the main complaint of progressive visual disturbance. Both CT SCAN and MRI demonstrated a cystic-solid contrast-enhancing sellar-suprasellar mass with obvious calcification. Histopathological examination of the first resected specimen showed a typical appearance of adamantinomatous craniopharyngioma. The patient received gamma knife therapy after his first operation because of partial tumor removal. He experienced two relapses in the subsequent 2 years, for which only surgical resection was performed. The later histopathology presented malignant appearance with tumor cells moderate to severe pleomorphism, hyperchromasia, increased nuclear cytoplastic ratio, high mitotic activity (30/10 high power fields) and focal coagulative necrosis. The patient died 9 months after identification of histologic malignancy. Clinical and histopathological features, biological behavior of one case of malignant craniopharyngioma were discussed, with a brief review of the relevant literature. PMID:25112406

  16. Childhood obesity treatment: targeting parents exclusively v. parents and children.

    Science.gov (United States)

    Golan, Moria; Kaufman, Vered; Shahar, Danit R

    2006-05-01

    There is a consensus that interventions to prevent and treat childhood obesity should involve the family; however, the extent of the child's involvement has received little attention. The goal of the present study was to evaluate the relative efficacy of treating childhood obesity via a family-based health-centred intervention, targeting parents alone v. parents and obese children together. Thirty-two families with obese children of 6-11 years of age were randomised into groups, in which participants were provided for 6 months a comprehensive educational and behavioural programme for a healthy lifestyle. These groups differed in their main agent of change: parents-only v. the parents and the obese child. In both groups, parents were encouraged to foster authoritative parenting styles (parents are both firm and supportive; assume a leadership role in the environmental change with appropriate granting of child's autonomy). Only the intervention aimed at parents-only resulted in a significant reduction in the percentage overweight at the end of the programme (P=0.02) as well as at the 1-year follow-up meeting. The differences between groups at both times were significant (Panalysis shows that the level of attendance in sessions explained 28 % of the variability in the children's weight status change, the treatment group explained another 10 %, and the improvement in the obesogenic load explained 11 % of the variability. These results suggest that omitting the obese child from active participation in the health-centred programme may be beneficial for weight loss and for the promotion of a healthy lifestyle among obese children. PMID:16611394

  17. Effects of childhood malignancy treatment on quality of life: Preliminary results of the QOLOP project

    Czech Academy of Sciences Publication Activity Database

    Blatný, Marek; Kepák, T.; Jelínek, Martin; Slezáčková, Alena; Vlčková, I.; Navrátilová, P.; Pilát, M.; Kárová, Š.; Hrstková, H.; Štěrba, J.

    2008-01-01

    Roč. 1, č. 1 (2008), s. 10-15 R&D Projects: GA ČR 406/07/1384 Institutional research plan: CEZ:AV0Z70250504 Keywords : cancer * quality of life * childhood Subject RIV: AN - Psychology http://www.spao.eu/archive/2008/spao2008_effects_of_childhood_malignancy_treatment_on_quality_of_life.pdf

  18. Growth patterns of craniopharyngiomas: clinical analysis of 226 patients.

    Science.gov (United States)

    Pan, Jun; Qi, Songtao; Liu, Yi; Lu, Yuntao; Peng, Junxiang; Zhang, XiAn; Xu, YiKai; Huang, Guang-Long; Fan, Jun

    2016-04-01

    OBJECT Craniopharyngiomas (CPs) are rare epithelial tumors that are often associated with an enigmatic and unpredictable growth pattern. Understanding the growth patterns of these tumors has a direct impact on surgical planning and may enhance the safety of radical tumor removal. The aim of this study was to analyze the growth patterns and surgical treatment of CPs with a focus on the involvement of the hypothalamopituitary axis and the relationship of the tumor to the arachnoid membrane and surrounding structures. METHODS Clinical data from 226 consecutive patients with primary CP were retrospectively reviewed. Tumor location and the relationship of the tumor to the third ventricle floor and the pituitary stalk were evaluated using preoperative MRI and intraoperative findings. A topographic classification scheme was proposed based on the site of tumor origin and tumor development. The clinical relevance of this classification on patient presentation and outcomes was also analyzed. RESULTS The growth of CPs can be broadly divided into 3 groups based on the site of tumor origin and on tumor-meningeal relationships: Group I, infrasellar/infradiaphragmatic CPs (Id-CPs), which mainly occurred in children; Group II, suprasellar subarachnoid extraventricular CPs (Sa-CPs), which were mainly observed in adults and rarely occurred in children; and Group III, suprasellar subpial ventricular CPs (Sp-CPs), which commonly occurred in both adults and children. Tumors in each group may develop complex growth patterns during vertical expansion along the pituitary stalk. Tumor growth patterns were closely related to both clinical presentation and outcomes. Patients with Sp-CPs had more prevalent weight gain than patients with Id-CPs or Sa-CPs; the rates of significant weight gain were 41.7% for children and 16.7% for adults with Sp-CPs, 2.2% and 7.1% for those with Id-CPs, and 12.5% and 2.6% for those with Sa-CPs (p tumor. More tailored, individualized surgical strategies based on

  19. Changes in lipidemia during chronic care treatment of childhood obesity

    DEFF Research Database (Denmark)

    Nielsen, Tenna Ruest Haarmark; Gamborg, Michael; Fonvig, Cilius Esmann;

    2012-01-01

    Childhood obesity and related co-morbidities are increasing. This intervention study assessed the associations between weight changes and lipidemia in obese children and adolescents.......Childhood obesity and related co-morbidities are increasing. This intervention study assessed the associations between weight changes and lipidemia in obese children and adolescents....

  20. Craniopharyngioma: the St. Jude Children's Research Hospital experience 1984-2001

    International Nuclear Information System (INIS)

    Purpose: To review our institution's experience in the treatment of craniopharyngioma and assess the merits of initial therapy with limited surgery and irradiation. Methods and Materials: The data of 30 patients (median age 8.6 years) with a diagnosis of craniopharyngioma between April 1984 and September 1997 were reviewed. Their course of treatment, neurologic, endocrine, and cognitive function, and quality of life at last follow-up were compared. Results: Fifteen patients were initially treated with surgery (8 required irradiation after relapse) and 15 with limited surgery and irradiation (2 required additional treatment for tumor progression). Only 1 patient died of tumor progression. The surgery group lost a mean of 9.8 points in full-scale IQ, and the combined-modality group lost only 1.25 points (p<0.063). Patients in the surgery group who had relapses (n=9) lost a mean of 13.1 points (p<0.067). A loss of 10 points was considered clinically significant. The surgery group also had more frequent neurologic, ophthalmic, and endocrine complications. The mean Health Utility Index (a functional quality-of-life index) was higher for the combined-modality group (0.85) than for the surgery group (0.71; p<0.063, one-sided t test). Conclusions: The acute neurologic, cognitive, and endocrine effects of surgery often affect long-term function and quality of life. Our experience suggests that limited surgery and radiotherapy cause lesser or comparable sequelae. Diabetes insipidus was the only endocrine deficiency that differed substantially in frequency between the two groups. Newer radiation planning and delivery techniques may make a combined-modality approach a good initial option for most patients

  1. Hypothalamic obesity in patients with craniopharyngioma: Profound changes of several weight regulatory circuits

    Directory of Open Access Journals (Sweden)

    Christian eRoth

    2011-10-01

    Full Text Available One of the most striking examples of dysfunctional hypothalamic signaling of energy homeostasis is observed in patients with hypothalamic lesions leading to hypothalamic obesity (HO. This drastic condition is frequently seen in patients with craniopharyngioma (CP, an embryological tumor located in the hypothalamic and/or pituitary region, frequently causing not only hypopituitarism, but also leading to damage of medial hypothalamic nuclei due to the tumor and its treatment. HO syndrome in CP patients is characterized by fatigue, decreased physical activity, uncontrolled appetite, and morbid obesity, and is associated with insulin and leptin resistance. Mechanisms leading to the profoundly disturbed energy homeostasis are complex. This review summarizes different aspects of important clinical studies as well as data obtained in rodent studies. In addition a model is provided describing how medial hypothalamic lesion can interact simultaneously with several weight regulating circuitries.

  2. Long-term outcomes for adult craniopharyngioma following radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Masson-Cote, Laurence; Masucci, Giuseppina Laura; Millar, Barbara-Ann; Laperriere, Normand J. [Dept. of Radiation Oncology, Princess Margaret Hospital, Univ. of Toronto, Toronto (Canada); Atenafu, Eshetu G. [Dept. of Biostatistics, Princess Margaret Hospital, Univ. of Toronto, Toronto (Canada); Cusimano, Michael [Dept. of Surgery, Div. of Neurosurgery, St. Michaels Hospital, Toronto (Canada); Croul, Sidney [Dept. of Pathology, Univ. of Toronto, Toronto (Canada); Mason, Warren [Dept. of Medicine, Princess Margaret Hospital, Univ. of Toronto, Toronto (Canada); Sahgal, Arjun [Dept. of Radiation Oncology, Princess Margaret Hospital, Univ. of Toronto, Toronto (Canada), E-mail: Arjun.sahgal@rmp.uhn.on.ca; Dept. of Radiation Oncology, Sunnybrook Health Sciences Center, Univ. of Toronto, Toronto (Canada)

    2013-01-15

    Background. We report long-term outcomes in adult patients with craniopharyngioma following surgery and radiation therapy (RT). Material and methods. Fifty-three patients treated with RT (median, 50 Gy in 25 fractions) between 1980 and 2009 with pathologically confirmed craniopharyngioma were reviewed (53% solid and 47% cystic/solid). The median age was 53 years (range, 22-76), 53% were female, 83% were sub-totally resected, 6% were gross totally resected and 11% had a biopsy and/or cyst aspiration alone. RT was delivered adjuvantly in 53% of patients as opposed to salvage intent upon progression. Results. Median follow-up was seven years (86 months, range, 8-259). The 5- and 10-year progression-free survival (PFS) rates were 85% and 69%, overall survival (OS) rates were 76% and 70%, and cause-specific survival (CSS) rates were both 88%, respectively. Both univariable and multivariable analysis identified age (<53 or {>=}53) as a prognostic factor for OS (p =0.0003) and CSS (p =0.05). PFS was observed to be worse in patients with >2 surgeries prior to RT (p =0.01). Neither the intent of radiation or tumor type (cystic vs. solid/cystic) were prognostic or predictive. New endocrinopathies and visual dysfunction were observed in 53% and 17% of patients post-surgery, and in 11% and 6% post-RT, respectively. Conclusion. We report long-term favorable PFS, CSS and OS for craniopharyngioma post-RT. We observe age as a significant prognostic factor, however, timing of radiation was not.

  3. A craniopharyngioma in a seven-year-old dog

    International Nuclear Information System (INIS)

    A seven-year-old male Border Collie was presented with a history of lethargy, episodic circling, incoordination and polydypsia. Physical examination revealed depression, obesity and bradycardia. A neurological examination indicated the possible presence of a space-occupying lesion in the brain. Results of the clinical investigation revealed hyposthenuria, sinus bradycardia and increased concentration of protein in the cerobrospinal fluid. A computerised axial tomography scan revealed a mass in the region of the hypophysis. The dog was euthanased and a post mortem examination confirmed the presence of a craniopharyngioma. 17 refs., 3 figs

  4. Factors related to under-diagnosis and under-treatment of childhood asthma in metropolitan France.

    OpenAIRE

    Annesi-Maesano Isabella; Sterlin Carla; Caillaud Denis; de Blay Fréderic; Lavaud François; Charpin Denis; Raherisson Chantal

    2012-01-01

    Abstract Background Under-diagnosis and under-treatment of childhood asthma were investigated in France using data collected during the 6 Cities Study, the French contribution to the International Study of Asthma and Allergies in Childhood. Methods 7,781 schoolchildren aged between 9 and 10 years underwent a medical visit including skin prick tests to common allergens and exercise test for Exercise-Induced Asthma (EIA) and their parents filled in a standardized questionnaire on asthma, manage...

  5. Changes of hypothalamus-pituitary hormones in patients after total removal of craniopharyngiomas

    Institute of Scientific and Technical Information of China (English)

    周忠清; 石祥恩

    2004-01-01

    Background This paper aimed to elucidate the changes of hypothalamus-pituitary hormones in patients after total removal of craniopharyngiomas.Methods A total of 40 patients with craniopharyngiomas received surgery. The levels of triiodothyronine (T3), thyroxine (T4), thyrotropic hormone (TSH), antidiuretic hormone (ADH), and adrenocorticotropin (ACTH) were measureed in the 40 patients before surgery and one week after surgery respectively.Results Twenty-eight patients (70%) had hypothyroidism before surgery, but 38 (95%) had hypothyroidism after surgery (P0.05), whereas those of ACTH were (23.97±2.69) pg/ml and (15.60±1.91) pg/ml respectively (P<0.05).Conclusions Hormone deficits after total removal of craniopharyngioma appear to be the common complication of surgery. Hypothyroidism and diabetes insipidus are more frequent after surgery than before surgery. Thyroxine and glucocorticoids should be administered routinely after total removal of craniopharyngioma.

  6. Risk factors for treatment related mortality in childhood acute lymphoblastic leukaemia

    DEFF Research Database (Denmark)

    Lund, Bendik; Åsberg, Ann; Heyman, Mats;

    2011-01-01

    BACKGROUND: In spite of major improvements in the cure rate of childhood acute lymphoblastic leukaemia (ALL), 2-4% of patients still die from treatment related complications. PROCEDURE: We investigated the pattern of treatment related deaths (TRDs) and possible risk factors in the NOPHO ALL-92 and...

  7. Risk factors for treatment related mortality in childhood acute lymphoblastic leukaemia

    DEFF Research Database (Denmark)

    Lund, Bendik; Åsberg, Ann; Heyman, Mats;

    2011-01-01

    BACKGROUND: In spite of major improvements in the cure rate of childhood acute lymphoblastic leukaemia (ALL), 2-4% of patients still die from treatment related complications. PROCEDURE: We investigated the pattern of treatment related deaths (TRDs) and possible risk factors in the NOPHO ALL-92 and...... towards patients at risk. Pediatr Blood Cancer. © 2010 Wiley-Liss, Inc....

  8. Friends or foes ? : predictors of treatment outcome of cognitieve behavioral therapy for childhood anxiety disorders

    NARCIS (Netherlands)

    Liber, Juliëtte Margo

    2008-01-01

    The present dissertation had as its central focus the prediction of outcome of the treatment of childhood anxiety disorders. In the present study a selection of variables that were thought to have prognostic validity for successful cognitive behavioral treatment (CBT) outcome were explored in a popu

  9. Random versus Blocked Practice in Treatment for Childhood Apraxia of Speech

    Science.gov (United States)

    Maas, Edwin; Farinella, Kimberly A.

    2012-01-01

    Purpose: To compare the relative effects of random vs. blocked practice schedules in treatment for childhood apraxia of speech (CAS). Although there have been repeated suggestions in the literature to use random practice in CAS treatment, no systematic studies exist that have directly compared random with blocked practice in this population.…

  10. MR and CT diagnosis of carotid pseudoaneurysm in children following surgical resection of craniopharyngioma

    International Nuclear Information System (INIS)

    We report the cases of two children who underwent CT, MR, MRA and angiography in the diagnosis of postoperative aneurysmal dilatation of the supraclinoid carotid arteries following surgical resection of craniopharyngioma. Craniopharyngiomas are relatively common lesions, accounting for 6-7 % of brain tumors in children. They are histologically benign, causing symptoms by their growth within the sella and suprasellar cistern with compression of adjacent structures, especially the pituitary gland, hypothalamus and optic nerves, chiasm, and tracts. (orig.)

  11. Ethical considerations in the treatment of childhood obesity

    OpenAIRE

    Perryman, Mandy

    2015-01-01

    Mandy L Perryman,1 Kara A Sidoti,2 1Department of Leadership and Counselor Education, University of Mississippi, MS, USA; 2Lynchburg College, Lynchburg, VA, USA Abstract: Rates of obesity in children and adolescents appear to be stabilizing, though the prevalence of extreme obesity in this population remains fairly consistent at 4%. Childhood obesity contributes to serious health complications, such as hypertension, orthopedic problems, hormonal imbalances, and adult obesity. Psychological, ...

  12. Radioactive Iodine for Thyrotoxicosis in Childhood and Adolescence: Treatment and Outcomes

    OpenAIRE

    Namwongprom, Sirianong; Unachak, Kevalee; Dejkhamron, Prapai; Ua-apisitwong, Supoj; Ekmahachai, Molrudee

    2013-01-01

    Objective: The aim of the present study was to evaluate the outcome of radioiodine treatment in thyrotoxicosis in childhood and adolescence. Methods: This was a retrospective study of 27 patients (ages 7.2- 19.8 years) with a diagnosis of thyrotoxicosis who received iodine-131 (I-131) treatment from January 2007 to December 2011 in the Nuclear Medicine Division, Department of Radiology, Faculty of Medicine, Chiang Mai University. Gender, duration of antithyroid drug (ATD) treatment, 24-hour I...

  13. Treatment Options for Childhood Central Nervous System Embryonal Tumors and Childhood Pineoblastoma

    Science.gov (United States)

    ... children. See the PDQ summary on Adult Central Nervous System Tumors Treatment for more information on the treatment of adults. There are different types of CNS embryonal tumors. Enlarge Anatomy of the inside of the brain, showing the ...

  14. Modeling social transmission dynamics of unhealthy behaviors for evaluating prevention and treatment interventions on childhood obesity.

    Directory of Open Access Journals (Sweden)

    Leah M Frerichs

    Full Text Available Research evidence indicates that obesity has spread through social networks, but lever points for interventions based on overlapping networks are not well studied. The objective of our research was to construct and parameterize a system dynamics model of the social transmission of behaviors through adult and youth influence in order to explore hypotheses and identify plausible lever points for future childhood obesity intervention research. Our objectives were: (1 to assess the sensitivity of childhood overweight and obesity prevalence to peer and adult social transmission rates, and (2 to test the effect of combinations of prevention and treatment interventions on the prevalence of childhood overweight and obesity. To address the first objective, we conducted two-way sensitivity analyses of adult-to-child and child-to-child social transmission in relation to childhood overweight and obesity prevalence. For the second objective, alternative combinations of prevention and treatment interventions were tested by varying model parameters of social transmission and weight loss behavior rates. Our results indicated child overweight and obesity prevalence might be slightly more sensitive to the same relative change in the adult-to-child compared to the child-to-child social transmission rate. In our simulations, alternatives with treatment alone, compared to prevention alone, reduced the prevalence of childhood overweight and obesity more after 10 years (1.2-1.8% and 0.2-1.0% greater reduction when targeted at children and adults respectively. Also, as the impact of adult interventions on children was increased, the rank of six alternatives that included adults became better (i.e., resulting in lower 10 year childhood overweight and obesity prevalence than alternatives that only involved children. The findings imply that social transmission dynamics should be considered when designing both prevention and treatment intervention approaches. Finally

  15. Childhood Cancer Survivor Study: An Overview

    Science.gov (United States)

    ... Cancers of Childhood Treatment Childhood Cancer Genomics Research Childhood Cancer Survivor Study: An Overview In 2016, it ... Late Effects of Treatment for Childhood Cancer .) The Childhood Cancer Survivor Study ( CCSS ), funded by the National ...

  16. Uveitis in childhood : Complications and treatment with emphasis on juvenile idiopathic arthritis

    NARCIS (Netherlands)

    Sijssens, K.M.

    2008-01-01

    The aim of this study was to gain more insight into the development of complications in childhood uveitis and to evaluate the treatment options for these mostly sight-threatening conditions with emphasis on juvenile idiopathic arthritis (JIA)-associated uveitis. The second aim was to investigate whi

  17. Threat Related Selective Attention Predicts Treatment Success in Childhood Anxiety Disorders

    Science.gov (United States)

    Legerstee, Jeroen S.; Tulen, Joke H. M.; Kallen, Victor L.; Dieleman, Gwen C.; Treffers, Philip D. A.; Verhulst, Frank C.; Utens, Elisabeth M. W. J.

    2009-01-01

    Threat-related selective attention was found to predict the success of the treatment of childhood anxiety disorders through administering a pictorial dot-probe task to 131 children with anxiety disorders prior to cognitive behavioral therapy. The diagnostic status of the subjects was evaluated with a semistructured clinical interview at both pre-…

  18. Imagery rescripting as a stand-alone treatment for posttraumatic stress disorder related to childhood abuse

    NARCIS (Netherlands)

    S. Raabe; T. Ehring; L. Marquenie; M. Olff; M. Kindt

    2015-01-01

    Objective This case series tested the feasibility and explored the efficacy of Imagery Rescripting (ImRs) as a stand-alone treatment for PTSD related to childhood physical and/or sexual abuse (CA). Method Participants (6 women and 2 men) were patients with PTSD related to CA who entered an 8 week tr

  19. Healing Childhood Ear Infections: Prevention, Home Care, and Alternative Treatment. 2nd Edition.

    Science.gov (United States)

    Schmidt, Michael A.

    This book describes current controversy in medical journals over existing treatments for chronic childhood earaches. It suggests that the causes of otitis media are a series of events which flourish when poor nutrition occurs, noting that careful attention to diet and nutrition to prevent food allergies, and the use of acupressure, homeopathic…

  20. Immunity and infectious morbidity in childhood ALL treatment : the benefits of intensity reduction

    NARCIS (Netherlands)

    van Tilburg, C.M.

    2011-01-01

    With current childhood acute lymphoblastic leukemia (ALL) treatment protocols the cure rate approaches 90%. In the 10 percent of case fatalities, 2 major challenges stand out: incurable relapses of ALL and (infectious) deaths-in-remission. Thus, reducing toxicity is becoming an important goal to fur

  1. Childhood leukaemia: Radiological changes caused by the disease and by treatment

    International Nuclear Information System (INIS)

    The radiological changes caused by acute lymphatic leukaemia in childhood, and by the treatment of this condition, are described for the individual organ systems. Of particular importance are changes in the skeleton, thoracic organs, kidneys, gastro-intestinal tract and central nervous system. Changes in the skeleton and mediastinal tumours are important for the initial diagnosis. (orig.)

  2. Moving Forward in Childhood Obesity Treatment: A Call for Translational Research

    Science.gov (United States)

    Watson, P. M.; Dugdill, L.; Murphy, R.; Knowles, Z.; Cable, N. T.

    2013-01-01

    Childhood obesity is one of the most serious challenges of the 21st century and it is vital that evidence-based treatment approaches can be translated into practice to meet public health needs. Yet policy-makers cannot afford to wait for the results of lengthy trials before "probably efficacious" interventions are made available to the public, and…

  3. Growth after treatment of solid tumours in childhood

    International Nuclear Information System (INIS)

    We examined 90 survivors of childhood solid tumours diagnosed in our hospital between 1960 and 1976. Their ages at the time of this study ranged from 12.2 to 41.5 years. Adult standing height was usually normal. However, final standing height was less than expected in the females, and sitting height was below the normal mean in the males. The males who had received both chemotheraphy and radiation therapy to the spine had a greater decrement in sitting height, but we did not find any association between radiation therapy to the spine without chemotherapy and subsequent total growth of the spine as measured by sitting height. We conclude that these children generally do not experience any major growth disturbances. (au)

  4. Childhood Central Nervous System Germ Cell Tumors Treatment

    Science.gov (United States)

    ... the tumor responds to treatment. Newly Diagnosed CNS Teratomas Treatment of newly diagnosed mature and immature central nervous system (CNS) teratomas may include the following: Surgery to remove as ...

  5. Treatment Option Overview (Childhood Central Nervous System Embryonal Tumors)

    Science.gov (United States)

    ... children. See the PDQ summary on Adult Central Nervous System Tumors Treatment for more information on the treatment of adults. There are different types of CNS embryonal tumors. Enlarge Anatomy of the inside of the brain, showing the ...

  6. Friends or foes ?: predictors of treatment outcome of cognitieve behavioral therapy for childhood anxiety disorders

    OpenAIRE

    Liber, Juliëtte Margo

    2008-01-01

    The present dissertation had as its central focus the prediction of outcome of the treatment of childhood anxiety disorders. In the present study a selection of variables that were thought to have prognostic validity for successful cognitive behavioral treatment (CBT) outcome were explored in a population of children with anxiety disorders. Eligible for participation were children aged 8-12 years (n = 133) attending primary education and diagnosed with Separation Anxiety Disorder (SAD), Gener...

  7. The School Psychologist's Primer on Childhood Depression: A Review of Research Regarding Epidemiology, Etiology, Assessment, and Treatment

    Science.gov (United States)

    Ruderman, Matthew A.; Stifel, Skye W. F.; O'Malley, Meagan; Jimerson, Shane R.

    2013-01-01

    The purpose of this article is to provide school psychologists with a synthesis of important information regarding the epidemiology, etiology, assessment, and treatment of childhood depression. A review of the recent research and relevant literature is summarized reflecting the contemporary knowledge regarding depression during childhood and…

  8. Treatment of Childhood Psoriasis with Phototherapy and Photochemotherapy

    OpenAIRE

    Irene Lara Corrales; Sabrina Ramnarine; Perla Lansang

    2013-01-01

    Phototherapy and photochemotherapy are well-described treatment modalities for psoriasis in adults. Like many other treatments, the experience and long-term safety of their use in children is limited. We conducted a literature search and identified publications reporting the use of phototherapy and photochemotherapy in pediatric populations. This article summarizes the existing literature on this topic. Although many studies report good improvement with these treatment modalities, long-term s...

  9. Fertility treatment and risk of childhood and adolescent mental disorders

    DEFF Research Database (Denmark)

    Bay, Bjørn; Mortensen, Erik Lykke; Hvidtjørn, Dorte;

    2013-01-01

    To assess the mental health of children born after fertility treatment by comparing their risk of mental disorders with that of spontaneously conceived children.......To assess the mental health of children born after fertility treatment by comparing their risk of mental disorders with that of spontaneously conceived children....

  10. MODERN TREATMENT METHODS OF PRIMARY CHILDHOOD DENTAL CARIES

    OpenAIRE

    Ekimov, E.; Fedotova, O.

    2015-01-01

    He uniqueness of tooth enamel focal demineralization (primary caries) is that it is the only form of tooth decay, which can be treated conservatively without any surgical treatment and filling. Therefore, the integral task in dentistry is to study all the possibilities of diagnosis and to increase the effectiveness of conservative treatment [10]. To determine the dental health of children in Omsk we carried out a dental check-up of 1682 schoolchildren from 7 to 12 years of age. In addition to...

  11. Treatment for childhood psoriasis%儿童银屑病的治疗现状

    Institute of Scientific and Technical Information of China (English)

    黄丹; 顾恒; 陈崑

    2010-01-01

    银屑病是一种常见的主要侵犯皮肤、并可累及关节的慢性炎症性疾病.儿童银屑病治疗时要注意选择合适的方法,充分考虑药物的安全性和有效性.一般局部治疗即可控制病情,中重度的各型银屑病需考虑系统治疗.随着分子生物学的发展,生物治疗被考虑用于儿童银屑病.近年来,健康教育也成为儿童银屑病治疗的重要部分.%Psoriasis is a common chronic inflammatory disorder of the skin, which can also affect joints. It is important to choose appropriate strategy to treat childhood psoriasis with the consideration of safety and effectiveness of drugs. Generally, topical treatment is sufficient to control psoriasis, while systemic treatment is reserved for moderate to severe psoriasis. Recently, with the development of molecular biology,biological therapies have been considered in the treatment of childhood psoriasis. Also, health education has become an important part of treatment for childhood psoriasis.

  12. Parents' perceptions, attitudes and acceptability of treatment of childhood malaria with artemisinin combination therapies in ghana

    DEFF Research Database (Denmark)

    Adjei, G O; Darkwah, A K; Goka, B Q;

    2009-01-01

    BACKGROUND: There is little information on sociocultural and contextual factors that may influence attitudes of patients to new treatments, such as artemisinin combination therapies (ACT). METHODS: Semi-structured questionnaires and focus group discussions were used to assess views of parents of...... children with uncomplicated malaria treated with ACT in a low socio-economic area in Accra, Ghana. RESULTS: The majority of parents reported a favourable experience, in terms of perceived i) rapidity of symptom resolution, compared to their previous experience of other therapies for childhood malaria, or...... explanations. Although care-seeking practices for childhood malaria were considered appropriate, perceived or real barriers to accessible health care were also important factors in the decision to seek treatment. Household dynamics and perceived inequities at the care-provider-patient interface were identified...

  13. Promising medical treatment for childhood psycho-cognitive problems

    Institute of Scientific and Technical Information of China (English)

    Parvaneh Karimzadeh; Sepideh Tabarestani

    2010-01-01

    Subclinical electroencephalogram discharges in children with psycho-cognitive problems are not uncommon. However, the clinical importance and relationship to cognitive deficits, as well as indications for medical treatment, are not well understood. Transient cognitive impairment, which accompanies electroencephalogram discharges, could negatively influence cognitive abilities over time. Studies have suggested that treatment with antiepileptic drugs normalizes electroencephalogram results, thereby preventing electrical paroxysmal discharges that could be harmful to the developing brain. Physicians should attempt to differentiate between corresponding factors, such as subtle seizures, nature of underlying etiology, stable cognitive deficits,seizure-inducing effects, and potential side effects of antiepileptic drugs prior to initiation of medical treatment for definitive diagnosis of transient cognitive impairment and its consequences. Therefore,appropriate criteria for patient selection and proper guidelines for medical therapy, should be addressed in future studies.

  14. Failure of peritoneal and gallbladder shunts in a child with craniopharyngioma

    Directory of Open Access Journals (Sweden)

    Julie Woodfield

    2013-01-01

    Full Text Available A 1-year-old girl with craniopharyngioma required external drainage of 40-50 mL/h of cerebrospinal fluid (CSF after biopsy and cyst fenestration. She developed CSF ascites following insertion of a ventriculoperitoneal (VP shunt and a distended painful gallbladder following ventriculogallbladder shunt insertion. Revision to a ventriculoatrial shunt was required. This is the first time a craniopharyngioma has been reported to cause increased CSF production. The potential mechanisms of CSF overproduction and the difficulties managing the large volume of CSF in a young child are discussed.

  15. Slow-growing craniopharyngioma masquarading as early-onset eating disorder: Two cases

    DEFF Research Database (Denmark)

    Vad Winkler, Laura; Andersen, Marianne; Hørder, Kirsten;

    2009-01-01

    BACKGROUND:: Craniopharyngiomas are slow-growing tumors, which can either be asymptomatic or present themselves with visual, neuropsychiatric or endocrine disturbances. Eating disorders (EDs) are syndromes with unknown etiology, associated with multiple endocrine abnormalities. In pediatric cases...... cases illustrate the importance to consider slow-growing craniopharyngioma in ED. Especially in atypical ED, neuro-radiographic, ophthalmologic and endocrine examination should be carried out. Furthermore, structural hypothalamic lesions in these cases mimicking features of ED, suggesting...... the possibility of an as yet unidentified structural hypothalamic disorder to be implicated in the etiopathogeny of ED. (c) 2008 by Wiley Periodicals, Inc. Int J Eat Disord, 2009....

  16. Magnetic resonance cystography with gadopenetate dimeglumine of a cystic craniopharyngioma in a child - a technical note

    International Nuclear Information System (INIS)

    Large cystic craniopharyngiomas can be treated with chemotherapy injected directly into the cyst. Chemotherapy is toxic if it leaks from the cyst into the subarachnoid space. We present a child with a cystic craniopharyngioma following surgical placement of a catheter into the cystic component. Computed tomography following iodinated contrast injection into the cyst was inconclusive in determining the cyst wall integrity. Magnetic resonance following dilute gadopentetate dimeglumine injection into the cyst clearly defined a leak into the subarachnoid space. Coronal imaging was especially helpful. This technique is simple to perform and useful for clinical management. (orig.)

  17. Tumor origin and growth pattern at diagnosis and surgical hypothalamic damage predict obesity in pediatric craniopharyngioma

    OpenAIRE

    Park, Seung Wan; Jung, Hae Woon; Lee, Young Ah; Shin, Choong Ho; Yang, Sei Won; Cheon, Jung-Eun; Kim, In-One; Phi, Ji Hoon; Kim, Seung-Ki; Wang, Kyu-Chang

    2013-01-01

    Severe obesity is a major problem in pediatric craniopharyngioma. We investigated whether tumor origin, growth pattern, and surgical damage predict obesity in pediatric craniopharyngioma. Subjects were 58 patients (30 males) with no tumor recurrence during the first postoperative 18 months. Preoperative hypothalamic involvement was classified into no (pre_G0, n = 19), little (pre_G1, n = 21), and severe (pre_G2, n = 18) involvement groups based on sub- or supradiaphragmatic tumor origin and g...

  18. Primary care providers' knowledge, practices, and perceived barriers to the treatment and prevention of childhood obesity.

    Science.gov (United States)

    Spivack, Jordan G; Swietlik, Maggie; Alessandrini, Evaline; Faith, Myles S

    2010-07-01

    This study evaluated primary care providers' (PCPs, pediatricians, and nurse practitioners) knowledge, current practices, and perceived barriers to childhood obesity prevention and treatment, with an emphasis on first-year well-child care visits. A questionnaire was distributed to 192 PCPs in the primary care network at The Children's Hospital of Philadelphia (CHOP) addressing (i) knowledge of obesity and American Academy of Pediatrics (AAP) guidelines, (ii) anticipatory guidance practices at well visits regarding nutrition and exercise, and (iii) perceived barriers to childhood obesity treatment and prevention. Eighty pediatricians and seven nurse practitioners responded, and a minority correctly identified the definition (26%) and prevalence (9%) of childhood overweight and AAP guidelines for exercise (39%) and juice consumption (44%). Most PCPs (81%) spent 11-20 min per well visit during the first 2 years, and 79% discussed diet, nutrition, and exercise for > or =3 min. Although >95% of PCPs discussed juice, fruits and vegetables, sippy cups, and finger foods during the first year, over 35% never discussed fast food, TV, or candy, and 55% never discussed exercise. Few rated current resources as adequate to treat or prevent childhood obesity. Over 90% rated the following barriers for obesity prevention and treatment as important or very important: parent is not motivated, child is not motivated, parents are overweight, families often have fast food, watch too much TV, and do not get enough exercise. In conclusion, there is much room to improve PCPs' knowledge of obesity and AAP guidelines. Although PCPs rate fast-food consumption, TV viewing, and lack of exercise as important treatment barriers, many never discussed these topics during the first year. PMID:19910934

  19. Maltreatment in early childhood: a scoping review of prevention, detection and treatment

    OpenAIRE

    Luis Lefio Celedón; Helia Silva Bustos; Katherinne Rivas Castro

    2013-01-01

    Purpose. To identify and synthesize the best available evidence on the effectiveness of interventions for universal prevention, detection and treatment of early childhood maltreatment (0-4 years). Design. Scoping Review. Data sources. MEDLINE, LILACS, PsycINFO, Psyclist, SciELO, ISI Web of Knowledge, Science Direct, EBSCO, EMBASE, Cochrane Library, DARE, Google Scholar and UNICEF Base. Methods. A variety of keywords were used to identify quantitative experimental and observational studies on ...

  20. Host genome variations and risk of infections during induction treatment for childhood acute lymphoblastic leukaemia

    DEFF Research Database (Denmark)

    Lund, Bendik; Wesolowska-Andersen, Agata; Lausen, Birgitte;

    2014-01-01

    Objectives: To investigate association of host genomic variation and risk of infections during treatment for childhood acute lymphoblastic leukaemia (ALL). Methods: We explored association of 34 000 singlenucleotide polymorphisms (SNPs) related primarily to pharmacogenomics and immune function...... to risk of infections among 69 ALL patients on induction therapy. Results: Forty-eight (70%) patients experienced infectious events including 23 with positive blood cultures. Infectious events and positive blood cultures were associated significantly with 24 and 21 SNPs, respectively (P

  1. Medicinal plants in the treatment of respiratoty diseases in childhood: a view from popular knowledge

    OpenAIRE

    Karla Rafaella Menezes Araújo; Marta Regina Kerntopf; Dayanne Rakelly de Oliveira; Irwin Rose Alencar de Menezes; Francisco Elizaudo de Brito Júnior

    2012-01-01

    This work investigates the popular knowledge regarding the usage of medicinal plants in the treatment of respiratory diseases in childhood. Exploratory descriptive study of qualitative nature, performed in Juazeiro do Norte/CE with twenty-two mothers and/or the ones responsible for the children patients of the Health Family Strategy. The data was collected through semi-structured interviews in the months of June and July, 2011. Collective Subject Discourse to Data analysis technique was used....

  2. Treatment Option Overview (Childhood Non-Hodgkin Lymphoma)

    Science.gov (United States)

    ... in a laboratory and used as drugs. Steroid therapy is used to treat cutaneous T-cell lymphoma. Phototherapy Phototherapy is a cancer treatment that uses a drug and a certain type of laser light to kill cancer cells. A drug that ...

  3. Treatment Options for Childhood Non-Hodgkin Lymphoma

    Science.gov (United States)

    ... in a laboratory and used as drugs. Steroid therapy is used to treat cutaneous T-cell lymphoma. Phototherapy Phototherapy is a cancer treatment that uses a drug and a certain type of laser light to kill cancer cells. A drug that ...

  4. Salvage treatment for childhood ependymoma after surgery only: Pitfalls of omitting 'at once' adjuvant treatment

    International Nuclear Information System (INIS)

    Purpose: To discuss the results obtained by giving adjuvant treatment for childhood ependymoma (EPD) at relapse after complete surgery only. Methods and Materials: Between 1993 and 2002, 63 children older than 3 years old entered the first Italian Association for Pediatric Hematology and Oncology protocol for EPD (group A), and another 14 patients were referred after relapsing after more tumor excisions only (group B). Prognostic factors were homogeneously matched in the two groups. We report on the outcome of group B. Results: Mean time to first local progression in group B had been 14 months. Tumors originated in the posterior fossa (PF) in 10 children and were supratentorial (ST) in 4; 11 had first been completely excised (NED) and 3 had residual disease (ED). Diagnoses were classic EPD in 9 patients, anaplastic in 5. Eight children were referred NED and 6 ED after two or more operations, 5 had cranial nerve palsy, 1 had recurrent meningitis, and 2 had persistent hydrocephalus. All received radiotherapy (RT) to tumor bed and 5 also had pre-RT chemotherapy. Six of 14 patients (6/10 with PF tumors) had a further relapse a mean 6 months after the last surgery; 4 of 6 died: progression-free survival and overall survival at 4 years after referral were 54.4% and 77%, respectively. Considering only PF tumors and setting time 0 as at the last surgery for group B, progression-free survival and overall survival were 32% and 50% for group B and 52% (p < 0.20)/70% (p < 0.29) for the 46 patients in group A with PF tumors. Local control was 32% in group B and 70.5% in group A (p = 0.02). Conclusions: Relapsers after surgery only, especially if with PF-EPD, do worse than those treated after first diagnosis; subsequent surgery for tumor relapse has severe neurologic sequelae

  5. Late effects of treatment in survivors of childhood acute lymphoblastic leukaemia

    International Nuclear Information System (INIS)

    The overall aim of this study was a comprehensive assessment of the nature and severity of the late effects of treatment in a group of children surviving acute lymphoblastic leukaemia. In the absence of damage preceding treatment, late effects could be ascribed to treatment. Cranial irradiation, methotrexate, L-asparaginase and cytosine arabinoside are therapeutic modalities most likely to cause injury to the central nervous system. Survivors of childhood leukaemia also showed an increase in weight-for-height during and after therapy which appeared to be the consequence of a loss in statural growth as well as increasing weight-for-age. Assessment of endocrine function in leukaemia survivors indicated abnormalities in the regulation of growth hormone and thyroid stimulating hormone in some patients. Survivors of childhood leukaemia were shown to have an intellectual deficit compared with their siblings and a high incidence of visual-perceptual defects. The intellectual effects of lower doses of cranial irradiation are as yet unknown. A variety of minor neurological abnormalities were detected among leukaemia survivors and thought to be related to preceding central nervous system 'prophylactic' chemotherapy and irradiation. A new instrument, the functional deficit score, was derived to reflect overall outcome in survivors of childhood leukaemia. With few exceptions, leukaemia survivors in this study had received 2400 rads of deep x-ray therapy as cranial irradiation. This dosage has since been reduced world-wide. Current cranial irradiation 'prophylaxis' consists of 1800 rad of megavoltage radiotherapy

  6. Risperidone as a treatment for childhood habitual behavior

    OpenAIRE

    Omranifard, Victoria; Najafi, Mostafa; Sharbafchi, Mohammad Reza; Emami, Parisa; Maracy, Mohammad

    2013-01-01

    Objective: The aim of this study was to investigate the effect of adding risperidone to the general behavioral treatment of masturbation in children 3-7 years old. Methods: A 4 week randomized clinical controlled trial was designed in year 2009. Samples have been chosen from children who have been referred to the Child and Adolescence Psychiatric Clinic of Isfahan University of Medical Sciences. Ninety children were recruited at the study and randomly allocated into the risperidone and contro...

  7. Medulloblastoma in childhood: long-term results of treatment

    International Nuclear Information System (INIS)

    Thirty-one children under the age of 15 years with verified medulloblastoma were treated at Addenbrookes Hospital from 1940 to 1976. In addition to surgical treatment, all received high dose irradiation to the whole neuraxis. Nine were still alive in 1979, of whom eight were examined. All these patients showed some residual problems, but five were leading active lives and had only minor physical disability. There was evidence of disturbance in growth, with shortening of the spine in relation to the limbs, in all the children. The height centile was lower than expected from parental height in four and one was severely dwarfed. Growth hormone secretion in response to exercise was, however, normal in five of six patients tested. Three children also showed failure of growth of the jaw sufficiently severe to be a cosmetic problem. Frank mental retardation was present in three children. A raised resting TSH level was found in two children, one of whom had a multinodular goiter. Of the three children with severe problems, two had been treated when under two years of age. Long-term follow-up of children who survive medulloblastoma is clearly necessary and consideration should perhaps be given to revision of current treatment regimes in very young children

  8. Cardiac damage after treatment of childhood cancer: A long-term follow-up

    International Nuclear Information System (INIS)

    With improved childhood cancer cure rate, long term sequelae are becoming an important factor of quality of life. Signs of cardiovascular disease are frequently found in long term survivors of cancer. Cardiac damage may be related to irradiation and chemotherapy. We have evaluated simultaneous influence of a series of independent variables on the late cardiac damage in childhood cancer survivors in Slovenia and identified groups at the highest risk. 211 long-term survivors of different childhood cancers, at least five years after treatment were included in the study. The evaluation included history, physical examination, electrocardiograpy, exercise testing and echocardiograpy. For analysis of risk factors, beside univariate analysis, multivariate classification tree analysis statistical method was used. Patients treated latest, from 1989–98 are at highest risk for any injury to the heart (73%). Among those treated earlier are at the highest risk those with Hodgkin's disease treated with irradiation above 30 Gy and those treated for sarcoma. Among specific forms of injury, patients treated with radiation to the heart area are at highest risk of injury to the valves. Patients treated with large doses of anthracyclines or concomitantly with anthracyclines and alkylating agents are at highest risk of systolic function defect and enlarged heart chambers. Those treated with anthracyclines are at highest risk of diastolic function defect. The time period of the patient's treatment is emerged as an important risk factor for injury of the heart

  9. [Commemorative lecture of receiving Imamura Memorial Prize. Studies on prevention and treatment of childhood tuberculosis].

    Science.gov (United States)

    Takamatsu, I

    1999-11-01

    We performed a retrospective analysis of 394 patients who were treated for active tuberculosis (TB) at our hospital from 1976 to 1997. We had started early BCG vaccination campaign in Osaka Prefecture from 1995 and the coverage of BCG vaccination in infants rose up to about 90%. From that experience, we studied the current situations and measures on prevention and treatment of childhood tuberculosis. Pulmonary TB in children is successfully treated with 6-month standard short-course chemotherapy using isoniazid, rifampin, and pyrazinamide daily for 2 months, followed by isoniazid and rifampin daily for 4 months. Prognosis of childhood tuberculous meningitis (TBM) is poor, early diagnosis and prevention of TBM is important. In order to promote TB control and eliminate childhood TB, especially in infants, the following is necessary; 1) early detection and treatment of adult TB patients, source of infection, 2) prompt and appropriate contact examination and chemoprophylaxis, 3) BCG vaccination during early infancy, 4) protection from MDR-TB are most important. PMID:10599214

  10. Analysis on the childhood and adolescent differentiated thyroid cancer: clinical features and radioiodine treatment

    International Nuclear Information System (INIS)

    Objective: Children with differentiated thyroid cancer (DTC) frequently present with more extensive disease than adults. The aim of this study was to characterize the clinical features of child-hood and adolescent DTC and evaluate the outcome and safety of radioiodine treatment. Methods: The records of 38 childhood and adolescent DTC cases, with 28 females and 10 males (mean age: 16.4 years) were reviewed. At diagnosis, all had metastatic lesions with 38 at regional lymph nodes, 15 at lung, 2 at brain and bone. Twenty-three had a total thyroidectomy, 7 had subtotal thyroidectomy, 5 had lobectomy, and 3 had other treatment. All received post-operative radioiodine therapy. All had follow-up for at least one year. Results: At the time of follow-up, all were survive (with a median follow-up of 5.13 years). Four-teen patients had no evidence of disease, 16 had partial remission, and 8 were stable disease. Conclusions: DTC of the thyroid in childhood and adolescent has high risks of residual/recurrence and metastasis. Post-thyroidectomy oral administration of radioiodine was an effective and safety adjuvant therapy for outcomes. (authors)

  11. Factors related to under-diagnosis and under-treatment of childhood asthma in metropolitan France

    Directory of Open Access Journals (Sweden)

    Annesi-Maesano Isabella

    2012-08-01

    Full Text Available Abstract Background Under-diagnosis and under-treatment of childhood asthma were investigated in France using data collected during the 6 Cities Study, the French contribution to the International Study of Asthma and Allergies in Childhood. Methods 7,781 schoolchildren aged between 9 and 10 years underwent a medical visit including skin prick tests to common allergens and exercise test for Exercise-Induced Asthma (EIA and their parents filled in a standardized questionnaire on asthma, management, treatment and potential risk factors. Results 903 children reported asthma (11.6%, 377 without a doctor’s diagnosis. Of the 526 participants with a diagnosis of asthma confirmed by a doctor (58.2%, 353 were treated and 76 were not treated during the year preceding the investigation despite their diagnosis. The information on the treatment was missing for the rest of individuals diagnosed with asthma (n = 97. Having a treatment was significantly associated with severe asthma and with the presence of other respiratory and allergic stigmata (atopic eczema, rhinitis, positive skin allergy tests, and EIA. In addition, having a treatment did not correspond to a good control of the disease. Similarly, children with asthma-like symptoms but without doctor-diagnosed asthma had asthma less well controlled than children with diagnosed asthma. They were also more exposed to passive smoking and traffic but had fewer pets. In contrast, diagnosed children reported more frequently a small weight at birth and a preterm birth. Conclusions In France, childhood asthma is still under-diagnosed and under-treated and environmental factors play a role in these phenomena.

  12. Position of anticholinergic drugs in the treatment of childhood asthma

    Directory of Open Access Journals (Sweden)

    Stojković-Anđelković Anđelka

    2010-01-01

    Full Text Available Anticholinergic drugs block muscarinic effect of acetylcholine on the receptors of postjunctional membranes and so inhibit the answer of the postganglionic parasympathetic nerve. The loss of M2 muscarinic receptors function occurs in asthmatics and it contributes to bronchial hyperresponsiveness and it is not a chronic feature of asthma, instead it characterizes asthma exacerbation. The loss of M2 muscarinic receptor function in children and adults happens during antigen bronchoprovocation or during exposition of asthmatics to ozone. After inhalation, ipratropium bromide (IB can be found in a small quantity in circulation and it links less readily to muscarinic receptors on airway smooth muscles as related to its absorption after intravenous application. In the stepwise approach of asthma inhaled anticholinergics is recommended if the symptoms of the disease cannot be adequately controlled by a regular inhalation of antiinflammatory drugs with β2-agonist and oral steroids. The improvement of the airway inspiratory capacity is more elevated than the improvement of FEV1 after inhalation of IB. IB has similar effect as salbutamol and it is recommended to control a stable chronic obstructive disease. During our numerous investigations and up-to-date experience in the usage of 5-7 μg/kg/body mass of IB repeated every 4-6 hours in combination with salbutamol, we did not notice adverse effects of the drug in infants. IB is recommended for hospital treatment of children. .

  13. Perceptions of childhood diarrhoea and its treatment in rural Zimbabwe.

    Science.gov (United States)

    de Zoysa, I; Carson, D; Feachem, R; Kirkwood, B; Lindsay-Smith, E; Loewenson, R

    1984-01-01

    In the course of a study on the acceptability and feasibility of home-based oral rehydration therapy in rural Zimbabwe, information was collected on attitudes and beliefs about diarrhoea and on action taken in response to an episode of diarrhoea in a child. Diarrhoea was found to be a perceived threat at community and family level and numerous possible causes of diarrhoea were described which were assigned to two broad classes: (1) 'physical' causes, such as a polluted environment, diet and teething and (2) 'social and spiritual' causes such as those associated with a depressed fontanelle. These domains were not, however, mutually exclusive; 76% of the described episodes of diarrhoea were attributed to 'physical' causes, 15% to 'social and spiritual' causes and 8% to a combination of both. Reported utilization rates of the formal health services were unexpectedly high. In contrast, we recorded a low demand for indigenous herbalists (n'angas). Home management was common and comprised the administration of indigenous herbal remedies, of sugar and salt solutions, of over-the-counter drugs or of enemas. These remedies were given on their own or alongside the treatment prescribed by a health worker. A number of variables were examined to assess their influence on health-seeking behaviour: perceived cause and severity of the illness, socio-demographic characteristics of the respondent or child and accessibility of the health services.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:6505741

  14. Optic Tract Edema: A Highly Specific Magnetic Resonance Imaging Finding for the Diagnosis of Craniopharyngiomas

    Energy Technology Data Exchange (ETDEWEB)

    Hirunpat, S.; Tanomkiat, W.; Sriprung, H.; Chetpaophan, J. [Prince of Songkla Univ., Hat Yai (Thailand). Dept. of Radiology and Epidemiology Unit

    2005-07-01

    Purpose: To clarify the accuracy, sensitivity, and specificity of optic tract edema in the diagnosis of craniopharyngiomas. Material and Methods: Preoperative magnetic resonance images (MRIs) of 49 patients (between May 1996 and March 2003) who had a diagnosis of parasellar masses were blindly reviewed by two radiologists. The spread of edema surrounding the tumor on the coronal TSE T2-weighted images was analyzed. Sensitivity and specificity were calculated based on the numbers in this series and also pooled numbers from previous known reported series. Results: Edema along the optic tracts was detected in 7 of 1 craniopharyngiomas, giving a sensitivity of 63.6% (95% CI{approx_equal}30.8-89.1) for our series and 66.7% (95% CI{approx_equal}47.2-82.7) for the pooled numbers. The specificity was 00% (95% CI{approx_equal}90.7-100.0) for our series and 93.9% (95% CI{approx_equal}87.1-97.7) for the pooled numbers. None of the 28 pituitary macroadenomas, 4 meningiomas, 2 hypothalamic astrocytomas, 2 germinomas, mixed-germ cell tumor and arachnoid cyst in our study showed edema of the optic pathways. Conclusion: Optic tract edema, commonly seen in craniopharyngiomas, is a useful MR finding for distinguishing craniopharyngiomas from other parasellar tumors with considerable sensitivity and high specificity.

  15. Optic Tract Edema: A Highly Specific Magnetic Resonance Imaging Finding for the Diagnosis of Craniopharyngiomas

    International Nuclear Information System (INIS)

    Purpose: To clarify the accuracy, sensitivity, and specificity of optic tract edema in the diagnosis of craniopharyngiomas. Material and Methods: Preoperative magnetic resonance images (MRIs) of 49 patients (between May 1996 and March 2003) who had a diagnosis of parasellar masses were blindly reviewed by two radiologists. The spread of edema surrounding the tumor on the coronal TSE T2-weighted images was analyzed. Sensitivity and specificity were calculated based on the numbers in this series and also pooled numbers from previous known reported series. Results: Edema along the optic tracts was detected in 7 of 1 craniopharyngiomas, giving a sensitivity of 63.6% (95% CI≅30.8-89.1) for our series and 66.7% (95% CI≅47.2-82.7) for the pooled numbers. The specificity was 00% (95% CI≅90.7-100.0) for our series and 93.9% (95% CI≅87.1-97.7) for the pooled numbers. None of the 28 pituitary macroadenomas, 4 meningiomas, 2 hypothalamic astrocytomas, 2 germinomas, mixed-germ cell tumor and arachnoid cyst in our study showed edema of the optic pathways. Conclusion: Optic tract edema, commonly seen in craniopharyngiomas, is a useful MR finding for distinguishing craniopharyngiomas from other parasellar tumors with considerable sensitivity and high specificity

  16. A craniopharyngioma with spontaneous involution of a gadolinium-enhanced region on magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Yasuyuki Kinoshita

    2014-01-01

    Full Text Available Background: It has not been reported previously that the solid enhancing portion of a craniopharyngioma has involuted without a change in cyst size. Case Description: We herein report a case of a craniopharyngioma with spontaneous involution of a solid gadolinium (Gd-enhanced region on magnetic resonance imaging (MRI. A 44-year-old female was referred to our department with a mass on MRI associated with headaches and polyuria. The images showed a suprasellar cystic lesion progressing from the posterior pituitary lobe to the right hypothalamus along the pituitary stalk. Examinations of the cerebrospinal fluid showed aseptic meningitis and a positive titer of beta-human chorionic gonadotropin (HCG-β preoperatively. The hypothalamic lesion became enlarged over the following 3 weeks, and a biopsy of the posterior pituitary lobe was performed via the endonasal transsphenoidal approach under a preoperative diagnosis of a germ cell tumor (GCT. The histological diagnosis was a craniopharyngioma, and the patient′s postoperative findings on MRI were atypical: The solid Gd-enhanced region in the hypothalamus had spontaneously decreased in size and the peritumoral edema had improved, although the biopsy site in the posterior pituitary lobe was distant from the area of shrinkage. We speculated that the involutional portion on MRI mimicking a tumor was actually the normal hypothalamus, which was abnormally enhanced due to a disruption of the blood-brain barrier caused by the craniopharyngioma. Conclusion: Gd-enhanced regions of parenchyma neighboring the cysts of craniopharyngioma should be carefully managed, taking into consideration the possibility of the enhancement of normal tissue.

  17. Childhood Obesity

    OpenAIRE

    Aydın, Ahmet; Koca, Fahrettin; Fıçıcıoğlu, Can; Çam, Halit; Mıkla, Şerare

    1995-01-01

    Management of childhood obesity and its early and late complications are among the most difficult problems confronted by pediatricians and practitioners The purpose of this review is to provide information for the evaluation and treatment of childhood obesity Key nbsp;words: nbsp;Child Obesity Etiology Management Complications

  18. Adolescent Substance Use in the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder (ADHD) (MTA) as a Function of Childhood ADHD, Random Assignment to Childhood Treatments, and Subsequent Medication

    Science.gov (United States)

    Molina, Brooke S. G.; Hinshaw, Stephen P.; Arnold, L. Eugene; Swanson, James M.; Pelham, William E.; Hechtman, Lily; Hoza, Betsy; Epstein, Jeffery N.; Wigal, Timothy; Abikoff, Howard B.; Greenhill, Laurence L.; Jensen, Peter S.; Wells, Karen C.; Vitiello, Benedetto; Gibbons, Robert D.; Howard, Andrea; Houck, Patricia R.; Hur, Kwan; Lu, Bo; Marcus, Sue

    2013-01-01

    Objective: To determine long-term effects on substance use and substance use disorder (SUD), up to 8 years after childhood enrollment, of the randomly assigned 14-month treatments in the multisite Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (MTA; n = 436); to test whether medication at follow-up, cumulative…

  19. Bedtime problems and night wakings: treatment of behavioral insomnia of childhood.

    Science.gov (United States)

    Moore, Melisa

    2010-11-01

    Bedtime problems and frequent night wakings are common sleep problems in infants and toddlers, affecting 20 to 30% of young children. Such problems, categorized as behavioral insomnia of childhood (BIC), lead to insufficient sleep, which contributes to multiple domains of child dysfunction. Behavioral treatments of BIC, such as extinction and positive routines are introduced, and supporting evidence is reviewed. Critical factors in developing a successful treatment plan include conducting a detailed assessment, collaboratively developing a plan that starts where the family is, and providing support between sessions. A case of a 3-year-old girl with BIC illustrates how treatment helped her to develop healthy sleep habits and taught her to sleep independently via graduated and standard extinction. PMID:20865768

  20. The Influence of Familial Predisposition to Cardiovascular Complications upon Childhood Obesity Treatment

    DEFF Research Database (Denmark)

    Nielsen, Louise A; Bøjsøe, Christine; Kloppenborg, Julie T;

    2015-01-01

    INTRODUCTION: The aim was to investigate whether a familial predisposition to obesity related cardiovascular complications was associated with the degree of obesity at baseline and/or changes in the degree of obesity during a multidisciplinary childhood obesity treatment program. METHODS: The study...... included 1421 obese children (634 boys) with a median age of 11.5 years (range 3.1-17.9 years), enrolled in treatment for 0.04 to 5.90 years (median 1.3 years) at the Children's Obesity Clinic, Denmark. At baseline, weight and height were measured, body mass index (BMI) standard deviation score (SDS......) calculated, and self-reported information on familial predisposition to obesity, hypertension, type 2 diabetes mellitus (T2DM), thromboembolic events, and dyslipidaemia were obtained. A familial predisposition included events in biological parents, siblings, grandparents, uncles, and aunts. The treatment...

  1. Hearing 25 years after surgical treatment of otitis media with effusion in early childhood

    DEFF Research Database (Denmark)

    Khodaverdi, M; Jørgensen, G; Lange, T; Stangerup, SE; Drozdziewizc, D; Tos, M; Bonding, P; Cayé-Thomasen, P

    2013-01-01

    OBJECTIVE: To determine the long-term hearing following surgical treatment of chronic OME in early childhood (myringotomy or ventilation tube) and to determine the impact of the occurrence and the extension of specific eardrum pathology on the hearing level. PATIENTS AND METHODS: In 1977-1978, 224...... age- and gender-matched normative data set. For the determination of the impact of specific eardrum pathology on the hearing, multiple linear regression modelling was used in adjustment for age and concomitant eardrum pathologies. RESULTS: Long-term hearing after chronic OME and associated treatment......B), but not in tubed ears, for which only high frequencies were affected. Conversely, tensa atrophy is associated with an overall hearing loss in tubed ears (3-4dB), but not in myringotomised ears, for which only high frequencies were affected. CONCLUSIONS: Hearing 25 years after surgical treatment of...

  2. A Behavioral Perspective of Childhood Trauma and Attachment Issues: Toward Alternative Treatment Approaches for Children with a History of Abuse

    Science.gov (United States)

    Prather, Walter; Golden, Jeannie A.

    2009-01-01

    Attachment theory provides a useful conceptual framework for understanding trauma and the treatment of children who have been abused. This article examines childhood trauma and attachment issues from the perspective of behavior analysis, and provides a theoretical basis for two alternative treatment models for previously abused children and their…

  3. Stress Moderates the Effect of Childhood Trauma and Adversity on Recent Drinking in Treatment-seeking Alcohol-dependent Men

    Science.gov (United States)

    Eames, Sarah F.; Businelle, Michael S.; Suris, Alina; Walker, Robrina; Rao, Uma; North, Carol S.; Xiao, Hong; Adinoff, Bryon

    2014-01-01

    Objective This study sought to clarify the relationship between childhood trauma and adversity with later alcohol consumption and the moderating effects of adult psychosocial stress. Method Seventy-seven recently abstinent alcohol-dependent men attending residential treatment programs were assessed. Childhood trauma/adversity was assessed with the Childhood Trauma Questionnaire (CTQ), drinks per drinking day (DDD) with the TimeLine Follow Back, and chronic psychosocial stress with the UCLA Stress Interview. Drinking and stress were retrospectively assessed for six months prior to the present treatment episode. Direct associations between childhood trauma/adversity and alcohol consumption and the moderating effects of recent psychosocial stress were assessed. All measures were considered as continuous variables. Results Pretreatment drinking severity (DDD) was associated with CTQ Total score (p = .009) and the Emotional Abuse (p < .001) and Physical Abuse (p < .01) subscales. UCLA Total Stress significantly moderated the effects of CTQ Total score on drinking severity (p = .04). Whereas higher CTQ scores were significantly associated with a greater amount of pretreatment drinking in participants with high UCLA stress scores (p = .01), CTQ scores were not associated with the amount of drinking in those with low UCLA stress scores (p = .63). Conclusions Childhood trauma predicts drinking severity in alcohol-dependent men and this effect is stronger in participants with ongoing stress in adult life. These findings suggest that early childhood trauma/adversity may sensitize stress-response systems. PMID:24635549

  4. Pityriasis Lichenoides in Childhood: Review of Clinical Presentation and Treatment Options.

    Science.gov (United States)

    Geller, Lauren; Antonov, Nina K; Lauren, Christine T; Morel, Kimberly D; Garzon, Maria C

    2015-01-01

    Pityriasis lichenoides (PL) is a skin condition of unclear etiology that occurs not uncommonly in childhood. It is often classified into the acute form, pityriasis lichenoides et varioliformis acuta (PLEVA), and the chronic form, pityriasis lichenoides chronica (PLC). We performed a comprehensive review of the English-language literature using the PubMed database of all cases of childhood PL reported from 1962 to 2014 and summarized the epidemiology, clinical features, treatment options, and prognosis of this condition in children. The proposed etiologies are discussed, including its association with infectious agents, medications, and immunizations and evidence for PL as a lymphoproliferative disorder. We found an average age of PL onset of 6.5 years, with a slight (61%) male predominance. We also found that PLEVA and PLC tend to occur with equal frequency and that, in many cases, there is clinical and histopathologic overlap between the two phenotypes. When systemic therapy is indicated, we propose that oral erythromycin and narrowband ultraviolet B phototherapy should be first-line treatment options for children with PL since they have been shown to be effective and well tolerated. In most cases, PL follows a benign course with no greater risk of cutaneous T-cell lymphoma, although given the rare case reports of transformation, long-term follow-up of these patients is recommended. PMID:25816855

  5. Long-term results of pediatric and adult craniopharyngiomas treated with combined surgery and radiation

    International Nuclear Information System (INIS)

    From 1958 to 1982, 58 patients with craniopharyngioma were treated with external beam radiation, 56 post surgery. Nineteen were pediatric and 39 were adult. Forty patients underwent primary treatment while 18 (7 pediatric and 11 adults) were treated for recurrence. Median follow-up is 17 years. Tumour dose and 'maximum dose' were recorded. The mean tumour and maximum dose for pediatric patients was 5588 and 5870 cGy vs. 6243 and 6542 cGy, respectively for adults. Overall disease recurrence rates were 26% (5/19) for pediatric patients and 18% (7/39) for adults. Of the multiple patient and treatment parameters analyzed, initial disease type in pediatric patients, surgical extent, tumor dose, maximum dose, age of adults and use of pretreatment CT evaluation appeared to impact on patient outcome. Pediatric patients treated for primary disease showed improved survival over those treated for recurrence. The same was not observed in adults and appeared to be due to treatment toxicity. All patients who underwent total resection developed surgical sequelae. Forty-four percent (4/9) of patients receiving tumor doses of ≤5400 cGy developed recurrences vs. 16% (8/49) in those receiving >5400 cGy. Nine of the 12 recurrences were in patients who did not undergo pretreatment CT evaluation. The 67% actuarial 5- 10-year survival for adults <50 years was significantly better than the respective 33% and 27% for the 15 patients ≥50 years (p=0.03). Five of the seven disease recurrences in adults occurred in patients ≥50 years. The incidence of radiation, vascular, visual and/or neurologic complications correlated strongly with maximum dose. The incidence of radiation endocrine sequelae appeared to correlate both with age and maximum dose. Tumor doses of 5500 cGy at 180 cGy per fraction appear satisfactory for local control of disease while associated maximum doses greater than 6100 cGy appear to be attendant with a marked increased risk of complications. Use of modern surgical

  6. Fertility treatment and the risk of childhood and adolescent mental disorders

    DEFF Research Database (Denmark)

    Bay, Bjørn; Mortensen, Erik Lykke; Kesmodel, Ulrik Schiøler

    2013-01-01

    embryos were used in the treatments. Limitations, reason for caution The study did not include information on parental psychiatric history and since it is well known that mental disorders run in families, this could explain our findings if children conceived after OI/IUI were born by parents with a higher......Abstract Study question We compared the risk of mental disorders in childhood and adolescence between children born after fertility treatments with in vitro fertilization (IVF), intra cytoplasmic sperm injection (ICSI) or ovulation induction (OI) with or without insemination (IUI) and children born...... after spontaneously conception. Summary answer We found an increased risk of mental disorders in children born after OI/IUI, while children born after IVF/ICSI were found to have overall comparable risk with children conceived spontaneously. What is known already Several follow-up studies have been...

  7. Systemic Retinoid Treatment in Childhood Psoriasis: Experience of 19 Mayıs Univer

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    Müge Güler Özden

    2010-06-01

    Full Text Available Background and Design: Severe psoriasis in childhood has a significant morbidity and can warrant the use of systemic agents, although there are very little information in this group. We aimed to show the results of acitretin treatment in children with severe psoriasis, in this study.Material and Method: We have retrospectively reviewed the notes of all 18 children treated with acitretin at Ondokuz Mayıs University Hospital. Patients’ responses to treatment, total treatment durations and acitretine dosage were recorded. Additionally, the laboratory results during the whole follow-up period and bone surveys for 3 patients who received long term treatment were evaluated.Results: Of the 18 patients reviewed, 2 (%11.1 responded with clearance of psoriasis, 10 (%55.5 responded well with small residual plaques. Two patients needed two courses of acitretine (11 and 12 months, 1 patient needed three courses for 15 months and 1 needed 5 courses for 24 months. Two patients stopped treatment due to mucocutaneous side effects at 4th and 5th months. There were no other adverse events.Conclusion: We propose that when carefully monitored, acitretine is a safe and efficacious treatment option for severe psoriasis in children.

  8. Childhood and Adult Trauma Experiences of Incarcerated Persons and Their Relationship to Adult Behavioral Health Problems and Treatment

    Directory of Open Access Journals (Sweden)

    Jing Shi

    2012-05-01

    Full Text Available Rates of childhood and adult trauma are high among incarcerated persons. In addition to criminality, childhood trauma is associated with the risk for emotional disorders (e.g., depression and anxiety and co-morbid conditions such as alcohol and drug abuse and antisocial behaviors in adulthood. This paper develops rates of childhood and adult trauma and examines the impact of age-of-onset and type-specific trauma on emotional problems and behavior for a sample of incarcerated males (N~4,000. Prevalence estimates for types of trauma were constructed by age at time of trauma, race and types of behavioral health treatment received while incarcerated. HLM models were used to explore the association between childhood and adult trauma and depression, anxiety, substance use, interpersonal problems, and aggression problems (each model estimated separately and controlling for age, gender, race, time incarcerated, and index offense. Rates of physical, sexual, and emotional trauma were higher in childhood than adulthood and ranged from 44.7% (physical trauma in childhood to 4.5% (sexual trauma in adulthood. Trauma exposure was found to be strongly associated with a wide range of behavioral problems and clinical symptoms. Given the sheer numbers of incarcerated men and the strength of these associations, targeted intervention is critical.

  9. Etiology, Treatment and Prevention of Obesity in Childhood and Adolescence: A Decade in Review

    OpenAIRE

    Spruijt-Metz, Donna

    2011-01-01

    Childhood obesity has become an epidemic on a worldwide scale. This article gives an overview of the progress made in childhood and adolescent obesity research in the last decade, with a particular emphasis on the transdisciplinary and complex nature of the problem. The following topics are addressed: 1) current definitions of childhood and adolescent overweight and obesity; 2) demography of childhood and adolescent obesity both in the US and globally; 3) current topics in the physiology of f...

  10. Palmar-plantar erythrodysesthesia, clinical case presentation in a patient with craniopharyngioma and sickle cell anemia

    OpenAIRE

    Lora-Fernández Alberto Carlos; Arias-Arias Ramón

    2010-01-01

    The sickle-cell disease complicatiosn include acute isquemic crisis in extremities and organs, occur to fuctional and estructural alteration in oxigen transport toward tissue, our case of a patient with craniopharyngioma after posoperatory tumoral resection show necrosis in hand and foot, conduce to amputation, describe this clinic presentation after a allergic reaction to vancomicine and ceftriazone associated the hemoglobinopatie of the patient and management instaurated.RESUMENLas complica...

  11. Diagnosis and treatment of childhood intussusception using rea-time ultrasonography and saline enema: preliminary report

    International Nuclear Information System (INIS)

    Diagnosis and successful reduction of intussusception using realtime ultrasonography and saline enema was reported in 2 cases of ileocolic childhood intussusception. The principle of this saline enema is the same with barium enema in terms of hydrostatic reduction. But barium and fluoroscopy were replaced by warm normal saline and realtime ultrasonography. Characteristic ultrasonographic findings of intussusception prior to and during the saline enema were well demonstrated. Reduction process of intussusception could be traced by real time scan along the course of the colon and successful reduction could be confirmed by ultrasonography alone. Ultrasonographic evidences of successful reduction were loss of echogenic mass with rapid turbulent flow of saline in cecum and absence of target sign in ultrasonography after evaluation of saline. This new method not only is free from radiation exposure and risk of barium peritonitis but also shows characteristic ultrasonographic findings of intussusception as specific as barium enema. Therefore it is expected that hydrostatic saline enema with reatime ultrasonography can replace the barium enema as a treatment of choice of childhood intussusception

  12. Characteristics and Outcomes of Second Malignant Neoplasms after Childhood Cancer Treatment: Multi-Center Retrospective Survey.

    Science.gov (United States)

    Koh, Kyung-Nam; Yoo, Keon Hee; Im, Ho Joon; Sung, Ki Woong; Koo, Hong Hoe; Kim, Hyo Sun; Han, Jung Woo; Yoon, Jong Hyung; Park, Hyeon Jin; Park, Byung-Kiu; Baek, Hee Jo; Kook, Hoon; Lee, Jun Ah; Lee, Jae Min; Lee, Kwang Chul; Kim, Soon Ki; Park, Meerim; Lee, Young-Ho; Lyu, Chuhl Joo; Seo, Jong Jin

    2016-08-01

    This retrospective study investigated the clinical characteristics and outcomes of second malignant neoplasms (SMNs) in survivors of childhood cancer from multiple institutions in Korea. A total of 102 patients from 11 institutions who developed SMN after childhood cancer treatment between 1998 and 2011 were retrospectively enrolled. The most common primary malignant neoplasms (PMNs) were central nervous system (CNS) tumors (n = 17), followed by acute lymphoblastic leukemia (n = 16), non-Hodgkin lymphoma (n = 13), and osteosarcoma (n = 12). The most common SMNs were therapy-related myeloid neoplasms (t-MNs; acute myeloid leukemia [AML], 29 cases; myelodysplastic syndrome [MDS], 12 cases), followed by thyroid carcinomas (n = 15) and CNS tumors (n = 10). The median latency period was 4.9 years (range, 0.5-18.5 years). Among 45 patients with solid tumors defined as an SMN, 15 (33%) developed the lesion in a field previously subjected to radiation. The 5-year overall survival (OS) rate of patients with an SMN was 45% with a median follow-up time of 8.6 years. Patients with AML, MDS, and CNS tumors exhibited the poorest outcomes with 5-year OS rates of 18%, 33%, and 32%, respectively, whereas those with second osteosarcoma showed comparable outcomes (64%) to patients with primary counterpart and those with second thyroid carcinoma had a 100% OS rate. Further therapeutic efforts are recommended to improve the survival outcomes in patients with SMNs, especially in cases with t-MNs and CNS tumors. PMID:27478336

  13. Diagnosis and treatment of childhood intussusception using rea-time ultrasonography and saline enema: preliminary report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Goo; Choi, B. I.; Yeon, K. M.; Kim, J. W. [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1982-12-15

    Diagnosis and successful reduction of intussusception using realtime ultrasonography and saline enema was reported in 2 cases of ileocolic childhood intussusception. The principle of this saline enema is the same with barium enema in terms of hydrostatic reduction. But barium and fluoroscopy were replaced by warm normal saline and realtime ultrasonography. Characteristic ultrasonographic findings of intussusception prior to and during the saline enema were well demonstrated. Reduction process of intussusception could be traced by real time scan along the course of the colon and successful reduction could be confirmed by ultrasonography alone. Ultrasonographic evidences of successful reduction were loss of echogenic mass with rapid turbulent flow of saline in cecum and absence of target sign in ultrasonography after evaluation of saline. This new method not only is free from radiation exposure and risk of barium peritonitis but also shows characteristic ultrasonographic findings of intussusception as specific as barium enema. Therefore it is expected that hydrostatic saline enema with reatime ultrasonography can replace the barium enema as a treatment of choice of childhood intussusception

  14. Etiology, Treatment, and Prevention of Obesity in Childhood and Adolescence: A Decade in Review

    Science.gov (United States)

    Spruijt-Metz, Donna

    2011-01-01

    Childhood obesity has become an epidemic on a worldwide scale. This article gives an overview of the progress made in childhood and adolescent obesity research in the last decade, with a particular emphasis on the transdisciplinary and complex nature of the problem. The following topics are addressed: (1) current definitions of childhood and…

  15. Childhood Tuberculosis in a Sub-Saharan Tertiary Facility: Epidemiology and Factors Associated with Treatment Outcome

    Science.gov (United States)

    Kinsiona, Christian; Fueza, Serge Bisuta; Kokolomami, Jack; Bolie, Grace; Lumbala, Paul

    2016-01-01

    Childhood tuberculosis (TB) is a diagnostic challenge in developing countries, and patient outcome can be influenced by certain factors. We report the disease course, clinical profile and factors associated with treatment outcome in a tertiary facility of Kinshasa. Documentary and analytical studies were conducted using clinical and exploratory data for children aged up to 15 years who were admitted to the University Clinics of Kinshasa for TB. Data are presented as frequencies and averages, and binary and logistic regression analyses were performed. Of 283 children with TB, 82 (29.0%) had smear-negative TB, 40 (14.1%) had smear-positive TB, 159 (56.1%) had extra-pulmonary TB (EPTB), 2 (0.7%) had multidrug-resistant TB (MDR-TB), 167 (59.0%) completed treatment, 30 (10.6%) were cured, 7 (2.5%) failed treatment, 4 (1.4%) died, 55 (19.4%) were transferred to health centers nearest their home, and 20 (7.0%) were defaulters. In the binary analysis, reported TB contacts (p = 0.048), type of TB (p = 0.000), HIV status (p = 0.050), Ziehl-Nielsen test result (p = 0.000), Lowenstein culture (p = 0.004) and chest X-ray (p = 0.057) were associated with outcome. In the logistic regression, none of these factors was a significant predictor of outcome. Tertiary level care facilities must improve the diagnosis and care of patients with childhood TB, which justifies the development of alternative diagnostic techniques and the assessment of other factors that potentially affect outcome. PMID:27101146

  16. Craniopharyngiomas - the utility of contrast medium enhancement for MR imaging at 1.5 T

    International Nuclear Information System (INIS)

    To evaluate the efficacy of i.v. contrast medium administration in MR imaging at 1.5 T in patients with craniopharyngiomas, MR studies of 10 men and 6 women with pathologically proven craniopharyngiomas were made. The MR images were obtained as 3- to 5-mm-thick coronal (n=13) or axial (n=3) T1-weighted images (T1WI) prior to an following i.v. Gd-DTPA administration. Proton density-(PD) and T2-weighted images (T2WI) were also obtained. Conspicuity of tumor margins, cystic versus solid components, size, location and effect upon adjacent structures were separately characterized in all imaging sequences. In 6 patients contrast medium-enhanced T1WI, PD and T2WI demonstrated cystic tumor components not seen on unenhanced T1WI. There were significant differences (p<0.004) on 2-tailed Student's t-test comparing tumor conspicuity on contrast medium-enhanced T1WI with unenhanced T1WI, PD and T2WI. Optimal tumor delineation on MR imaging of patients with craniopharyngiomas justifies the use of i.v. contrast medium. (orig.)

  17. Infrasellar craniopharyngioma: case report Craniofaringioma infra-selar: relato de caso

    Directory of Open Access Journals (Sweden)

    Asdrubal Falavigna

    2001-06-01

    Full Text Available We report a case of infrasellar craniopharyngioma in a 34 year-old woman who presented with progressive headache and diplopia. Computed tomographic and magnetic resonance images showed a heterogeneous tumor originating from the sphenoid bone with ethmoid sinus and sella turcica extension. A sublabial rhinoseptal transsphenoidal surgery was performed. Craniopharyngiomas with infrasellar development are very rare. Infrasellar craniopharyngioma is uncommon, thirty-five cases has been reported in literature. The embryology, clinical features and radiographic investigation of these tumors are discussed.Relatamos um caso de craniofaringioma infra-selar em uma paciente de 34 anos com sintomas de cefaléia e diplopia. A investigação radiológica com tomografia computadorizada e ressonância magnética de encéfalo demonstrou um tumor heterogêneo localizado no osso esfenoidal e com extensão para o seio etmoidal e sela turcica. Realizada cirurgia pela via transesfenoidal. A ocorrência de craniofaringioma com topografia infra-selar é incomum, havendo relato na literatura de 35 casos. A literatura é revisada, sendo discutidas a embriologia, a apresentação clínica e características radiológicas do tumor.

  18. New dosimetry for childhood skin hemangioma treatments with 226Ra needles or tubes

    International Nuclear Information System (INIS)

    Background: The Stockholm Hemangioma Cohort is important for evaluation of late effects after exposure to ionizing radiation during childhood. Dose estimates in this cohort were based on both measurements and calculations using an old treatment planning system. Methods: We compare previously published and calculated dose estimates with new ones, obtained by Monte Carlo simulations, which mimic the hemangioma treatments with 226Ra needles and tubes. The distances between the 226Ra sources and the thyroid and breasts, respectively, were reassessed. Result: The Monte Carlo calculations showed significantly lower dose values than those obtained earlier. The differences depended both on the modeling of the sources and on further individualized distances from the sources. The mean value of the new calculated doses was 25% of the old breast doses and 46% of the old thyroid doses. Conclusion: New dosimetry for hemangioma treatments gives significantly lower organ doses for the few cases receiving the highest absorbed dose values. This implies that radiation risk estimates will increase and have to be recalculated. For retrospective studies it is now possible to calculate organ doses from radium treatments using modern treatment planning systems by modeling the source geometry carefully and apply the TG-43 formalism. It is important to be aware of the large uncertainties in calculated absorbed dose values

  19. Outcome of treatment in childhood acute lymphoblastic leukaemia with rearrangements of the 11q23 chromosomal region

    NARCIS (Netherlands)

    Pui, CH; Gaynon, PS; Boyett, JM; Chessells, JM; Baruchel, A; Kamps, W; Silverman, LB; Biondi, A; Harms, DO; Vilmer, E; Schrappe, M; Camitta, B

    2002-01-01

    Background The prognosis and optimum treatment of childhood acute lymphoblastic leukaemia (ALL) with abnormalities of chromosomal band 11q23 are controversial. We aimed to identify prognostic factors that might help in planning future therapy, and to assess the effectiveness of haemopoietic stem-cel

  20. Bickerstaff's brainstem encephalitis (BBE) in childhood: rapid resolution after intravenous immunoglobulins treatment.

    Science.gov (United States)

    Pavone, P; Le Pira, A; Greco, F; Vitaliti, G; Smilari, P L; Parano, E; Falsaperla, R

    2014-01-01

    Three young patients with Bickerstaff's brainstem encephalitis (BBE) are reported. Some weeks following an upper tract infection, the children after a short period of recovery, showed acute onset of symmetric weakness of the lower limbs with difficulty in standing by and walking. The distal muscle weakness had a rapid progression with involvement of the cranial nerve, and then with severe impairment of the consciousness till to coma in one of the three children. BBE is a rare and often underdiagnosed affection in childhood. Common neuro-immune pathogenesis, overlap of clinical signs and strict correlation among BBE with Fisher syndrome and Guillain-Barrè syndrome lead to think that these affections represent an unique spectrum with different central and peripheral involvement. In these children, treatment with intravenous immunoglobulins resulted in a progressive and rapid resolution of the clinical features. PMID:25268095

  1. Maltreatment in early childhood: a scoping review of prevention, detection and treatment

    Directory of Open Access Journals (Sweden)

    Luis Lefio Celedón

    2013-08-01

    Full Text Available Purpose. To identify and synthesize the best available evidence on the effectiveness of interventions for universal prevention, detection and treatment of early childhood maltreatment (0-4 years. Design. Scoping Review. Data sources. MEDLINE, LILACS, PsycINFO, Psyclist, SciELO, ISI Web of Knowledge, Science Direct, EBSCO, EMBASE, Cochrane Library, DARE, Google Scholar and UNICEF Base. Methods. A variety of keywords were used to identify quantitative experimental and observational studies on detection, prevention and treatment strategies in different situations of child maltreatment. Sexual abuse was excluded. The search spanned from 2002 to 2012, in English and Spanish. Results. Of 105 articles, 36 met the selection criteria. In prevention, the best evaluated strategies were parenting programs based on cognitive or cognitive-behavioral approach and interactive learning strategies. In detection, only two instruments were identified with optimum specificity and positive predictive value. In treatment, a variety of treatment strategies were identified with favorable effects on behavioral, functional and psycho affective indicators. The population relevance of these interventions is unclear, as the differential effectiveness of these therapeutic approaches. Conclusions. There are many child maltreatment prevention strategies at the individual and family level. The instruments used for detection are not reliable for use at the collective level. Insofar as therapy, not enough evidence was found both in quality and quantity to favor one intervention over another. It is recommended to understand the problem from the public health perspective and to generate multisectoral and interdisciplinary approaches.

  2. Clinical use of a modified release methylphenidate in the treatment of childhood attention deficit hyperactivity disorder.

    Science.gov (United States)

    Takon, Inyang

    2011-01-01

    Attention deficit hyperactivity disorder (ADHD) is the most commonly diagnosed neurobehavioural disorder in childhood, affecting over 5% of children worldwide. As well as the core symptoms of inattention, hyperactivity and impulsivity, patients often exhibit learning difficulties and impairment in social functioning. The frequency of referral is higher for boys than for girls (about 2:1), and girls are generally older at the time of referral.Pharmacological therapy is considered the first-line treatment for patients with severe ADHD and severe impairment. Stimulant medications are licensed in the UK for the management of ADHD in school-age children and young people, and are effective in controlling ADHD symptoms.While immediate-release preparations of methylphenidate (MPH) have proven effective in the treatment of ADHD, there are a number of problems associated with their use, most notably compliance, stigma and medication diversion. Modified release preparations are now available that overcome the need for multiple daily dosing, and which offer different MPH release profiles, thereby enabling the physician to match the medication to the patient's particular requirements.This review describes the diagnosis, referral and treatment pathways for patients with ADHD in the UK and the practical considerations when initiating pharmacological treatment. The clinical experience of treating ADHD with a modified-release MPH preparation (Equasym XL®) is illustrated with case studies. PMID:21962224

  3. Clinical use of a modified release methylphenidate in the treatment of childhood attention deficit hyperactivity disorder

    Directory of Open Access Journals (Sweden)

    Takon Inyang

    2011-09-01

    Full Text Available Abstract Attention deficit hyperactivity disorder (ADHD is the most commonly diagnosed neurobehavioural disorder in childhood, affecting over 5% of children worldwide. As well as the core symptoms of inattention, hyperactivity and impulsivity, patients often exhibit learning difficulties and impairment in social functioning. The frequency of referral is higher for boys than for girls (about 2:1, and girls are generally older at the time of referral. Pharmacological therapy is considered the first-line treatment for patients with severe ADHD and severe impairment. Stimulant medications are licensed in the UK for the management of ADHD in school-age children and young people, and are effective in controlling ADHD symptoms. While immediate-release preparations of methylphenidate (MPH have proven effective in the treatment of ADHD, there are a number of problems associated with their use, most notably compliance, stigma and medication diversion. Modified release preparations are now available that overcome the need for multiple daily dosing, and which offer different MPH release profiles, thereby enabling the physician to match the medication to the patient's particular requirements. This review describes the diagnosis, referral and treatment pathways for patients with ADHD in the UK and the practical considerations when initiating pharmacological treatment. The clinical experience of treating ADHD with a modified-release MPH preparation (Equasym XL® is illustrated with case studies.

  4. Impact monitoring of the national scale up of zinc treatment for childhood diarrhea in Bangladesh: repeat ecologic surveys.

    Directory of Open Access Journals (Sweden)

    Charles P Larson

    2009-11-01

    Full Text Available BACKGROUND: Zinc treatment of childhood diarrhea has the potential to save 400,000 under-five lives per year in lesser developed countries. In 2004 the World Health Organization (WHO/UNICEF revised their clinical management of childhood diarrhea guidelines to include zinc. The aim of this study was to monitor the impact of the first national campaign to scale up zinc treatment of childhood diarrhea in Bangladesh. METHODS/FINDINGS: Between September 2006 to October 2008 seven repeated ecologic surveys were carried out in four representative population strata: mega-city urban slum and urban nonslum, municipal, and rural. Households of approximately 3,200 children with an active or recent case of diarrhea were enrolled in each survey round. Caretaker awareness of zinc as a treatment for childhood diarrhea by 10 mo following the mass media launch was attained in 90%, 74%, 66%, and 50% of urban nonslum, municipal, urban slum, and rural populations, respectively. By 23 mo into the campaign, approximately 25% of urban nonslum, 20% of municipal and urban slum, and 10% of rural under-five children were receiving zinc for the treatment of diarrhea. The scale-up campaign had no adverse effect on the use of oral rehydration salt (ORS. CONCLUSIONS: Long-term monitoring of scale-up programs identifies important gaps in coverage and provides the information necessary to document that intended outcomes are being attained and unintended consequences avoided. The scale-up of zinc treatment of childhood diarrhea rapidly attained widespread awareness, but actual use has lagged behind. Disparities in zinc coverage favoring higher income, urban households were identified, but these were gradually diminished over the two years of follow-up monitoring. The scale up campaign has not had any adverse effect on the use of ORS. Please see later in the article for the Editors' Summary.

  5. Addressing Prediabetes in Childhood Obesity Treatment Programs: Support from Research and Current Practice

    Science.gov (United States)

    Grow, H. Mollie; Fernandez, Cristina; Lukasiewicz, Gloria J.; Rhodes, Erinn T.; Shaffer, Laura A.; Sweeney, Brooke; Woolford, Susan J.; Estrada, Elizabeth

    2014-01-01

    Abstract Background: Type 2 diabetes mellitus (T2DM) and prediabetes have increased in prevalence among overweight and obese children, with significant implications for long-term health. There is little published evidence on the best approaches to care of prediabetes among overweight youth or the current practices used across pediatric weight management programs. Methods: This article reviews the literature and summarizes current practices for screening, diagnosis, and treatment of prediabetes at childhood obesity treatment centers. Findings regarding current practice were based on responses to an online survey from 28 pediatric weight management programs at 25 children's hospitals in 2012. Based on the literature reviewed, and empiric data, consensus support statements on prediabetes care and T2DM prevention were developed among representatives of these 25 children's hospitals' obesity clinics. Results: The evidence reviewed demonstrates that current T2DM and prediabetes diagnostic parameters are derived from adult-based studies with little understanding of clinical outcomes among youth. Very limited evidence exists on preventing progression of prediabetes. Some evidence suggests that a significant proportion of obese youth with prediabetes will revert to normoglycemia without pharmacological management. Evidence supports lifestyle modification for children with prediabetes, but further study of specific lifestyle changes and pharmacological treatments is needed. Conclusion: Evidence to guide management of prediabetes in children is limited. Current practice patterns of pediatric weight management programs show areas of variability in practice, reflecting the limited evidence base. More research is needed to guide clinical care for overweight youth with prediabetes. PMID:25055134

  6. The results of the treatment of childhood medulloblastoma with radiotherapy at Kaunas University of Medicine Hospital in 1994–2000

    OpenAIRE

    Rutkauskienė, Giedrė; Labanauskas, Liutauras; Jaruševičius, Laimonas

    2006-01-01

    Medulloblastoma, a primitive neuroectodermal tumor growing in cerebellum, is one of the most sensitive to radiation therapy childhood brain tumors, therefore, this method of treatments is justly considered to be the standard for the treatment of medulloblastoma. The outcome of this malignant brain tumor differs in standard and high-risk groups of patients. The aim of the work was to evaluate the survival rate for children with medulloblastoma according to two risk groups. Patients and...

  7. Hyperfractionated cranio-spinal irradiation in the complex treatment of inoperable pinealoblastoma in childhood

    International Nuclear Information System (INIS)

    We present a rare case of brain pineal neoplasm in 14 years old girl - pinealobastoma - brain primitive neuroectodermal tumor (PNET). The tumor in the pineal region causes occlusive hydrocephaly, not cured following ventriculostomy of the 3rd ventricle. After liquor-draining valve (ventriculo-peritoneal drain) was applied hyperfractionated cranio-spinal irradiation (cranio-spinal irradiation), which was needed due to the high risk of leptomeningeal and spinal liquor metastases. Unfavorable prognosis requires postoperative hyperfractionated cranio-spinal irradiation twice daily whit daily dose of 1,5 Gy in 6 hours interval to total dose of 36 Gy in CNS and spinal; at second step boost - hyperfractionated in 6 hours interval to total dose 48 Gy in the ventricles and of 58-60 Gy in pineal tumor. In addition to cranio-spinal irradiation was applied Dexometasone 1 amp. daily i.m. and Ecomer 3 x 1-2 caps, daily per os. Hyperfractionated cranio-spinal irradiation was required in pinealobastoma with hydrocephaly, followed by chemotherapy after ventriculo-peritoneat liquor drain and biopsy. This complex treatment approach significantly improves free of disease survival through minimization of local leptomeningeal and spinal recurrences. (authors) Key words: PINEALOBASTOMA IN CHILDHOOD. PNET. HYPER-FRACTIONATED CRANIO-SPINAL IRRADIATION. COMPLEX TREATMENT. CHEMOTHERAPY

  8. Brachytherapy in childhood rhabdomyosarcoma treatment; Braquiterapia no tratamento do rabdomiossarcoma da infancia

    Energy Technology Data Exchange (ETDEWEB)

    Novaes, Paulo Eduardo Ribeiro dos Santos

    1995-07-01

    A retrospective study of 21 children with rhabdomyosarcoma treated by brachytherapy to the primary site of the tumor at the Radiotherapy Department of the A.C.Camargo Hospital between january/1980 to june/1993 was undertaken. The main objectives were to comprove the utility of brachytherapy in childhood rhabdomyosarcoma, to evaluate the local control and survival, in association with chemotherapy, to analyze the late effects of the treatment and to determinate the preferential technique to each clinical situation. All patients received brachytherapy to the tumor site. The radioactive isotopes employed were Gold{sup 198}, Cesium{sup 137} and Iridium{sup 192}. The brachytherapy techniques depended on the tumor site, period of treatment, availability of the radioactive material and stage of the disease. Patients treated exclusively by brachytherapy received 40 Gy to 60 Gy. When brachytherapy was associated with external radiotherapy the dose ranged from 20 Gy to 40 Gy. Local control was achieved in 18 of 20 patients (90%). The global survival and local control survival rates were 61.9% (13/21 patients) and 72,2% (13/18 patients) respectively. (author)

  9. Megacolon in adulthood after surgical treatment of Hirschsprung's disease in early childhood

    Institute of Scientific and Technical Information of China (English)

    Christoph R. Werner; Bertram Wiedenmann; Hubert M(o)nnikes; Gisela Stoltenburg-Didinger; Henning Weidemann; Christoph Benckert; Marco Schmidtmann; Ivo R. van der Voort; Viola Andresen; Burghard F. Klapp; Peter Neuhaus

    2005-01-01

    Hirschsprung's disease (HD) is a disorder associated with congenital malformation of the enteric nervous system with segmental aganglionosis. Prevailing therapy includes a resection of the affected part of the bowel. However, patients often do not obtain complete functional improvement after surgical treatment. We present the case of a 25-year-old woman who had surgical treatment of HD in early childhood. After that procedure she had clinical features of constipation for years in the end,passing of stool once a week, requiring laxatives and enemas. We diagnosed an incomplete resection of the aganglionic bowel via rectal biopsy and resected the remaining aganglionic segment. Two months after surgery the patient's bowel function improved to a frequency of 1-4 stools per day. We conclude that regular follow-up is required to identify HD patients with persistent alterations of bowel function after surgery. In patients presenting with constipation, recognition of a remaining aganglionic segment or other alterations of the enteric nervous system should be aimed at in an early stage.

  10. Scanning and transmission electron microscopy of a craniopharyngioma: x-ray microanalytical study of the intratumoral mineralized deposits

    Energy Technology Data Exchange (ETDEWEB)

    Vilches, J.; Lopez, A.; Martinez, M.C.; Gomez, J.; Barbera, J.

    This paper discusses the value of scanning electron microscopy (SEM) and x-ray microanalysis in the classification of craniopharyngiomas. This neoplasm shows epithelial nest, cords of cuboid cells, foci of squamous metaplasia, and microcystic degeneration. SEM reveals that the epithelial cysts are lined with elongated cells that possess numerous microvilli and blebs and that some cysts are lined with polyhedral cells. The microvilli are interpreted as characteristic of the fast growing craniopharyngiomas. A microanalytical study of the calcified areas reveals the presence of magnesium, phosphorus, and calcium.

  11. Consensus definitions of 14 severe acute toxic effects for childhood lymphoblastic leukaemia treatment: a Delphi consensus.

    Science.gov (United States)

    Schmiegelow, Kjeld; Attarbaschi, Andishe; Barzilai, Shlomit; Escherich, Gabriele; Frandsen, Thomas Leth; Halsey, Christina; Hough, Rachael; Jeha, Sima; Kato, Motohiro; Liang, Der-Cherng; Mikkelsen, Torben Stamm; Möricke, Anja; Niinimäki, Riitta; Piette, Caroline; Putti, Maria Caterina; Raetz, Elizabeth; Silverman, Lewis B; Skinner, Roderick; Tuckuviene, Ruta; van der Sluis, Inge; Zapotocka, Ester

    2016-06-01

    Although there are high survival rates for children with acute lymphoblastic leukaemia, their outcome is often counterbalanced by the burden of toxic effects. This is because reported frequencies vary widely across studies, partly because of diverse definitions of toxic effects. Using the Delphi method, 15 international childhood acute lymphoblastic leukaemia study groups assessed acute lymphoblastic leukaemia protocols to address toxic effects that were to be considered by the Ponte di Legno working group. 14 acute toxic effects (hypersensitivity to asparaginase, hyperlipidaemia, osteonecrosis, asparaginase-associated pancreatitis, arterial hypertension, posterior reversible encephalopathy syndrome, seizures, depressed level of consciousness, methotrexate-related stroke-like syndrome, peripheral neuropathy, high-dose methotrexate-related nephrotoxicity, sinusoidal obstructive syndrome, thromboembolism, and Pneumocystis jirovecii pneumonia) that are serious but too rare to be addressed comprehensively within any single group, or are deemed to need consensus definitions for reliable incidence comparisons, were selected for assessment. Our results showed that none of the protocols addressed all 14 toxic effects, that no two protocols shared identical definitions of all toxic effects, and that no toxic effect definition was shared by all protocols. Using the Delphi method over three face-to-face plenary meetings, consensus definitions were obtained for all 14 toxic effects. In the overall assessment of outcome of acute lymphoblastic leukaemia treatment, these expert opinion-based definitions will allow reliable comparisons of frequencies and severities of acute toxic effects across treatment protocols, and facilitate international research on cause, guidelines for treatment adaptation, preventive strategies, and development of consensus algorithms for reporting on acute lymphoblastic leukaemia treatment. PMID:27299279

  12. Combined proton and photon irradiation for craniopharyngioma: Long-term results of the early cohort of patients treated at Harvard Cyclotron Laboratory and Massachusetts General Hospital

    International Nuclear Information System (INIS)

    Purpose: We report the results of the early cohort of patients treated for craniopharyngioma with combined proton-photon irradiation at the Massachusetts General Hospital and the Harvard Cyclotron Laboratory. Methods and Materials: Between 1981 and 1988, 15 patients with craniopharyngioma were treated in part or entirely with fractionated 160 MeV proton beam therapy. The group consisted of 5 children (median age, 15.9 years) and 10 adults (median age, 36.2 years). Median dose prescribed to the tumor was 56.9 cobalt Gray equivalent (CGE; 1 proton Gray = 1.1 CGE). The median proton component was 26.9 CGE. Patients were treated after documented recurrence after initial surgery (n = 6) or after subtotal resection or biopsy (n = 9). None had had prior radiation therapy. Results: Median observation period of surviving patients (n = 11) was 13.1 years from radiotherapy. One patient was lost to follow-up with tumor control after 5.2 years. Actuarial 10-year survival rate was 72%. Four patients have died 5-9.1 years after treatment, two from local failure. Actuarial 5- and 10-year local control rates were 93% and 85%, respectively. The functional status of the living adult patients is unaltered from their preradiotherapy status; all of them continued leading normal or near normal working lives. None of the patients treated as a child had experienced recurrence of tumor. One child shows learning difficulties and slight retardation, comparable to his preradiotherapy status. The others have professional achievements within the normal range. Conclusion: Results in terms of survival and local control are comparable with other contemporary series. Although no formal neuropsychological testing was performed, the surrogate measures of lifestyle and professional accomplishments appear to be satisfactory

  13. Study of Factors Influencing Treatment Adherence in Childhood Attention Deficit Hyperactivity Disorder in a Tertiary Healthcare Facility

    OpenAIRE

    Ashok Antony

    2016-01-01

    Background: Attention deficit hyperactivity disorder (ADHD) is a common childhood mental health disorder. Treatment has shown to improve both short and long-term prognosis. Hence, study of factors leading to nonadherence is undertaken. Objective: The objective was to know the rate of nonadherence and factors affecting nonadherence. Setting and Design: Cross-sectional follow-up study at child guidance clinic in a tertiary health care facility. Materials and Methods: Forty children with a diagn...

  14. Early childhood caries update: A review of causes, diagnoses, and treatments.

    Science.gov (United States)

    Colak, Hakan; Dülgergil, Coruh T; Dalli, Mehmet; Hamidi, Mehmet Mustafa

    2013-01-01

    Dental caries (decay) is an international public health challenge, especially amongst young children. Early childhood caries (ECC) is a serious public health problem in both developing and industrialized countries. ECC can begin early in life, progresses rapidly in those who are at high risk, and often goes untreated. Its consequences can affect the immediate and long-term quality of life of the child's family and can have significant social and economic consequences beyond the immediate family as well. ECC can be a particularly virulent form of caries, beginning soon after dental eruption, developing on smooth surfaces, progressing rapidly, and having a lasting detrimental impact on the dentition. Children experiencing caries as infants or toddlers have a much greater probability of subsequent caries in both the primary and permanent dentitions. The relationship between breastfeeding and ECC is likely to be complex and confounded by many biological variables, such as mutans streptococci, enamel hypoplasia, intake of sugars, as well as social variables, such as parental education and socioeconomic status, which may affect oral health. Unlike other infectious diseases, tooth decay is not self-limiting. Decayed teeth require professional treatment to remove infection and restore tooth function. In this review, we give detailed information about ECC, from its diagnosis to management. PMID:23633832

  15. 颅咽管瘤术后水电解质紊乱的临床特点及预后%The clinical characteristics and prognosis of postoperative water-electrolyte disorders following craniopharyngioma surgery

    Institute of Scientific and Technical Information of China (English)

    钟庆丽; 冯凤

    2011-01-01

    目的 探讨成人颅咽管瘤术后水电解质紊乱的临床特点、治疗以及预后.方法 根据术后血钠的变化情况,对57例成人颅咽管瘤术后水电解质紊乱的临床特点和治疗进行了分析.结果 除20例(35.1%)患者术后水电解质正常外,37例(64.9%)患者在术后出现了不同程度和不同类型的水电解质紊乱.其中低渗性脱水(血清钠150 mmol/L)7例(18.9%),等渗性脱水3例(8.1%),典型的"三期"变化6例(16.2%),高钠-低钠交替出现4例(10.8%).结论 颅咽管瘤术后水电解质异常纠正是颅咽管瘤治疗和患者恢复过程中非常重要的方面,需要及时监测其变化并给予针对性的治疗.%Objective To investigate the clinical characteristics, treatment and prognosis of water-electrolyte disorders following adult craniopharyngioma surgery. Methods The alterations of water-electrolyte balance in 57 cases were retrospectively analyzed according to the serum sodium level after adult craniopharyngioma surgery. Results Most patients developed water-electrolyte disorders of different extents and types after craniopharyngioma surgery. Except 20 (35. 0% ) patients, the other 37 (65. 0% ) patients developed various types and degrees of postoperative water-electrolyte disturbances. There were hypotonic dehydration (serum sodium 150mmol/L) in 7 patients ( 18. 9% ) , isotonic dehydration in 3 patients (8. 1% ) , typical triphasic alterations in 6 patients( 16. 2% ) , and alternation between high and low sodium levels in 4 patients( 10. 8% ). Conclusion It is critical for a sound outcome of craniopharyngioma surgery to manage dehydration and endocrine disorders.

  16. Determinants of early childhood morbidity and proper treatment responses in Vietnam: results from the Multiple Indicator Cluster Surveys, 2000–2011

    OpenAIRE

    Hwa-Young Lee; Nguyen Huy; Sugy Choi

    2016-01-01

    Background: Despite significant achievements in health indicators during previous decades, Vietnam lags behind other developing countries in reducing common early childhood illnesses, such as diarrhea and respiratory infections. To date, there has been little research into factors that contribute to the prevalence and treatment of childhood morbidity in Vietnam. Objective: This study examines the determinants of diarrhea and ‘illness with a cough’ and treatments for each of the conditions amo...

  17. Antioxidant defence-related genetic variants are not associated with higher risk of secondary thyroid cancer after treatment of malignancy in childhood or adolescence

    Directory of Open Access Journals (Sweden)

    Vodusek Ana Lina

    2016-03-01

    Full Text Available Thyroid cancer is one of the most common secondary cancers after treatment of malignancy in childhood or adolescence. Thyroid gland is very sensitive to the carcinogenic effect of ionizing radiation, especially in children. Imbalance between pro- and anti-oxidant factors may play a role in thyroid carcinogenesis. Our study aimed to assess the relationship between genetic variability of antioxidant defence-related genes and the risk of secondary thyroid cancer after treatment of malignancy in childhood or adolescence.

  18. Brachytherapy as Part of the Multidisciplinary Treatment of Childhood Rhabdomyosarcomas of the Orbit

    International Nuclear Information System (INIS)

    Introduction: Rhabdomyosarcomas in the orbit form a major challenge in terms of cure without severe side effects in childhood cancer. Our specifically developed approach consists of applying brachytherapy to the tumor area using a mold. Analysis of its results for 20 patients was performed. Methods and Materials: Thirteen patients were referred for brachytherapy if complete remission was not reached after chemotherapy (Group I) and 7 in case of relapse (Group II). In total, 20 patients were treated between 1991 and 2007. Four were female and 16 male; their ages varied from 1.1 to 16.5 years, with an average of 8.5 years. After macroscopically radical tumor resection, molds with holes drilled to hold flexible catheters were placed into the orbit. The dose to the clinical target volume was 40-50 Gy. Results: Three patients of Group I and 1 patient of Group II developed local recurrence and underwent exenteration. The progression-free survival in Group I is 71.9% (95% CI 0.44-1.0), in Group II 85.7% (95% CI 0.60-1.0), the overall 5-year survival rate of the entire group is 92% (95% CI 0.76-1.0). During treatment, no serious side effects were observed. The late complications encountered in this series were cataract in 2 patients, 1 of whom also developed mild retinopathy. Two patients with ptosis needed surgical correction. No facial asymmetries or bone growth anomalies were observed. Conclusions: This entire procedure of brachytherapy with a mold offers a tailor-made treatment for orbital rhabdomyosarcomas with only few signs of late toxicity.

  19. Clinical Research on Treatment of Hyperkinetic Syndrome of Childhood by Electroacupuncture plus Acupoint Application

    Institute of Scientific and Technical Information of China (English)

    WU Yao-chi; KUAI Le

    2003-01-01

    Objective To observe the clinical therapeu tic effect of hyperkinetic syndrome of childhood treated by electroacupuncture plus acupoint application. Method Sixty-five cases with hyperkinetic syndrome of childhood were treated by electroacupuncture plus acupoint application (electroacupuncture group); 53 cases were treated by acupuncture (acupuncture group) and 53 cases were treated by Ritalin (west drug group). The above three groups were compared with each other in therapeutic effect. Results The effective rate of treating hyperkinetic syndrome of childhood by electroacupuncture plus acupoint application was 87.7%; the effective rate in west drug group was 86.8% and in acupuncture group was 77.4%. A comparison among the three groups showed there was no significant difference in clinical ther apeutic effect ( P > 0.05 ). Conclusion Electroacupuncture plus acupoint application was an effective therapy of hyperkinetic syndrome of childhood.

  20. [A significant increase in intraoperative flash visual evoked potential amplitude during craniopharyngioma surgery-case report].

    Science.gov (United States)

    Kawaguchi, Tomohiro; Ogawa, Yoshikazu; Fujiwara, Satoru; Tominaga, Teiji

    2015-04-01

    The flash visual evoked potential (VEP) is a useful diagnostic modality for visual preservation during surgery. Decreased VEP amplitude is recognized to indicate visual deterioration;however, whether intraoperative VEP can detect visual improvement remains unclear. We describe a craniopharyngioma case with a significant increase in VEP amplitude during surgery. A 67-year-old woman presented with progressive gait disturbance and impaired consciousness. Head magnetic resonance imaging demonstrated a sellar-suprasellar tumor compressing the optic chiasm upward with significant ventricular dilation. Her Glasgow Coma Scale was E3V3M5. Visual fields and acuity could not be examined because of impaired consciousness, and she could not see/recognize objects on a table. Preoperative VEP showed reproducible waveforms. Tumor removal by the extended transsphenoidal approach was performed with VEP monitoring. Increased VEP amplitude was observed after dural incision and persisted until the surgery ended. Postoperative VEP waveforms were also reproducible, but visual fields/acuity could not be examined because of cognitive dysfunction. Useful visual function was restored, and she became independent in daily life. The histological diagnosis was craniopharyngioma. The patient underwent ventriculo-peritoneal shunting for hydrocephalus 16 days after tumor removal. The postoperative course was uneventful and she was transferred to another hospital for rehabilitation. Intraoperative VEP may indicate visual improvement during surgery, which is a useful objective assessment for visual function in patients with impaired consciousness and cognitive dysfunction. PMID:25838303

  1. Early loss of teeth after treatment for childhood leukemia; Fruehzeitiger Zahnverlust nach Leukaemiebehandlung im Kindesalter. Fallbericht und Literaturuebersicht

    Energy Technology Data Exchange (ETDEWEB)

    Herrmann, T.; Doerr, W.; Lesche, A.; Lehmann, D. [Klinik und Poliklinik fuer Strahlentherapie und Radioonkologie, Medizinische Fakultaet der Technischen Univ. Dresden (Germany); Koy, S. [Klinik und Poliklinik fuer Mund-, Kiefer- und Gesichtschirurgie, Medizinische Fakultaet der Technischen Univ. Dresden (Germany)

    2004-06-01

    Background: only few reports of effects of radiotherapy in childhood on the dental apparatus are available in the literature. The basis for early loss of teeth appears to be a reduction of the root surface area after radiation exposure. These effects in the periodontium are a consequence of combined radiochemotherapy usually applied for treatment of childhood neoplasia. Chemotherapy alone also results in changes of periodontal development. Case report: a 33-year-old patient is reported, who, at the age of 11 years, received high-dose chemotherapy and radiotherapy of neuroaxis and cranium for acute lymphatic leukemia with relapse. The patient consulted the Implant Section of the Department of Oral and Maxillofacial Surgery because of severe dental changes and tooth loss despite adequate dental care and oral hygiene. Radiation doses given to the superior maxilla and mandible at the age of 11 were estimated to be in the range of 8-25 Gy. Conclusion: intense, life-long dental care and follow-up of patients cured from malignant disease in childhood must hence be postulated in order to minimize dental treatment sequelae by supportive measures, but also to initiate timely adequate dental and prosthetic management. (orig.)

  2. On certain aspects of reproductive function preservation and social adjustment following complex treatment for Hodgkin's disease in childhood

    International Nuclear Information System (INIS)

    Data on the reproductive status and social adjustment of 443 children exposed to combined treatment of Hodgkin's disease according 3 different programs (from 1976 up to 1994). 1 program consists of chemoradiotherapy, 2 program includes the irradiation of zones of primary injury (cumulative dose up to 40 Gy), 3 program stipulates the irradiation of zones of primary injury at the cumulative dose 30 Gy. 258 patients reach the age of 18. It is shown that the treatment in childhood does not affect considerably the reproductive function and social adjustment

  3. A comparison of two treatments for childhood apraxia of speech: methods and treatment protocol for a parallel group randomised control trial

    OpenAIRE

    Murray Elizabeth; McCabe Patricia; Ballard Kirrie J

    2012-01-01

    Abstract Background Childhood Apraxia of Speech is an impairment of speech motor planning that manifests as difficulty producing the sounds (articulation) and melody (prosody) of speech. These difficulties may persist through life and are detrimental to academic, social, and vocational development. A number of published single subject and case series studies of speech treatments are available. There are currently no randomised control trials or other well designed group trials available to gu...

  4. The role of radiation therapy in the management of craniopharyngioma: a 25-year experience and review of the literature

    International Nuclear Information System (INIS)

    outcome was impaired in all but 5 children out of 35 fully evaluable (86%) and related with the initial symptomatology and/or therapy. Endocrinological, visual, neurological functions were affected in 97, 34, and 40%, respectively. It appeared correlated with the initial performance status (p = 0.02) and possibly with a younger age at treatment (p = 0.07). Conclusions: Long-term follow-up beyond 5 years is warranted in craniopharyngioma to assess tumor control and functional outcome after radiation therapy. Although this therapeutical modality provides a high cure rate alone or in combination with surgery and even though at the time of failure, further strategies should aim to limit the severe toxicity (i.e., Wen gr 3 + 4) that was observed in more than one-third of our patients

  5. The Efficacy of Topical 0.1% Adapalene Gel for Use in the Treatment of Childhood Acanthosis Nigricans: A Pilot Study

    OpenAIRE

    Arucha Treesirichod; Suthida Chaithirayanon; Nattakarn Wongjitrat; Pattra Wattanapan

    2015-01-01

    Aims: To assess the degree of improvement of neck hyperpigmentation in childhood acanthosis nigricans (AN) after treatment with topical 0.1% adapalene gel and the assessment of localized tissue tolerance to the gel. Subjects and Methods: A split comparison study of the hyperpigmentation on the neck was conducted in patients diagnosed with childhood AN. Patients were treated with topical 0.1% adapalene gel for a period of 4 weeks. The skin color of their neck was evaluated at baseline, 2 weeks...

  6. School-Based Psychosocial Interventions for Childhood Depression: Acceptability of Treatments among School Psychologists.

    Science.gov (United States)

    Miller, David N.; DuPaul, George J.; Lutz, J. Gary

    2002-01-01

    Examines the acceptability and effectiveness ratings of three psychosocial interventions for childhood depression among school psychologist practitioners. Interventions included cognitive restructuring, self-control therapy, and social skills training. Cognitive restructuring and self-control therapy were rated as significantly more acceptable and…

  7. Invited Commentary: Childhood and Adolescent Obesity--Psychological and Behavioral Issues in Weight Loss Treatment

    Science.gov (United States)

    Sarwer, David B.; Dilks, Rebecca J.

    2012-01-01

    The prevalence of childhood and adolescent obesity has tripled in the past three decades. This increase has been accompanied by a dramatic rise in obesity-related health complications among American youth. Thus, many obese youth are now experiencing illnesses that will threaten their life expectancy in the absence of significant weight loss.…

  8. Childhood Posttraumatic Stress Disorder: Diagnosis, Treatment, and School Reintegration. General Articles

    Science.gov (United States)

    Cook-Cottone, Catherine

    2004-01-01

    Childhood, in our culture, does not preclude exposure to trauma. Sexual abuse, physical abuse, natural disaster, urban violence, school violence, and terrorism result in significant numbers of children with posttraumatic stress disorder (PTSD) symptomatology. Many factors contribute to symptomatic expression, with some children showing few effects…

  9. ADHD: Not Just a Childhood Disorder--A Discussion of Evaluation, Diagnosis, and Treatment

    Science.gov (United States)

    Dodson, William

    2008-01-01

    While many people tend to think of Attention Deficit Hyperactivity Disorder (ADHD) as a childhood problem, at least two-thirds of children with ADHD maintain symptoms such as inattention, hyperactivity, and impulsivity into adulthood. This article presents the fifth of a 10-part series exploring ADHD. The author provides some background…

  10. Frequency, Prognosis and Surgical Treatment of Structural Abnormalities Seen with Magnetic Resonance Imaging in Childhood Epilepsy

    Science.gov (United States)

    Berg, Anne T.; Mathern, Gary W.; Bronen, Richard A.; Fulbright, Robert K.; DiMario, Francis; Testa, Francine M.; Levy, Susan R.

    2009-01-01

    The epidemiology of lesions identified by magnetic resonance imaging (MRI), along with the use of pre-surgical evaluations and surgery in childhood-onset epilepsy patients has not previously been described. In a prospectively identified community-based cohort of children enrolled from 1993 to 1997, we examined (i) the frequency of lesions…

  11. A Clinician's Guide to STAIR/MPE: Treatment for PTSD Related to Childhood Abuse

    Science.gov (United States)

    Levitt, Jill T.; Cloitre, Marylene

    2005-01-01

    Women who have PTSD related to childhood abuse have significant deficits in the areas of emotion regulation and interpersonal skills. These problems are associated with impaired functioning in social, work, and home life. In addition, there is substantial clinical concern that limited emotion-regulation skills puts this population at risk for…

  12. DNA methylation for subtype classification and prediction of treatment outcome in patients with childhood acute lymphoblastic leukemia

    DEFF Research Database (Denmark)

    Milani, Lili; Lundmark, Anders; Kiialainen, Anna; Nordlund, Jessica; Flaegstad, Trond; Forestier, Erik; Heyman, Mats; Jonmundsson, Gudmundur; Kanerva, Jukka; Schmiegelow, Kjeld; Söderhäll, Stefan; Gustafsson, Mats; Lönnerholm, Gudmar; Syvänen, Ann-Christine

    2010-01-01

    Despite improvements in the prognosis of childhood acute lymphoblastic leukemia (ALL), subgroups of patients would benefit from alternative treatment approaches. Our aim was to identify genes with DNA methylation profiles that could identify such groups. We determined the methylation levels of 1320...... ALL and gene sets that discriminated between subtypes of ALL and between ALL and controls in pairwise classification analyses. We also identified 20 individual genes with DNA methylation levels that predicted relapse of leukemia. Thus, methylation analysis should be explored as a method to improve...

  13. Impact of Cancer Support Groups on Childhood Cancer Treatment and Abandonment in a Private Pediatric Oncology Centre

    OpenAIRE

    Arathi Srinivasan; Khushboo Tiwari; Julius Xavier Scott; Priya Ramachandran; Mathangi Ramakrishnan

    2015-01-01

    Aims: To analyze the impact of two cancer support groups in the treatment and abandonment of childhood cancer. Materials and Methods: This is a retrospective review of children with cancer funded and non-funded who were treated at Kanchi Kamakoti CHILDS Trust Hospital from 2010 to 2013. A total of 100 patients were funded, 57 by Ray of Light Foundation and 43 by Pediatric Lymphoma Project and 70 non-funded. Results: The total current survival of 80%, including those who have completed...

  14. High-field MR imaging of craniopharyngiomas: Correlations with biochemical data

    International Nuclear Information System (INIS)

    Seventeen patients with craniopharyngiomas underwent MR imaging performed with a 1.5-unit. Correlations were made with CT and pathologic findings in all cases. Cystic collections were analyzed in seven cases (proteins, lactic dehydrogenase [LDH], lipid and ferrous content). Three-dimensional spin-echo sequences were performed with T1 and T2 weighting. Fast imaging was done in nine cases. Contrast medium (Gd-DTPA or Gd-DOTA) was intravenously injected in five patients. MR imaging clearly depicted the cystic and solid portions of the tumor; moreover, the solid vascularized parts and the cylic tumoral walls enhanced after contrast agent injection. Analysis of the cystic collections allowed correlation of the variable MR signals and the biochemical data: high concentrations of proteins and LDH, various lipid and iron contents. Calcifications were visualized in only seven cases. Relationships with the optic pathways, the hypothalmus, and the cisterns were precisely established

  15. Childhood Eye Diseases and Conditions

    Science.gov (United States)

    ... Things College Students Should Do For Their Eyes Childhood Eye Diseases and Conditions Nov. 01, 2013 The ... cataract or eye disorder that needs treatment. Common Childhood Eye Diseases & Conditions When the following diseases are ...

  16. General Information about Childhood Ependymoma

    Science.gov (United States)

    ... without radiation therapy . Childhood ependymoma, anaplastic ependymoma, or RELA fusion–positive ependymoma Treatment of newly diagnosed childhood ... Grade II), anaplastic ependymoma (WHO Grade III), or RELA fusion–positive ependymoma is: Surgery . After surgery, the ...

  17. A comparison of two treatments for childhood apraxia of speech: methods and treatment protocol for a parallel group randomised control trial

    Directory of Open Access Journals (Sweden)

    Murray Elizabeth

    2012-08-01

    Full Text Available Abstract Background Childhood Apraxia of Speech is an impairment of speech motor planning that manifests as difficulty producing the sounds (articulation and melody (prosody of speech. These difficulties may persist through life and are detrimental to academic, social, and vocational development. A number of published single subject and case series studies of speech treatments are available. There are currently no randomised control trials or other well designed group trials available to guide clinical practice. Methods/Design A parallel group, fixed size randomised control trial will be conducted in Sydney, Australia to determine the efficacy of two treatments for Childhood Apraxia of Speech: 1 Rapid Syllable Transition Treatment and the 2 Nuffield Dyspraxia Programme – Third edition. Eligible children will be English speaking, aged 4–12 years with a diagnosis of suspected CAS, normal or adjusted hearing and vision, and no comprehension difficulties or other developmental diagnoses. At least 20 children will be randomised to receive one of the two treatments in parallel. Treatments will be delivered by trained and supervised speech pathology clinicians using operationalised manuals. Treatment will be administered in 1-hour sessions, 4 times per week for 3 weeks. The primary outcomes are speech sound and prosodic accuracy on a customised 292 item probe and the Diagnostic Evaluation of Articulation and Phonology inconsistency subtest administered prior to treatment and 1 week, 1 month and 4 months post-treatment. All post assessments will be completed by blinded assessors. Our hypotheses are: 1 treatment effects at 1 week post will be similar for both treatments, 2 maintenance of treatment effects at 1 and 4 months post will be greater for Rapid Syllable Transition Treatment than Nuffield Dyspraxia Programme treatment, and 3 generalisation of treatment effects to untrained related speech behaviours will be greater for Rapid

  18. Sudden losses and sudden gains during a DBT-PTSD treatment for posttraumatic stress disorder following childhood sexual abuse

    Directory of Open Access Journals (Sweden)

    Antje Krüger

    2014-09-01

    Full Text Available Background: Exposure-based treatment approaches are first-line interventions for patients suffering from posttraumatic stress disorder (PTSD. However, the dissemination of exposure-based treatments for PTSD is challenging, as a large proportion of clinicians report being concerned about symptoms worsening as a result of this type of intervention and are therefore reluctant to offer it to patients with PTSD. However, there is only little empirical evidence to date on the pattern of symptom worsening during exposure-based treatment for PTSD. Objective: The goal of the present study was to explore the frequency of sudden losses and sudden gains in the course of an exposure-based treatment programme for female patients suffering from PTSD related to childhood sexual abuse who also show severe comorbidity. In addition, the relationship between sudden changes and treatment outcome was examined. Methods: Female participants (N=74 were randomised to either a 12-week residential DBT-PTSD programme or a treatment-as-usual wait list. The pattern of symptom change was assessed via weekly assessments using the Posttraumatic Diagnostic Scale (PDS. Sudden changes were computed as suggested by the literature on sudden gains. Results: During treatment, only one participant (3% experienced a sudden loss, whereas 25% of participants experienced sudden gains. In the waiting condition, 8% of the participants experienced sudden losses and 5% experienced sudden gains during the same time period. No symptom worsening was observed in response to exposure sessions. However, sudden gains occurred during exposure and non-exposure treatment weeks. Patients with sudden gains showed better treatment outcome in the post-treatment and follow-up assessments. Conclusions: Exposure-based treatment did not lead to PTSD symptom worsening in the study sample. Results show that sudden gains occur frequently during PTSD treatment and have a prognostic value for treatment outcome.

  19. Zinc and childhood infections: From the laboratory to new treatment recommendations

    Directory of Open Access Journals (Sweden)

    Tor A. Strand

    2009-10-01

    Full Text Available Zinc is an essential nutrient particularly important for growing children and for those who experience frequent infections. Many children in developing countries have inadequate zinc nutrition that impairs their immune system. Diarrhea and pneumonia are among the leading causes of morbidity and mortality in children of low-income countries. Zinc deficiency increases the susceptibility to these infections and administration of zinc to children with diarrhea and, possibly, pneumonia speeds up recovery. Furthermore, zinc given to otherwise healthy children also reduces the incidence of diarrhea and pneumonia. Thus, thousands of lives can be saved every year by giving zinc to prevent childhood infections or by providing zinc to children with ongoing infections. This paper gives a brief outline of the history of zinc research and reviews existing evidence from clinical trials on the prophylactic and therapeutic effect of oral zinc on childhood pneumonia and diarrhea

  20. Therapy-Related Myelodysplastic Syndrome Following Treatment for Childhood Acute Lymphoblastic Leukemia: Outcome of Patients Registered in the EWOG-MDS 98/06 Studies

    DEFF Research Database (Denmark)

    Strahm, Birgitte; Amann, Roland; De Moerloose, Barbara;

    Objective: Therapy-related myelodysplastic syndrome (tMDS) following treatment of childhood acute lymphoblastic leukemia (ALL) is one of the most frequently observed secondary malignancies in survivors of childhood cancer. Allogeneic stem cell transplantation (SCT) is the only curative treatment....... This analysis was performed to asses the outcome of patients with tMDS following treatment for childhood ALL reported to the EWOG-MDS study group. Patients and Transplant Procedure: Forty-three patients (19 male/24 female) were diagnosed with tMDS between August 1989 and August 2009. The median age at diagnosis......, cyclophosphamide and melphalan (Bu/Cy/Mel) (23), an alternative busulfan based regimen (6), a radiation based regimen (5) or others (3). Results: After a median follow up of 4.1 (0.5 – 9.4) years, 14 patients are alive in first complete remission (CR). Seventeen patients developed relapse after a median time...

  1. Child cranio-pharyngioma: the benefit of proton-therapy; Craniopharyngiome de l'enfant: interet de la protontherapie

    Energy Technology Data Exchange (ETDEWEB)

    Alapetite, C.; Bolle, S. [Institut Curie, 75 - Paris (France); Alapetite, C.; Habrand, J.L.; Bolle, S.; Datchary, J.; Nauraye, C.; De Marzy, L. [Institut Curie Centre de protontherapie d' Orsay, 91 - Orsay (France); Puget, S.; Sainte Rose, C. [Hopital Necker-Enfants Malades, 75 - Paris (France); Habrand, J.L.; Datchary, J. [Institut Gustave-Roussy, 94 - Villejuif (France); Noel, G. [Centre Paul-Strauss, 67 - Strasbourg (France); Laffond, C. [Hopital national Saint-Maurice, Saint-Maurice (France)

    2010-10-15

    Based on a survey concerning 33 children suffering from cranio-pharyngiomas, the authors report a comparison of the dosimetry of different techniques (three-dimensional conformational radiotherapy, intensity-modulated conformation radiotherapy or IMRT, and proton therapy). They show that the ballistic peculiarities of proton beams result in a better protection of proximity critical structures and a reduction of the parenchyma total dose, and therefore in morbidity reduction without altering the local control rate. Short communication

  2. Role of Synbiotics in the Treatment of Childhood Constipation: A Double-Blind Randomized Placebo Controlled Trial

    Directory of Open Access Journals (Sweden)

    Mozhgan Sabbaghian

    2010-12-01

    Full Text Available Objective:Constipation is a common problem in children. There is some clinical evidence for the role of probiotics and prebiotics in the treatment of constipated children. This is the first study on the therapeutic effect of synbiotics (combination of probiotics and prebiotic in treatment of childhood constipation. Methods:In a double-blind randomized placebo controlled study 102 children aged 4-12 years with functional constipation were assessed according to Rome III criteria for 4 weeks. They were divided into 3 groups: Group A, received 1.5 ml/kg/day oral liquid paraffin plus placebo, group B, 1 sachet synbiotic per day plus placebo and group C, 1.5 ml/kg/day oral liquid paraffin plus 1 sachet synbiotic per day. Frequency of bowel movements (BMs, stool consistency, number of fecal incontinence episodes, abdominal pain, painful defecation per week, success of treatment and side effects were determined in each group before and after treatment. Findings:The frequency of BMs per week increased in all groups (P<0.001, but it differed between groups and was higher in group C (P=0.03. Stool consistency increased and number of fecal incontinence episodes, abdominal pain and painful defecation per week decreased in all groups similarly and there was statistically no difference between them. No side effects were reported in group B; the main side effect in group A and C was seepage of oil (P<0.001. Treatment success was similar in all groups without any significant difference between them (P=0.6.   Conclusion:This study showed that synbiotics have positive effects on symptoms of childhood constipation without any side effects.

  3. Clinical use of a modified release methylphenidate in the treatment of childhood attention deficit hyperactivity disorder

    OpenAIRE

    Takon Inyang

    2011-01-01

    Abstract Attention deficit hyperactivity disorder (ADHD) is the most commonly diagnosed neurobehavioural disorder in childhood, affecting over 5% of children worldwide. As well as the core symptoms of inattention, hyperactivity and impulsivity, patients often exhibit learning difficulties and impairment in social functioning. The frequency of referral is higher for boys than for girls (about 2:1), and girls are generally older at the time of referral. Pharmacological therapy is considered the...

  4. Seizure Clustering during Drug Treatment Affects Seizure Outcome and Mortality of Childhood-Onset Epilepsy

    Science.gov (United States)

    Sillanpaa, Matti; Schmidt, Dieter

    2008-01-01

    To provide evidence of whether seizure clustering is associated with drug resistance and increased mortality in childhood-onset epilepsy, a prospective, long-term population-based study was performed. One hundred and twenty patients who had been followed since disease onset (average age 37.0 years, SD 7.1, median 40.0, range 11-42; incident cases)…

  5. Early childhood caries update: A review of causes, diagnoses, and treatments

    OpenAIRE

    Çolak, Hakan; Dülgergil, Çoruh T.; Dalli, Mehmet; Hamidi, Mehmet Mustafa

    2013-01-01

    Dental caries (decay) is an international public health challenge, especially amongst young children. Early childhood caries (ECC) is a serious public health problem in both developing and industrialized countries. ECC can begin early in life, progresses rapidly in those who are at high risk, and often goes untreated. Its consequences can affect the immediate and long-term quality of life of the child's family and can have significant social and economic consequences beyond the immediate fami...

  6. Modeling Social Transmission Dynamics of Unhealthy Behaviors for Evaluating Prevention and Treatment Interventions on Childhood Obesity

    OpenAIRE

    Frerichs, Leah M.; Araz, Ozgur M.; Huang, Terry T. – K.

    2013-01-01

    Research evidence indicates that obesity has spread through social networks, but lever points for interventions based on overlapping networks are not well studied. The objective of our research was to construct and parameterize a system dynamics model of the social transmission of behaviors through adult and youth influence in order to explore hypotheses and identify plausible lever points for future childhood obesity intervention research. Our objectives were: (1) to assess the sensitivity o...

  7. Treatment of early childhood medulloblastoma by postoperative chemotherapy and deferred radiotherapy

    OpenAIRE

    Rutkowski, Stefan; Gerber, Nicolas Ulrich; von Hoff, Katja; Gnekow, Astrid; Bode, Udo; Graf, Norbert; Berthold, Frank; Henze, Günter; Wolff, Johannes E.A.; Warmuth-Metz, Monika; Soerensen, Niels; Emser, Angela; Ottensmeier, Holger; Deinlein, Frank; Schlegel, Paul-Gerhardt

    2009-01-01

    To investigate the utility of postoperative chemotherapy in delaying radiotherapy and to identify prognostic factors in early childhood medulloblastoma, we studied children younger than 3 years of age registered to the HIT-SKK’87 (Therapieprotokoll für Säuglinge und Kleinkinder mit Hirntumoren [Brain Tumor Radiotherapy for Infants and Toddlers with Medulloblastoma] 1987) trial who received systemic interval chemotherapy until craniospinal radiotherapy was applied at 3 years of age or at relap...

  8. The role of shops in the treatment and prevention of childhood malaria on the coast of Kenya.

    Science.gov (United States)

    Snow, R W; Peshu, N; Forster, D; Mwenesi, H; Marsh, K

    1992-01-01

    A community survey of 388 mothers in a rural and peri-urban population surrounding a district hospital on the coast of Kenya revealed that the preferred choice of treatment for childhood febrile illnesses was with proprietary drugs bought over the counter at shops and kiosks (72% of interviews). 67% of the mothers who reported using shops claimed they would buy chloroquine-based drugs. Preventative measures such as mosquito nets were uncommon (6.2%), but the use of commercial pyrethrum mosquito coils was reported more frequently (46.4%). Separate investigations of treatment given to 394 children before presentation at hospital with severe and mild malaria was consistent with the reports in the community of high usage of shop-bought anti-malarials and anti-pyretics. The involvement of the private sector in peripheral health care delivery for malaria is discussed. PMID:1412642

  9. Impact of cancer support groups on childhood cancer treatment and abandonment in a private pediatric oncology centre

    Directory of Open Access Journals (Sweden)

    Arathi Srinivasan

    2015-01-01

    Full Text Available Aims: To analyze the impact of two cancer support groups in the treatment and abandonment of childhood cancer. Materials and Methods: This is a retrospective review of children with cancer funded and non-funded who were treated at Kanchi Kamakoti CHILDS Trust Hospital from 2010 to 2013. A total of 100 patients were funded, 57 by Ray of Light Foundation and 43 by Pediatric Lymphoma Project and 70 non-funded. Results: The total current survival of 80%, including those who have completed treatment and those currently undergoing treatment, is comparable in both the groups. Abandonment of treatment after initiating therapy was not seen in the financially supported group whereas abandonment of treatment after initiation was seen in one child in the non-funded group. Conclusions: Besides intensive treatment with good supportive care, financial support also has an important impact on compliance and abandonment in all socioeconomic strata of society. Financial support from private cancer support groups also has its impact beyond the patient and family, in reducing the burden on government institutions by non-governmental funding in private sector. Improvement in the delivery of pediatric oncology care in developing countries could be done by financial support from the private sector.

  10. Childhood Sexual Abuse: Identification, Screening, and Treatment Recommendations in Primary Care Settings.

    Science.gov (United States)

    Hanson, Rochelle F; Adams, Cristin S

    2016-06-01

    It is estimated that 8% to 12% of American youths have experienced at least one sexual assault in their lifetime, making childhood sexual abuse (CSA) an important public health problem that is likely to be encountered by primary care providers. Use of screening tools and understanding the principles behind targeted clinical evaluation can aid in identification of CSA victims despite highly variable presentation. The primary care provider must be aware of potential signs and symptoms as well as differential diagnoses in order to identify children who may benefit from further mental health evaluation and intervention. PMID:27262010

  11. Antenatal steroid treatment reduces childhood asthma risk in very low birth weight infants without bronchopulmonary dysplasia

    OpenAIRE

    Hung, Yi-Li; Hsieh, Wu-Shiun; Chou, Hung-Chieh; Yang, Yao-Hsu; Chen, Chien-Yi; Tsao, Po-Nien

    2009-01-01

    Bronchopulmonary dysplasia (BPD) and very low birth weight (VLBW) are associated with increased incidences of asthma and pulmonary dysfunction in childhood. However, no studies exist which examine asthma risk factors in children who were VLBW infants and did not have BPD. To address this issue, we assessed the asthma incidence and risk factors for asthma in 117 children (approximate mean age of 5 years) who were VLBW [<1500 g, mean gestational age (GA): 30 weeks] infants without BPD. The ...

  12. Description of the SAGhE Cohort: A Large European Study of Mortality and Cancer Incidence Risks after Childhood Treatment with Recombinant Growth Hormone

    OpenAIRE

    Swerdlow, Anthony J.; Cooke, Rosi; Albertsson-Wikland, Kersti; Borgström, Birgi; Butler, Gar; Cianfarani, Stefan; Clayton, Pete; Coste, Joë; Deodati, Annalis; Ecosse, Emmanue; Gausche, Rut; Giacomozzi, Claudi; Kiess, Wielan; Hokken-Koelega, Anita C. S.; Kuehni, Claudia E.

    2015-01-01

    Background The long-term safety of growth hormone treatment is uncertain. Raised risks of death and certain cancers have been reported inconsistently, based on limited data or short-term follow-up by pharmaceutical companies. Patients and Methods: The SAGhE (Safety and Appropriateness of Growth Hormone Treatments in Europe) study assembled cohorts of patients treated in childhood with recombinant human growth hormone (r-hGH) in 8 European countries since the first use of this treatment in 198...

  13. Socio-economic determinants in selecting childhood diarrhoea treatment options in Sub-Saharan Africa: A multilevel model

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    Lawoko Stephen

    2011-03-01

    Full Text Available Abstract Background Diarrhoea disease which has been attributed to poverty constitutes a major cause of morbidity and mortality in children aged five and below in most low-and-middle income countries. This study sought to examine the contribution of individual and neighbourhood socio-economic characteristics to caregiver's treatment choices for managing childhood diarrhoea at household level in sub-Saharan Africa. Methods Multilevel multinomial logistic regression analysis was applied to Demographic and Health Survey data conducted in 11 countries in sub-Saharan Africa. The unit of analysis were the 12,988 caregivers of children who were reported to have had diarrhoea two weeks prior to the survey period. Results There were variability in selecting treatment options based on several socioeconomic characteristics. Multilevel-multinomial regression analysis indicated that higher level of education of both the caregiver and that of the partner, as well as caregivers occupation were associated with selection of medical centre, pharmacies and home care as compared to no treatment. In contrast, caregiver's partners' occupation was negatively associated with selection medical centre and home care for managing diarrhoea. In addition, a low-level of neighbourhood socio-economic disadvantage was significantly associated with selection of both medical centre and pharmacy stores and medicine vendors. Conclusion In the light of the findings from this study, intervention aimed at improving on care seeking for managing diarrhoea episode and other childhood infectious disease should jointly consider the influence of both individual SEP and the level of economic development of the communities in which caregivers of these children resides.

  14. Differentiation of clinically non-functioning pituitary adenomas from meningiomas and craniopharyngiomas by positron emission tomography with [18F]fluoro-ethyl-spiperone

    International Nuclear Information System (INIS)

    The differential diagnosis among various types of non-functioning sellar and parasellar tumours is sometimes difficult using currently available methods of morphological imaging. The aim of this study was to define whether assessment of the uptake of [18F]fluoro-ethyl-spiperone (FESP) with positron emission tomography (PET) could be helpful for the differential diagnosis of pituitary adenomas and other parasellar lesions, and for establishing the appropriate therapeutic approach. The population examined comprised 16 patients with the diagnosis of primary tumour of the sellar/parasellar region who were waiting to undergo surgical treatment. The results demonstrated that PET with [18F]FESP is a very specific method for differentiating adenomas from craniopharyngiomas and meningiomas. The visual interpretation of images allows such differentiation at approximately 70 min after tracer injection. Semiquantitative analysis of the dynamic PET data confirmed the results of visual interpretation, demonstrating that the uptake of [18F]FESP was consistently (i.e. throughout the series) at least two- to threefold higher in non-functioning adenomas than in other parasellar tumours as early as 70 min after tracer injection, and that it increased still further thereafter. It is concluded that PET with [18F]FESP might be of clinical value in those cases in which the differential diagnosis among various histological types of sellar tumour is uncertain with conventional methods. (orig.). With 3 figs., 1 tab

  15. Childhood vitiligo

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    Aparna Palit

    2012-01-01

    Full Text Available Childhood vitiligo is often encountered in dermatological practice. When present in infancy or early childhood, various nevoid and hereditary disorders are to be differentiated. In many cases, familial aggregation of the disease is seen and other autoimmune disorders may be associated. Segmental presentation is more common, and limited body surface area involvement is usual in this age group. Children with vitiligo often suffer from anxiety and depression because of their unusual appearance. Management of vitiligo in children is difficult as therapeutic options are restricted when compared to that in adult patients. Selection of treatment should be careful in these patients with the aim to achieve best results with minimal side effects as well as relieving patients′ and parents′ anxiety.

  16. Childhood cancer in Africa.

    Science.gov (United States)

    Kruger, Mariana; Hendricks, Marc; Davidson, Alan; Stefan, Cristina D; van Eyssen, Ann L; Uys, Ronelle; van Zyl, Anel; Hesseling, Peter

    2014-04-01

    The majority of children with cancer live in low- and middle-income countries (LMICs) with little or no access to cancer treatment. The purpose of the paper is to describe the current status of childhood cancer treatment in Africa, as documented in publications, dedicated websites and information collected through surveys. Successful twinning programmes, like those in Malawi and Cameroon, as well as the collaborative clinical trial approach of the Franco-African Childhood Cancer Group (GFAOP), provide good models for childhood cancer treatment. The overview will hopefully influence health-care policies to facilitate access to cancer care for all children in Africa. PMID:24214130

  17. Individualized toxicity-titrated 6-mercaptopurine increments during high-dose methotrexate consolidation treatment of lower risk childhood acute lymphoblastic leukemia

    DEFF Research Database (Denmark)

    Frandsen, Thomas Leth; Abrahamsson, Jonas; Lausen, Birgitte Frederiksen;

    2011-01-01

    This study explored the feasibility and toxicity of individualized toxicity-titrated 6-mercaptopurine (6MP) dose increments during post-remission treatment with High-dose methotrexate (HDM) (5000 mg/m2, ×3) in 38 patients with Childhood (ALL). Patients were increased in steps of 25 mg 6MP/m2 per ...

  18. Expanding the role of primary care in the prevention and treatment of childhood obesity: a review of clinic- and community-based recommendations and interventions.

    Science.gov (United States)

    Vine, Michaela; Hargreaves, Margaret B; Briefel, Ronette R; Orfield, Cara

    2013-01-01

    Although pediatric providers have traditionally assessed and treated childhood obesity and associated health-related conditions in the clinic setting, there is a recognized need to expand the provider role. We reviewed the literature published from 2005 to 2012 to (1) provide examples of the spectrum of roles that primary care providers can play in the successful treatment and prevention of childhood obesity in both clinic and community settings and (2) synthesize the evidence of important characteristics, factors, or strategies in successful community-based models. The review identified 96 articles that provide evidence of how primary care providers can successfully prevent and treat childhood obesity by coordinating efforts within the primary care setting and through linkages to obesity prevention and treatment resources within the community. By aligning the most promising interventions with recommendations published over the past decade by the Institute of Medicine, the American Academy of Pediatrics, and other health organizations, we present nine areas in which providers can promote the prevention and treatment of childhood obesity through efforts in clinical and community settings: weight status assessment and monitoring, healthy lifestyle promotion, treatment, clinician skill development, clinic infrastructure development, community program referrals, community health education, multisector community initiatives, and policy advocacy. PMID:23710345

  19. Expanding the Role of Primary Care in the Prevention and Treatment of Childhood Obesity: A Review of Clinic- and Community-Based Recommendations and Interventions

    Directory of Open Access Journals (Sweden)

    Michaela Vine

    2013-01-01

    Full Text Available Although pediatric providers have traditionally assessed and treated childhood obesity and associated health-related conditions in the clinic setting, there is a recognized need to expand the provider role. We reviewed the literature published from 2005 to 2012 to (1 provide examples of the spectrum of roles that primary care providers can play in the successful treatment and prevention of childhood obesity in both clinic and community settings and (2 synthesize the evidence of important characteristics, factors, or strategies in successful community-based models. The review identified 96 articles that provide evidence of how primary care providers can successfully prevent and treat childhood obesity by coordinating efforts within the primary care setting and through linkages to obesity prevention and treatment resources within the community. By aligning the most promising interventions with recommendations published over the past decade by the Institute of Medicine, the American Academy of Pediatrics, and other health organizations, we present nine areas in which providers can promote the prevention and treatment of childhood obesity through efforts in clinical and community settings: weight status assessment and monitoring, healthy lifestyle promotion, treatment, clinician skill development, clinic infrastructure development, community program referrals, community health education, multisector community initiatives, and policy advocacy.

  20. Comorbid Anxiety and Social Avoidance in Treatment of Severe Childhood Aggression: Response to Adding Risperidone to Stimulant and Parent Training; Mediation of Disruptive Symptom Response

    OpenAIRE

    Arnold, L. Eugene; Gadow, Kenneth D.; Farmer, Cristan A.; Findling, Robert L; Bukstein, Oscar; Molina, Brooke S. G.; Brown, Nicole V.; Li, Xiaobai; Rundberg-Rivera, E. Victoria; Bangalore, Srihari; Buchan-Page, Kristin; Hurt, Elizabeth A.; Rice, Robert; McNamara, Nora K.; Aman, Michael G

    2015-01-01

    Objective: In the four-site Treatment of Severe Childhood Aggression (TOSCA) study, addition of risperidone to stimulant and parent training moderately improved parent-rated disruptive behavior disorder (DBD) symptoms. This secondary study explores outcomes other than DBD and attention-deficit/hyperactivity disorder (ADHD) as measured by the Child and Adolescent Symptom Inventory-4R (CASI-4R).

  1. Medical progress, psychological factors and global care of the patient: lessons from the treatment of childhood leukemia

    Directory of Open Access Journals (Sweden)

    Girolamo Digilio

    2013-03-01

    Full Text Available The history of treatment of childhood leukemia is a meaningful model of ethical, bioethical and organizational repercussions of medical progress. Specifically, it has provided precious indications and very useful tools to cope with several of the more important problems of modern medicine: the value of controlled randomized studies; the risks of intense medicalization impairing the quality of care; the importance of a valid doctor-patient relationship; the psycho-emotive involvement of the pediatric staff; and last but not least, the need of an unrelenting effort of humanization of the procedures and environments, hand in hand with the frequent adjustments of the protocols according to scientific and technological progress. Finally, the authors comment upon the first cures (1962-1966 observed in the Pediatrics Clinic of the Sapienza University of Rome.

  2. Consensus definitions of 14 severe acute toxic effects for childhood lymphoblastic leukaemia treatment

    DEFF Research Database (Denmark)

    Schmiegelow, Kjeld; Attarbaschi, Andishe; Barzilai, Shlomit;

    2016-01-01

    toxic effects, that no two protocols shared identical definitions of all toxic effects, and that no toxic effect definition was shared by all protocols. Using the Delphi method over three face-to-face plenary meetings, consensus definitions were obtained for all 14 toxic effects. In the overall......Although there are high survival rates for children with acute lymphoblastic leukaemia, their outcome is often counterbalanced by the burden of toxic effects. This is because reported frequencies vary widely across studies, partly because of diverse definitions of toxic effects. Using the Delphi...... method, 15 international childhood acute lymphoblastic leukaemia study groups assessed acute lymphoblastic leukaemia protocols to address toxic effects that were to be considered by the Ponte di Legno working group. 14 acute toxic effects (hypersensitivity to asparaginase, hyperlipidaemia, osteonecrosis...

  3. Prognosis and complications of acute childhood leukemia after prophylactic treatment of the central nervous

    International Nuclear Information System (INIS)

    From 1970 through 1979, 22 children with acute childhood leukemia and in remimmion were treated with preventive central nervous system (CNS) irradiation and simultaneous intrathecal methotrexate. A minimum follow-up duration was five months. Of 22 cases, 20 were acute lymphocytic leukemia (ALL) and 2 were acute myelocytic leukemia (ALL). Five-year cumulative survival rate and five-year relapse free survival rate of ALL case were 48% and 46% respectively. Nor neurological disorders after the prophylactic combined therapy were recognized clinically by the time when this follow-up was finished. Of 15 children with ALL who were followed by computed tomography of the brain, 5(33%) had abnormal findings. Dilatation of the ventricles were seen in 3 cases, and low density areas of the occipital regions in 2 cases. (author)

  4. Relationships of Childhood Adverse Experiences With Mental Health and Quality of Life at Treatment Start for Adult Refugees Traumatized by Pre-Flight Experiences of War and Human Rights Violations

    OpenAIRE

    Opaas, Marianne; Varvin, Sverre

    2015-01-01

    Abstract Adverse and potentially traumatic experiences (PTEs) in childhood were examined among 54 adult refugee patients with pre-flight PTEs of war and human rights violations (HRVs) and related to mental health and quality of life at treatment start. Extent of childhood PTEs was more strongly related to mental health and quality of life than the extent of war and HRV experiences. Childhood PTEs were significantly related to arousal and avoidance symptoms of posttraumatic stress disorder (PT...

  5. EpCAM (CD326) is differentially expressed in craniopharyngioma subtypes and Rathke's cleft cysts.

    Science.gov (United States)

    Thimsen, Vivian; Hölsken, Annett; Buchfelder, Michael; Flitsch, Jörg; Fahlbusch, Rudolf; Stefanits, Harald; Losa, Marco; Jones, David T W; Buslei, Rolf

    2016-01-01

    The epithelial cell adhesion molecule (EpCAM) is a type I glycoprotein located on the surface of epithelial cells. It is strongly expressed in many neoplasms and already used in the diagnosis and distinction of various tumour subtypes. Comparative studies about EpCAM expression in cystic sellar lesions are lacking. Therefore, we analysed its distribution pattern in adamantinomatous (aCP) and papillary (pCP) craniopharyngiomas (CP) and Rathke's Cleft Cysts (RCC) using immunohistochemistry and gene expression profiling. Whereas the protein was not detectable in pCP (n = 10), all aCP (n = 64) showed distinct staining patterns. The vast majority of RCC (n = 10) also appeared positive, but these displayed notably lower labeling scores. Additionally, significantly higher mRNA levels were detectable in aCP (n = 19) when compared to pCP (n = 10) (p = 9.985(-8)). Furthermore, pediatric aCP cases, in general, exhibited stronger EpCAM staining levels compared to adult ones (p = 0.015). However, we were not able to verify this result on mRNA level. In summary, our findings demonstrate that EpCAM can be used as an additional distinction-marker for cystic lesions of the sellar region. Its unknown function in aCP and the presence of an approved monoclonal bispecific trifunctional antibody for cancer therapy are interesting starting points for further studies. PMID:27431859

  6. Palmar-plantar erythrodysesthesia, clinical case presentation in a patient with craniopharyngioma and sickle cell anemia

    Directory of Open Access Journals (Sweden)

    Lora-Fernández Alberto Carlos

    2010-12-01

    Full Text Available The sickle-cell disease complicatiosn include acute isquemic crisis in extremities and organs, occur to fuctional and estructural alteration in oxigen transport toward tissue, our case of a patient with craniopharyngioma after posoperatory tumoral resection show necrosis in hand and foot, conduce to amputation, describe this clinic presentation after a allergic reaction to vancomicine and ceftriazone associated the hemoglobinopatie of the patient and management instaurated.RESUMENLas complicaciones de la anemia de células falciformes incluyen crisis de isquemia en extremidades y órganos debido a la alteración estructural y funcional en el transporte de oxígeno a los tejidos. Se presenta el caso de una paciente con craneofaringioma, que en su posoperatorio de resección del tumor, presenta necrosis en manos y pies, lo cual la conduce a amputación. Se describe este cuadro clínico presentado tras una reacción alérgica a la vancomicina, asociado a la condición de hemoglobinopatía de la paciente.

  7. Changes in Candida spp., mutans streptococci and lactobacilli following treatment of early childhood caries: a 1-year follow-up.

    Science.gov (United States)

    Klinke, T; Urban, M; Lück, C; Hannig, C; Kuhn, M; Krämer, N

    2014-01-01

    Early childhood caries (ECC) is closely related to high numbers of mutans streptococci, lactobacilli and Candida albicans. Oral colonization of these microorganisms was monitored in a prospective clinical study in order to investigate the effect of comprehensive treatment under general anesthesia and the sustainability of microbial changes. Saliva samples were collected from 50 healthy infants with ECC before and in regular intervals up to 12 months after treatment. Microorganisms were detected by cultivation on selective agars (CRT® bacteria and Sabouraud/CandiSelect™) and scored. Additionally, plaque on upper front teeth and the dmft were recorded. Parents were repeatedly interviewed regarding the children's diet and oral hygiene, accompanied by corresponding advice. Plaque frequency and the numbers of mutans streptococci, lactobacilli and yeasts were significantly reduced as a result of treatment (p caries relapse (p Nutritional and oral hygiene habits changed only slightly despite advising. Elimination and restoration of ECC lesions under general anesthesia proved to be an effective procedure in reducing cariogenic bacteria and yeasts. A satisfactory and sustainable success, however, could be achieved neither regarding microbiologic parameters nor with respect to the relapse rate. More suitable strategies are needed. PMID:24216710

  8. Associations among treatment-related neurological risk factors and neuropsychological functioning in survivors of childhood brain tumor.

    Science.gov (United States)

    McCurdy, Mark D; Rane, Shruti; Daly, Brian P; Jacobson, Lisa A

    2016-03-01

    Adverse neurological side effects associated with childhood brain tumors and their treatments contribute to long-term neurocognitive morbidity. Measures designed to quantify tumor-related risk factors are lacking. The neurological predictor scale (NPS) is designed to assess treatment-related neurological risks. Preliminary validation established associations between the NPS and global cognitive functioning in this population, though its associations with specific neurobehavioral domains has yet to be addressed. Participants referred for outpatient neuropsychological assessment completed performance-based measures of intellectual, attentional, working memory, motor speed, and executive abilities. Caregivers completed ratings of adaptive functioning. Neuropsychological and adaptive data were available for 100 brain tumor survivors (51 % female), ages 6 to 22 years (M = 12.83, SD = 4.37). Total NPS scores were generated via retrospective medical record review. Total NPS scores were significantly associated with several neurocognitive composite scores including verbal reasoning and working memory, after controlling for years post-diagnosis (ps  .05). Results indicate that the NPS is associated with performance-based neurocognitive functioning and executive skills but not with functioning in specific caregiver-reported adaptive behavior domains. The NPS offers some value as a resource for understanding associations between treatment-related neurological risks and select aspects of neurocognitive morbidity. Future studies should examine whether the NPS can aid in planning appropriate therapeutic intervention as survivors progress into early adulthood. PMID:26725098

  9. CD20 Positive Childhood B-non Hodgkin Lymphoma (B-NHL): Morphology, Immunophenotype and a Novel Treatment Approach: A Single Center Experience

    OpenAIRE

    Bilić, Ernest; Femenić, Ranka; Konja, Josip; Šimat, Marija; Dubravčić, Klara; Batinić, Drago; Ries, Sunčica; Rajić, Ljubica

    2010-01-01

    Lymphomas represent the third most common group of cancers in childhood and adolescence, mature B non Hodgkin’s lymphoma (B-NHL) accounting for up to 60% of newly diagnosed patients. The diagnosis of specific entities of B-NHL is based on well-defined morphologic analysis, immunophenotyping, cytogenetics and molecular genetics, which determine the optimal treatment strategy. In adult population a major turning point in treatment of B-NHL has been achieved since rituximab, in combination with ...

  10. Cardiovascular Conditions of Childhood

    Science.gov (United States)

    ... This childhood illness can result in long-term heart complications. Learn the symptoms, diagnosis and treatment for Kawasaki disease. Rheumatic Fever This inflammatory infection can occur after strep ...

  11. Childhood Ovarian Malignancy

    OpenAIRE

    Mahadik, Kalpana; Ghorpade, Kanchanmala

    2014-01-01

    Objective of this article is to appraise diagnostic aspects and treatment modalities in childhood ovarian tumor in background of available evidence. Literature search on Pubmed revealed various aspects of epidemiology, histopathological diagnosis, and treatment of pediatric ovarian tumor. 85 % of childhood tumors are germ cell tumors. The varied histopathological picture in germ cell tumors poses a diagnostic and therapeutic challenge. Immunohistochemistry and newer genetic markers like SALL4...

  12. Childhood obesity.

    Science.gov (United States)

    Han, Joan C; Lawlor, Debbie A; Kimm, Sue Y S

    2010-05-15

    Worldwide prevalence of childhood obesity has increased greatly during the past three decades. The increasing occurrence in children of disorders such as type 2 diabetes is believed to be a consequence of this obesity epidemic. Much progress has been made in understanding of the genetics and physiology of appetite control and from these advances, elucidation of the causes of some rare obesity syndromes. However, these rare disorders have so far taught us few lessons about prevention or reversal of obesity in most children. Calorie intake and activity recommendations need reassessment and improved quantification at a population level because of sedentary lifestyles of children nowadays. For individual treatment, currently recommended calorie prescriptions might be too conservative in view of evolving insight into the so-called energy gap. Although quality of research into both prevention and treatment has improved, high-quality multicentre trials with long-term follow-up are needed. Meanwhile, prevention and treatment approaches to increase energy expenditure and decrease intake should continue. Recent data suggest that the spiralling increase in childhood obesity prevalence might be abating; increased efforts should be made on all fronts to continue this potentially exciting trend. PMID:20451244

  13. Treatment Sequencing for Childhood ADHD: A Multiple-Randomization Study of Adaptive Medication and Behavioral Interventions.

    Science.gov (United States)

    Pelham, William E; Fabiano, Gregory A; Waxmonsky, James G; Greiner, Andrew R; Gnagy, Elizabeth M; Pelham, William E; Coxe, Stefany; Verley, Jessica; Bhatia, Ira; Hart, Katie; Karch, Kathryn; Konijnendijk, Evelien; Tresco, Katy; Nahum-Shani, Inbal; Murphy, Susan A

    2016-01-01

    Behavioral and pharmacological treatments for children with attention deficit/hyperactivity disorder (ADHD) were evaluated to address whether endpoint outcomes are better depending on which treatment is initiated first and, in case of insufficient response to initial treatment, whether increasing dose of initial treatment or adding the other treatment modality is superior. Children with ADHD (ages 5-12, N = 146, 76% male) were treated for 1 school year. Children were randomized to initiate treatment with low doses of either (a) behavioral parent training (8 group sessions) and brief teacher consultation to establish a Daily Report Card or (b) extended-release methylphenidate (equivalent to .15 mg/kg/dose bid). After 8 weeks or at later monthly intervals as necessary, insufficient responders were rerandomized to secondary interventions that either increased the dose/intensity of the initial treatment or added the other treatment modality, with adaptive adjustments monthly as needed to these secondary treatments. The group beginning with behavioral treatment displayed significantly lower rates of observed classroom rule violations (the primary outcome) at study endpoint and tended to have fewer out-of-class disciplinary events. Further, adding medication secondary to initial behavior modification resulted in better outcomes on the primary outcomes and parent/teacher ratings of oppositional behavior than adding behavior modification to initial medication. Normalization rates on teacher and parent ratings were generally high. Parents who began treatment with behavioral parent training had substantially better attendance than those assigned to receive training following medication. Beginning treatment with behavioral intervention produced better outcomes overall than beginning treatment with medication. PMID:26882332

  14. Growth hormone deficiency, secondary hypothyroidism, and empty sella following treatment of childhood macroprolactinoma

    Directory of Open Access Journals (Sweden)

    Chitra Selvan

    2013-01-01

    Full Text Available Macroprolactinoma are rare in childhood, especially in the first decade. A 9-year-old girl presented with headache, vomiting, and decreased vision for 8 months. A diagnosis of macroprolactinoma was made following documentation of elevated serum prolactin (958 ng/ml with a contrast enhancing macroadenoma (30 × 27 × 28 mm on magnetic resonance imaging of pituitary. Anterior pituitary function was normal. Cabergoline therapy resulted in resolution of all symptoms in 2-8 months. Revaluation at 10 months of cabergoline therapy revealed normal serum prolactin (14 ng/ml, normal pituitary function, with 91% decrease in adenoma size (11.5 × 13.6 × 12.7 mm. Evaluation at 36 months of cabergoline therapy for growth arrest and weight gain for past 6 months revealed low serum prolactin, growth hormone deficiency, and secondary hypothyroidism with empty sella. She had biochemical as well as structural resolution of prolactinoma. This report highlights the development of multiple pituitary hormone deficiency with empty sella, an uncommon side effect of cabergoline therapy for macroprolactinoma.

  15. Disseminated glioneuronal tumors occurring in childhood: treatment outcomes and BRAF alterations including V600E mutation.

    Science.gov (United States)

    Dodgshun, Andrew J; SantaCruz, Nadine; Hwang, Jaeho; Ramkissoon, Shakti H; Malkin, Hayley; Bergthold, Guillaume; Manley, Peter; Chi, Susan; MacGregor, Duncan; Goumnerova, Liliana; Sullivan, Michael; Ligon, Keith; Beroukhim, Rameen; Herrington, Betty; Kieran, Mark W; Hansford, Jordan R; Bandopadhayay, Pratiti

    2016-06-01

    Disseminated glioneuronal tumors of childhood are rare. We present a retrospective IRB-approved review of the clinical course and frequency of BRAF mutations in disseminated glioneuronal tumors at two institutions. Defining features of our cohort include diffuse leptomeningeal-spread, often with a discrete spinal cord nodule and oligodendroglioma-like histologic features. Patients were identified through a pathology database search of all cases with disseminated low-grade neoplasms with an oligodendroglioma-like component. De-identified clinical information was collected by chart review and all imaging was reviewed. We retrieved the results of targeted genomic analyses for alterations in BRAF. Ten patients (aged 2-14 years) were identified from the Dana-Farber/Boston Children's Hospital and the Royal Children's Hospital, Melbourne pathology databases. Nine patients received chemotherapy. Eight patients are alive, although three have had episodes of progressive disease. We identified genomic alterations affecting the MAPK pathway in six patients. One patient had a germline RAF1 mutation and a clinical diagnosis of cardio-facio-cutaneous syndrome. BRAF duplications were identified in four and BRAF V600E mutation was identified in one. These data support the presence of targetable genomic alterations in this disease. PMID:26994902

  16. Treatment patterns of childhood diarrhoea in rural Uganda: a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Löfgren Jenny

    2012-09-01

    Full Text Available Abstract Background Diarrhoea is the second leading cause of death in children under five accounting for 1.8 million deaths yearly. Despite global efforts to reduce diarrhoea mortality through promotion of proper case management, there is still room for ample improvement. In order to seek options for such improvements this study explored the knowledge and practices of diarrhoea case management among health care providers at health centres and drug shops in Uganda. Methods Records were reviewed for case management and structured interviews concerning knowledge and practices were conducted with the staff at all health centres and at all identified drug shops in the rural district of Namutumba, Uganda. Results There was a significant gap between knowledge and documented practices among staff. Antibiotics, antimalarials and antipyretics were prescribed or recommended as frequently as Oral Rehydration Solution (ORS. In almost a third of the health facilities, ORS was out of stock. 81% of staff in health centres and 87% of staff in drug shops stated that they prescribed antibiotics for common diarrhoea. Zinc was not prescribed or recommended in any case. Conclusions The findings indicate that many children presenting with diarrhoea are inadequately treated. As a result they may not get the rehydration they need and are at risk of potential side effects from unjustified usage of antibiotics. Practices must be improved at health centres and drug shops in order to reduce childhood mortality due to diarrhoeal diseases.

  17. Possibilities of the primary and secondary prophylaxis in treatment of childhood asthma

    Directory of Open Access Journals (Sweden)

    Petrović Slobodanka

    2010-01-01

    Full Text Available Introduction The natural course of asthma is unpredictable and appears to be unaffected by any therapeutic strategy. Under such circumstances, the attention must be focused on the opportunities for prevention of a disease which is chronic, life long and incurable, even thought it can be very effectively controlled. During the past decades, a lot of a studies have been performed and started, in which relatively large numbers of children were included and followed prospectively to determine the incidence of risk factors for asthma in childhood. All these studies have contributed significant new information. The levels of prevention must be considered in all patients. There are two main separate components to the strategy. Primary prophylaxis Primary prophylaxis (time course of allergic sensitization, timing of exposure to allergens, influence of tobacco smoke, maternal health and allergen exposure is introduced before there is any evidence of sensitization to factors which might have caused the disease. There is increasing evidence that allergic sensitization is a very common precursor to the development of asthma. Secondary prophylaxis Secondary prophylaxis (allergen avoidance, hygiene hypothesis is important after primary sensitization to allergen has occurred, but before there is any evidence of asthma. Conclusion In this article the authors reviewed all results of studies about primary and secondary prophylaxis of asthma and its influence on the course of disease.

  18. The role of leukotriene receptor antagonists in the treatment of chronic asthma in childhood.

    Science.gov (United States)

    Warner, J O

    2001-01-01

    A considerable increase in the prevalence of childhood asthma over the last few decades has been mirrored by a dramatic increase in usage of anti-asthma drugs; however, there has been no reduction in the numbers of patients dying of asthma. Concern has been expressed about the development of tolerance with continuous use of inhaled beta-agonist bronchodilators and about the potential adverse systemic effects of high-dose inhaled corticosteroids in children. Moreover, patient compliance with inhaled therapy tends to be poor. The leukotriene receptor antagonists, including montelukast, pranlukast and zafirlukast, are orally administered agents with proven benefits in asthma. In a large, placebo-controlled pediatric trial, montelukast significantly (P exercise-induced bronchospasm in both adults and children, and this protection was maintained during the trough period at the end of the once-daily administration interval (namely, 20-24 h post-dose). Several studies have demonstrated that the formation of cysteinyl leukotrienes in the airways of asthmatic patients is not suppressed by corticosteroids; thus, it is not surprising that montelukast demonstrates complementary effects when given with inhaled corticosteroids. Currently, the most compelling evidence from published trials suggests that leukotriene receptor antagonists can be used as add-on therapy to inhaled corticosteroids to allow tapering of corticosteroid dose and reduction in beta-agonist use. Recent clinical trial results suggest there may also be a role for these agents as first-line therapy in children with mild asthma. PMID:11421938

  19. Childhood psoriasis

    Directory of Open Access Journals (Sweden)

    Dogra Sunil

    2010-01-01

    Full Text Available Psoriasis is a common dermatosis in children with about one third of all patients having onset of disease in the first or second decade of life. A chronic disfiguring skin disease, such as psoriasis, in childhood is likely to have profound emotional and psychological effects, and hence requires special attention. Psoriasis in children has been reported to differ from that among adults being more frequently pruritic; plaque lesions are relatively thinner, softer, and less scaly; face and flexural involvement is common and guttate type is the characteristic presentation. Whether onset in childhood predicts a more severe form of psoriasis is a matter of controversy, it may cause significant morbidity particularly if it keeps relapsing. Most children have mild form of psoriasis which can be generally treated effectively with topical agents such as emollients, coal tar, corticosteroids, dithranol, calcipotriol etc. according to age and the sites affected. Narrow band UVB is the preferred form of phototherapy in children for moderate to severe disease or in patients not responding to topical therapy alone. Systemic therapies are reserved for more severe and extensive cases that cannot be controlled with topical treatment and/or phototherapy such as severe plaque type, unstable forms like erythrodermic and generalized pustular psoriasis and psoriatic arthritis. There are no controlled trials of systemic therapies in this age group, most experience being with retinoids and methotrexate with favorable results. Cyclosporine can be used as a short-term intermittent crisis management drug. There is an early promising experience with the use of biologics (etanercept and infliximab in childhood psoriasis. Systemic treatments as well as phototherapy have limited use in children due to cumulative dose effects of drugs, low acceptance, and risk of gonadal toxicity. More evidence-based data is needed about the effectiveness and long-term safety of topical

  20. European audit of current practice in diagnosis and treatment of childhood growth hormone deficiency

    DEFF Research Database (Denmark)

    Juul, Anders; Bernasconi, Sergio; Clayton, Peter E; Kiess, Wieland; DeMuinck-Keizer Schrama, Sabine

    2002-01-01

    The present survey among members of the ESPE on current practice in diagnosis and treatment of growth hormone (GH) deficiency (GHD) is of great clinical relevance and importance in the light of the recently published guidelines for diagnosis and treatment of GHD by the Growth Hormone Research Soc...

  1. Mediators and Moderators of Outcome in the Behavioral Treatment of Childhood Social Phobia

    Science.gov (United States)

    Alfano, Candica A.; Pina, Armando A.; Villalta, Ian K.; Beidel, Deborah C.; Ammerman, Robert T.; Crosby, Lori E.

    2009-01-01

    Data from a study involving 88 youths who participated in one of two randomized controlled treatment trials of Social Effectiveness Therapy for Children reveals that loneliness scores and social effectiveness predicted changes in social anxiety and overall functioning after the treatment. Child-reported loneliness mediated changes in social…

  2. Cure rates of childhood acute lymphoblastic leukemia in Lithuania and the benefit of joining international treatment protocol

    DEFF Research Database (Denmark)

    Vaitkevičienė, Goda; Matuzevičienė, Rėda; Stoškus, Mindaugas;

    2014-01-01

    BACKGROUND: Childhood acute lymphoblastic leukemia (ALL) represents the largest group of pediatric malignancies with long-term survival rates of more than 80% achieved in developed countries. Epidemiological data and survival rates of childhood ALL in Lithuania were lacking. Therefore, the aim of...

  3. Pulmonary function and fitness years after treatment for hypersensitivity pneumonitis during childhood

    DEFF Research Database (Denmark)

    Sisman, Yagmur; Buchvald, Frederik; Blyme, Anne Katrine; Mortensen, Jann; Nielsen, Kim Gjerum

    2016-01-01

    BACKGROUND: Hypersensitivity pneumonitis (HP) is an immune-mediated diffuse lung disease. Significant improvement in lung function and diffusing capacity after treatment was previously demonstrated, while long-term data focusing specifically on peripheral airway impairment and peak oxygen uptake...

  4. Individualised homeopathy as an adjunct in the treatment of childhood asthma: a randomised placebo controlled trial

    OpenAIRE

    White, A.; Slade, P.; Hunt, C.; Hart, A.; Ernst, E.

    2003-01-01

    Background: Homeopathy is frequently used to treat asthma in children. In the common classical form of homeopathy, prescriptions are individualised for each patient. There has been no rigorous investigation into this form of treatment for asthma.

  5. Comparative Cost Analysis of Sequential, Adaptive, Behavioral, Pharmacological, and Combined Treatments for Childhood ADHD.

    Science.gov (United States)

    Page, Timothy F; Pelham, William E; Fabiano, Gregory A; Greiner, Andrew R; Gnagy, Elizabeth M; Hart, Katie C; Coxe, Stefany; Waxmonsky, James G; Foster, E Michael; Pelham, William E

    2016-01-01

    We conducted a cost analysis of the behavioral, pharmacological, and combined interventions employed in a sequential, multiple assignment, randomized, and adaptive trial investigating the sequencing and enhancement of treatment for children with attention deficit hyperactivity disorder (ADHD; Pelham et al., 201X; N = 146, 76% male, 80% Caucasian). The quantity of resources expended on each child's treatment was determined from records that listed the type, date, location, persons present, and duration of all services provided. The inputs considered were the amount of physician time, clinician time, paraprofessional time, teacher time, parent time, medication, and gasoline. Quantities of these inputs were converted into costs in 2013 USD using national wage estimates from the Bureau of Labor Statistics, the prices of 30-day supplies of prescription drugs from the national Express Scripts service, and mean fuel prices from the Energy Information Administration. Beginning treatment with a low-dose/intensity regimen of behavior modification (large-group parent training) was less costly for a school year of treatment ($961) than beginning treatment with a low dose of stimulant medication ($1,669), regardless of whether the initial treatment was intensified with a higher "dose" or if the other modality was added. Outcome data from the parent study (Pelham et al., 201X) found equivalent or superior outcomes for treatments beginning with low-intensity behavior modification compared to intervention beginning with medication. Combined with the present analyses, these findings suggest that initiating treatment with behavior modification rather than medication is the more cost-effective option for children with ADHD. PMID:26808137

  6. Pulmonary hydatid cyst rupture in childhood: Presentation diagnosis and treatment strategies

    OpenAIRE

    Özdemir, Tunç; Arıkan, Ahmet

    2013-01-01

    Aim: Rupture of pulmonary hydatid cyst is rare yet very serious complication The patients may be presented with cough and hydroptysis or may be presented with anaphylaxis and suffocation Pediatric patients with ruptured pulmonary hydatid cyst were evaluated retrospectively surgical and medical options yielding to treatment are discussed Material and Method: Between January 1999 and June 2012 a total of 956 patients with hydatid cyst had undergone surgical treatment One hundred and ten...

  7. European audit of current practice in diagnosis and treatment of childhood growth hormone deficiency

    DEFF Research Database (Denmark)

    Juul, Anders; Bernasconi, Sergio; Clayton, Peter E;

    2002-01-01

    The present survey among members of the ESPE on current practice in diagnosis and treatment of growth hormone (GH) deficiency (GHD) is of great clinical relevance and importance in the light of the recently published guidelines for diagnosis and treatment of GHD by the Growth Hormone Research Soc...... Society. We have found much conformity but also numerous discrepancies between the recommendations of the Growth Hormone Research Society and the current practice in Europe....

  8. A Pilot Study of 1% Pimecrolimus Cream for the Treatment of Childhood Segmental Vitiligo

    OpenAIRE

    Shim, Woo-Haing; Suh, Sung-Won; Jwa, Seung-Wook; Song, Margaret; Kim, Hoon-Soo; Ko, Hyun-Chang; Kim, Byung-Soo; Kim, Moon-Bum

    2013-01-01

    Background There is as yet no effective and safe treatment for vitiligo. One percent pimecrolimus cream, a topical calcineurin inhibitor, has been tried for the treatment of vitiligo, with its therapeutic efficacy having mostly been reported in non-segmental vitiligo. However, questions about the therapeutic efficacy of 1% pimecrolimus cream have remained unanswered regarding segmental vitiligo. Objective The aim of this study was to study the therapeutic efficacy and safety of 1% pimecrolimu...

  9. Effectiveness of group cognitive–behavioral treatment for childhood anxiety disorders in community clinics: benchmarking against an efficacy trial at a university clinic

    DEFF Research Database (Denmark)

    Jónsson, Hjalti; Arendt, Kristian Bech; Jørgensen, Lisbeth;

    Denmark (Arendt & Thastum, 2013). Objective: To evaluate the outcomes of evidence based, manualized group cognitive-behavioural treatment (CBT) for children and adolescent with anxiety disorders, when delivered in an outpatient Child and Adolescent Psychiatry or in a community based School Counselling......Background: The efficacy of a group cognitive behavioural therapy program (Cool Kids) of childhood anxiety has been demonstrated in a university-clinic setting in Australia (Hudson et al., 2009) and findings from a randomized controlled trial (RCT) at a University-clinic supports its efficacy in...... Service in Denmark. Method: Psychologists and psychiatrists from three Child and Adolescent Psychiatry clinics and four community bases School Counselling Services are trained and supervised in a manualized group CBT treatment program (Cool Kids) for Childhood anxiety. Ninety-six children with anxiety...

  10. [Comparison between penicillin and amoxicillin-clavulanic acid for the treatment of recurrent tonsillopharyngitis in childhood].

    Science.gov (United States)

    Asensi, F; López-Hontangas, J L; Otero, M; Santos, M; Román, J; Pérez-Tamarit, D

    1999-09-01

    Fifty-one children aged 2-14 years with recurrent tonsillopharyngitis, presenting dysphagia, fever and lymphadenitis, with more than two similar episodes in the last three years and showing a beta-hemolytic group A streptococci in the pharyngeal smear, were studied. They underwent random treatment for ten days with phenoxymethylpenicillin (40-60 mg/kg/day) (n = 28) or amoxicillin-clavulanic acid (20-40 mg/kg/day) (n = 23) taken orally three times a day. Clinical and bacteriological tests were carried out at 10 days and 2, 6 and 12 months post-treatment. The clinical and bacteriological results showed the superiority of the amoxicillin-clavulanic acid treatment both in the short term (disappearance of symptoms) and in the long term (decrease in recurrence). These results support the idea that betalactamases produced by the pharyngeal flora play an important role in the failures of penicillin. PMID:10878510

  11. Hodgkin Illness in the childhood. Results with combined treatment of OPPA with radiotherapy

    International Nuclear Information System (INIS)

    A retrospective revision was made (not randomized) among the years 1988 and 1997, of patients histories that had entered the INC for treatment for the Hodgkin illness. All the cases, patient smaller than 16 years were studied, that had not been treated in other centers neither it had received another oncospecific treatment. The sheets or the anatomy-pathology study were revised, being remarkable that for but of 10 years the histology study is in charge of oneself pathologists' group. In total 144 patients were recruited; 29 were excluded: 2 for treatments in other centers, 17 to only have received radiotherapy, 9 to receive other outlines of treatment chemo therapeutic and a patient to reject the treatment; finally 115 patients were studied. To all they were made complete analysis of hematology with erythro sedimentation and serology for hepatitis study B and C. Biopsy of bony marrow was not made in the I and II states; echography and thorax X rays, was made to all patients but the TAC it could not be carried out to all for logistical difficulties; in some patients the corporal journey was made with gammagraphy, using gallium. The final results showed a complete answer in 100 patients (87%). There were 7 deaths: 2 for causes different to the illness, one for sepsis for klebsiella, one for cardio toxicity for anthracycline, 2 for abandonment of the treatment and 3 patients got lost. 13 patients were presented with neutropenia, 3 patients with pneumonia, 1 with chicken pox and 2 with sepsis. The global survival is of 90%

  12. Evaluation of salivary interleukin-6 in children with early childhood caries after treatment

    Science.gov (United States)

    Menon, Medhini Madhavan; Balagopal, R. Varma; Sajitha, Krishnan; Parvathy, Kumaran; Sangeetha, G. Bhat; Arun, X. Mamachan; Sureshkumar, Janardhanan

    2016-01-01

    Background: The role of cytokines as a marker in the oral inflammatory process in ECC has not been fully explored before and after full mouth rehabilitation. Aims: The aim of this study was to assess the level of salivary interleukin-6 (IL-6) in children with ECC and to compare its levels before and after comprehensive full mouth rehabilitation. Methods and Materials: Saliva samples were collected from children with ECC prior to dental treatment and 3-month post treatment. The salivary IL-6 levels were analyzed using the ELISA method. The gingival index was also timely recorded. Oral health awareness sessions were conducted for children and their parents at regular intervals during the 3-month study period. Statistical analysis used: Wilcoxon Signed Rank test compared the levels of salivary IL-6 while, the paired t test compared the values of gingival index before and after treatment. Results: The mean level of salivary IL-6 before and 3 months after treatment had reduced and this reduction was statistically significant (P caries activity state, the level of inflammation (IL-6) can definitely be minimized and thereby improving the quality of life of affected children. PMID:27307667

  13. Family Factors in the Development, Treatment, and Prevention of Childhood Anxiety Disorders

    Science.gov (United States)

    Drake, Kelly L.; Ginsburg, Golda S.

    2012-01-01

    It is now widely accepted that anxiety disorders run in families, and current etiological models have proposed both genetic and environmental pathways to anxiety development. In this paper, the familial role in the development, treatment, and prevention of anxiety disorders in children is reviewed. We focus on three anxiety disorders in youth,…

  14. Prediction of immunophenotype, treatment response, and relapse in childhood acute lymphoblastic leukemia using DNA microarrays

    DEFF Research Database (Denmark)

    Willenbrock, Hanni; Juncker, Agnieszka; Schmiegelow, K.; Knudsen, Steen; Ryder, L.P.

    2004-01-01

    Gene expression profiling is a promising tool for classification of pediatric acute lymphoblastic leukemia ( ALL). We analyzed the gene expression at the time of diagnosis for 45 Danish children with ALL. The prediction of 5-year event-free survival or relapse after treatment by NOPHO-ALL92 or 2000...

  15. Considerations regarding the diagnosis and treatment of childhood type 2 diabetes.

    Science.gov (United States)

    Zeitler, Philip

    2010-05-01

    The prevalence of diabetes among children and adolescents has been steadily increasing, making it even more important that diabetes be adequately managed in this patient population. A basic distinction between type 1 and type 2 diabetes has long been understood. Type 1 diabetes results from a primary loss of pancreatic insulin production, usually as a consequence of autoimmune destruction of pancreatic cells; in type 2 diabetes, insulin production continues and may even be exaggerated, but is insufficient to adequately compensate for resistance to insulin action, leading to the loss of glycemic control. Regardless of the type of diabetes, the treatment goal is to control hyperglycemia. However, the optimal treatment strategy depends on the underlying cause of hyperglycemia. It is therefore important to accurately diagnose whether a patient has type 1 or type 2 diabetes. Historically, this has been thought possible based on the different clinical presentations and age of onset of the conditions. More recently, with the increasing prevalence of type 2 diabetes among adolescents and the trend toward a more obese society, the distinction has become less clear. This has led to the need for the differential diagnosis of diabetes to be confirmed using biochemical and immunological testing. In addition, because the prevalence of type 2 diabetes in the pediatric population is a relatively new phenomenon, available treatments for type 2 diabetes have been studied predominantly in adult populations. With type 2 diabetes becoming increasingly common in pediatric centers, there is a need to evaluate the optimal treatments for children and adolescents. PMID:20463418

  16. Fine motor and handwriting problems after treatment for childhood acute lymphoblastic leukemia

    NARCIS (Netherlands)

    ReindersMesselink, HA; Schoemaker, MM; Hofte, M; Goeken, LNH; Kingma, A; vandenBriel, MM; Kamps, WA

    1996-01-01

    Motor skills were investigated in 18 children 2 years after treatment for acute lymphoblastic leukemia (ALL). Cross and fine motor functioning were examined with the Movement Assessment Battery for Children. Handwriting as a specific fine motor skill was studied with a computerized writing task. We

  17. Childhood Leukemia

    Science.gov (United States)

    ... cells. It is the most common type of childhood cancer. Your blood cells form in your bone ... in the bones or joints Risk factors for childhood leukemia include having a brother or sister with ...

  18. Childhood Stress

    Science.gov (United States)

    ... 5 Things to Know About Zika & Pregnancy Childhood Stress KidsHealth > For Parents > Childhood Stress Print A A ... and feel stress to some degree. Sources of Stress Stress is a function of the demands placed ...

  19. Childhood and Adult Trauma Experiences of Incarcerated Persons and Their Relationship to Adult Behavioral Health Problems and Treatment

    OpenAIRE

    Jing Shi; Nancy Wolff

    2012-01-01

    Rates of childhood and adult trauma are high among incarcerated persons. In addition to criminality, childhood trauma is associated with the risk for emotional disorders (e.g., depression and anxiety) and co-morbid conditions such as alcohol and drug abuse and antisocial behaviors in adulthood. This paper develops rates of childhood and adult trauma and examines the impact of age-of-onset and type-specific trauma on emotional problems and behavior for a sample of incarcerated males (N~4,000)....

  20. Childhood Obesity

    OpenAIRE

    Wilkinson, Justine; Howard, Simon

    2014-01-01

    Childhood obesity has important consequences for health and wellbeing both during childhood and also in later adult life. The rising prevalence of childhood obesity poses a major public health challenge in both developed and developing countries by increasing the burden of chronic non-communicable diseases. Despite the urgent need for effective preventative strategies, there remains disagreement over its definition due to a lack of evidence on the optimal cut-offs linking childhood BMI to dis...

  1. Endobronchial tumours in childhood

    International Nuclear Information System (INIS)

    Endobronchial tumours are rare in childhood and are not often considered in the differential diagnosis of persistent pneumonitis and atelectasis. We present the clinical and radiological features of seven cases of childhood bronchial 'adenoma' seen at our hospital over a 16-year period. Because they are relatively slow growing, prompt diagnosis and early surgical treatment offer the best chance of cure in these patients. A review of the literature is given

  2. Endobronchial tumours in childhood

    International Nuclear Information System (INIS)

    Endobronchial tumours are rare in childhood and are not often considered in the differential diagnosis of persistent pneumonitis and atelectasis. We present the clinical and radiological features of seven cases of childhood bronchial 'adenoma' seen at our hospital over a 16-year period. Because they are relatively slow growing, prompt diagnosis and early surgical treatment offer the best chance of cure in these patients. A review of the literature is given. (Copyright (c) Elsevier Science B.V., Amsterdam. All rights reserved.)

  3. Response to planned treatment interruptions in HIV infection varies across childhood

    DEFF Research Database (Denmark)

    NN, NN; Valerius, Niels Henrik

    2010-01-01

    OBJECTIVE: To evaluate clinical, immunological and virological consequences of CD4-guided antiretroviral therapy (ART) planned treatment interruptions (PTIs) compared with continuous therapy in children with chronic HIV infection in the Paediatric European Network for Treatment of AIDS 11 trial...... PTI (56). In PTI, ART was restarted if confirmed CD4% was less than 20% or more than 48 weeks had been spent off ART. The primary outcome was Centers for Disease Control and Prevention (CDC) stage C event, death or CD4% less than 15% (and CD4 cell count less than 200 cells/microl for children aged 7...... versus 48% of time was spent off ART in continuous therapy and PTI, respectively. No child died or had a new CDC stage C event; one (2%) continuous therapy versus four (7%) PTI children had a primary outcome based on CD4%/cell count (P = 0.2). Lower nadir CD4% predicted faster CD4% decline after stopping...

  4. Clinical experience with radioactive iodine in the treatment of childhood and adolescent Graves' disease

    OpenAIRE

    Cury, Adriano N; Meira, Verônica T; Monte, Osmar; Marone, Marília; Scalissi, Nilza M; Kochi, Cristiane; Calliari, Luís E P; Carlos A. Longui

    2012-01-01

    Background/aims Treatments for Graves' disease (GD) in children and adolescents include oral antithyroid drugs (ATDs), near total thyroidectomy, and radioactive iodine (RAI). ATDs remain the preferred choice in this age group, but because persistent remission occurs in 30% of cases, RAI is becoming a common option for definitive therapy. Methods We performed a review of 65 medical records of GD patients under age 19 years who were followed between 1985 and 2005. Results The prevalence of GD w...

  5. Fertility treatment and risk of childhood and adolescent mental disorders: register based cohort study

    OpenAIRE

    Bay, Bjørn; Mortensen, Erik Lykke; Hvidtjørn, Dorte; Kesmodel, Ulrik Schiøler

    2013-01-01

    Objective To assess the mental health of children born after fertility treatment by comparing their risk of mental disorders with that of spontaneously conceived children. Design Prospective register based cohort study. Setting Nationwide register based information from Danish National Health Registers cross linked by a unique personal identification number assigned to all citizens in Denmark. Participants All children born in Denmark in 1995-2003 with follow-up in 2012 when the children were...

  6. Multidisciplinary management of ankyloglossia in childhood. Treatment of 101 cases. A protocol

    OpenAIRE

    Ferrés Amat, Elvira; Pastor-Vera, Tomasa; Ferrés-Amat, Eduard; Mareque Bueno, Javier; Prats Armengol, Jordi; Ferrés Padró, Eduard

    2016-01-01

    Background Partial ankyloglossia is a limitation which restricts the possibility of protrusion and elevation of the tip of the tongue due to the shortness of either the lingual frenulum or the genioglossus muscles or both. The principal objective of this paper is to present our protocol of action for the treatment of ankyloglossia. The specific objectives are to study patients with ankyloglossia treated by the Service of Maxillofacial Surgery and the Service of Speech Therapy of our pediatric...

  7. Risk-adapted stratification and treatment of childhood acute lymphoblastic leukaemia

    International Nuclear Information System (INIS)

    Systematic enrolment of children and adolescents with acute lymphoblastic leukaemia (ALL) into clinical trials has allowed the establishment of prognostic parameters derived from initial diagnostic findings. More important, these trials have significantly contributed to the reduction of disease recurrence as much as to the reduction of acute and late side effects. Some problems that are related to the specificity of the parameters used for risk assessment were not overcome: high tumour load by white blood cell count (WBC), age and (rare) cytogenetic subtypes (e.g. t9;22) may characterise a significant proportion of children and adolescents with high-risk ALL. Most patients who will eventually relapse do not present with characteristic features at initial diagnosis. It appears feasible through careful response assessment to identify these patients at risk of relapse, who present initially without specific features. Earlier trials of the ALL-BFM (Berlin/Frankfurt/Muenster) study group and others have demonstrated that inadequate leukaemic blast reduction in the peripheral blood or bone marrow after the first few days of therapy is highly predictive of treatment failure. Using clone-specific polymerase chain reaction-based detection of minimal residual disease (MRD) as done in trial AIEOP-BFM ALL 2000 allowed a close surveillance of specific treatment elements when applied in MRD positive patients. This may facilitate innovative chemotherapy approaches and a more rational use of allogeneic haematopoietic stem cell transplantation. In addition, genetic signatures of treatment response or failure have been identified. (authors)

  8. Childhood Cancer

    Science.gov (United States)

    ... Story" 5 Things to Know About Zika & Pregnancy Childhood Cancer KidsHealth > For Parents > Childhood Cancer Print A A A Text Size What's ... in children, but can happen. The most common childhood cancers are leukemia , lymphoma , and brain cancer . As ...

  9. Gonadal status and reproductive function following treatment for Hodgkin's disease in childhood: The Stanford experience

    International Nuclear Information System (INIS)

    To ascertain the impact of therapy on gonadal function and reproductive outcome among children treated for Hodgkin's disease, we reviewed the experience at Stanford University Medical Center during the years 1965-1986. There were 240 children 15 years of age or younger, 92 girls and 148 boys; with median follow-up of 9 years, maximum follow-up was 26 years. Of this cohort, data on gonadal function were available on 20 boys, 5 of whom were considered prepubescent; they had no clinical evidence of sexual maturation and were less than 13 years of age. Evaluation of the boys included testicular biopsy, semen analyses and the ability to procreate. Serum gonadotropin hormone levels (FSH, LH) were studied in 11 boys who also had semen analyses. Sexual maturation was attained in all boys without the need for androgen replacement. Among the eight boys treated with radiation alone, four were able to father a child (3 following 40-45 Gy pelvic radiation dose, 1 without pelvic radiation) from 3-19 years following treatment. Three others who received 30-44 Gy pelvic radiation were oligospermic when tested at 10 to 15 years post-treatment. Semen analyses in 10 of 12 (83%) boys who had been treated with six cycles of MOPP with or without pelvic radiation revealed absolute azoospermia with no evidence of recovery as along as 11 years of follow-up. Following prolonged azoospermia, 2 of the 12 boys (17%) had recovery of fertility, with normalization of sperm count and/or ability to procreate at 12 and 15 years following treatment. There was no correlation with serum gonadotropin levels and sterility. Data on menstrual history, pregnancy and offspring were available in 86 (92%) of the girls. Seventy-five of the 86 girls (87%) have normal menstrual function. However, none of the females who underwent pelvic radiation without prior oophoropexy has maintained ovarian function

  10. Duration of adrenal insufficiency during treatment for childhood acute lymphoblastic leukemia

    DEFF Research Database (Denmark)

    Vestergaard, Therese Risom; Juul, Anders; Lausten-Thomsen, Ulrik; Lausen, Birgitte Frederiksen; Hjalgrim, Henrik; Kvist, Tine Kajsa; Andersen, Elisabeth Anne Wreford; Schmiegelow, Kjeld

    2011-01-01

    Children with acute lymphoblastic leukemia (ALL) recive high doses of glucocorticosteroid as part of their treatment. This may lead to suppression of the hypothalamic-pituitary-adrenal axis, acute adrenal insufficiency, and ultimately to life-threatening conditions. This study explores the adrenal...... function in 96 children with ALL treated according to common protocols. After cessation of induction glucocorticosteroid therapy, they received hydrocortisone substitution therapy (10 mg/m/24 h) until an adrenocorticotropic hormone test (250 µg tetracosatide) showed a sufficient adrenal response [plasma (p...

  11. Segmental omental infarction in childhood: a typical case diagnosed by CT allowing successful conservative treatment

    Energy Technology Data Exchange (ETDEWEB)

    Coulier, Bruno [Clinique St. Luc, Department of Diagnostic Radiology, Bouge (Belgium)

    2006-02-01

    Segmental omental infarction (SOI) is an uncommon cause of right lower quadrant pain in children that is often misdiagnosed as appendicitis. During the last decade, imaging findings of SOI have proved to be sufficiently typical to avoid unnecessary surgery in the majority of reported adult patients. The condition has a spontaneous favourable evolution under medical treatment. In children the surgical option remains controversial. We report a typical case of SOI in a 10-year-old boy. The diagnosis was suspected by sonography, unambiguously confirmed by multidetector CT and successfully treated conservatively. This report emphasizes the use of CT in selected acute abdominal situations, peculiarly in obese children, to avoid unnecessary surgery. (orig.)

  12. Segmental omental infarction in childhood: a typical case diagnosed by CT allowing successful conservative treatment

    International Nuclear Information System (INIS)

    Segmental omental infarction (SOI) is an uncommon cause of right lower quadrant pain in children that is often misdiagnosed as appendicitis. During the last decade, imaging findings of SOI have proved to be sufficiently typical to avoid unnecessary surgery in the majority of reported adult patients. The condition has a spontaneous favourable evolution under medical treatment. In children the surgical option remains controversial. We report a typical case of SOI in a 10-year-old boy. The diagnosis was suspected by sonography, unambiguously confirmed by multidetector CT and successfully treated conservatively. This report emphasizes the use of CT in selected acute abdominal situations, peculiarly in obese children, to avoid unnecessary surgery. (orig.)

  13. Investigation of treatment related neurotoxicity following childhood cancer by proton magnetic resonance spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Davidson, A

    1999-05-01

    Children who survive treatment for cancer may suffer late effects, and neurotoxicity is a particular problem following central nervous system (CNS) directed therapy. Conventionally, this is assessed by neuropsychological assessments and neuroimaging. Cognitive deficits cannot be detected until several years after therapy, and although neuroimaging abnormalities are frequent they do not appear to be predictive of late problems. Thus, this study evaluated the role of localised proton magnetic resonance spectroscopy ({sup 1}H-MRS), a non-invasive method of quantifying metabolites in-vivo, which has the potential to be a sensitive, and quantifiable, means of detecting neurotoxicity and predicting clinical outcome.

  14. Comparison of efficacy of ferrous and iron polymaltose salts in the treatment of childhood iron deficiency anemia

    International Nuclear Information System (INIS)

    Iron deficiency of anemia (IDA) is defined as reduced number of red blood cells, and / or reduced concentration hemoglobin (Hb) due to deficiency of iron. Treatment involves dietary modifications and inorganic iron salt supplements like ferrous sulfate (FS) or Iron polymaltose complex (IPC). The decision to select either drug rests on therapeutic efficacy, untoward side effects; cost of complete course, patient's compliance and discretion of physician. Both drugs can be prescribed in oral form. This study aimed at comparing the efficacy of two iron preparations (ferrous sulphate and iron polymaltose complex salts) in childhood iron deficiency anemia. Objective: To compare the efficacy of Ferrous Sulphate and Iron Polymaltose Complex salts in the treatment of childhood Iron Deficiency Anemia. Methodology: This randomized controlled trial was conducted at Department of Pediatric Medicine Unit-II Mayo Hospital, Lahore, for a period of 6 months. One hundred and fifty children aged 6 months to 5 years suffering from iron deficiency anemia were selected and randomly divided into two groups of 75 each (Group A and B prescribed FS and IPC respectively). Results were analyzed in terms of rise in Hb from the baseline after three months. Increase in Hb level 2 gm/dl after three months of treatment was considered as effective. Results were analyzed by SPSS version 17. Efficacy of both the drugs, was compared by chi square test. P value 0.05 was accepted as significant. Results: There were 34 cases (22.7%) in 6-12 months age, 77 cases (51.3%) between 1-3 years age and 39 cases (26%) between 3-5 years age. The number of male and female children was 82 (54.7%) and 68 (45.3%) respectively. The baseline hemoglobin of all study cases was 6.64+-1.08 gm/dl (6.59+-1.13 gm/dl in Group A and 6.69+-1.04 gm/dl in Group B). At completion of therapy, the mean hemoglobin of all study cases was 9.15+-1.21 gm/dl (9.20+9-1.17 gm/dl in Group A and 9.11+-1.25 gm/dl in Group B). The difference

  15. Determinants of early childhood morbidity and proper treatment responses in Vietnam: results from the Multiple Indicator Cluster Surveys, 2000–2011

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    Hwa-Young Lee

    2016-02-01

    Full Text Available Background: Despite significant achievements in health indicators during previous decades, Vietnam lags behind other developing countries in reducing common early childhood illnesses, such as diarrhea and respiratory infections. To date, there has been little research into factors that contribute to the prevalence and treatment of childhood morbidity in Vietnam. Objective: This study examines the determinants of diarrhea and ‘illness with a cough’ and treatments for each of the conditions among young children in Vietnam, and describes trends over time. Design: Data from the Vietnam Multiple Indicator Cluster Surveys in 2000, 2006, and 2011 were used. Multivariable logistic regressions were undertaken to investigate factors associated with these childhood illnesses and proper treatment patterns. Results: Between 2000 and 2011, the prevalence of diarrhea among children under the age of five declined from 11 to 7%, while having illness with a cough increased to 40% in 2011 after falling from 69 to 28% between 2000 and 2006. During the same period, the prevalence of oral rehydration therapy (ORT for treating diarrhea increased from 13 to 46%, whereas the rate of seeking formal treatment for illnesses with a cough fell from 24 to 7%. Multivariable models indicated that children who were older than 2 years (odds ration [OR]: 0.44, 95% confidence interval [CI]: 0.37–0.53, p<0.001, male (OR: 1.21, 95% CI: 0.64–2.37, p<0.05, living in rural areas (OR: 1.28, 95% CI: 1.00–1.64, p<0.05, or of Kinh ethnicity (OR: 0.70, 95% CI: 0.56–0.87, p<0.01 were more likely to suffer from diarrhea. Ethnic differences and higher household wealth were factors significantly associated with having illness with a cough. In particular, the effect of level of wealth on illness with a cough varied in each wave. Mothers with higher levels of education had higher odds of seeking ORT compared with mothers with the lowest level of education. Seeking formal treatment for

  16. The development of cerebral CT changes during treatment of acute lymphocytic leukemia in childhood

    International Nuclear Information System (INIS)

    Twenty-three children with acute lymphocytic leukemia (ALL) were examined with cranial CT at least twice with a minimal interval of 10 months. The first CT was performed at the time of diagnosis in 11 children and during therapy in 12; all but two were normal on the first CT examination. These two had slight enlargement of the ventricular system and subarachnoid space at the time of diagnosis. These findings were unchanged on the second CT examinations. Seven patients, all in remission from leukemia of the central nervous system manifested abnormal findings on later CTs. Low density areas in the periventricular white matter were seen in the brains of three, with increasing subcortical calcification in one of these cases. Five children had slight enlargement of the ventricular system and subarachnoid space, especially of the basal and Sylvian cisterns. Later CT examinations in five, plus brain autopsy in two cases, revealed unchanged or progressive conditions. The CT findings have been related to the treatment and some characteristics of the disease. The frequency of CT abnormalities was higher in patients who had received therapeutic irradiation and intraventricular methotrexate treatment. The possible reasons for the CT abnormalities are discussed. (orig.)

  17. Social support during childhood cancer treatment enhances quality of life at survival

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    Carmina Castellano-Tejedor

    2015-10-01

    Full Text Available Background: Health-related quality of life (HRQoL in cancer has been related to several protective and risk factors such as perceived social support (PSS and coping. However, their effects on HRQoL once patients are in survivorship have not been fully described in pediatric samples. Objective: To describe and explore the relationship between HRQoL in survivorship and some factors (PSS, coping present while active treatment. Methods: Cross-sectional study. Forty-one pediatric cancer survivors answered HRQoL measures referred to survivorship, as well as PSS and coping measures referred to treatment period. Results: The discriminant function obtained succeeds to correctly classify 78% of the sample. Survivors who showed high HRQoL were those who, in the hardest moment while hospitalization, perceived satisfactory emotional support (from nurses and did not deploy a wide range of active coping resources to cope with stressful events (only social action coping strategy showed a significant relationship with HRQoL. Conclusions and implications: Considering these outcomes, educational and counseling interventions to strengthen patients' social networks and supportive relationships are recommended, specially, among health providers (nurses. These results highlight the importance of not overlooking opportunities to address the emotional needs of patients while hospitalization, since a positive and endurable effect has been observed at survivorship.

  18. Childhood sexual abuse, post-traumatic stress disorder, and use of heroin among female clients in Israeli methadone maintenance treatment programs (MMTPS).

    Science.gov (United States)

    Schiff, Miriam; Levit, Shabtay; Cohen-Moreno, Rinat

    2010-01-01

    This study investigated association between post-traumatic stress disorder (PTSD) and a 1-year follow-up heroin use among female clients in methadone clinics in Israel. Participants were 104 Israeli female clients from four methadone clinics (Mean age = 39.09, SD = 8.61) who reported victimization to childhood sexual abuse. We tested traces in urine of these female clients for heroin a year preceding and a year following the assessment of their PTSD. Results show that 54.2% reported symptoms that accedes the DSM-IV criteria for PTSD. We found that among childhood victimized women PTSD is associated with more frequent use of heroin at a 1-year follow-up even after controlling for duration of the stay at the clinic, background, other traumatic experiences and heroin use a year prior the assessment of their PTSD. This study shows the potential long-run negative consequences of childhood sexual abuse. Not only are these sexually abused women trapped into drug dependence and addiction, they cannot break the vicious cycle of continuing the use of illicit drugs even when treated for their addiction. One major practice implication is that treatment for PTSD proven efficacious will be provided in the methadone and other drug treatment services. PMID:20938876

  19. Neurotoxicity during induction treatment of childhood acute lymphoblastic leukaemia: Two case reports

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    Kostić Gordana

    2009-01-01

    Full Text Available Introduction. During chemotherapy of acute lymphoblastic leukaemia (ALL, children sometimes exhibit neurological disturbances. Chemiotherapeutic regimens include methotrexate, administered either intravenously or via intrathecal route. Although multiple drugs are used in addition to methotrexate, the acute neurotoxicity reported in patients is usually attributed to methotrexate. The acute neurotoxicity usually results in stroke-like symptoms such as aphasia, weakness, sensory deficits, ataxia and seizures. Outline of Cases. From 2002 until January 2008, 32 children with ALL were diagnosed and treated at the Children's Hospital in Niš. The patients' age ranged from 1.5 to 16 years. They were treated in accordance with the protocol ALL IC-BFM 2002 (ALL Intercontinental Berlin Frankfurt M'nster 2002. Two of the patients (6.25% exhibited neurotoxicity. After the occurrence of neurological symptoms, the patients were ophthalmologically and neurologically examined. In addition, the magnetic resonance (MR imaging, computerized tomography and electroencephalography were applied. The paper presents two patients, aged 9 and 15 years respectively, who exhibited acute neurotoxicity - methotrexate encephalopathy during ALL treatment. Both patients had tonic-clonic seizures and neurological symptoms in the course of the induction therapy. Neurotoxicity occurred 7 days after the third, and 3 days after the fourth intrathecal methotrexate therapy. MR images confirmed multi-focal morphological changes of brain density in one of the patients, while the other patient had normal CT reading. Even though the development significantly differed, the changes were reversible in both patients. Conclusion. The neurotoxicity in patients with ALL can be combined with significant structural changes of the brain, but also morphological changes can be absent. Several questions concerning aetiology and treatment of neurological events are raised.

  20. Improved Childhood Diarrhea Treatment Practices in Ghana: A Pre-Post Evaluation of a Comprehensive Private-Sector Program.

    Science.gov (United States)

    El-Khoury, Marianne; Banke, Kathryn; Sloane, Phoebe

    2016-06-20

    Diarrhea is the fourth leading cause of child mortality in Ghana. In 2010, Ghana endorsed guidelines from the World Health Organization and the United Nations Children's Fund for use of zinc with low-osmolarity oral rehydration salts (ORS) for the treatment of acute childhood diarrhea. From late 2011 through 2014, the Strengthening Health Outcomes through the Private Sector (SHOPS) project implemented a comprehensive program in 3 regions of Ghana to increase the availability and use of ORS and zinc and to decrease incorrect use of antibiotics and antidiarrheals. The program included (1) partnering with local pharmaceutical firms to introduce and market locally produced zinc products, (2) collaborating with the Ghanaian Pharmacy Council to provide training and supportive supervision of private-sector providers on diarrhea management, and (3) conducting mass media campaigns to raise caregiver awareness. We evaluated the effect of this program using a baseline survey of 754 caregivers of children under 5 with diarrhea at the start of the intervention in 2012 and a follow-up survey of 751 caregivers in 2014. Regression analysis showed that use of ORS with zinc increased from 0.8% in 2012 to 29.2% in 2014 (P<.001), and antibiotic use declined from 66.2% to 38.2% (P<.001) during the same period. The magnitude and statistical significance of these results remained the same after including potential confounding factors as covariates. Inappropriate antibiotic use, however, remained high at follow-up. We conclude that similar programs applied in other settings have the potential to rapidly scale up use of ORS and zinc. Additional efforts are required to reduce persistent incorrect antibiotic use. PMID:27353619

  1. Use of digital media for the education of health professionals in the treatment of childhood asthma

    Directory of Open Access Journals (Sweden)

    Helena F. Velasco

    2015-04-01

    Full Text Available OBJECTIVES: Inhalation therapy is the main treatment for asthma and its adequate use has been a factor responsible for disease control; therefore, the aim of the study was to determine whether a digital media tool, which features portability on mobile phones, modifies the assimilation of the inhalation technique. METHODS: A total of 66 professionals working in the health care area with the pediatric population were selected. They were submitted to a pre-test on their knowledge of inhalation therapy. The professionals were randomized into two groups (A and B. Group A received a media application on their mobile phones showing the steps of inhalation therapy, while group B received the same information in written form only. A post-test was applied after 15 days. The results (pre- and post- were analyzed by two pediatric pulmonologists. RESULTS: Of the 66 professionals, 87.9% were females. Of a total possible score of ten, the mean score obtained in the pre-test was 5.3 ± 3, and in the second test, 7.5 ± 2 (p < 0.000. There were no significant differences when comparing the two groups (p = 0.726. The nurses had the lowest mean scores in the initial test (2.3 ± 2; however, they were the group that learned the most with the intervention, showing similar means to those of other groups in the second test (6.1 ± 3. CONCLUSION: There was significant improvement in knowledge about inhalation therapy in all professional categories using both methods, demonstrating that education, when available to professionals, positively modifies medical practice.

  2. Long-term treatment of childhood refractory and steroid dependent nephrotic syndrome with Cyclosporin A

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    Madani A

    2002-07-01

    Full Text Available Background: Cyclosporin A (CsA is now commonly used in the management of children with steroid-dependent and steroid resistant nephoitic syndrome. It has been reported to be effective in maintaining remission in 70-100 percent of patients with SDNS but somewhat SRNS 0-100 percent. The aim of this study was to evaluate the efficacy of long-term (CsA in children with refractory nephrotic syndrome (RNS and steroid dependent nephrotic syndrome (SDNS. Materials and Methods: The long-term effect of (CsA in 91 Iranian children aged 3 months to 11 years (54 with RNS and 37 with SDNS was assessed between 1984 and 1999. Eighty of 91 children received renal biopsy prior to introduction of (CsA, and the other 11 patients had not consent for kidney biopsy. If the patients did not show remission aftre receiving 3-6 months of (CsA, the medication was discontinued. Results: All patient were treated with (CsA in combination with low dose alternate day prednisolone. In children with RNS and SDNS, therapy with (CsA induced, remission in 25 of 54 (46.2 percent and 27 of 37 (73 percent respectively (P<0.02. Of the 32 patients with minimal change disease (MCD, 23 (72 percent responded to therapy, compared with 4 of 18 (22 percent with focal segmental glomerulosclerosis (FSGS (P<0.005. Twenty-four (48 percent of 50 who entered complete remission, had relapse 1-12 months after cessation of (CsA. The duration between the onset of nephrotic syndrome (NS and administration of (CsA and sexuality of patients had no effect in result of treatment. Side effects occurred in 25 patients (27.4 percent. No patients exhibited raised transaminases, 8 (8.7 percent of the children developed hirsutism, 7 (7.6 percent hypertension, 7 (7.6 percent gingival hyperplasia, (2.2 percent neurological toxicity and 1 (1 percent increase in serum creatinine. Conclusion: Our findings suggest that (CsA can be used to induce a complete remission in a significant proportion of patients with RNS and

  3. Effect of shortened Integrated Management of Childhood Illness training on classification and treatment of under-five children seeking care in Rwanda

    Directory of Open Access Journals (Sweden)

    Harerimana JM

    2014-05-01

    Full Text Available Jean-Modeste Harerimana,1 Laetitia Nyirazinyoye,1 Jean-Bosco Ahoranayezu,2 Ferdinand Bikorimana,3 Bethany L Hedt-Gauthier,1,4 Katherine A Muldoon,5 Edward J Mills,6,7 Joseph Ntaganira1 1University of Rwanda College of Medicine and Health Sciences School of Public Health, Kigali, Rwanda; 2Community Vision Initiative, Kigali, Rwanda; 3Maternal and Child Health, Child Unit, Rwandan Ministry of Health, Kigali, Rwanda; 4Harvard Medical School, Boston, MA, USA; 5University of British Columbia, Vancouver, BC, Canada; 6University of Ottawa, Ottawa, ON, Canada; 7Stanford University, Stanford, CA, USA Background: Integrated Management of Childhood Illness (IMCI is an effective 11-day standard training; however, due to budgetary expenses and human resource constraints, many health professionals cannot take 11 days off work. As a result, shortened training curriculums (6-day have been proposed. We used a cross-sectional study to evaluate the effect of this shortened training on appropriate IMCI classification and treatment of under-five childhood illness management in Rwanda. Methods: A cross-sectional study was conducted in 22 health centers in Rwanda, comparing data from 121 nurses, where 55 nurses completed the 11-day and 66 nurses completed the 6-day training. Among 768 children, we evaluated clinical outcomes from May 2011 to April 2012. Descriptive statistics were used to display the sociodemographic characteristics of health providers; including level of education, sex, age, and professional experiences. Bivariable and multivariable analyses were used to test for differences between nurses in the 6-day versus 11-day training on the appropriate classification and treatment of childhood illness. Results: Our findings show that at the bivariable level and after controlling for confounders in the multivariable analysis, the only significant differences detected between nurses in the long and short training was the classification of fever (adjusted odds

  4. Garlic compounds selectively kill childhood pre-B acute lymphoblastic leukemia cells in vitro without reducing T-cell function: Potential therapeutic use in the treatment of ALL

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    Greg Hodge

    2008-03-01

    Full Text Available Greg Hodge1, Stephen Davis2, Michael Rice1, Heather Tapp1, Ben Saxon1, Tamas Revesz11Haematology/Oncology Department, Women’s and Children’s Hospital, North Adelaide, Australia; 2Department of Mycology, Women’s and Children’s Hospital, North Adelaide, AustraliaAbstract: Drugs used for remission induction therapy for childhood precursor-B acute lymphoblastic leukemia (ALL are nonselective for malignant cells. Several garlic compounds have been shown to induce apoptosis of cancer cells and to alter lymphocyte function. To investigate the effect of garlic on the apoptosis of ALL cells and lymphocyte immune function, cells from newly diagnosed childhood ALL patients were cultured with several commonly used chemotherapeutic agents and several garlic compounds. Apoptosis, lymphocyte proliferation and T-cell cytokine production were determined using multiparameter flow cytometry. At concentrations of garlic compounds that did not result in significant increases in Annexin V and 7-AAD staining of normal lymphocytes, there was a significant increase in apoptosis of ALL cells with no alteration of T-cell proliferation as determined by CD25/CD69 upregulation or interferonγ, interleukin-2 or tumor necrosis factor-α intracellular cytokine production. In contrast, the presence of chemotherapeutic agents resulted in nonselective increases in both lymphocyte and ALL apoptosis and a decrease in T-cell proliferation and cytokine production. In conclusion, we show selective apoptosis of malignant cells by garlic compounds that do not alter T-cell immune function and indicate the potential therapeutic benefit of garlic compounds in the treatment of childhood ALL.Keywords: childhood precursor-B acute lymphoblastic leukemia, garlic, apoptosis, immune function, intracellular cytokines

  5. Randomized double blind trial of ciprofloxacin prophylaxis during induction treatment in childhood acute lymphoblastic leukemia in the WK-ALL protocol in Indonesia

    Directory of Open Access Journals (Sweden)

    Widjajanto PH

    2013-02-01

    Full Text Available Pudjo H Widjajanto,1 Sumadiono Sumadiono,1 Jacqueline Cloos,2,3 Ignatius Purwanto,1 Sutaryo Sutaryo,1 Anjo JP Veerman1,21Pediatric Hematology and Oncology Division, Department of Pediatrics, Dr Sardjito Hospital, Medical Faculty, Universitas Gadjah Mada, Yogyakarta, Indonesia; 2Pediatric Oncology/Hematology Division, Department of Pediatrics, 3Department of Hematology, VU University Medical Center, Amsterdam, The NetherlandsObjectives: Toxic death is a big problem in the treatment of childhood acute lymphoblastic leukemia (ALL, especially in low-income countries. Studies of ciprofloxacin as single agent prophylaxis vary widely in success rate. We conducted a double-blind, randomized study to test the effects of ciprofloxacin monotherapy as prophylaxis for sepsis and death in induction treatment of the Indonesian childhood ALL protocol.Methods: Patients were randomized to the ciprofloxacin arm (n = 58 and to the placebo arm (n = 52. Oral ciprofloxacin monotherapy or oral placebo was administered twice a day. All events during induction were recorded: toxic death, abandonment, resistant disease, and complete remission rate.Results: Of 110 patients enrolled in this study, 79 (71.8% achieved CR. In comparison to the placebo arm, the ciprofloxacin arm had lower nadir of absolute neutrophil count during induction with median of 62 (range: 5–884 versus 270 (range: 14–25,480 × 109 cells/L (P > 0.01, greater risks for experiencing fever (50.0% versus 32.7%, P = 0.07, clinical sepsis (50.0% versus 38.5%, P = 0.22, and death (18.9% versus 5.8%, P = 0.05.Conclusion: In our setting, a reduced intensity protocol in a low-income situation, the data warn against using ciprofloxacin prophylaxis during induction treatment. A lower nadir of neutrophil count and higher mortality were found in the ciprofloxacin group.Keywords: ciprofloxacin, prophylaxis, childhood acute lymphoblastic leukemia, randomized trial, low-income country

  6. Role of Cerebellum in Fine Speech Control in Childhood: Persistent Dysarthria after Surgical Treatment for Posterior Fossa Tumour

    Science.gov (United States)

    Morgan, A. T.; Liegeois, F.; Liederkerke, C.; Vogel, A. P.; Hayward, R.; Harkness, W.; Chong, K.; Vargha-Khadem, F.

    2011-01-01

    Dysarthria following surgical resection of childhood posterior fossa tumour (PFT) is most commonly documented in a select group of participants with mutism in the acute recovery phase, thus limiting knowledge of post-operative prognosis for this population of children as a whole. Here we report on the speech characteristics of 13 cases seen…

  7. Adult growth hormone (GH)-deficient patients demonstrate heterogeneity between childhood onset and adult onset before and during human GH treatment. Adult Growth Hormone Deficiency Study Group

    DEFF Research Database (Denmark)

    Attanasio, A F; Lamberts, S W; Matranga, A M;

    1997-01-01

    The onset of adult GH deficiency may be during either adulthood (AO) or childhood (CO), but potential differences have not previously been examined. In this study the baseline and GH therapy (12.5 micrograms/kg per day) data from CO (n = 74; mean age 29 yr) and AO (n = 99; mean age 44 yr) GH......-deficient adult patients have been compared. The first 6 months comprised randomized, double-blind treatment with GH or placebo, then all patients were GH-treated for a further 12 months. At baseline the height, body weight, body mass index, lean body mass, and waist/hip ratio of AO patients were significantly (P...

  8. Systematic review to identify and appraise outcome measures used to evaluate childhood obesity treatment interventions (CoOR): evidence of purpose, application, validity, reliability and sensitivity.

    Science.gov (United States)

    Bryant, Maria; Ashton, Lee; Brown, Julia; Jebb, Susan; Wright, Judy; Roberts, Katharine; Nixon, Jane

    2014-01-01

    BACKGROUND Lack of uniformity in outcome measures used in evaluations of childhood obesity treatment interventions can impede the ability to assess effectiveness and limits comparisons across trials. OBJECTIVE To identify and appraise outcome measures to produce a framework of recommended measures for use in evaluations of childhood obesity treatment interventions. DATA SOURCES Eleven electronic databases were searched between August and December 2011, including MEDLINE; MEDLINE In-Process and Other Non-Indexed Citations; EMBASE; PsycINFO; Health Management Information Consortium (HMIC); Allied and Complementary Medicine Database (AMED); Global Health, Maternity and Infant Care (all Ovid); Cumulative Index to Nursing and Allied Health Literature (CINAHL) (EBSCOhost); Science Citation Index (SCI) [Web of Science (WoS)]; and The Cochrane Library (Wiley) - from the date of inception, with no language restrictions. This was supported by review of relevant grey literature and trial databases. REVIEW METHODS Two searches were conducted to identify (1) outcome measures and corresponding citations used in published childhood obesity treatment evaluations and (2) manuscripts describing the development and/or evaluation of the outcome measures used in the childhood intervention obesity evaluations. Search 1 search strategy (review of trials) was modelled on elements of a review by Luttikhuis et al. (Oude Luttikhuis H, Baur L, Jansen H, Shrewsbury VA, O'Malley C, Stolk RP, et al. Interventions for treating obesity in children. Cochrane Database Syst Rev 2009;1:CD001872). Search 2 strategy (methodology papers) was built on Terwee et al.'s search filter (Terwee CB, Jansma EP, Riphagen II, de Vet HCW. Development of a methodological PubMed search filter for finding studies on measurement properties of measurement instruments. Qual Life Res 2009;18:1115-23). Eligible papers were appraised for quality initially by the internal project team. This was followed by an external

  9. The efficacy of topical 0.1% adapalene gel for use in the treatment of childhood acanthosis nigricans: A pilot study

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    Arucha Treesirichod

    2015-01-01

    Full Text Available Aims: To assess the degree of improvement of neck hyperpigmentation in childhood acanthosis nigricans (AN after treatment with topical 0.1% adapalene gel and the assessment of localized tissue tolerance to the gel. Subjects and Methods: A split comparison study of the hyperpigmentation on the neck was conducted in patients diagnosed with childhood AN. Patients were treated with topical 0.1% adapalene gel for a period of 4 weeks. The skin color of their neck was evaluated at baseline, 2 weeks and 4 weeks using a skin color chart. Skin color ratio (the skin on their necks compared with the skin on their backs was calculated for all subjects. The investigator′s global evaluation (IGE scale and the parent′s global evaluation (PGE scale were used to assess the efficacy of the patients′ treatment at the end of the 4 th week. Results: The mean skin color ratio of therapeutic side was significantly decreased from the baseline scores, at weeks 2 and 4, respectively (30.1%, 18.3%, and 12.9%, P < 0.001, with marked skin improvement at 60.7% ± 28.5%. The percentage of changes of skin color ratio was consistent with the efficacy evaluations as performed by the IGE and PGE scales. Treatment-related cutaneous irritation was minimal, predominantly in the first 2 weeks of treatment and was shown to be well-tolerated at week 4 following a modification of the treatment regimen. Conclusions: The study has shown the efficacy of topical 0.1% adapalene gel in the treatment of AN, specifically, in regards to the skin darkening with minimal cutaneous irritation.

  10. Childhood Acute Lymphoblastic Leukemia

    DEFF Research Database (Denmark)

    Pui, Ching-Hon; Yang, Jun J; Hunger, Stephen P;

    2015-01-01

    PURPOSE: To review the impact of collaborative studies on advances in the biology and treatment of acute lymphoblastic leukemia (ALL) in children and adolescents. METHODS: A review of English literature on childhood ALL focusing on collaborative studies was performed. The resulting article was...

  11. Childhood microbial keratitis

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    Abdullah G Al Otaibi

    2012-01-01

    Conclusion: Children with suspected microbial keratitis require comprehensive evaluation and management. Early recognition, identifying the predisposing factors and etiological microbial organisms, and instituting appropriate treatment measures have a crucial role in outcome. Ocular trauma was the leading cause of childhood microbial keratitis in our study.

  12. The Influence of Child and Parent Health Literacy Status on Health Outcomes from a Childhood Obesity Treatment Program

    OpenAIRE

    Lowery, Kamilan Aurielle

    2016-01-01

    While limited health literacy has been associated with poorer health decisions and poorer health outcomes, there remains a gap in the literature related to the influence of health literacy on weight and weight-related behaviors. The primary aim of this study is to examine the influence of child and parent health literacy status on childs body mass index (BMI) and health behaviors, within an adapted evidence-based family-based childhood obesity intervention, iChoose, implemented in the medical...

  13. Corticosteroid receptor genes and childhood neglect influence susceptibility to crack/cocaine addiction and response to detoxification treatment.

    Science.gov (United States)

    Rovaris, Diego L; Mota, Nina R; Bertuzzi, Guilherme P; Aroche, Angelita P; Callegari-Jacques, Sidia M; Guimarães, Luciano S P; Pezzi, Júlio C; Viola, Thiago W; Bau, Claiton H D; Grassi-Oliveira, Rodrigo

    2015-09-01

    The aim of this study was to analyze hypotheses-driven gene-environment and gene-gene interactions in smoked (crack) cocaine addiction by evaluating childhood neglect and polymorphisms in mineralocorticoid and glucocorticoid receptor genes (NR3C2 and NR3C1, respectively). One hundred thirty-nine crack/cocaine-addicted women who completed 3 weeks of follow-up during early abstinence composed our sample. Childhood adversities were assessed using the Childhood Trauma Questionnaire (CTQ), and withdrawal symptoms were assessed using the Cocaine Selective Severity Assessment (CSSA) scale. Conditional logistic regression with counterfactuals and generalized estimating equation modeling were used to test gene-environment and gene-gene interactions. We found an interaction between the rs5522-Val allele and childhood physical neglect, which altered the risk of crack/cocaine addiction (Odds ratio = 4.0, P = 0.001). Moreover, a NR3C2-NR3C1 interaction (P = 0.002) was found modulating the severity of crack/cocaine withdrawal symptoms. In the post hoc analysis, concomitant carriers of the NR3C2 rs5522-Val and NR3C1 rs6198-G alleles showed lower overall severity scores when compared to other genotype groups (P-values ≤ 0.035). This gene-environment interaction is consistent with epidemiological and human experimental findings demonstrating a strong relationship between early life stress and the hypothalamic-pituitary-adrenal (HPA) axis dysregulation in cocaine addiction. Additionally, this study extended in crack/cocaine addiction the findings previously reported for tobacco smoking involving an interaction between NR3C2 and NR3C1 genes. PMID:26228405

  14. Effective treatment of advanced-stage childhood lymphoblastic lymphoma without prophylactic cranial irradiation: Results of St Jude NHL13 study

    OpenAIRE

    Sandlund, John T.; Pui, Ching-Hon; Zhou, Yinmei; Behm, Frederick G.; Onciu, Mihaela; Razzouk, Bassem I.; Hijiya, Nobuko; Campana, Dario; Hudson, Mlissa M.; Ribeiro, Raul C.

    2009-01-01

    There has been a steady improvement in cure rates for children with advanced-stage lymphoblastic non-Hodgkin lymphoma. To further improve cure rates while minimizing long-term toxicity, we designed a protocol (NHL13) based on a regimen for childhood T-cell acute lymphoblastic leukemia, which features intensive intrathecal chemotherapy for central-nervous-system-directed therapy and excludes prophylactic cranial irradiation. From 1992 to 2002, 41 patients with advanced-stage lymphoblastic lymp...

  15. Mothers’ perception of recovery and satisfaction with patent medicine dealers’ treatment of childhood febrile conditions in rural communities

    OpenAIRE

    Ibeneme, Georgian Chiaka; Nwaneri, Ada Caroline; Ibeneme, Sam Chidi; Ezenduka, Pauline; Strüver, Vanessa; Fortwengel, Gerhard; Okoye, Ifeoma Joy

    2016-01-01

    Background Infant mortality in rural areas of Nigeria can be minimized if childhood febrile conditions are treated by trained health personnel, deployed to primary healthcare centres (PHCs) rather than the observed preference of mothers for patent medicine dealers (PMDs). However, health service utilization/patronage is driven by consumer satisfaction and perception of services/product value. The objective of this study was to determine ‘mothers’ perception of recovery’ and ‘mothers’ sati...

  16. Current and future strategies in radiotherapy of childhood low-grade glioma of the brain. Part I. Treatment modalities of radiation therapy

    International Nuclear Information System (INIS)

    Background: Treatment of childhood low-grade gliomas is a challenging issue owing to their low incidence and the lack of consensus about ''optimal'' treatment approach. Material and Methods: Reports in the literature spanning 60 years of radiation therapy, including orthovoltage, megavoltage and recently modern high-precision treatments, were reviewed with respect to visual function, survival, prognostic factors, dose prescriptions, target volumes, and treatment techniques. Based on these experiences, future strategies in the management of childhood low-grade glioma are presented. Results: Evaluation of published reports is difficult because of inconsistencies in data presentation, relatively short follow-up in some series and failure to present findings and results in a comparable way. Even with the shortcomings of the reports available in the literature, primarily concerning indications, age at treatment, dose response, timing and use of ''optimal'' treatment fields, radiation therapy continues to play an important role in the management of these tumors achieving long-term survival rates up to 80% or more. Particularly in gliomas of the visual pathway, high local tumor control and improved or stable function is achieved in approximately 90% of cases. Data on dose-response relationships recommend dose prescriptions between 45 and 54 Gy with standard fractionation. There is consensus now to employ radiation therapy in older children in case of progressive disease only, regardless of tumor location and histologic subtype. In younger children, the role of radiotherapy is unclear. Recent advances in treatment techniques, such as 3-D treatment planning and various ''high-precision'' treatments achieved promising initial outcome, however with limited patient numbers and short follow-ups. Conclusions: Radiation therapy is an effective treatment modality in children with low-grade glioma regarding tumor control and improvement and/or preservation of neurologic function or

  17. Current and future strategies in radiotherapy of childhood low-grade glioma of the brain. Part I. Treatment modalities of radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kortmann, R.D.; Timmermann, B.; Plasswilm, L.; Paulsen, F.; Jeremic, B.; Kay, S.; Bamberg, M. [Dept. of Radiooncology, Univ. of Tuebingen (Germany); Taylor, R.E. [Radiotherapy Dept., Cookridge Hospital, Leeds (United Kingdom); Scarzello, G. [Dept. of Radiotherapy, Padua General Hospital (Italy); Gnekow, A.K. [Children' s Hospital, Augsburg (Germany); Dieckmann, K. [Dept. of Radiooncology, General Hospital Vienna (Austria)

    2003-08-01

    Background: Treatment of childhood low-grade gliomas is a challenging issue owing to their low incidence and the lack of consensus about ''optimal'' treatment approach. Material and Methods: Reports in the literature spanning 60 years of radiation therapy, including orthovoltage, megavoltage and recently modern high-precision treatments, were reviewed with respect to visual function, survival, prognostic factors, dose prescriptions, target volumes, and treatment techniques. Based on these experiences, future strategies in the management of childhood low-grade glioma are presented. Results: Evaluation of published reports is difficult because of inconsistencies in data presentation, relatively short follow-up in some series and failure to present findings and results in a comparable way. Even with the shortcomings of the reports available in the literature, primarily concerning indications, age at treatment, dose response, timing and use of ''optimal'' treatment fields, radiation therapy continues to play an important role in the management of these tumors achieving long-term survival rates up to 80% or more. Particularly in gliomas of the visual pathway, high local tumor control and improved or stable function is achieved in approximately 90% of cases. Data on dose-response relationships recommend dose prescriptions between 45 and 54 Gy with standard fractionation. There is consensus now to employ radiation therapy in older children in case of progressive disease only, regardless of tumor location and histologic subtype. In younger children, the role of radiotherapy is unclear. Recent advances in treatment techniques, such as 3-D treatment planning and various ''high-precision'' treatments achieved promising initial outcome, however with limited patient numbers and short follow-ups. Conclusions: Radiation therapy is an effective treatment modality in children with low-grade glioma regarding tumor control

  18. A clinical analysis of 183 patients with craniopharyngioma%颅咽管瘤183例临床分析

    Institute of Scientific and Technical Information of China (English)

    姜兰叶; 徐剑; 钟历勇

    2008-01-01

    Objective To explore the clinical characteristics,changes of neuroendocrine hormone before and aftter operation in patients with craniopharyngioma,so as to provide the basis for the replacement therapy after operation and educational practice.Methods The clinical data of 183 patients with craniopharyngioma were retrospectively analyzed. Results (1)Symptoms mainly were headache with nausea,disevesight,the second symptom was polydipsia and polyuria,in child,growth and development retardation was more,and another was hypothalamus syndrome.(2)Functions in endocrine:functions in thyreoid,adrenal and gonad(except PRL),the dysfunctions in neurohypophysis was displayed with completed insipidus and immaturity insipidus,contrasted it anteoperation to that postoperation,it was obvious in statishcs meanings (P<0.05). Conclusions In patients with craniopharyngioma,children and adolescent is more than the other people,clinical situation is complicated,neuroendocrine hormone is derangement before and after operation,tumor itself to oppress and operation trauma are the basic reasons for the hypofunction of neuroendocrine hormpne,hormones replacement therapy and monitoring should be catch earlier.%目的 探讨鞍区颅咽管瘤患者的临床特点,手术前后神经内分泌激素变化规律,为颅咽管瘤患者内分泌激素监控和更好地替代治疗、进一步实施教育提供依据.方法 回顾性分析183例颅咽管瘤患者临床表现、手术前及手术后不同时期内分泌激素变化等的临床资料.结果 患者术后甲状腺、肾上腺、性腺激素(泌乳素除外)测定较术前均下降,差异有统计学意义(P<0.05或<0.01);术后10 d与术后3 d比较,甲状腺(除T4外)、肾上腺、性腺激素水平虽有好转,但差异无统计学意义(P>0.05).术后糖皮质激素替代治疗143例(78.14%);甲状腺激素替代治疗89例(48.63%);抗利尿激素替代治疗40例(21.86%).结论 颅咽管瘤患者以儿童及青少年起病多

  19. Migraine and lifestyle in childhood.

    Science.gov (United States)

    Casucci, Gerardo; Villani, Veronica; d'Onofrio, Florindo; Russo, Antonio

    2015-05-01

    Migraine is one of the most frequently reported somatic complaints in childhood, with a negative impact on health-related quality of life. The incidence of migraine in childhood has substantially increased over the past 30 years, probably due to both increased awareness of the disease and lifestyle changes in this age group. Indeed, several conditions have been identified as risk factors for migraine in childhood. Amongst these, dysfunctional family situation, the regular consumption of alcohol, caffeine ingestion, low level of physical activity, physical or emotional abuse, bullying by peers, unfair treatment in school and insufficient leisure time seem to play a critical role. Nevertheless, there are only few studies about the association between migraine and lifestyle in childhood, due to previous observations specifically focused on "headache" in children. In this brief review, we will concentrate upon recent studies aimed to explore migraine and lifestyle risk factors in childhood. PMID:26017522

  20. Norwegian Childhood Diabetes Registry: Childhood onset diabetes in Norway 1973-2012

    OpenAIRE

    Torild Skrivarhaug

    2013-01-01

    The Norwegian Childhood Diabetes Registry (NCDR) is a prospective, population-based, nationwide registry which systematically register all incident cases of childhood diabetes, and systematically monitors the outcome of diabetes care in children and adolescents. NCDR includes data on childhood onset diabetes since 1973, and diabetes care outcome since 2001. NCDR was founded with the following objectives: To improve the diagnostics, classifications and treatment of childhood-onset diabetes, su...

  1. Childhood Leukemia

    Science.gov (United States)

    Leukemia is cancer of the white blood cells. It is the most common type of childhood cancer. ... blood cells help your body fight infection. In leukemia, the bone marrow produces abnormal white blood cells. ...

  2. Calcification of the bilateral basal ganglia after radiation therapy for childhood brain tumors

    International Nuclear Information System (INIS)

    Calcification of the basal ganglia subsequent to radiation therapy for childhood brain tumors has rarely been reported. Three cases of this calcification subsequent to radiation are presented here. Case 1 is a 7 year-old boy who underwent irradiation of 5000 rads locally for craniopharyngioma at the age of 4 years. Case 2 is a 4 year-old boy who was treated with irradiation of 4500 rads locally for cerebellar medulloblastoma at the age of 1 year. Case 3 is a 15 year-old girl who was treated with irradiation of 5000 rads to the brain and 3000 rads locally for suprasellar germinoma at the age of 11 years. In all these cases, the interval between radiation and evidence of calcification as detected only by CT scan, was more than 3 years and 2 cases are experiencing mild mental retardation. These findings suggest the possibility of long-term complications due to radiation therapy. (author)

  3. Childhood leukaemia

    International Nuclear Information System (INIS)

    The debate on whether there is any link between leukaemia clusters and nuclear installations has been raging since the early eighties. A Government Inquiry found no link between childhood leukaemia and residence near Seascale, an area near British Nuclear Fuels Sellafield plant. Research in the 1980s linked childhood leukaemia to fathers' occupations prior to conception in the Seascale plant but also to workers in the iron, steel, farming and chemical industries. This article reviews research findings to date. (UK)

  4. Impaired cardiac adrenergic innervation assessed by MIBG imaging as a predictor of treatment response in childhood dilated cardiomyopathy

    OpenAIRE

    Acar, P; Merlet, P.; Iserin, L; Bonnet, D.; Sidi, D; Syrota, A; Kachaner, J

    2001-01-01

    OBJECTIVE—To evaluate the prognostic value of metaiodobenzylguanidine (MIBG) imaging in childhood cardiomyopathy.
DESIGN—Prospective cohort study.
SETTING—Tertiary referral centre.
PATIENTS—40 children (21 boys, 19 girls; mean (SD) age, 7.0 (5.6) years) with heart failure resulting from idiopathic dilated cardiomyopathy (n = 23) or various other disorders (n = 17).
METHODS—At the initial examination, cardiac 123I-MIBG uptake and release, circulating noradrenaline (norepinephrine) concentratio...

  5. Dental and maxillofacial abnormalities in long-term survivors of childhood cancer: effects of treatment with chemotherapy and radiation to the head and neck

    Energy Technology Data Exchange (ETDEWEB)

    Jaffe, N.; Toth, B.B.; Hoar, R.E.; Ried, H.L.; Sullivan, M.P.; McNeese, M.D.

    1984-06-01

    Sixty-eight long-term survivors of childhood cancer were evaluated for dental and maxillofacial abnormalities. Forty-five patients had received maxillofacial radiation for lymphoma, leukemia, rhabdomyosarcoma, and miscellaneous tumors. Forty-three of the 45 patients and the remaining 23 who had not received maxillofacial radiation also received chemotherapy. Dental and maxillofacial abnormalities were detected in 37 of the 45 (82%) radiated patients. Dental abnormalities comprised foreshortening and blunting of roots, incomplete calcification, premature closure of apices, delayed or arrested tooth development, and caries. Maxillofacial abnormalities comprised trismus, abnormal occlusal relationships, and facial deformities. The abnormalities were more severe in those patients who received radiation at an earlier age and at higher dosages. Possible chemotherapeutic effects in five of 23 patients who received treatment for tumors located outside the head and neck region comprised acquired amelogenesis imperfecta, microdontia of bicuspid teeth, and a tendency toward thinning of roots with an enlarged pulp chamber. Dental and maxillofacial abnormalities should be recognized as a major consequence of maxillofacial radiation in long-term survivors of childhood cancer, and attempts to minimize or eliminate such sequelae should involve an effective interaction between radiation therapists, and medical and dental oncologists.

  6. Dental and maxillofacial abnormalities in long-term survivors of childhood cancer: effects of treatment with chemotherapy and radiation to the head and neck

    International Nuclear Information System (INIS)

    Sixty-eight long-term survivors of childhood cancer were evaluated for dental and maxillofacial abnormalities. Forty-five patients had received maxillofacial radiation for lymphoma, leukemia, rhabdomyosarcoma, and miscellaneous tumors. Forty-three of the 45 patients and the remaining 23 who had not received maxillofacial radiation also received chemotherapy. Dental and maxillofacial abnormalities were detected in 37 of the 45 (82%) radiated patients. Dental abnormalities comprised foreshortening and blunting of roots, incomplete calcification, premature closure of apices, delayed or arrested tooth development, and caries. Maxillofacial abnormalities comprised trismus, abnormal occlusal relationships, and facial deformities. The abnormalities were more severe in those patients who received radiation at an earlier age and at higher dosages. Possible chemotherapeutic effects in five of 23 patients who received treatment for tumors located outside the head and neck region comprised acquired amelogenesis imperfecta, microdontia of bicuspid teeth, and a tendency toward thinning of roots with an enlarged pulp chamber. Dental and maxillofacial abnormalities should be recognized as a major consequence of maxillofacial radiation in long-term survivors of childhood cancer, and attempts to minimize or eliminate such sequelae should involve an effective interaction between radiation therapists, and medical and dental oncologists

  7. Treatment of generalized pustular psoriasis in childhood%儿童泛发性脓疱性银屑病治疗进展

    Institute of Scientific and Technical Information of China (English)

    管海宏; 李泓馨; 林麟

    2011-01-01

    Childhood generalized pustular psoriasis is rare,and accounts for about 0.6% of all the cases of psoriasis in children.Up to date,there has been no specific treatment for this disease in the world.Childhood generalized pustular psoriasis has its characteristics,and therapeutic effect and safety of drugs in children differ from those in adults,hence,the use of drugs in pediatric patients is limited and should be given more cautions,and the benefit and risk should be weighed sufficiently before the selection of drugs in clinical practice.It is generally believed that the course of systemic treatment in children should be no longer than half a year to avoid or reduce the long-term side effects of drugs.The authors review the advances in the treatment of childhood generalized pustular psoriasis with tretinoin,glucocorticoids,immunosuppressants,antibiotics,phototherapy and biological agents.%儿童泛发性脓疱性银屑病临床少见,约占儿童银屑病患儿的0.6%,其治疗难度较大.因儿童泛发性脓疱性银屑病具有自身的一些特征,其用药的疗效和安全性不完全同于成人,因此对药物的选择需要更加谨慎,甚至存在一定的限制,临床工作中应充分权衡疗效与安全性之比.一般认为,儿童系统治疗的疗程尽量不超过半年,以避免或减少药物长期使用的不良反应.概述维A酸、糖皮质激素、免疫抑制剂、抗生素、光疗及生物制剂治疗儿童泛发性脓疱性银屑病的进展.

  8. Survivors of childhood cancer.

    Science.gov (United States)

    Bradwell, Moira

    2009-05-01

    Treatment of childhood cancer aims to cure with minimum risk to the patient's subsequent health. Monitoring the long-term effects of treatment on children and young adults is now an essential part of the continued care of survivors. Late effects include: impact on growth, development and intellectual function; organ system impairment; the development of second malignancies; and psychosocial problems. These can adversely affect long-term survival and the quality of life. In the UK, models of long-term follow up for survivors of childhood cancer vary from centre to centre but nurses have a significant role to play. Combining the nurse specialist role with that of the advanced practitioner ensures that the goals of improving the quality of nursing care to the survivors of childhood cancer are achieved and maximises the nursing contribution to their follow up. With the number of childhood cancer survivors increasing, providing holistic, health promotional care, tailored to the specific needs of survivors will be crucial for their future. PMID:19505060

  9. Male reproductive health after childhood cancer

    DEFF Research Database (Denmark)

    Lähteenmäki, P M; Arola, M; Suominen, J; Salmi, T T; Andersson, A M; Toppari, J

    2008-01-01

    Twenty-five male patients were investigated to elucidate the correlation of semen parameters and other related parameters in the assessment of spermatogenesis after childhood cancer treatment.......Twenty-five male patients were investigated to elucidate the correlation of semen parameters and other related parameters in the assessment of spermatogenesis after childhood cancer treatment....

  10. A case report on the relationship between treatment-resistant childhood-onset schizophrenia and an abnormally enlarged cavum septum pellucidum combined with cavum vergae

    Institute of Scientific and Technical Information of China (English)

    LIAO Zheng-luan; HU Shao-hua; XU Yi

    2012-01-01

    The treatment of refractory schizophrenia has been a clinical challenge for most psychiatrists; the possible reasons include diagnostic errors,medical conditions and brain dysgenesis.Here,we described a patient with childhood-onset schizophrenia who had severe psychiatric symptoms such as auditory hallucinations and persecutory delusions,and etc.We reexamined all his possible medical conditions and found that the patient had an abnormally enlarged cavus septum pellucidum (CSP) combined with cavum vergae (CV) (maximum length >30 mm).Some reports suggested that abnormal CSP (length >6 mm) has a significant association with schizophrenia.However,abnormally large CSP or CSP/CV and related prognosis were reported rarely.This case suggested that abnormally enlarged CSP or CSP/CV may worsen the prognosis.

  11. Clinical analysis of diagnosis and treatment with 48 childhood malignant lymphoma%儿童恶性淋巴瘤48例诊治分析

    Institute of Scientific and Technical Information of China (English)

    刘安生; 庞菊萍; 高文瑾; 王华; 王旭青

    2012-01-01

    目的:探讨儿童恶性淋巴瘤的临床表现特点、诊断及治疗方法.方法:对48例小儿恶性淋巴瘤患者的临床表现、发病特点、病理分型、治疗及预后资料进行回顾性分析.结果:本组48例中男33例,女15例.年龄2~14岁,平均9.6岁,非霍奇金淋巴瘤(NHL)41例,占85.42%;霍奇金淋巴瘤(HL)7例,占14.58%;Ⅰ~Ⅱ期患儿8例,Ⅲ~Ⅳ期患儿40例;浅表淋巴结肿大为首发症状者32例;病理类型中,NHL以淋巴母细胞型最多见(占43.90%),HL以混合细胞型多见(占42.86%);NHL易发生骨髓浸润和中枢神经系统侵犯.总体治疗率低.结论:儿童恶性淋巴瘤早期临床表现具有多样性,且不典型,易误诊;预后与病期及治疗相关.%Objective: To investigate the clinical manifestations of childhood malignant lymphoma. Methods: A retrospective study was carried out in clinical manifestations, initial symptoms, pathological grouping, treatment and prognosis of 48 children who hospitalized for malignant lymphoma. Results: A total of 48(33 males and 15 females)childhood malignant lymphoma cases, the media age was 9. 6 (2~14) years, include 41(85. 42%) Non-Hodgkin's lymphoma (NHL) and 7 (14. 58%) Hodgkin's lymphoma (HD). Among these cases, 8 were stage I or II and the rest were stage III or IV. The mose common symptoms at first was enlargement of the lymphnodes,32 of 48 cases. The general pathological type of NHL was lymphoblastic(43. 90%) and mixed lymphocytic lymphoma(42. 86%) in HD. Bone marrow and center nerve system involevement was common in NHL than in HD. Conclusion: The clinical manifestations of childhood malignant lymphoma is variety and non- typical at first,it shall be attach importance to avoid misdiagnosis. Prognosis relation to stage of lymphoma and treatment,it need treat for long-term.

  12. Cognitive Behavioral Treatment for Childhood Anxiety Disorders: Long-Term Effects on Anxiety and Secondary Disorders in Young Adulthood

    Science.gov (United States)

    Saavedra, Lissette M.; Silverman, Wendy K.; Morgan-Lopez, Antonio A.; Kurtines, William M.

    2010-01-01

    Background: The present study's aim was to examine the long-term effects (8 to 13 years post-treatment; M = 9.83 years; SD = 1.71) of the most widely used treatment approaches of exposure-based cognitive behavioral treatment for phobic and anxiety disorders in children and adolescents (i.e., group treatment and two variants of individual…

  13. Childhood depression: a systematic review

    Directory of Open Access Journals (Sweden)

    Lima NNR

    2013-09-01

    Full Text Available Nádia Nara Rolim Lima,1 Vânia Barbosa do Nascimento,1 Sionara Melo Figueiredo de Carvalho,1 Luiz Carlos de Abreu,1,3 Modesto Leite Rolim Neto,2 Aline Quental Brasil,2 Francisco Telésforo Celestino Junior,2 Gislene Farias de Oliveira,2 Alberto Olavo Advíncula Reis3 1Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil; 2Departamento de Medicina. Universidade Federal do Ceará, UFC, Barbalha, Ceará, Brazil; 3Departamento de Saúde Materno Infantil, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil Abstract: As an important public health issue, childhood depression deserves special attention, considering the serious and lasting consequences of the disease to child development. Taking this into consideration, the present study was based on the following question: what practical contributions to clinicians and researchers does the current literature on childhood depression have to offer? The objective of the present study was to conduct a systematic review of articles regarding childhood depression. To accomplish this purpose, a systematic review of articles on childhood depression, published from January 1, 2010 to November 24, 2012, on MEDLINE and SciELO databases was carried out. Search terms were “depression” (medical subject headings [MeSH], “child” (MeSH, and "childhood depression" (keyword. Of the 180 retrieved studies, 25 met the eligibility criteria. Retrieved studies covered a wide range of aspects regarding childhood depression, such as diagnosis, treatment, prevention and prognosis. Recent scientific literature regarding childhood depression converge to, directly or indirectly, highlight the negative impacts of depressive disorders to the children's quality of life. Unfortunately, the retrieved studies show that childhood depression commonly grows in a background of vulnerability and poverty, where individual and familiar needs

  14. Childhood obesity

    DEFF Research Database (Denmark)

    Heitmann, Berit L; Koplan, Jeffrey; Lissner, Lauren

    2009-01-01

    Despite progress toward assuring the health of today's young population, the 21(st) century began with an epidemic of childhood obesity. There is general agreement that the situation must be addressed by means of primary prevention, but relatively little is known about how to intervene effectively....... The evidence behind the assumption that childhood obesity can be prevented was discussed critically in this roundtable symposium. Overall, there was general agreement that action is needed and that the worldwide epidemic itself is sufficient evidence for action. As the poet, writer, and scholar...

  15. 关注儿童铁缺乏症的有效防治%Attention to the effective prevention and treatment for childhood iron deficiency

    Institute of Scientific and Technical Information of China (English)

    赵惠君

    2015-01-01

    我国儿童铁缺乏症(ID)和缺铁性贫血(IDA)发病率较高,但相关防治工作仍显滞后.文章在结合近年相关文献和儿科血液学组于近期推荐的《儿童缺铁和缺铁性贫血防治建议》基础上,简要归纳儿童ID和IDA的防治意义和经验方法.%The incidence of children with iron deficiency (ID) and iron deficiency anemia (IDA) is still higher in ourcountry now, but the relevant prevention and treatment still lag behind. This paper provides a brief summary of the importanceand impact of childhood ID and IDA prevention and treatment practice based on the recent literatures and"The recommendationsof prevention and treatment for children with iron deficiency and iron-deficiency anemia" recommended by the Pediatric HematologyGroup recently.

  16. Integrating Art into Group Treatment for Adults with Post-Traumatic Stress Disorder from Childhood Sexual Abuse: A Pilot Study

    Science.gov (United States)

    Becker, Carol-Lynne J.

    2015-01-01

    Current research supports the use of exposure-based treatments for posttraumatic stress disorder (PTSD) and integrated treatments show potential for enhanced symptom reduction. This pilot study developed a manualized group treatment integrating art interventions with exposure, grounding, and narrative therapy for five adults with PTSD who were…

  17. Childhood Obesity

    Science.gov (United States)

    Yuca, Sevil Ari, Ed.

    2012-01-01

    This book aims to provide readers with a general as well as an advanced overview of the key trends in childhood obesity. Obesity is an illness that occurs due to a combination of genetic, environmental, psychosocial, metabolic and hormonal factors. The prevalence of obesity has shown a great rise both in adults and children in the last 30 years.…

  18. Childhood Obesity

    Centers for Disease Control (CDC) Podcasts

    2013-08-06

    In this podcast, Dr. Tom Frieden, CDC Director, discusses the decrease in childhood obesity rates and what strategies have been proven to work to help our children grow up and thrive.  Created: 8/6/2013 by National Center for Injury Prevention and Control.   Date Released: 3/6/2014.

  19. Chemotherapy-only treatment effects on long-term neurocognitive functioning in childhood ALL survivors: a review and meta-analysis.

    Science.gov (United States)

    Iyer, Neel S; Balsamo, Lyn M; Bracken, Michael B; Kadan-Lottick, Nina S

    2015-07-16

    Therapy for childhood acute lymphoblastic leukemia (ALL) is associated with 5-year survival rates of ∼90% even after largely eliminating cranial radiation. This meta-analysis assesses the long-term neurocognitive functioning after chemotherapy-only regimens among survivors of childhood ALL. We conducted a systematic review to identify studies that evaluated long-term neurocognitive functioning following treatment of ALL by searching MEDLINE/PubMed, Database of Abstracts of Reviews of Effects, and secondary sources. Studies were included if ALL survivors were in continuous first remission, did not receive any radiation, were at least ≥2 years off therapy or ≥5 years since diagnosis, and were compared with a healthy control group. Weighted mean differences with 95% confidence intervals (CIs) were calculated. Ten nonexperimental studies met all eligibility criteria and included 509 patients and 555 controls. Meta-analysis demonstrated statistically significant moderate impairment across multiple neurocognitive domains evaluated, with intelligence most affected. Significant differences in standard deviation (SD) scores were found for Full Scale intelligence quotient (IQ) (-0.52 SD; 95% CI, -0.68 to -0.37), Verbal IQ (-0.54 SD; 95% CI, -0.69 to -0.40), and Performance IQ (-0.41 SD; 95% CI, -0.56 to -0.27); these SD scores correspond to changes in IQ of 6 to 8 points. Working memory, information processing speed, and fine motor domains were moderately, but statistically significantly, impaired. Meta-analysis of ALL survivors treated without cranial radiation demonstrated significant impairment in IQ and other neurocognitive domains. Patients and their families should be informed about these potential negative effects to encourage surveillance and educational planning. Both preventive and intervention strategies are needed. PMID:26048910

  20. Successful treatment of metastatic relapse of medulloblastoma in childhood with single session stereotactic radiosurgery: a report of 3 cases.

    Science.gov (United States)

    King, David; Connolly, Daniel; Zaki, Hesham; Lee, Vicki; Yeomanson, Daniel

    2014-05-01

    Stereotactic radiosurgery (SRS) is an increasingly used treatment modality in adults, but its use and effectiveness in pediatric brain tumors is still uncertain. We describe 3 patients with metastatic relapse of medulloblastoma, who were treated with SRS, and achieved prolonged, progression-free survival. Tolerability of the treatment was excellent with no adverse effects reported. This work adds to the growing evidence that SRS may have an important role to play in the treatment of pediatric brain tumors. PMID:23459380

  1. Slower early response to treatment and distinct expression profile of childhood high hyperdiploid acute lymphoblastic leukaemia with DNA index < 1.16.

    Science.gov (United States)

    Zaliova, Marketa; Hovorkova, Lenka; Vaskova, Martina; Hrusak, Ondrej; Stary, Jan; Zuna, Jan

    2016-09-01

    Acute lymphoblastic leukaemias (ALL) with 51-67 chromosomes are defined as high hyperdiploid (HHD) and are generally associated with good prognosis. However, several studies show heterogeneity in HHD ALL and suggest that the favourable prognosis is associated rather with higher ploidy defined by DNA index (DNAi) ≥ 1.16 or with a presence of specific single or combined trisomies. HHD ALL with DNAi < 1.16 are only rarely studied separately. Using single nucleotide polymorphism array, we analysed 89 childhood HHD ALL patients divided into groups with lower (<1.16; n = 34) and higher (≥1.16; n = 55) DNAi. We assessed treatment response, presence of secondary aberrations, mutations in RAS pathway genes and CREBBP and also gene expression profile (GEP) to reveal differences between the two subgroups. Cases with 51-54 chromosomes had DNAi 1.1-1.16 and cases with 55-67 chromosomes had DNAi ≥ 1.16. The groups with lower and higher DNAi had distinct response to early treatment and distinct GEP. The better response of the group with higher DNAi was associated with specific trisomies (trisomy of chromosome 10 or combined with trisomies 4 and/or 17). Our results suggest that cytogenetically defined HHD ALL can in fact be divided into two biologically distinguishable subgroups and that DNAi 1.16 is a relevant value to separate between the two. © 2016 Wiley Periodicals, Inc. PMID:27163296

  2. CBT for Childhood Anxiety Disorders: Differential Changes in Selective Attention between Treatment Responders and Non-Responders

    Science.gov (United States)

    Legerstee, Jeroen S.; Tulen, Joke H. M.; Dierckx, Bram; Treffers, Philip D. A.; Verhulst, Frank C.; Utens, Elisabeth M. W. J.

    2010-01-01

    Background: This study examined whether treatment response to stepped-care cognitive-behavioural treatment (CBT) is associated with changes in threat-related selective attention and its specific components in a large clinical sample of anxiety-disordered children. Methods: Ninety-one children with an anxiety disorder were included in the present…

  3. Fluoxetine for the Treatment of Childhood Anxiety Disorders: Open-Label, Long-Term Extension to a Controlled Trial

    Science.gov (United States)

    Clark, Duncan B.; Birmaher, Boris; Axelson, David; Monk, Kelly; Kalas, Catherine; Ehmann, Mary; Bridge, Jeffrey; Wood, D. Scott; Muthen, Bengt; Brent, David

    2005-01-01

    Objective: To assess the efficacy of fluoxetine for the long-term treatment of children and adolescents with anxiety disorders, including generalized anxiety disorder, separation anxiety disorder, and/or social phobia. Method: Children and adolescents (7-17 years old) with anxiety disorders were studied in open treatment for 1 year after they…

  4. Childhood ovarian malignancy.

    Science.gov (United States)

    Mahadik, Kalpana; Ghorpade, Kanchanmala

    2014-04-01

    Objective of this article is to appraise diagnostic aspects and treatment modalities in childhood ovarian tumor in background of available evidence. Literature search on Pubmed revealed various aspects of epidemiology, histopathological diagnosis, and treatment of pediatric ovarian tumor. 85 % of childhood tumors are germ cell tumors. The varied histopathological picture in germ cell tumors poses a diagnostic and therapeutic challenge. Immunohistochemistry and newer genetic markers like SALL4 and karyopherin-2 (KPNA2) have been helpful in differentiating ovarian yolk sac tumor from dysgerminoma, teratomas, and other pictures of hepatoid, endometrioid, clear cell carcinomatous, and adenocarcinomatous tissues with varied malignant potential. Before platinum therapy, these tumors were almost fatal in children. Fertility-conserving surgery with bleomycin, etoposide, and cisplatin has dramatically changed the survival rates in these patients. This modality gives cancer cure with healthy offspring to female patients with childhood ovarian tumor. Evidence also supports this protocol resulting in successful pregnancy rates and safety of cytotoxic drugs in children born to these patients. PMID:24757335

  5. Effects of radiation treatment planning and patient fixation on the results of postoperative radiotherapy of childhood medulloblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Kocsis, B.; Pap, L.; Nemeth, G. [Dept. of Radiotherapy, National Inst. of Oncology, Budapest (Hungary); Szekely, G. [Dept. of Cytogenetics, National Inst. of Oncology, Budapest (Hungary)

    2003-12-01

    Purpose: To assess the prognostic factors and the benefit of introducing head fixation and CT-assisted radiation treatment planning following postoperative radiotherapy in 83 children with medulloblastoma. Patients and Methods: In 24 children treated between 1986 and 1994, no head fixation was applied and boost irradiation was not based on individual radiation treatment planning. Since 1995, boost irradiation has been assisted by CT-based individual radiation treatment planning and ORFIT head fixation in 59 patients. The influence of various factors including age, sex, tumor location, extent, type of surgery, risk group, radiation dose to posterior fossa and spinal axis, and the effect of head fixation and CT-assisted radiation treatment planning on 5-year relapse-free and 5-year overall survival was investigated. Results: Overall and relapse-free survival rates for all 83 patients were 73.5% and 60.7%. Univariate analysis identified metastatic disease (p = 0.034) and the application of head fixation and individual radiation treatment planning (p = 0.013) as significant prognostic factors for overall survival. Relapse-free survival rates were influenced by metastatic disease (p = 0.028) and the application of head fixation and individual radiation treatment planning (p = 0.009). On multivariate analysis, metastatic disease (p = 0.04) and the application of head fixation and individual radiation treatment planning (p = 0.045) were significant factors for overall and relapse-free survival (p = 0.036 and p = 0.041) as well. Conclusion: Metastatic disease appears to be correlated with a worse prognosis in this analysis. Individual radiation treatment planning and head fixation have a positive impact on survival. For postoperative radiotherapy of the posterior fossa, the application of head fixation and individual CT-based radiation treatment planning is considered indispensable in each case. (orig.)

  6. Subclinical hypothyroidism in childhood.

    LENUS (Irish Health Repository)

    O'Grady, M J

    2012-02-01

    Subclinical hypothyroidism (SH) is defined as an elevated thyroid stimulating hormone (TSH) in association with a normal total or free thyroxine (T4) or triiodothyronine (T3). It is frequently encountered in both neonatology and general paediatric practice; however, its clinical significance is widely debated. Currently there is no broad consensus on the investigation and treatment of these patients; specifically who to treat and what cut-off level of TSH should be used. This paper reviews the available evidence regarding investigation, treatments and outcomes reported for childhood SH.

  7. Childhood psoriasis

    OpenAIRE

    Dogra Sunil; Kaur Inderjeet

    2010-01-01

    Psoriasis is a common dermatosis in children with about one third of all patients having onset of disease in the first or second decade of life. A chronic disfiguring skin disease, such as psoriasis, in childhood is likely to have profound emotional and psychological effects, and hence requires special attention. Psoriasis in children has been reported to differ from that among adults being more frequently pruritic; plaque lesions are relatively thinner, softer, and less scaly; face and flexu...

  8. Childhood Traumatic Grief

    Science.gov (United States)

    ... Educators Resources for Kids and Teens Childhood Traumatic Grief What is Childhood Traumatic Grief? Children grieve in their own way following the ... child may have a condition called Childhood Traumatic Grief (CTG). Thinking about the person who died—even ...

  9. Childhood Cancer Statistics

    Science.gov (United States)

    ... Shop With CureSearch Blog Donate Now Select Page Childhood Cancer Statistics Home > Understanding Children’s Cancer > Childhood Cancer Statistics Childhood Cancer Statistics – Graphs and Infographics Number of Diagnoses ...

  10. Relationship between Use of Water from Community-Scale Water Treatment Refill Kiosks and Childhood Diarrhea in Jakarta

    OpenAIRE

    Sima, Laura C.; Desai, Mayur M.; McCarty, Kathleen M; Elimelech, Menachem

    2012-01-01

    In developing countries, safe piped drinking water is generally unavailable, and bottled water is unaffordable for most people. Purchasing drinking water from community-scale decentralized water treatment and refill kiosks (referred to as isi ulang depots in Indonesia) is becoming a common alternative. This study investigates the association between diarrhea risk and community-scale water treatment and refill kiosk. We monitored daily diarrhea status and water source for 1,000 children 1–4 ye...

  11. Long Term Follow%u2013Up, Treatment and Prognosis of Acute Transverse Myelitis Patients In Childhood

    OpenAIRE

    Mehmet Canpolat

    2013-01-01

    Aim: To overview the medical history, clinical signs, imaging studies, laboratory data and treatment effectiveness in children with acute idiopathic transverse myelitis. Material and Method: Eight patients under the age of 15 years who presented acute transverse myelitis were included in the study by using the criteria of the Transverse Myelitis Consortium Working Group (2002). Chart analysis, clinical evaluation, imaging studies, laboratory data and treatment effectiveness were evaluated ret...

  12. Societal solutions to childhood origins of coronary artery disease.

    Science.gov (United States)

    Doss, Heather; Jayaram, Natalie; Raghuveer, Geetha

    2013-01-01

    Childhood obesity and associated risks result in premature cardiovascular damage and disease with a consequent, large burden to society. There are causes for childhood obesity that are rooted in the socioeconomic milieu. Interventions that are population-based, and aimed towards prevention as opposed to treatment, are likely to be most effective in curtailing childhood obesity. Reforms to federal and state managed social welfare programs provide a compelling opportunity to affect the course and consequences of childhood obesity. PMID:23107787

  13. Prospective study of perioperative cognitive changes in pediatric craniopharyngioma patients%儿童颅咽管瘤患者术后认知功能变化的前瞻性研究

    Institute of Scientific and Technical Information of China (English)

    柏建军; 姜涛; 张玉琪; 孙锋磊; 薛超强

    2012-01-01

    Objective To evaluate the perioperative cognitive changes in pediatric craniopharyngioma patients prospectively.Methods The patients were divided into three groups (Type 0,Type 1,and Type 2) depending on the degree of hypothalamic involvement on preoperative sagittal MRI images.The cognitive function of these patients were evaluated by four neuropsychological tests:WISC-R,Stroop test,Cancellation test,and Hanoi tower test before and four to nine months after tumor resection.The patients included 22 children (13 males and 9 females) with a mean age of 10.5 (6~16) years old during operation.The number of cases within the three groups was 4,4,and 14 respectively.4 out of 22 were operated through the subfrontal approach,7 through the translongitudinal fissure approach,10 through the transcallosal interforniceal approach,and 1 through the pterion approach.Results The IQ scores of 4 patients declined dramatically after tumor removal in the Type 2 group.However,there was no significant decline in IQ scores after surgery in the other patients.All 4 patients with IQ drops were operated through the transcollosal interforniceal approach.There was a significant difference in contributive index 1 between the 4 patients who received radiation treatment and the others who did not (P =0.047).Conclusions The risk factors,which may influence cognitive functions in children with craniopharyngiomas after surgery,are the degree of hypothalamic involvement,surgical approach,and radiation therapy.%目的 对儿童颅咽管瘤患者术后认知功能变化进行前瞻性研究.方法 根据术前MRI正中矢状位检查将病例分为三级(Type 0级、Type 1级、Type 2级),术前及术后半年左右分别进行认知功能检查.检查项目包括韦氏儿童智力测试(C-WISC)、汉诺塔测试、Stroop测试、数字划消测试.共22例有完整资料,男13例,女9例;平均10.5岁(6~16岁);Type 0级4例,Type 1级4例,Type 2级14例.经额底入路4例,经纵裂入路7

  14. Intravenous immunoglobulin treatment and screening for hypocretin neuron-specific autoantibodies in recent onset childhood narcolepsy with cataplexy

    DEFF Research Database (Denmark)

    Knudsen, S; Mikkelsen, J D; Bang, B; Gammeltoft, S; Jennum, P J

    2010-01-01

    Narcolepsy with cataplexy (NC) is caused by substantial loss of hypocretin neurons. NC patients carry the HLA-DQB1*0602 allele suggesting that hypocretin neuron loss is due to an autoimmune attack. We tested intravenous immunoglobulin (IVIG) treatment in early onset NC.......Narcolepsy with cataplexy (NC) is caused by substantial loss of hypocretin neurons. NC patients carry the HLA-DQB1*0602 allele suggesting that hypocretin neuron loss is due to an autoimmune attack. We tested intravenous immunoglobulin (IVIG) treatment in early onset NC....

  15. The impact of therapy for childhood acute lymphoblastic leukaemia on intelligence quotients; results of the risk-stratified randomized central nervous system treatment trial MRC UKALL XI

    Directory of Open Access Journals (Sweden)

    Vargha-Khadem Faraneh

    2011-10-01

    Full Text Available Abstract Background The MRC UKALLXI trial tested the efficacy of different central nervous system (CNS directed therapies in childhood acute lymphoblastic leukaemia (ALL. To evaluate morbidity 555/1826 randomised children underwent prospective psychological evaluations. Full Scale, verbal and performance IQs were measured at 5 months, 3 years and 5 years. Scores were compared in; (1 all patients (n = 555 versus related controls (n = 311, (2 low-risk children (presenting white cell count (WCC 9/l randomised to intrathecal methotrexate (n = 197 versus intrathecal and high-dose intravenous methotrexate (HDM (n = 202, and (3 high-risk children (WCC ≥ 50 × 109/l, age ≥ 2 years randomised to HDM (n = 79 versus cranial irradiation (n = 77. Results There were no significant differences in IQ scores between the treatment arms in either low- or high-risk groups. Despite similar scores at baseline, results at 3 and 5 years showed a significant reduction of between 3.6 and 7.3 points in all three IQ scores in all patient groups compared to controls (P Conclusion Children with ALL are at risk of CNS morbidity, regardless of the mode of CNS-directed therapy. Further work needs to identify individuals at high-risk of adverse CNS outcomes. Trial registration ISRCTN: ISRCTN16757172

  16. Clozapine Treatment of Childhood-Onset Schizophrenia: Evaluation of Effectiveness, Adverse Effects, and Long-Term Outcome

    Science.gov (United States)

    Sporn, Alexandra L.; Vermani, Anoop; Greenstein, Deanna K.; Bobb, Aaron J.; Spencer, Edgar P.; Clasen, Liv S.; Tossell, Julia W.; Stayer, Catherine C.; Gochman, Peter A.; Lenane, Marge C.; Rapoport, Judith L.; Gogtay, Nitin

    2007-01-01

    Objective: Clozapine is a unique atypical antipsychotic with superior efficacy in treatment-resistant schizophrenia. Plasma concentration of clozapine and its major metabolite N-desmethylclozapine (NDMC) as well as the ratio of NDMC to clozapine have been reported to be predictors of clozapine response. Here we evaluate these as well as other…

  17. Parental Factors that Detract from the Effectiveness of Cognitive-Behavioral Treatment for Childhood Anxiety: Recommendations for Practitioners

    Science.gov (United States)

    Walker, Jerry V., III

    2012-01-01

    This article reviews the recent empirical literature on the various parental factors that detract from the effectiveness of cognitive-behavioral treatment for children with anxiety. Interventions such as treating parental anxiety and increasing parental involvement in the therapeutic process may combat these factors. Newer strategies such as…

  18. Early Childhood Interventionists' Perceptions of the Child Abuse Prevention and Treatment Act: Provider Characteristics and Organizational Climate

    Science.gov (United States)

    Herman-Smith, Robert L.

    2013-01-01

    Research Findings: A 2003 amendment to the Child Abuse Prevention and Treatment Act (CAPTA) required states to develop plans to ensure that children younger than the age of 3 years who are victims of substantiated abuse or neglect have access to developmental screenings. Programs authorized under Part C of the Individuals with Disabilities…

  19. Toward an Optimal Treatment for Childhood Anxiety Disorders: The Influence of Parental Psychopathology, Selective Attention, and Cognitive Coping

    NARCIS (Netherlands)

    J.S. Legerstee (Jeroen)

    2009-01-01

    textabstractThe aim of the present thesis was to explore wether parental psychopathology and threat-related selective attention were related to outcome of cognitive-behavioral therapy in anxiety-disordered children and adolescents. Pre- to post-treatment changes of selective attention were also exam

  20. The Relations among Measurements of Informant Discrepancies within a Multisite Trial of Treatments for Childhood Social Phobia

    Science.gov (United States)

    De Los Reyes, Andres; Alfano, Candice A.; Beidel, Deborah C.

    2010-01-01

    Discrepancies between informants' reports of children's behavior are robustly observed in clinical child research and have important implications for interpreting the outcomes of controlled treatment trials. However, little is known about the basic psychometric properties of these discrepancies. This study examined the relation between…

  1. Improving childhood malaria treatment and referral practices by training patent medicine vendors in rural south-east Nigeria

    Directory of Open Access Journals (Sweden)

    Uzochukwu Benjamin SC

    2009-11-01

    Full Text Available Abstract Background Malaria remains a major cause of morbidity and mortality among children under five years of age in Nigeria. Most of the early treatments for fever and malaria occur through self-medication with anti-malarials bought over-the-counter (OTC from untrained drug vendors. Self-medication through drug vendors can be ineffective, with increased risks of drug toxicity and development of drug resistance. Global malaria control initiatives highlights the potential role of drug vendors to improve access to early effective malaria treatment, which underscores the need for interventions to improve treatment obtained from these outlets. This study aimed to determine the feasibility and impact of training rural drug vendors on community-based malaria treatment and advice with referral of severe cases to a health facility. Methods A drug vendor-training programme was carried out between 2003 and 2005 in Ugwuogo-Nike, a rural community in south-east Nigeria. A total of 16 drug vendors were trained and monitored for eight months. The programme was evaluated to measure changes in drug vendor practice and knowledge using exit interviews. In addition, home visits were conducted to measure compliance with referral. Results The intervention achieved major improvements in drug selling and referral practices and knowledge. Exit interviews confirmed significant increases in appropriate anti-malarial drug dispensing, correct history questions asked and advice given. Improvements in malaria knowledge was established and 80% compliance with referred cases was observed during the study period, Conclusion The remarkable change in knowledge and practices observed indicates that training of drug vendors, as a means of communication in the community, is feasible and strongly supports their inclusion in control strategies aimed at improving prompt effective treatment of malaria with referral of severe cases.

  2. Stereotactic intracavitary brachytherapy with P-32 for cystic craniopharyngiomas in children

    International Nuclear Information System (INIS)

    Although microsurgery remains the first-line treatment, gross total resection of cystic craniopharyngeomas (CP) is associated with significant morbidity and mortality and the addition of external irradiation to subtotal resection proves to achieve similar tumor control. However, concern regarding long-term morbidity associated with external irradiation in children still remains. With this retrospective analysis, the authors emphasize intracavitary brachytherapy using phosphorus-32 (P-32) as a treatment option for children with cystic CP. Between 1992 and 2009, 17 children (median age 15.4 years; range 7-18 years) with cystic CP underwent intracavitary brachytherapy using P-32. Eleven patients were treated for recurrent tumor cysts; 6 patients were treated primarily. MR imaging revealed solitary cysts in 7 patients; 10 patients had mixed solid-cystic lesions (median tumor volume 11.1 ml; range 0.5-78.9 ml). The median follow-up time was 61.9 months (range 16.9-196.6 months). Local cyst control could be achieved in 14 patients (82 %). Three patients showed progression of the treated cystic formation (in-field progression) after a median time of 8.3 months (range 5.3-10.3 months), which led to subsequent interventions. The development of new, defined cysts and progression of solid tumor parts (out-of-field progression) occurred in 5 patients and led to additional interventions in 4 cases. There was neither surgery-related permanent morbidity nor mortality in this study. The overall progression-free survival was 75, 63, and 52 % after 1, 3, and 5 years, respectively. Intracavitary brachytherapy using P-32 represents a safe and effective treatment option for children harboring cystic CP, even as primary treatment. However, P-32 does not clearly affect growth of solid tumor parts or the development of new cystic formations. (orig.)

  3. The usefulness of growth hormone treatment for psychological status in young adult survivors of childhood leukaemia: an open-label study

    Directory of Open Access Journals (Sweden)

    van Coeverden Silvia CCM

    2008-06-01

    Full Text Available Abstract Background To reduce the risk of brain damage children with acute lymphoblastic leukaemia (ALL are nowadays mainly treated with intrathecal chemotherapy (ITC instead of central nervous system (CNS radiation therapy (CRT to prevent CNS relapse. However, chemotherapy may also lead to cognitive deficits. As growth hormone deficiency (GHD or impaired growth hormone secretion are frequently found in ALL patients treated with cranial radiation therapy and/or chemotherapy, we hypothesized that GH therapy may reduce cognitive deficits in these patients. Methods Twenty young adult survivors of childhood ALL with reduced bone mineral density ( IQ and neuropsychological performance were assessed at pre-treatment (T1 and after one (T2 and two (T3 years. ANOVA was performed with assessment at T1, T2 and T3 as repeated measurements factor. Relations between test score changes and changes of IGF-I levels were determined by calculating the Pearson correlation coefficient. Results Scores on the cognitive tests were in the normal range. Verbal short- and long-term memory performance decreased between T1 and T2, and increased between T2 and T3. Performance at T3 was not significantly different from that at T1. Performance for sustained attention improved from T1 to T2 and from T1 to T3. Visual-spatial memory was improved after one year of GH treatment. A significant positive correlation was found for Δ IGF-I (T2-T1 with difference scores of visual-spatial memory (T2-T1 and T3-T1, indicating that IGF-I increase after one year of GH treatment is associated with increase in cognitive-perceptual performance at month 12 and 24. Conclusion Since the level of intellectual functioning of our patient cohort was in the normal range the present finding that GH treatment has negative effects on verbal memory and positive on attention and visual-spatial memory warrants similar studies in other groups of ALL survivors. Also, a lower dose of GH should be determined

  4. Physical Therapy as Treatment for Childhood Obesity in Primary Health Care: Clinical Recommendation From AXXON (Belgian Physical Therapy Association)

    OpenAIRE

    Hansen, Dominique; Hens, Wendy; Peeters, Stefaan; Wittebrood, Carla; Van Ussel, Sofi; Verleyen, Dirk; Vissers, Dirk

    2015-01-01

    Worldwide, an obesity epidemic among children and adolescents is apparent. In the care of obesity in children and adolescents, exercise therapy is considered a cornerstone. Official position statements describe and endorse the need and effect of exercise therapy and increased physical activity in children and adolescents with obesity. Physical therapists working in private and home care settings (first-line treatment) can play a key role in maximizing participation rates in exercise and physi...

  5. Childhood malaria in the Niger delta area of Nigeria:mothers/care givers 'perception,definition and treatment practices

    Institute of Scientific and Technical Information of China (English)

    Idogun ES; Airauhi LU

    2009-01-01

    Objective:The objective of the study was to evaluate mothers/care givers perception of malaria,their treat-ment practices and the effects on the outcome of malaria.Methods:Four hundred and sixty children were en-rolled and their mothers/care givers interviewed.The children were screened for malaria parasitaemia and there after,blood specimens were obtained for biochemical and haematological evaluation from those children who met the criteria and tested positive to P.falciparum parasites.Packed cell volume,electrolytes,urea, creatinine,plasma glucose,and serum bilirubin were analyzed.Results:A total of 460 children were studied, 233 (50.7%)males and 227 (49.3%)females.Mild malaria cases were 112 (24.3%)and severe malaria 348 (75.7%).Those who presented early 106 (23.0%)and those who presented late 354 (77.0%).Per-ception and definition of malaria as well as the treatment seeking behaviors vary significantly with the level of education of the mothers and care givers.Those without formal education 68 (51.9%)wrongly perceived that the etiology of malaria can only be diagnosed by native doctors compared to those with primary six education 61 (26.5%)and junior secondary education 10 (10.1%).Only 43 (9.3%)gave the correct dose of chloro-quine syrup to their sick children,while 32 (7.0%)gave at sub optimal doses.Conclusion:Wrong percep-tion of malaria especially the complicated malaria and wrong treatment practices are major contributory factors to the high mortality and morbidity of malaria in Nigeria.There is therefore a need for health education to cor-rect the wrong ideas about the cause and treatment practices of malaria as part of malaria control programme.

  6. Improving childhood malaria treatment and referral practices by training patent medicine vendors in rural south-east Nigeria

    OpenAIRE

    Uzochukwu Benjamin SC; Okeke Theodora A

    2009-01-01

    Abstract Background Malaria remains a major cause of morbidity and mortality among children under five years of age in Nigeria. Most of the early treatments for fever and malaria occur through self-medication with anti-malarials bought over-the-counter (OTC) from untrained drug vendors. Self-medication through drug vendors can be ineffective, with increased risks of drug toxicity and development of drug resistance. Global malaria control initiatives highlights the potential role of drug vendo...

  7. Inpatient treatment of conduct disorders in childhood and adolescence a€“ A retrospective analysis of case numbers and treatment duration

    OpenAIRE

    Zepf, Florian Daniel; Bubenzer, S.; Gaber, T. J.; BAURMANN, D; Helmbold, K.; Wöckel, L.

    2011-01-01

    Objective: Conduct disorders (CD) are among the most frequently diagnosed disorders in child and adolescent psychiatry. However, to date, a thorough analysis of clinical case numbers and treatment duration in children and adolescents is missing. Method: Data provided by the German Federal Health Monitoring System were analyzed for the period from 2000-2007 with respect to case numbers, treatment duration and different subtypes of disorders related to the CD spectrum. Results: The...

  8. Epidemiology and treatment of childhood condyloma acuminatum: an update%儿童尖锐湿疣的流行病学及治疗的研究进展

    Institute of Scientific and Technical Information of China (English)

    苑春雨; 鞠梅; 陈崑

    2014-01-01

    尖锐湿疣是人乳头瘤病毒所引起的性传播疾病.近年来,儿童患病的报道有所增加,其传播途径多样,不能忽略性虐待的可能,儿童感染人乳头瘤病毒类型及临床表现有别于成年人.儿童尖锐湿疣的治疗主要包括物理治疗、手术治疗、局部药物治疗等.选择治疗方案需要充分考虑安全性、有效性及耐受性,目前尚无美国食品药品监督管理局批准的可用于治疗< 12岁儿童尖锐湿疣的药物.%Condyloma acuminatum (CA) is a sexually transmitted disease caused by human papillomavirus (HPV).In recent years,reports on childhood CA have increased.Childhood CA is transmitted via various routes and the possibility of sexual abuse cannot be ignored.Meanwhile,HPV type and clinical manifestations are different between childhood and adult CA.The treatment of childhood CA includes physical therapy,surgery,topical medications,and so on.Safety,efficacy and tolerability should be fully considered in selection of treatment protocols.For CA in children under 12 years of age,there are no treatments approved by the United States Food and Drug Administration.

  9. The Effects of Two Different Doses of Iron in Ferric Form in Treatment of Childhood Iron Deficiency Anemia

    OpenAIRE

    Ünüvar, Emin; Oğuz, Fatma; Şahin, Kamil; Sıdal, Müjgan

    1999-01-01

    Objectives: To determine the effectiveness of two different doses of iron in ferric form in the treatment of iron deficiency anemia in children 3 vs 6 mg kg day nbsp; Methods: In this prospective open sided randomly syncronised study 130 cases diagnosed as iron deficiency anemia Hb lt; 11 gr dl Hct lt; 34 serum iron saturation index lt; 12 ferritin lt; 12 ng ml were divided into two groups: Group 1 n:65 received 6 mg kg d and Group 2 n:65 received 3 mg kg d iron orally The duration of treatme...

  10. Predicting adult asthma in childhood

    NARCIS (Netherlands)

    Vonk, JM; Boezen, HM

    2006-01-01

    PURPOSE OF REVIEW: There still is no cure for asthma. Early identification of patients at risk for disease progression may lead to better treatment opportunities and hopefully better disease outcomes in adulthood. Recent literature on childhood risk factors associated with the outcome of asthma in a

  11. Thrombotic thrombocytopenic purpura in childhood

    NARCIS (Netherlands)

    M.C. Bouw; N. Dors; H. van Ommen; N.L. Ramakers-van Woerden

    2009-01-01

    Thrombotic thrombocytopenic puripura (TTP) is a rare disease, especially in childhood, and has a high mortality rate in the absence of appropriate treatment. it is characterised by microangiopathic haemolytic anaemia and consumptive thrombocytopenia. TTP may be difficult to distinguish from haemolyt

  12. Stereotactic intracavitary brachytherapy with P-32 for cystic craniopharyngiomas in children

    Energy Technology Data Exchange (ETDEWEB)

    Maarouf, Mohammad; El Majdoub, Faycal [University Hospital of Cologne, Department of Stereotaxy and Functional Neurosurgery, Cologne (Germany); University of Witten/Herdecke, Department of Stereotaxy and Functional Neurosurgery, Center of Neurosurgery, Cologne-Merheim Medical Center (CMMC), Cologne (Germany); Fuetsch, Manuel [University Hospital of Munich, Department of Neurosurgery, Munich (Germany); Hoevels, Mauritius [University Hospital of Cologne, Department of Stereotaxy and Functional Neurosurgery, Cologne (Germany); Lehrke, Ralph [St. Barbara-Klinik Hamm-Heessen, Department of Stereotaxy and Functional Neurosurgery, Hamm (Germany); Berthold, Frank [University Hospital of Cologne, Department Pediatric Oncology, Cologne (Germany); Voges, Juergen [University Hospital of Magdeburg, Department of Stereotaxy and Functional Neurosurgery, Magdeburg (Germany); Sturm, Volker [University Hospital of Cologne, Department of Stereotaxy and Functional Neurosurgery, Cologne (Germany); University Hospital of Wurzburg, Department of Neurosurgery, Wuerzburg (Germany)

    2016-03-15

    Although microsurgery remains the first-line treatment, gross total resection of cystic craniopharyngeomas (CP) is associated with significant morbidity and mortality and the addition of external irradiation to subtotal resection proves to achieve similar tumor control. However, concern regarding long-term morbidity associated with external irradiation in children still remains. With this retrospective analysis, the authors emphasize intracavitary brachytherapy using phosphorus-32 (P-32) as a treatment option for children with cystic CP. Between 1992 and 2009, 17 children (median age 15.4 years; range 7-18 years) with cystic CP underwent intracavitary brachytherapy using P-32. Eleven patients were treated for recurrent tumor cysts; 6 patients were treated primarily. MR imaging revealed solitary cysts in 7 patients; 10 patients had mixed solid-cystic lesions (median tumor volume 11.1 ml; range 0.5-78.9 ml). The median follow-up time was 61.9 months (range 16.9-196.6 months). Local cyst control could be achieved in 14 patients (82 %). Three patients showed progression of the treated cystic formation (in-field progression) after a median time of 8.3 months (range 5.3-10.3 months), which led to subsequent interventions. The development of new, defined cysts and progression of solid tumor parts (out-of-field progression) occurred in 5 patients and led to additional interventions in 4 cases. There was neither surgery-related permanent morbidity nor mortality in this study. The overall progression-free survival was 75, 63, and 52 % after 1, 3, and 5 years, respectively. Intracavitary brachytherapy using P-32 represents a safe and effective treatment option for children harboring cystic CP, even as primary treatment. However, P-32 does not clearly affect growth of solid tumor parts or the development of new cystic formations. (orig.) [German] Obwohl die Mikrochirurgie die Methode der Wahl darstellt, ist die komplette Resektion zystischer Kraniopharyngeome haeufig mit einer

  13. Fusiform dilatation of the internal carotid artery in childhood-onset craniopharyngioma : multicenter study on incidence and long-term outcome

    NARCIS (Netherlands)

    Hoffmann, Anika; Warmuth-Metz, Monika; Lohle, Kristin; Reichel, Julia; Daubenbuchel, Anna M. M.; Sterkenburg, Anthe S.; Mueller, Hermann L.

    2016-01-01

    Fusiform dilatations of the internal carotid artery (FDCA) represent a vascular complication following surgery for suprasellar tumors in children. Incidence rate and long-term prognosis of FDCA in terms of survival rates, vascular complications, and quality of survival are unknown for patients with

  14. A flexible endoscope-assisted interhemispheric transcallosal approach through the contralateral ventricle for the removal of a third ventricle craniopharyngioma: A technical report

    Directory of Open Access Journals (Sweden)

    Shigetoshi Yano

    2015-01-01

    Full Text Available Background: Intraventricular craniopharyngiomas are difficult to remove. We combined an interhemispheric transcallosal approach with a flexible endoscope (videoscope for successful tumor removal. Case Description: A 52-year-old male complained of general fatigue and memory disturbance. Magnetic resonance imaging revealed a well-enhanced third ventricle mass with dilatation of lateral ventricles. During removal with the interhemispheric transcallosal approach, a videoscope that was inserted into the left lateral ventricle revealed the interface of the tumor and the ventricular wall. The tumor was pushed to the right using forceps and removed totally through the right foramen of Monro without any fornix injury. Conclusion: This procedure is a safe option for removing third ventricular tumors especially in the case with hydrocephalus.

  15. Pilocytic astrocytoma following radiotherapy for craniopharyngioma: case report Astrocitoma pilocítico pós-radioterapia para tratamento de craniofaringioma: relato de caso

    Directory of Open Access Journals (Sweden)

    LEONARDO BONILHA

    2000-09-01

    Full Text Available Administration of fractionated doses of irradiation is part of the adjutant therapy for CNS tumours such as craniopharyngiomas and pituitary adenomas. It can maximise cure rates or expand symptom-free period. Among the adverse effects of radiotherapy, the induction of a new tumour within the irradiated field has been frequently described. The precise clinical features that correlate irradiation and oncogenesis are not completely defined, but some authors have suggested that tumors are radiation induced when they are histologically different from the treated ones, arise in greater frequency in irradiated patients than among normal population and tend to occur in younger people with an unusual aggressiveness. In this article, we report a case of a papillary astrocytoma arising in a rather unusual latency period following radiotherapy for craniopharyngioma.A administração de doses fracionadas de radiação é parte do tratamento adjuvante de tumores do sistema nervoso central como craniofaringiomas ou adenomas hipofisários. A radioterapia pode aumentar as chances de cura ou expandir o período livre de sintomas. Dentre seus efeitos adversos, é conhecida a possibilidade de aparecimento de novo tumor na região irradiada. Os critérios que definem se um novo tumor é de fato induzido por radiação ainda não são completamente definidos. Adimite-se, no entanto, que se o novo tumor é histologicamente diferente do primeiro, aparece em indivíduos mais jovens e é mais agressivo que o habitual, provavelmente sua origem é devida à oncogênese da irradiação. Descrevemos um caso de astrocitoma pilocítico possivelmente induzido por radioterapia, com surgimento em tempo de latência inesperadamente curto.

  16. CT studies before and after CNS treatment for acute lymphoblastic leukemia and malignant non-Hodgkin's lymphoma in childhood

    International Nuclear Information System (INIS)

    CT was performed on 72 children with acute lymphoblasitc leukemia or non-Hodgkin's lymphoma. Thirty-two of these patients were investigated prior to CNS radiation and intrathecal methotrexate therapy. Ten of these patients (31%) were known to have hydrocephalic dilatation of the CSF spaces. Clinical data and subsequent observations with analysis of the CT findings show that no difference in the attenuation values of brain tissue occurs in the absence of a CNS relapse. The percentage of abnormal findings before and after therapy remains constant. The adverse late effects described in the CT literature seem principally to be damage diagnosed too late. It is questionable if the CT demonstration of dilated CSF spaces before treatment has a prognostic significance. (orig.)

  17. Individualized toxicity-titrated 6-mercaptopurine increments during high-dose methotrexate consolidation treatment of lower risk childhood acute lymphoblastic leukaemia. A Nordic Society of Paediatric Haematology and Oncology (NOPHO) pilot study

    DEFF Research Database (Denmark)

    Frandsen, Thomas L; Abrahamsson, Jonas; Lausen, Birgitte;

    2011-01-01

    This study explored the feasibility and toxicity of individualized toxicity-titrated 6-mercaptopurine (6MP) dose increments during post-remission treatment with High-dose methotrexate (HDM) (5000 mg/m(2), ×3) in 38 patients with Childhood (ALL). Patients were increased in steps of 25 mg 6MP/m(2......) per day if they did not develop myelotoxicity within 2 weeks after HDM. 6MP could be increased in 31 patients (81%). Toxicity was acceptable and did not differ significantly between groups. Patients receiving 75 mg/m(2) per day had significantly shorter duration of treatment interruptions of 6MP than...

  18. Village-randomized clinical trial of home distribution of zinc for treatment of childhood diarrhea in rural Western kenya.

    Directory of Open Access Journals (Sweden)

    Daniel R Feikin

    Full Text Available BACKGROUND: Zinc treatment shortens diarrhea episodes and can prevent future episodes. In rural Africa, most children with diarrhea are not brought to health facilities. In a village-randomized trial in rural Kenya, we assessed if zinc treatment might have a community-level preventive effect on diarrhea incidence if available at home versus only at health facilities. METHODS: We randomized 16 Kenyan villages (1,903 eligible children to receive a 10-day course of zinc and two oral rehydration solution (ORS sachets every two months at home and 17 villages (2,241 eligible children to receive ORS at home, but zinc at the health-facility only. Children's caretakers were educated in zinc/ORS use by village workers, both unblinded to intervention arm. We evaluated whether incidence of diarrhea and acute lower respiratory illness (ALRI reported at biweekly home visits and presenting to clinic were lower in zinc villages, using poisson regression adjusting for baseline disease rates, distance to clinic, and children's age. RESULTS: There were no differences between village groups in diarrhea incidence either reported at the home or presenting to clinic. In zinc villages (1,440 children analyzed, 61.2% of diarrheal episodes were treated with zinc, compared to 5.4% in comparison villages (1,584 children analyzed, p<0.0001. There were no differences in ORS use between zinc (59.6% and comparison villages (58.8%. Among children with fever or cough without diarrhea, zinc use was low (<0.5%. There was a lower incidence of reported ALRI in zinc villages (adjusted RR 0.68, 95% CI 0.46-0.99, but not presenting at clinic. CONCLUSIONS: In this study, home zinc use to treat diarrhea did not decrease disease rates in the community. However, with proper training, availability of zinc at home could lead to more episodes of pediatric diarrhea being treated with zinc in parts of rural Africa where healthcare utilization is low. TRIAL REGISTRATION: ClinicalTrials.gov NCT

  19. Low-level laser therapy for treatment of chemotherapy-induced oral mucositis in childhood: a randomized double-blind controlled study.

    Science.gov (United States)

    Amadori, Francesca; Bardellini, Elena; Conti, Giulio; Pedrini, Nicola; Schumacher, Richard Fabian; Majorana, Alessandra

    2016-08-01

    The aim of this study was to verify if low-level laser therapy could be useful to reduce chemotherapy-related oral mucositis grading and pain in childhood undergoing chemotherapy. A randomized double-blind clinical trial was carried out. Patients from 3 to 18 years of age undergoing cancer therapy and presenting OM grade 2 or more were eligible for this study. Patients were randomly divided in two groups: group A received laser therapy from the day of OM diagnosis and other 3 consecutive days (830 nm wavelength, power 150 mW, spot size 1 cm(2), 30 s per cm(2), energy density 4.5 J/cm(2)); group B received sham therapy (placebo) with the same timing. Two blind clinicians performed OM scoring and pain evaluation at day 1 (immediately before the beginning of laser treatment-T0), day 4 (after finishing laser therapy cycle-T1) and at day 7 (T2) as follow-up. A total of 123 patients were included in the study. Group A was composed of 62 children while group B is 61; in both groups, there was a progressive reduction in grade of OM, and at day 7, not every mucosal lesion disappeared. The difference in the decline of OM grading between the two groups resulted not statistically significant (p = 0.07). A statistically significant difference in pain reduction between two groups both at T1 and at T2 (p < 0.005) was observed. This study demonstrated the efficacy of LLLT in reducing pain due to chemotherapy-induced oral mucositis in children, while no significant benefit was noted in reducing OM grade. PMID:27272517

  20. Psychiatric comorbidity of childhood obesity.

    Science.gov (United States)

    Kalarchian, Melissa A; Marcus, Marsha D

    2012-06-01

    The onset of psychiatric symptoms and disorders is relatively common in childhood, occurring among youths across the weight spectrum. However, available research suggests that certain psychiatric comorbidities are more prevalent in obese children and adolescents than in healthy weight youths. First, we review research on disordered eating, including evidence to suggest that loss of control eating is associated with weight gain and obesity in youths, as well as poor outcome in family-based treatment of paediatric obesity. Second, we highlight evidence on the relationship between depression and obesity, especially in girls. Third, we present data on attention deficit hyperactivity disorder (ADHD), particularly the symptoms of impulsivity and inattention, and childhood obesity. We also consider that some medical conditions and psychotropic medications contribute to weight gain and obesity in children and adolescents. Throughout the review, we emphasize that psychiatric comorbidity may be a cause or consequence of childhood obesity, or they may share common aetiological factors. PMID:22724645

  1. Effect of Carisolv Chemo-Mechanical Caries Removal Technique on Early Childhood Caries Treatment%研究伢碘微创凝胶去龋技术在儿童龋齿治疗中的临床应用

    Institute of Scientific and Technical Information of China (English)

    沈玥

    2014-01-01

    目的:研究伢碘微创凝胶去龋技术在儿童龋齿治疗中的疗效。方法:选取80例儿童龋齿患者,随机分为观察组和对照组各40例,对观察组应用伢碘微创凝胶去龋技术进行治疗,对照组的治疗采用传统的磨牙技术,观察和比较两组患儿的龋齿治疗效果。结果:观察组治疗的总体效果优于对照组,差异有统计学意义( P<0.05);龋齿继发率观察组明显少于对照组,差异有统计学意义( P<0.05)。结论:在儿童龋齿治疗中采用伢典微创凝胶去龋技术效果良好,值得临床推广。%Objective:To analyze the effect of carisolv chemo-mechanical caries removal technique on early childhood caries treatment. Methods:80 cases early childhood caries were divided into treatment group and control group with 40 cases. Control group were treated by conventional teeth grinding. Treatment group was treated by carisolv chemo-mechanical caries removal technique. The effect of Childhood Caries treatment between two groups was observed and compared. Results:The general effect of the treatment was better than control group, the difference was statistical significance (p<0.05). Compared with control group, the secondary caries in treatment group were lower, difference was statistical significance (p<0.05). Conclusion:Carisolv chemo-mechanical caries removal technique showed significant effect in early childhood caries treatment, worth clinical promotion.

  2. Determinants of Utilization and Community Experiences with Community Health Volunteers for Treatment of Childhood Illnesses in Rural Sierra Leone.

    Science.gov (United States)

    Yansaneh, Aisha I; George, Asha S; Sharkey, Alyssa; Brieger, William R; Moulton, Lawrence H; Yumkella, Fatu; Bangura, Peter; Kabano, Augustin; Diaz, Theresa

    2016-04-01

    In 2010, at the same time as the national roll out of the Free Health Care Initiative (FHCI), which removed user fees for facility based health care, trained community health volunteers (CHVs) were deployed to provide integrated community case management of diarrhea, malaria and pneumonia to children under 5 years of age (U5) in Kambia and Pujehun districts, Sierra Leone. After 2 years of implementation and in the context of FHCI, CHV utilization rate was 14.0 %. In this study, we examine the factors associated with this level of CHV utilization. A cross-sectional household-cluster survey of 1590 caregivers of 2279 children U5 was conducted in 2012; with CHV utilization assessed using a multiple logistic regression model. Focus groups and in-depth interviews were also conducted to understand communities' experiences with CHVs. Children with diarrhea (OR = 3.17, 95 % CI: 1.17-8.60), from female-headed households (OR = 4.55, 95 % CI: 1.88-11.00), and whose caregivers reported poor quality of care as a barrier to facility care-seeking (OR = 8.53, 95 % CI: 3.13-23.16) were more likely to receive treatment from a CHV. Despite low utilization, caregivers were highly familiar and appreciative of CHVs, but were concerned about the lack of financial remuneration for CHVs. CHVs remained an important source of care for children from female-headed households and whose caregivers reported poor quality of care at health facilities. CHVs are an important strategy for certain populations even when facility utilization is high or when facility services are compromised, as has happened with the recent Ebola epidemic in Sierra Leone. PMID:26507650

  3. How Are Childhood Cancers Found?

    Science.gov (United States)

    ... Topic How are childhood cancers treated? How are childhood cancers found? Screening for childhood cancers Screening is testing for a disease such ... in people who don’t have any symptoms. Childhood cancers are rare, and there are no widely ...

  4. Chronic care treatment of obese children and adolescents

    DEFF Research Database (Denmark)

    Holm, Jens-Christian; Gamborg, Michael; Bille, Dorthe S;

    2011-01-01

    Clinically-relevant protocols for the treatment of childhood obesity are lacking. This study report results for a clinic-based structured treatment program for chronic childhood obesity.......Clinically-relevant protocols for the treatment of childhood obesity are lacking. This study report results for a clinic-based structured treatment program for chronic childhood obesity....

  5. Fatty liver in childhood

    Institute of Scientific and Technical Information of China (English)

    Yesim; Ozturk; Ozlem; Bekem; Soylu

    2014-01-01

    Fatty liver is a growing health problem worldwide. It might evolve to nonalcoholic steatohepatitis, cirrhosis and cause hepatocellular carcinoma. This disease, which has increased because of eating habits, changes in food content and lifestyle, affects people from childhood. The most important risk factors are obesity and insulin resistance. Besides these factors, gender, ethnicity, genetic predisposition and some medical problems are also important. Cirrhosis in children is rare but is reported. Nonalcoholic fatty liver disease(NAFLD) has no specific symptoms or signs but should be considered in obese children. NAFLD does not have a proven treatment. Weight loss with family based treatments is the most acceptable management. Exercise and an applicable diet with low glycemic index and appropriate calorie intake are preferred. Drugs are promising but not sufficient in children for today.

  6. Hairy Cell Leukemia Treatment Option Overview

    Science.gov (United States)

    ... Childhood ALL Treatment Childhood AML Treatment Research Hairy Cell Leukemia Treatment (PDQ®)–Patient Version General Information About Hairy Cell Leukemia Go to Health Professional Version Key Points ...

  7. Combined dyslipidemia in childhood.

    Science.gov (United States)

    Kavey, Rae-Ellen W

    2015-01-01

    Combined dyslipidemia (CD) is now the predominant dyslipidemic pattern in childhood, characterized by moderate-to-severe elevation in triglycerides and non-high-density lipoprotein cholesterol (non-HDL-C), minimal elevation in low-density lipoprotein cholesterol (LDL-C), and reduced HDL-C. Nuclear magnetic resonance spectroscopy shows that the CD pattern is represented at the lipid subpopulation level as an increase in small, dense LDL and in overall LDL particle number plus a reduction in total HDL-C and large HDL particles, a highly atherogenic pattern. In youth, CD occurs almost exclusively with obesity and is highly prevalent, seen in more than 40% of obese adolescents. CD in childhood predicts pathologic evidence of atherosclerosis and vascular dysfunction in adolescence and young adulthood, and early clinical cardiovascular events in adult life. There is a tight connection between CD, visceral adiposity, insulin resistance, nonalcoholic fatty liver disease, and the metabolic syndrome, suggesting an integrated pathophysiological response to excessive weight gain. Weight loss, changes in dietary composition, and increases in physical activity have all been shown to improve CD significantly in children and adolescents in short-term studies. Most importantly, even small amounts of weight loss are associated with significant decreases in triglyceride levels and increases in HDL-C levels with improvement in lipid subpopulations. Diet change focused on limitation of simple carbohydrate intake with specific elimination of all sugar-sweetened beverages is very effective. Evidence-based recommendations for initiating diet and activity change are provided. Rarely, drug therapy is needed, and the evidence for drug treatment of CD in childhood is reviewed. PMID:26343211

  8. Optimizing Cognitive-Behavioral Therapy for Childhood Psychiatric Disorders

    Science.gov (United States)

    Piacentini, John

    2008-01-01

    Reports that expand the understanding of the treatment of childhood obsessive-compulsive disorder by using exposure-based cognitive-behavioral therapy in the age group of 5 to 8-year-olds are presented. A model for collecting the common core elements of evidence-based psychosocial treatments for childhood disorders is also presented.

  9. Childhood medulloblastoma.

    Science.gov (United States)

    Massimino, Maura; Biassoni, Veronica; Gandola, Lorenza; Garrè, Maria Luisa; Gatta, Gemma; Giangaspero, Felice; Poggi, Geraldina; Rutkowski, Stefan

    2016-09-01

    Medulloblastoma accounts for 15-20% of childhood nervous system tumours. The risk of dying was reduced by 30% in the last twenty years. Patients are divided in risk strata according to post-surgical disease, dissemination, histology and some molecular features such as WNT subgroup and MYC status. Sixty to 70% of patients older than 3 years are assigned to the average-risk group. High-risk patients include those with disseminated and/or residual disease, large cell and/or anaplastic histotypes, MYC genes amplification. Current and currently planned clinical trials will: (1) evaluate the feasibility of reducing both the dose of craniospinal irradiation and the volume of the posterior fossa radiotherapy (RT) for those patients at low biologic risk, commonly identified as those having a medulloblastoma of the WNT subgroup; (2) determine whether intensification of chemotherapy (CT) or irradiation can improve outcome in patients with high-risk disease; (3) find target therapies allowing tailored therapies especially for relapsing patients and those with higher biological risk. PMID:27375228

  10. Health Behaviors of Childhood Cancer Survivors

    Directory of Open Access Journals (Sweden)

    Jennifer S. Ford

    2014-10-01

    Full Text Available There has been a dramatic increase in the number of childhood cancer survivors living to an old age due to improved cancer treatments. However, these survivors are at risk of numerous late effects as a result of their cancer therapy. Engaging in protective health behaviors and limiting health damaging behaviors are vitally important for these survivors given their increased risks. We reviewed the literature on childhood cancer survivors’ health behaviors by searching for published data and conference proceedings. We examine the prevalence of a variety of health behaviors among childhood cancer survivors, identify significant risk factors, and describe health behavior interventions for survivors.

  11. Childhood Brain Tumors

    Science.gov (United States)

    ... They are among the most common types of childhood cancers. Some are benign tumors, which aren't ... can still be serious. Malignant tumors are cancerous. Childhood brain and spinal cord tumors can cause headaches ...

  12. Childhood Brain Tumors

    Science.gov (United States)

    Brain tumors are abnormal growths inside the skull. They are among the most common types of childhood ... still be serious. Malignant tumors are cancerous. Childhood brain and spinal cord tumors can cause headaches and ...

  13. Childhood Overweight and Obesity

    Science.gov (United States)

    ... Childhood Obesity Facts The prevalence of obesity among low-income children aged 2 through 4 years, by state ... Obesity now affects 1 in 6 children and adolescents in the United States. Childhood Obesity Facts How ...

  14. Reducing Childhood Obesity

    Science.gov (United States)

    ... Navigation Bar Home Current Issue Past Issues Reducing Childhood Obesity Past Issues / Summer 2007 Table of Contents For ... page please turn Javascript on. The We Can! childhood obesity-prevention program involves parents, caregivers, and community leaders ...

  15. Clinical Holistic Medicine: The Case Story of Anna. I. Long-Term Effect of Childhood Sexual Abuse and Incest with a Treatment Approach

    Directory of Open Access Journals (Sweden)

    Søren Ventegodt

    2006-01-01

    Full Text Available The nervous breakdown of a 22-year-old, young woman was caused by severe sexual abuse in childhood, which was repressed over many years. During therapy, the patient accumulated resources to start the painful integration of these old traumas. Using holistic existential therapy in accordance with the life mission theory and the holistic process theory of healing, she finally was able to confront her old traumas and heal her existence. She seemingly recovered completely (including regaining full emotional range through holistic existential therapy, individually and in a group. The therapy took 18 months and more than 100 hours of intensive therapy. In the beginning of the therapy, the issues were her physical and mental health; in the middle of the therapy, the central issue was her purpose of life and her love life; and at the conclusion of the therapy, the issue was gender and sexuality. The strategy was to build up her strength for several months, mobilizing hidden resources and motivation for living, before the old traumas could be confronted and integrated. The therapy was based on quality of life philosophy, on the life mission theory, the theory of ego, the theory of talent, the theory of the evil side of man, the theory of human character, and the holistic process theory of healing. The clinical procedures included conversation, philosophical training, group therapeutic tools, extended use of therapeutic touch, holistic pelvic examination, and acceptance through touch was used to integrate the early traumas bound to the pelvis and scar tissue in the sexual organs. She was processed according to 10 levels of the advanced toolbox for holistic medicine and the general plan for clinical holistic psychiatry. The emotional steps she went through are well described by the scale of existential responsibility. The case story of Anna is an example of how even the most severely ill patient can recover fully with the support of holistic medical

  16. Paraplegia of late onset in adolescents with healed childhood caries of dorsal spine: A cause of pressure on the cord and treatment

    Directory of Open Access Journals (Sweden)

    Paravastu Rangachari

    2008-01-01

    Full Text Available Background: Paraplegia of late onset in adolescents with caries of dorsal spine is considered to be due to the reactivation of infection. Internal salient at the level of acute kyphotic deformity of the dorsal spine is formed by posterior cartilaginous remains of grossly destroyed vertebral bodies. The author presents a study of eight adolescent patients with paraplegia of late onset associated with severe kyphotic deformity of dorsal spine with observations on the cause of paraplegia, the final neurological outcome following anterior decompression and its prevention. Materials and Methods: Eight adolescent patients mean age 14.4 yrs 6 males and 2 females with healed childhood caries of dorsal spine, having a mean kyphotic angle of 80° (range 60°-140° presented with paraplegia of late onset. Of these patients, two had medical research council grade 0 muscle power; four had grade 2 muscle power, and two others had grade 3 muscle power in the lower limbs and were unable to walk unaided. One patient with 140° kyphoscoliotic deformity with grade 3 muscle power had post-polio residual paralysis (PPRP in addition. All patients were subjected to thorough anterior spinal decompression through transthoracic, transpleural thoracotomy from the left side. Results: In six of the eight patients, the spine at the site of deformity being very rigid, the deformity could not be corrected and the intervertebral gap was bridged with appropriate autogenous tricortical cortico cancelluous bone graft. In one patient (case 4, the kyphotic deformity could be corrected by 50%. In one patient with 140° kyphosis and PPRP, the gap after the decompression of cord, could not be bridged with bone graft and was given a custom made, well molded plastic black shell to wear while walking and, in particular, while traveling in a vehicle. In all seven patients, bone grafts took six months for bridging the intervertebral gaps. All patients recovered to grade 4 muscle power 6

  17. Treatment Option Overview (Childhood Rhabdomyosarcoma)

    Science.gov (United States)

    ... child’s hip bone. Samples of blood, bone, and bone marrow are removed for examination under a microscope. Lumbar puncture : A procedure used to collect cerebrospinal fluid (CSF) from the spinal column . This is done by placing a needle ...

  18. Treatment Options for Childhood Rhabdomyosarcoma

    Science.gov (United States)

    ... child’s hip bone. Samples of blood, bone, and bone marrow are removed for examination under a microscope. Lumbar puncture : A procedure used to collect cerebrospinal fluid (CSF) from the spinal column . This is done by placing a needle ...

  19. Treatment Options for Childhood Astrocytomas

    Science.gov (United States)

    ... to grow. If fluid builds up around the brain and spinal cord, a cerebrospinal fluid diversion procedure may be done. Cerebrospinal fluid diversion is a method used to drain fluid that has built up around the brain ...

  20. Imaging findings in craniofacial childhood rhabdomyosarcoma

    International Nuclear Information System (INIS)

    Rhabdomyosarcoma (RMS) is the commonest paediatric soft-tissue sarcoma constituting 3-5% of all malignancies in childhood. RMS has a predilection for the head and neck area and tumours in this location account for 40% of all childhood RMS cases. In this review we address the clinical and imaging presentations of craniofacial RMS, discuss the most appropriate imaging techniques, present characteristic imaging features and offer an overview of differential diagnostic considerations. Post-treatment changes will be briefly addressed. (orig.)

  1. Imaging findings in craniofacial childhood rhabdomyosarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Freling, Nicole J.M.; Rijn, Rick R. van [Academic Medical Centre, Radiology Department, Amsterdam (Netherlands); Merks, Johannes H.M. [Academic Medical Centre, Paediatric Oncology, Amsterdam (Netherlands); Saeed, Peerooz [Academic Medical Centre, Orbital Surgery and Ophthalmology, Amsterdam (Netherlands); Balm, Alfons J.M. [Netherlands Cancer Institute, Head and Neck Oncology, Amsterdam (Netherlands); Bras, Johannes [Academic Medical Centre, Pathology, Amsterdam (Netherlands); Pieters, Bradley R. [Academic Medical Centre, Radiotherapy, Amsterdam (Netherlands); Adam, Judit A. [Academic Medical Centre, Nuclear Medicine, Amsterdam (Netherlands)

    2010-11-15

    Rhabdomyosarcoma (RMS) is the commonest paediatric soft-tissue sarcoma constituting 3-5% of all malignancies in childhood. RMS has a predilection for the head and neck area and tumours in this location account for 40% of all childhood RMS cases. In this review we address the clinical and imaging presentations of craniofacial RMS, discuss the most appropriate imaging techniques, present characteristic imaging features and offer an overview of differential diagnostic considerations. Post-treatment changes will be briefly addressed. (orig.)

  2. 宣桂琪主任辨治小儿哮喘与提高疗效的思路%Doctor Xuan Guiqi's Experience in the Diagnosis and Treatment of Childhood Asthma and the Thinking of Improving Efficacy

    Institute of Scientific and Technical Information of China (English)

    宣晓波; 宣桂琪

    2013-01-01

    [Objective]To summarize Doctor Xuan Guiqi's experience in the treatment of childhood asthma and the idea of improving the curative efficacy. [Methods]By learning from Doctor Xuan and clearing up medical cases, the author finishes the summary on doctor Xuan's clinical experience on child-hood asthma based on the syndrome differentiation and clinical medication.[Results]The childhood asthma is divided into acute and chronic, the former is divided into cold asthma, heat asthma and wind-phlegm types. At the same time, we strengthen pertinence treatment of clearing heat and removing toxi-city, Qi spasmolytics, dispel ing wind and desensitization, activating blood and eliminating stasis, promoting Qi and regulating middle-jiao and relieving dyspepsia.[Conclusions] Doctor Xuan Guiqi's experience in the diagnosis and treatment of childhood asthma can significantly improve the clinical efficacy , and it is meaningful to clinic.%  [目的]总结宣桂琪主任对于小儿哮喘的临床治疗经验及提高疗效的思路。[方法]笔者通过跟师学习、整理医案,从辨证分型和临床用药等方面分析和总结宣主任治疗小儿哮喘的临床经验。[结果]宣主任将小儿哮喘分为急性哮喘与慢性哮喘进行辨治,其中前者又分寒哮、热哮、风痰哮三型,同时加强清热解毒、理气解痉、祛风脱敏、活血祛瘀、理气调中、消导积滞等针对性治疗,显著提高了哮喘的疗效。[结论]宣桂琪主任对小儿哮喘分型辨治及根据不同病因病机的针对性治疗显著提高了临床疗效,具有临床启示意义。

  3. Allergic Rhinitis in Childhood - Review

    Directory of Open Access Journals (Sweden)

    Arzu Babayiğit

    2010-12-01

    Full Text Available Allergic rhinitis, an immunoglobulin E mediated disease, is the most common chronic allergic childhood disease. The disease is characterized by nasal sneezing, rhinorrhea, palate and eye itchiness, and congestion and it can significantly impact children’s health. It causes uncomfortable symptoms, impairs quality of life and can predispose to the development of comorbidities such as asthma. Etiological diagnosis is based on cutaneous prick tests, which have a high sensitivity and specificity rate and which can be easily applied to young children. Treatment initially involves avoidance measures and, when necessary, pharmacotherapy or immunotherapy. Pharmacotherapy generally involves antihistamines and/or nasal corticosteroids, but leukotriene antagonists have also demonstrated effectiveness in treating allergic rhinitis symptoms. In this article, the symptoms, diagnosis and treatment of allergic rhinitis in childhood are discussed. (Journal of Current Pediatrics 2010; 8: 105-12

  4. Follow-up in Childhood Functional Constipation

    DEFF Research Database (Denmark)

    Modin, Line; Walsted, Anne-Mette; Rittig, Charlotte Siggaard; Hansen, Anne Vinkel; Jakobsen, Marianne Skytte

    2016-01-01

    OBJECTIVES: Guidelines recommend close follow-up during treatment of childhood functional constipation. Only sparse evidence exists on how follow-up is best implemented. Our aim was to evaluate if follow-up by phone or self-management through web-based information improved treatment outcomes....... METHODS: In this randomized, controlled trial, conducted in secondary care, 235 children, aged 2-16 years, who fulfilled the Rome III criteria of childhood constipation, were assigned to one of three follow-up regimens: (I) control group (no scheduled contact), (II) phone group (2 scheduled phone contacts......: Improved self-management behavior caused by access to self-motivated web-based information induced faster short-term recovery during treatment of functional constipation. Patient empowerment rather than health care promoted follow-up might be a step towards more effective treatment for childhood...

  5. HOSPITAL BASED STUDY ON CHILDHOOD PSORIASIS

    Directory of Open Access Journals (Sweden)

    Murugan

    2015-10-01

    Full Text Available Childhood psoriasis is a distressing condition with significant social and psychological consequences. Childhood psoriasis being less reported entity, this study was undertaken to study the incidence, pattern and prevalence of childhood psoriasis. MATERIALS & METHODS: In this retrospective epidemiologic study, a complete analysis of OP Records of patients with psoriasis who attended the Psoriasis Clinic of dermatology OPD, during the period of 1 year from June 2014- June 2015 were taken. The age at presentation, duration of psoriasis, pattern of involvement, h/o treatment, h/o preceeding infections were all recorded. RESULTS: The incidence of childhood psoriasis was observed to be (1.16%. The incidence of psoriasis in male (43% children and female (57% children was-. The mean age of onset of childhood psoriasis was -, positive family history seen in 5% of patients. Psoriasis vulgaris is the most common type of psoriasis followed by palmoplantar psoriasis. Nail involvement was seen in 30% of cases. Arthropathy was seen in 1% of patients. Preceeding infection was seen in 155 of patients. CONCLUSION: The rising trends in incidence of childhood psoriasis in recent times may mirror the evolving lifestyle and psychosocial environment in society. The evolving patterns of childhood psoriasis has significant avenues for research & further follow-up. Larger, coordinated multicentric long term studies to determine their course in adulthood may be required in future.

  6. Childhood proptosis

    International Nuclear Information System (INIS)

    Proptosis in children is a hallmark of orbital diseases which can present a diagnostic challenge requiring thoughtful investigation. The aim of this review is to provide the reader an overview of the subject of childhood proptosis with an emphasis on the systematic and practical approach for the work-up of proptosis in children. Use of proper imaging studies is essential for the correct diagnosis. Computed tomography is a good screening test for any space occupying lesion of the orbit. Proptosis describes eye prominence due to space occupying orbital lesions. Congenital lesions usually present in the first decade of life. Acquired orbital lesions such as lymphangiomas, orbital varix, rhabdomyosarcoma and neural tumors may present at the end of the first decade of life. Metastatic tumors to the orbit, adenocarcinoma of lacrimal gland and rapidly growing masses may present with proptosis associated with pain. Visual loss can be the presenting symptoms in the patients with optic nerve (ON) gliomas, orbital meningiomas and posteriorly located tumors. Cystic lesions of the orbit may be congenital or acquired, dermoid cysts being the most common congenital orbital lesions. Some of the vascular lesions of the orbit include capillary hemangiomas, lymphangiomas, orbital varix, and arteriovenous malformations. Inflammatory process of the orbit in children include cellulitis and pseudotumor. Neural tumors such as neurofibromas, ON gilomas and meningiomas are less common causes of proptosis in children. Rhabdomyosarcoma is the most common primary orbital malignancy in children which can present with acute proptosis and is one of the few life-threatening diseases seen initially by an ophthalmologist. Secondary orbital tumors invade the orbit from adjacent sinuses, cranium or extended from the eye itself. The most common distant metastases in children include neuroblastoma and Ewing's sarcoma. Although many orbital processes can be diagnosed based on history, clinical

  7. Childhood Obesity: A New Menace

    OpenAIRE

    Salazar, Maria L.; Lea S Eiland

    2007-01-01

    Childhood obesity is increasing in prevalence in the United States. Comorbid diseases once thought of as adult issues such as hypertension, diabetes, and dyslipidemia, are now being encountered in the pediatric population as a result of obesity. Primary prevention is still the most cost-effective approach to this growing problem. In terms of management, the treatment of obesity in children is not identical to that in adults. Thus far, the only accepted weight loss therapy for children are die...

  8. Monitoring asthma in childhood

    Directory of Open Access Journals (Sweden)

    Karin C. Lødrup Carlsen

    2015-06-01

    Full Text Available The goal of asthma treatment is to obtain clinical control and reduce future risks to the patient. However, to date there is limited evidence on how to monitor patients with asthma. Childhood asthma introduces specific challenges in terms of deciding what, when, how often, by whom and in whom different assessments of asthma should be performed. The age of the child, the fluctuating course of asthma severity, variability in clinical presentation, exacerbations, comorbidities, socioeconomic and psychosocial factors, and environmental exposures may all influence disease activity and, hence, monitoring strategies. These factors will be addressed in herein. We identified large knowledge gaps in the effects of different monitoring strategies in children with asthma. Studies into monitoring strategies are urgently needed, preferably in collaborative paediatric studies across countries and healthcare systems.

  9. Understanding Market Size and Reporting Gaps for Paediatric TB in Indonesia, Nigeria and Pakistan: Supporting Improved Treatment of Childhood TB in the Advent of New Medicines

    OpenAIRE

    Coghlan, Renia; Gardiner, Elizabeth; Amanullah, Farhana; Ihekweazu, Chikwe; Triasih, Rina; Grzemska, Malgorzata; Sismanidis, Charalambos

    2015-01-01

    Objective of the Study We sought to understand gaps in reporting childhood TB cases among public and private sector health facilities (dubbed “non-NTP” facilities) outside the network of national TB control programmes, and the resulting impact of under-reporting on estimates of paediatric disease burden and market demand for new medicines. Methodology Exploratory assessments were carried out in Indonesia, Nigeria and Pakistan, reaching a range of facility types in two selected areas of each c...

  10. Diabetes insípida adípsica en un operado de craneofaringioma Adipsic diabetes insipidus after surgery for craniopharyngioma

    Directory of Open Access Journals (Sweden)

    A Insúa

    2011-03-01

    Full Text Available La variada clínica de la enfermedad hipotalámica (convulsiones, hidrocefalia, hipopituitarismo, alteraciones del apetito, el sueño y la temperatura corporal incluye también los desórdenes regulatorios de la tonicidad y el volumen del líquido extracelular, debidos a la disrupción de la secreción de ADH (hormona antidiurética, vasopresina y/o del mecanismo de la sed. Se presenta un caso de un paciente operado de un craneofaringioma, que desarrolló diabetes insípida adípsica, que ilustra la alteración conjunta de los mecanismos regulatorios del balance hídrico. Los autores declaran no poseer conflictos de interés.The varied manifestations of hypothalamic disease (seizures, hydrocephalus, hypopytuitarism, altered appetite, sleep and body temperature regulation also include plasma tonicity and extracellular volume regulation disorders, due to the disruption of ADH (antidiuretic hormone, vasopressin secretion and/ or thirst mechanisms. We report the case of a patient operated on craniopharyngioma, who developed adipsic diabetes insipidus which illustrates the combined alterations of the mechanisms regulating water balance. No financial conflicts of interest exist.

  11. A study of clinical characteristics and prognosis of infradiaphragmatic craniopharyngioma%鞍膈下型颅咽管瘤临床特点及预后分析

    Institute of Scientific and Technical Information of China (English)

    万仁宽; 潘军; 汪潮湖; 邱明兴; 刘忆; 陈铭; 漆松涛

    2015-01-01

    Objective To summarize clinical characteristics of infradiaphragmatic craniopharyngioma and explore its prognosis factors. Methods The clinical date, imaging and follow-up findings were analyzed retrospectively in 58 pa⁃tients with infradiaphragmatic craniopharyngioma who underwent surgical operation in our hospital. Factors related to the postoperative quality of life of patients were analyzed using multi-factors Logistic regression analysis. Results There were 45 minor cases with infradiaphragmatic craniopharyngioma, of which forty cases (88.9%) had preoperative visual im⁃pairment. Preoperative endocrine examination revealed that 21 cases (46.7%) had pan-hypopituitarism and 24 cases (53.3%) had pari-hypopituitarism. In addition, preoperative MRI showed that 38 cases (84.4%) had tumor involvement in/on the saddle and the average tumor size was(4.53 ± 1.71)cm. There were 13 adult cases, of which 8 cases (61.5%) had preoperative visual impairment. Only 1 case (15.4%) had pan-hypopituitarism, 7 cases had pari-hypopituitarism and 5 cases had normal pituitary function. Ten cases (76.9%) had tumor involvement in/on the saddle and average tumor size was(2.92 ±1.18)cm. Multi-factors Logistic regression analysis revealed the patient's age (OR=0.090, P=0.090) and tu⁃mor size (OR=8.350, P=8.350), preoperative vision loss (OR=0.086, P=0.086), preoperative hypopituitarism (OR=0.198, P=0.198) were the relative factors affecting the quality of life. Conclusion Infradiaphragmatic craniopharyngioma is more common in minor patients. The clinical features and prognosis are significantly different between minor patients and adult patients. Age, size of tumors, preoperative vision loss and hypopituitarism of patients are associated with poor prog⁃nosis.%目的:总结鞍膈下型颅咽管瘤的临床特点,探讨影响鞍膈下型颅咽管瘤患者预后的相关因素。方法对58例在我院进行手术的鞍膈下型颅咽管瘤患者的临床、影像及

  12. Childhood trauma and childhood urbanicity in relation to psychotic disorder

    NARCIS (Netherlands)

    Frissen, Aleida; Lieverse, Ritsaert; Drukker, Marjan; van Winkel, Ruud; Delespaul, Philippe; Cahn, W

    2015-01-01

    BACKGROUND: Urban upbringing and childhood trauma are both associated with psychotic disorders. However, the association between childhood urbanicity and childhood trauma in psychosis is poorly understood. The urban environment could occasion a background of social adversity against which any effect

  13. Childhood Sexual Abuse

    Directory of Open Access Journals (Sweden)

    Evrim Aktepe

    2009-08-01

    Full Text Available Sexual abuse is defined as use of child or adolescent by the adults for satisfying of sexual urges and needs with forcing, threatening or tricking. Sexual abuse can be in the form of sexual abuse without touch, sexual touch, interfemoral intercourse, sexual penetration, and sexual exploitation. The prevalence of sexual abuse is reported as 10-40%. It is seen in female four times more than in males. Abusers are frequently male, only 5-15% of them are female. The abuse by females is usually towards male child. Thirty-fifty percent of abuse cases among child and adolescent are outside the family including strangers or familiar person. Some features of abusers are introvert personality, pedophilic and antisocial personality. Most of the abusers have a history of sexual abuse or aggression during childhood. Sexual intercourse between two people who are not allowed to marry by law is called as incest. Family pattern of incest is defined globally as disorganized and dysfunctional. The most commonly reported familial pattern is rigid and patriarchal family pattern with a harsh father using force quite frequently. The clinical features and impacts of the sexual abuse on the child varies according to the relation between abusers and the child, form of abuse, duration of abuse, presence of physical assault, developmental phase, child age and psychological development before the abuse. Sexual abuse history may result in psychiatric disorders including anxiety, depression, substance dependence, suicide act, borderline personality disorder, posttraumatic stress disorder. Abuse negatively affects interpersonal relationships and self esteem of abused individuals. Several studies reported close association between risky sexual behaviors in adulthood and a history of of sexual abuse during childhood. Four traumatic dynamics including traumatic sexuality with abuse, feeling of betrayal, weakness, and stigmatization exist in childhood abuse. Trauma can cause

  14. Parental Perceptions of the Schools' Role in Addressing Childhood Obesity

    Science.gov (United States)

    Murphy, Maureen; Polivka, Barbara

    2007-01-01

    As childhood obesity has increased, schools have struggled with their role in this epidemic. Parents with a school-age child in a suburban latchkey program were surveyed regarding their perceptions of childhood obesity, body mass index, and the school's role in prevention and treatment of obesity. More than 80% of participants identified…

  15. Health Information Needs of Childhood Cancer Survivors and Their Family

    NARCIS (Netherlands)

    S.L. Knijnenburg; L.C. Kremer; C. Bos; K.I. Braam; M.W.M. Jaspers

    2010-01-01

    Background. Knowledge about past disease, treatment, and possible late effects has previously been shown to be low in survivors of childhood cancer and their relatives. This study investigated the information needs of childhood cancer survivors and their parents and explored possible determinants fo

  16. Childhood as a value

    OpenAIRE

    EWELINA PIECUCH

    2011-01-01

    The article encompasses the problems of childhood and its influence on the rest of one's life. I have concentrated on this crucial and specific time in life. It is demonstrated by biology, medicine, psychology, and psychoanalysis that human habits are formed in childhood. Health, hygiene and aesthetic behaviour determine one's further fate and influence life in its entirety. It is that phase of human life that determines the rest of it. In childhood children manifest their cogn...

  17. The Association between Provider Practice and Knowledge of ORS and Zinc Supplementation for the Treatment of Childhood Diarrhea in Bihar, Gujarat and Uttar Pradesh, India: A Multi-Site Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Laura M Lamberti

    Full Text Available Programs aimed at reducing the burden of diarrhea among children under-five in low-resource settings typically allocate resources to training community-level health workers, but studies have suggested that provider knowledge does not necessarily translate into adequate practice. A diarrhea management program implemented in Bihar, Gujarat and Uttar Pradesh, India trained private sector rural medical practitioners (RMPs and public sector Accredited Social Health Activists (ASHAs and Anganwadi workers (AWWs in adequate treatment of childhood diarrhea with oral rehydration salts (ORS and zinc. We used cross-sectional program evaluation data to determine the association between observed diarrhea treatment practices and reported knowledge of ORS and zinc among each provider cadre.We conducted principal components analysis on providers' responses to diarrhea treatment questions in order to generate a novel scale assessing ORS/zinc knowledge. We subsequently regressed a binary indicator of whether ORS/zinc was prescribed during direct observation onto the resulting knowledge scores, controlling for other relevant knowledge predictors.There was a positive association between ORS/zinc knowledge score and prescribing ORS and zinc to young children with diarrhea among private sector RMPs (aOR: 2.32; 95% CI: 1.29-4.17 and public sector ASHAs and AWWs (aOR 2.48; 95% CI: 1.90-3.24. Controlling for knowledge score, receipt of training in the preceding 6 months was a good predictor of adequate prescribing in the public but not the private sector. In the public sector, direct access to ORS and zinc supplies was also highly associated with prescribing.To enhance the management of childhood diarrhea in India, programmatic activities should center on increasing knowledge of ORS and zinc among public and private sector providers through biannual trainings but should also focus on ensuring sustained access to an adequate supply chain.

  18. Clinicopathological significance of D2-40 expression in craniopharyngioma%颅咽管瘤中D2-40的表达及临床意义

    Institute of Scientific and Technical Information of China (English)

    刘雪咏; 朱琼; 陈余朋; 张声; 王行富; 吴晶晶; 李国平

    2015-01-01

    目的:探讨D2-40在颅咽管瘤中的表达及与临床病理学特征的关系及意义。方法采用免疫组化法检测D2-40在126例颅咽管瘤中的表达,并复习相关文献。结果 D2-40在颅咽管瘤中的总阳性率为87.30%(110/126),其中(+)、()、()阳性率分别为44.44%(56/126)、37.30%(47/126)和5.56%(7/126)。造釉细胞型主要表达在中间层细胞,乳头瘤样型主要表达在基底层细胞,两型表达模式不同。随着肿瘤伴发炎症程度的加重,D2-40表达程度上调。在肿瘤浸润灶及侵袭前沿, D2-40常常高表达,表现为基底层细胞及中间层细胞同时弥漫表达,侵袭性颅咽管瘤中D2-40的表达程度高于非侵袭性颅咽管瘤。复发性颅咽管瘤中D2-40的表达程度高于非复发性颅咽管瘤。D2-40表达与患者性别、肿瘤组织学分型无明显相关性。结论 D2-40表达上调与颅咽管瘤的发生、发展相关,可能导致肿瘤细胞的侵袭能力增强,并可能与炎症相关机制有关。D2-40高表达可能是颅咽管瘤患者易复发的因素之一。%Purpose To investigate the expression pattern and c1inicopatho1ogica1 significance of D2-40 in craniopharyngioma( CP). Methods Immunohistochemica1 method was used to assess D2-40 expression in 126 cases of craniopharyngioma. Statistic software was used to ana1yze the corre1ation between D2-40 expression and c1inicopatho1ogica1 features. Results The overa11 positive rate of D2-40 expression in 126 craniopharyngioma was 87. 30%. The rate of +, and  were 44. 44%( 56/126 ),37. 30%( 47/126 )and 5. 56%(7/126)respective1y. In adamantinomatous CPs,D2-40 expression was observed in epithe1ia1 components corresponding to the stratum intermedium,whi1e in papi11ary CPs,it was immuno-positive in basa1 ce11s. With the increasing of the existence of inf1amma-tion in tumor,D2-40 expression was up-regu1ated. Tumor ce11s were over-expressed for D2-40 in basa1

  19. [Childhood and transsexualism].

    Science.gov (United States)

    Chiland, C

    1988-01-01

    The introduction covers the ground that led the author to take an interest in transsexualism. The word "transsexualism" came into being at a specific time: 1953 (Benjamin). The concept, the facts, covered by this word, have existed in several known forms, as well as in "anonymous" ones. But the possibility of changing sex by hormonal or surgical means has given a new twist to the problem, with the role of the doctor and the media that go along with it. The definition is studied carefully and gives a description of transsexuals in its present forms working with biological males and biological females. The author suggests substituting "sexuel" and "sexué" in French for the distinction made in English between "sex" and "gender". The follow up should give a crucial value in order to justify turning a healthy subject into one who lives between the two genders. Unfortunately, such studies are neither numerous nor completely satisfactory because of insurmountable hurdles: a limited number of subjects who have been followed up, the impossibility of making up a test group, etc. Over the past few years, a reaction has sprung up, giving psychotherapy a more important role in treating patients, taking advantage of the treatment borderline cases have been given and what it has taught us. In all fairness, no one can speak of transsexual or transvestite children as has been done in the past, but only of feminine or effeminate boys and tomboy girls. When samples of such children have been followed longitudinally, one realizes that an extremely small number of them becomes transsexual, becoming for the most part homo- or bi-sexual, though some become heterosexual. Treating these children and their parents seems very important to everyone, given how hard it is to treat adult transsexuals. Only a few kinds of treatment have been published, and more especially, there is no data on the long-term future of those children having received treatment. We are trying to bring together data

  20. Best Clinical Practices for Male Adult Survivors of Childhood Sexual Abuse: “Do No Harm”

    OpenAIRE

    Gallo-Silver, Les; Anderson, Christopher M; Romo, Jaime

    2014-01-01

    The health care literature describes treatment challenges and recommended alterations in practice procedures for female survivors of childhood sexual abuse, a subtype of adverse childhood experiences. Currently, there are no concomitant recommendations for best clinical practices for male survivors of childhood sexual abuse or other adverse clinical experiences. Anecdotal information suggests ways physicians can address the needs of adult male survivors of childhood sexual abuse by changes in...

  1. Childhood tuberculosis.

    Science.gov (United States)

    Jacobs, R F; Eisenach, K D

    1993-01-01

    The dramatic resurgence and increase in the total number of cases of tuberculous infection and disease in children is alarming in the United States. With poverty, poor access to health care, overcrowding (predominantly in inner-city areas), and an increase in immigration from areas with high endemic rates of tuberculosis, the problem in children will continue to increase. If the impact of coinfection with HIV and M. tuberculosis becomes significant, as it has in adults in the United States, this increase in the total number of cases of tuberculous disease could be staggering. The impact of multiple drug-resistant strains of M. tuberculosis and the current crises in availability of effective antituberculous drugs will need to undergo basic and clinical research. Although the possibility for eradication of M. tuberculosis as a human pathogen in the United States still exists, clinicians must reeducate themselves regarding the epidemiology, pathophysiology, diagnostic work-up, and effective treatment of children with tuberculosis in the current situation of increasing tuberculous disease and resistant organisms in children. PMID:8217004

  2. Brucellosis in Childhood

    Directory of Open Access Journals (Sweden)

    Ulku Gul

    2011-06-01

    Full Text Available Objective: Brucellosis is still an important infectious disease, being widespread as endemic and sporadic cases in Turkey. The aim of this study was to evaluate clinical and laboratory findings, treatment modalities and final outcomes of brucellosis in children. Material and Methods: This is a retrospective record review of all patients 0-18 years of age with brucellosis admitted during a 8-year period between January 2003 and September 2010.Results: Of the 62 patients, 39 (63% were male. The mean age and standard deviation of patients was 120±51.7 months (4 months-18 years. Most common symptoms on admission were fever (88%, arthralgia (64% and dizziness (19%. On physical examination, the findings and percentages were as follows; arthritis (29%, lymphadenopathy (25%, hepatomegaly (24% and splenomegaly (17%. Fifty-one percent of the patients had high sedimentation rate, 41% had high transaminase levels, and 40% had positivity for C-Reactive Protein. Brucella agglutination tests were positive in all cases. Brucella spp. was isolated from blood cultures in 27% of the cases. All of the cases were given combined drug therapy. Three of the cases (4.8% had relapses during the follow up period. No mortality was seen in patients with brucellosis.Conclusion: Childhood brucellosis remains an important public health problem in our country. It may cause serious complications in children, and treatment with at least two antibiotics for not less than six weeks appears to be effective.

  3. Severity of Childhood Trauma is Predictive of Cocaine Relapse Outcomes in Women but not Men

    OpenAIRE

    Hyman, Scott M.; Paliwal, Prashni; Chaplin, Tara M.; Mazure, Carolyn M.; Rounsaville, Bruce J.; Sinha, Rajita

    2007-01-01

    We prospectively examined the gender-specific effects of childhood trauma on cocaine relapse outcomes in an inpatient sample of treatment engaged cocaine dependent adults. Cocaine dependent men (n = 70) and women (n = 54) participating in inpatient treatment for cocaine dependence were assessed on severity of childhood trauma and followed for 90 days after discharge from treatment. Greater severity of childhood emotional abuse was associated with an increased risk of relapse in women. Severit...

  4. Childhood Obesity. ERIC Digest.

    Science.gov (United States)

    Summerfield, Liane M.

    In this discussion of childhood obesity, the medical and psychological problems associated with the condition are noted. Childhood obesity most likely results from an interaction of nutritional, psychological, familial, and physiological factors. Three factors--the family, low-energy expenditure, and heredity--are briefly examined. Early…

  5. Reframing Early Childhood Leadership

    Science.gov (United States)

    Stamopoulos, Elizabeth

    2012-01-01

    Rapid changes in Australian education have intensified the role of early childhood leaders and led to unprecedented challenges. The Australian Curriculum (ACARA, 2011), mandated Australian "National Quality Framework" (NQF) for Early Childhood Education & Care (DEEWR, 2010b) and the "National Early Years Learning Framework" (EYLF) (DEEWR, 2009)…

  6. Severe Asthma in Childhood Linked to COPD Risk Later

    Science.gov (United States)

    ... 158815.html Severe Asthma in Childhood Linked to COPD Risk Later Treatments for kids didn't seem ... go on to develop chronic obstructive pulmonary disease (COPD) in early adulthood, a new study suggests. People ...

  7. Predictors of intractable childhood epilepsy

    International Nuclear Information System (INIS)

    To determine the prognosis of seizures in epileptic children and identify early predictors of intractable childhood epilepsy. All children (aged 1 month to 16 years) with idiopathic or cryptogenic epilepsy who were treated and followed at the centre during the study period were included. The patients who had marked seizures even after two years of adequate treatment were labeled as intractable epileptics (cases). Children who had no seizure for more than one year at last follow-up visit were the controls. Adequate treatment was described as using at least three anti-epileptic agents either alone or in combination with proper compliance and dosage. Records of these patients were reviewed to identify the variables that may be associated with seizure intractability. Of 442 epileptic children, 325 (74%) intractable and 117 (26%) control epileptics were included in the study. Male gender (OR=3.92), seizures onset in infancy >10 seizures before starting treatment (OR=3.76), myoclonic seizures (OR=1.37), neonatal seizures (OR=3.69), abnormal EEG (OR=7.28) and cryptogenic epilepsy (OR=9.69) and head trauma (OR=4.07) were the factors associated with intractable epilepsy. Seizure onset between 5-7 years of age, idiopathic epilepsy, and absence seizures were associated with favourable prognosis in childhood epilepsy. Intractable childhood epilepsy is expected if certain risk factors such as type, age of onset, gender and cause of epilepsy are found. Early referral of such patients to the specialized centres is recommended for prompt and optimal management. (author)

  8. Childhood trauma and childhood urbanicity in relation to psychotic disorder

    OpenAIRE

    Frissen, Aleida; Lieverse, Ritsaert; Drukker, Marjan; van Winkel, Ruud; Delespaul, Philippe; [...

    2015-01-01

    Background Urban upbringing and childhood trauma are both associated with psychotic disorders. However, the association between childhood urbanicity and childhood trauma in psychosis is poorly understood. The urban environment could occasion a background of social adversity against which any effect of childhood trauma increases. Also, any impact of the urban environment on likelihood of exposure to childhood trauma could be stronger in children who later develop psychotic disorder. The aim of...

  9. Childhood trauma and childhood urbanicity in relation to psychotic disorder

    OpenAIRE

    Frissen, Aleida; Lieverse, Ritsaert; Drukker, Marjan; van Winkel, Ruud; Delespaul, Philippe; Cahn, W.

    2015-01-01

    BACKGROUND: Urban upbringing and childhood trauma are both associated with psychotic disorders. However, the association between childhood urbanicity and childhood trauma in psychosis is poorly understood. The urban environment could occasion a background of social adversity against which any effect of childhood trauma increases. Also, any impact of the urban environment on likelihood of exposure to childhood trauma could be stronger in children who later develop psychotic disorder. The aim o...

  10. Uveitis in childhood : clinical and fundamental developments

    NARCIS (Netherlands)

    Kalinina Ayuso, V.

    2013-01-01

    This thesis aimed to gain new insights regarding the course and prognosis of uveitis in childhood, the pathogenesis of JIA-uveitis and the treatment of uveitis in children. The role of baseline prognostic factors in JIA-uveitis was studied by a retrospective analysis of 117 affected eyes of 65 patie

  11. Growth hormone (GH) treatment increases serum insulin-like growth factor binding protein-3, bone isoenzyme alkaline phosphatase and forearm bone mineral content in young adults with GH deficiency of childhood onset

    DEFF Research Database (Denmark)

    Juul, A; Pedersen, S A; Sørensen, S; Winkler, K; Jørgensen, J O; Christiansen, J S; Skakkebaek, N E

    1994-01-01

    the effect of GH treatment on a marker of bone formation (bone alkaline phosphatase), hepatic excretory function and distal forearm bone mineral content in GH-deficient adults. Growth hormone was administered subcutaneously in 21 adults (13 males and 8 females) with GH deficiency of childhood onset....../l after 4 months of GH treatment (p <0.0001). In addition, the molar ratio between IGF-I and IGFBP-3 increased significantlyfrom 0.22 to 0.33 after GH treatment (p <0.0001). Bone alkaline phosphatase increased significantly from 38.6 to 92.9 U/l during GH therapy in male patients (p <0.0001), whereas...... liver-derived alkaline phosphatase was unaltered by GH. In the females, the increase in bone alkaline phosphatase did not reach statistical significance (19.1 vs 40.0 U/l, p = 0.06). The GH-induced increase in bone alkaline phosphatase correlated significantly with the increase in serum IGFBP-3 (r = 0...

  12. Endocrine disorders in childhood cancer survivors: More answers, more questions

    OpenAIRE

    Clement, S.C.

    2016-01-01

    Treatment of pediatric malignancies has advanced substantially over the past several decades, resulting in a rapidly growing group of long-term childhood cancer survivors (CCS). Improved survival leads to an increasing number of individuals who may be at increased risk of substantial morbidity and even mortality as a direct or indirect consequence of their prior cancer therapy. Moreover, many CCS face lifelong health-related challenges after curative treatment of a childhood malignancy. Aroun...

  13. [Quality of life in childhood epilepsy].

    Science.gov (United States)

    Herranz, J L; Casas, C

    1996-01-01

    We describe a Quality Life scale in childhood epilepsy (CAVE) composed by 8 items, behaviour, school compliance, learning, autonomy, social relation, frequency and intensity of seizures and the parents opinions. Each item may be answered as very bad (5), bad (2), medium (3), good (4), or very good (5), and we can obtain full scores before and after the beginning of epileptic treatment and we can compare them. Although other Quality Life questionnaires exist for adult epilepsy, CAVE is the first scale applied for chronic childhood epilepsy. PMID:8851997

  14. Hyperparathyroidism After Irradiation for Childhood Malignancy

    International Nuclear Information System (INIS)

    Purpose: To examine the occurrence of hyperparathyroidism in a cohort of patients undergoing combined parathyroid and thyroid surgery after previous head-and-neck irradiation for childhood malignancy. Methods and Materials: This is a retrospective cohort study for the years 1996 to 2007. The study group comprised patients undergoing surgery in University of Sydney Endocrine Surgical Unit who had received previous head-and-neck irradiation in childhood and who were identified as having pathologic thyroid and parathyroid characteristics. Results: A total of 53 patients were identified in whom head-and-neck irradiation for the treatment of childhood malignancy had been documented. In each of the cases, thyroid disease was the primary reason for referral for surgery. Five of these patients (10%) were found to exhibit coexisting hyperparathyroidism. The latency period for hyperparathyroidism was less than 20 years in 4 of the 5 cases. There were four conventional parathyroid adenomas and one parathyroid lipoadenoma. All patients exhibited a significant decrease in postoperative calcium levels after surgery. Conclusions: To our knowledge, this is the first study to document the significant risk of hyperparathyroidism after radiation exposure for childhood malignancy. The timeframe for development of disease is much shorter than that published for individuals who have undergone irradiation for benign diseases. High doses of therapeutic radiation at a young age make childhood survivors of malignancy at especially high risk for developing hyperparathyroidism

  15. Reducing Childhood Obesity

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Reducing Childhood Obesity Past Issues / Summer 2007 Table of Contents For ... Ga. were the first three We Can! cities. Obesity Research: A New Approach The percentage of children ...

  16. Childhood Immunization Schedule

    Science.gov (United States)

    ... Why Immunize? Vaccines: The Basics Instant Childhood Immunization Schedule Recommend on Facebook Tweet Share Compartir Get the ... See Disclaimer for additional details. Based on Immunization Schedule for Children 0 through 6 Years of age ...

  17. Childhood Vaccine Schedule

    Science.gov (United States)

    ... Navigation Bar Home Current Issue Past Issues Childhood Vaccine Schedule Past Issues / Spring 2008 Table of Contents ... please turn Javascript on. When to Vaccinate What Vaccine Why Birth (or any age if not previously ...

  18. Tooth decay - early childhood

    Science.gov (United States)

    ... Ribeiro NM, Ribeiro MA. Breastfeeding and early childhood caries: a critical review. J Pediatr (Rio J) . 2004;80:S199-S210. Sexton S, Natale R. Risks and benefits of pacifiers. Am Fam Physician . 2009; ...

  19. Early Childhood Caries

    OpenAIRE

    Kawashita, Yumiko; Kitamura, Masayasu; Saito, Toshiyuki

    2011-01-01

    Dental caries is one of the most common childhood diseases, and people continue to be susceptible to it throughout their lives. Although dental caries can be arrested and potentially even reversed in its early stages, it is often not self-limiting and progresses without proper care until the tooth is destroyed. Early childhood caries (ECC) is often complicated by inappropriate feeding practices and heavy infection with mutans streptococci. Such children should be targeted with a professional ...

  20. Abdominal MRI in childhood

    International Nuclear Information System (INIS)

    MRI provides diagnostic information in multiple abdominal diseases in childhood. Additional information to sonographic findings can be achieved in the diagnosis of abdominal malformation as well as in several inflammatory processes. In childhood cancer imaging MRI is essential at the beginning as well as during therapy to assess response to therapy. Because of radiation protection MRI has to replace CT in abdominal imaging in children. Some technical details have to be considered when children are examined. (orig.)

  1. Meningeal hemangiopericytoma in childhood

    International Nuclear Information System (INIS)

    Meningeal hemangiopericytoma (MHP) is extremely rare in childhood. Mean age at diagnosis is between 38 and 43 years. We present an 8-year-old boy with MHP of the middle cranial fossa. Imaging findings were indistinguishable from an aggressive bone tumor such as Ewing's sarcoma. Imaging findings are presented and discussed. Our case indicates that MHP should be considered in the differential diagnosis of skull-base tumors despite the fact that MHP is extremely rare in childhood. (orig.)

  2. Fractures in childhood

    International Nuclear Information System (INIS)

    Clinical diagnosis of fractures in childhood can be very difficult. Therefore imaging, not only x-rays but also ultrasound, computed tomography and magnetic resonance imaging are of special importance. There are typical pediatric types of fractures due to epiphyseal plates and high flexibility of the bone. Fractures heal faster and dislocations can be spontaneously corrected better but also growth disturbance can occur. The second part of the article describes the special types of fractures with special attention to the characteristics in childhood.

  3. Stress and childhood epilepsy

    OpenAIRE

    Campen, J.S. van

    2015-01-01

    Epilepsy is one of the most common chronic diseases in childhood, characterized by the enduring predisposition to generate epileptic seizures. Children with epilepsy and their parents often report seizures precipitated by stress. In order to increase our understanding of the pathophysiological mechanisms underlying the effects of stress on seizures in childhood epilepsy, we performed a variety of studies, which are described in this thesis. In part I we evaluate the extent of stress sensitivi...

  4. Early childhood aggression

    OpenAIRE

    Alink, Lenneke Rosalie Agnes

    2006-01-01

    In this thesis the development, stability, and correlates of early childhood aggression were investigated. The normative development was examined in a general population sample using questionnaires completed by the parents of 12-, 24-, and 36-month-old children and again one year later. Results showed an early childhood aggression curve, with increasing rates of aggression in the second year of life and decreasing rates in the fourth year. One-year stabilities were moderate for 12-month-olds ...

  5. Pesticides and childhood cancers.

    OpenAIRE

    Daniels, J L; Olshan, A.F.; Savitz, D A

    1997-01-01

    To evaluate the possible association between pesticides and the risk of childhood cancers, epidemiologic studies published between 1970 and 1996 were critically reviewed. Thirty-one studies investigated whether occupational or residential exposure to pesticides by either parents or children was related to increased risk of childhood cancer. In general, the reported relative risk estimates were modest. Risk estimates appeared to be stronger when pesticide exposure was measured in more detail. ...

  6. Malaria diagnosis and treatment under the strategy of the integrated management of childhood illness (IMCI): relevance of laboratory support from the rapid immunochromatographic tests of ICT Malaria P.f/P.v and OptiMal

    DEFF Research Database (Denmark)

    Tarimo, D S; Minjas, J N; Bygbjerg, I C

    2001-01-01

    The algorithm developed for the integrated management of childhood illness (IMCI) provides guidelines for the treatment of paediatric malaria. In areas where malaria is endemic, for example, the IMCI strategy may indicate that children who present with fever, a recent history of fever and/or pallor...... and by using two rapid immunochromatographic tests (RIT) for the diagnosis of malaria (ICT Malaria P.f/P.v and OptiMal. At the time they were tested, each of these children had been targeted for antimalarial treatment (following the IMCI strategy) because of fever and/or pallor. Only 70% of the 395...... sensitivity of 93.0% and a specificity of 15.5% whereas pallor had a sensitivity of 72.2% and a specificity of 50.8%. The RIT both had very high corresponding sensitivities (of 100.0% for the ICT and 94.0% for OptiMal) but the specificity of the ICT (74.0%) was significantly lower than that for OptiMal (100...

  7. Large central lesions compressing the hypothalamus and brainstem. Operative approaches and combination treatment with radiosurgery

    International Nuclear Information System (INIS)

    A major aim of minimally invasive neurosurgery is to preserve function in the brain and cranial nerves. Based on previous results of radiosurgery for central lesions (19 craniopharyngiomas, 46 pituitary adenomas, 9 meningeal tumors), combined micro- and/or radiosurgery was applied for large lesions compressing the hypothalamus and/or brainstem. A basal interhemispheric approach via superomedial orbitotomy or a transcallosal-transforaminal approach was used for these large tumors. Tumors left behind in the hypothalamus or cavernous sinus were treated with radiosurgery using a gamma unit. Preoperative hypothalamo-pituitary functions were preserved in most of these patients. Radiosurgical results were evaluated in patients followed for more than 2 years after treatment. All 9 craniopharyngiomas decreased in size after radiosurgery, although a second treatment was required in 4 patients. All 20 pituitary adenomas were stable or decreased in size and 5 of 7 functioning adenomas showed normalized values of hormones in the serum. All 3 meningeal tumors were stable or decreased in size after treatment. No cavernous sinus symptoms developed after radiosurgery. We conclude that combined micro- and radio-neurosurgery is an effective and less invasive treatment for large central lesions compressing the hypothalamus and brainstem. (author)

  8. Risks and consequences of childhood and adolescent obesity.

    Science.gov (United States)

    Must, A; Strauss, R S

    1999-03-01

    This report reviews the risks and consequences associated with childhood and adolescent obesity. Although no consensus definition of childhood obesity exists, the various measures encountered in the literature are moderately well correlated. The paper is organized in three parts. The first section reviews childhood obesity sequelae that occur during childhood. These short-term risks, for orthopedic, neurological, pulmonary, gasteroenterological, and endocrine conditions, although largely limited to severely overweight children, are becoming more common as the prevalence of severe overweight rises. The social burden of pediatric obesity, especially during middle childhood and adolescence, may have lasting effects on self-esteem, body image and economic mobility. The second section examines the intermediate consequences, such as the development of cardiovascular risk factors and persistence of obesity into adulthood. These mid-range effects of early obesity presage later adult disease and premature mortality. In the final section, the small body of research on the long-term morbidity and mortality associated with childhood obesity is reviewed. These studies suggest that risk of cardiovascular disease and all-cause mortality is elevated among those who were overweight during childhood. The high prevalence and dramatic secular trend toward increasing childhood obesity suggest that without aggressive approaches to prevention and treatment, the attendant health and social consequences will be both substantial and long-lasting. PMID:10340798

  9. Ulcerative Lichen Planus in Childhood

    Directory of Open Access Journals (Sweden)

    Chiyadu Padmini

    2013-01-01

    Full Text Available Lichen planus (LP is a chronic inflammatory mucocutaneous condition which is relatively common in adults but rarely affects children. The present study is a report on an unusual case of ulcerative oral LP involving the dorsum of tongue in a 12-year-old boy. Patient complained of painful oral lesion on the tongue which was burning in nature and obstructing talking and eating spicy foods. On intraoral examination, a white ulcerative lesion on the dorsum of tongue was observed. Diagnosis was made based on clinical examination and histopathological features. We instituted local treatment and patient responded well to the treatment. Although rarely reported in childhood, lichen planus should be considered in a differential diagnosis of hyperkeratotic, reticular, and ulcerative lesions of the oral mucosa in children.

  10. Treatment of posttraumatic stress disorder - related nightmares and other sleep disturbances with risperidone in combat veterans and victims of domestic and childhood abuse

    Directory of Open Access Journals (Sweden)

    Nina Khachiyants

    2010-09-01

    Full Text Available Sleep disturbances including nightmares are often reported as hallmark of posttraumatic stress disorder (PTSD. The literature related to the pharmacological treatment of PTSD-related nightmares is sparse and inconclusive. After reviewing the literature it was obvious that currently a limited data on studies supporting the use of antipsychotic medications for the treatment of PTSD are published. Moreover, even more limited scientific evidence is now available to formulate evidence-based guidelines for the treatment of PTSD-related nightmares which are often reported as the most intrusive and disruptive symptom. Objective for this study is to review comprehensively the current research literature which reflects use of antipsychotic medication risperidone for the treatment of PTSD-related nightmares of different etiology.

  11. Late endocrine effects of childhood cancer.

    Science.gov (United States)

    Rose, Susan R; Horne, Vincent E; Howell, Jonathan; Lawson, Sarah A; Rutter, Meilan M; Trotman, Gylynthia E; Corathers, Sarah D

    2016-06-01

    The cure rate for paediatric malignancies is increasing, and most patients who have cancer during childhood survive and enter adulthood. Surveillance for late endocrine effects after childhood cancer is required to ensure early diagnosis and treatment and to optimize physical, cognitive and psychosocial health. The degree of risk of endocrine deficiency is related to the child's sex and their age at the time the tumour is diagnosed, as well as to tumour location and characteristics and the therapies used (surgery, chemotherapy or radiation therapy). Potential endocrine problems can include growth hormone deficiency, hypothyroidism (primary or central), adrenocorticotropin deficiency, hyperprolactinaemia, precocious puberty, hypogonadism (primary or central), altered fertility and/or sexual function, low BMD, the metabolic syndrome and hypothalamic obesity. Optimal endocrine care for survivors of childhood cancer should be delivered in a multidisciplinary setting, providing continuity from acute cancer treatment to long-term follow-up of late endocrine effects throughout the lifespan. Endocrine therapies are important to improve long-term quality of life for survivors of childhood cancer. PMID:27032982

  12. Influences of Childhood Experiences on Early Childhood Education Students

    OpenAIRE

    Strekalova-Hughes, Ekaterina; Maarouf, Saoussan; Keskin, Burhanettin

    2015-01-01

    This qualitative study examined whether or not childhood experiences of the early childhood education students affected their present personal beliefs and pedagogies. A digital survey was filled out by 58 students majoring in Early Childhood Education program. The participants were asked to identify and reflect on their impactful early experiences. The follow-up interviews with two participants were conducted to deepen the reflections on childhood experiences and explore their effects on the ...

  13. Childhood obesity: public-health crisis, common sense cure.

    Science.gov (United States)

    Ebbeling, Cara B; Pawlak, Dorota B; Ludwig, David S

    2002-08-10

    During the past two decades, the prevalence of obesity in children has risen greatly worldwide. Obesity in childhood causes a wide range of serious complications, and increases the risk of premature illness and death later in life, raising public-health concerns. Results of research have provided new insights into the physiological basis of bodyweight regulation. However, treatment for childhood obesity remains largely ineffective. In view of its rapid development in genetically stable populations, the childhood obesity epidemic can be primarily attributed to adverse environmental factors for which straightforward, if politically difficult, solutions exist. PMID:12241736

  14. Long-term follow-up study and long-term care of childhood cancer survivors

    Directory of Open Access Journals (Sweden)

    Hyeon Jin Park

    2010-04-01

    Full Text Available The number of long-term survivors is increasing in the western countries due to remarkable improvements in the treatment of childhood cancer. The long-term complications of childhood cancer survivors in these countries were brought to light by the childhood cancer survivor studies. In Korea, the 5-year survival rate of childhood cancer patients is approaching 70%; therefore, it is extremely important to undertake similar long-term follow-up studies and comprehensive long-term care for our population. On the basis of the experiences of childhood cancer survivorship care of the western countries and the current Korean status of childhood cancer survivors, long-term follow-up study and long-term care systems need to be established in Korea in the near future. This system might contribute to the improvement of the quality of life of childhood cancer survivors through effective intervention strategies.

  15. The MCT-ketogenic diet as a treatment option in refractory childhood epilepsy: A prospective study with 2-year follow-up.

    Science.gov (United States)

    Lambrechts, Danielle A J E; de Kinderen, Reina J A; Vles, Hans S H; de Louw, Anton J; Aldenkamp, Albert P; Majoie, Marian J M

    2015-10-01

    The present study assessed the long-term (i.e., 24months) efficacy of the ketogenic diet (KD) as an add-on therapy in children with refractory epilepsy, with focus on seizure frequency, seizure severity, and tolerability. Most patients were treated with the MCT-diet. At one and two years, 33% and 23%, respectively, of the 48 included patients were still on the KD. After three months, one year, and two years of treatment, 16.7% of the patients were responders. The highest responder rate (i.e., 22.9%) was seen at six and nine months of treatment. Of the fifteen patients with seizure clusters during baseline, 60% were responders after three months when looking at cluster reduction and most of them were not responders for the total seizure frequency. From three months of treatment onwards, most of the patients had a relevant decrease in seizure severity which was mainly related to the most severe seizure type. Gastrointestinal dysfunction was often reported, especially in the first six weeks of treatment. Growth deceleration was present in 30% of the patients, and weight reduction in 15%. Improved arousal was mentioned in 30% of patients. No patients developed ECG abnormalities or kidney stones. Increase in lipid profile was rare. The KD is an effective therapy for children with therapy-resistant epilepsy. Effectiveness is reflected in the reduction of seizure frequency as well as in the reduction of seizure severity. After 6months of treatment, it is obvious which patients are responders and tolerate the treatment well. Most of these patients will continue to benefit from the KD for a longer time. Long-term use of the diet was well tolerated. PMID:26301622

  16. Caregiver recognition of childhood diarrhea, care seeking behaviors and home treatment practices in rural Burkina Faso: a cross-sectional survey.

    Directory of Open Access Journals (Sweden)

    Shelby E Wilson

    Full Text Available INTRODUCTION: To design effective national diarrhea control programs, including oral rehydration solution (ORS and therapeutic zinc supplementation, information is needed on local perceptions of illness, external care seeking behaviors, and home treatment practices. METHODS: A cross-sectional, community-based household survey was conducted in the Orodara Health District, Burkina Faso. Caregivers of 10,490 children <27 months were interviewed to assess child diarrhea prevalence and related care practices. Characteristics of households, caregivers, children, and reported illnesses were compared for those caregivers who did or did not recognize the presence of diarrhea, as defined according to clinical criteria (≥ 3 liquid or semi-liquid stools/day. Multiple logistic regression models were used to examine factors associated with illness recognition and treatment. RESULTS: Clinically defined diarrhea was present in 7.6% (95% CI: 7.1-8.1% of children during the 24 hours preceding the survey but recognized by only 55% of caregivers. Over half (55% of the caregivers of 1,067 children with a clinically defined diarrhea episode in the past 14 days sought care outside the home; 78% of those seeking care attended a public sector clinic. Care was sought and treatment provided more frequently for children with fever, vomiting, anorexia, longer illness duration, and those living closer to the health center; and care was sought more frequently for male children. 80% of children with recent diarrhea received some form of treatment; only 24% received ORS, whereas 14% received antibiotics. Zinc was not yet available in the study area. CONCLUSIONS: Caregivers frequently fail to recognize children's diarrhea, especially among younger infants and when illness signs are less severe. Treatment practices do not correspond with international recommendations in most cases, even when caregivers consult with formal health services. Child caregivers need additional

  17. Childhood trauma in bipolar disorder

    OpenAIRE

    Watson, S; Gallagher, P.; Dougall, D.; R Porter; Moncrieff, J.; Ferrier, I. N.; Young, A. H.

    2014-01-01

    Objective: There has been little investigation of early trauma in bipolar disorder despite evidence that stress impacts on the course of this illness. We aimed to compare the rates of childhood trauma in adults with bipolar disorder to a healthy control group, and to investigate the impact of childhood trauma on the clinical course of bipolar disorder. Methods: Retrospective assessment of childhood trauma was conducted using the Childhood Trauma Questionnaire (CTQ) in 60 outpatients with bipo...

  18. 小儿外伤性颈总动脉瘤的外科治疗(附1例报告)%Surgical Treatment of Traumatic Aneurysm of Carotid Artery in Childhood

    Institute of Scientific and Technical Information of China (English)

    程邦昌; 姚震

    1982-01-01

    This paper reports a case of 2.5 years old boy with traumatic right common carotid aneurysm.It was resulted from a penetration of chopsticks in oral pharynx.Under hypothermia general anesthesia the right common carotid was clampped to block the bloodflow.Then the cyst of the aneurysm was incised.The clot and organalized tissue were removed.The defect on the carotid artery was repaired with Dacron patch.The patient recovered quickly.Some related literatures were reviewed,and the diagnosis and treatment of the carotid aneurysm in childhood were discussedw.%@@ 病例介绍 病例:男孩,2岁半.1981年4月25日入院.2个月前病儿口含筷子跑步而跌倒,筷子刺入右咽喉部,出血不止.3日后右颈部出现蚕豆大包块.一周后吐血约300毫升.曾穿刺包块抽出鲜血.诊断为右颈动脉瘤.体检:发育尚好,贫血貌.

  19. Designing Insurance to Promote Use of Childhood Obesity Prevention Services

    OpenAIRE

    Rask, Kimberly J.; Julie A. Gazmararian; Kohler, Susan S.; Hawley, Jonathan N.; Jenny Bogard; Victoria A. Brown

    2013-01-01

    Childhood obesity is a recognized public health crisis. This paper reviews the lessons learned from a voluntary initiative to expand insurance coverage for childhood obesity prevention and treatment services in the United States. In-depth telephone interviews were conducted with key informants from 16 participating health plans and employers in 2010-11. Key informants reported difficulty ensuring that both providers and families were aware of the available services. Participating health plans...

  20. Treating childhood cancer in Rwanda: the nephroblastoma example

    OpenAIRE

    Kanyamuhunga, Aimable; Tuyisenge, Lisine; Stefan, Daniela Cristina

    2015-01-01

    Introduction Wilms tumor (WT) or nephroblastoma is the commonest childhood cancer in Rwanda. Nephroblastoma is regarded as one of the successes of pediatric oncology with long-term survival approaching 90%. The Objectives to evaluate the feasibilityof treating childhood cancer using the nephroblastoma example and to calculate its cost of treatment in Rwanda. Methods Prospective study over a 2 year period: 01 Jan 2010- 31 December 2011. A questionnaire was completed by all participants in the ...

  1. Parental stress and the onset and course of childhood asthma

    OpenAIRE

    Yamamoto, Noriko; Nagano, Jun

    2015-01-01

    The influence of a caregiver’s stress on the development of childhood asthma is an important aspect of the treatment and prevention of illness. Many cross-sectional studies have investigated the association between parenting attitude and/or caregiver’s stress and childhood asthma morbidity, but prospective studies are more advantageous than cross-sectional studies in interpreting a causal relationship from the results. We here present an overview of prospective studies that have reported a re...

  2. A Randomized Controlled Trial for Children with Childhood Apraxia of Speech Comparing Rapid Syllable Transition Treatment and the Nuffield Dyspraxia Programme-Third Edition

    Science.gov (United States)

    Murray, Elizabeth; McCabe, Patricia; Ballard, Kirrie J.

    2015-01-01

    Purpose: This randomized controlled trial compared the experimental Rapid Syllable Transition (ReST) treatment to the Nuffield Dyspraxia Programme-Third Edition (NDP3; Williams & Stephens, 2004), used widely in clinical practice in Australia and the United Kingdom. Both programs aim to improve speech motor planning/programming for children…

  3. The Efficacy of Short- and Long-Term Therapy in the Treatment of Childhood Sexual Abuse: A Review of the Literature.

    Science.gov (United States)

    Aoto-Sullivan, Stacey Y.

    This paper presents a review of the short- and long-term treatments for children who have been sexually abused. Short-term group therapy, long-term group therapy, short-term individual, and long-term individual therapy were each evaluated in terms of efficacy in alleviating symptoms associated with sexual abuse. The paper also evaluates the…

  4. Childhood Pneumonia Screener: a concept

    Directory of Open Access Journals (Sweden)

    Jukka Räsänen

    2014-06-01

    Full Text Available Childhood pneumonia continues to be the number one cause of death in children under five years of age in developing countries. In addition to mortality, pneumonia constitutes an enormous economic and social burden because late diagnosis is associated with high cost of treatment and often leads to chronic health problems. There are several bottlenecks in developing countries in the case flow of a child with lung infection: 1 recognising the symptoms as a reason to seek care, 2 getting the patient to a first-tier health facility, 3 scarcity of trained healthcare personnel who can diagnose the condition and its severity, 4 access to a second-tier facility in severe cases. These factors are commonly present in rural areas but even in more urban settings, access to a physician is often delayed. The Childhood Pneumonia Screener project aims at bridging the diagnostic gap using emerging technology. Mobile “smart” phone communication with several inexpensive dedicated sensors is proposed as a rapid data-collection and transmission unit that is connected to a central location where trained personnel assisted by sophisticated signal processing algorithms, evaluate the data and determine if the child is likely to have pneumonia and what the level and urgency of care should be.

  5. Reconceptualizing the "Nature" of Childhood

    Science.gov (United States)

    Taylor, Affrica

    2011-01-01

    This interdisciplinary article draws upon human geography to bring fresh new perspectives to the relationship between two commonly conflated concepts: "childhood" and "nature". Childhood studies scholars have gone a long way towards retheorizing childhood beyond the "natural" and the "universal" by pointing to its historical and cultural…

  6. Discovering the Culture of Childhood

    Science.gov (United States)

    Plank, Emily

    2016-01-01

    We often filter our interactions with children through the lens of adulthood. View the culture of childhood through a whole new lens. Identify age-based bias and expand your outlook on and understanding of early childhood as a culture. Examine various elements of childhood culture: language, the power of believing, artistic expressions, and social…

  7. Late bone and soft tissue sequelae of childhood radiotherapy. Relevance of treatment age and radiation dose in 146 children treated between 1970 and 1997

    Energy Technology Data Exchange (ETDEWEB)

    Doerr, W. [Technical Univ. of Dresden (Germany). Dept. of Radiotherapy and Radiation Oncology; Medical University / AKH Vienna (Austria). Dept. of Radiation Oncology; Kallfels, S. [Technical Univ. of Dresden (Germany). Dept. of Radiotherapy and Radiation Oncology; Kinder- und Jugendmedizin, Chemnitz (Germany); Herrmann, T. [Technical Univ. of Dresden (Germany). Dept. of Radiotherapy and Radiation Oncology

    2013-07-15

    Purpose: The present retrospective study was initiated to characterize the effect of oncological treatments in children and adolescents on bone and soft tissues, and to assess their dependence on radiation dose and age at exposure. Patients and methods: The study included 146 patients treated between 1970 and 1997. All patients received external beam radiotherapy to the trunk or extremities, but no cranial irradiation. Median age at treatment was 8.8 years. Patients were screened at 18 years (median time interval since treatment 9.2 years, range 0.9-17.7 years) for pathological changes in the skeletal system and soft tissues (scoliosis, kyphosis, bony hypoplasia, soft tissue defects, asymmetries), which were classified as minor/moderate (grade 1) or substantial (grade 2). Results: Pathological findings were recorded in 75/146 patients (51 %). These were scored as minor in 44 (59 %) and substantial in 31 patients (41 %). Most pathological changes occurred in children treated under the age of 6 years. At 6 years and older, only doses > 35 Gy caused an effect, and no substantial changes were seen for treatment ages exceeding 12 years. Significant effects of radiation dose and age at exposure were observed for kyphoscoliosis (with vertebral body dose gradients < 35 Gy), hypoplasia and soft tissue defects and asymmetrical growth. Conclusion: Tolerance doses of 20 Gy need to be respected for growing bone, particularly in children treated under the age of 6 years. The late treatment sequelae analysed in the present study are largely avoided with the use of current therapeutic protocols. However, the systematic evaluation, documentation and continuous analysis of adverse events in paediatric oncology remains essential, as does the evaluation of novel radio(chemo)therapeutic approaches. (orig.)

  8. Birthweight and Childhood Cancer

    DEFF Research Database (Denmark)

    Paltiel, Ora; Tikellis, Gabriella; Linet, Martha; Golding, Jean; Lemeshow, Stanley; Phillips, Gary; Lamb, Karen; Stoltenberg, Camilla; Håberg, Siri E; Strøm, Marin; Granstrøm, Charlotta; Northstone, Kate; Klebanoff, Mark; Ponsonby, Anne-Louise; Milne, Elizabeth; Pedersen, Marie; Kogevinas, Manolis; Ha, Eunhee; Dwyer, Terence

    2015-01-01

    BACKGROUND: Evidence relating childhood cancer to high birthweight is derived primarily from registry and case-control studies. We aimed to investigate this association, exploring the potential modifying roles of age at diagnosis and maternal anthropometrics, using prospectively collected data from...... the International Childhood Cancer Cohort Consortium. METHODS: We pooled data on infant and parental characteristics and cancer incidence from six geographically and temporally diverse member cohorts [the Avon Longitudinal Study of Parents and Children (UK), the Collaborative Perinatal Project (USA......). Childhood cancer (377 cases diagnosed prior to age 15 years) risk was analysed by type (all sites, leukaemia, acute lymphoblastic leukaemia, and non-leukaemia) and age at diagnosis. We estimated hazard ratios (HR) and 95% confidence intervals (CI) from Cox proportional hazards models stratified by cohort...

  9. A Tewo Tibetan Childhood

    Directory of Open Access Journals (Sweden)

    Rdo rje tshe brtan

    2013-04-01

    Full Text Available Rdo rje tshe brtan (b. 1986 describes his childhood in Dredze Village, Yiwa Township, Tewo County, Gannan Tibetan Autonomous Prefecture, Gansu Province, China, as well as being a student in Xining City, Qinghai Province. Topics covered include his family, childhood injuries and illnesses, education, Terang (malicious household deities, mountain deities and associated rituals and sacrifices, death, conflict with other locals, collecting local plants, a birth in the village, stealing fruit, a wedding, plowing, a visit to a hot spring, a lost yak, slaughtering pigs, government confiscation of fields, and slaughtering pigs. Photos provide additional detail.

  10. Pharmacokinetics of 6-Thioguanine and 6-Mercaptopurine Combination Maintenance Therapy of Childhood ALL

    DEFF Research Database (Denmark)

    Nielsen, Stine N; Frandsen, Thomas L; Nersting, Jacob; Hjalgrim, Lisa L; Schmiegelow, Kjeld

    2015-01-01

    Methotrexate/6-mercaptopurine maintenance therapy of childhood acute lymphoblastic leukemia is challenged by treatment-related hepatotoxicity, failure to achieve the myelosuppressive target, and lack of direct parameters for monitoring treatment efficacy or even intensity. Patients with low...

  11. Obesity in childhood and adolescence, genetic factors.

    Science.gov (United States)

    Memedi, Rexhep; Tasic, Velibor; Nikolic, Erieta; Jancevska, Aleksandra; Gucev, Zoran

    2013-01-01

    Obesity and overweight are a pandemic phenomenon in the modern world. Childhood and adolescent obesity often ends up in obesity in adults. The costs of obesity and its consequences are staggering for any society, crippling for countries in development. The etiology is complex, but most often idiopathic. Hormonal, syndromic and medication-induced obesity are well investigated. Genetic causes are increasingly described. Novel technologies such as whole exome sequencing identify ever more candidate genes influencing or causing obesity. All insights into the complex problem of obesity in a team approach to treatment: diet, psychology, medications and surgery. We briefly review epidemiology, etiology, consequences and treatment approaches in childhood and adolescent obesity, with special emphasis on emerging knowledge of its genetics. PMID:24296635

  12. Mesothelioma following Wilms' tumor in childhood

    International Nuclear Information System (INIS)

    A high percentage of children with Wilms' tumor are cured with multimodal treatment. A small percentage of these children will develop second tumors, perhaps related to a genetic predisposition to neoplasia or possibly secondary to the treatment utilized for Wilms' tumor. Malignant mesothelioma has been associated with contact with asbestos but has also been reported after radiation exposure. Two patients are reported who developed malignant mesothelioma of the pleura after treatment for Wilms' tumor in childhood. Both received orthovoltage radiation; one patient also received triethylenemelamine (TEM), an alkylating agent closely related to nitrogen mustard, for 5 years. Factors in the development of second tumors are discussed

  13. Childhood trauma predicts antidepressant response in adults with major depression: data from the randomized international study to predict optimized treatment for depression.

    Science.gov (United States)

    Williams, L M; Debattista, C; Duchemin, A-M; Schatzberg, A F; Nemeroff, C B

    2016-01-01

    Few reliable predictors indicate which depressed individuals respond to antidepressants. Several studies suggest that a history of early-life trauma predicts poorer response to antidepressant therapy but results are variable and limited in adults. The major goal of the present study was to evaluate the role of early-life trauma in predicting acute response outcomes to antidepressants in a large sample of well-characterized patients with major depressive disorder (MDD). The international Study to Predict Optimized Treatment for Depression (iSPOT-D) is a randomized clinical trial with enrollment from December 2008 to January 2012 at eight academic and nine private clinical settings in five countries. Patients (n=1008) meeting DSM-IV criteria for MDD and 336 matched healthy controls comprised the study sample. Six participants withdrew due to serious adverse events. Randomization was to 8 weeks of treatment with escitalopram, sertraline or venlafaxine with dosage adjusted by the participant's treating clinician per routine clinical practice. Exposure to 18 types of traumatic events before the age of 18 was assessed using the Early-Life Stress Questionnaire. Impact of early-life stressors-overall trauma 'load' and specific type of abuse-on treatment outcomes measures: response: (⩾50% improvement on the 17-item Hamilton Rating Scale for Depression, HRSD17 or on the 16-item Quick Inventory of Depressive Symptomatology-Self-Rated, QIDS_SR16) and remission (score ⩽7 on the HRSD17 and ⩽5 on the QIDS_SR16). Trauma prevalence in MDD was compared with controls. Depressed participants were significantly more likely to report early-life stress than controls; 62.5% of MDD participants reported more than two traumatic events compared with 28.4% of controls. The higher rate of early-life trauma was most apparent for experiences of interpersonal violation (emotional, sexual and physical abuses). Abuse and notably abuse occurring at ⩽7 years of age predicted poorer outcomes

  14. Averting the legacy of kidney disease - focus on childhood

    Directory of Open Access Journals (Sweden)

    J.R. Ingelfinger

    2016-01-01

    Full Text Available World Kidney Day 2016 focuses on kidney disease in childhood and the antecedents of adult kidney disease that can begin in earliest childhood. Chronic kidney disease (CKD in childhood differs from that in adults, in that the largest diagnostic group among children includes congenital anomalies and inherited disorders, with glomerulopathies and kidney disease as a consequence of diabetes being relatively uncommon. In addition, many children with acute kidney injury will ultimately develop sequelae that may lead to hypertension and CKD in later childhood or in adult life. Children born early or who are small-for-date newborns have relatively increased risk for the development of CKD later in life. Persons with a high-risk birth and early childhood history should be watched closely in order to help detect early signs of kidney disease in time to provide effective prevention or treatment. Successful therapy is feasible for advanced CKD in childhood; there is evidence that children fare better than adults, if they receive kidney replacement therapy including dialysis and transplantation, although only a minority of children may require this ultimate intervention. Because there are disparities in access to care, effort is needed so that children with kidney disease, wherever they live, may be treated effectively, irrespective of their geographic or economic circumstances. Our hope is that the World Kidney Day will inform the general public, policy makers and caregivers about the needs and possibilities surrounding kidney disease in childhood.

  15. Averting the legacy of kidney disease – focus on childhood

    Directory of Open Access Journals (Sweden)

    Julie R. Ingelfinger

    2016-03-01

    Full Text Available World Kidney Day 2016 focuses on kidney disease in childhood and the antecedents of adult kidney disease that can begin in earliest childhood. Chronic kidney disease (CKD in childhood differs from that in adults, as the largest diagnostic group amongst children includes congenital anomalies and inherited disorders, with glomerulopathies and kidney disease in the setting of diabetes being relatively uncommon. In addition, many children with acute kidney injury will ultimately develop sequelae that may lead to hypertensionand CKD in later childhood or in adult life. Children born early or who are small-for-date newborns have relatively increased risk for the development of CKD later in life. Persons with a high-risk birth and early childhood history should be watched closely to help to detect early signs of kidney disease in time to provide effective prevention or treatment. Successful therapy is feasible for advanced CKD in childhood; there is evidence that children fare better than adults, if they receive kidney replacement therapy including dialysis and transplantation, whilst only a minority of children may require this ultimate intervention. Because there are disparities in access to care, effort is needed so that children with kidney disease, wherever they live, may be treated effectively, irrespective of their geographic oreconomic circumstances. Our hope is that World Kidney Day will inform the general public, policymakers and caregivers about the needs and possibilities surrounding kidney disease in childhood.

  16. Averting the Legacy of Kidney Disease - Focus on Childhood.

    Science.gov (United States)

    Ingelfinger, Julie R; Kalantar-Zadeh, Kamyar; Schaefer, Franz

    2016-04-01

    World Kidney Day 2016 focuses on kidney disease in childhood and the antecedents of adult kidney disease that can begin in earliest childhood. Chronic kidney disease (CKD) in childhood differs from that in adults, as the largest diagnostic group among children includes congenital anomalies and inherited disorders, with glomerulopathies and kidney disease in the setting of diabetes being relatively uncommon. In addition, many children with acute kidney injury will ultimately develop sequelae that may lead to hypertension and CKD in later childhood or in adult life. Children born early or who are small-for date newborns have relatively increased risk for the development of CKD later in life. Persons with a high-risk birth and early childhood history should be watched closely in order to help detect early signs of kidney disease in time to provide effective prevention or treatment. Successful therapy is feasible for advanced CKD in childhood; there is evidence that children fare better than adults, if they receive kidney replacement therapy including dialysis and transplantation, while only a minority of children may require this ultimate intervention. Because there are disparities in access to care, effort is needed so that those children with kidney disease, wherever they live, may be treated effectively, irrespective of their geographic or economic circumstances. Our hope is that World Kidney Day will inform the general public, policy makers and caregivers about the needs and possibilities surrounding kidney disease in childhood. PMID:27536691

  17. Does electron and proton therapy reduce the risk of radiation induced cancer after spinal irradiation for childhood medulloblastoma? A comparative treatment planning study

    Energy Technology Data Exchange (ETDEWEB)

    Xiangkui Mu; Zackrisson, Bjoern [Umeaa Univ. (Sweden). Dept. of Radiation Sciences; Bjoerk-Eriksson, Thomas; Johansson, Lennart; Karlsson, Mikael [Sahlgrenska Univ. Hospital, Goeteborg (Sweden). Dept. of Oncology; Nill, Simeon; Oelfke, Uwe [DKFZ-Heidelberg, (Germany). Dept. of Medical Physics; Johansson, Karl-Axel [Sahlgrenska Univ. Hospital, Goeteborg (Sweden). Dept. of Therapeutic Radiation Physics; Gagliardi, Giovanna [Radiumhemmet, Stockholm (Sweden). Dept. of Hospital Physics

    2005-09-01

    The aim of this treatment planning comparison study was to explore different spinal irradiation techniques with respect to the risk of late side-effects, particularly radiation-induced cancer. The radiotherapy techniques compared were conventional photon therapy, intensity modulated x-ray therapy (IMXT), conventional electron therapy, intensity/energy modulated electron therapy (IMET) and proton therapy (IMPT). CT images for radiotherapy use from five children, median age 8 and diagnosed with medulloblastoma, were selected for this study. Target volumes and organs at risk were defined in 3-D. Treatment plans using conventional photon therapy, IMXT, conventional electron therapy, IMET and IMPT were set up. The probability of normal tissue complication (NTCP) and the risk of cancer induction were calculated using models with parameters-sets taken from published data for the general population; dose data were taken from dose volume histograms (DVH). Similar dose distributions in the targets were achieved with all techniques but the absorbed doses in the organs-at-risk varied significantly between the different techniques. The NTCP models based on available data predicted very low probabilities for side-effects in all cases. However, the effective mean doses outside the target volumes, and thus the predicted risk of cancer induction, varied significantly between the techniques. The highest lifetime risk of secondary cancers was estimated for IMXT (30%). The lowest risk was found with IMPT (4%). The risks associated with conventional photon therapy, electron therapy and IMET were 20%, 21% and 15%, respectively. This model study shows that spinal irradiation of young children with photon and electron techniques results in a substantial risk of radiation-induced secondary cancers. Multiple beam IMXT seems to be associated with a particularly high risk of secondary cancer induction. To minimise this risk, IMPT should be the treatment of choice. If proton therapy is not

  18. Non-invasive brain stimulation for the treatment of brain diseases in childhood and adolescence: state of the art, current limits and future challenges

    Directory of Open Access Journals (Sweden)

    Carmelo Mario Vicario

    2013-11-01

    Full Text Available In the last decades interest in application of non-invasive brain stimulation for enhancing neural functions is growing continuously. However, the use of such techniques in pediatric populations remains rather limited and mainly confined to the treatment of severe neurological and psychiatric diseases. In this article we provide a complete review of non-invasive brain stimulation studies conducted in pediatric populations. We also provide a brief discussion about the current limitations and future directions in a field of research still very young and full of issues to be explored.

  19. Treatment of non-metastatic rhabdomyosarcomas in childhood and adolescence. Results of the second study of the International Society of Paediatric Oncology: MMT84

    Energy Technology Data Exchange (ETDEWEB)

    Oberlin, O.; Terrier-Lacombe, M.-J. [Institut Gustave-Roussy, Department of Paediatric Oncology, 94805 Villejuif (France); Barrett, A. [Radiotherapy, Beatson Oncology Centre, Western Infirmary, Glasgow (United Kingdom); Martelli, H. [Paediatric Surgery, Hopital Necker, Paris (France); Habrand, J.L. [Institut Gustave-Roussy, Department of Paediatric Oncology, 94805 Villejuif (France); Voute, P.A. [Paediatric Oncology, Emma Kinderziekenhuis, Amsterdam (Netherlands); Otten, J. [Paediatric Oncology, Academisch Ziekenhuis VUB, Brussels (Belgium); Brunat-Mentigny, M. [Paediatric Oncology, Centre Leon Berard, Lyon (France); Theobald, S. [Institut Gustave-Roussy, Department of Paediatric Oncology, 94805 Villejuif (France); Quintana, E. [Paediatric Oncology, Institut Curie, Paris (France); Sommelet, D. [Paediatric Oncology, CHU Nancy (France); Praquin, M.-T.; Rey, A.; Rodary, C.; Flamant, F. [Institut Gustave-Roussy, Department of Paediatric Oncology, 94805 Villejuif (France)

    1998-06-01

    The second International Society of Paediatric Oncology (SIOP) study for rhabdomyosarcoma (MMT84) had several goals. The two principal aimswere: (1) to improve the survival of children with rhabdomyosarcoma; and (2) to reduce the late effects from therapy by restricting the indications for surgery and/or radiotherapy after good response to initial chemotherapy. A further aim was to investigate the role of high-dose chemotherapy in young patients with parameningeal primary tumours. 186 previously untreated eligible patients entered the study. Patients with completely resected primary tumour received three courses of IVA (ifosfamide, vincristine and actinomycin D). Patients with incompletely resected tumour received six to 10 courses of IVA according to stage. Patients achieving complete remission with chemotherapy alone did not usually receive radiotherapy or undergo extensive surgery, but patients remaining in partial remission received local therapy with surgery and/or radiotherapy. Only patients over 5 years of age with parameningeal disease and patients over 12 years with tumours at any site were given systematic irradiation. Complete remission was achieved in 91% (170/186) of all patients. With a median follow-up of 8 years, the 5-year overall survival was 68% ({+-}3% standard error of the mean (SEM)) and the 5-year event-free survival 53% ({+-}4% SEM). These results show an improvement over previous SIOP study (RMS75) in which survival was 52% and event-free survival was 47%. Among the 54 patients who exhibited isolated local relapse, 35% (19/54) survived in further remission longer than 2 years after retreatment, including local therapy (surgery{+-}radiotherapy). Analysis of the overall burden of therapy received by all surviving children (including primary treatment and treatment for relapse if required) showed that 24% (28/116) were treated by limited surgery followed by three courses of IVA, 29% (34/116) were treated by chemotherapy alone (after initial

  20. Treatment of non-metastatic rhabdomyosarcomas in childhood and adolescence. Results of the second study of the International Society of Paediatric Oncology: MMT84

    International Nuclear Information System (INIS)

    The second International Society of Paediatric Oncology (SIOP) study for rhabdomyosarcoma (MMT84) had several goals. The two principal aims were: (1) to improve the survival of children with rhabdomyosarcoma; and (2) to reduce the late effects from therapy by restricting the indications for surgery and/or radiotherapy after good response to initial chemotherapy. A further aim was to investigate the role of high-dose chemotherapy in young patients with parameningeal primary tumours. 186 previously untreated eligible patients entered the study. Patients with completely resected primary tumour received three courses of IVA (ifosfamide, vincristine and actinomycin D). Patients with incompletely resected tumour received six to 10 courses of IVA according to stage. Patients achieving complete remission with chemotherapy alone did not usually receive radiotherapy or undergo extensive surgery, but patients remaining in partial remission received local therapy with surgery and/or radiotherapy. Only patients over 5 years of age with parameningeal disease and patients over 12 years with tumours at any site were given systematic irradiation. Complete remission was achieved in 91% (170/186) of all patients. With a median follow-up of 8 years, the 5-year overall survival was 68% (±3% standard error of the mean (SEM)) and the 5-year event-free survival 53% (±4% SEM). These results show an improvement over previous SIOP study (RMS75) in which survival was 52% and event-free survival was 47%. Among the 54 patients who exhibited isolated local relapse, 35% (19/54) survived in further remission longer than 2 years after retreatment, including local therapy (surgery±radiotherapy). Analysis of the overall burden of therapy received by all surviving children (including primary treatment and treatment for relapse if required) showed that 24% (28/116) were treated by limited surgery followed by three courses of IVA, 29% (34/116) were treated by chemotherapy alone (after initial biopsy