Factors associated with growth disturbance at celiac disease diagnosis in children: a retrospective cohort study.

Science.gov (United States)

Nurminen, Samuli; Kivelä, Laura; Taavela, Juha; Huhtala, Heini; Mäki, Markku; Kaukinen, Katri; Kurppa, Kalle

2015-10-06

Impaired growth is a well-known complication in celiac disease, but factors associated with it are poorly known. We investigated this issue in a large cohort of children. 530 children with biopsy-proven celiac disease were included. The participants were divided into two groups on the basis of the presence (n = 182) or absence (n = 348) of growth disturbance at diagnosis. Histological, serological and clinical characteristics were compared between children with growth failure and those with normal growth. Further, patients with growth failure as the sole clinical presentation were compared to those with poor growth and concomitant other symptoms. Children with growth failure were younger (p celiac antibody (p symptoms (OR 3.4 (1.8-6.7) vs mild symptoms) and vomiting (OR 3.1 (1.5-6.3). The presence of abdominal pain reduced the risk (OR 0.5 (0.3-0.7)), while there was no effect of gender, diarrhea, constipation, other chronic diseases and celiac disease in the family. Children evincing poor growth as the sole clinical presentation were older (p symptoms. In particular young age and severe clinical and histological presentation were associated with growth disturbance at celiac disease diagnosis. Children with only poor growth are markedly different from those with other concomitant symptoms, suggesting different pathogenic mechanisms.

Laterality of cerebral hemispheres on CT scan and gross motor function in severely handicapped children

Energy Technology Data Exchange (ETDEWEB)

Iwasaki, Nobuaki; Hamano, Kenzo; Nakamoto, Natsue; Okada, Yusuke [Tsukuba Univ., Ibaraki (Japan); Takeya, Toshiki

1997-06-01

The relation between brain damage and gross motor function in severely handicapped children (spastic type) was studied. The subjects were fifteen cases with laterality in their cerebral hemisphere CT scans (laterality group) and 28 cases with no laterality (control group). All cases were divided into four groups according to the level of gross motor function. The grade of brain damage was estimated based on CT scan analysis using the following parameters and index: maximum frontal extracerebral space (ES), maximum width of Sylvian fissure (SY), Evans` ratio, and cella media index. In the laterality group, the parameters and index were measured for both cerebral hemispheres, respectively. In the more severely disturbed hemisphere of the laterality group, ES and SY were significantly enlarged compared with those of the cases with the same level of motor function in the control group (p<0.01). In the less severely disturbed hemisphere of the laterality group, the ES, SY, Evans` ratio and cell media index were not significantly enlarged compared to cases with the same level of motor function as the control group. These findings may indicate that gross motor function of severely handicapped children is closely related to the less severely disturbed cerebral hemisphere. (author)

Laterality of cerebral hemispheres on CT scan and gross motor function in severely handicapped children

International Nuclear Information System (INIS)

Iwasaki, Nobuaki; Hamano, Kenzo; Nakamoto, Natsue; Okada, Yusuke; Takeya, Toshiki.

1997-01-01

The relation between brain damage and gross motor function in severely handicapped children (spastic type) was studied. The subjects were fifteen cases with laterality in their cerebral hemisphere CT scans (laterality group) and 28 cases with no laterality (control group). All cases were divided into four groups according to the level of gross motor function. The grade of brain damage was estimated based on CT scan analysis using the following parameters and index: maximum frontal extracerebral space (ES), maximum width of Sylvian fissure (SY), Evans' ratio, and cella media index. In the laterality group, the parameters and index were measured for both cerebral hemispheres, respectively. In the more severely disturbed hemisphere of the laterality group, ES and SY were significantly enlarged compared with those of the cases with the same level of motor function in the control group (p<0.01). In the less severely disturbed hemisphere of the laterality group, the ES, SY, Evans' ratio and cell media index were not significantly enlarged compared to cases with the same level of motor function as the control group. These findings may indicate that gross motor function of severely handicapped children is closely related to the less severely disturbed cerebral hemisphere. (author)

Study on cardiac output in children with orthostatic disturbances measured by the external dilution method with a radioisotope

Energy Technology Data Exchange (ETDEWEB)

Hattori, K [Nippon Medical School, Tokyo

1975-04-01

As one of the studies on circulation dynamics which possibly contributed to orthostatic disturbance, application to children of the external measurement of cardiac output with /sup 131/I labeled human serum albumin was examined. The effect of orthostatic load was then studied by this method on the children with orthostatic disturbances and the patients improving from other diseases, and the following results were obtained: (1) As in the external method with radioisotope, the head of the scintillation detector was easily oriented, and the diversion of orientation was examined by circulation dilution curve, and the cardiac output was easily and safely measured without causing severe pain to the subjects. This method was performed on 40 children in the recumbent position and 27 in orthostatic load, and it was confirmed that the method was fully applicable to the pediatric field. (2) In half of the 20 patients with orthostatic disturbances and 20 control subjects, the cardiac index in the recumbent position was between 3 l/min/m/sup 2/ and 5 l/min/m/sup 2/. Mean cardiac index was 4.45 l/min/m/sup 2/ in male children, while 4.72 l/min/m/sup 2/ in female children. This mean value was the same or a little higher than the reported adult value.

Helping Emotionally Disturbed Children Deal with the Separation Process.

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Kreger, Robert D.; Kreger, Linda R.

1989-01-01

The article presents examples of emotionally disturbed children's reactions to separation from a teacher with whom they have become involved. Suggestions are offered for facilitating healthy separation from the teacher. (JDD)

CONSEQUENCES OF SEVERE TRAUMATIC BRAIN INJURY IN CHILDREN AND THEIR TREATMENT

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N.N. Zavadenko

2006-01-01

Full Text Available Traumatic brain injury is one of the major causes for invalidization in children. The research purpose is an integrated study of consequences of severe and moderate closed traumatic brain injury in children and evaluation of their dynamics during therapy by means of a no tropic medication — cerebrolysin (Ebewe Pharma, Austria. The total of 283 children aged from 4 to 14 years were examined in the longaterm period of severe and moderate closed traumatic brain injury, from 6 months to 4 years after injury. Their neurological status was characterized by nona specific focal symptoms along with evident motor coordination disturbances, elements of dynamic and staticoloa comotory ataxia, reduction in execution speed of serial movements. Statistically significant differences with ageamatched controls were confirmed for measures of acousticaverbal memory and sustained attention. Posttraumatic epilepsy developed in 16 (5,7% patients with the onset of secondarily generalized seizures in 4–12 months following the injury. Effectiveness of the no tropic medication was evaluated in 60 patients aged from 7 to 12 years, who were distributed into 2 equal groups. The research has confirmed a positive effect of no tropic medication in the treatment of traumatic brain injury consequences manifested in the regression of headaches, fatigue, motor coordination disturbances along with improvements of memory, attention, intellectual performance rates, as well as EEG characteristics.Key words: traumatic brain injury, consequences, children, therapy, nootropic medications.

Disturbances in dental development and craniofacial growth in children treated with hematopoietic stem cell transplantation.

Science.gov (United States)

Vesterbacka, M; Ringdén, O; Remberger, M; Huggare, J; Dahllöf, G

2012-02-01

To investigate the correlation between age, degree of disturbances in dental development, and vertical growth of the face in children treated with hematopoietic stem cell transplantation (HSCT). 39 long-term survivors of HSCT performed in childhood and transplanted before the age of 12, at a mean age of 6.8±3.3 years. Panoramic and cephalometric radiographs were taken at a mean age of 16.2 years. For each patient two age- and sex-matched healthy controls were included. The area of three mandibular teeth was measured and a cephalometric analysis was performed. The mean area of the mandibular central incisor, first and second molar was significantly smaller in the HSCT group, and the vertical growth of the face was significantly reduced, especially in the lower third, compared to healthy controls. A statistically significant correlation between age at HSCT, degree of disturbances in dental development, and vertical growth of the face was found. Children subjected to pre-HSCT chemotherapy protocols had significantly more growth reduction in vertical craniofacial variables compared to children without pre-HSCT chemotherapy. Conditioning regimens including busulfan or total body irradiation had similar deleterious effects on tooth area reduction and craniofacial parameters. The younger the child is at HSCT, the greater the impairment in dental and vertical facial development. This supports the suggestion that the reduction in lower facial height found in SCT children mainly is a result of impaired dental development and that young age is a risk factor for more severe disturbances. © 2012 John Wiley & Sons A/S.

MEANINGS OF SPACE OF COTTAGE-TYPE RESIDENTIAL CENTER IN MILIEU THERAPY FOR EMOTIONALLY DISTURBED CHILDREN

OpenAIRE

Ishigaki, Aya; Kanno, Minoru; Onoda, Yasuaki; Sakaguchi, Taiyo

2004-01-01

The number of emotionally disturbed children in Japan has been increasing recently; However, only few attempts with an aim at improving children's living space have been made at treatment centers. We conducted some field surveys on the cottage-type residential center to examine the relationship among space, communication, and the effectiveness of therapy. In addition, to clarify conditions of treatment for children with emotional disturbances, the children's daily life with milieu therapy was...

Assessment of Growth Disturbance in Japanese Children with IBD

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Tetsuo Shono

2010-01-01

Full Text Available In Japan, there is as yet no report on growth retardation in children with IBD. We therefore investigated the cause of growth retardation in Japanese children with IBD. We investigated the height, body weight, serum levels of albumin, IGF-I, CRP, and cytokines, and the amount of corticosteroid administered in children with Crohn's disease (CD, =15 and ulcerative colitis (UC, =18. Our results suggest that growth retardation is already present before the initial visit in children with CD, and chronic inflammation may be responsible this growth disturbance. Moreover, the amount of PSL used may contribute to growth retardation by decreasing the serum levels of IGF-I in children with IBD.

The development and psychometric assessment of a questionnaire to assess sleep and daily troubles in parents of children and young adults with severe psychomotor impairment.

Science.gov (United States)

Tietze, Anna L; Zernikow, Boris; Otto, Michael; Hirschfeld, Gerrit; Michel, Erik; Koh, Michelle; Blankenburg, Markus

2014-02-01

Children with severe psychomotor impairment (SPMI) often experience sleep disturbances that severely distress both the child and his or her parents. Validated questionnaires for the assessment of parents' distress related to their child's sleep disturbances are lacking. We developed and validated a new questionnaire, the HOST (holistic assessment of sleep and daily troubles in parents of children with SPMI) to assess the effect of the sleep disturbances in children with SPMI on their parents. The questionnaire was developed based on published data and expert opinion, and it was refined via direct consultation with affected parents. Its psychometric characteristics were assessed in a sample of parents of 214 children with SPMI. It was retested using a random subsample of the participants. Explorative factor analysis revealed that the HOST was composed of four scales. Fit indices, item analysis, and convergent validity (coherence with preexisting instruments of sleep disturbances and health status) were adequate. Retest analysis (n=62) revealed high stability of the HOST questionnaire and adequate replication validity. Sleep-related difficulties significantly impact the sociomedical characteristics of the parents of children with complex neurologic diseases. Typically, parents are severely affected in various aspects of daily life (i.e., medical health, social life, professional life). The HOST proved to be a valid, reliable and economical assessment tool of sleep-related difficulties in parents and relatives of children with SPMI. The HOST is capable of identifying individuals and specific areas requiring intervention. Copyright © 2013 Elsevier B.V. All rights reserved.

[Sleep disturbances in children with autistic spectrum disorders].

Science.gov (United States)

Kelmanson, I A

2015-01-01

An association between sleep disorders and autistic spectrum disorders in children is considered. Characteristic variants of sleep disorders, including resistance to going to bed, frequent night awakenings, parasomnias, changes in sleep structure, primarily, the decrease in the percentage of rapid eye movement sleep, are presented. Attention is focused on the possibility of the direct relationship between sleep disturbance and the pathogenesis of autistic spectrum disorders. A role of pathological alterations in the production of neuromediators and morphological changes in the brain structures characteristic of autistic spectrum disorders in the genesis of sleep disorders in children is discussed. Possible non-pharmacological and pharmacological approaches are suggested.

Prevalence and severity of sleep disturbances among patients with early breast cancer

Directory of Open Access Journals (Sweden)

Rami Fakih

2018-01-01

Full Text Available Context: Data regarding health-related quality of life in breast cancer patients in the Middle East are limited with fatigue and sleep disturbance being the most distressing symptoms reported by patients treated for early breast cancer. Aims: The aim of this study was to examine the prevalence and incidence of insomnia among patients with early-stage breast cancer patients treated with chemotherapy. Subjects and Methods: This was a prospective cohort study. We enrolled patients with stage I-III breast cancer patients treated with chemotherapy at the American University of Beirut Medical Center. At three different time points (prior to, during, and following chemotherapy, we assessed the severity of sleep disturbances using the Pittsburgh Sleep Quality Index and the Insomnia Severity Index. The Institution Review Board approved the study. Results: Fifty-two patients were recruited. There was a significant increase in sleep disturbances during chemotherapy which improved to below baseline levels on completion of therapy. Prior to chemotherapy, 36% of patients reported poor sleep versus 58% during chemotherapy. The percentage of patients reporting clinical insomnia rose from 11% pretreatment to 36% during chemotherapy reflecting a significant symptomatic burden that is poorly documented and managed in routine clinical practice. Conclusions: Patients with nonmetastatic breast cancer experience an increase in sleep disturbances during the treatment phase. Physicians should be aware of the need to routinely screen for sleep disturbance in breast cancer patients undergoing chemotherapy.

Effects of different types of moderate severity disturbance on forest structural complexity and ecosystem functioning: A story of ice and fire

Science.gov (United States)

Fahey, R. T.; Atkins, J.; Gough, C. M.; Hardiman, B. S.; Haber, L.; Stuart-Haentjens, E.; David, O.; Campbell, J. L.; Rustad, L.; Duffy, M.

2017-12-01

Disturbances that alter the structure and function of forest ecosystems occur along a continuum of severity. In contrast to the extremes of the disturbance gradient (i.e., stand-replacing disturbance and small gap formation), moderate severity disturbances are poorly understood, even though they make up the majority of the gradient and their spatial extent (and likely overall importance to regional disturbance regimes) often exceeds that of more severe disturbances. Moderate severity disturbances originate from a variety of causes, such as fires, ice storms, or pest and pathogen outbreaks, and each of these could reshape structure and function in different ways. Observational data from a limited number of sites shows that moderate disturbance can increase ecosystem complexity, but the generality of this effect has not been tested across a broad range of disturbance types and severities. Here, we utilize data from a set of five case studies of experimental or natural moderate disturbance to assess the effects of different types and severities of disturbance on forest canopy structural complexity (CSC) and the relationship of canopy structure with ecosystem functioning. Using pre- and post-disturbance measures of CSC derived from aerial and terrestrial LiDAR, UAV imagery, and Landsat data we quantified changes in CSC following an experimental ice storm, a low-severity surface fire, Beech Bark Disease and Hemlock Wooly Adelgid outbreaks, and experimental accelerated succession. Our initial findings indicate that different disturbance types have highly variable effects on CSC, and also that progressive increases in disturbance severity alter CSC differently among disturbance types. Differential effects of variable disturbance types on CSC has implications for the carbon cycle, as forest structure is strongly linked with both growth-limiting resource (e.g., nutrients and light) acquisition and net primary productivity. Understanding how different types and severities of

Factors associated with positive adjustment in siblings of children with severe emotional disturbance: the role of family resources and community life.

Science.gov (United States)

Kilmer, Ryan P; Cook, James R; Munsell, Eylin Palamaro; Salvador, Samantha Kane

2010-10-01

This study builds on the scant research involving siblings of children with severe emotional disturbances (SED) and examines: associations between adversity experiences and adjustment among 5- to 10-year-old siblings, and relations among family resources, community life, and sibling adjustment. Caregivers from 100 families completed standardized indicators of sibling adjustment and scales reflecting multiple contextual variables. Results document negative associations between stress exposure and sibling adjustment. Regression models also indicate positive associations between the caregiver-child relationship and broader family resources on sibling behavioral and emotional strengths, even after accounting for adversity experiences; adversity exposure was the prime correlate in regression models involving sibling oppositional behavior. Analyses also suggest that strain related to parenting a child with SED is associated with sibling adjustment. This work documents the needs of these siblings and their family systems and highlights the relevance of not only core proximal influences (e.g., child-caregiver relationship) but also elements of their broader contexts. Implications and recommendations are described, including the need to support plans of care that involve services, supports, or preventive strategies for these siblings. © 2010 American Orthopsychiatric Association.

Enamel defect of primary dentition in SGA children in relation to onset time of intrauterine growth disturbance

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Willyanti Soewondo Sjarif

2013-06-01

Full Text Available Background: Prenatal disturbances disturb the development of organs resulting in small for gestational age (SGA babies and also causes enamel defects in primary teeth. There are disturbances occur in the beginning of pregnancy causing symmetrical SGA, and asymmetrical type of SGA, where the disturbances occur late in pregnancy. Purpose: This research was to determined differences in severity of enamel defect of primary dentition in small for gestational age children based on the time of intrauterine growth restriction. Methods: This was a clinical epidemiological cohort study. The Ponderal index was used to determine SGA type. The subjects were 129 SGA children aged 9-42 months, 82 with asymmetrical SGA and 47 with symmetrical SGA. Two hundred normal birth weight children were the control group. Intra-oral examinations to determine enamel defect used the FDI modification of the Developmental Defect of Enamel score at 3 months intervals. Statistical t-tests were used to test the difference in severity of enamel defect, and chisquare to find out the difference of Relative Risk Ratio (RRR. Results: The results showed that the enamel defect scores of symmetrical SGA were significantly higher than those with asymmetrical SGA. RRR for severe defect was also significantly higher in symmetrical type for anterior and canines. Conclusion: The study suggested that the severity of enamel defect for infants with symmetrical SGA was higher than those with asymmetrical SGA, indicating that the severity of the defect occurs in the beginning of pregnancy is more severe than in the late pregnancy.Latar belakang: Adanya gangguan prenatal mengganggu perkembangan organ, mengakibatkan terjadinya bayi lahir dengan kecil masa kehamilan (KMK dan defek email pada gigi sulung. Terdapat 2 tipe KMK yaitu tipe simetri; gangguan terjadi pada awal kehamilan; dimana lingkar kepala, berat dan panjang lahir lebih rendah dari normal. Tipe asimetri dimana gangguan terjadi saat

Sleep Disturbance in Children with Rett Syndrome: A Qualitative Investigation of the Parental Experience

Science.gov (United States)

McDougall, Allyson; Kerr, Alison M.; Espie, Colin A.

2005-01-01

Background: Sleep problems in children with intellectual disability can be precipitated and maintained by intrinsic and external factors. The present study comprised a qualitative investigation of the experiences of parents of children with Rett syndrome, a neurodevelopmental disorder where sleep disturbance is common. Method: Audio-taped…

B. Radiologic-pathologic correlation of disturbed growth in children

International Nuclear Information System (INIS)

Borns, P.F.; Borden, S. IV.

1987-01-01

The second part of the course concentrates on the growing metaphysis in children as an indicator of bone growth and physiology. The authors concentrate on growth disturbances that cause abnormalities of metaphyseal contour, growth velocity, and width of the metaphysis. Densities within the metaphysis, including growth arrest lines, healing metaphyseal fractures, catch-up bone growth, and metabolic poisons, are addressed in detail. Radiographs with accompanying histopathologic sections are presented to illustrate the dynamic changes in the metaphyseal region in children. Lucencies in the metaphysis, including leukemic lines, metastatic disease, and acute disuse osteoporosis, receive special attention. Prognostic factors affecting the metasphysis such as intrinsic chondrodysplasia, previous fracture, or closure of the epiphyseal plate are described in detail

[Children of mentally ill parents: the impact of parental psychiatric diagnosis, comorbidity, severity and chronicity on the well-being of children].

Science.gov (United States)

Wiegand-Grefe, S; Geers, P; Petermann, F; Plass, A

2011-01-01

Children of mentally ill parents are known as a high-risk population for the development of psychological disturbances. In this study, the psychiatric diagnoses, the severity and chronicity and the comorbidity of a parental mental illness as well as the non-specific parameters were examined in terms of their influence on the children's mental health. n = 62 children of psychiatric inpatients were examined regarding their psychic symptomatology, assessed with the CBCL-Parent Report Form. The psychiatric ICD-10 diagnoses and comorbidities as well as the severity (CGI) of the mentally ill parents were collected from psychiatric assessment forms. Children of parents with personality disorders (PD) are evaluated as highly affected by their parents, regardless of whether the PD is the primary or the comorbid diagnosis. Children of parents suffering from addictive disorders are seen as the least affected by their parents. Overall, children of parents with multiple diagnoses tend to be rated as more affected. Severity of illness and chronicity do not have a considerable impact on the children's development of mental health problems. Strikingly, children with a high length of exposure to a parental illness are psychologically less affected than children with shorter times of exposure. Thus, children possibly acquire effective coping mechanisms with increasing time of exposure. The results reveal the necessity of preventive programmes, especially in case of personality disorders. In addition the necessity for external assessment of the children becomes clear, especially in those cases where the parents exhibit a poor acceptance of their disease. © Georg Thieme Verlag KG Stuttgart · New York.

Sleep disturbances in 50 children with attention-deficit hyperactivity disorder

OpenAIRE

Neves, Sergio Nolasco Hora das; Reimão, Rubens

2007-01-01

OBJECTIVE: This study assesses the relationship between sleep disturbances (SD) and attention-deficit and hyperactivity disorder (ADHD) to characterize clinical features and associated problems. METHOD: The medical records of 50 children and adolescents ranging in age from 4 to 17 years with ADHD without the diagnosis of mental retardation or pervasive developmental disorders were reviewed. RESULTS: Significant relationships were found between SD and drug therapy (p

Sleep Disturbances in Neurodevelopmental Disorders.

Science.gov (United States)

Robinson-Shelton, Althea; Malow, Beth A

2016-01-01

Sleep disturbances are extremely prevalent in children with neurodevelopmental disorders compared to typically developing children. The diagnostic criteria for many neurodevelopmental disorders include sleep disturbances. Sleep disturbance in this population is often multifactorial and caused by the interplay of genetic, neurobiological and environmental overlap. These disturbances often present either as insomnia or hypersomnia. Different sleep disorders present with these complaints and based on the clinical history and findings from diagnostic tests, an appropriate diagnosis can be made. This review aims to provide an overview of causes, diagnosis, and treatment of sleep disturbances in neurodevelopmental disorders that present primarily with symptoms of hypersomnia and/or insomnia.

Sleep habits and sleep disturbances in Dutch children: a population-based study

NARCIS (Netherlands)

van Litsenburg, R.R.L.; Waumans, R.C.; van den Berg, G.; Gemke, R.J.B.J.

2010-01-01

Sleep disorders can lead to significant morbidity. Information on sleep in healthy children is necessary to evaluate sleep disorders in clinical practice, but data from different societies cannot be simply generalized. The aims of this study were to (1) assess the prevalence of sleep disturbances in

Subjective sleep disturbances in children with partial epilepsy and their effects on quality of life

NARCIS (Netherlands)

Gutter, Th; Brouwer, O. F.; de Weerd, A. W.

Purpose: The purposes of this study were to explore the prevalence of sleep disturbances in a large cohort of school-aged children with partial epilepsy, to compare the findings with those in children without epilepsy of the same age and gender, and to evaluate the relationship between sleep

Severe Anemia in Malawian Children

NARCIS (Netherlands)

Calis, J.C.J.; Kamija, S.P.; Faragher, E.B.; Brabin, B.J.; Bates, I.; Cuevas, L.E.; Haan, de R.J.; Phiri, A.I.; Malange, P.; Khoka, M.; Hulshof, P.J.M.; Lieshout, L.; Beld, M.G.H.M.; Teo, Y.Y.; Rockett, K.A.; Richardson, A.; Kwiatkowski, D.P.; Molyneux, M.E.; Hensbroek, van M.B.

2008-01-01

Background Severe anemia is a major cause of sickness and death in African children, yet the causes of anemia in this population have been inadequately studied. Methods We conducted a case¿control study of 381 preschool children with severe anemia (hemoglobin concentration,

Facial morphology in children and adolescents with juvenile idiopathic arthritis and moderate to severe temporomandibular joint involvement

DEFF Research Database (Denmark)

Hsieh, Yuh-Jia; Darvann, Tron Andre; Hermann, Nuno V.

2016-01-01

Introduction: The aims of this study were to (1) assess lateral facial morphology in children and adolescents with juvenile idiopathic arthritis and moderate to severe temporomandibular joint (TMJ) involvement, (2) compare the lateral facial morphology of these subjects with and without TMJ...... morphologies between the groups. Lateral projections of oriented 3D photographs were superimposed on the lateral cephalograms. The results of the lateral 3D photographic analysis were correlated with those of lateral cephalometric analysis. Results: Group 3 showed the most severe growth disturbances, including...

Border-line neuro psychic disturbances in children and teenagers living on the territory contaminated with radionuclides

International Nuclear Information System (INIS)

Bazyl'chik, S. V.

1993-01-01

Spread of the border-line neuro psychic disturbances in children and teenagers aged 10-16 living in the districts contaminated with radionuclides was studied. A marked increase of psychic disturbances, particularly in girls, attributed to the growth of neurotic and neurosis-like disorders as compared with the control group was revealed. Asthenic type disorders prevailed in derangement structure. 7 refs., 1 tab

Cardiometabolic risk is associated with the severity of sleep-disordered breathing in children with obesity.

Science.gov (United States)

Isacco, Laurie; Roche, Johanna; Quinart, Sylvain; Thivel, David; Gillet, Valérie; Nègre, Véronique; Mougin, Fabienne

2017-03-01

The alarming progression of pediatric obesity is associated with the development of sleep-disordered breathing (SDB), and both exhibit similar adverse cardiometabolic health outcomes. Physical activity level (PAL) may counteract sleep and metabolic disturbances. The present study investigates i) the association between the metabolic syndrome in childhood obesity and SDB, ii) the impact of SDB severity on cardiometabolic risk scores and PAL in children with obesity. Maturation status (Tanner stages), anthropometric (height, weight, body mass index, waist circumference, body adiposity index) and cardiometabolic characteristics (systolic and diastolic blood pressure, lipid and glycemic profiles) were assessed in 83 obese children (mean±SD, age: 10.7±2.7years). PAL and SDB were investigated with a step test and interviews, and an overnight sleep monitor, respectively. The presence or absence of metabolic syndrome (MS) was established and continuous cardiometabolic risk scores were calculated (MetScore BMI and MetScore WC ). Obese children with (61.4%) and without (38.6%) MS present similar SDB. SDB severity is associated with increased insulin concentrations, MetScore BMI and MetScore WC (pobese children. There is no association between SDB and PAL. In a context where no consensus exists for SDB diagnosis in children, our results suggest the influence of SDB severity on cardiometabolic risk factors. Further studies are needed to explore the association between PAL and both metabolic and sleep alterations in obese children. Copyright © 2016 Elsevier Inc. All rights reserved.

Severe anemia in Malawian children

NARCIS (Netherlands)

Calis, Job C. J.; Phiri, Kamija S.; Faragher, E. Brian; Brabin, Bernard J.; Bates, Imelda; Cuevas, Luis E.; de Haan, Rob J.; Phiri, Ajib I.; Malange, Pelani; Khoka, Mirriam; Hulshof, Paul J. M.; van Lieshout, Lisette; Beld, Marcel G. H. M.; teo, Yik Y.; Rockett, Kirk A.; Richardson, Anna; Kwiatkowski, Dominic P.; Molyneux, Malcolm E.; Boele van Hensbroek, Michael

2008-01-01

Background Severe anemia is a major cause of sickness and death in African children, yet the causes of anemia in this population have been inadequately studied. Methods We conducted a case-control study of 381 preschool children with severe anemia (hemoglobin concentration, <5.0 g per deciliter) and

Severe anemia in Malawian children

NARCIS (Netherlands)

Calis, Job Cj; Phiri, Kamija S.; Faragher, E. Brian; Brabin, Bernard J.; Bates, Imelda; Cuevas, Luis E.; de Haan, Rob J.; Phiri, Ajib I.; Malange, Pelani; Khoka, Mirriam; Hulshof, Paul Jm; van Lieshout, Lisette; Beld, Marcel Ghm; teo, Yik Y.; Rockett, Kirk A.; Richardson, Anna; Kwiatkowski, Dominic P.; Molyneux, Malcolm E.; van Hensbroek, Michaël Boele

2016-01-01

Severe anemia is a major cause of sickness and death in African children, yet the causes of anemia in this population have been inadequately studied. We conducted a case-control study of 381 preschool children with severe anemia (hemoglobin concentration, <5.0 g per deciliter) and 757 preschool

Severe anemia in Malawian children.

Science.gov (United States)

Calis, Job Cj; Phiri, Kamija S; Faragher, E Brian; Brabin, Bernard J; Bates, Imelda; Cuevas, Luis E; de Haan, Rob J; Phiri, Ajib I; Malange, Pelani; Khoka, Mirriam; Hulshof, Paul Jm; van Lieshout, Lisette; Beld, Marcel Ghm; Teo, Yik Y; Rockett, Kirk A; Richardson, Anna; Kwiatkowski, Dominic P; Molyneux, Malcolm E; van Hensbroek, Michaël Boele

2016-09-01

Severe anemia is a major cause of sickness and death in African children, yet the causes of anemia in this population have been inadequately studied. We conducted a case-control study of 381 preschool children with severe anemia (hemoglobin concentration, <5.0 g per deciliter) and 757 preschool children without severe anemia in urban and rural settings in Malawi. Causal factors previously associated with severe anemia were studied. The data were examined by multivariate analysis and structural equation modeling. Bacteremia (adjusted odds ratio, 5.3; 95% confidence interval [CI], 2.6 to 10.9), malaria (adjusted odds ratio, 2.3; 95% CI, 1.6 to 3.3), hookworm (adjusted odds ratio, 4.8; 95% CI, 2.0 to 11.8), human immunodeficiency virus infection (adjusted odds ratio, 2.0; 95% CI, 1.0 to 3.8), the G6PD -202/-376 genetic disorder (adjusted odds ratio, 2.4; 95% CI, 1.3 to 4.4), vitamin A deficiency (adjusted odds ratio, 2.8; 95% CI, 1.3 to 5.8), and vitamin B 12 deficiency (adjusted odds ratio, 2.2; 95% CI, 1.4 to 3.6) were associated with severe anemia. Folate deficiency, sickle cell disease, and laboratory signs of an abnormal inflammatory response were uncommon. Iron deficiency was not prevalent in case patients (adjusted odds ratio, 0.37; 95% CI, 0.22 to 0.60) and was negatively associated with bacteremia. Malaria was associated with severe anemia in the urban site (with seasonal transmission) but not in the rural site (where malaria was holoendemic). Seventy-six percent of hookworm infections were found in children under 2 years of age. There are multiple causes of severe anemia in Malawian preschool children, but folate and iron deficiencies are not prominent among them. Even in the presence of malaria parasites, additional or alternative causes of severe anemia should be considered.

Metabolic Disturbances in Children with Chronic Liver Disease

Directory of Open Access Journals (Sweden)

A Rezaeian

2014-04-01

Full Text Available Introduction: Liver disease results in complex pathophysiologic disturbances affecting nutrient digestion, absorption, distribution, storage, and use. This article aimed to present a classification of metabolic disturbances in chronic liver disease in children?   Materials and Methods: In this review study databases including proquest, pubmedcentral, scincedirect, ovid, medlineplus were been searched with keyword words such as” chronic liver disease"  ” metabolic disorder””children” between 1999 to 2014. Finally, 8 related articles have been found.   Results: Metabolic disorder in this population could be categorized in four set: 1carbohydrates, 2proteins,3 fats and 4vitamins. 1 Carbohydrates: Children with CLD are at increased risk for fasting hypoglycemia, because the capacity for glycogen storage and gluconeogenesis is reduced as a result of abnormal hepatocyte function and loss of hepatocyte mass. 2 Proteins: The liver’s capacity for plasma protein synthesis is impaired by reduced substrate availability, impaired hepatocyte function, and increased catabolism. This results in hypoalbuminemia, leading to peripheral edema and contributing to ascites. Reduced synthesis of insulin-like growth factor (IGF-1 and its binding protein IGF-BP3 by the chronically diseased liver results in growth hormone resistance and may contribute to the poor growth observed in these children. 3 Fats: There is increased fat oxidation in children with end-stage liver disease in the fed and fasting states compared with controls, which is probably related to reduced carbohydrate availability. The increased lipolysis results in a decrease in fat stores, which may not be easily replenished in the setting of the fat malabsorption that accompanies cholestasis. Reduced bile delivery to the gut results in impaired fat emulsification, and hence digestion. The products of fat digestion are also poorly absorbed, because bile is also required for micelle formation

No objectively measured sleep disturbances in children with attention-deficit/hyperactivity disorder.

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Bergwerff, Catharina E; Luman, Marjolein; Oosterlaan, Jaap

2016-10-01

The main goal of this study was to gain more insight into sleep disturbances in children with attention-deficit/hyperactivity disorder, using objective measures of sleep quality and quantity. The evidence for sleep problems in children with attention-deficit/hyperactivity disorder thus far is inconsistent, which might be explained by confounding influences of comorbid internalizing and externalizing problems and low socio-economic status. We therefore investigated the mediating and moderating role of these factors in the association between attention-deficit/hyperactivity disorder and sleep problems. To control for the effects of stimulant medication use, all participants were tested free of medication. Sixty-three children with attention-deficit/hyperactivity disorder and 61 typically developing children, aged 6-13 years, participated. Sleep was monitored for one to three school nights using actigraphy. Parent and teacher questionnaires assessed symptoms of attention-deficit/hyperactivity disorder, internalizing behaviour, oppositional defiant disorder and conduct disorder. Results showed no differences between the attention-deficit/hyperactivity disorder and typically developing group in any sleep parameter. Within the attention-deficit/hyperactivity disorder group, severity of attention-deficit/hyperactivity disorder symptoms was not related to sleep quality or quantity. Moderation analyses in the attention-deficit/hyperactivity disorder group showed an interaction effect between attention-deficit/hyperactivity disorder symptoms and internalizing and externalizing behaviour on total sleep time, time in bed and average sleep bout duration. The results of our study suggest that having attention-deficit/hyperactivity disorder is not a risk factor for sleep problems. Internalizing and externalizing behaviour moderate the association between attention-deficit/hyperactivity disorder and sleep, indicating a complex interplay between psychiatric symptoms and sleep. �

Sleep disturbance in family caregivers of children who depend on medical technology: A systematic review.

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Keilty, Krista; Cohen, Eyal; Ho, Michelle; Spalding, Karen; Stremler, Robyn

2015-01-01

Society relies on family caregivers of children who depend on medical technology (e.g. mechanical ventilation), to provide highly skilled and vigilant care in their homes 24 hours per day. Sleep disturbance is among the most common complaints of these caregivers. The purpose of this review is to systematically examine studies reporting on sleep outcomes in family caregivers of technology dependent children. All relevant databases were systematically searched: MEDLINE, EMBASE, PsycINFO and CINAHL. Given the heterogeneity of the studies, a qualitative analysis was completed and thus results of this review are presented as a narrative. Thirteen studies were retrieved that met eligibility criteria for inclusion. All of the studies reported on family caregivers of children with medical complexity living at home. Moreover, all of the studies relied entirely on self-report, not objective sleep measures. No intervention studies were found. Sleep disturbance was found to be common (51-100%) along with caregiver reports of poor sleep quality. Sleep quantity was seldom measured, but was found in the few studies that did, to be approximately 6 hours, or less than recommendations for optimal health and daytime function. Multiple caregiver, child and environmental factors were also identified that may negatively influence caregiver sleep, health and daytime function. Findings of this review suggest that family caregivers of children with medical complexity who depend on medical technology achieve poor sleep quality and quantity that may place them at risk of the negative consequences of sleep deprivation. Recommendations for practice include that health care providers routinely assess for sleep disturbance in this vulnerable population. The review also suggests that studies using objective sleep measurement are needed to more fully characterize sleep and inform the development of targeted interventions to promote sleep in family caregivers of technology dependent children.

Radioimmunological determination of somatomedin B in healthy children and in children with growth disturbances

International Nuclear Information System (INIS)

Wirth, S.; Schoenberger, W.; Roth, A.; Grimm, W.

1983-01-01

Serum somatomedin B levels were determined by radioimmunoassay in 209 helthy boys and girls from one month to 16 years of age. Low values were found up to the second year life. In the first year the mean level was 13.8 mg/l in girls and 11.5 mg/l in boys. In older children the values increased to levels between 13 and 22 mg/l in boys and between 13 and 18.5 mg/l in girls. They were independent of the stage of pubertal development. Somatomedin B levels were normal in 71 children with constitutional growth delay, primordial dwarfism, familial dwarfism and other forms of growth disturbance. The mean levels were between 12.1 and 14.4 mg/l. Values below 6 mg/l were present only in children with hGH deficiency. In these patients we could find an increase of the mean level from 4.3 mg/l without therapy to 9.4 mg/l under treatment. Thus the determination of somatomedin B seems to be useful for the diagnosis of hGH deficiency. (author)

Radioimmunological determination of somatomedin B in healthy children and in children with growth disturbances

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Wirth, S.; Schoenberger, W.; Roth, A.; Grimm, W. (Children' s Hospital and Department of Clinical Radiologie, Johannes Gutenberg-Universitaet Mainz, FRG)

1983-01-01

Serum somatomedin B levels were determined by radioimmunoassay in 209 healthy boys and girls from one month to 16 years of age. Low values were found up to the second year life. In the first year the mean level was 13.8 mg/l in girls and 11.5 mg/l in boys. In older children the values increased to levels between 13 and 22 mg/l in boys and between 13 and 18.5 mg/l in girls. They were independent of the stage of pubertal development. Somatomedin B levels were normal in 71 children with constitutional growth delay, primordial dwarfism, familial dwarfism and other forms of growth disturbance. The mean levels were between 12.1 and 14.4 mg/l. Values below 6 mg/l were present only in children with hGH deficiency. In these patients we could find an increase of the mean level from 4.3 mg/l without therapy to 9.4 mg/l under treatment. Thus the determination of somatomedin B seems to be useful for the diagnosis of hGH deficiency.

Disturbances in dental development after total body irradiation in bone marrow transplant recipients

International Nuclear Information System (INIS)

Dahlloef, G.B.; Barr, M.; Bolme, P.; Modeer, T.; Loennqvist, B.R.; Ringden, O.; Heimdahl, A.

1988-01-01

The dental status of 16 children who had been treated with bone marrow transplantation (BMT) for serious bone marrow diseases was followed for up to 6 years. Several types of disturbances in dental development were observed in children who had been conditioned with total body irradiation (TBI) at 10 Gy before BMT. Thus, impaired root development that caused short V-shaped roots was found in all patients, a complete failure of root development and premature apical closure were found in five patients, enamel hypoplasia was observed in four patients, and microdontia was observed in three patients conditioned with TBI. Patients younger than 6 years of age at BMT exhibited the most severe and extensive dental aberrations. The TBI at 10 Gy appeared to be the major cause of the disturbances found

Disturbance hydrology: Preparing for an increasingly disturbed future

Science.gov (United States)

Mirus, Benjamin B.; Ebel, Brian A.; Mohr, Christian H.; Zegre, Nicolas

2017-01-01

This special issue is the result of several fruitful conference sessions on disturbance hydrology, which started at the 2013 AGU Fall Meeting in San Francisco and have continued every year since. The stimulating presentations and discussions surrounding those sessions have focused on understanding both the disruption of hydrologic functioning following discrete disturbances, as well as the subsequent recovery or change within the affected watershed system. Whereas some hydrologic disturbances are directly linked to anthropogenic activities, such as resource extraction, the contributions to this special issue focus primarily on those with indirect or less pronounced human involvement, such as bark-beetle infestation, wildfire, and other natural hazards. However, human activities are enhancing the severity and frequency of these seemingly natural disturbances, thereby contributing to acute hydrologic problems and hazards. Major research challenges for our increasingly disturbed planet include the lack of continuous pre- and post-disturbance monitoring, hydrologic impacts that vary spatially and temporally based on environmental and hydroclimatic conditions, and the preponderance of overlapping or compounding disturbance sequences. In addition, a conceptual framework for characterizing commonalities and differences among hydrologic disturbances is still in its infancy. In this introduction to the special issue, we advance the fusion of concepts and terminology from ecology and hydrology to begin filling this gap. We briefly explore some preliminary approaches for comparing different disturbances and their hydrologic impacts, which provides a starting point for further dialogue and research progress.

Sleep and gastrointestinal disturbances in autism spectrum disorder in children.

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Klukowski, Mark; Wasilewska, Jolanta; Lebensztejn, Dariusz

2015-01-01

Autism spectrum disorder (ASD), a neurodevelopmental disorder with a prevalence of 1 in 68 children, commonly presents with comorbid conditions which include sleep disorders. Sleep disorders reported in ASD include, among others, increased bedtime resistance, insomnia, parasomnia, sleep disordered breathing, morning rise problems, and daytime sleepiness. Polysomnography studies show that children with ASD have altered sleep architecture including shorter total sleep time and longer sleep latency than typically developing peers. Sleep-related problems have been shown to affect overall autism scores, social skills decits, stereotypic behavior, and cognitive performance. Additionally, problematic sleep in children with ASD has been associated with higher levels of parental stress. Underlying causes specically related to sleep disorders are not fully known. Gastrointestinal (GI) disorders are commonly associated with sleep problems in these patients. Children with ASD and GI symptoms have been found to have a higher prevalence of sleep disturbances compared with typically developing peers who do not have GI symptoms. Treatment approaches to children with sleep disorders are varied and range from lifestyle modications and behavioral interventions to drug therapies and surgical interventions. Physicians should take into account GI disorders as possible underlying causes of sleep-related problems in children with ASD. Therapeutic interventions should begin with less invasive methods before progressing to more invasive options such as pharmacotherapy and should be based on medical indications in order to provide effective care while minimizing potential adverse health effects. Evidence-based studies concerning GI and sleep disorders in children with ASD are limited and further studies are warranted.

Clinical trial: esomeprazole for moderate-to-severe nighttime heartburn and gastro-oesophageal reflux disease-related sleep disturbances.

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Johnson, D; Crawley, J A; Hwang, C; Brown, K

2010-07-01

Nighttime heartburn, common among patients with gastro-oesophageal reflux disease (GERD), is associated with substantial clinical effects. GERD-related sleep disturbances are underappreciated and undertreated. To evaluate the efficacy of esomeprazole on GERD-related nighttime heartburn and associated sleep disturbances. In this multicentre, randomized, double-blind, placebo-controlled study, patients with moderate-to-severe nighttime heartburn and GERD-related sleep disturbances (endoscopies not required) received esomeprazole 20 mg or placebo each morning for 4 weeks. Heartburn symptoms and GERD-related sleep disturbances were evaluated using the validated Pittsburgh Sleep Quality Index and validated Work Productivity and Activity Impairment Questionnaire. The analysis included 262 patients (esomeprazole, n = 137; placebo, n = 125). Significantly more patients receiving esomeprazole achieved nighttime heartburn relief (primary end point) than those receiving placebo (34.3% vs. 10.4%; P heartburn and GERD-related sleep disturbances, improving heartburn symptoms, sleep quality, work productivity and functionality.

THE THERAPEUTIC EFFECT OF ENVIRONMENT ON EMOTIONALLY DISTURBED AND MENTALLY SUBNORMAL CHILDREN. A KAUFMANN INTERNATIONAL DESIGN AWARD STUDY, 1964-66.

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BAYES, KENNETH

CURRENT RESEARCH AND THOUGHT ON THE EFFECTS OF ARCHITECTURAL FORM AND COLOR IN THE TREATMENT OF EMOTIONALLY DISTURBED AND RETARDED CHILDREN ARE SURVEYED IN THIS PUBLICATION. TO A LESSER EXTENT, IT COVERS THE RELATIONSHIP OF THERAPY TO BEHAVIOR, NORMAL CHILDREN TO HANDICAPPED CHILDREN, NORMAL ADULTS TO MENTAL PATIENTS, AND CHILDREN TO ADULTS.…

Impaired carbohydrate digestion and transport and mucosal dysbiosis in the intestines of children with autism and gastrointestinal disturbances.

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Williams, Brent L; Hornig, Mady; Buie, Timothy; Bauman, Margaret L; Cho Paik, Myunghee; Wick, Ivan; Bennett, Ashlee; Jabado, Omar; Hirschberg, David L; Lipkin, W Ian

2011-01-01

Gastrointestinal disturbances are commonly reported in children with autism, complicate clinical management, and may contribute to behavioral impairment. Reports of deficiencies in disaccharidase enzymatic activity and of beneficial responses to probiotic and dietary therapies led us to survey gene expression and the mucoepithelial microbiota in intestinal biopsies from children with autism and gastrointestinal disease and children with gastrointestinal disease alone. Ileal transcripts encoding disaccharidases and hexose transporters were deficient in children with autism, indicating impairment of the primary pathway for carbohydrate digestion and transport in enterocytes. Deficient expression of these enzymes and transporters was associated with expression of the intestinal transcription factor, CDX2. Metagenomic analysis of intestinal bacteria revealed compositional dysbiosis manifest as decreases in Bacteroidetes, increases in the ratio of Firmicutes to Bacteroidetes, and increases in Betaproteobacteria. Expression levels of disaccharidases and transporters were associated with the abundance of affected bacterial phylotypes. These results indicate a relationship between human intestinal gene expression and bacterial community structure and may provide insights into the pathophysiology of gastrointestinal disturbances in children with autism.

Disturbance Hydrology: Preparing for an Increasingly Disturbed Future

Science.gov (United States)

Mirus, Benjamin B.; Ebel, Brian A.; Mohr, Christian H.; Zegre, Nicolas

2017-12-01

This special issue is the result of several fruitful conference sessions on disturbance hydrology, which started at the 2013 AGU Fall Meeting in San Francisco and have continued every year since. The stimulating presentations and discussions surrounding those sessions have focused on understanding both the disruption of hydrologic functioning following discrete disturbances, as well as the subsequent recovery or change within the affected watershed system. Whereas some hydrologic disturbances are directly linked to anthropogenic activities, such as resource extraction, the contributions to this special issue focus primarily on those with indirect or less pronounced human involvement, such as bark-beetle infestation, wildfire, and other natural hazards. However, human activities are enhancing the severity and frequency of these seemingly natural disturbances, thereby contributing to acute hydrologic problems and hazards. Major research challenges for our increasingly disturbed planet include the lack of continuous pre and postdisturbance monitoring, hydrologic impacts that vary spatially and temporally based on environmental and hydroclimatic conditions, and the preponderance of overlapping or compounding disturbance sequences. In addition, a conceptual framework for characterizing commonalities and differences among hydrologic disturbances is still in its infancy. In this introduction to the special issue, we advance the fusion of concepts and terminology from ecology and hydrology to begin filling this gap. We briefly explore some preliminary approaches for comparing different disturbances and their hydrologic impacts, which provides a starting point for further dialogue and research progress.

Bioimpedance in Severely Malnourished Children

DEFF Research Database (Denmark)

Girma Nigatu, Tsinuel

Worldwide severe acute malnutrition (SAM) affects millions of children and considerably contributes to under-five mortality, mainly in low-income settings. Among children with SAM, deaths occur largely in those with oedema and during early phase of treatment often aggravated by infection. Treatment...

Are there any disturbances in vestibular organ of children and young adults with Type I diabetes?

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Gawron, W; Pospiech, L; Orendorz-Fraczkowska, K; Noczynska, A

2002-05-01

The aim of the work was to evaluate the vestibular organ condition in children and young adults suffering from Type I (insulin-dependent) diabetes mellitus. The group examined consisted of 95 children and young adults aged from 6 to 28 years with Type I diabetes diagnosed. The diabetic group was divided into subgroups according to duration of the disease, compensation of the disease, and presence and character of hypoglycaemic incidents, and presence of diabetic complications. The control group consisted of 44 healthy children and young adults aged 6 to 28 years. After collecting detailed medical history in each case an electronystagmographic test was performed using the computed two-canal electronystagmographer. Within the diabetic group 6 patients complained about vertigo and balance disorders. Spontaneous nystagmus occurred in 10 cases, positional one in 21 cases. Impaired optokinesis occurred in 36 cases and impaired eye tracking test in 33 cases. In caloric tests there was partial canal paresis in 4 cases and directional preponderance in 7 cases. Metabolic disturbances present in Type I diabetes cause disturbances in different parts of vestibular organ but mostly in its central part. Comparing disturbances in the vestibular organ with clinical and biochemical parameters characterising diabetes, the range of vestibular organ impairment in diabetes mellitus type 1 seems to depend mainly on the presence and character of hypoglycaemic incidents and the duration of the disease and to some extent on the compensation of diabetes.

Abnormal secretion of melatonin and cortisol in relation to sleep disturbances in children with Williams syndrome.

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Sniecinska-Cooper, Anna Maria; Iles, Ray Kruse; Butler, Stephen Andrew; Jones, Huw; Bayford, Richard; Dimitriou, Dagmara

2015-01-01

A high rate of sleep disturbances has been reported in individuals with Williams syndrome (WS) but the underlying aetiology has yet to be identified. Melatonin and cortisol levels display circadian rhythmicity and are known to affect and regulate sleep/wake patterns. The current study examined the levels of these two endocrine markers and explored a possible relationship with sleep patterns in children with WS. Twenty-five children with WS and 27 typically developing age- and gender-matched comparison children were recruited. Saliva was collected from each child at three time points: 4-6 pm, before natural bedtime, and after awakening. The levels of salivary melatonin and cortisol were analysed by specific enzyme-linked immunoassays. Sleep patterns were examined using actigraphy and the Children's Sleep Habit Questionnaire. The WS group had shallower drops in cortisol and less pronounced increase in melatonin at bedtime compared to the controls. Furthermore, they also had significantly higher levels of cortisol before bedtime. Increased bedtime cortisol and less pronounced rise in melatonin levels before sleep may play a role in the occurrence of sleep disturbances, such as delayed sleep onset, observed in children with WS. As both markers play a significant role in our circadian rhythm and sleep/wake cycle, it is necessary to examine sleep using multi-system analysis. Copyright © 2014 Elsevier B.V. All rights reserved.

Perceived causes of severe mental disturbance and preferred interventions by the Borana semi-nomadic population in southern Ethiopia: a qualitative study

Science.gov (United States)

2012-01-01

Background Culture affects the way people conceptualize causes of severe mental disturbance which may lead to a variation in the preferred intervention methods. There is a seemingly dichotomous belief regarding what causes severe mental disturbance: people living in western countries tend to focus mainly on biological and psychosocial risk factors; whereas, in non-western countries the focus is mainly on supernatural and religious factors. These belief systems about causation potentially dictate the type of intervention preferred. Studying such belief systems in any society is expected to help in planning and implementation of appropriate mental health services. Methods A qualitative study was conducted among the Borana semi-nomadic population in southern Ethiopia to explore perceived causes of severe mental disturbance and preferred interventions. We selected, using purposive sampling, key informants from three villages and conducted a total of six focus group discussions: three for males and three for females. Results The views expressed regarding the causes of mental disturbance were heterogeneous encompassing supernatural causes such as possession by evil spirits, curse, bewitchment, ‘exposure to wind’ and subsequent attack by evil spirit in postnatal women and biopsychosocial causes such as infections (malaria), loss, ‘thinking too much’, and alcohol and khat abuse. The preferred interventions for severe mental disturbance included mainly indigenous approaches, such as consulting Borana wise men or indigenous healers, prayer, holy water treatment and seeking modern mental health care as a last resort. Conclusions These findings will be of value for health care planners who wish to expand modern mental health care to this population, indicating the need to increase awareness about the causes of severe mental disturbance and their interventions and collaborate with influential people and indigenous healers to increase acceptability of modern mental

Symptom profile of delirium in children and adolescent--does it differ from adults and elderly?

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Grover, Sandeep; Kate, Natasha; Malhotra, Savita; Chakrabarti, Subho; Mattoo, Surendra Kumar; Avasthi, Ajit

2012-01-01

The objective was to evaluate the phenomenology, etiology and outcome of delirium in children and adolescents (8-18 years of age) seen in a consultation-liaison psychiatric service in India. Additionally, an attempt was made to compare the phenomenology with adult and elderly patients with delirium. Thirty children and adolescents (age 8-18 years) diagnosed with delirium by the consultation-liaison psychiatry team were rated on the Delirium Rating Scale-Revised-98 (DRS-R-98) and compared with DRS-R-98 data on 120 adults and 109 elderly patients. The commonly observed symptoms in children and adolescents with delirium were disturbance in attention, orientation, sleep-wake cycle disturbances, fluctuation of symptoms, disturbance of short-term memory and motor agitation. The least commonly seen symptoms included delusions and motor retardation. Compared to adults, children and adolescents had lower frequency of long-term memory and visuospatial disturbances. Compared to the elderly, children and adolescents had higher frequency of lability of affect. For severity of symptoms, compared to adults, the children and adolescents had lower severity of sleep-wake disturbances, abnormality of thought, motor agitation, orientation, attention, short-term memory, long-term memory and visuospatial abilities. When compared to elderly patients, children and adolescents had higher severity of lability of affect and lower severity of language disturbances, short-term memory and visuospatial abilities. In general, phenomenology, of delirium in children and adolescents (age 8-18 years) is similar to that seen in adults and elderly patients. Copyright © 2012 Elsevier Inc. All rights reserved.

Severe Sepsis in Severely Malnourished Young Bangladeshi Children with Pneumonia: A Retrospective Case Control Study.

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Mohammod Jobayer Chisti

Full Text Available In developing countries, there is no published report on predicting factors of severe sepsis in severely acute malnourished (SAM children having pneumonia and impact of fluid resuscitation in such children. Thus, we aimed to identify predicting factors for severe sepsis and assess the outcome of fluid resuscitation of such children.In this retrospective case-control study SAM children aged 0-59 months, admitted to the Intensive Care Unit (ICU of the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh from April 2011 through July 2012 with history of cough or difficult breathing and radiologic pneumonia, who were assessed for severe sepsis at admission constituted the study population. We compared the pneumonic SAM children with severe sepsis (cases = 50 with those without severe sepsis (controls = 354. Severe sepsis was defined with objective clinical criteria and managed with fluid resuscitation, in addition to antibiotic and other supportive therapy, following the standard hospital guideline, which is very similar to the WHO guideline.The case-fatality-rate was significantly higher among the cases than the controls (40% vs. 4%; p<0.001. In logistic regression analysis after adjusting for potential confounders, lack of BCG vaccination, drowsiness, abdominal distension, acute kidney injury, and metabolic acidosis at admission remained as independent predicting factors for severe sepsis in pneumonic SAM children (p<0.05 for all comparisons.We noted a much higher case fatality among under-five SAM children with pneumonia and severe sepsis who required fluid resuscitation in addition to standard antibiotic and other supportive therapy compared to those without severe sepsis. Independent risk factors and outcome of the management of severe sepsis in our study children highlight the importance for defining optimal fluid resuscitation therapy aiming at reducing the case fatality in such children.

Severe ionosphere disturbances caused by the sudden response of evening subequatorial ionospheres to geomagnetic storms

International Nuclear Information System (INIS)

Tanaka, T.

1981-01-01

By monitoring C band beacon signals from geostationary satellites in Japan, we have observed anomalously strong ionospheric scintillations several times during three years from 1978 to 1980. These severe scinitillations occur associated with geomagnetic storms and accompany sudden and intense ionospheric perturbations in the low-latiude region. Through the analysis of these phenomena we have identified a new type of ionospheric disturbances characterized by intensifications of equatorial anomalies and successive severe ionospheric scintillations that extend to the C band range. The events occur only during a limited local time interval after the sunset, when storm time decreases of midlatitude geomagnetic fields in the same meridan take place during the same time interval. From the viewpoint of ionospheric storms, these disturbances precede the occurrence of midlatitude negative phases and storm time depressions of equatorial anomalies to indicate that the cause of the events is different from distrubed thermospheric circulations. The timing and magnitude of substorms at high-latitudes not always correlate with the events. We have concluded that the phenomena are closely related with penetrations toward low-latitudes of electric fields owing to the partial closure of asymmetrical ring currents

High prevalence of subtle and severe menstrual disturbances in exercising women: confirmation using daily hormone measures.

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De Souza, M J; Toombs, R J; Scheid, J L; O'Donnell, E; West, S L; Williams, N I

2010-02-01

The identification of subtle menstrual cycle disturbances requires daily hormone assessments. In contrast, the identification of severe menstrual disturbances, such as amenorrhea and oligomenorrhea, can be established by clinical observation. The primary purpose of this study was to determine the frequency of subtle menstrual disturbances, defined as luteal phase defects (LPD) or anovulation, in exercising women, with menstrual cycles of 26-35 days, who engage in a variety of sports, both recreational and competitive. Secondly, the prevalence of oligomenorrhea and amenorrhea was also determined via measurement of daily urinary ovarian steroids rather than self report alone. Menstrual status was documented by daily measurements of estrone and pregnanediol glucuronide and luteinizing hormone across two to three consecutive cycles and subsequently categorized as ovulatory (Ovul), LPD, anovulatory (Anov), oligomenorrheic (Oligo) and amenorrheic (Amen) in sedentary (Sed) and exercising (Ex) women. Sed (n = 20) and Ex women (n = 67) were of similar (P > 0.05) age (26.3 +/- 0.8 years), weight (59.3 +/- 1.8 kg), body mass index (22.0 +/- 0.6 kg/m2), age of menarche (12.8 +/- 0.3 years) and gynecological maturity (13.4 +/- 0.9 years). The Sed group exercised less (P exercising women experience subtle menstrual disturbances, i.e. LPD and anovulation, and that one third of exercising women may be amenorrheic. Estimates of the prevalence of subtle menstrual disturbances in exercising women determined by the presence or absence of short or long cycles does not identify these disturbances. In light of known clinical consequences of menstrual disturbances, these findings underscore the lack of reliability of normal menstrual intervals and self report to infer menstrual status.

Event-based prospective memory in mildly and severely autistic children.

Science.gov (United States)

Sheppard, Daniel P; Kvavilashvili, Lia; Ryder, Nuala

2016-01-01

There is a growing body of research into the development of prospective memory (PM) in typically developing children but research is limited in autistic children (Aut) and rarely includes children with more severe symptoms. This study is the first to specifically compare event-based PM in severely autistic children to mildly autistic and typically developing children. Fourteen mildly autistic children and 14 severely autistic children, aged 5-13 years, were matched for educational attainment with 26 typically developing children aged 5-6 years. Three PM tasks and a retrospective memory task were administered. Results showed that severely autistic children performed less well than typically developing children on two PM tasks but mildly autistic children did not differ from either group. No group differences were found on the most motivating (a toy reward) task. The findings suggest naturalistic tasks and motivation are important factors in PM success in severely autistic children and highlights the need to consider the heterogeneity of autism and symptom severity in relation to performance on event-based PM tasks. Copyright © 2015 Elsevier Ltd. All rights reserved.

Influence of stocking, site quality, stand age, low-severity canopy disturbance, and forest composition on sub-boreal aspen mixedwood carbon stocks

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Reinikainen, Michael; D’Amato, Anthony W.; Bradford, John B.; Fraver, Shawn

2014-01-01

Low-severity canopy disturbance presumably influences forest carbon dynamics during the course of stand development, yet the topic has received relatively little attention. This is surprising because of the frequent occurrence of such events and the potential for both the severity and frequency of disturbances to increase as a result of climate change. We investigated the impacts of low-severity canopy disturbance and average insect defoliation on forest carbon stocks and rates of carbon sequestration in mature aspen mixedwood forests of varying stand age (ranging from 61 to 85 years), overstory composition, stocking level, and site quality. Stocking level and site quality positively affected the average annual aboveground tree carbon increment (CAAI), while stocking level, site quality, and stand age positively affected tree carbon stocks (CTREE) and total ecosystem carbon stocks (CTOTAL). Cumulative canopy disturbance (DIST) was reconstructed using dendroecological methods over a 29-year period. DIST was negatively and significantly related to soil carbon (CSOIL), and it was negatively, albeit marginally, related to CTOTAL. Minima in the annual aboveground carbon increment of trees (CAI) occurred at sites during defoliation of aspen (Populus tremuloides Michx.) by forest tent caterpillar (Malacosoma disstria Hubner), and minima were more extreme at sites dominated by trembling aspen than sites mixed with conifers. At sites defoliated by forest tent caterpillar in the early 2000s, increased sequestration by the softwood component (Abies balsamea (L.) Mill. and Picea glauca (Moench) Voss) compensated for overall decreases in CAI by 17% on average. These results underscore the importance of accounting for low-severity canopy disturbance events when developing regional forest carbon models and argue for the restoration and maintenance of historically important conifer species within aspen mixedwoods to enhance stand-level resilience to disturbance agents and maintain

Two-year follow-up of outcomes related to scarring and distress in children with severe burns.

Science.gov (United States)

Wurzer, Paul; Forbes, Abigail A; Hundeshagen, Gabriel; Andersen, Clark R; Epperson, Kathryn M; Meyer, Walter J; Kamolz, Lars P; Branski, Ludwik K; Suman, Oscar E; Herndon, David N; Finnerty, Celeste C

2017-08-01

We assessed the perception of scarring and distress by pediatric burn survivors with burns covering more than one-third of total body surface area (TBSA) for up to 2 years post-burn. Children with severe burns were admitted to our hospital between 2004 and 2012, and consented to this IRB-approved-study. Subjects completed at least one Scars Problems and/or Distress questionnaire between discharge and 24 months post burn. Outcomes were modeled with generalized estimating equations or using mixed linear models. Significance was accepted at p body areas over time (p self-conscious with respect to their body image even 2 years after burn injury. Implications for Rehabilitation According to self-assessment questionnaires, severely burned children perceive significant improvements in scarring and distress during the first 2 years post burn. Significant improvements were seen in reduction of pain, itching, sleeping disturbances, tightness, range of motion, and strength (p body areas. The rehabilitation team should provide access to wigs or other aids to pediatric burn survivors to address these needs.

Vocabulary and Working Memory in Children Fit with Hearing Aids

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Stiles, Derek J.; McGregor, Karla K.; Bentler, Ruth A.

2012-01-01

Purpose: To determine whether children with mild-to-moderately severe sensorineural hearing loss (CHL) present with disturbances in working memory and whether these disturbances relate to the size of their receptive vocabularies. Method: Children 6 to 9 years of age participated. Aspects of working memory were tapped by articulation rate, forward…

Use of Videotape Feedback with Severely Disturbed Adolescents.

Science.gov (United States)

Michel, Jane; Blitstein, Sheldon

1979-01-01

Summarizes the design and effects of a group therapy project using videotape feedback with seriously disturbed adolescents. Offers anecdotal evidence that the feedback facilitated the correction of the participants' distorted body images, low self-esteem, lack of capacity for self-observation, and poor peer relationships. (SS)

Improving free play skills of severely retarded children.

Science.gov (United States)

Wehman, P; Marchant, J A

1978-02-01

Severely and profoundly retarded children are usually deficient in play skills. Since play facilitates socialization, language, and motor development, it is a vitally improtant skill to acquire. This pilot study examined the effects of a behavioral training program on the autistic, independent, and social types of play of four severely and profoundly retarded children. The training program involved the use of instructions, modeling, physical guidance, and verbal reinforcement. Results indicated that a marked increase in independent and social play occurred with the introduction of the training program with all four children. Occupational therapists can play an increasingly important role in helping educators formulate relevant educational programs for severely retarded children, particularly in the areas of play and motor skill development.

Evaluating the clinical management of severely malnourished children

African Journals Online (AJOL)

To assess the management of severely malnourished children in two rural district hospitals and to recommend improvements for their care. Methods. Based on draft World Health Organisation (WHO) guidelines for inpatient care of children with severe malnutrition, data collection instruments were developed in conjunction ...

Children with problematic severe asthma: A biopsychosocial perspective

NARCIS (Netherlands)

Verkleij, M.

2016-01-01

This thesis focuses on problematic severe asthma in children and its treatment from a biopsychosocial perspective. Asthma is a chronic inflammatory disease of the airways. In children with problematic severe asthma, asthma is not under control despite optimal medical treatment. Asthma control is the

Radiation injuries in children with lymphogranulomatosis

International Nuclear Information System (INIS)

Grulich, M.; Schoentube, M.; Doerffel, W.

1990-01-01

37 children with M. Hodgkin received radiotherapy to the involved cervical lymph nodes. Localized growth disturbances and muscle atrophies were observed as late effects. 12 children had severe sequelae and 19 patients moderate late effects. The effects were stronger the younger the children were at the time of irradiation. (author)

A psychosocial comparison of computer-mediated and face-to-face language use among severely disturbed adolescents.

Science.gov (United States)

Zimmerman, D P

1987-01-01

This study analyzes the content of communications among 18 severely disturbed adolescents. Interactions were recorded from two sources: computer-based "conferences" for the group, and small group face-to-face sessions which addressed similar topics. The purpose was to determine whether there are important differences in indications of psychological state, interpersonal interest, and expressive style. The research was significant, given the strong attraction of computers to many adolescents and the paucity of research on social-psychological effects of this technology. A content analysis based on a total sample of 10,224 words was performed using the Harvard IV Psychosociological Dictionary. Results indicated that computer-mediated communication was more expressive of feelings and made more frequent mention of interpersonal issues. Further, it displayed a more positive object-relations stance, was less negative in expressive style, and appeared to diminish certain traditional gender differences in group communication. These findings suggest that the computer may have an interesting adjunct role to play in reducing communication deficits commonly observed in severely disturbed adolescent clinical populations.

Music therapy for children with severe burn injury

OpenAIRE

Edwards, Jane

1998-01-01

peer-reviewed Music therapy for children with severe burns is a developing field of practice and research interest in pediatric music therapy. The following article presents an overview of the nature of severe burn injury and provides a rationale for the use of music therapy in the Burn Unit. The application of song writing techniques to address needs of children receiving care for severe burns in a hospital setting is presented.

[The influence of metabolic disturbances present in diabetes mellitus type I on vestibulo-spinal reflexes in children and young adults].

Science.gov (United States)

Gawron, Wojciech; Pośpiech, Lucyna; Orendorz-Fraczkowska, Krystyna; Noczyńska, Anna

2002-01-01

Diabetic neuropathy encompasses various disturbances concerning somatic and autonomic nervous system and has significant impact on prognosis and course of diabetes mellitus. The aim of the work is an evaluation of vestibulo-spinal reflexes in children and young adults suffering from diabetes mellitus type 1. Material--95 children and young adults aged from 6 to 28 years with diabetes mellitus type 1 diagnosed. The control group consisted of 44 otoneurologically healthy subjects aged from 6 to 28 years. After detailed medical history collection and physical ENT examination stato-posturography was performed in each case. Posturographer PE 62 Model 04 was applied in the studies. Static posturography as well as dynamic one (one leg standing test) was performed in each case. 6 patients belonging to diabetic group complained about vertigo or dizziness. There were worse stabilograms parameters in diabetic group in comparison to control one, statistically significant in younger children. There were better stabilogram parameters in diabetic patients with longer history of the disease. The parameters analysed were significantly worse in the subgroup with not compensated diabetes. The parameters were slightly better in relation to the presence of hypoglycaemic incidents. No apparent differences in stabilograms parameters were present in relation to the presence of diabetic complications. Diabetes mellitus type 1 with slight or without complications does not have significant influence on vestibulo-spinal reflexes and posture stability of the patients. Balance organ disturbances in diabetes mellitus type 1 in children and young adults despite their presence have subclinical course. Perhaps one should consider monitoring of those disturbances in the course of the disease.

Prevalence and Severity of Malaria Parasitemia among Children ...

African Journals Online (AJOL)

induced anemia is much more common in younger children and may require blood transfusion with high mortality rates.[2,3]. In Sub-Saharan Africa (SSA), children admitted with severe anemia are more likely to die than those without anemia.[4,5]. Blood transfusion in severe malarial anemia can be important in preventing ...

[Transcranial magnetic therapy in the treatment of psychoautonomous disturbances in children with diabetes mellitus type 1].

Science.gov (United States)

Filina, N Iu; Bolotova, N V; Manukian, V Iu; Nikolaeva, N V; Kompaniets, O V

2009-01-01

Results of a clinical-physiological study of 80 children with diabetes mellitus type 1 with psychoautonomous disturbances are presented. Forty patients of the main group received transcranial magnetic therapy (TcMT), 40 patients of the control group had placebo sessions of TcMT with magnetic power supply switched off. TcMT was applied using bitemporal method, running regime with modulation frequency 1-10 Hz. Patients received 10 sessions. Positive changes were found in the main group compared to the controls. In the main group, TcMT sessions allowed to normalize the autonomous status in 75% of children and to improve psychoemotional state in 55%. The correction of psychoemotional status of children changed their behavior towards diabetes, improved control and compensation of the disease.

Management of severe constipation in children.

Science.gov (United States)

Noviello, C; Romano, M; Zangari, A; Papparella, A; Martino, A; Cobellis, G

2013-04-01

Constipation is a common pediatric problem. Sometimes the hospitalization is necessary and in these patients the organic cause should be verified. The authors report their experience in the management of children with severe constipation. Anorectal manometry (ARM) was performed after a careful examination of perineum and bowel disimpaction. Once organic cause had be excluded, the patient got medical therapy. If recto-anal inhibitory reflex (RAIR) was absent, not collaborative patient or medical treatment failed, the child underwent contrast enema (CE) and rectal suction biopsies (RSB). Local anesthetics were used for anal fissures or internal anal sphincter (IAS) hypertonia. Anal malformations and Hirschsprung's disease (HD) were surgically treated. Posterior sagittal anorectoplasty was performed for anal malformations. In 5 years 98 children (63 males) were observed (mean age 6 years). 5 children were premature for gestational age, 4 presented failure to thrive, 5 anal malformations and 45 anal fissures. ARM was performed in 87 children and 74 of them showed normal RAIR. Hypertonia of the IAS was recorded in 38 patients. RAIR was absent/unclear in 13 patients. Follow-up revealed 6 patients (negative to ARM) with poor results without oral laxative. CE was performed in 19 children (2 positive cases) and RBS in 25 patients (2 cases of HD). Children with severe constipation must be carefully observed and studied because of not negligible incidence of organic cause. The first step in the management of these patients is the evacuation of the fecaloma.

Sleep disturbances in children with epilepsy compared with their nearest-aged siblings.

Science.gov (United States)

Wirrell, Elaine; Blackman, Marlene; Barlow, Karen; Mah, Jean; Hamiwka, Lorie

2005-11-01

The aim of the study was to compare sleep patterns in children with epilepsy with those of their non-epileptic siblings and to determine which epilepsy-specific factors predict greater sleep disturbance. We conducted a case-control study of 55 children with epilepsy (mean age 10y, range 4 to 16y; 27 males, 28 females) and their nearest-aged non-epileptic sibling (mean age 10y, range 4 to 18y; 26 males, 29 females). Epilepsy was idiopathic generalized in eight children (15%), symptomatic generalized in seven (13%), and focal in 40 (73%); the mean duration was 5 years 8 months. Parents or caregivers completed the Sleep Behavior Questionnaire (SBQ) and Child Behavior Checklist (CBCL) for patients and controls, and the Quality of Life in Childhood Epilepsy (QOLCE) for patients. Patients had a higher (more adverse) Total Sleep score (p<0.001) and scored worse than controls on nearly all subscales of the SBQ. In patients, higher Total Sleep scores were correlated with higher scores on the Withdrawn, Somatic complaints, Social problems, and Attention subscales of the CBCL, and significantly lower Total Quality of Life Scores. Refractory epilepsy, mental retardation, and remote symptomatic etiology predicted greater sleep problems in those with epilepsy. We conclude that children with epilepsy in this current study had significantly greater sleep problems than their non-epileptic siblings.

Parenting Stress Related to Behavioral Problems and Disease Severity in Children with Problematic Severe Asthma

NARCIS (Netherlands)

Verkleij, Marieke; van de Griendt, Erik-Jonas; Colland, Vivian; van Loey, Nancy; Beelen, Anita; Geenen, Rinie

2015-01-01

Our study examined parenting stress and its association with behavioral problems and disease severity in children with problematic severe asthma. Research participants were 93 children (mean age 13.4 +/- A 2.7 years) and their parents (86 mothers, 59 fathers). As compared to reference groups

CYCLOSPORINE IN TREATMENT OF SEVERE ATOPIC DERMATITIS IN CHILDREN

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A.A. Alekseeva

2010-01-01

Full Text Available Atopic dermatitis (AtD is one of the most widespread types of allergic lesions of skin in children. Increase of severe types of AtD with lesion of big parts of skin, high frequency of exacerbations, presence of concomitant atopic diseases, and inefficiency of standard therapeutic approaches, torpid clinical course and early development of disability, causes an anxiety. Present standard approaches can be ineffective in children with severe clinical course of AtD and they are not able to prevent progression of disease, development of severe exacerbations and child’s disability. One of therapeutic alternatives for these patients is treatment with immunosuppressive agents. The article describes questions of treatment with cyclosporine in systemic therapy of severe resistant forms of AtD in children. Author discusses effectiveness and safety of a drug, formulated rules of treatment of severe AtD with cyclosporine. Key words: children, atopic dermatitis, cyclosporine, treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(5:117-120

Parenting Stress Related to Behavioral Problems and Disease Severity in Children with Problematic Severe Asthma

NARCIS (Netherlands)

Verkleij, Marieke; van de Griendt, E-J.; Colland, V.; Van Loey, N.E.E.; Beelen, A.; Geenen, R.

2015-01-01

Our study examined parenting stress and its association with behavioral problems and disease severity in children with problematic severe asthma. Research participants were 93 children (mean age 13.4 ± 2.7 years) and their parents (86 mothers, 59 fathers). As compared to reference groups analyzed in

Climate change and forest disturbances

Science.gov (United States)

Virginia H. Dale; Linda A. Joyce; Steve McNulty; Ronald P. Neilson; Matthew P. Ayres; Michael D. Flannigan; Paul J. Hanson; Lloyd C. Irland; Ariel E. Lugo; Chris J. Peterson; Daniel Simberloff; Frederick J. Swanson; Brian J. Stocks; Michael Wotton

2001-01-01

This article examines how eight disturbances influence forest structure, composition, and function, and how climate change may influence the severity, frequency, and magnitude of disturbances to forests. We focus on examples from the United States, although these influences occur worldwide. We also consider options for coping with disturbance under changing climate....

Introduction to natural disturbances and historic range of variation: type, frequency, severity, and post-disturbance structure in central hardwood forests

Science.gov (United States)

Katie Greenberg; Beverly S. Collins; Henry McNab; Douglas K. Miller; Gary R. Wein

2015-01-01

EXCERPT FROM: Natural Disturbances and Historic Range Variation 2015. Throughout the history of upland hardwood forests of the Central Hardwood Region, natural disturbances have been integral to shaping forest structure and composition, and essential in maintaining diverse biotic...

MAPPING DISTURBANCE DYNAMICS IN WET SCLEROPHYLL FORESTS USING TIME SERIES LANDSAT

Directory of Open Access Journals (Sweden)

A. Haywood

2016-06-01

Full Text Available In this study, we characterised the temporal-spectral patterns associated with identifying acute-severity disturbances and low-severity disturbances between 1985 and 2011 with the objective to test whether different disturbance agents within these categories can be identified with annual Landsat time series data. We analysed a representative State forest within the Central Highlands which has been exposed to a range of disturbances over the last 30 years, including timber harvesting (clearfell, selective and thinning and fire (wildfire and prescribed burning. We fitted spectral time series models to annual normal burn ratio (NBR and Tasseled Cap Indices (TCI, from which we extracted a range of disturbance and recovery metrics. With these metrics, three hierarchical random forest models were trained to 1 distinguish acute-severity disturbances from low-severity disturbances; 2a attribute the disturbance agents most likely within the acute-severity class; 2b and attribute the disturbance agents most likely within the low-severity class. Disturbance types (acute severity and low-severity were successfully mapped with an overall accuracy of 72.9 %, and the individual disturbance types were successfully attributed with overall accuracies ranging from 53.2 % to 64.3 %. Low-severity disturbance agents were successfully mapped with an overall accuracy of 80.2 %, and individual agents were successfully attributed with overall accuracies ranging from 25.5 % to 95.1. Acute-severity disturbance agents were successfully mapped with an overall accuracy of 95.4 %, and individual agents were successfully attributed with overall accuracies ranging from 94.2 % to 95.2 %. Spectral metrics describing the disturbance magnitude were more important for distinguishing the disturbance agents than the post-disturbance response slope. Spectral changes associated with planned burning disturbances had generally lower magnitudes than selective harvesting

The role of punishment in the in-patient treatment of psychiatrically disturbed children.

Science.gov (United States)

Alderton, H R

1967-02-01

The role of punishment in the psychiatric in-patient treatment of nonpsychotic latency-age children with behaviourdisorders is discussed. Punishment is defined as the removal of previously existing positive reinforcers or the administration of aversive stimuli. Ways in which appropriate social behaviour may be acquired are briefly considered. These include reinforcement of desirable responses, non-reinforcement of undesirable responses, reinforcement of incompatible responses and imitative learning. The reported effects of punishment on behaviour are reviewed and the psychological functions necessary before punishment can have the intended effects considered. For seriously disturbed children punishment is ineffective as a treatment technique. It reinforces pathological perceptions of self and adults even if it successfully suppresses behaviour. The frame of reference of the seriously disturbed child contraindicates the removal of positive reinforcers and verbal as well as physical aversive stimuli. Controls and punishments must be clearly distinguished. Controls continue only as long as the behaviour towards which they are directed. They do not include the deliberate establishment of an unpleasant state by the adult as a result of particular behaviour. Control techniques such as removal from a group may be necessary but when possible should be avoided in favour of techniques less likely to be misinterpreted. Avoidance of punishment in treatment makes even more important explicit expectations and provision of realistic controls. Natural laws may result in unpleasant experiences as an unavoidable result of certain behaviour. By definition such results can never be imposed by the adult. Treatment considerations may necessitate that the child be protected from the results of his actions. Avoidance of punishment requires a higher staff/child ratio, more mature and better trained staff. Sometimes children have previously been deterred from serious community acting out

Rapidly restoring biological soil crusts and ecosystem functions in a severely disturbed desert ecosystem.

Science.gov (United States)

Chiquoine, Lindsay P; Abella, Scott R; Bowker, Matthew A

2016-06-01

Restoring biological soil crusts (biocrusts) in degraded drylands can contribute to recovery of ecosystem functions that have global implications, including erosion resistance and nutrient cycling. To examine techniques for restoring biocrusts, we conducted a replicated, factorial experiment on recently abandoned road surfaces by applying biocrust inoculation (salvaged and stored dry for two years), salvaged topsoil, an abiotic soil amendment (wood shavings), and planting of a dominant perennial shrub (Ambrosia dumosa). Eighteen months after treatments, we measured biocrust abundance and species composition, soil chlorophyll a content and fertility, and soil resistance to erosion. Biocrust addition significantly accelerated biocrust recovery on disturbed soils, including increasing lichen and moss cover and cyanobacteria colonization. Compared to undisturbed controls, inoculated plots had similar lichen and moss composition, recovered 43% of total cyanobacteria density, had similar soil chlorophyll content, and exhibited recovery of soil fertility and soil stability. Inoculation was the only treatment that generated lichen and moss cover. Topsoil application resulted in partial recovery of the cyanobacteria community and soil properties. Compared to untreated disturbed plots, topsoil application without inoculum increased cyanobacteria density by 186% and moderately improved soil chlorophyll and ammonium content and soil stability. Topsoil application produced 22% and 51% of the cyanobacteria density g⁻¹ soil compared to undisturbed and inoculated plots, respectively. Plots not treated with either topsoil or inoculum had significantly lower cyanobacteria density, soil chlorophyll and ammonium concentrations, and significantly higher soil nitrate concentration. Wood shavings and Ambrosia had no influence on biocrust lichen and moss species recovery but did affect cyanobacteria composition and soil fertility. Inoculation of severely disturbed soil with native

Blood electrolyte disturbances during severe hypoglycemia in Korean patients with type 2 diabetes.

Science.gov (United States)

Kang, Mi Yeon

2015-09-01

To investigate abnormalities in blood electrolyte levels during severe hypoglycemia in Korean patients with type 2 diabetes mellitus (T2DM) in a clinical setting. Blood electrolyte levels in adult T2DM patients during severe hypoglycemia were collected from January 1, 2008 to December 31, 2012. Patients who maintained normal serum creatinine and blood urea nitrogen levels were utilized in the study. Severe hypoglycemia was defined as a condition requiring medical assistance, such as administering carbohydrates when serum glucose levels less than 70 mg/dL were observed, in conjunction with other symptoms of hypoglycemia. A total of 1,068 patients who visited the emergency room with severe hypoglycemia were screened, of which 219 patients were included in this study. The incidence of abnormal levels for any electrolyte was 47%. Hypokalemia (type of electrolyte disturbance observed at 21.9%. A decrease in serum potassium levels was associated with decreases in blood glucose levels (r = 0.151, p = 0.025). During severe hypoglycemia, median blood glucose levels, incidence of tachycardia (> 100 beats per minute) and severe hypertension (≥ 180/120 mmHg) were 30 mg/dL (range, 14 to 62) and 35 mg/dL (range, 10 to 69; p = 0.04), 18.8% and 7.2% (p = 0.02), and 20.8% and 10.2% (p = 0.05) in the hypokalemia and normokalemia groups, respectively. During severe hypoglycemia, hypokalemia occurred in 21.9% of T2DM patients and was associated with tachycardia and severe hypertension. Therefore, the results suggest that severe hypoglycemia may increase cardiovascular events in T2DM.

Parenting Stress Related to Behavioral Problems and Disease Severity in Children with Problematic Severe Asthma.

Science.gov (United States)

Verkleij, Marieke; van de Griendt, Erik-Jonas; Colland, Vivian; van Loey, Nancy; Beelen, Anita; Geenen, Rinie

2015-09-01

Our study examined parenting stress and its association with behavioral problems and disease severity in children with problematic severe asthma. Research participants were 93 children (mean age 13.4 ± 2.7 years) and their parents (86 mothers, 59 fathers). As compared to reference groups analyzed in previous research, scores on the Parenting Stress Index in mothers and fathers of the children with problematic severe asthma were low. Higher parenting stress was associated with higher levels of internalizing and externalizing behavioral problems in children (Child Behavior Checklist). Higher parenting stress in mothers was also associated with higher airway inflammation (FeNO). Thus, although parenting stress was suggested to be low in this group, higher parenting stress, especially in the mother, is associated with more airway inflammation and greater child behavioral problems. This indicates the importance of focusing care in this group on all possible sources of problems, i.e., disease exacerbations and behavioral problems in the child as well as parenting stress.

Automated attribution of remotely-sensed ecological disturbances using spatial and temporal characteristics of common disturbance classes.

Science.gov (United States)

Cooper, L. A.; Ballantyne, A.

2017-12-01

Forest disturbances are critical components of ecosystems. Knowledge of their prevalence and impacts is necessary to accurately describe forest health and ecosystem services through time. While there are currently several methods available to identify and describe forest disturbances, especially those which occur in North America, the process remains inefficient and inaccessible in many parts of the world. Here, we introduce a preliminary approach to streamline and automate both the detection and attribution of forest disturbances. We use a combination of the Breaks for Additive Season and Trend (BFAST) detection algorithm to detect disturbances in combination with supervised and unsupervised classification algorithms to attribute the detections to disturbance classes. Both spatial and temporal disturbance characteristics are derived and utilized for the goal of automating the disturbance attribution process. The resulting preliminary algorithm is applied to up-scaled (100m) Landsat data for several different ecosystems in North America, with varying success. Our results indicate that supervised classification is more reliable than unsupervised classification, but that limited training data are required for a region. Future work will improve the algorithm through refining and validating at sites within North America before applying this approach globally.

Application of Psychoanalytic, Cognitive, Psychosocial and Other Theories in the Developmentally Integrated Assessment and Treatment of Emotionally Disturbed Children.

Science.gov (United States)

Grass, Linda; Kreger, Robert

The authors describe their efforts to produce a global assessment scale for young emotionally disturbed children derived from an integrated synthesis of developmenta theories. Charts outline developmental stages, zones, modes, and dominant traits or characteristics of five major theorists (S. Freud, E. Erikson, A. Maslow, J. Piaget, and F.…

The Influence of Environmental Consequences and Internalizing Symptoms on Children's Tic Severity.

Science.gov (United States)

Eaton, Cyd K; Jones, Anna M; Gutierrez-Colina, Ana M; Ivey, Emily K; Carlson, Olivia; Melville, Lauren; Kardon, Patricia; Blount, Ronald L

2017-04-01

Although there is evidence that environmental consequences for displaying tics and internalizing symptoms are related to tic severity in children with TS, less is known about the inter-relationships of these variables or how these factors jointly contribute to tic severity. This study included 45 children with Tourette syndrome. Caregivers reported on children's environmental consequences for displaying tics, internalizing symptoms, and tic severity. Results indicated that children with higher levels of internalizing symptoms experienced significantly more environmental consequences for displaying tics. Children with higher levels of separation anxiety symptoms demonstrated significantly greater tic severity. Environmental consequences for displaying tics accounted for significantly more variance in predicting tic severity than anxiety symptoms. This preliminary evidence suggests that environmental consequences for displaying tics, such as receiving accommodations or attention from others, have a greater influence on children's tic severity than emotional factors.

Rhythm disturbances in childhood obstructive sleep apnea during apnea-hypopnea episodes

International Nuclear Information System (INIS)

Khositseth, Anant; Chokechuleekorn, Jittamas; Kuptanon, Teeradej; Leejakpai, Anchalee

2013-01-01

Obstructive sleep apnoea (OSA) can result in cardiovascular complications. Nocturnal arrhythmias are reported up to 50% of adult OSA patients. Arrhythmias and heart rate variability in children with OSA have not been well studied. We sought to study rhythm disturbances in childhood OSA and also to analyze the relationship of heart rate variability to the severity of OSA in children. In a retrospective cross sectional study, records of children aged < 15 years with history of snoring and suspected OSA, who had undergone polysomnography (PSG) for first time were analyzed. The cardiac rhythm and heart rate variability were studied during PSG. A total of 124 patients diagnosed with OSA were grouped into mild (n = 52), moderate (n = 30), and severe (n = 42) OSA. During PSG, all had sinus arrhythmias and only three patients had premature atrial contractions (PACs). The standard deviation of heart rate (SD-HR) during rapid eye movement (REM) sleep in severe OSA (9.1 ± 2.4) was significantly higher than SD-HR in mild OSA (7.5 ± 1.3, P < 0.0001). The maximum heart rate (max-HR) during REM-sleep in severe OSA (132.1 ± 22.1) was significantly higher than the max-HR in mild OSA (121.3 ± 12.6 bpm, P = 0.016). There was no significant arrhythmia in children with OSA during their sleep. Heart rate variability correlated with the severity of OSA

Pathophysiological mechanisms of severe anaemia in Malawian children.

Directory of Open Access Journals (Sweden)

Michaël Boele van Hensbroek

2010-09-01

Full Text Available Severe anaemia is a major cause of morbidity and mortality in African children. The aetiology is multi-factorial, but interventions have often targeted only one or a few causal factors, with limited success.We assessed the contribution of different pathophysiological mechanisms (red cell production failure [RCPF], haemolysis and blood loss to severe anaemia in Malawian children in whom etiological factors have been described previously. More complex associations between etiological factors and the mechanisms were explored using structural equation modelling. In 235 children with severe anaemia (haemoglobin<3.2 mMol/L [5.0 g/dl] studied, RCPF, haemolysis and blood loss were found in 48.1%, 21.7% and 6.9%, respectively. The RCPF figure increased to 86% when a less stringent definition of RCPF was applied. RCPF was the most common mechanism in each of the major etiological subgroups (39.7-59.7%. Multiple aetiologies were common in children with severe anaemia. In the final model, nutritional and infectious factors, including malaria, were directly or indirectly associated with RCPF, but not with haemolysis.RCPF was the most common pathway leading to severe anaemia, from a variety of etiological factors, often found in combination. Unlike haemolysis or blood loss, RCPF is a defect that is likely to persist to a significant degree unless all of its contributing aetiologies are corrected. This provides a further explanation for the limited success of the single factor interventions that have commonly been applied to the prevention or treatment of severe anaemia. Our findings underline the need for a package of measures directed against all of the local aetiologies of this often fatal paediatric syndrome.

Management of severe malarial anaemia in Gambian children

NARCIS (Netherlands)

Bojang, K. A.; Palmer, A.; Boele van Hensbroek, M.; Banya, W. A.; Greenwood, B. M.

1997-01-01

The optimum management of children with severe malarial anaemia is still uncertain. Hence, we have undertaken a study to determine whether iron treatment is as effective at restoring haemoglobin levels one month after presentation as blood transfusion without iron treatment in children with

Reading networks in children with dyslexia compared to children with ocular motility disturbances revealed by fMRI

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Ibone eSaralegui

2014-11-01

Full Text Available Developmental dyslexia is a neurological disorder whose underlying biological and cognitive causes are still being investigated, a key point of great significance, because it will determine the best therapeutic approach to use.Using functional magnetic resonance imaging, we studied the brain activation pattern while reading in the most eloquent cortical areas from the two reading routes, phonological and orthographic, and the strength of their association with reading scores in 66 Spanish children aged 9-12 years divided into three groups: typically developing readers (controls, dyslexic readers and readers with monocular vision due to ocular motility disorders but with a normal reading development, to assess whether (or not the neuronal network for reading in children with dyslexia has similarities with that in children with impaired binocular vision due to ocular motility disorders.We found that Spanish-speaking children with dyslexia have a brain circuit for reading that differs from that in children with monocular vision. Individuals with dyslexia tend to hypoactivate some of the more eloquent areas in the left hemisphere engaged by the phonological route, especially the visual word form area and left Wernicke´s area, and try to compensate this deficit by activating eloquent areas related to the orthographic route, such as the anterior part of the visual word form area and the posterior regions of both middle temporal gyri. That is, they seem to compensate for impairment in the phonological route through orthographic routes of both hemispheres.Our results suggest that ocular motility disturbances do not play a causal role in dyslexia. Dyslexia seems to be a neurological disorder that requires early recognition and evidence-based assessments and treatment to achieve the best possible outcome.

Cytokine Profiles of Severe Influenza Virus-Related Complications in Children

OpenAIRE

Andrew Fiore-Gartland; Angela Panoskaltsis-Mortari; Anna A. Agan; Anushay J. Mistry; Paul G. Thomas; Michael A. Matthay; Michael A. Matthay; PALISI PICFlu Investigators; Tomer Hertz; Tomer Hertz; Tomer Hertz; Adrienne G. Randolph; Adrienne G. Randolph; Adrienne G. Randolph; Ronald C. Sanders

2017-01-01

RationaleEffective immunomodulatory therapies for children with life-threatening “cytokine storm” triggered by acute influenza infection are lacking. Understanding the immune profiles of children progressing to severe lung injury and/or septic shock could provide insight into pathogenesis.ObjectivesTo compare the endotracheal and serum cytokine profiles of children with influenza-related critical illness and to identify their associations with severe influenza-associated complications.Methods...

Melatonin Secretion Is Increased in Children with Severe Traumatic Brain Injury.

Science.gov (United States)

Marseglia, Lucia; D'Angelo, Gabriella; Manti, Sara; Rulli, Immacolata; Salvo, Vincenzo; Buonocore, Giuseppe; Reiter, Russel J; Gitto, Eloisa

2017-05-13

Traumatic brain injury (TBI) is a leading cause of death and disability in children. Oxidative stress plays a significant role in brain damage and melatonin exhibits both direct and indirect antioxidant effects. The primary aim of the present study was to evaluate serum melatonin levels in children with severe TBI in comparison to critically ill children admitted to the Pediatric Intensive Care Unit for conditions other than TBI. Twenty-four children were evaluated, equally divided into severe TBI and no-TBI. Blood samples for serum melatonin analysis were collected at 22:00, 01:00, 03:00, 05:00, 08:00, and 12:00. Mean serum melatonin peaks in children of the TBI group were higher compared to the values of no-TBI critically ill children (495 ± 102 vs. 294 ± 119 pg/mL, p = 0.0002). Furthermore, the difference was even more significant in comparison to values reported in literature for healthy age-matched children (495 ± 102 vs. 197 ± 71 pg/mL, p melatonin levels dramatically increase in children after severe TBI. This elevation is likely to represent a response to oxidative stress and/or inflammation due to severe head injury.

Metabolomic changes in serum of children with different clinical diagnoses of malnutrition

Science.gov (United States)

Mortality in children with severe acute malnutrition (SAM) remains high despite standardized rehabilitation protocols. Two forms of SAM are classically distinguished: kwashiorkor and marasmus. Children with kwashiorkor have nutritional edema and metabolic disturbances, including hypoalbuminemia and ...

Unintentional injuries among Chinese children with different types and severity of disability.

Science.gov (United States)

Zhu, Huiping; Xiang, Huiyun; Xia, Xin; Yang, Xia; Li, Dan; Stallones, Lorann; Du, Yukai

2014-01-01

Little research has been done in China to study injury in individuals with disability. We investigated the impact of type and severity of disability on injury among children with disability in Hubei Province of China. A sample of 1201 children with disability were matched with 1201 healthy children on gender, age, and neighborhood. Disability type and severity were determined using the Chinese national standards. Caregivers were interviewed face-to-face about nonfatal unintentional injuries suffered by the child in the past 12 months before the interview. Univariate χ(2) test and logistic regression models were used to investigate association between disability type/severity and nonfatal unintentional injuries. Injury rate among children with disability was significantly higher than that among children without disability (10.2% vs. 4.4%; P disability and injury varied by type and severity of disability. The magnitude of the association between the presence or absence of disability in children and their risk of injury was large and significant, regardless of the type or severity of the children's disabilities. Copyright © 2014 Elsevier Inc. All rights reserved.

Management of Angular Cheilitis in children

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Fajriani Fajriani

2017-04-01

Full Text Available Objective : Angular cheilitis is a type of oral soft tissue disease that can occur in children and adults, the condition is characterized by cracks and inflammation on both corners of the mouth. Although this disease can not cause severe disorder, it quite disturbs one's activity and physical appearance. Mild Angular cheilitis will recover itself over times. However severe conditions can cause pain and bleeding. This paper aims to inform colleagues about management of angular cheilitis in children.

Management of angular cheilitis for children

Directory of Open Access Journals (Sweden)

Fajriani Fajriani

2016-06-01

Full Text Available Angular cheilitis is one type of oral soft tissue disease that can occur in both children and adults, the condition is characterized by cracks and inflammation in both corners of the mouth. Although this disease does not cause severe disruption but quite disturbing activity and also one's physical appearance. Angular cheilitis light will disappear on their own over time.Severe conditions that can cause pain and bleading. aims to give feedback on peers about managment angular cheilitis in children.

Cardiac autonomic regulation is disturbed in children with euthyroid Hashimoto thyroiditis.

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Kilic, Ayhan; Gulgun, Mustafa; Tascilar, Mehmet Emre; Sari, Erkan; Yokusoglu, Mehmet

2012-03-01

Hashimoto thyroiditis (chronic autoimmune thyroiditis) is the most common form of thyroiditis in childhood. Previous studies have found autonomic dysfunction of varying magnitude in patients with autoimmune diseases, which is considered a cardiovascular risk factor. We aimed to evaluate the heart rate variability (HRV), a measure of cardiac autonomic modulation, in children with euthyroid Hashimoto thyroiditis (eHT). The study included 32 patients with eHT (27 girls and 5 boys; mean age 11 ± 4.1 years, range 8-16; body mass index 0.47 ± 0.69 kg/m(2)), as judged by normal or minimally elevated serum TSH levels (normal range: 0.34-5.6 mIU/l) and normal levels of free thyroid hormones (FT4 and FT3) and 38 euthyroid age-matched controls. Patients with eHT and control subjects underwent physical examination and 24-hour ambulatory ECG monitoring. Time-domain parameters of HRV were evaluated for cardiac autonomic functions. Children with eHT displayed significantly lower values of time-domain parameters of SDANN (standard deviation of the averages of NN intervals), RMSSD (square root of the mean of the sum of the squares of differences between adjacent NN intervals), NN50 counts (number of pairs of adjacent NN intervals differing by more than 50 ms) and PNN50 (NN50 count divided by the total number of all NN intervals) for each 5-min interval, compared to healthy controls (p < 0.05 for each), indicating the decreased beat-to-beat variation of heart rate. In conclusion, eHT is associated with disturbed autonomic regulation of heart rate. Hence, the children with eHT are at higher risk for developing cardiovascular diseases.

Incidence, Depth and Severity of Children in Poverty

Science.gov (United States)

Delamonica, Enrique Ernesto; Minujin, Alberto

2007-01-01

Recently, the first ever estimate of the number of children living poverty in developing countries was undertaken. The incidence of child poverty was estimated by establishing how many children suffer severe deprivation in at least one out of seven indicators which are internationally recognized as their rights as well as constitutive of poverty.…

Ultrasound assessment of severe dehydration in children with diarrhea and vomiting.

Science.gov (United States)

Levine, Adam C; Shah, Sachita P; Umulisa, Irenee; Munyaneza, Richard B Mark; Dushimiyimana, Jean Marie; Stegmann, Katrina; Musavuli, Juvenal; Ngabitsinze, Protogene; Stulac, Sara; Epino, Henry M; Noble, Vicki E

2010-10-01

The objective of this study was to determine the test characteristics for two different ultrasound (US) measures of severe dehydration in children (aorta to inferior vena cava [IVC] ratio and IVC inspiratory collapse) and one clinical measure of severe dehydration (the World Health Organization [WHO] dehydration scale). The authors enrolled a prospective cohort of children presenting with diarrhea and/or vomiting to three rural Rwandan hospitals. Children were assessed clinically using the WHO scale and then underwent US of the IVC by a second clinician. All children were weighed on admission and then fluid-resuscitated according to standard hospital protocols. A percent weight change between admission and discharge of greater than 10% was considered the criterion standard for severe dehydration. Receiver operating characteristic (ROC) curves were created for each of the three tests of severe dehydration compared to the criterion standard. Children ranged in age from 1 month to 10 years; 29% of the children had severe dehydration according to the criterion standard. Of the three different measures of dehydration tested, only US assessment of the aorta/IVC ratio had an area under the ROC curve statistically different from the reference line. At its best cut-point, the aorta/IVC ratio had a sensitivity of 93% and specificity of 59%, compared with 93% and 35% for IVC inspiratory collapse and 73% and 43% for the WHO scale. Ultrasound of the aorta/IVC ratio can be used to identify severe dehydration in children presenting with acute diarrhea and may be helpful in guiding clinical management. © 2010 by the Society for Academic Emergency Medicine.

Early-onset restrictive eating disturbances in primary school boys and girls.

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Kurz, Susanne; van Dyck, Zoé; Dremmel, Daniela; Munsch, Simone; Hilbert, Anja

2015-07-01

This study sought to determine the distribution of early-onset restrictive eating disturbances characteristic of the new DSM-5 diagnosis, avoidant/restrictive food intake disorder (ARFID) in middle childhood, as well as to evaluate the screening instrument, Eating Disturbances in Youth-Questionnaire (EDY-Q). A total of 1,444 8- to 13-year-old children were screened in regular schools (3rd to 6th grade) in Switzerland using the self-report measure EDY-Q, consisting of 12 items based on the DSM-5 criteria for ARFID. 46 children (3.2%) reported features of ARFID in the self-rating. Group differences were found for body mass index, with underweight children reporting features of ARFID more often than normal and overweight children. The EDY-Q revealed good psychometric properties, including adequate discriminant and convergent validity. Early-onset restrictive eating disturbances are commonly reported in middle childhood. Because of possible negative short- and long-term impact, early detection is essential. Further studies with structured interviews and parent reports are needed to confirm this study's findings.

The Quality of Life of Children with Severe Developmental Disabilities

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Ncube, B. L.; Perry, A.; Weiss, J. A.

2018-01-01

Background: Research examining the quality of life (QoL) of children with severe developmental disabilities (SDD) is limited. The present study examines parent perceptions of child QoL in children with SDD compared with typically developing (TD) children and then examines predictors of QoL for the SDD group. Method: Parents of 246 children with…

Severe obesity and high blood pressure among children, Philadelphia health centers, 2010.

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Nguyen, John V; Robbins, Jessica M; Houck, Kevin L; Nobis, Elizabeth A; Inman, Katelyn A; Khan, Khudsiya S; Robbins, Susan W

2014-04-01

Child obesity is a major health problem particularly affecting disadvantaged population groups. Severe obesity carries additional health risks for children. In the context of the childhood obesity epidemic, high blood pressure among children is of increasing concern. Chart reviews were carried out to examine the prevalence of severe obesity and its association with high blood pressure measurements among randomly selected patients aged 3 to 17 years who had well-child care visits at 8 public community health centers during 2010. A majority of the 691 patients reviewed were African American (58%); an additional 16% were Hispanic. The prevalence of severe obesity was 7.7% (95% confidence interval = 5.8% to 9.9%) and the prevalence of high blood pressure measurements was 17.5% (95% confidence interval = 14.8% to 20.6%). Patients who were severely obese were more than twice as likely as other children to have high blood pressure values. Severe obesity is associated with substantially increased frequency of high blood pressure measurements in children, and should be investigated further as a potential marker for hypertension in children. Primary care providers should be prepared to diagnose and treat hypertension in severely obese children.

Celiac Disease in Children with Moderate-to-Severe Iron-deficiency Anemia.

Science.gov (United States)

Narang, Manish; Natarajan, Ravikumar; Shah, Dheeraj; Puri, Amarender Singh; Manchanda, Vikas; Kotru, Mrinalini

2018-01-15

To evaluate the proportion of children with moderate to severe iron-deficiency anemia who have associated celiac disease. This cross-sectional analytical study was conducted among children aged 1 to 12 years of age with moderate-to-severe iron deficiency anemia and control children without anemia. Serum IgA-tissue trans-glutaminase levels were assessed in both cases and controls. All children with positive celiac serology underwent upper gastrointestinal endoscopy and duodenal biopsy; biopsy finding of Marsh grade 3 was considered positive for celiac disease. There were 152 anemic children and 152 controls with mean (SD) hemoglobinof 7.7 (1.8) and 12.2 (0.74) g/dL, respectively. 16 (10.5%) cases and 3 (2%) control patients had positive serology for celiac disease [OR (95% CI) 5.33 (1.52-18.67), P=0.007]. Six (3.9%) children with iron-deficiency anemia and none of the controls had biopsy features diagnostic of celiac disease. In the Northern Indian tertiary-care hospital outpatient setting, Celiac disease was associated with 4% of children presenting with moderate-to-severe anemia.

Visual-motor integration performance in children with severe specific language impairment.

Science.gov (United States)

Nicola, K; Watter, P

2016-09-01

This study investigated (1) the visual-motor integration (VMI) performance of children with severe specific language impairment (SLI), and any effect of age, gender, socio-economic status and concomitant speech impairment; and (2) the relationship between language and VMI performance. It is hypothesized that children with severe SLI would present with VMI problems irrespective of gender and socio-economic status; however, VMI deficits will be more pronounced in younger children and those with concomitant speech impairment. Furthermore, it is hypothesized that there will be a relationship between VMI and language performance, particularly in receptive scores. Children enrolled between 2000 and 2008 in a school dedicated to children with severe speech-language impairments were included, if they met the criteria for severe SLI with or without concomitant speech impairment which was verified by a government organization. Results from all initial standardized language and VMI assessments found during a retrospective review of chart files were included. The final study group included 100 children (males = 76), from 4 to 14 years of age with mean language scores at least 2SD below the mean. For VMI performance, 52% of the children scored below -1SD, with 25% of the total group scoring more than 1.5SD below the mean. Age, gender and the addition of a speech impairment did not impact on VMI performance; however, children living in disadvantaged suburbs scored significantly better than children residing in advantaged suburbs. Receptive language scores of the Clinical Evaluation of Language Fundamentals was the only score associated with and able to predict VMI performance. A small subgroup of children with severe SLI will also have poor VMI skills. The best predictor of poor VMI is receptive language scores on the Clinical Evaluation of Language Fundamentals. Children with poor receptive language performance may benefit from VMI assessment and multidisciplinary

Safety of Induced Sputum Collection in Children Hospitalized With Severe or Very Severe Pneumonia.

Science.gov (United States)

DeLuca, Andrea N; Hammitt, Laura L; Kim, Julia; Higdon, Melissa M; Baggett, Henry C; Brooks, W Abdullah; Howie, Stephen R C; Deloria Knoll, Maria; Kotloff, Karen L; Levine, Orin S; Madhi, Shabir A; Murdoch, David R; Scott, J Anthony G; Thea, Donald M; Amornintapichet, Tussanee; Awori, Juliet O; Chuananon, Somchai; Driscoll, Amanda J; Ebruke, Bernard E; Hossain, Lokman; Jahan, Yasmin; Kagucia, E Wangeci; Kazungu, Sidi; Moore, David P; Mudau, Azwifarwi; Mwananyanda, Lawrence; Park, Daniel E; Prosperi, Christine; Seidenberg, Phil; Sylla, Mamadou; Tapia, Milagritos D; Zaman, Syed M A; O'Brien, Katherine L

2017-06-15

Induced sputum (IS) may provide diagnostic information about the etiology of pneumonia. The safety of this procedure across a heterogeneous population with severe pneumonia in low- and middle-income countries has not been described. IS specimens were obtained as part a 7-country study of the etiology of severe and very severe pneumonia in hospitalized children <5 years of age. Rigorous clinical monitoring was done before, during, and after the procedure to record oxygen requirement, oxygen saturation, respiratory rate, consciousness level, and other evidence of clinical deterioration. Criteria for IS contraindications were predefined and serious adverse events (SAEs) were reported to ethics committees and a central safety monitor. A total of 4653 IS procedures were done among 3802 children. Thirteen SAEs were reported in relation to collection of IS, or 0.34% of children with at least 1 IS specimen collected (95% confidence interval, 0.15%-0.53%). A drop in oxygen saturation that required supplemental oxygen was the most common SAE. One child died after feeding was reinitiated 2 hours after undergoing sputum induction; this death was categorized as "possibly related" to the procedure. The overall frequency of SAEs was very low, and the nature of most SAEs was manageable, demonstrating a low-risk safety profile for IS collection even among severely ill children in low-income-country settings. Healthcare providers should monitor oxygen saturation and requirements during and after IS collection, and assess patients prior to reinitiating feeding after the IS procedure, to ensure patient safety. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Implications of recurrent disturbance for genetic diversity.

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Davies, Ian D; Cary, Geoffrey J; Landguth, Erin L; Lindenmayer, David B; Banks, Sam C

2016-02-01

Exploring interactions between ecological disturbance, species' abundances and community composition provides critical insights for ecological dynamics. While disturbance is also potentially an important driver of landscape genetic patterns, the mechanisms by which these patterns may arise by selective and neutral processes are not well-understood. We used simulation to evaluate the relative importance of disturbance regime components, and their interaction with demographic and dispersal processes, on the distribution of genetic diversity across landscapes. We investigated genetic impacts of variation in key components of disturbance regimes and spatial patterns that are likely to respond to climate change and land management, including disturbance size, frequency, and severity. The influence of disturbance was mediated by dispersal distance and, to a limited extent, by birth rate. Nevertheless, all three disturbance regime components strongly influenced spatial and temporal patterns of genetic diversity within subpopulations, and were associated with changes in genetic structure. Furthermore, disturbance-induced changes in temporal population dynamics and the spatial distribution of populations across the landscape resulted in disrupted isolation by distance patterns among populations. Our results show that forecast changes in disturbance regimes have the potential to cause major changes to the distribution of genetic diversity within and among populations. We highlight likely scenarios under which future changes to disturbance size, severity, or frequency will have the strongest impacts on population genetic patterns. In addition, our results have implications for the inference of biological processes from genetic data, because the effects of dispersal on genetic patterns were strongly mediated by disturbance regimes.

Assessment of problematic severe asthma in children

DEFF Research Database (Denmark)

Carlsen, K. C. L.; Hedlin, G.; Bush, A.

2011-01-01

Assessment of problematic severe asthma in children should be performed in a stepwise manner to ensure an optimal approach. A four-step assessment scheme is proposed. First, a full diagnostic work-up is performed to exclude other diseases which mimic asthma. Secondly, a multi-disciplinary assessm......Assessment of problematic severe asthma in children should be performed in a stepwise manner to ensure an optimal approach. A four-step assessment scheme is proposed. First, a full diagnostic work-up is performed to exclude other diseases which mimic asthma. Secondly, a multi......-disciplinary assessment is performed to identify issues that may need attention, including comorbidities. Thirdly, the pattern of inflammation is assessed, and finally steroid responsiveness is documented. Based upon these four steps an optimal individualised treatment plan is developed. In this article the many gaps...... in our current knowledge in all these steps are highlighted, and recommendations for current clinical practice and future research are made. The lack of good data and the heterogeneity of problematic severe asthma still limit our ability to optimise the management on an individual basis in this small...

Assessment and Management of Severe Malnutrition in Children ...

African Journals Online (AJOL)

BACKGROUND: Severe malnutrition is a common cause of morbidity and mortality among children less than five years of age. The World Health Organisation (WHO) has developed two manuals for the in-patient treatment of severe malnutrition. However, these manuals are not widely distributed with the result that most ...

Mapping disturbance dynamics in wet sclerophyll forests using time series Landsat

NARCIS (Netherlands)

Haywood, A.; Verbesselt, J.; Baker, P.J.

2016-01-01

In this study, we characterised the temporal-spectral patterns associated with identifying acute-severity disturbances and low-severity disturbances between 1985 and 2011 with the objective to test whether different disturbance agents within these categories can be identified with annual Landsat

Clinical and socioeconomic impact of moderate-to-severe versus mild influenza in children.

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Heikkinen, T; Silvennoinen, H; Heinonen, S; Vuorinen, T

2016-07-01

Some studies have assessed the efficacy of influenza vaccination in children separately for moderate-to-severe and any influenza, but the definition used for identifying children with moderate-to-severe illness has not been validated. We analyzed clinical and socioeconomic data from two prospective cohort studies of respiratory infections among children aged ≤13 years (four influenza seasons, 3,416 child-seasons of follow-up). We categorized children with laboratory-confirmed influenza into two mutually exclusive groups of moderate-to-severe and mild influenza using the previously proposed criteria. We obtained the data for the analyses from structured medical records filled out by the study physicians and from daily symptom cards filled out by the parents. Of 434 cases of influenza, 217 (50 %) were classified as moderate-to-severe and 217 (50 %) as mild. The mean duration of fever was 4.0 days in children with moderate-to-severe influenza and 3.1 days in those with milder illness (P socioeconomic impact of influenza is highest. Illness severity should be considered when assessing influenza vaccine effectiveness in children.

Working memory limitations in children with severe language impairment

NARCIS (Netherlands)

Daal, J.G.H.L. van; Verhoeven, L.T.W.; Leeuwe, J.F.J. van; Balkom, L.J.M. van

2008-01-01

In the present study, the relations of various aspects of working memory to various aspects of language problems in a clinical sample of 97 Dutch speaking 5-year-old children with severe language problems were studied. The working memory and language abilities of the children were examined using an

Prothrombin Time Prolongation was the Most Important Indicator of Severe Bleeding in Children with Severe Dengue Viral Infection.

Science.gov (United States)

Laoprasopwattana, Kamolwish; Binsaai, Jehrabeeyah; Pruekprasert, Pornpimol; Geater, Alan

2017-08-01

To determine the indicators of severe bleeding in children with severe dengue viral infection (DVI), the medical records of patients aged <15 years admitted to Songklanagarind Hospital in southern Thailand during 1989-2011 were reviewed. Severe-bleeding DVI was defined as needing blood products transfusion owing to DVI-caused bleeding. Of the 238 children with severe DVI according to the World Health Organization 2009 criteria, 44 (18.5%) had severe bleeding, of whom 28 (63.6%) died. The international normalized ratio (INR) had high correlations with both transaminase enzymes (Spearman correlation, rs = 0.67-0.69, p <0.01). Multivariate analysis found that patients who had dengue haemorrhagic fever (DHF) grade IV, platelets <20 000/mm3 and INR ≥ 1.5 had increased risk of severe bleeding with odds ratios (95% confidence intervals) of 3.4 (1.4, 8.6), 2.6 (1.1, 6.2) and 10.6 (4.0, 28.4), respectively. Blood products should be at hand in severe DHF children with high risk of severe bleeding. © The Author [2017]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

[Severe trampoline injuries and their risk factors among children and the young].

Science.gov (United States)

Sinikumpu, Juha-Jaakko; Salokorpi, Niina; Suo-Palosaari, Maria; Pesälä, Juha; Serlo, Willy

2016-01-01

Although the majority of trampoline injuries in children are minor, severe injuries occur as well. We have analyzed the risk factors, treatment and outcome of severe trampoline injuries treated in the Oulu University Hospital in children and the young between April and November 2105. There was a total of eight severe injuries. Five injuries involved a danger of death. Almost all severe trampoline injuries resulted from an unsuccessful trick. A safety net was in use in half of the cases. All cervical spine injuries would have been avoided provided that the children would have refrained from doing a somersault on the trampoline.

Associations of Physical Activity and Sedentary Behavior with Atopic Disease in United States Children.

Science.gov (United States)

Strom, Mark A; Silverberg, Jonathan I

2016-07-01

To determine if eczema, asthma, and hay fever are associated with vigorous physical activity, television/video game usage, and sports participation and if sleep disturbance modifies such associations. Data were analyzed from 2 cross-sectional studies including 133 107 children age 6-17 years enrolled in the 2003-2004 and 2007-2008 National Survey of Children's Health. Bivariate and multivariate survey logistic regression models were created to calculate the odds of atopic disease and atopic disease severity on vigorous physical activity, television/video game use, and sports participation. In multivariate logistic regression models controlling for sociodemographic factors, lifetime history of asthma was associated with decreased odds of ≥1 days of vigorous physical activity (aOR, 0.87; 95% CI, 0.77-0.99) and decreased odds of sports participation (0.91; 95% CI, 0.84-0.99). Atopic disease accompanied by sleep disturbance had significantly higher odds of screen time and lower odds of sports participation compared with children with either atopic disease or sleep disturbance alone. Severe eczema (aOR, 0.39; 95% CI, 0.19-0.78), asthma (aOR, 0.29; 95% CI, 0.14-0.61), and hay fever (aOR, 0.48; 95% CI, 0.24-0.97) were all associated with decreased odds of ≥1 days of vigorous physical activity. Moderate (aOR, 0.76; 95% CI, 0.57-0.99) and severe eczema (aOR, 0.45; 95% CI, 0.28-0.73), severe asthma (aOR, 0.47; 95% CI, 0.25-0.89), and hay fever (aOR, 0.53; 95% CI, 0.36-0.61) were associated with decreased odds of sports participation in the past year. Children with severe atopic disease, accompanied by sleep disturbance, have higher risk of sedentary behaviors. Copyright © 2016 Elsevier Inc. All rights reserved.

Serum vaspin level as a predictive indicator in the amelioration of fatty liver and metabolic disturbance in patients with severe obesity after laparoscopic vertical banded gastroplasty.

Science.gov (United States)

Wang, Yong; Yu, Zong-Fan; Cheng, Yun-Sheng; Jia, Ben-Li; Yu, Gang; Yin, Xiao-Qiang; Wang, Yang

2017-07-01

This study is all about predicting the value of serum vaspin level in the amelioration of fatty liver and metabolic disturbance in patients with severe obesity after laparoscopic vertical banded gastroplasty (LVBG). A total of 164 patients (from January 2012 to May 2015) with severe obesity were chosen and performed LVBG. Enzyme-linked immunosorbent assay was performed to detect the serum vaspin level. The patients were given a biochemical automatic analyzer to measure the biochemical indicators. Homeostasis model assessment (HOMA) helps in the calculation of fasting insulin level (FINS) and insulin resistance (IR). The changes in fatty liver were examined by computed tomography (CT). Receiver operating characteristic curve is used to increase the predictive value of serum vaspin level in the amelioration of liver function and disturbances in the metabolism. Weight, BMI, waist circumference, serum vaspin level, and triglyceride (TG) decreased, but CT value of liver increased at 4th, 7th, and 12th month after surgery. After the 7th and 12th month period of surgery, the alanine aminotransferase, aspartate aminotransferase, FINS, and HOMA-IR reduced in the patients (P fatty liver and metabolic disturbance. This study proves that the serum vaspin level serves as a predictive indicator in the amelioration of fatty liver and metabolic disturbance in patients with severe obesity after LVBG.

To identify Electrocardiographic changes in severely malnourished children

Directory of Open Access Journals (Sweden)

neeraj eKumar

2015-09-01

Full Text Available AbstractAims and objective: To identify myocardial changes in severely malnourished children.Material and method: This prospective, observational study enrolled 200 children between six months- five years of age who were fulfilling WHO criteria for severe malnutrition. The parents were duly informed and explained about the study and consent was taken. The material for the present study consisted of 200 cases (120 male and 80 female children suffering from severe protein energy malnutrition according to the mentioned criteria during the period of one year. The age group of the selected cases were divided in five groups viz. <1 years,1-2 years,2-3 years,3-4 years,4-5 years. A random selection of cases was done irrespectively of caste, creed, religion, sex and socioeconomic status etc.Results: 32% cases had flat P-wave on admission, out of which 75%. 84% of cases have increased Q-Tc-Interval at admission. S-T segment was depressed only in 8% of cases. 88% of cases have altered (flat to depressed T-wave at admission. All of these changes reverted to normal upon nutritional supplementation at discharge.Conclusion: The Electrocardiographic changes may be of help in assessing the severity and prognosis of severe acute malnutrition. The reversal of electrocardiographic changes was observed after dietary therapy. Reversibility of ECG changes suggests that the cardiac changes are not permanent in nature and will not have an effect in adult life. The cardiac status as denoted by heart rate remained same even after a fortnight, suggesting that a prolonged therapy and assessment of cardiac status is warranted even after fortnight therapy.

Defining a target population at high risk of long-term foster care: barriers to permanency for families of children with serious emotional disturbances.

Science.gov (United States)

Akin, Becci A; Bryson, Stephanie A; McDonald, Tom; Walker, Sheila

2012-01-01

Long-term foster care (LTFC) is an enduring problem that lacks evidence of effective strategies for practice or policy. This article describes initial activities of a statewide project of the national Permanency Innovations Initiative. The authors sought to: (1) verify the relevance of children's mental health as a predictor of LTFC, (2) describe critical barriers encountered by parents of children with serious emotional disturbances, and (3) identify systems barriers that hinder permanency for this target population.

The psychosocial effects of severe caries in 4-year-old children in Recife, Pernambuco, Brazil

Directory of Open Access Journals (Sweden)

Sandra Feitosa

2005-10-01

Full Text Available The aim of this study was to analyze the psychosocial effects of severe caries in 4-year-old children in Recife, Pernambuco, Brazil. The clinical examination was conducted by a single examiner in order to select children with severe caries and caries-free (kappa = 1. Of the 861 children examined, 77 (8.1% had severe caries and 225 (23.6% were caries-free. Data were collected by applying validated questionnaires answered by the parents or guardians. Most of the parents or guardians of children with severe caries reported that their children complained of toothache (72.7%, and a significant portion stated that their children had problems eating certain kinds of food (49.4% and missed school (26.0% because of their teeth. Most of the parents or guardians of children with severe caries (68.8% stated that oral health affects their children's life, while the same was stated by 9.8% of the parents or guardians of the caries-free children. Severe caries was found to have a negative impact on children's oral health-related quality of life.

Psychiatric disorders and symptoms severity in preschool children with atopic eczema.

Science.gov (United States)

Catal, F; Topal, E; Soylu, N; Ozel Ozcan, O; Celiksoy, M H; Babayiğit, A; Karakoç, H T E; Erge, D; Sancak, R

2016-01-01

To compare with a control group the frequency of psychiatric disorders and severity of psychiatric symptoms in preschool children with atopic eczema. The study included children between the ages of 3-5 who were diagnosed to have atopic eczema. The parents of the children with atopic eczema were interviewed in person and were asked to fill in "The Early Childhood Inventory-4" form. This form assesses the psychiatric disorders and symptoms severity in children between the ages of 3-5. The atopic eczema group included 80 patients (38 male, 42 female) with a mean age of 48.4 ± 15.7 months and the control group included 74 patients (41 male, 33 female) with a mean age of 49.9 ± 15.19 months. It was established that 68.8% of the group with atopic eczema received at least one psychiatric diagnosis. Between the psychiatric disorders, ADHD (Odds ratio: 2.57, 95% CI: 1.049-6.298, p=0.035), enuresis and encopresis (Odds ratio: 2.39, 95% CI: 1.121-5.097, p=0.022) and attachment disorder (Odds ratio: 2.03, 95% CI: 1.046-3.953, p=0.035) were found to be significantly higher when compared with the healthy control group. When the groups were compared in terms of psychiatric symptom severity scores calculated by using ECI-4, ADHD severity (p=0.043), conduct disorder severity (p=0.001), anxiety disorders severity (p<0.001), eating disorders severity (p=0.011) and tic disorder severity (p=0.01) were found to be higher in the atopic eczema group. Psychiatric illnesses are frequent in preschool children with atopic eczema. Copyright © 2015 SEICAP. Published by Elsevier Espana. All rights reserved.

Psychosocial stimulation interventions for children with severe acute malnutrition: a systematic review

NARCIS (Netherlands)

Daniel, Allison I.; Bandsma, Robert H.; Lytvyn, Lyubov; Voskuijl, Wieger P.; Potani, Isabel; van den Heuvel, Meta

2017-01-01

Background The WHO Guidelines for the inpatient treatment of severely malnourished children include a recommendation to provide sensory stimulation or play therapy for children with severe acute malnutrition (SAM). This systematic review was performed to synthesize evidence around this

Neurophysiological determinants of tic severity in children with chronic motor tic disorder.

Science.gov (United States)

Siniatchkin, Michael; Kuppe, Andrea

2011-06-01

Tics wax and wane in severity. Although the understanding of the natural course of symptoms in tic disorder (TD) is important for planning and assessing therapeutic interventions, neurophysiological mechanisms and predictors of tic exacerbation and remission have not been sufficiently investigated. In each of seven children suffering from TD, contingent negative variation (CNV) was recorded on 10 occasions over a period of 2 months. CNV parameters of children with TD were compared with CNV data of healthy, age-matched children. During the entire time of observation, tic severity was assessed by parents and the investigator using a scale developed from the Yale Global Tic Severity Scale. Moreover, tic severity was also evaluated using video assessments. Patients with TD were characterized by significantly lower amplitude of the total CNV and more pronounced habituation of the early CNV component as compared to healthy children. Correlation analysis between tic severity and CNV parameters demonstrated that the more severe the tics were, the lower the amplitude of the total CNV. Since CNV amplitude represents processes of resource mobilization and control over neuronal excitability, tic severity may result from less ability to control neurophysiological functions in patients with TD.

Cytokine Profiles of Severe Influenza Virus-Related Complications in Children

Directory of Open Access Journals (Sweden)

Andrew Fiore-Gartland

2017-11-01

Full Text Available RationaleEffective immunomodulatory therapies for children with life-threatening “cytokine storm” triggered by acute influenza infection are lacking. Understanding the immune profiles of children progressing to severe lung injury and/or septic shock could provide insight into pathogenesis.ObjectivesTo compare the endotracheal and serum cytokine profiles of children with influenza-related critical illness and to identify their associations with severe influenza-associated complications.MethodsChildren with influenza-related critical illness were enrolled across 32 hospitals in development (N = 171 and validation (N = 73 cohorts (December 2008 through May 2016. Concentrations of 42 cytokines were measured in serum and endotracheal samples and clustered into modules of covarying cytokines. Relative concentrations of cytokines and cytokine modules were tested for associations with acute lung injury (ALI, shock requiring vasopressors, and death/ECMO.Measurements and main resultsModules of covarying cytokines were more significantly associated with disease severity than individual cytokines. In the development cohort, increased levels of a serum module containing IL6, IL8, IL10, IP10, GCSF, MCP1, and MIP1α [shock odds ratio (OR = 3.37, family-wise error rate (FWER p < 10−4], and decreased levels of a module containing EGF, FGF2, SCD40L, and PAI-1 (shock OR = 0.43, FWER p = 0.002, were both associated with ALI, shock, and death-ECMO independent of age and bacterial coinfection. Both of these associations were confirmed in the validation cohort. Endotracheal and serum cytokine associations differed markedly and were differentially associated with clinical outcomes.ConclusionWe identified strong positive and negative associations of cytokine modules with the most severe influenza-related complications in children, providing new insights into the pathogenesis of influenza-related critical illness in children. Effective

Cardiometabolic Risks and Severity of Obesity in Children and Young Adults.

Science.gov (United States)

Skinner, Asheley C; Perrin, Eliana M; Moss, Leslie A; Skelton, Joseph A

2015-10-01

The prevalence of severe obesity among children and young adults has increased over the past decade. Although the prevalence of cardiometabolic risk factors is relatively low among children and young adults who are overweight or obese, those with more severe forms of obesity may be at greater risk. We performed a cross-sectional analysis of data from overweight or obese children and young adults 3 to 19 years of age who were included in the National Health and Nutrition Examination Survey from 1999 through 2012 to assess the prevalence of multiple cardiometabolic risk factors according to the severity of obesity. Weight status was classified on the basis of measured height and weight. We used standard definitions of abnormal values for total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein cholesterol, triglycerides, blood pressure, glycated hemoglobin, and fasting glucose and report the prevalence of abnormal values in children and young adults according to weight status. Among 8579 children and young adults with a body-mass index at the 85th percentile or higher (according to the Centers for Disease Control and Prevention growth charts), 46.9% were overweight, 36.4% had class I obesity, 11.9% had class II obesity, and 4.8% had class III obesity. Mean values for some, but not all, cardiometabolic variables were higher with greater severity of obesity in both male and female participants, and the values were higher in male participants than in female participants; for HDL cholesterol, the mean values were lower with greater severity of obesity. Multivariable models that controlled for age, race or ethnic group, and sex showed that the greater the severity of obesity, the higher the risks of a low HDL cholesterol level, high systolic and diastolic blood pressures, and high triglyceride and glycated hemoglobin levels. Severe obesity in children and young adults was associated with an increased prevalence of cardiometabolic risk factors

Motor Proficiency and Emotional/Behavioural Disturbance in Autism and Asperger's Disorder: Another Piece of the Neurological Puzzle?

Science.gov (United States)

Papadopoulos, Nicole; McGinley, Jennifer; Tonge, Bruce; Bradshaw, John; Saunders, Kerryn; Murphy, Anna; Rinehart, Nicole

2012-01-01

The relationship of motor proficiency with emotional/behavioural disturbance, autistic symptoms and communication disturbance was investigated in children diagnosed with autism and Asperger's disorder (AD). The Movement Assessment Battery for Children was used as a measure of motor impairment, and the Developmental Behavioural Checklist was used…

Hematogenous osteomyelitis in children

DEFF Research Database (Denmark)

Rud, B; Halken, S; Damholt, V

1986-01-01

approach. At follow-up after 5 (1-12) years, 3 neonates had developed severe growth disturbances despite optimal initial treatment. Acceptable results were obtained with antibiotic therapy for 6 weeks or more. We recommend ampicillin and a penicillinase-resistant penicillin, unless bacterial resistance......In a 10-year period, 31 children, including 9 infants, were treated for hematogenous osteomyelitis. Fifteen children were treated closed and 16 open. Thirteen of 14 positive cultures were Staphylococcus aureus. Three recurrences could possibly have been prevented by a more aggressive primary...

Does age or gender influence quality of life in children with atopic dermatitis?

Science.gov (United States)

Hon, K L E; Leung, T F; Wong, K Y; Chow, C M; Chuh, A; Ng, P C

2008-11-01

Quality of life (QoL) is impaired in children with atopic dermatitis (AD) but the various aspects of QoL may not be equally affected. Aim. To evaluate if age and gender affect some aspects of QoL in children with AD. The Children's Dermatology Life Quality Index (CDLQI) was used for all children with AD seen at a paediatric dermatology clinic over a 3-year period. Disease severity was assessed using the SCORing Atopic Dermatitis (SCORAD) and Nottingham Eczema Severity Score (NESS) tools. We reviewed CDLQI in 133 children (70 male and 63 female; age range 5-16 years) with AD. Itch, sleep disturbance, treatment and swimming/sports were the four aspects of QoL issues that were most commonly affected, in 50%, 47%, 38% and 29% of patients, respectively. Problems with interpersonal issues (friendship, school/holidays, and teasing/bullying) occurred in only a minority of children (genders similarly but were generally more common in children gender are relevant factors in QoL, with the issue of clothes/shoes being more troublesome for girls. itch and sleep disturbance seem to be a problem mainly in younger children.

The role of the father in child sleep disturbance: child, parent, and parent-child relationship.

Science.gov (United States)

Millikovsky-Ayalon, Maaian; Atzaba-Poria, Naama; Meiri, Gal

2015-01-01

The majority of studies on child sleep problems focus primarily on mothers, neglecting paternal influences. Guided by the transactional framework, we explored how child temperament, paternal and maternal stress, and the parent-child interactions differ between families having children with sleep disturbances and a selected comparison group. The role of paternal involvement in child caregiving as a moderator of these differences was assessed. The sample consisted of 51 children (1-3 years old) and their mothers and fathers. Data were collected during home visits, when mothers and fathers completed questionnaires and were interviewed. In addition, mother-child and father-child interactions were videotaped. Results indicate that compared to the comparison group, fathers rated children with sleep disturbances as fussier, both their mothers and fathers experienced higher levels of stress, and reported using more bedtime interactions that interfere with child's sleep-wake self-regulation. In addition, their fathers were less sensitive during father-child interaction and less involved in child caregiving. Finally, paternal involvement moderated the group differences seen in maternal stress, suggesting that high paternal involvement acted as a buffer to protect parents of children with sleep disturbances from experiencing parental stress. The important role of fathers in families having children with sleep disturbances is discussed. © 2014 Michigan Association for Infant Mental Health.

Atopy, but not obesity is associated with asthma severity among children with persistent asthma.

Science.gov (United States)

Lu, Kim D; Phipatanakul, Wanda; Perzanowski, Matthew S; Balcer-Whaley, Susan; Matsui, Elizabeth C

2016-12-01

Obesity is associated with an increased risk of asthma in children. Atopic sensitization is a major risk factor for asthma including severe asthma in children. It is unclear if obesity is associated with worse asthma control or severity in children and how its effects compare to atopy. We sought to examine relationships of weight status and atopy to asthma control and severity among a population of predominantly low income, minority children and adolescents with persistent asthma. A cross-sectional analysis of 832 children and adolescents, age range 5-17 years, with persistent asthma was performed. Clinical assessments included asthma questionnaires of symptoms, asthma severity score, health care utilization and medication treatment step, lung function testing, and skin prick testing as well as measures of adiposity. Data were collected between December 2010 and August 2014 from Johns Hopkins Hospital in Baltimore, MD and Children's Hospital of Boston, MA. Obesity was not associated with worse asthma control or severity in this group of predominantly low income, minority children and adolescents with persistent asthma. However, a greater degree of atopy was associated with lower lung function, higher asthma severity score, and higher medication treatment step. Atopy may be a more important risk factor for asthma severity than obesity among low-income minority children and adolescents with persistent asthma living in Northeastern cities in the United States.

Social, dietary and clinical correlates of oedema in children with severe acute malnutrition

DEFF Research Database (Denmark)

Rytter, Maren Johanne Heilskov; Namusoke, Hanifa; Babirekere-Iriso, Esther

2015-01-01

BACKGROUND: Severe acute malnutrition is a serious public health problem, and a challenge to clinicians. Why some children with malnutrition develop oedema (kwashiorkor) is not well understood. The objective of this study was to investigate socio-demographic, dietary and clinical correlates...... of oedema, in children hospitalised with severe acute malnutrition. METHODS: We recruited children with severe acute malnutrition admitted to Mulago Hospital, Uganda. Data was collected using questionnaires, clinical examination and measurement of blood haemoglobin, plasma c-reactive protein and α1-acid...... glycoprotein. Correlates of oedema were identified using multiple logistic regression analysis. RESULTS: Of 120 children included, 77 (64%) presented with oedematous malnutrition. Oedematous children were slightly older (17.7 vs. 15.0 months, p = 0.006). After adjustment for age and sex, oedematous children...

Physical activity level among children recovering from severe acute malnutrition

DEFF Research Database (Denmark)

Babirekere-Iriso, Esther; Rytter, Maren Johanne Heilskov; Namusoke, Hanifa

2018-01-01

OBJECTIVE: To assess the level and predictors of physical activity at discharge among children recovering from severe acute malnutrition (SAM). METHODS: We conducted a prospective study among 69 children 6 - 59 months of age admitted with SAM for nutritional rehabilitation at Mulago National...

Plantar pressures in children with and without sever's disease.

Science.gov (United States)

Becerro de Bengoa Vallejo, Ricardo; Losa Iglesias, Marta Elena; Rodríguez Sanz, David; Prados Frutos, Juan Carlos; Salvadores Fuentes, Paloma; Chicharro, José López

2011-01-01

a case-control study was conducted to compare static plantar pressures and distribution of body weight across the two lower limbs, as well as the prevalence of gastrocnemius soleus equinus, in children with and without calcaneal apophysitis (Sever's disease). the participants were 54 boys enrolled in a soccer academy, of which eight were lost to follow-up. Twenty-two boys with unilateral Sever's disease comprised the Sever's disease group and 24 healthy boys constituted a control group. Plantar pressure data were collected using pedobarography, and gastrocnemius soleus equinus was assessed. peak pressure and percentage of body weight supported were significantly higher in the symptomatic feet of the Sever's disease group than in the asymptomatic feet of the Sever's disease group and the control group. Every child in the Sever's disease group had bilateral gastrocnemius equinus, while nearly all children in the control group had no equinus. high plantar foot pressures are associated with Sever's disease, although it is unclear whether they are a predisposing factor or a result of the condition. Gastrocnemius equinus may be a predisposing factor for Sever's disease. Further research is needed to identify other factors involved in the disease and to better understand the factors that contribute to abnormal distribution of body weight in the lower limbs.

Predisposition of Nigerian children with severe malaria to urinary ...

African Journals Online (AJOL)

The predisposition of children with severe malaria to urinary tract infection was investigated in a group of 112 clinically diagnosed and para sitologically confirmed severe malaria patients (test) and in another subset of 114 apparently physically healthy non-malaria infected subjects (control). Standard bacteriological and ...

Sleep Disturbances in Patients with Rheumatoid Arthritis | Abbasi ...

African Journals Online (AJOL)

Sleep Disturbances in Patients with Rheumatoid Arthritis. ... that insomnia, pain and disease intensity were the most important factors that ... that sleep disturbances are frequent in patients with RA and may contribute to disease severity.

Active war in Sri Lanka: Children's war exposure, coping, and posttraumatic stress disorder symptom severity.

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Soysa, Champika K; Azar, Sandra T

2016-01-01

Posttraumatic stress disorder (PTSD) in response to active war is understudied among Sinhalese children in Sri Lanka. We investigated PTSD symptom severity in children using child (n = 60) and mother (n = 60) reports; child-reported war exposure and coping; as well as self-reported maternal PTSD symptom severity. The study addressed active war in 2 rural locations (acute and chronic community war exposure). Child-reports were significantly greater than mother-reports of child PTSD symptom severity. Furthermore, children's war exposure, child-reported and mother-reported child PTSD symptom severity, and maternal PTSD symptom severity were significantly greater in the acute versus chronic community war exposure location, but children's approach and avoidance coping did not significantly differ, indicating a potential ceiling effect. Children's war exposure significantly, positively predicted child-reported child PTSD symptom severity, controlling for age, gender, and maternal PTSD symptom severity, but only maternal PTSD symptom severity significantly, positively predicted mother-reported child PTSD symptom severity. Avoidance coping (in both acute and chronic war) significantly positively mediated the children's war exposure-child-reported child PTSD symptom severity relation, but not mother-reports of the same. Approach coping (in chronic but not acute war) significantly, positively mediated the children's war exposure-child-reported and mother-reported child PTSD symptom severity relations. We advanced the literature on long-term active war by confirming the value of children's self-reports, establishing that both approach and avoidance coping positively mediated the war-exposure-PTSD symptom severity relation, and that the mediation effect of approach coping was situationally moderated by acute verses chronic community war exposure among Sri Lankan children. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Macroscopic anisotropic bone material properties in children with severe osteogenesis imperfecta.

Science.gov (United States)

Albert, Carolyne; Jameson, John; Tarima, Sergey; Smith, Peter; Harris, Gerald

2017-11-07

Children with severe osteogenesis imperfecta (OI) typically experience numerous fractures and progressive skeletal deformities over their lifetime. Recent studies proposed finite element models to assess fracture risk and guide clinicians in determining appropriate intervention in children with OI, but lack of appropriate material property inputs remains a challenge. This study aimed to characterize macroscopic anisotropic cortical bone material properties and investigate relationships with bone density measures in children with severe OI. Specimens were obtained from tibial or femoral shafts of nine children with severe OI and five controls. The specimens were cut into beams, characterized in bending, and imaged by synchrotron radiation X-ray micro-computed tomography. Longitudinal modulus of elasticity, yield strength, and bending strength were 32-65% lower in the OI group (p<0.001). Yield strain did not differ between groups (p≥0.197). In both groups, modulus and strength were lower in the transverse direction (p≤0.009), but anisotropy was less pronounced in the OI group. Intracortical vascular porosity was almost six times higher in the OI group (p<0.001), but no differences were observed in osteocyte lacunar porosity between the groups (p=0.086). Volumetric bone mineral density was lower in the OI group (p<0.001), but volumetric tissue mineral density was not (p=0.770). Longitudinal OI bone modulus and strength were correlated with volumetric bone mineral density (p≤0.024) but not volumetric tissue mineral density (p≥0.099). Results indicate that cortical bone in children with severe OI yields at the same strain as normal bone, and that their decreased bone material strength is associated with reduced volumetric bone mineral density. These results will enable the advancement of fracture risk assessment capability in children with severe OI. Copyright © 2017 Elsevier Ltd. All rights reserved.

Intertidal soft-sediment community does not respond to disturbance as postulated by the intermediate disturbance hypothesis

Science.gov (United States)

Gerwing, Travis G.; Allen Gerwing, Alyssa M.; Macdonald, Tara; Cox, Kieran; Juanes, Francis; Dudas, Sarah E.

2017-11-01

The Intermediate Disturbance Hypothesis (IDH) predicts that disturbances of an intermediate frequency or intensity will maximize community biodiversity/richness. Once almost universally accepted, controversy now surrounds this hypothesis, and there have even been calls for its abandonment. Therefore, we experimentally evaluated if an infaunal community along the north coast of British Columbia, Canada, would respond to disturbances as predicted by the IDH. The characteristics of this soft-sediment intertidal mudflat (productivity, species pool, population growth rate) maximized our chances of finding evidence to support the IDH. More specifically, we tested if intermediate severities and frequencies of disturbance maximized infaunal community richness by mechanically disturbing sediment, and varying the intensity (0%, 25%, 50%, 75%, and 100% of the surface area of a plot disturbed) and frequency of sediment disturbance (never, once, twice, and every week during a four week period). No effect of frequency or intensity of sediment disturbance on community richness was observed. Further, none of our experimental treatments were statistically different than the controls. This is likely due to the subtle difference between successional stages in this soft-sediment habitat (difference of less than one taxa between treatments). Therefore, in habitats whose productivity, regional species pool, and population growth rates would otherwise suggest a response to disturbances as predicted by the IDH, minor differences between successional stages may result in richness patterns that deviate from those predicted by the IDH.

Severe ocular injuries in Greek children.

Science.gov (United States)

Mela, Ephigenia K; Georgakopoulos, Constantinos D; Georgalis, Athanasios; Koliopoulos, John X; Gartaganis, Sotirios P

2003-02-01

To determine the epidemiological characteristics of severe eye injuries in childhood, in a mixed urban and rural Greek setting. Retrospective analysis of 95 cases (103 eyes) of eye injuries in children younger than 17 years of age admitted to the Department of Ophthalmology, University Hospital of Patras, Greece, during a five-year period. The data were analyzed with respect to age, sex, type, cause and mode of injury, method of management, duration of hospitalization and final visual deficit. The average age was 9.8 years and males were involved in 80% of the cases. The most common type of eye injury was mechanical closed-globe injury (71.8%). Mechanical open-globe injuries were found in 21.3% of the eyes, while burns comprised 6.7% of the injuries. Most injuries were agent-related, with blows and falls being responsible most often. Multiple operations were part of the treatment in 11.6% of the eyes; 14.5% of the eyes were blinded and 15.5% had significant final visual acuity loss. These hospital-based data suggest that there is a need for health education of both parents and children, since some injuries in children could easily have been prevented.

Increased frequency of severe major anomalies in children conceived by intracytoplasmic sperm injection

DEFF Research Database (Denmark)

Sanchez-Albisua, I; Borell-Kost, S; Mau-Holzmann, U A

2007-01-01

anomalies (MaCAs). Four children born after ICSI versus no control children had severe MaCAs (p=0.04). These were defined as having a significant impact on development or causing chronic disease: Angelman syndrome (n=1), lissencephaly (n=1), Hanhart syndrome (n=1), and persistent hyperinsulinemic...... for imprinting defects cannot be excluded. If we exclude children with severe MaCAs, the incidence of an abnormal somatic or neurodevelopmental outcome in the fourth year of life in children born after ICSI is similar to that of spontaneously conceived children....

Vocabulary and working memory in children fit with hearing aids.

Science.gov (United States)

Stiles, Derek J; McGregor, Karla K; Bentler, Ruth A

2012-02-01

To determine whether children with mild-to-moderately severe sensorineural hearing loss (CHL) present with disturbances in working memory and whether these disturbances relate to the size of their receptive vocabularies. Children 6 to 9 years of age participated. Aspects of working memory were tapped by articulation rate, forward and backward digit span in the auditory and visual modalities, Corsi span, parent surveys, and a sequential encoding task. Articulation rate, digit spans, and Corsi spans were also administered in low-level broadband noise. CHL and children with normal hearing (CNH) demonstrated auditory advantage in forward serial recall. CHL demonstrated slower articulation rates than CNH, but similar memory spans. CHL with poor executive function presented with poorer performance on the Corsi span task. The presence of background noise had no effect on performance in either group. CHL presented with significantly smaller receptive vocabularies than their CNH peers. Across groups, receptive vocabulary size was positively correlated with digit span in quiet, Corsi span in noise, and articulation rate. In the presence of mild-to-moderately severe hearing loss, children demonstrated resilient working memory systems. For all children, working memory and vocabulary were related; that is, children with poorer working memory had smaller vocabulary sizes.

Human Metapneumovirus Infection in Jordanian Children: Epidemiology and Risk Factors for Severe Disease

Science.gov (United States)

Schuster, Jennifer E.; Khuri-Bulos, Najwa; Faouri, Samir; Shehabi, Asem; Johnson, Monika; Wang, Li; Fonnesbeck, Christopher; Williams, John V.; Halasa, Natasha

2016-01-01

Background Human metapneumovirus (HMPV) is a leading cause of acute respiratory tract infection (ARTI) in young children. Our objectives were to define HMPV epidemiology and circulating strains and determine markers of severe disease in Jordanian children. Methods We conducted a prospective study March 16, 2010-March 31, 2013 using quantitative RT-PCR to determine the frequency of HMPV infection among children <2 years old admitted with fever and/or acute respiratory illness to a major government hospital in Amman, Jordan. Results HMPV was present in 273/3168 (8.6%) of children presenting with ARTI. HMPV A2, B1, and B2, but not A1, were detected during the 3-year period. HMPV-infected children were older and more likely to be diagnosed with bronchopneumonia than HMPV-negative children. HMPV-infected children with lower respiratory tract infection (LRTI) had higher rates of cough and shortness of breath than children with LRTI infected with other or no identifiable viruses. Symptoms and severity were not different between children with HMPV only compared with HMPV co-infection. Children with HMPV subgroup A infection were more likely to require supplemental oxygen. In a multivariate analysis, HMPV subgroup A and age <6 months were independently associated with supplemental oxygen requirement. Conclusions HMPV is a leading cause of acute respiratory tract disease in Jordanian children <2 years old. HMPV A and young age were associated with severe disease. Ninety percent of HMPV-infected hospitalized children were full-term and otherwise healthy, in contrast to high-income nations; thus, factors contributing to disease severity likely vary depending on geographic and resource differences. PMID:26372450

Imagining the future in children with severe traumatic brain injury.

Science.gov (United States)

Lah, Suncica; Gott, Chloe; Epps, Adrienne; Parry, Louise

2018-03-22

Imagining the future events is thought to rely on re-combination and integration of past episodic memory traces into future events. Future and past events contain episodic and non-episodic details. Children with severe traumatic brain injury (TBI) were found to have impaired recall of past episodic (but not semantic) event details. Here we examined whether severe TBI impairs construction of future events. Cross-sectional. Children with severe TBI (n = 14) and healthy controls (NC; n = 33) (i) completed tests of anterograde (narrative and relational) memory and executive skills, (ii) recalled past events and generated future events, and (iii) rated events' phenomenological qualities. Events were scored for episodic (internal) and non-episodic (external) details. The groups did not differ in generating details of future events although children with TBI recalled significantly fewer past internal (but not external) events' details relative to NCs. Moreover, the number of past internal details relative to future internal details was significantly higher in the NC group, but not in the TBI groups. Significant correlations between past and future were found for (i) episodic details in both groups, and (ii) semantic details in the NC group. The TBI group rated their events as being less significant than did the NC group. The groups did not differ on ratings of visual intensity and rehearsal. Children who have sustained severe TBI had impoverished recall of past, but not generation of future events. This unexpected dissociation between past and future event construction requires further research.

Static and Dynamic Balance in Congenital Severe to Profound Hearing-Impaired Children

Directory of Open Access Journals (Sweden)

Farideh HajiHeydari

2011-09-01

Full Text Available Background and Aim: Research conducted since the early 1900s has consistently identified differences between deaf and hearing children on performance of a wide variety of motor tasks, most notably balance. Our study was performed to test static and dynamic balance skills in congenital severe to profound hearing impaired children in comparison with normal age-matched children.Methods: This cross-sectional study was conducted on 30 severe to profound hearing impaired and 40 normal children with age 6 to 10 years old. Bruininks-Oseretsky test of motor proficiency 2, balance subset with 9 parts was used for evaluation of balance skills.Results: Hearing-impaired children showed 16.7 to 100% fail results in 7 parts of the balance subset. In normal children fail result was revealed just in 3 parts of the balance subset from 2.5 to 57.5%, and differences between two groups were significant (p<0.0001. There was a significant difference between two groups in two static balance skills of standing on one leg on a line and standing on one leg on a balance beam with eyes closed (p<0.0001.conclusion: It seems that development of static balance skills are longer than dynamic ones. Because severe to profound hearing-impaired children showed more weakness than normal children in both static and dynamic balance abilities, functional tests of balance proficiency can help to identify balance disorders in these children.

Quantifying human disturbance in watersheds: Variable selection and performance of a GIS-based disturbance index for predicting the biological condition of perennial streams

Science.gov (United States)

Falcone, James A.; Carlisle, Daren M.; Weber, Lisa C.

2010-01-01

Characterizing the relative severity of human disturbance in watersheds is often part of stream assessments and is frequently done with the aid of Geographic Information System (GIS)-derived data. However, the choice of variables and how they are used to quantify disturbance are often subjective. In this study, we developed a number of disturbance indices by testing sets of variables, scoring methods, and weightings of 33 potential disturbance factors derived from readily available GIS data. The indices were calibrated using 770 watersheds located in the western United States for which the severity of disturbance had previously been classified from detailed local data by the United States Environmental Protection Agency (USEPA) Environmental Monitoring and Assessment Program (EMAP). The indices were calibrated by determining which variable or variable combinations and aggregation method best differentiated between least- and most-disturbed sites. Indices composed of several variables performed better than any individual variable, and best results came from a threshold method of scoring using six uncorrelated variables: housing unit density, road density, pesticide application, dam storage, land cover along a mainstem buffer, and distance to nearest canal/pipeline. The final index was validated with 192 withheld watersheds and correctly classified about two-thirds (68%) of least- and most-disturbed sites. These results provide information about the potential for using a disturbance index as a screening tool for a priori ranking of watersheds at a regional/national scale, and which landscape variables and methods of combination may be most helpful in doing so.

Severe Obesity Decreasing in Children in Cincinnati, Ohio.

Science.gov (United States)

Kharofa, Roohi Y; Klein, Jillian A; Khoury, Philip; Siegel, Robert M

2017-07-01

Childhood obesity rates appear to be leveling off. Studies not looking at severe obesity may be masking a rightward shift in the distribution of body mass indexes. Our objective was to provide current prevalence rates and examine trends in overweight, obesity, class 2 obesity, and class 3 obesity for youth in Cincinnati, Ohio. We performed a retrospective chart review of children 2 to 18 years old seen at Cincinnati Children's Hospital Medical Center between July 1, 2011, and June 30, 2014. Data from 217 037 BMIs were obtained; 35.2% of children were found to have an elevated BMI. Prevalence rates were highest in older, Hispanic, and Medicaid-insured children. The only significant trend over the 3-year period was a downward shift in class 3 obesity ( P = .02), contrary to national findings. Further studies assessing which clinical/community efforts have led to this downward trend will be essential to target future resources and facilitate continued progress.

Tracking Change in Children with Severe and Persisting Speech Difficulties

Science.gov (United States)

Newbold, Elisabeth Joy; Stackhouse, Joy; Wells, Bill

2013-01-01

Standardised tests of whole-word accuracy are popular in the speech pathology and developmental psychology literature as measures of children's speech performance. However, they may not be sensitive enough to measure changes in speech output in children with severe and persisting speech difficulties (SPSD). To identify the best ways of doing this,…

Pancreatic Enzyme Replacement Therapy in Children with Severe Acute Malnutrition: A Randomized Controlled Trial.

Science.gov (United States)

Bartels, Rosalie H; Bourdon, Céline; Potani, Isabel; Mhango, Brian; van den Brink, Deborah A; Mponda, John S; Muller Kobold, Anneke C; Bandsma, Robert H; Boele van Hensbroek, Michael; Voskuijl, Wieger P

2017-11-01

To assess the benefits of pancreatic enzyme replacement therapy (PERT) in children with complicated severe acute malnutrition. We conducted a randomized, controlled trial in 90 children aged 6-60 months with complicated severe acute malnutrition at the Queen Elizabeth Central Hospital in Malawi. All children received standard care; the intervention group also received PERT for 28 days. Children treated with PERT for 28 days did not gain more weight than controls (13.7 ± 9.0% in controls vs 15.3 ± 11.3% in PERT; P = .56). Exocrine pancreatic insufficiency was present in 83.1% of patients on admission and fecal elastase-1 levels increased during hospitalization mostly seen in children with nonedematous severe acute malnutrition (P Children who died had low fecal fatty acid split ratios at admission. Exocrine pancreatic insufficiency was not improved by PERT, but children receiving PERT were more likely to be discharged with every passing day (P = .02) compared with controls. PERT does not improve weight gain in severely malnourished children but does increase the rate of hospital discharge. Mortality was lower in patients on PERT, a finding that needs to be investigated in a larger cohort with stratification for edematous and nonedematous malnutrition. Mortality in severe acute malnutrition is associated with markers of poor digestive function. ISRCTN.com: 57423639. Copyright © 2017 Elsevier Inc. All rights reserved.

Sleep disturbance in psoriasis - a case-controlled study.

Science.gov (United States)

Jensen, P; Zachariae, C; Skov, L; Zachariae, R

2018-04-28

Sleep is essential for daytime functioning and health. Given the physical symptoms of psoriasis, a higher prevalence of sleep disorders could be expected. So far, the studies examining sleep disturbance in psoriasis have been of less-than-optimal methodological quality and with mixed results. We aimed to: 1) examine the prevalence of sleep disturbance in patients with plaque psoriasis compared to controls, 2) evaluate associations with health-related quality of life (HRQoL), and 3) examine possible disease-related predictors of disturbed sleep. We used a cross-sectional, case-controlled design. Participants included 179 consecutively recruited patients with plaque psoriasis and 105 controls. Measures included psoriasis severity (Psoriasis Area and Severity index [PASI]); HRQoL (Dermatology Life Quality Index [DLQI]); insomnia severity (Insomnia Severity Index [ISI]); sleep quality (Pittsburgh Sleep Quality Index [PSQI]); stress (Perceived Stress Scale [PSS]); Itch (Itch Severity Scale [ISS]); and depressive symptoms (Beck Depression Inventory [BDI]). Analyses included group comparisons and regression analyses to identify predictors of sleep disturbance. Twenty-five per cent of patients with psoriasis reported clinical insomnia (ISI > 15), compared with 10.5% of controls. In all, 53.9% of patients with psoriasis were poor sleepers (PSQI > 5), compared with 21.9% of controls. Itch was statistically significantly associated with all sleep-related outcomes. A higher proportion of patients with psoriasis suffer from poor sleep than controls from the general population. Itch was the main predictor of impaired sleep. Improved control of psoriasis with decreased itch may improve sleep disturbance in psoriasis. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

[Community assistance programme for children and adolescents with severe mental illness].

Science.gov (United States)

Barcala, Alejandra; Torricelli, Flavia; Alvarez Zunino, Patricia; Marotta, Julio

2009-01-01

The purpose of the following paper is to present an experience which links the production of knowledge resulting from academic research, with the transmission of said knowledge to the health system -with specific reference to mental health- by means of the implementation of the Community Assistance Programme for Children and/or Adolescents within the City of Buenos Aires. This programme is aimed at children and adolescents afflicted with severe psychological suffering, who consult the Mental Health Services in the public subsector of the City of Buenos Aires. It is the product of clinical institutional experience and of diverse investigations in health systems and services which showed a significant increase in the amount of consultations of children with severe and or complex mental health problems and which brought to light the lack of adequate sanitary response for these children by said sector. Based on the analysis and evaluation of the difficulties and obstacles in the functioning of the system a scheme was devised and implemented which aimed -from its beginning- to favour the possibilities of subjective constitution and integration into the community of these children and adolescents with severe mental deficiencies. By means of an interdisciplinary work consisting in the permanent training of human resources and the setup of intra and intersectional networks, it aims at facilitating accessibility and improving equality of opportunity, thus attempting to guarantee the right to a full protection of the health of children and adolescents.

Variants of early-onset restrictive eating disturbances in middle childhood.

Science.gov (United States)

Kurz, Susanne; van Dyck, Zoé; Dremmel, Daniela; Munsch, Simone; Hilbert, Anja

2016-01-01

This study sought to determine the factor structure of the newly developed self-report screening questionnaire Eating Disturbances in Youth-Questionnaire (EDY-Q) as well as to report the distribution of variants of early-onset restrictive eating disturbances characteristic of avoidant/restrictive food intake disorder (ARFID) in a middle childhood population sample. Using the EDY-Q, a total of 1,444 children aged 8-13 years were screened in elementary schools in Switzerland via self-report. The factor analysis of the 12 items covering ARFID related symptoms was performed using a principal component analysis (PCA). The PCA showed a four factor solution, with clear allocation to the scales covering three variants of early-onset restrictive eating disturbances and weight problems. Inadequate overall food intake was reported by 19.3% of the children, a limited accepted amount of food by 26.1%, and food avoidance based on a specific underlying fear by 5.0%. The postulated factor structure of the EDY-Q was confirmed, further supporting the existence of distinct variants of early-onset restrictive eating disturbances. Avoidant/restrictive eating behavior seems to be a common experience in middle childhood, but results have to be confirmed using validated interviews. © 2015 Wiley Periodicals, Inc.

Severe neutropenia in children: a single institutional experience.

Science.gov (United States)

Yilmaz, Deniz; Ritchey, Arthur Kim

2007-08-01

Severe neutropenia (SN) is a rare disorder in childhood. This study aimed to document the approach to diagnosis and treatment of children with SN in a single university-based children's hospital, determine the types of SN seen in a 4-year period, and determine outcomes of the subtypes of SN. Forty-five children with SN were identified between 2000 and 2004. Two patients had autoimmune, 3 congenital, 3 familial, 6 cyclic, and 31 idiopathic SN. The median age of the patients with idiopathic SN was 15 months (3 mo to 17 y). Thirteen patients with idiopathic SN received filgrastim and 18 were observed. The history of severe infection and hospitalization at presentation was significantly more common among the patients who received filgrastim than those observed, but was not different between the 2 groups during the follow-up period. SN resolved in 16 patients and persisted in 14 patients. One patient with idiopathic SN did not respond to filgrastim and died of sepsis while she was still neutropenic. In summary, the majority of patients with SN had idiopathic SN, the infection risk was variable, treatment was based on clinical judgment rather than absolute neutrophil count, and approximately half of the patients had complete recovery.

Severe falciparum malaria in young children of the Kassena-Nankana district of northern Ghana.

Science.gov (United States)

Oduro, Abraham R; Koram, Kwadwo A; Rogers, William; Atuguba, Frank; Ansah, Patrick; Anyorigiya, Thomas; Ansah, Akosua; Anto, Francis; Mensah, Nathan; Hodgson, Abraham; Nkrumah, Francis

2007-07-27

Severe falciparum malaria in children was studied as part of the characterization of the Kassena-Nankana District Ghana for future malaria vaccine trials. Children aged 6-59 months with diagnosis suggestive of acute disease were characterized using the standard WHO definition for severe malaria. Of the total children screened, 45.2% (868/1921) satisfied the criteria for severe malaria. Estimated incidence of severe malaria was 3.4% (range: 0.4-8.3%) cases per year. The disease incidence was seasonal: 560 cases per year, of which 70.4% occurred during the wet season (June-October). The main manifestations were severe anaemia (36.5%); prolonged or multiple convulsions (21.6%); respiratory distress (24.4%) and cerebral malaria (5.4%). Others were hyperpyrexia (11.1%); hyperparasitaemia (18.5%); hyperlactaemia (33.4%); and hypoglycaemia (3.2%). The frequency of severe anaemia was 39.8% in children of six to 24 months of age and 25.9% in children of 25-60 months of age. More children (8.7%) in the 25-60 months age group had cerebral malaria compared with 4.4% in the 6-24 months age group. The overall case fatality ratio was 3.5%. Cerebral malaria and hyperlactataemia were the significant risk factors associated with death. Severe anaemia, though a major presentation, was not significantly associated with risk of death. Severe malaria is a frequent and seasonal childhood disease in northern Ghana and maybe an adequate endpoint for future malaria vaccine trials.

Sleep disturbances after non-cardiac surgery

DEFF Research Database (Denmark)

Rosenberg, Jacob

2001-01-01

. The sleep disturbances seem to be related to the magnitude of trauma and thereby to the surgical stress response and/or post-operative opioid administration. Post-operative sleep disturbances may contribute to the development of early post-operative fatigue, episodic hypoxaemia, haemodynamic instability......After major non-cardiac surgery sleep pattern is usually disturbed with initial suppression of rapid eye movement sleep with a subsequent rebound during the first post-operative week. Deep sleep is also suppressed for several days after the operation and subjective sleep quality is impaired...... and altered mental status, all with a potential negative effect on post-operative outcome. Minimizing surgical trauma and avoiding or minimizing use of opioids for pain relief may prevent or reduce post-operative sleep disturbances. Post-operative sleep pattern represents an important research field, since...

Climate change and the future of natural disturbances in the central hardwood region

Energy Technology Data Exchange (ETDEWEB)

Dale, Virginia H [ORNL; Hughes, M. Joseph [University of Tennessee (UT); Hayes, Daniel J [ORNL

2015-01-01

The spatial patterns and ecological processes of the southeastern upland hardwood forests have evolved to reflect past climatic conditions and natural disturbance regimes. Changes in climate can lead to disturbances that exceed their natural range of variation, and the impacts of these changes will depend on the vulnerability or resiliency of these ecosystems. Global Circulation Models generally project annual increases in temperature across the southeastern United States over the coming decades, but changes in precipitation are less consistent. Even more unclear is how climate change might affect future trends in the severity and frequency of natural disturbances, such as severe storms, fires, droughts, floods, and insect outbreaks. Here, we use a time-series satellite data record to map the spatial pattern and severity of broad classes of natural disturbances the southeast region. The data derived from this map allow analysis of regional-scale trends in natural and anthropogenic disturbances in the region over the last three decades. Throughout the region, between 5% and 25% of forest land is affected by some sort of disturbance each year since 1985. The time series reveals periodic droughts that themselves are widespread and of low severity but are associated with more localized, high-severity disturbances such as fire and insect outbreaks. The map also reveals extensive anthropogenic disturbance across the region in the form of forest conversion related to resource extraction and urban and residential development. We discuss how changes in climate and disturbance regimes might affect southeastern forests in the future via altering the exposure, sensitivity and adaptive capacity of these ecosystems. Changes in climate are highly likely to expose southeastern forests to more frequent and severe disturbances, but ultimately how vulnerable or resilient southeastern forests are to these changes will depend on their sensitivity and capacity to adapt to these novel

Emotional Disturbance. NICHCY Disability Fact Sheet #5

Science.gov (United States)

National Dissemination Center for Children with Disabilities, 2010

2010-01-01

The mental health of our children is a natural and important concern for us all. The fact is, many mental disorders have their beginnings in childhood or adolescence, yet may go undiagnosed and untreated for years. "Umbrella" terms such as emotional disturbance, behavioral disorders, or mental illness are used to refer to mental…

Post-discharge mortality in children with severe malnutrition and pneumonia in Bangladesh.

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Mohammod Jobayer Chisti

Full Text Available BACKGROUND: Post-discharge mortality among children with severe illness in resource-limited settings is under-recognized and there are limited data. We evaluated post-discharge mortality in a recently reported cohort of children with severe malnutrition and pneumonia, and identified characteristics associated with an increased risk of death. METHODS: Young children (<5 years of age with severe malnutrition (WHO criteria and radiographic pneumonia on admission to Dhaka Hospital of icddr,b over a 15-month period were managed according to standard protocols. Those discharged were followed-up and survival status at 12 weeks post-discharge was determined. Verbal autopsy was requested from families of those that died. RESULTS: Of 405 children hospitalized with severe malnutrition and pneumonia, 369 (median age, 10 months were discharged alive with a follow-up plan. Of these, 32 (8.7% died in the community within 3 months of discharge: median 22 (IQR 9-35 days from discharge to death. Most deaths were reportedly associated with acute onset of new respiratory or gastrointestinal symptoms. Those that died following discharge were significantly younger (median 6 [IQR 3,12] months and more severely malnourished, on admission and on discharge, than those that survived. Bivariate analysis found that severe wasting on admission (OR 3.64, 95% CI 1.66-7.97 and age <12 months (OR 2.54, 95% CI 1.1-8.8 were significantly associated with post-discharge death. Of those that died in the community, none had attended a scheduled follow-up and care-seeking from a traditional healer was more common (p<0.001 compared to those who survived. CONCLUSION AND SIGNIFICANCE: Post-discharge mortality was common in Bangladeshi children following inpatient care for severe malnutrition and pneumonia. The underlying contributing factors require a better understanding to inform the potential of interventions that could improve survival.

Effect of probiotics on diarrhea in children with severe acute malnutrition

DEFF Research Database (Denmark)

Grenov, Benedikte; Namusoke, Hanifa; Lanyero, Betty

2017-01-01

OBJECTIVES: To assess the effect of probiotics on diarrhea during in- and outpatient treatment of children with severe acute malnutrition (SAM). METHODS: A randomized, double-blind, placebo-controlled study was conducted involving 400 children admitted with SAM. Patients received one daily dose...

Sleep disturbance associated factors in menopausal women

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Hamid Haghani

2011-09-01

Full Text Available Background: Sleep is necessary in life and approximately 1/3 of human life is devoted to sleep. One of the most common problems in menopausal women is sleep disturbance. The aim of this study was to determine frequency of sleep disorders and its related factors in 50 – 60 years old women Methods: A cross-sectional, descriptive study was conducted on 200 eligible women who referred to selected health centers of Tehran University of Medical Sciences (TUMS. Demographic form, ten-point slide to review sexual satisfaction and Pittsburg Sleep Quality Index Questioner (PSQI were used for data collection. Data was analyzed using ANOVA, t-test, and Pearson correlation tests.Results: The mean age of women was 53.6±3.6 year, menopause age 47.8±4, number of children 4.76±2 and partner age was 57.99±6.6. 34.5% of women were satisfied from their sexual relationship and their score was 8-10. Rate of sleep disturbances in this group was about 70%. The results showed that between four variables: economical status, occupation, partner occupation and educational status were significantly associated with sleep disturbance (P=0.002. There was not significant difference between other demographic information and sleep disturbance.Conclusion: The results show high prevalence of sleep disturbance symptoms among menopausal women. According to the relationship between some personal characters and sleep disturbance, health care providers need to consider these variables.

The severity of the visual impairment and practice matter for drawing ability in children.

Science.gov (United States)

Vinter, Annie; Bonin, Patrick; Morgan, Pascal

2018-07-01

Astonishing drawing capacities have been reported in children with early visual impairments. However, most of the evidence relies on single case studies. Hitherto, no study has systematically jointly investigated, in these children, the role of (1) the severity of the visual handicap, (2) age and (3) practice in drawing. The study aimed at revealing the specificities of the drawing in children deprived from vision, as compared to children with less severe visual handicap and to sighted children performing under haptic or usual visual control. 148 children aged 6-14 years had to produce 12 drawings of familiar objects. 38 had a severe visual impairment, 41 suffered from low vision, and 69 were sighted children performing either under visual condition or blindfolded under haptic control. Recognizability and other characteristics of the drawings were highly dependent on the child's degree of vision and level of drawing practice, and progressed with chronological age more clearly in the sighted children or those with low vision than in those deprived of vision. The study confirmed that all groups showed significant drawing ability, even the group totally deprived of visual experience. Furthermore, the specificities of the drawings produced by visually-impaired children appeared clearly related to their practice and the severity of their visual impairment. This should incite parents and professionals to encourage these children to practice drawing as early as possible. Copyright © 2018 Elsevier Ltd. All rights reserved.

Language disturbances from mesencephalo-thalamic infarcts

International Nuclear Information System (INIS)

Lazzarino, L.G.; Nicolai, A.; Valassi, F.; Biasizzo, E.

1991-01-01

The authors report the cases of two patients with CT-documented paramedian mesencephalo-thalamic infarcts, showing language disturbances. The first patient showed a non fluent, transcortical motor-like aphasia, the other had a fluent but severely paraphasic language disorder. The CT study disclosed that it was the dorso-median thalamic nucleus that was mostly involved in both cases. These findings agree with a few previous pathological studies suggesting that the paramedian thalamic nuclei, particlularly the dorso-median nucleus may play some role in language disturbances. However the anatomical basis for thalamic aphasia remains speculative, taking into account the importantce of cortical connections in the origin of subcortical neuropsychological disturbances. (orig.)

Severe allergic hair dye reactions in 8 children

DEFF Research Database (Denmark)

Sosted, Heidi; Johansen, Jeanne Duus; Andersen, Klaus Ejner

2006-01-01

Serious adverse skin reactions to permanent hair dyes and temporary black tattoos have been reported. As temporary tattoos have become fashionable among adolescents, the risk profile for p-phenylenediamine (PPD) sensitization of the population has changed simultaneously with an increasing use...... of hair dyes in this age group. This investigation reports PPD sensitization in children with regard to cause of sensitization, clinical presentation and consequences. Clinical history and patch test results for consecutive children below 16 years of age with suspected hair dye allergic reactions...... and positive patch tests to PPD were collected over 2 years in 2 Danish dermatology clinics. 8 children aged 12-15 years were collected, and they all reacted to several hair dye ingredients. 5 of the patients were hospitalized, 1 in the intensive care unit. 6 of the patients gave a history of prior reaction...

Serum and urinary thioredoxin concentrations are associated with severity of children hydronephrosis.

Science.gov (United States)

Xu, Zhe-Ming; Li, Min-Ju; Tao, Chang

2017-03-01

Ureteropelvic junction obstruction (UPJO) is the most common cause of hydronephrosis in children. This study was to assess the relationship between serum thioredoxin (S-Trx) and urinary thioredoxin (U-Trx) concentrations and severity of children hydronephrosis caused by UPJO. This study included 156 hydronephrosis children with unilateral UPJO and 80 healthy children. S-Trx and U-Trx concentrations were measured using enzyme-linked immunosorbent assay. U-Trx/creatinine (cr) ratio was calculated. S-Trx and U-Trx concentrations and U-Trx/cr ratio were significantly higher in hydronephrosis children than in healthy children. They were significantly correlated with split renal function, anterior-posterior diameter and Society for Fetal Urology classification, as well as were independently related to the split renal function 30mm and Society for Fetal Urology grade IV. Under receiver operating characteristic curves, U-Trx/cr ratio showed the higher predictive value compared to S-Trx and U-Trx concentrations. Increased S-Trx and U-Trx concentrations, especially U-Trx/cr ratio, are closely associated with the severity of children hydronephrosis, substantializing Trx as a promising biomarker for the progression of children hydronephrosis. Copyright © 2017 Elsevier B.V. All rights reserved.

Environmental and Personal Factors Related to Asthma Severity among Children: Hospital Based Study, Egypt

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Omaima Ibrahim AboElkheir

2016-09-01

Full Text Available Background: Childhood asthma is a complex disorder in which many environmental and personal factors play a role. However, the contribution of these factors to asthma severity is poorly understood. This study aims to determine the relationship between environmental exposures, personal factors and asthma severity among asthmatic children. Methods: This cross-sectional hospital based study was conducted on 180 asthmatic children; they were divided into mild, moderate and severe asthma according to forced expiratory volume in first second. Environmental factors (indoor and outdoor, food allergy, history of other allergic diseases, family history of allergic disorders, time trend of attacks as well as asthma outcome were reported. Results: Children with severe asthma were younger than those with mild or moderate asthma. Severe asthma was significantly linked to family history of allergy, presence of co-morbid allergic diseases, fish, egg and milk allergy, as well as exposure to passive smoking (73.7% and poor housing conditions. Also, it was significantly linked to presence of unauthorized factories in residential area (31.6 %, p=0.001. As well as, contact with pets (42.1%. Children with severe asthma had more limitations of physical activities (73.7%, missed school days (81.5%, with poor school performance (p=0.04 than those with mild moderate or asthma. Conclusion: Severe asthma was linked to female gender and younger age, co-morbid allergic diseases, family history of atopy and food allergy. It was higher among children residing in places with unauthorized factories and living in substandard housing condition. Children with severe asthma had poor asthma outcome.

Restoration of heterogeneous disturbance regimes for the preservation of endangered species

Science.gov (United States)

Steven D. Warren; Reiner Buttner

2014-01-01

Disturbance is a natural component of ecosystems. All species, including threatened and endangered species, evolved in the presence of, and are adapted to natural disturbance regimes that vary in the kind, frequency, severity, and duration of disturbance. We investigated the relationship between the level of visible soil disturbance and the density of four endangered...

Disturbance phenomena in VLF standard radio wave observation

International Nuclear Information System (INIS)

Muraoka, Yoshikazu

1977-01-01

Storm aftereffect, i.e. the phase disturbance after initiation of a magnetic storm has been revealed in the observation of VLF standard radio waves. In VLF long distance propagation at middle latitudes (L - 3), the phase disturbance for several days after the initiation of a magnetic storm is due to electron fall from the radiation belt. This has been confirmed by the comparison with electron flux detected by an artificial satellite. The correlations between VLF phase disturbance and magnetism activity or ionosphere absorption are described. The relation between winter anomaly and phase disturbance is also discussed. (Mori, K.)

A home-centered instructional communication strategy for severely handicapped children.

Science.gov (United States)

Wulz, S V; Hall, M K; Klein, M D

1983-02-01

Family involvement is an essential element of language intervention with severely handicapped children for several reasons. First, the parent-child interaction is the focus of normal language development, and can be a powerful impetus in language learning for handicapped children. Second, limited generalization and maintenance of skills often occur when they are acquired in environments that do not also teach the appropriate use of skills. Third, parents can be successful intervention agents and may generalize their skills to other interactions with their child. Training conducted in the home must be compatible with that environment: it should involve only those skills that are of immediate use in the home. The Instructional Communication Strategy described herein represents such a program. It is a synthesis of training strategies used with normal and handicapped children, and is applicable regardless of child's level of functioning, age, or handicapping condition. This training model involves considerable modification in the role of speech-language pathologists dealing with the severely handicapped. The professional's skills are best utilized for assessment, program development, monitoring progress, and training specialized skills. The parents provide most of the direct training; however, professionals are also utilized for the child's maximum benefit.

Concepts and Challenges in Disturbance Hydrology

Science.gov (United States)

Ebel, B. A.; Mirus, B. B.

2016-12-01

Landscape disturbances are increasing, often promoted and enhanced by climate shifts and human activities. Insect infestations, wildfires, earthquakes, urban development, forest harvest, mineral and petroleum resource extraction, and hurricanes are common landscape disturbances that can have profound hydrologic consequences. These cause relatively abrupt changes in the landscape, which alter local processes on plots and hillslopes in addition to coarser-scale processes across watersheds through cross-scale interactions. Shifts in soil properties and cover of vegetation and leaf litter change the water storage or buffering capacity as well as the hydrologic functional connectivity across multiple scales. These changes increase the risk of catastrophic flooding, erosion, and mass movements that degrade water resources, ecosystem services, and protection from hydrologically driven natural hazards. Although it is imperative that we understand the hydrologic effects of these disturbances, several major barriers exist. Four challenges are: (i) overlapping disturbances in space and time with unknown recovery trajectories, (ii) a paucity of long-term recovery records (>5 years duration), (iii) inefficacy of traditional modeling and parameterization approaches, and (iv) lack of pre-disturbance characterization. Examples of these challenges will be presented along with proposed opportunities for improved mechanistic understanding of processes and thresholds in disturbance hydrology.

Serum IL-33 Is Elevated in Children with Asthma and Is Associated with Disease Severity.

Science.gov (United States)

Bahrami Mahneh, Sedigheh; Movahedi, Masoud; Aryan, Zahra; Bahar, Mohammad Ali; Rezaei, Arezou; Sadr, Maryam; Rezaei, Nima

2015-01-01

The role of IL-33, a member of the IL-1 family, in airway hyperresponsiveness and asthma has still to be fully understood. This study is aimed at investigating serum IL-33 in children with asthma and its association with asthma severity. This age- and sex-matched case-control study comprised 61 children with asthma and 63 healthy controls. The mean age of the participants was 9.21 years (range: 6-14). Serum IL-33 was measured using ELISA and was compared between children with asthma and controls. In addition, the association of serum IL-33 with asthma severity was investigated. The level of serum IL-33 was significantly higher in children with asthma than in controls (15.17 ± 32.3 vs. 0.61 ± 2.16 pg/ml; p = 0.028). It was significantly increased proportionately to asthma severity, namely 9.92 ± 30.26 pg/ml in children with mild asthma, 13.68 ± 29.27 pg/ml in children with moderate asthma and 31.92 ± 41.45 pg/ml in children with severe asthma (p = 0.026). Serum IL-33 is increased in children with asthma and is associated with disease severity. © 2016 S. Karger AG, Basel.

Outcome of short-term hospitalization for children with severe asthma.

Science.gov (United States)

Weinstein, A G; Faust, D S; McKee, L; Padman, R

1992-07-01

This study presents results of a family-centered, short-term residential program in which medical, behavioral, and treatment assessments were provided to the child with severe asthma and the family. After a median stay of 15 days, forty-four consecutively admitted children with severe asthma achieved a 93% reduction in hospital days (median, 7 hospital days for the year before treatment versus median 0 hospital days per patient per year at 20 1/2-month follow-up; p less than 0.001) and an 81% reduction in emergency care (median, 4 visits for the year previously versus median, 0.4 visits per patient per year at follow-up; p less than 0.01). There was also a significant reduction in corticosteroid bursts and improvement in FEV1. Unique to this program was mandatory family participation focusing on the child's and family's adaptation to severe asthma and development of family-specific interventions to promote compliance with the treatment regimen. Child and family functioning was assessed at admission and follow-up. Hospital use at follow-up was greater for children from dysfunctional families. Families demonstrating difficulties in disciplining the child with asthma required more hospital days both before admission and at follow-up. Short-term hospitalization for children with severe asthma is associated with significant improvement in pulmonary morbidity when the family of the child is included in assessment and treatment.

The Developmental Course of Sleep Disturbances Across Childhood Relates to Brain Morphology at Age 7: The Generation R Study.

Science.gov (United States)

Kocevska, Desana; Muetzel, Ryan L; Luik, Annemarie I; Luijk, Maartje P C M; Jaddoe, Vincent W; Verhulst, Frank C; White, Tonya; Tiemeier, Henning

2017-01-01

Little is known about the impact of sleep disturbances on the structural properties of the developing brain. This study explored associations between childhood sleep disturbances and brain morphology at 7 years. Mothers from the Generation R cohort reported sleep disturbances in 720 children at ages 2 months, 1.5, 2, 3, and 6 years. T1-weighted Magnetic Resonance Imaging (MRI) images were used to assess brain structure at 7 years. Associations of sleep disturbances at each age and of sleep disturbance trajectories with brain volumes (total brain volume, cortical and subcortical grey matter, white matter) were tested with linear regressions. To assess regional differences, sleep disturbance trajectories were tested as determinants for cortical thickness in whole-brain analyses. Sleep disturbances followed a declining trend from toddlerhood onwards. Infant sleep was not associated with brain morphology at age 7. Per SD sleep disturbances (one frequent symptom or two less frequent symptoms) at 2 and 3 years of age, children had -6.3 (-11.7 to -0.8) cm3 and -6.4 (-11.7 to -1.7) cm3 smaller grey matter volumes, respectively. Sleep disturbances at age 6 years were associated with global brain morphology (grey matter: -7.3 (-12.1 to -2.6), p value = .01). Consistently, trajectory analyses showed that more adverse developmental course of childhood sleep disturbances are associated with smaller grey matter volumes and thinner dorsolateral prefrontal cortex. Sleep disturbances from age 2 years onwards are associated with smaller grey matter volumes. Thinner prefrontal cortex in children with adverse sleep disturbance trajectories may reflect effects of sleep disturbances on brain maturation. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

CT evaluation of severe renal inflammatory disease in children

International Nuclear Information System (INIS)

Montgomery, P.; Kuhn, J.P.; Afshani, E.

1987-01-01

We have performed CT scans on 15 children and 2 young adults with severe renal inflammatory disease. Most children with urinary tract infections do not require such evaluation. We have, however, found CT helpful in defining the nature of renal abnormality and in defining the extent of disease in selected patients who either presented as diagnostic dilemmas or who did not respond initially to proper medical treatment. We therefore use CT scanning as our initial examination in such problem patients. (orig.)

In-hospital mortality pattern of severely injured children

DEFF Research Database (Denmark)

Do, Hien Quoc; Steinmetz, Jacob; Rasmussen, Lars S

2012-01-01

the mortality pattern of severely injured children admitted to a Danish level I trauma centre. METHODS: We included trauma patients aged 15 years or less, who subsequent a trauma team activation were admitted during the 9-year period 1999-2007. Data were collected prospectively for subjects who had a length...

Cow's milk allergic children - Can component resolved diagnostics predict duration and severity?

DEFF Research Database (Denmark)

Petersen, Thomas Houmann; Mortz, Charlotte Gotthard; Bindslev-Jensen, Carsten

2018-01-01

BACKGROUND: Cow's Milk Allergy (CMA) affects 2% of all children. This study investigates CRD to cow's milk proteins in children suspected for CMA, by correlating the level of CRD with outcome of the oral challenge. Furthermore, we evaluate the ability of serial CRD measurements to distinguish....... Furthermore, a correlation between s-IgE level to cow's milk and Casein and the severity of the allergic reaction elicited by food challenges was found. CONCLUSION: Oral food challenge cannot be replaced by s-IgE to whole milk protein or milk components nor SPT in the diagnosis of CMA, however high levels...... children with persistent CMA from children developing tolerance. METHODS: We included data from 78 children referred to the Allergy Centre during a 13 years period. Results from oral food challenges including threshold, severity and sensitization data (IgE antibodies to whole milk protein, IgE components...

Genetic and environmental influences on the transmission of parental depression to children’s depression and conduct disturbance: An extended Children of Twins study

Science.gov (United States)

Silberg, Judy L.; Maes, Hermine; Eaves, Lindon J.

2010-01-01

Background Despite the increased risk of depression and conduct problems in children of depressed parents, the mechanism by which parental depression affects their children’s behavioral and emotional functioning is not well understood. The present study was undertaken to determine whether parental depression represents a genuine environmental risk factor in children’s psychopathology, or whether children’s depression/conduct can be explained as a secondary consequence of the genetic liability transmitted from parents to their offspring. Methods Children of Twins (COT) data collected on 2,674 adult female and male twins, their spouses, and 2,940 of their children were used to address whether genetic and/or family environmental factors best account for the association between depression in parents and depression and conduct problems in their children. Data collected on juvenile twins from the Virginia Twin Study of Adolescent Behavioral Development (VTSABD) were also included to estimate child-specific genetic and environmental influences apart from those effects arising from the transmission of the parental depression itself. The fit of alternative Children of Twin models were evaluated using the statistical program Mx. Results The most compelling model for the association between parental and juvenile depression was a model of direct environmental risk. Both family environmental and genetic factors accounted for the association between parental depression and child conduct disturbance. Conclusions These findings illustrate how a genetically mediated behavior such as parental depression can have both an environmental and genetic impact on children’s behavior. We find developmentally specific genetic factors underlying risk to juvenile and adult depression. A shared genetic liability influence both parental depression and juvenile conduct disturbance, implicating child CD as an early indicator of genetic risk for depression in adulthood. In summary, our

Erythropoiesis in HIV-infected and uninfected Malawian children with severe anemia

NARCIS (Netherlands)

Calis, Job C. J.; Phiri, Kamija S.; Vet, Raymond J. W. M.; de Haan, Rob J.; Munthali, Francis; Kraaijenhagen, Robert J.; Hulshof, Paul J. M.; Molyneux, Malcolm E.; Brabin, Bernard J.; Boele van Hensbroek, Michaël; Bates, Imelda

2010-01-01

Anemia is common in HIV infection, but the pathophysiology is poorly understood. Bone marrow analysis in 329 severely anemic (hemoglobin <5 g/dl) Malawian children with (n = 40) and without (n = 289) HIV infection showed that HIV-infected children had fewer CD34(+) hematopoietic progenitors (median

Building Structure into a Class for Emotionally Disturbed Children: One Teacher's Experience.

Science.gov (United States)

Cambone, Joseph

The paper is a description of how one teacher structured a classroom for five seriously disturbed violent boys (ages 5.5 to 8 years) at a private residential and day school for emotionally disturbed students. Anecdotes are reported as well as the teacher's reflections. Changes in the teacher's original planned class structure while maintaining the…

Severe neurological sequelae and behaviour problems after cerebral malaria in Ugandan children

Directory of Open Access Journals (Sweden)

Tugumisirize Joshua

2010-04-01

Full Text Available Abstract Background Cerebral malaria is the most severe neurological complication of falciparum malaria and a leading cause of death and neuro-disability in sub-Saharan Africa. This study aimed to describe functional deficits and behaviour problems in children who survived cerebral malaria with severe neurological sequelae and identify patterns of brain injury. Findings Records of children attending a specialist child neurology clinic in Uganda with severe neurological sequelae following cerebral malaria between January 2007 and December 2008 were examined to describe deficits in gross motor function, speech, vision and hearing, behaviour problems or epilepsy. Deficits were classified according to the time of development and whether their distribution suggested a focal or generalized injury. Any resolution during the observation period was also documented. Thirty children with probable exposure to cerebral malaria attended the clinic. Referral information was inadequate to exclude other diagnoses in 7 children and these were excluded. In the remaining 23 patients, the commonest severe deficits were spastic motor weakness (14, loss of speech (14, hearing deficit (9, behaviour problems (11, epilepsy (12, blindness (12 and severe cognitive impairment (9. Behaviour problems included hyperactivity, impulsiveness and inattentiveness as in attention deficit hyperactivity disorder (ADHD and conduct disorders with aggressive, self injurious or destructive behaviour. Two patterns were observed; a immediate onset deficits present on discharge and b late onset deficits. Some deficits e.g. blindness, resolved within 6 months while others e.g. speech, showed little improvement over the 6-months follow-up. Conclusions In addition to previously described neurological and cognitive sequelae, severe behaviour problems may follow cerebral malaria in children. The observed differences in patterns of sequelae may be due to different pathogenic mechanisms, brain

Socio-economic determinants of severe and moderate stunting among under-five children of rural Bangladesh.

Science.gov (United States)

Mostafa, Kamal S M

2011-04-01

Malnutrition among under-five children is a chronic problem in developing countries. This study explores the socio-economic determinants of severe and moderate stunting among under-five children of rural Bangladesh. The study used data from the 2007 Bangladesh Demographic and Health Survey. Cross-sectional and multinomial logistic regression analyses were used to assess the effect of the socio-demographic variables on moderate and severe stunting over normal among the children. Findings revealed that over two-fifths of the children were stunted, of which 26.3% were moderately stunted and 15.1% were severely stunted. The multivariate multinomial logistic regression analysis yielded significantly increased risk of severe stunting (OR=2.53, 95% CI=1.34-4.79) and moderate stunting (OR=2.37, 95% CI=1.47-3.83) over normal among children with a thinner mother. Region, father's education, toilet facilities, child's age, birth order of children and wealth index were also important determinants of children's nutritional status. Development and poverty alleviation programmes should focus on the disadvantaged rural segments of people to improve their nutritional status.

Interviews with children of persons with a severe mental illness: investigating their everyday situation.

Science.gov (United States)

Ostman, Margareta

2008-01-01

Research on children of persons with a severe mental illness focuses predominantly on parents' and others' perceptions. Children of mentally ill parents form a vulnerable group that has not been adequately paid attention to in psychiatric care institutions. Comparatively little is known about the children's recognition of their parents and the everyday situation of these families. The aim of the study was to investigate experiences of their life situation in children 10-18 years of age in a family with a parent with a severe mental illness. Eight children were interviewed concerning their everyday life situation. The interviews were analysed inspired from using thematic analysis. From the analysis of the material emerged aspects concerning the following themes: need for conversation, love for their family, maturity, experience of fear and blame, feelings of loneliness, responsibility and associated stigma. This study highlights the situation experienced by children of severely mentally ill persons who also are parents. The study may be found to be a basis for inspiring structured interventions and treatments programmes including children of the adult patients seeking psychiatric treatment.

Severity of MIH findings at tooth surface level among German school children.

Science.gov (United States)

Petrou, M A; Giraki, M; Bissar, A-R; Wempe, C; Schäfer, M; Schiffner, U; Beikler, T; Schulte, A G; Splieth, C H

2015-06-01

This study was to investigate the distribution and clinical characteristics of teeth diagnosed with MIH at surface and defect type level in a cohort of German children. The study cohort included 242 children diagnosed with MIH which had been recorded during the compulsory dental school examinations of 20 German primary schools. The subjects had been enrolled by cluster sampling. All children attended the second to fourth grade (age 7-10 years, mean 8.1 ± 0.8). The children were examined by five calibrated examiners (kappa = 0.9) after tooth brushing. The recording comprised teeth, surfaces, type and severity of MIH defects and was conducted using a portable light, mirrors and cotton rolls. MIH was registered according to the EAPD criteria. Defects MIH defects at various surfaces of the same tooth were common. The number of affected tooth surfaces was positively correlated with the severity of MIH at child (p MIH teeth. The knowledge of the intra-oral distribution and severity of MIH findings at the enamel surface level is important for assessing the treatment needs.

Social desirability response tendencies in psychiatric inpatient children.

Science.gov (United States)

Mabe, P A; Treiber, F A

1989-03-01

This study examined the substantive features of children's social desirability (SD) tendencies that could influence the nature and severity of psychopathology. Examinations of substantive features of SD responding in an inpatient child psychiatry unit (N = 76) suggested that higher scores on the Children's Social Desirability questionnaire were associated strongly with (1) lower mental age; (2) higher scores on self-reported social competence; (3) lower scores on self-reported anger; and (4) lower scores on parent-reported externalization behavioral disturbance. Results were interpreted as suggesting that SD responding for child inpatients may reflect a mixed picture of negative features of cognitive and social immaturity that could affect adversely their ability to judge their own and others' social behavior and of positive features of less external behavioral disturbance and more prosocial attitudes and behaviors.

Bone metabolism in cow milk allergic children.

Science.gov (United States)

Jakusova, Lubica; Jesenak, Milos; Schudichova, Jela; Banovcin, Peter

2013-07-01

Children with cow milk allergy are suspected to develop calcium metabolism disturbances. We observed increased markers of bone turnover in these children. Children with cow milk allergy are more prone to develop the disturbances of the bone mineralization even in the first year of life.

ANTI-IGE THERAPY FOR SEVERE ASTHMA IN CHILDREN: TWO-YEAR TRIAL

Directory of Open Access Journals (Sweden)

T.Yu. Kulichenko

2010-01-01

Full Text Available The article summarizes a two-year experience of treating children and adolescents with severe uncontrolled atopic asthma using Omalizumab. This treatment facilitated to achieve full asthma control in 70% of patients and partial control in 30% of patients. Anti-Ig Etherapy contributes to reduce the frequency of asthma relapses 77%, and the number of those seeking emergency medical treatment, particularly no need for in-patient asthma care. Thanks to treatment, lung function parameters improve, particularly in children with low bronchial patency parameters even after administration of broncholytics. Thanks to treatment with omalizumab, the dosage of inhalant glucocorticosteroids is reduced 1.5 to 2.5 times in 75% patients. Treatment tolerance in all children is satisfactory, no serious adverse events associated with the medication or any system side effects are registered in patients. Anti-IgE therapy is a good alternative to use of high and ultra-high doses of inhalant glucocorticosteroids in children with severe atopic asthma. Key words: omalizumab, anti-IgE-antibodies, treatment-resistant asthma, atopic asthma, treatment, children, adolescents, asthma control. (Pediatric Pharmacology. – 2010; 7(3:57-65

Prediction of Severe Disease in Children with Diarrhea in a Resource-Limited Setting

Science.gov (United States)

Levine, Adam C.; Munyaneza, Richard M.; Glavis-Bloom, Justin; Redditt, Vanessa; Cockrell, Hannah C.; Kalimba, Bantu; Kabemba, Valentin; Musavuli, Juvenal; Gakwerere, Mathias; Umurungi, Jean Paul de Charles; Shah, Sachita P.; Drobac, Peter C.

2013-01-01

Objective To investigate the accuracy of three clinical scales for predicting severe disease (severe dehydration or death) in children with diarrhea in a resource-limited setting. Methods Participants included 178 children admitted to three Rwandan hospitals with diarrhea. A local physician or nurse assessed each child on arrival using the World Health Organization (WHO) severe dehydration scale and the Centers for Disease Control (CDC) scale. Children were weighed on arrival and daily until they achieved a stable weight, with a 10% increase between admission weight and stable weight considered severe dehydration. The Clinical Dehydration Scale was then constructed post-hoc using the data collected for the other two scales. Receiver Operator Characteristic (ROC) curves were constructed for each scale compared to the composite outcome of severe dehydration or death. Results The WHO severe dehydration scale, CDC scale, and Clinical Dehydration Scale had areas under the ROC curves (AUCs) of 0.72 (95% CI 0.60, 0.85), 0.73 (95% CI 0.62, 0.84), and 0.80 (95% CI 0.71, 0.89), respectively, in the full cohort. Only the Clinical Dehydration Scale was a significant predictor of severe disease when used in infants, with an AUC of 0.77 (95% CI 0.61, 0.93), and when used by nurses, with an AUC of 0.78 (95% CI 0.63, 0.93). Conclusions While all three scales were moderate predictors of severe disease in children with diarrhea, scale accuracy varied based on provider training and age of the child. Future research should focus on developing or validating clinical tools that can be used accurately by nurses and other less-skilled providers to assess all children with diarrhea in resource-limited settings. PMID:24349271

Hospital Management of Severe Hypertriglyceridemia in Children.

Science.gov (United States)

Valaiyapathi, Badhma; Ashraf, Ambika P

2017-01-01

Severe Hypertriglyceridemia (HTG), i.e., plasma triglyceride levels exceeding 1000 mg/dL, is one of the established causes of acute pancreatitis and severe abdominal pain. There are no established pediatric guidelines regarding treatment of children and adolescents with severe HTG. To review the pathophysiology and etiology of severe HTG in the pediatric age group, and to discuss management options. Severe HTG is usually due to deficient or absent Lipoprotein Lipase (LPL) activity, which can be due to primary genetic etiology or secondary causes triggering HTG in those with underlying genetic susceptibility. Hospitalization is indicated for patients with severe HTG who are symptomatic with abdominal pain or pancreatitis, in those with uncontrolled diabetes requiring insulin, or, in those with substantial elevations of plasma TG. Fasting followed by fat free diet until plasma TG declines to severe pancreatitis, shock or multi-organ failure. Medications such as fibrates and omega-3 fatty acids are not effective if LPL activity is absent or when plasma TG is >1800 mg/dL. Medications only have an adjunct role in the management. Low fat diet, lifestyle changes, weight loss, control of secondary causes, and patient education form the mainstay of management once the patient is discharged. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Human Metapneumovirus Infection is Associated with Severe Respiratory Disease in Preschool Children with History of Prematurity.

Science.gov (United States)

Pancham, Krishna; Sami, Iman; Perez, Geovanny F; Huseni, Shehlanoor; Kurdi, Bassem; Rose, Mary C; Rodriguez-Martinez, Carlos E; Nino, Gustavo

2016-02-01

Human metapneumovirus (HMPV) is a recently discovered respiratory pathogen of the family Paramyxoviridae, the same family as that of respiratory syncytial virus (RSV). Premature children are at high risk of severe RSV infections, however, it is unclear whether HMPV infection is more severe in hospitalized children with a history of severe prematurity. We conducted a retrospective analysis of the clinical respiratory presentation of all polymerase chain reaction-confirmed HMPV infections in preschool-age children (≤5 years) with and without history of severe prematurity (prematurity. Preschool children with a history of prematurity had more severe HMPV disease as illustrated by longer hospitalizations, new or increased need for supplemental O2, and higher severity scores independently of age, ethnicity, and history of asthma. Our study suggests that HMPV infection causes significant disease burden among preschool children with a history of prematurity leading to severe respiratory infections and increasing health care resource utilization due to prolonged hospitalizations. Copyright © 2016. Published by Elsevier B.V.

Mortality after Inpatient Treatment for Severe Pneumonia in Children: a Cohort Study.

Science.gov (United States)

Ngari, Moses M; Fegan, Greg; Mwangome, Martha K; Ngama, Mwanajuma J; Mturi, Neema; Scott, John Anthony Gerard; Bauni, Evasius; Nokes, David James; Berkley, James A

2017-05-01

Although pneumonia is a leading cause of inpatient mortality, deaths may also occur after discharge from hospital. However, prior studies have been small, in selected groups or did not fully evaluate risk factors, particularly malnutrition and HIV. We determined 1-year post-discharge mortality and risk factors among children diagnosed with severe pneumonia. A cohort study of children aged 1-59 months admitted to Kilifi County Hospital with severe pneumonia (2007-12). The primary outcome was death pneumonia, 1041 (25%) had severe acute malnutrition (SAM), 267 (6.4%) had a positive HIV antibody test, and 364 (8.7%) died in hospital. After discharge, 2279 KHDSS-resident children were followed up; 70 (3.1%) died during 2163 child-years: 32 (95% confidence interval (CI) 26, 41) deaths per 1000 child years. Post-discharge mortality was greater after admission for severe pneumonia than for other diagnoses, hazard ratio 2.5 (95% CI 1.2, 5.3). Malnutrition, HIV status, age and prolonged hospitalisation, but not signs of pneumonia severity, were associated with post-discharge mortality. Fifty-two per cent (95% CI 37%, 63%) of post-discharge deaths were attributable to low mid-upper arm circumference and 11% (95% CI 3.3%, 18%) to a positive HIV test. Admission with severe pneumonia is an important marker of vulnerability. Risk stratification and better understanding of the mechanisms underlying post-discharge mortality, especially for undernourished children, are needed to reduce mortality after treatment for pneumonia. © 2017 The Authors. Paediatric and Perinatal Epidemiology Published by John Wiley & Sons Ltd.

Reducing Bedtime Disturbance and Night Waking Using Positive Bedtime Routines and Sleep Restriction

Science.gov (United States)

Christodulu, Kristin V.; Durand, V. Mark

2004-01-01

The purpose of this study was to investigate behavioral interventions designed to reduce sleep difficulties in four young children with developmental disorders. Positive bedtime routines and sleep restriction were successful in eliminating bedtime disturbances and nighttime awakenings in four children with significant sleep problems. Positive…

Severity of motor dysfunction in children with cerebral palsy seen in ...

African Journals Online (AJOL)

GMD) of varying degrees of severity. The Gross Motor Function Classification System (GMFCS) is widely used internationally to classify children with CP into functional severity levels. There are few reports on the use of GMFCS in Nigeria to ...

Language Outcomes in Young Children with Mild to Severe Hearing Loss.

Science.gov (United States)

Tomblin, J Bruce; Harrison, Melody; Ambrose, Sophie E; Walker, Elizabeth A; Oleson, Jacob J; Moeller, Mary Pat

2015-01-01

This study examined the language outcomes of children with mild to severe hearing loss during the preschool years. The longitudinal design was leveraged to test whether language growth trajectories were associated with degree of hearing loss and whether aided hearing influenced language growth in a systematic manner. The study also explored the influence of the timing of hearing aid fitting and extent of use on children's language growth. Finally, the study tested the hypothesis that morphosyntax may be at particular risk due to the demands it places on the processing of fine details in the linguistic input. The full cohort of children in this study comprised 290 children who were hard of hearing (CHH) and 112 children with normal hearing who participated in the Outcomes of Children with Hearing Loss (OCHL) study between the ages of 2 and 6 years. CHH had a mean better-ear pure-tone average of 47.66 dB HL (SD = 13.35). All children received a comprehensive battery of language measures at annual intervals, including standardized tests, parent-report measures, and spontaneous and elicited language samples. Principal components analysis supported the use of a single composite language score for each of the age levels (2, 3, 4, 5, and 6 years). Measures of unaided (better-ear pure-tone average, speech intelligibility index) and aided (residualized speech intelligibility index) hearing were collected, along with parent-report measures of daily hearing aid use time. Mixed modeling procedures were applied to examine the rate of change (227 CHH; 94 children with normal hearing) in language ability over time in relation to (1) degree of hearing loss, (2) aided hearing, (3) age of hearing aid fit and duration of use, and (4) daily hearing aid use. Principal components analysis was also employed to examine factor loadings from spontaneous language samples and to test their correspondence with standardized measures. Multiple regression analysis was used to test for

Dysphonia Severity Index in Typically Developing Indian Children.

Science.gov (United States)

Pebbili, Gopi Kishore; Kidwai, Juhi; Shabnam, Srushti

2017-01-01

Dysphonia is a variation in an individual's quality, pitch, or loudness from the voice characteristics typical of a speaker of similar age, gender, cultural background, and geographic location. Dysphonia Severity Index (DSI) is a recognized assessment tool based on a weighted combination of maximum phonation time, highest frequency, lowest intensity, and jitter (%) of an individual. Although dysphonia in adults is accurately evaluated using DSI, standard reference values for school-age children have not been studied. This study aims to document the DSI scores in typically developing children (8-12 years). A total of 42 typically developing children (8-12 years) without complaint of voice problem on the day of testing participated in the study. DSI was computed by substituting the raw scores of substituent parameters: maximum phonation time, highest frequency, lowest intensity, and jitter% using various modules of CSL 4500 software. The average DSI values obtained in children were 2.9 (1.23) and 3.8 (1.29) for males and females, respectively. DSI values are found to be significantly higher (P = 0.027) for females than those for males in Indian children. This could be attributed to the anatomical and behavioral differences among females and males. Further, pubertal changes set in earlier for females approximating an adult-like physiology, thereby leading to higher DSI values in them. The mean DSI value obtained for male and female Indian children can be used as a preliminary reference data against which the DSI values of school-age children with dysphonia can be compared. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Pancreatic Enzyme Replacement Therapy in Children with Severe Acute Malnutrition : A Randomized Controlled Trial

NARCIS (Netherlands)

Bartels, Rosalie H.; Bourdon, Celine; Potani, Isabel; Mhango, Brian; van den Brink, Deborah A.; Mponda, John S.; Kobold, Anneke C. Muller; Bandsma, Robert H.; van Hensbroek, Michael Boele; Voskuijl, Wieger P.

Objective: To assess the benefits of pancreatic enzyme replacement therapy (PERT) in children with complicated severe acute malnutrition. Study design: We conducted a randomized, controlled trial in 90 children aged 6-60 months with complicated severe acute malnutrition at the Queen Elizabeth

Pancreatic Enzyme Replacement Therapy in Children with Severe Acute Malnutrition: A Randomized Controlled Trial

NARCIS (Netherlands)

Bartels, Rosalie H.; Bourdon, Céline; Potani, Isabel; Mhango, Brian; van den Brink, Deborah A.; Mponda, John S.; Muller Kobold, Anneke C.; Bandsma, Robert H.; Boele van Hensbroek, Michael; Voskuijl, Wieger P.

2017-01-01

Objective To assess the benefits of pancreatic enzyme replacement therapy (PERT) in children with complicated severe acute malnutrition. Study design We conducted a randomized, controlled trial in 90 children aged 6-60 months with complicated severe acute malnutrition at the Queen Elizabeth Central

Mothers’ Depression and Stress, Severity of Autism among Children and Family Income

OpenAIRE

Athari, Pegah; Department of educational psychology, Faculty of Education Universiti Teknologi Malaysia; Ghaedi, Leila; Department of educational psychology, Faculty of Education Universiti Teknologi Malaysia

2013-01-01

This study was conducted to investigate the relationship between mothers’ depression and stress compared with severity of autism in children and the effect of family income on the relationship between these two latter variables. Levels of depression and stress among mothers (n=250) were measured based on Depression Anxiety and Stress Scale of 42 items (DASS¬-42). The severity of autism among children was assessed by Autism Behavior Checklist (ABC) according to children’s teachers reports (n=2...

Severity and Features of Epistaxis in Children with a Mucocutaneous Bleeding Disorder

NARCIS (Netherlands)

Stokhuijzen, Eva; Segbefia, Catherine I.; Biss, Tina T.; Clark, Dewi S.; James, Paula D.; Riddel, Jim; Blanchette, Victor S.; Rand, Margaret L.

2018-01-01

Objective To use standardized bleeding questionnaires to compare the severity and patterns of epistaxis in children with a mucocutaneous bleeding disorder and control children. Study design The epistaxis sections of the Pediatric Bleeding Questionnaire (PBQ) administered to pediatric patients with

Playable One-Switch Video Games for Children with Severe Motor Disabilities Based on GNomon

OpenAIRE

ACED LOPEZ, Sebastian; Corno, Fulvio; DE RUSSIS, Luigi

2015-01-01

Being able to play games in early years is very important for the development of children. Even though, children with physical disabilities encounter several obstacles that exclude them from engaging in many popular games. In particular, children with severe motor disabilities that rely on one-switch interfaces for accessing electronic devices find dynamic video games completely unplayable. In this paper we present the development and evaluation of GNomon: a framework, based on the NOMON inte...

Does Viral Co-Infection Influence the Severity of Acute Respiratory Infection in Children?

Science.gov (United States)

Cebey-López, Miriam; Herberg, Jethro; Pardo-Seco, Jacobo; Gómez-Carballa, Alberto; Martinón-Torres, Nazareth; Salas, Antonio; Martinón-Sánchez, José María; Justicia, Antonio; Rivero-Calle, Irene; Sumner, Edward; Fink, Colin; Martinón-Torres, Federico

2016-01-01

Multiple viruses are often detected in children with respiratory infection but the significance of co-infection in pathogenesis, severity and outcome is unclear. To correlate the presence of viral co-infection with clinical phenotype in children admitted with acute respiratory infections (ARI). We collected detailed clinical information on severity for children admitted with ARI as part of a Spanish prospective multicenter study (GENDRES network) between 2011-2013. A nested polymerase chain reaction (PCR) approach was used to detect respiratory viruses in respiratory secretions. Findings were compared to an independent cohort collected in the UK. 204 children were recruited in the main cohort and 97 in the replication cohort. The number of detected viruses did not correlate with any markers of severity. However, bacterial superinfection was associated with increased severity (OR: 4.356; P-value = 0.005), PICU admission (OR: 3.342; P-value = 0.006), higher clinical score (1.988; P-value = 0.002) respiratory support requirement (OR: 7.484; P-value respiratory distress (OR: 2.917; P-value = 0.035), PICU admission (OR: 0.301; P-value = 0.011), lower clinical score (-1.499; P-value = 0.021) respiratory support requirement (OR: 0.324; P-value = 0.016) and oxygen necessity (OR: 0.328; P-value = 0.001). All these findings were replicated in the UK cohort. The presence of more than one virus in hospitalized children with ARI is very frequent but it does not seem to have a major clinical impact in terms of severity. However bacterial superinfection increases the severity of the disease course. On the contrary, pneumococcal vaccination plays a protective role.

Risk factors for death in children during inpatient treatment of severe acute malnutrition

DEFF Research Database (Denmark)

Rytter, Maren Johanne Heilskov; Babirekere-Iriso, Esther; Namusoke, Hanifa

2017-01-01

BACKGROUND: Children who receive in-hospital treatment of severe acute malnutrition often have high mortality rates, and the reasons are not well understood. OBJECTIVE: We assessed risk factors for death in children who were treated for malnutrition in a hospital. DESIGN: In a prospective...... observational study of 120 children who were receiving in-hospital treatment of severe acute malnutrition in Uganda with therapeutic formulas F-75 and F-100, we collected data on symptoms, clinical findings, plasma markers of refeeding syndrome (electrolytes and phosphate), and acute phase reactants......% CI: 1.9, 13.3), which was an association that remained after adjustment for potential confounders (HR: 69.5; 95% CI: 7.0, 694.6). CONCLUSIONS: Refeeding syndrome may occur in children who are treated for malnutrition, even with moderately low plasma phosphate, and, in particular, in children...

A Functional Analysis of Gestural Behaviors Emitted by Young Children with Severe Developmental Disabilities

Science.gov (United States)

Ferreri, Summer J.; Plavnick, Joshua B.

2011-01-01

Many children with severe developmental disabilities emit idiosyncratic gestures that may function as verbal operants (Sigafoos et al., 2000). This study examined the effectiveness of a functional analysis methodology to identify the variables responsible for gestures emitted by 2 young children with severe developmental disabilities. Potential…

Risk factors of severe pneumonia among children aged 2-59 months ...

African Journals Online (AJOL)

Introduction Globally, pneumonia is the leading cause of death in children under the age of 5 years. In Kenya, it is the second leading cause of mortality, accounting for greater than 30,000 deaths in this age group annually. This study sought to identify risk factors for severe pneumonia in children under the age of five years.

Impact of sleep disturbance on patients in treatment for mental disorders

Directory of Open Access Journals (Sweden)

Kallestad Håvard

2012-10-01

Full Text Available Abstract Background In clinical practice, sleep disturbance is often regarded as an epiphenomenon of the primary mental disorder. The aim of this study was to test if sleep disturbance, independently of primary mental disorders, is associated with current clinical state and benefit from treatment in a sample representative of public mental health care clinics. Method 2246 patients receiving treatment for mental disorders in eight public mental health care centers in Norway were evaluated in a cross-sectional study using patient and clinician reported measures. Patients reported quality of life, symptom severity, and benefit from treatment. Clinicians reported disorder severity, level of functioning, symptom severity and benefit from treatment. The hypothesis was tested using multiple hierarchical regression analyses. Results Sleep disturbance was, adjusted for age, gender, time in treatment, type of care, and the presence of any primary mental disorder, associated with lower quality of life, higher symptom severity, higher disorder severity, lower levels of functioning, and less benefit from treatment. Conclusion Sleep disturbance ought to be considered a stand-alone therapeutic entity rather than an epiphenomenon of existing diagnoses for patients receiving treatment in mental health care.

Disturbing forest disturbances

Energy Technology Data Exchange (ETDEWEB)

Volney, W.J.A.; Hirsch, K.G. [Natural Resources Canada, Canadian Forest Service, Northern Forestry Centre, Edmonton, AB (Canada)

2005-10-01

This paper described the role that disturbances play in maintaining the ecological integrity of Canadian boreal forests. Potential adaptation options to address the challenges that these disturbances present were also examined. Many forest ecosystems need fire for regeneration, while other forests rely on a cool, wet disintegration process driven by insects and commensal fungi feeding on trees to effect renewal. While there are characteristic natural, temporal and spatial patterns to these disturbances, recent work has demonstrated that the disturbances are being perturbed by climatic change that has been compounded by anthropogenic disturbances in forests. Fire influences species composition and age structure, regulates forest insects and diseases, affects nutrient cycling and energy fluxes, and maintains the productivity of different habitats. Longer fire seasons as a result of climatic change will lead to higher intensity fires that may more easily evade initial attacks and become problematic. Fire regimes elevated beyond the range of natural variation will have a dramatic effect on the regional distribution and functioning of forest ecosystems and pose a threat to the safety and prosperity of people. While it was acknowledged that if insect outbreaks were to be controlled on the entire forest estate, the productivity represented by dead wood would be lost, it was suggested that insects such as the forest tent caterpillar and the spruce bud worm may also pose a greater threat as the climate gets warmer and drier. Together with fungal associates, saproxylic arthropods are active in nutrient cycling and ultimately determine the fertility of forest sites. It was suggested that the production of an age class structure and forest mosaic would render the forest landscape less vulnerable to the more negative aspects of climate change on vegetation response. It was concluded that novel management design paradigms are needed to successfully reduce the risk from threats

Using electronic storybooks to support word learning in children with severe language impairments

NARCIS (Netherlands)

Smeets, Daisy J. H.; van Dijken, Marianne J.; Bus, Adriana G

2012-01-01

Novel word learning is reported to be problematic for children with severe language impairments (SLI). In this study, we tested electronic storybooks as a tool to support vocabulary acquisition in SLI children. In Experiment 1, 29 kindergarten SLI children heard four e-books each four times: (a) two

Association between congenital heart defects and severe infections in children with Down syndrome.

Science.gov (United States)

Faria, Paula Foresti; Nicolau, Juliana Augusta Zeglin; Melek, Marina Zaponi; de Oliveira, Nanci de Santa Palmieri; Bermudez, Beatriz Elizabeth Bagatin Veleda; Nisihara, Renato Mitsunori

2014-01-01

There is a high prevalence of congenital heart disease (CHD) in Down syndrome (DS) patients. Children with DS and CHD also present greater susceptibility to pulmonary infections than those without CHD. To investigate the prevalence and types of CHD and their association with severe infections in children with DS in southern Brazil seen in a reference outpatient clinic. Children aged between six and 48 months with a diagnosis of DS were included consecutively in the period May 2001 to May 2012, and the presence of CHD and severe infections (pneumonia and sepsis) was investigated, classified and analyzed. A total of 127 patients were included, of whom 89 (70.1%) had some type of CHD, 33 (37.7%) of them requiring surgical correction. Severe infections (pneumonia and sepsis) were seen in 23.6% and 5.5%, respectively. Of the cases of pneumonia, 70% had associated CHD (p=0.001) and of those with sepsis, 85% presented CHD (p=0.001). Our study showed a high prevalence of CHD and its association with severe infections in children with DS seen in southern Brazil. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

Eczema and sleep and its relationship to daytime functioning in children.

Science.gov (United States)

Camfferman, Danny; Kennedy, John D; Gold, Michael; Martin, Alfred J; Lushington, Kurt

2010-12-01

Chronic childhood eczema has significant morbidity characterised by physical discomfort, emotional distress, reduced child and family quality-of-life and, of particular note, disturbed sleep characterised by frequent and prolonged arousals. Sleep disturbance affects up to 60% of children with eczema, increasing to 83% during exacerbation. Even when in clinical remission, children with eczema demonstrate more sleep disturbance than healthy children. Notably, disturbed sleep in otherwise healthy children is associated with behavioural and neurocognitive deficits. Preliminary evidence suggests that disturbed sleep in children with eczema is also associated with behavioural deficits while the impact on neuropsychological functioning remains unexplored. In conclusion, a disease which affects up to 20% of children in some countries and may produce long-term behavioural and neurocognitive deficits merits further evaluation using standardised tests of sleep, behaviour and neurocognition. Copyright © 2010 Elsevier Ltd. All rights reserved.

Playable One-Switch Video Games for Children with Severe Motor Disabilities Based on GNomon

Directory of Open Access Journals (Sweden)

Sebastián Aced López

2015-12-01

Full Text Available Being able to play games in early years is very important for the development of children. Even though, children with physical disabilities encounter several obstacles that exclude them from engaging in many popular games. In particular, children with severe motor disabilities that rely on one-switch interfaces for accessing electronic devices find dynamic video games completely unplayable. In this paper we present the development and evaluation of GNomon: a framework, based on the NOMON interaction modality, that enables the creation of dynamic one-switch games for children with severe motor disabilities. The framework was designed following a series of guidelines elicited in close collaboration with a team of speech therapists, physiotherapists and psychologists from one of the Local Health Agencies in Turin, Italy. Likewise, three mini games were developed for testing the playability of GNomon-based games. Finally, we conducted a series of trials with 8 children with severe motor disabilities assisted by the health agency, in which we found that all of them enjoyed playing the GNomon- based mini games and that 7 of them were able to interact and play autonomously.

Ankylosis of the temporomandibular joint and mandibular growth disturbance caused by neglected condylar fracture in childhood

Directory of Open Access Journals (Sweden)

Endrajana Endrajana

2010-06-01

Full Text Available Background: Fractures of the mandibular condyle may lead to complications such as disturbance of occlusal function, internal derangement of the joint, ankylosis and mandibular growth disturbance. When treating young patients with the history of mandible trauma, ankylosis of the temporomandibular joint and mandibular growth disturbance are two most important complications of condyle fracture that should be considered. Purpose: This case report attempts to emphasize the long term complication of neglected condylar fracture in children i.e. ankylosis of the temporomandibular joint and subsequently lead to mandibular growth disturbance. Case: A case of right temporo-mandibular joint ankylosis and mandibular growth disturbance in a 28 years old male patient is presented. He had a history of trauma to the mandible after a traffic accident when he was 8 years old. Since then, he experienced difficulty in mouth opening which eventually developed into severe trismus. Case management: The case was treated surgically with gap and interpositional arthroplasty using Mersilen mesh™. Conclusion: Mandibular fractures involving temporomandibular joint in young children should be examined thoroughly and treated adequately in order to prevent ankylosis of the TMJ and the subsequent mandibular growth disturbance.Latar belakang: Fraktur pada kondilus mandibula dapat menyebabkan beberapa komplikasi berupa: gangguan oklusi, internal derangement sendi, ankilosis serta gangguan pertumbuhan mandibula. Pada perawatan penderita usia muda dengan riwayat trauma pada mandibula, perlu diwaspadai dua macam komplikasi akibat fraktur pada kondilus, yaitu ankilosis sendi temporo mandibula dan adanya gangguan pertumbuhan mandibula. Tujuan: Laporan kasus ini bertujuan untuk menekankan bahwa fraktur kondilus pada anak-anak yang tidak mendapatkan perawatan yang semestinya akan mengakibatkan komplikasi jangka panjang berupa ankilosis sendi temporomandibula yang diikuti dengan

The Implementation of a Video-Enhanced Aikido-Based School Violence Prevention Training Program To Reduce Disruptive and Assaultive Behaviors among Severely Emotionally Disturbed Adolescents.

Science.gov (United States)

Edelman, Andrew J.

The martial art of Aikido was used as an intervention with 15 middle and high school students with severe emotional disturbances in an alternative educational setting. Students with an extensive history of violently disruptive and assaultive behaviors were trained for 12 weeks in this nonviolent Japanese martial art in order to achieve the…

Longitudinal study of symptom severity and language in minimally verbal children with autism.

Science.gov (United States)

Thurm, Audrey; Manwaring, Stacy S; Swineford, Lauren; Farmer, Cristan

2015-01-01

A significant minority of children with autism spectrum disorder (ASD) are considered 'minimally verbal' due to language development stagnating at a few words. Recent developments allow for the severity of ASD symptoms to be examined using Autism Diagnostic Observation Schedule (ADOS) Social Affect (SA) and Restricted and Repetitive Behaviors (RRB) domain severity scores. The aim of the current study was to explore language outcomes in a cohort of minimally verbal children with autism evaluated through the preschool years and determine if and how ASD symptom severity in core domains predicts the development of spoken language by age 5. The sample consisted of 70 children with autism aged 1-5 years at the first evaluation who were examined at least 1 year later, during their fifth year of age. The ADOS overall level of language item was used to categorize children as minimally verbal or having phrase speech, and the Mullen Scales of Early Learning was used as a continuous measure of expressive language. At Time 1, 65% (n = 47) of children in the sample were minimally verbal and by Time 2, 36% (n = 17 of 47) of them had developed phrase speech. While the Time 1 ADOS calibrated severity scores did not predict whether or not a child remained minimally verbal at Time 2, change in the SA calibrated severity score (but not RRB) was predictive of the continuous measure of expressive language. However, change in SA severity no longer predicted continuous expressive language when nonverbal cognitive ability was added to the model. Findings indicate that the severity of SA symptoms has some relationship with continuous language outcome, but not categorical. However, the omnipresent influence of nonverbal cognitive ability was confirmed in the current study, as the addition of it to the model rendered null the predictive utility of SA severity. © 2014 The Authors. Journal of Child Psychology and Psychiatry. © 2014 Association for Child and Adolescent Mental Health.

Symbolization Levels in Communicative Behaviors of Children Showing Pervasive Developmental Disorders.

Science.gov (United States)

Atlas, Jeffrey A.; Lapidus, Leah Blumberg

1988-01-01

A total of 48 children (aged 4-14) with severe pervasive developmental disturbance, exhibiting mutism, echolalia, or nonecholalic speech, were observed in their communicative behaviors across modalities. Levels of symbolization in gesture, play, and drawing were significantly intercorrelated and were most strongly correlated with the criterion…

Clinical and laboratory assessment of dehydration severity in children with acute gastroenteritis.

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Parkin, Patricia C; Macarthur, Colin; Khambalia, Amina; Goldman, Ran D; Friedman, Jeremy N

2010-03-01

To evaluate clinical and laboratory assessment of dehydration severity in children, 1 to 36 months, with acute gastroenteritis. Clinical and laboratory measures and weight change following rehydration were collected for enrolled children. Pediatric emergency department. Likelihood ratio (LR+) and 95% confidence interval (CI): for a clinical score of 0, the LR+ was 2.2 (95% CI = 0.9-5.3); for a clinical score of 1 to 4, the LR+ was 1.3 (95% CI = 0.90-1.74); for a clinical score of 5 to 8, the LR+ was 5.2 (95% CI = 2.2-12.8); for a venous pH Dehydration Scale and laboratory measures into clinical decision-making algorithms to assess dehydration severity in children with acute gastroenteritis.

Differences in postural disturbances between female adolescents handball players and nontraining peers.

Science.gov (United States)

Jandrić, Slavica Đ

2016-04-01

Physical activity and sport can influence the extent of the presence of the postural disturbances in children. The aim of this study was to investigate the occurrence of differences in the postural disturbances in female adolescents in relation to team handball training. This investigation involved 150 female adolescents with the average age of 13.4 ± 1.5 years divided into two groups (50 adolescents trained handball and 100 did non train it). The study determined a statistically significant difference in the total number of postural disturbances between the two groups of adolescents (p 0.05). Handball adolescents players have less postural disturbances than untrained adolescents. Flat foot is significantly less frequent in female adolescents handball players than in untrained ones. Findings obtained in this investigation can help us in planning continuous prevention, observation and care for untrained and trained team handball female adolescents with postural disturbances.

Correlates and Risk Markers for Sleep Disturbance in Participants of the Autism Treatment Network

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Hollway, Jill A.; Aman, Michael G.; Butter, Eric

2013-01-01

We explored possible cognitive, behavioral, emotional, and physiological risk markers for sleep disturbance in children with autism spectrum disorders. Data from 1,583 children in the Autism Treatment Network were analyzed. Approximately 45 potential predictors were analyzed using hierarchical regression modeling. As medication could confound…

A Novel Group Therapy for Children with ADHD and Severe Mood Dysregulation

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Waxmonsky, James G.; Wymbs, Fran A.; Pariseau, Meaghan E.; Belin, Peter J.; Waschbusch, Daniel A.; Babocsai, Lysett; Fabiano, Gregory A.; Akinnusi, Opeolowa O.; Haak, Jenifer L.; Pelham, William E.

2013-01-01

Objective: No psychosocial treatments have been developed for children with ADHD and severe mood dysregulation (SMD) despite the significant prevalence and morbidity of this combination. Therefore, the authors developed a novel treatment program for children with ADHD and SMD. Method: The novel therapy program integrates components of…

Arterial alterations in severely obese children with obstructive sleep apnoea.

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Dubern, Beatrice; Aggoun, Yacine; Boulé, Michèle; Fauroux, Brigitte; Bonnet, Damien; Tounian, Patrick

2010-05-03

Obstructive sleep apnoea (OSA) in obese adults is associated with cardiovascular disease independently of obesity. Vascular alterations exist in children with obesity and may constitute the first stage in the development of adulthood cardiovascular disease. To investigate the relationship between OSA and early arterial alterations in obese children. Cross-sectional study of a prospective cohort. A total of 51 children with severe obesity managed at a teaching hospital outpatient clinic. Polysomnography was performed. We measured the intima-media thickness and incremental elastic modulus (Einc) to assess the mechanical characteristics of the common carotid artery. Arterial endothelial function was evaluated by measuring flow-mediated dilation and glyceryl trinitrate-mediated dilation (GTNMD) of the brachial artery. A total of 24 (47%) children had a desaturation index (DI) >10/h and 7 (14%) had a respiratory event index >10/h. DI >10/h was associated with significantly higher values of Einc (4.0 + or - 0.5 vs. 2.4 + or - 0.4 mm Hg(-1) x 10(3), p=0.003) and GTNMD (18.0 + or - 1.1 vs. 14.1 + or - 1.0 %, p=0.02) after adjustment for age, sex, body mass index, fasting insulin, and leptin. In the univariate analysis, GTNMD correlated positively with DI (r=0.14, p=0.02) after adjustment for age, sex, fasting insulin and leptin. By multivariate analysis with BMI as an additional independent variable, both GTNMD and Einc correlated significantly with DI (beta=0.4, p=0.02 and beta=0.27, p=0.04, respectively). OSA in children is associated with arterial alterations independently from obesity. The increased vasodilation in response to glyceryl trinitrate reflects pre-existing vasoconstriction probably induced by intermittent hypoxia. OSA should be detected early in children with severe obesity.

Comparison of inflammation and oxidative stress levels by the severity of obesity in prepubertal children

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Ni Luh Putu Surya Candra Eka Pertiwi

2018-01-01

Full Text Available Background Children with severe obesity are more likely to develop diabetes and cardiovascular diseases at a younger age. Inflammation and oxidative stress associated with childhood obesity may be important in the development of insulin resistance and atherosclerosis. Objective To compare levels of high-sensitivity C-reactive protein (hsCRP and malondialdehyde (MDA by the severity of obesity in prepubertal children aged 6 to 10 years. Methods We conducted a cross-sectional study at the Pediatric Nutrition and Metabolic Syndrome Clinic, Sanglah Hospital, Bali, from August to December 2015. Subjects were categorized into three body mass index (BMI groups, according to the 2000 Centers for Disease Control and Prevention growth chart: overweight (85th-94.9th percentile, obese (95th-98.9th percentile, or severely obese (≥ 99th percentile. Plasma MDA and serum hsCRP were analyzed in blood specimens obtained at enrollment. Data were analyzed by Kruskal-Wallis test, followed by Mann-Whitney U test for post-hoc comparison between groups. Results Subjects were 20 overweight children, 29 obese children, and 28 severely obese children. Levels of MDA were significantly higher in the severely obese [median 0.25 (IQR 0.1 μmol/L] than in obese subjects [median 0.19 (IQR 0.1 μmol/L; P=0.001], and than in overweight subjects [median 0.16 (IQR 0.1 μmol/L; P<0.0001]. Also, the severely obese children had significantly higher hsCRP levels compared to obese [median 3.2 (IQR 2.0 mg/L vs. 1.3 (1.6 mg/L, respectively; P<0.0001] and compared to overweight children [median 0.7 (IQR 0.6 mg/L; P<0.0001].     Conclusion Prepubertal children at the ≥ 99th percentile for BMI (severely obese are more likely to have significantly higher hsCRP and MDA compared to those in the obese and overweight groups.

Sleep Disturbance as a Precursor of Severe Regression in Kleefstra Syndrome Suggests a Need for Firm and Rapid Pharmacological Treatment.

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Vermeulen, Karlijn; Staal, Wouter G; Janzing, Joost G; van Bokhoven, Hans; Egger, Jos I M; Kleefstra, Tjitske

Intellectual disability is frequently accompanied by psychiatric symptoms that require pharmacological interventions. Treatment guidelines often provide a general treatment approach for these symptoms in intellectual disability. However, this may not always be the best strategy, as illustrated here in Kleefstra syndrome. We present 3 patients showing severe regression after sleep disturbances. If these are treated with care as usual (eg, behavioral programs and sleep medication) deterioration is likely to follow. It is observed that rapid treatment with relatively high dosages of antipsychotics contributes to restore sleep, halt further regression, and improve daily life functioning.

Forest disturbance interactions and successional pathways in the Southern Rocky Mountains

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Lu Liang,; Hawbaker, Todd J.; Zhu, Zhiliang; Xuecao Li,; Peng Gong,

2016-01-01

The pine forests in the southern portion of the Rocky Mountains are a heterogeneous mosaic of disturbance and recovery. The most extensive and intensive stress and mortality are received from human activity, fire, and mountain pine beetles (MPB;Dendroctonus ponderosae). Understanding disturbance interactions and disturbance-succession pathways are crucial for adapting management strategies to mitigate their impacts and anticipate future ecosystem change. Driven by this goal, we assessed the forest disturbance and recovery history in the Southern Rocky Mountains Ecoregion using a 13-year time series of Landsat image stacks. An automated classification workflow that integrates temporal segmentation techniques and a random forest classifier was used to examine disturbance patterns. To enhance efficiency in selecting representative samples at the ecoregion scale, a new sampling strategy that takes advantage of the scene-overlap among adjacent Landsat images was designed. The segment-based assessment revealed that the overall accuracy for all 14 scenes varied from 73.6% to 92.5%, with a mean of 83.1%. A design-based inference indicated the average producer’s and user’s accuracies for MPB mortality were 85.4% and 82.5% respectively. We found that burn severity was largely unrelated to the severity of pre-fire beetle outbreaks in this region, where the severity of post-fire beetle outbreaks generally decreased in relation to burn severity. Approximately half the clear-cut and burned areas were in various stages of recovery, but the regeneration rate was much slower for MPB-disturbed sites. Pre-fire beetle outbreaks and subsequent fire produced positive compound effects on seedling reestablishment in this ecoregion. Taken together, these results emphasize that although multiple disturbances do play a role in the resilience mechanism of the serotinous lodgepole pine, the overall recovery could be slow due to the vast area of beetle mortality.

[Neurological disorders in preterm children with neuropathy].

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Nikolaeva, G V; Sidorenko, E I; Guseva, M R; Akbasheva, N G

2017-01-01

To establish the correlation between the frequency and severity of hypoxic CNS lesions in preterm children with neuropathy and improve the early diagnosis of lesions of the brain structures based on clinical ophthalmologic results. The authors examined 712 premature infants with body mass neurological examination and neurosonography were performed. RP was found in 367 (51.5%) children. In 255 children, the disease regressed naturally. One hundred and twelve (15.7%) children, underwent laser coagulation of the avascular retina due to the severity of RP. Signs of intraventricular hemorrhages (IVH) were noted in 434 (61%) children in the neonatal period. IVH were found in 285 (77.6%) children with RP. RP with the regression after laser coagulation was combined with IVH in 98% of cases, with the higher frequency (55.3%) of IVH, 3 rd degree. Periventricular leucomalation (PVL) was found in 10% of children without RP, in 22.3% of children with RP with naturally regression and in 51,7% of children with RP with laser coagulation of the retina. In 70 children, neurosonographic signs of ischemia of the head of caudate nucleus were identified on the 14-15 th days of life. In this group, RP developed in 54 (77%) children, 27 (38.5%) children needed laser coagulation of the retina. The correlation found between the severity of RP and hypoxic CNS lesions in highly preterm infants might allow the prognosis of visual and neurosomatic disturbances in the early age and timely effective rehabilitation.

Reconstructing disturbances and their biogeochemical consequences over multiple timescales

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McLauchlan, Kendra K.; Higuera, Philip E.; Gavin, Daniel G.; Perakis, Steven S.; Mack, Michelle C.; Alexander, Heather; Battles, John; Biondi, Franco; Buma, Brian; Colombaroli, Daniele; Enders, Sara K.; Engstrom, Daniel R.; Hu, Feng Sheng; Marlon, Jennifer R.; Marshall, John; McGlone, Matt; Morris, Jesse L.; Nave, Lucas E.; Shuman, Bryan; Smithwick, Erica A.H.; Urrego, Dunia H.; Wardle, David A.; Williams, Christopher J.; Williams, Joseph J.

2014-01-01

Ongoing changes in disturbance regimes are predicted to cause acute changes in ecosystem structure and function in the coming decades, but many aspects of these predictions are uncertain. A key challenge is to improve the predictability of postdisturbance biogeochemical trajectories at the ecosystem level. Ecosystem ecologists and paleoecologists have generated complementary data sets about disturbance (type, severity, frequency) and ecosystem response (net primary productivity, nutrient cycling) spanning decadal to millennial timescales. Here, we take the first steps toward a full integration of these data sets by reviewing how disturbances are reconstructed using dendrochronological and sedimentary archives and by summarizing the conceptual frameworks for carbon, nitrogen, and hydrologic responses to disturbances. Key research priorities include further development of paleoecological techniques that reconstruct both disturbances and terrestrial ecosystem dynamics. In addition, mechanistic detail from disturbance experiments, long-term observations, and chronosequences can help increase the understanding of ecosystem resilience.

[One of the approaches to psychological-pedagogical help to children with severe movement disorders].

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Levchenko, I Iu; Simonova, T N

2012-01-01

The objective of the study was to work out an effective model of complex help to children with severe movement disorders. We examined 440 preschoolers with children cerebral palsy with severe movement disorders and 70 children with mild movement disorders. Functions of motor, emotional-personal and cognitive spheres and independence status with determination of 5 levels were studied in 47 patients. Three groups (from the group without concomitant (sensor, intellectual etc) disorders to the group with most severe disorders) were singled out. The authors characterize the model as an open integral system of methods, tools and ways providing the adaptation of children in response to external circumstances and changes in the state of patients. The creation of a correction-developing environment, consisting of 3 components: spatial-objective, technological (methodological) and social, is discussed. We present results of the development of children, evaluated by the following indices: general technique, sensory perceptive development, social adaptation, anxiety, cognitive activity, from 1997 to 2008. The 15 year follow-up demonstrated the stability of achieved positive results.

Development of the Respiratory Index of Severity in Children (RISC score among young children with respiratory infections in South Africa.

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Carrie Reed

Full Text Available OBJECTIVE: Pneumonia is a leading cause of death in children worldwide. A simple clinical score predicting the probability of death in a young child with lower respiratory tract infection (LRTI could aid clinicians in case management and provide a standardized severity measure during epidemiologic studies. METHODS: We analyzed 4,148 LRTI hospitalizations in children <24 months enrolled in a pneumococcal conjugate vaccine trial in South Africa from 1998-2001, to develop the Respiratory Index of Severity in Children (RISC. Using clinical data at admission, a multivariable logistic regression model for mortality was developed and statistically evaluated using bootstrap resampling techniques. Points were assigned to risk factors based on their coefficients in the multivariable model. A child's RISC score is the sum of points for each risk factor present. Separate models were developed for HIV-infected and non-infected children. RESULTS: Significant risk factors for HIV-infected and non-infected children included low oxygen saturation, chest indrawing, wheezing, and refusal to feed. The models also included age and HIV clinical classification (for HIV-infected children or weight-for-age (for non-infected children. RISC scores ranged up to 7 points for HIV-infected or 6 points for non-infected children and correlated with probability of death (0-47%, HIV-infected; 0-14%, non-infected. Final models showed good discrimination (area under the ROC curve and calibration (goodness-of-fit. CONCLUSION: The RISC score incorporates a simple set of risk factors that accurately discriminate between young children based on their risk of death from LRTI, and may provide an objective means to quantify severity based on the risk of mortality.

Sleep disturbance relates to neuropsychological functioning in late-life depression.

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Naismith, Sharon L; Rogers, Naomi L; Lewis, Simon J G; Terpening, Zoë; Ip, Tony; Diamond, Keri; Norrie, Louisa; Hickie, Ian B

2011-07-01

Sleep-wake disturbance in older people is a risk factor for depression onset and recurrence. The aim of this study was to determine if objective sleep-wake disturbance in late-life depression relates to neuropsychological functioning. Forty-four older patients with a lifetime history of major depression and 22 control participants underwent psychiatric, medical and neuropsychological assessments. Participants completed self-report sleep measures, sleep diaries and wore wrist actigraphy for two weeks. Outcome measures included sleep latency, the number and duration of nocturnal awakenings and the overall sleep efficiency. Patients with depression had a greater duration of nocturnal awakenings and poorer sleep efficiency, in comparison to control participants. Sleep disturbance in patients was associated with greater depression severity and later ages of depression onset. It also related to poorer psychomotor speed, poorer verbal and visual learning, poorer semantic fluency as well as poorer performance on tests of executive functioning. These relationships largely remained significant after controlling for depression and estimated apnoea severity. This sample had only mild levels of depression severity and results require replication in patients with moderate to severe depression. The inclusion of polysomnography and circadian markers would be useful to delineate the specific features of sleep-wake disturbance that are critical to cognitive performance. Sleep-wake disturbance in older patients with depression is related to neuropsychological functioning and to later ages of illness onset. This study suggests that common neurobiological changes may underpin these disease features, which may, in turn, warrant early identification and management. Copyright © 2011 Elsevier B.V. All rights reserved.

Intravenous rehydration of malnourished children with acute gastroenteritis and severe dehydration: A systematic review.

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Houston, Kirsty A; Gibb, Jack G; Maitland, Kathryn

2017-01-01

Background: Rehydration strategies in children with severe acute malnutrition (SAM) and severe dehydration are extremely cautious. The World Health Organization (WHO) SAM guidelines advise strongly against intravenous fluids unless the child is shocked or severely dehydrated and unable to tolerate oral fluids. Otherwise, guidelines recommend oral or nasogastric rehydration using low sodium oral rehydration solutions. There is limited evidence to support these recommendations. Methods: We conducted a systematic review of randomised controlled trials (RCTs) and observational studies on 15 th June 2017 comparing different strategies of rehydration therapy in children with acute gastroenteritis and severe dehydration, specifically relating to intravenous rehydration, using standard search terms. Two authors assessed papers for inclusion. The primary endpoint was evidence of fluid overload. Results: Four studies were identified, all published in English, including 883 children, all of which were conducted in low resource settings. Two were randomised controlled trials and two observational cohort studies, one incorporated assessment of myocardial and haemodynamic function. There was no evidence of fluid overload or other fluid-related adverse events, including children managed on more liberal rehydration protocols. Mortality was high overall, and particularly in children with shock managed on WHO recommendations (day-28 mortality 82%). There was no difference in safety outcomes when different rates of intravenous rehydration were compared. Conclusions: The current 'strong recommendations' for conservative rehydration of children with SAM are not based on emerging evidence. We found no clinical trials providing a direct assessment of the current WHO guidelines, and those that were available suggested that these children have a high mortality and remain fluid depleted on current therapy. Recent studies have reported no evidence of fluid overload or heart failure with more

Differences in postural disturbances between female adolescents handball players and nontraining peers

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Jandrić Slavica Đ.

2016-01-01

Full Text Available Background/Aim. Physical activity and sport can influence the extent of the presence of the postural disturbances in children. The aim of this study was to investigate the occurrence of differences in the postural disturbances in female adolescents in relation to team handball training. Methods. This investigation involved 150 female adolescents with the average age of 13.4 ± 1.5 years divided into two groups (50 adolescents trained handball and 100 did non train it. Results. The study determined a statistically significant difference in the total number of postural disturbances between the two groups of adolescents (p 0.05. Conclusion. Handball adolescents players have less postural disturbances than untrained adolescents. Flat foot is significantly less frequent in female adolescents handball players than in untrained ones. Findings obtained in this investigation can help us in planning continuous prevention, observation and care for untrained and trained team handball female adolescents with postural disturbances.

Management of children with holoprosencephaly.

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Levey, Eric B; Stashinko, Elaine; Clegg, Nancy J; Delgado, Mauricio R

2010-02-15

Holoprosencephaly (HPE) is the most common malformation of the embryonic forebrain in humans. Although HPE occurs along a continuous spectrum, it has been categorized into four types from most severe to least severe: alobar, semilobar, lobar, and middle interhemispheric (MIH) variant. Facial malformations are often associated with HPE and usually correlate with the severity of brain malformation. With the most severely affected newborns, there is a high mortality rate in the first month of life, however, with milder forms of HPE, the majority survive beyond infancy. The Carter Centers for Brain Research in Holoprosencephaly and Related Malformations have enrolled 182 living children in a prospective research study. Based on previously published reports using this database, reports from other investigators, as well as our experience and personal observations, the range of developmental, neurological, and medical problems found in children with HPE is described in this article. Virtually all children with HPE have some developmental disability and the severity correlates with the severity of the brain malformation on neuroimaging. Common medical problems include hydrocephalus, seizures, motor impairment, oromotor dysfunction with risk of poor nutrition and aspiration, chronic lung disease, gastroesophageal reflux, constipation, hypothalamic dysfunction with disturbed sleep-wake cycles and temperature dysregulation, as well as endocrine dysfunction. Diabetes insipidus in particular is found in about 70% of children with classic HPE. Recommendations for management of these problems are given based on experiences of the authors and familiarity with the literature. 2010 Wiley-Liss, Inc.

Supratarsal injection of triamcinolone for severe vernal keratoconjunctivitis in children

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Alexandre Xavier da Costa

Full Text Available ABSTRACT Purpose: To evaluate the use of supratarsal injection of triamcinolone acetonide in severe vernal keratoconjunctivitis (VKC in children. Methods: Patients included in this open clinical trial were those with severe VKC-associated with keratitis, gelatinous limbal infiltrates, and/or giant papillae, with a history of recurrence and resistance to conventional topical antiallergic agents. Patients were treated with a supratarsal injection of 20 mg triamcinolone acetonide. Results: Analysis included 27 injections in 23 eyes of 17 patients with severe allergic keratoconjunctivitis. Mean age was 12.3 (range: 7-19 years. Mean follow-up time was 39.3 months (SD=19.21. In the 17 patients, the disease was successfully controlled for an average of 3.6 months (range: 1-16, during which allergy symptoms and signs were significantly improved, with complete resolution of lid edema and conjunctival chemosis, significant decline of pannus and keratitis, and reduction of giant papillae size. Conclusion: Treatment of severe, acute VKC in children with supratarsal injection of 20 mg triamcinolone acetonide showed satisfactory results and was well tolerated by patients; it may therefore constitute a safe option for severe and challenging cases. While full disease remission was not achieved, a significant improvement was found in ocular allergy symptoms and signs, with a reduction in the frequency of acute recurrences.

SLEEP DISORDERS IN MENTALLY RETARDED CHILDREN

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I. A. Kelmanson

2014-01-01

Full Text Available The paper presents the study of the association between sleep disturbances and mental retardation in children. Attention is paid to the instant connection between sleep neurophysiology and intellectual progress, as well as between sleep disorders and the pathogenesis of mental retardation in children. The data on characteristic forms of sleep disturbances, including bed-time resistance, frequent night awakenings, parasomnias, abnormal sleep structure, and notably reduced REM-sleep proportion are provided. The potential role of abnormal melatonin production in the origins of sleep disturbances in children with mental retardation is discussed. Certain approaches to pharmacological and non-pharmacological corrections of sleep disorders are outlined.

Interaction of historical and nonhistorical disturbances maintains native plant communities.

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Davies, K W; Svejcar, T J; Bates, J D

2009-09-01

Historical disturbance regimes are often considered a critical element in maintaining native plant communities. However, the response of plant communities to disturbance may be fundamentally altered as a consequence of invasive plants, climate change, or prior disturbances. The appropriateness of historical disturbance patterns under modern conditions and the interactions among disturbances are issues that ecologists must address to protect and restore native plant communities. We evaluated the response of Artemisia tridentata ssp. wyomingensis (Beetle & A. Young) S.L. Welsh plant communities to their historical disturbance regime compared to other disturbance regimes. The historical disturbance regime of these plant communities was periodic fires with minimal grazing by large herbivores. We also investigated the influence of prior disturbance (grazing) on the response of these communities to subsequent disturbance (burning). Treatments were: (1) ungrazed (livestock grazing excluded since 1936) and unburned, (2) grazed and unburned, (3) ungrazed and burned (burned in 1993), and (4) grazed and burned. The ungrazed-burned treatment emulated the historical disturbance regime. Vegetation cover, density, and biomass production were measured the 12th, 13th, and 14th year post-burning. Prior to burning the presence of Bromus tectorum L., an exotic annual grass, was minimal (resilience to more severe disturbances. Modern deviations from historical conditions can alter ecosystem response to disturbances, thus restoring the historical disturbance regime may not be an appropriate strategy for all ecosystems.

Adulthood outcome of tic and obsessive-compulsive symptom severity in children with Tourette syndrome.

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Bloch, Michael H; Peterson, Bradley S; Scahill, Lawrence; Otka, Jessica; Katsovich, Lily; Zhang, Heping; Leckman, James F

2006-01-01

Tourette syndrome (TS) is a childhood-onset neuropsychiatric disorder that is characterized by both motor and phonic tics. One half to two thirds of children with TS experience a reduction or complete resolution of tic symptoms during adolescence. At least one third of adults with TS have comorbid obsessive-compulsive disorder (OCD). To clarify the clinical course of tic and OCD symptoms in children with TS and determine if baseline clinical measurements in childhood are associated with future symptom severity in late adolescence and early adulthood. Prospective cohort study. Yale Child Study Center tic and OCD outpatient specialty clinic. Forty-six children with TS who received a structured clinical evaluation prior to age 14 years. Expert-rated tic and OCD symptom severity at follow-up interview an average of 7.6 years later (range, 3.8-12.8 years). Eighty-five percent of subjects reported a reduction in tic symptoms during adolescence. Only increased tic severity in childhood was associated with increased tic severity at follow-up. The average age at worst-ever tic severity was 10.6 years. Forty-one percent of patients with TS reported at one time experiencing at least moderate OCD symptoms. Worst-ever OCD symptoms occurred approximately 2 years later than worst-ever tic symptoms. Increased childhood IQ was strongly associated with increased OCD severity at follow-up. Obsessive-compulsive disorder symptoms in children with TS became more severe at a later age and were more likely to persist than tic symptoms.

Phonemic verbal fluency and severity of anxiety disorders in young children

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Rudineia Toazza

Full Text Available Abstract Introduction: Previous studies have implicated impaired verbal fluency as being associated with anxiety disorders in adolescents. Objectives: To replicate and extend previously reported evidence by investigating whether performance in phonemic verbal fluency tasks is related to severity of anxiety symptoms in young children with anxiety disorders. We also aim to investigate whether putative associations are independent from co-occurring attention deficit hyperactivity disorder (ADHD symptoms. Methods: Sixty children (6-12 years old with primary diagnoses of anxiety disorders participated in this study. Severity of symptoms was measured using clinician-based, parent-rated and self-rated validated scales. Verbal fluency was assessed using a simple task that measures the number of words evoked in 1-minute with the letter F, from which we quantified the number of isolated words, number of clusters (groups of similar words and number of switches (transitions between clusters and/or between isolated words. Results: There was a significant association between the number of clusters and anxiety scores. Further analysis revealed associations were independent from co-occurring ADHD symptoms. Conclusion: We replicate and extend previous findings showing that verbal fluency is consistently associated with severity in anxiety disorders in children. Further studies should explore the potential effect of cognitive training on symptoms of anxiety disorders.

ROTAVIRUS INFECTION. HOW TO REALLY PROTECT CHILDREN FROM SEVERE GASTROENTERITIS?

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T. A. Grechukha

2013-01-01

Full Text Available According to the statistics of the recent 5 years, the share of rotavirus gastroenterites is 44-47% of all acute intestinal infections in children under 5 years of age in the Russian Federation. Up to 5% of mortality rate in children under 5 years of age is connected with rotavirus gastroenteritis. Rotavirus gastroenteritis takes an especially severe course in children of 6-24 months of age. The only reliable method of preventing this infection is vaccination. The authors present information on the rotavirus strains dominant in Russia and abroad, efficacy and safety of immunization with a pentavalent vaccine and the recommended schemes of its administration. This vaccine is registered in the Russian Federation; it is to be first used in the nearest future.

Complement activation in Ghanaian children with severe Plasmodium falciparum malaria

DEFF Research Database (Denmark)

Helegbe, Gideon K; Goka, Bamenla Q; Kurtzhals, Jørgen

2007-01-01

BACKGROUND: Severe anaemia (SA), intravascular haemolysis (IVH) and respiratory distress (RD) are severe forms of Plasmodium falciparum malaria, with RD reported to be of prognostic importance in African children with malarial anaemia. Complement factors have been implicated in the mechanism lead...

Impact of sleep disturbances in inflammatory bowel disease.

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Ranjbaran, Ziba; Keefer, Laurie; Farhadi, Ashkan; Stepanski, Edward; Sedghi, Shahriar; Keshavarzian, Ali

2007-11-01

Normal sleep is paramount for a healthy lifestyle and high quality of life. Sleep modulates the immune system and thus affects the course of several chronic inflammatory conditions. There are no reported studies that address the role of sleep disturbance in the course of inflammatory bowel disease (IBD). The aim of this study was to characterize sleep disturbance in IBD using validated measures of sleep and quality of life. A self-administered, mail-in questionnaire package was sent to 205 subjects after a brief instruction. The questionnaire package was composed of the Pittsburgh Sleep Quality Index (PSQI), a measure of disease severity and the IBD-Quality of Life Questionnaire. A total of 119 subjects were recruited (58% response rate): 80 with inactive IBD, 24 with irritable bowel syndrome (IBS) and 15 healthy controls. The IBD subjects reported significantly prolonged sleep latency, frequent sleep fragmentation, higher rate of using sleeping pills, decreased day-time energy, increased tiredness and poor overall sleep quality compared to healthy controls. The abnormal sleep patterns in IBD subjects were similar to IBS subjects. The reported sleep quality was correlated with IBD disease severity score (r(2) = 0.55, P = 0.02). Both IBD and IBS subjects thought that sleep and their disease status were correlated. The results show that IBD patients have significant sleep disturbance even when their disease is not active. This problem might affect quality of life, gastrointestinal symptoms and coping ability, and might potentially modify disease severity or increase risk of flare-up. Regardless of the primary or secondary origin of this problem, sleep disturbance should be addressed in the clinical management of patients with IBD.

Psychiatric disorders and symptoms severity in pre-school children with cow's milk allergy.

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Topal, E; Catal, F; Soylu, N; Ozcan, O O; Celiksoy, M H; Babayiğit, A; Erge, D; Karakoç, H T E; Sancak, R

2016-01-01

Psychiatric disorders are seen frequently in atopic diseases. The present study aims to evaluate the frequency of psychiatric disorders and the severity of psychiatric symptoms in pre-school children with cow's milk allergy. The parents of the pre-school children with cow's milk allergy were interviewed in person and asked to fill out the Early Childhood Inventory-4 form. The cow's milk allergy group included 40 children (27 male, 13 female) with mean age, 44.5±14.7 months, and the control group included 41 children (25 male, 16 female) with mean age, 47.6±15.2 months. It was established that 65% of the group with cow's milk allergy received at least one psychiatric diagnosis, while 36.6% of the control group received at least one psychiatric diagnosis, with a statistically significant difference (p=0.02). Within the psychiatric disorders, attention deficit hyperactivity disorders (odds ratio: 4.9, 95% CI: 1.472-16.856, p=0.006), oppositional defiant disorder (odds ratio: 5.6, 95% CI: 1.139-28.128, p=0.026), and attachment disorder (odds ratio: 4.8, 95% CI: 1.747-13.506, p=0.004) were found significantly higher compared with the healthy control group. When the groups were compared in terms of psychiatric symptom severity scores, calculated by using the Early Childhood Inventory-4 form, attention deficit hyperactivity disorders severity (p=0.006) and oppositional defiant disorder severity (p=0.037) were found to be higher in the cow's milk allergy group. Psychiatric disorders are frequent and severe in pre-school children with cow's milk allergy. Copyright © 2016 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

Artemisinin derivatives versus quinine in treating severe malaria in children: a systematic review

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de Frey Albie

2008-10-01

Full Text Available Abstract Background The efficacy of intravenous quinine, which is the mainstay for treating severe malaria in children, is decreasing in South East Asia and Africa. Artemisinin derivatives are a potential alternative to quinine. However, their efficacy compared to quinine in treating severe malaria in children is not clearly understood. The objective of this review was to assess the efficacy of parenteral artemisinin derivatives versus parenteral quinine in treating severe malaria in children. Methods All randomized controlled studies comparing parenteral artemisinin derivatives with parenteral quinine in treating severe malaria in children were included in the review. Data bases searched were: The Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 4, 2007, MEDLINE (1966 to February 2008, EMBASE (1980 to February 2008, and LILACS (1982 to February 2008. Dichotomous variables were compared using risk ratios (RR and the continuous data using weighted mean difference (WMD. Results Twelve trials were included (1,524 subjects. There was no difference in mortality between artemisinin derivatives and quinine (RR = 0.90, 95% CI 0.73 to 1.12. The artemisinin derivatives resolved coma faster than quinine (WMD = -4.61, 95% CI: -7.21 to -2.00, fixed effect model, but when trials with adequate concealment only were considered this differences disappeared. There was no statistically significant difference between the two groups in parasite clearance time, fever clearance time, incidence of neurological sequelae and 28th day cure rate. One trial reported significantly more local reactions at the injection site with intramuscular quinine compared to artemether. None of the trials was adequately powered to demonstrate equivalence. Conclusion There was no evidence that treatment of children with severe malaria with parenteral artemisinin derivatives was associated with lower mortality or long-term morbidity compared to parenteral quinine

Psychosocial stimulation interventions for children with severe acute malnutrition: a systematic review.

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Daniel, Allison I; Bandsma, Robert H; Lytvyn, Lyubov; Voskuijl, Wieger P; Potani, Isabel; van den Heuvel, Meta

2017-06-01

The WHO Guidelines for the inpatient treatment of severely malnourished children include a recommendation to provide sensory stimulation or play therapy for children with severe acute malnutrition (SAM). This systematic review was performed to synthesize evidence around this recommendation. Specifically, the objective was to answer the question: "In children with severe acute malnutrition, does psychosocial stimulation improve child developmental, nutritional, or other outcomes?" A review protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO 2016: CRD42016036403). MEDLINE, Embase, CINAHL, and PsycINFO were searched with terms related to SAM and psychosocial stimulation. Studies were selected if they applied a stimulation intervention in children with SAM and child developmental and nutritional outcomes were assessed. Findings were presented within a narrative synthesis and a summary of findings table. Quality of the evidence was evaluated using the Cochrane risk of bias tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Only two studies, both non-randomized controlled trials, met the selection criteria for this review. One was conducted in Jamaica (1975) with a follow-up period of 14 years; the other was done in Bangladesh (2002) with a six-month follow-up. At the individual study level, each of the included studies demonstrated significant differences in child development outcomes between intervention and control groups. Only the study conducted in Bangladesh demonstrated a clinically significant increase in weight-for-age z-scores in the intervention group compared to the control group. The evidence supporting the recommendation of psychosocial stimulation for children with SAM is not only sparse, but also of very low quality across important outcomes. High-quality trials are needed to determine the effects of psychosocial stimulation interventions on outcomes in children

Psychosocial stimulation interventions for children with severe acute malnutrition: a systematic review

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Daniel, Allison I; Bandsma, Robert H; Lytvyn, Lyubov; Voskuijl, Wieger P; Potani, Isabel; van den Heuvel, Meta

2017-01-01

Background The WHO Guidelines for the inpatient treatment of severely malnourished children include a recommendation to provide sensory stimulation or play therapy for children with severe acute malnutrition (SAM). This systematic review was performed to synthesize evidence around this recommendation. Specifically, the objective was to answer the question: “In children with severe acute malnutrition, does psychosocial stimulation improve child developmental, nutritional, or other outcomes?” Methods A review protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO 2016: CRD42016036403). MEDLINE, Embase, CINAHL, and PsycINFO were searched with terms related to SAM and psychosocial stimulation. Studies were selected if they applied a stimulation intervention in children with SAM and child developmental and nutritional outcomes were assessed. Findings were presented within a narrative synthesis and a summary of findings table. Quality of the evidence was evaluated using the Cochrane risk of bias tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Findings Only two studies, both non–randomized controlled trials, met the selection criteria for this review. One was conducted in Jamaica (1975) with a follow–up period of 14 years; the other was done in Bangladesh (2002) with a six–month follow–up. At the individual study level, each of the included studies demonstrated significant differences in child development outcomes between intervention and control groups. Only the study conducted in Bangladesh demonstrated a clinically significant increase in weight–for–age z–scores in the intervention group compared to the control group. Conclusions The evidence supporting the recommendation of psychosocial stimulation for children with SAM is not only sparse, but also of very low quality across important outcomes. High–quality trials are needed to determine the effects of

Cost of management of severe pneumonia in young children: systematic analysis

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Zhang, Shanshan; Sammon, Peter M.; King, Isobel; Andrade, Ana Lucia; Toscano, Cristiana M.; Araujo, Sheila N; Sinha, Anushua; Madhi, Shabir A.; Khandaker, Gulam; Yin, Jiehui Kevin; Booy, Robert; Huda, Tanvir M; Rahman, Qazi S; El Arifeen, Shams; Gentile, Angela; Giglio, Norberto; Bhuiyan, Mejbah U.; Sturm–Ramirez, Katharine; Gessner, Bradford D.; Nadjib, Mardiati; Carosone–Link, Phyllis J.; Simões, Eric AF; Child, Jason A; Ahmed, Imran; Bhutta, Zulfiqar A; Soofi, Sajid B; Khan, Rumana J; Campbell, Harry; Nair, Harish

2016-01-01

Background Childhood pneumonia is a major cause of childhood illness and the second leading cause of child death globally. Understanding the costs associated with the management of childhood pneumonia is essential for resource allocation and priority setting for child health. Methods We conducted a systematic review to identify studies reporting data on the cost of management of pneumonia in children younger than 5 years old. We collected unpublished cost data on non–severe, severe and very severe pneumonia through collaboration with an international working group. We extracted data on cost per episode, duration of hospital stay and unit cost of interventions for the management of pneumonia. The mean (95% confidence interval, CI) and median (interquartile range, IQR) treatment costs were estimated and reported where appropriate. Results We identified 24 published studies eligible for inclusion and supplemented these with data from 10 unpublished studies. The 34 studies included in the cost analysis contained data on more than 95 000 children with pneumonia from both low– and–middle income countries (LMIC) and high–income countries (HIC) covering all 6 WHO regions. The total cost (per episode) for management of severe pneumonia was US$ 4.3 (95% CI 1.5–8.7), US$ 51.7 (95% CI 17.4–91.0) and US$ 242.7 (95% CI 153.6–341.4)–559.4 (95% CI 268.9–886.3) in community, out–patient facilities and different levels of hospital in–patient settings in LMIC. Direct medical cost for severe pneumonia in hospital inpatient settings was estimated to be 26.6%–115.8% of patients’ monthly household income in LMIC. The mean direct non–medical cost and indirect cost for severe pneumonia management accounted for 0.5–31% of weekly household income. The mean length of stay (LOS) in hospital for children with severe pneumonia was 5.8 (IQR 5.3–6.4) and 7.7 (IQR 5.5–9.9) days in LMIC and HIC respectively for these children. Conclusion This is the most

The family role in children׳s sleep disturbances: Results from a cross-sectional study in a Portuguese Urban pediatric population.

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Martins, Andreia Luís; Chaves, Petra; Papoila, Ana Luísa; Loureiro, Helena Cristina

2015-11-01

Sleep Disorders (SlD) are frequently undervalued complaints in childhood. Several factors influence sleep, particularly socio-cultural environment and medical conditions such as breathing disorders. Poor sleep hygiene has physical, educational and social consequences. In Portugal, there are few published studies about children׳s sleep habits and rarely based on validated questionnaires. To study the prevalence of SlD and associated factors, in an outpatient pediatric population of a Primary Health Care Center (PHCC). Cross-sectional study of children admitted to a PHCC on a suburban area of Lisbon. Children Sleep Habits Questionnaire, validated for the Portuguese population (CSHQ-PT) for the screening of SlD (cut-off=44), was applied to parents, as well as a demographic inquiry. Body mass index z-score was evaluated. Children scoring 44 or above were sent to Pediatric Sleep Disorders consultation (PSDC). Parametric and non-parametric tests were used whenever appropriate. From 128 children, 57.8% were male; the median age was 6.0 years (P 25=5.0; P 75=8.0). The median of cohabitants per family was 4.0 (P 25=3.0; P 75=5.0); 21.1% lived in a single-parent family. From CSHQ-PT, 59.4% (76) scored above the cut-off. Data showed that children from a single-parent family have more SlD (p=0.048), particularly parasomnia (p=0.019). Children with sleep disordered breathing (SDB) suffer more daytime sleepiness (p=0.034). From 63 children sent to PSDC, 33 attended. Regarding these children, a difference was found between BMI z-scores of those with and without SDB (p=0.06). Family structure plays a non-negligible role in children's sleep habits. Daily performance of children with SDB may become compromised.

Low morning serum cortisol levels in children with tonsillar hypertrophy and moderate-to-severe OSA.

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Malakasioti, Georgia; Alexopoulos, Emmanouel I; Varlami, Vasiliki; Chaidas, Konstantinos; Liakos, Nikolaos; Gourgoulianis, Konstantinos; Kaditis, Athanasios G

2013-09-01

Hypertrophic tonsillar tissue in children with obstructive sleep apnea (OSA) has enhanced expression of glucocorticoid receptors, which may reflect low endogenous cortisol levels. We have evaluated the effect of the interaction between tonsillar hypertrophy and OSA severity on morning serum cortisol levels. Children with and without snoring underwent polysomnography, tonsillar size grading, and measurement of morning serum cortisol. Seventy children (2-13 years old) were recruited: 30 with moderate-to-severe OSA (apnea-hypopnea index [AHI] > 5 episodes/h), 26 with mild OSA (AHI > 1 and ≤ 5), and 14 controls (no snoring; AHI ≤ 1). Tonsillar hypertrophy was present in 56.7%, 53.8%, and 42.9% of participants in each group, respectively. Application of a general linear model demonstrated a significant effect of the interaction between severity of OSA and tonsillar hypertrophy on cortisol levels (P = 0.04), after adjustment for obesity, gender, and age. Among children with tonsillar hypertrophy, subjects with moderate-to-severe OSA (n = 17; AHI 14.7 ± 10.6), mild OSA (n = 14; AHI 2.3 ± 1.2), and control participants (n = 6; AHI 0.7 ± 0.2) were significantly different regarding cortisol levels (P = 0.02). Subjects with moderate-to-severe OSA had lower cortisol (16.9 ± 8.7 mcg/dL) than those with mild OSA (23.3 ± 4.2; P = 0.01) and those without OSA (controls) (23.6 ± 5.3 mcg/dL; P = 0.04). In contrast, children with normal-size tonsils and moderate-to-severe OSA, mild OSA, and controls did not differ in cortisol levels. Children with moderate-to-severe obstructive sleep apnea and the phenotype of hypertrophic tonsils have reduced morning serum cortisol levels and potentially decreased glucocorticoid inhibitory effects on tonsillar growth.

Cytokines and soluble adhesion molecules in children and adolescents with a tic disorder.

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Bos-Veneman, Netty G P; Bijzet, Johan; Limburg, Pieter C; Minderaa, Ruud B; Kallenberg, Cees G; Hoekstra, Pieter J

2010-12-01

Dysregulation of the immune system may play a role in tic disorders. We screened for immune disturbances by investigating serum levels of cytokines and soluble adhesion molecules in patients with a tic disorder. Serum levels of interleukin (IL)-2, IL-4, IL-5, IL-10, IL-12, soluble IL-2 receptor (sIL2R), tumor necrosis factor (TNF)-α, interferon (IFN)-γ, soluble vascular cell adhesion molecule-1 (sVCAM-1), and intercellular adhesion molecule-1 (sICAM-1) of 66 children and adolescents with a tic disorder and 71 healthy volunteers were compared. We also addressed possible relations between concentrations of the immune markers and severity of tics and comorbid obsessive-compulsive symptoms. Median serum concentrations did not differ significantly between patients and healthy subjects. Serum IL-2 concentrations were positively associated with tic severity ratings; serum IL-12 concentrations negatively with severity ratings of obsessive-compulsive symptoms. These preliminary findings do not reveal major immune activation in children with a tic disorder but may suggest more subtle disturbances related to disease expression. Copyright © 2010 Elsevier Inc. All rights reserved.

Omalizumab in Japanese children with severe allergic asthma uncontrolled with standard therapy.

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Odajima, Hiroshi; Ebisawa, Motohiro; Nagakura, Toshikazu; Fujisawa, Takao; Akasawa, Akira; Ito, Komei; Doi, Satoru; Yamaguchi, Koichi; Katsunuma, Toshio; Kurihara, Kazuyuki; Kondo, Naomi; Sugai, Kazuko; Nambu, Mitsuhiko; Hoshioka, Akira; Yoshihara, Shigemi; Sato, Norio; Seko, Noriko; Nishima, Sankei

2015-10-01

Omalizumab has demonstrated clinical benefits in children with moderate to severe allergic asthma. However, no studies have been performed in Japanese asthmatic children. The aim of this study was to evaluate the efficacy including free IgE suppression and safety of omalizumab in Japanese children with severe allergic asthma. The primary objective was to examine whether omalizumab decreases serum free IgE levels to less than 25 ng/ml (target level of suppression). Thirty-eight Japanese children (6-15 years) with uncontrolled severe allergic asthma despite inhaled corticosteroids (>200 μg/day fluticasone propionate or equivalent) and two or more controller therapies received add-on treatment with omalizumab in a 24-week, multicenter, uncontrolled, open-label study. The geometric mean serum free IgE level at 24 weeks was 15.6 ng/mL. Compared with baseline, total asthma symptom scores, daily activity scores and nocturnal sleep scores at 24 weeks were significantly improved. The rates of asthma exacerbation and hospitalization due to asthma were reduced by 69.2% and 78.2%, respectively (p omalizumab decreased free IgE levels to less than 25 ng/mL. Omalizumab improved asthma control and was well-tolerated, as well. Copyright © 2015 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

Relative impact of previous disturbance history on the likelihood of additional disturbance in the Northern United States Forest Service USFS Region

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Hernandez, A. J.

2015-12-01

The Landsat archive is increasingly being used to detect trends in the occurrence of forest disturbance. Beyond information about the amount of area affected, forest managers need to know if and how disturbance regimes change. The National Forest System (NFS) has developed a comprehensive plan for carbon monitoring that requires a detailed temporal mapping of forest disturbances across 75 million hectares. A long-term annual time series that shows the timing, extent, and type of disturbance beginning in 1990 and ending in 2011 has been prepared for several USFS Regions, including the Northern Region. Our mapping starts with an automated detection of annual disturbances using a time series of historical Landsat imagery. Automated detections are meticulously inspected, corrected and labeled using various USFS ancillary datasets. The resulting maps of verified disturbance show the timing and types are fires, harvests, insect activity, disease, and abiotic (wind, drought, avalanche) damage. Also, the magnitude of each change event is modeled in terms of the proportion of canopy cover lost. The sequence of disturbances for every pixel since 1990 has been consistently mapped and is available across the entirety of NFS. Our datasets contain sufficient information to describe the frequency of stand replacement, as well as how often disturbance results in only a partial loss of canopy. This information provides empirical insight into how an initial disturbance may predispose a stand to further disturbance, and it also show a climatic signal in the occurrence of processes such as fire and insect epidemics. Thus, we have the information to model the likelihood of occurrence of certain disturbances after a given event (i.e. if we have a fire in the past what does that do to the likelihood of occurrence of insects in the future). Here, we explore if previous disturbance history is a reliable predictor of additional disturbance in the future and we present results of applying

Climate change and disturbance interactions: Workshop on climate change and disturbance interactions in western North America, Tucson, Ariz., 12-15 February 2007

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McKenzie, Don; Allen, Craig D.

2007-01-01

Warming temperatures across western North America, coupled with increased drought, are expected to exacerbate disturbance regimes, particularly wildfires, insect outbreaks, and invasions of exotic species. Many ecologists and resource managers expect ecosystems to change more rapidly from disturbance effects than from the effects of a changing climate by itself. A particular challenge is to understand the interactions among disturbance regimes; for example, how will massive outbreaks of bark beetles, which kill drought-stressed trees by feeding on cambial tissues, increase the potential for large severe wildfires in a warming climate?Researchers in climatology, ecosystem science, fire and insect ecology, and landscape modeling from across western North America convened in Tucson, Ariz., for a 2 and a half day intensive workshop to identify new research directions in climate change and disturbance ecology. Four work groups focused on different aspects of the response of disturbance regimes to climate change: (1) extreme events and climatic variability (2) the effects of changing disturbance regimes on ecosystems, (3) disturbance interactions and cumulative effects, and (4) developing new landscape disturbance models. The workshop was structured with the analytic hierarchy process, a decision support method for achieving consensus from diverse groups of experts without sacrificing individual contributions.

Agenda nacional para lograr mejores resultados para los ninos y jovenes con desordenes emocionales serios (National Agenda for Achieving Better Results for Children and Youth with Serious Emotional Disturbance).

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Chesapeake Inst., Washington, DC.

This report documents the problem of educating students with serious emotional disturbance, reviews the legislative and administrative background, and identifies seven strategic targets in a national agenda for these children. Data for these students on academic outcomes, graduation rates, school placement, school absenteeism, dropout rates,…

The role of human rhinovirus (HRV) species on asthma exacerbation severity in children and adolescents.

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Lambert, Katrina A; Prendergast, Luke A; Dharmage, Shyamali C; Tang, Mimi; O'Sullivan, Molly; Tran, Thomas; Druce, Julian; Bardin, Philip; Abramson, Michael J; Erbas, Bircan

2017-10-11

It is recognized that human rhinovirus (HRV) infection is an important factor in asthma exacerbations requiring hospitalization in children. However, previous studies have disagreed on the differential impact of various HRV species. We sought to assess the impact of HRV species on the severity of asthma exacerbations in children and adolescents. We also examined whether the effect of HRV species on severity was modified by age and gender. Virus strain was determined for 113 children with HRV detectable at the time of admission for asthma exacerbation. Patient characteristics were collected on admission and exacerbation severity was scored using several validated scales. HRV species by itself was not associated with moderate/severe vs. mild exacerbations. Boys with HRV-C infections were more likely (OR: 3.7, 95% CI: 1.2-13.4) to have a moderate/severe exacerbation than girls with HRV-C (p = 0.04 for interaction term). Higher odds were observed in younger boys (3 years old: OR: 9.1, 95% CI: 1.8-47.1 vs 5 years old: OR: 3.3, 95% CI: 0.9-11.8 vs 7 years old: OR: 1.2, 95% CI: 0.2-6.6). In contrast, children with HRV-C infection and sensitized to pollen during the pollen season were less likely to have moderate/severe exacerbations (p = 0.01 for the interaction term). Acute asthma exacerbations are more likely to be moderate/severe in boys under 5 years of age who had HRV-C infection on admission. The opposite was found in children with sensitization to pollen during pollen season.

Validity of antibodies in lymphocyte supernatant in diagnosing tuberculosis in severely malnourished children presenting with pneumonia.

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Mohammod Jobayer Chisti

Full Text Available The diagnosis of tuberculosis (TB in young children can be challenging, especially in severely malnourished children. There is a critical need for improved diagnostics for children. Thus, we sought to evaluate the performance of a technique that measures antibodies in lymphocyte supernatant (ALS for the diagnosis of TB in severely malnourished children presenting with suspected pneumonia.Children less than 5 years with severe acute malnutrition and radiological features of pneumonia admitted to the Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh, were enrolled consecutively following informed written consent. In addition to clinical and radiological assessment, samples taken for TB diagnosis included gastric lavage fluid and induced sputum for microbiological confirmation. ALS was measured from venous blood, and results were evaluated in children classified as "confirmed", "non-confirmed TB" or "not TB".Among 224 children who had ALS analysis, 12 (5.4% children had microbiologically "confirmed TB", a further 41 (18% had clinically diagnosed "non-confirmed TB" and the remaining 168 (75% were considered not to have TB. ALS was positive in 89 (40% and negative in 85 (39% of children, with a large number (47 or 21% reported as "borderline". These proportions were similar between the three diagnostic groups. The sensitivity and specificity of ALS when comparing "Confirmed TB" to "Not TB" was only 67% (95% CI: 31-91% and 51% (95% CI: 42-60%, respectively.Our data suggest that ALS is not sufficiently accurate to improve the diagnosis of TB in children with severe malnutrition.

Severe cutaneous drug reactions in Guinean children: a monocentric retrospective study of 35 cases

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Thierno Mamadou Tounkara

2018-04-01

Full Text Available Background: Data on Severe cutaneous drug reactions (CADRs are not common among in sub-Saharan Africa children. The purpose of this study was to document the clinical, etiological and evolutionary aspects of Severe CDRs in children hospitalized at the dermatology department of university hospitals of Conakry. Material and Methods: Retrospective study, conducted from 1 January 2000 to 31 December 2014. Were included all children aged 0-17 years hospitalized for severe CARDs. The data collected were Socio-demographic, clinical, para-clinical and evolution variables. The data was entered and analyzed using the Excel 8.0 software. Results: During a study period, 4437 patients of all ages was hospitalized in dermatology department. 35 patients were included with an average age of 11.3 years and a sex ratio of 1.5. The main clinical patterns were: Stevens Johnson syndrome 37.14% (13/35 Lyell syndrome 25.71 % and generalized bullous fixed eruption 22.85%. The drug was identified as 32 patients (91.42%: Sulfadoxine–Pyriméthamine 40.62%, cotrimoxazole 21.85%, nevirapin 12.5%, ampicillin 6.25%, traditional Pharmacopoeia 6.25% and griseofulin 3.12%. It was taken following self-medication in 14 patients, including a parental initiative in 9 patients. 7 patients had a history of drug allergy and 4 were HIV positive. We recorded 5 deaths. Conclusion: Our study confirms the rarity of severe CADRs in children. The importance of the sulfadoxine-pyrimethamine in the occurrence of severe CADRs in children is the particularity of our series.

Oral Communication Development in Severe to Profound Hearing Impaired Children After Receiving Aural Habilitation

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Soleimani Farin

2009-10-01

Full Text Available Communication, cognition, language, and speech are interrelated and develop together. It should come as no surprise to us that the key to intervention with deaf children is to establish, as early as possible, a functional communication system for the child and the parents. Early intervention programs need to be multidisciplinary, technologically sound and most important, it should take cognizance of the specific context (community, country in which the child and family function. The main aim of this study was to obtain oral communication development regarding current status of the intervention (aural habilitation and speech therapyfor children with severe to profound hearing impairment in Iran. A prospective longitudinal study was undertaken on a consecutive group of children with severe to profound deafness. Nine severe to profound hearing-impaired children out of the primer 42 cases, who were detected below two years old, had been selected in the previous study to receive aural habilitation. The average of their speech intelligibility scores was near 70% at age 6, which was accounted as poor oral communication and only two of them were able to communicate by spoken language. An integrated intervention services continued again for one year and their oral communication skill was assessed by their speech intelligibility. The intelligibility test of children was recorded on audio-tape, when they read 10 questions such as where is your home. This can be answered only in one word. Each tape was presented to10 normal hearing listeners, and their task was to write down, the answers in Persian orthography. At the beginning (at age 6 the average speech intelligibility score of these children was 72% and only two of them had score of 90% and 100%. At age 7, all of the severe groups were over 90%, and only two profound ones achieved the score of 48% and 62%. All of severe groups develop oral communication, but profound ones had a semi-intelligible speech

Transience after disturbance: Obligate species recovery dynamics depend on disturbance duration.

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Singer, Alexander; Johst, Karin

2017-06-01

After a disturbance event, population recovery becomes an important species response that drives ecosystem dynamics. Yet, it is unclear how interspecific interactions impact species recovery from a disturbance and which role the disturbance duration (pulse or press) plays. Here, we analytically derive conditions that govern the transient recovery dynamics from disturbance of a host and its obligately dependent partner in a two-species metapopulation model. We find that, after disturbance, species recovery dynamics depend on the species' role (i.e. host or obligately dependent species) as well as the duration of disturbance. Host recovery starts immediately after the disturbance. In contrast, for obligate species, recovery depends on disturbance duration. After press disturbance, which allows dynamics to equilibrate during disturbance, obligate species immediately start to recover. Yet, after pulse disturbance, obligate species continue declining although their hosts have already begun to increase. Effectively, obligate species recovery is delayed until a necessary host threshold occupancy is reached. Obligates' delayed recovery arises solely from interspecific interactions independent of dispersal limitations, which contests previous explanations. Delayed recovery exerts a two-fold negative effect, because populations continue declining to even smaller population sizes and the phase of increased risk from demographic stochastic extinction in small populations is prolonged. We argue that delayed recovery and its determinants -species interactions and disturbance duration - have to be considered in biodiversity management. Copyright © 2017 Elsevier Inc. All rights reserved.

Autism Severity and Motor Abilities Correlates of Imitation Situations in Children with Autism Spectrum Disorders

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Zachor, Ditza A.; Ilanit, Tzaig; Itzchak, Esther Ben

2010-01-01

Impaired performance in a range of imitation tasks has been described in children with autism spectrum disorders (ASD) and several underlying mechanism have been suggested. This study examined whether imitation abilities are related to autism severity and to motor skills. Furthermore, the performance of children with ASD in four imitation…

Automated radiogrammetry is a feasible method for measuring bone quality and bone maturation in severely disabled children

International Nuclear Information System (INIS)

Mergler, Sandra; Man, Stella A. de; Boot, Annemieke M.; Heus, Karen G.C.B.B.; Huijbers, Wim A.R.; Rijn, Rick R. van; Penning, Corine; Evenhuis, Heleen M.

2016-01-01

Children with severe neurological impairment and intellectual disability are prone to low bone quality and fractures. We studied the feasibility of automated radiogrammetry in assessing bone quality in this specific group of children. We measured outcome of bone quality and, because these children tend to have altered skeletal maturation, we also studied bone age. We used hand radiographs obtained in 95 children (mean age 11.4 years) presenting at outpatient paediatric clinics. We used BoneXpert software to determine bone quality, expressed as paediatric bone index and bone age. Regarding feasibility, we successfully obtained a paediatric bone index in 60 children (63.2%). The results on bone quality showed a mean paediatric bone index standard deviation score of -1.85, significantly lower than that of healthy peers (P < 0.0001). Almost 50% of the children had severely diminished bone quality. In 64% of the children bone age diverged more than 1 year from chronological age. This mostly concerned delayed bone maturation. Automated radiogrammetry is feasible for evaluating bone quality in children who have disabilities but not severe contractures. Bone quality in these children is severely diminished. Because bone maturation frequently deviated from chronological age, we recommend comparison to bone-age-related reference values. (orig.)

Automated radiogrammetry is a feasible method for measuring bone quality and bone maturation in severely disabled children

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Mergler, Sandra [Erasmus MC, Department of General Practice and Intellectual Disability Medicine, University Medical Centre, Rotterdam (Netherlands); Care and Service Centre for People with Intellectual Disabilities, Medical Department ASVZ, Sliedrecht (Netherlands); Man, Stella A. de [Amphia Hospital, Department of Paediatrics, Breda (Netherlands); Boot, Annemieke M. [University of Groningen, Department of Paediatric Endocrinology, University Medical Centre Groningen, Groningen (Netherlands); Heus, Karen G.C.B.B. [Erasmus MC, Department of General Paediatrics, Sophia Children' s Hospital, University Medical Centre, Rotterdam (Netherlands); Huijbers, Wim A.R. [Beatrix Hospital, Department of Paediatrics, Gorinchem (Netherlands); Rijn, Rick R. van [Emma Children' s Hospital/Academic Medical Centre, Department of Radiology, Amsterdam (Netherlands); Penning, Corine; Evenhuis, Heleen M. [Erasmus MC, Department of General Practice and Intellectual Disability Medicine, University Medical Centre, Rotterdam (Netherlands)

2016-06-15

Children with severe neurological impairment and intellectual disability are prone to low bone quality and fractures. We studied the feasibility of automated radiogrammetry in assessing bone quality in this specific group of children. We measured outcome of bone quality and, because these children tend to have altered skeletal maturation, we also studied bone age. We used hand radiographs obtained in 95 children (mean age 11.4 years) presenting at outpatient paediatric clinics. We used BoneXpert software to determine bone quality, expressed as paediatric bone index and bone age. Regarding feasibility, we successfully obtained a paediatric bone index in 60 children (63.2%). The results on bone quality showed a mean paediatric bone index standard deviation score of -1.85, significantly lower than that of healthy peers (P < 0.0001). Almost 50% of the children had severely diminished bone quality. In 64% of the children bone age diverged more than 1 year from chronological age. This mostly concerned delayed bone maturation. Automated radiogrammetry is feasible for evaluating bone quality in children who have disabilities but not severe contractures. Bone quality in these children is severely diminished. Because bone maturation frequently deviated from chronological age, we recommend comparison to bone-age-related reference values. (orig.)

Relationship between stuttering severity in children and their mothers’ speaking rate

Directory of Open Access Journals (Sweden)

Ali Dehqan

Full Text Available CONTEXT AND OBJECTIVE: Stuttering is a complex disease that influences occupational, social, academic and emotional achievements. The aim of this study was to correlate the stuttering severity index with speaking rates of mothers and children. DESIGN AND SETTING: Cross-sectional study, at the child rehabilitation clinics of Tehran city. METHODS: 35 pairs of mothers and their children who stuttered were studied. There were 29 boys and six girls, of mean age 8.5 years (range: 5.1-12.0. Speech samples from the mother-child pairs were audiotaped for approximately 15 minutes, until a reciprocal verbal interaction had been obtained. This sample was then analyzed in accordance with a stuttering severity index test and speaking rate parameters. RESULTS: The research results outlined a significant relationship between the mothers’ speaking rate and their children’s stuttering severity. CONCLUSION: The results suggest that the mothers’ speaking rate should be incorporated in the assessment and treatment of stuttering.

Assessment Practices of School Psychologists When Identifying Children for SED Classes.

Science.gov (United States)

Strelnieks, Maija; Wessel, Joan

This study investigated the procedures used by psychologists in a large midwestern urban area for the initial diagnosis and placement of elementary children with severe emotional disturbance (SED) in educational programs in light of the widespread criticism of the use of projective tests due to the questionable reliability of the tests and…

ICT based technology to support play for children with severe physical disabilities.

Science.gov (United States)

van den Heuvel, Renée; Lexis, Monique; de Witte, Luc

2015-01-01

Play is important for a child's development. Children with severe physical disabilities experience difficulties engaging in play. With the progress of technology the possibilities to support play are increasing. The purpose of this review was to gain insight into the possibilities and availability of ICT based technology to support play in children with severe physical disabilities. A systematic literature search within the databases PubMed, CINAHL, IEEE and ERIC was carried out. Three reviewers assessed titles and abstracts independently. Additionally, Google Scholar, conference proceedings and reference lists were used. The included publications reported on 27 different technologies, which can be classified into three main groups; robots, virtual reality systems and computer systems. There are several options that may have great potential in supporting play for this target group.

Prevalence and predictors of severe hypoglycemia in Danish children and adolescents with diabetes

DEFF Research Database (Denmark)

Johansen, Anders; Kanijo, B; Fredheim, S

2015-01-01

OBJECTIVE: To investigate the prevalence of severe hypoglycemia in Danish children and adolescents with type 1 diabetes and to pinpoint predictors of this acute complication in children on modern treatment modalities. RESEARCH DESIGN AND METHODS: The study is based on data from DanDiabKids...

Application of the Mitrofanoff principle in children with severe impairment of bladder function

NARCIS (Netherlands)

Heij, H. A.; Ekkelkamp, S.; Moorman-Voestermans, C. G.; Vos, A.

1997-01-01

Treatment of children with severe impairment of bladder function requires a large-volume, low-pressure reservoir combined with a continent, easily catheterizable valve. The Mitrofanoff principle (MP) appears to meet these requirements. Between 1986 and 1993, the MP was applied in 15 children (4

Hydrological disturbance diminishes predator control in wetlands.

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Dorn, Nathan J; Cook, Mark I

2015-11-01

Effects of predators on prey populations can be especially strong in aquatic ecosystems, but disturbances may mediate the strength of predator limitation and even allow outbreaks of some prey populations. In a two-year study we investigated the numerical responses of crayfish (Procambarus fallax) and small fishes (Poeciliidae and Fundulidae) to a brief hydrological disturbance in replicated freshwater wetlands with an experimental drying and large predatory fish reduction. The experiment and an in situ predation assay tested the component of the consumer stress model positing that disturbances release prey from predator limitation. In the disturbed wetlands, abundances of large predatory fish were seasonally reduced, similar to dynamics in the Everglades (southern Florida). Densities of small fish were unaffected by the disturbance, but crayfish densities, which were similar across all wetlands before drying, increased almost threefold in the year after the disturbance. Upon re-flooding, juvenile crayfish survival was inversely related to the abundance of large fish across wetlands, but we found no evidence for enhanced algal food quality. At a larger landscape scale (500 km2 of the Everglades), crayfish densities over eight years were positively correlated with the severity of local dry disturbances (up to 99 days dry) during the preceding dry season. In contrast, densities of small-bodied fishes in the same wetlands were seasonally depressed by dry disturbances. The results from our experimental wetland drought and the observations of crayfish densities in the Everglades represent a large-scale example of prey population release following a hydrological disturbance in a freshwater ecosystem. The conditions producing crayfish pulses in the Everglades appear consistent with the mechanics of the consumer stress model, and we suggest crayfish pulses may influence the number of nesting wading birds in the Everglades.

Is severity of motor coordination difficulties related to co-morbidity in children at risk for developmental coordination disorder?

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Schoemaker, Marina M; Lingam, Raghu; Jongmans, Marian J; van Heuvelen, Marieke J G; Emond, Alan

2013-10-01

Aim of the study was to investigate whether 7-9 year old children with severe motor difficulties are more at risk of additional difficulties in activities in daily living, academic skills, attention and social skills than children with moderate motor difficulties. Children (N=6959) from a population based cohort, the Avon Longitudinal Study of Parents and Children (ALSPAC), were divided into three groups based on their scores on the ALSPAC Coordination Test at age 7: control children (scores above 15th centile; N=5719 [82.1%]); children with moderate (between 5th and 15th centile; N=951 [13.7%]); and children with severe motor difficulties (below 5th centile N=289 [4.2%]). Children with neurological disorders or an IQactivities of daily living (ADL); academic skills (reading, spelling and handwriting); attention; social skills (social cognition and nonverbal skills). Children with severe motor difficulties demonstrated a higher risk of difficulties in ADL, handwriting, attention, reading, and social cognition than children with moderate motor difficulties, who in turn had a higher risk of difficulties than control children in five out of seven domains. Screening and intervention of co-morbid problems is recommended for children with both moderate and severe motor difficulties. Copyright © 2013. Published by Elsevier Ltd.

VGKC complex antibodies in pediatric severe acute encephalitis: a study and literature review.

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Lin, Jainn-Jim; Lin, Kuang-Lin; Hsia, Shao-Hsuan; Wang, Huei-Shyong; Chiu, Cheng-Hsun; CHEESE Study Group

2013-08-01

Antibodies to surface proteins like voltage-gated potassium channel (VGKC) complexes are increasingly found in different neurologic diseases and encephalitis in adults and recently, in children. Detecting such antibodies can help identify forms of encephalitis that may respond to immuno-therapies. However, there are few reports on VGKC complex antibodies in pediatric severe acute encephalitis. This study retrospectively reviewed antibodies to VGKC, leucine-rich glioma-inactivated 1 (Lgi1), and contactin-associated protein-like 2 (Caspr2) in 46 children with severe acute encephalitis. Published cases of VGKC complex antibodies in pediatric encephalitis in the period of 2000-2012 were also reviewed. Elevated VGKC complex antibodies (>100pM) were detected in one of the 46 children with severe acute encephalitis. The 4-year and 6-month-old girl presented with seizure and disturbed consciousness. Viral PCR/culture and serologic evidence of influenza A infection was noted. She also had complications of epilepsy, impaired cognition, and altered behavior and psychology. Antibodies to Lgi1 and Caspr2 were not detected. Ten previously published reports revealed that VGKC complex antibodies can occur in children with limbic encephalitis and acute or sub-acute encephalitis. The incidence of VGKC complex antibodies in pediatric severe acute encephalitis is not high with only one (2.2%) of 46 children in this study. And, this is the first report on the association of VGKC complex antibodies and patients with influenza A-related severe acute encephalitis. The mechanism of VGKC complex antibodies in pediatric severe acute encephalitis warrants further study. Copyright © 2012 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Viruses as Sole Causative Agents of Severe Acute Respiratory Tract Infections in Children.

Science.gov (United States)

Moesker, Fleur M; van Kampen, Jeroen J A; van Rossum, Annemarie M C; de Hoog, Matthijs; Koopmans, Marion P G; Osterhaus, Albert D M E; Fraaij, Pieter L A

2016-01-01

Respiratory syncytial virus (RSV) and influenza A viruses are known to cause severe acute respiratory tract infections (SARIs) in children. For other viruses like human rhinoviruses (HRVs) this is less well established. Viral or bacterial co-infections are often considered essential for severe manifestations of these virus infections. The study aims at identifying viruses that may cause SARI in children in the absence of viral and bacterial co-infections, at identifying disease characteristics associated with these single virus infections, and at identifying a possible correlation between viral loads and disease severities. Between April 2007 and March 2012, we identified children (acute respiratory tract infection (ARTI) (controls). Data were extracted from the clinical and laboratory databases of our tertiary care paediatric hospital. Patient specimens were tested for fifteen respiratory viruses with real-time reverse transcriptase PCR assays and we selected patients with a single virus infection only. Typical bacterial co-infections were considered unlikely to have contributed to the PICU or MC admission based on C-reactive protein-levels or bacteriological test results if performed. We identified 44 patients admitted to PICU with SARI and 40 patients admitted to MC with ARTI. Twelve viruses were associated with SARI, ten of which were also associated with ARTI in the absence of typical bacterial and viral co-infections, with RSV and HRV being the most frequent causes. Viral loads were not different between PICU-SARI patients and MC-ARTI patients. Both SARI and ARTI may be caused by single viral pathogens in previously healthy children as well as in children with a medical history. No relationship between viral load and disease severity was identified.

Serum 25-hyroxyvitamin D levels and tic severity in Chinese children with tic disorders.

Science.gov (United States)

Li, Hong-Hua; Shan, Ling; Wang, Bing; Du, Lin; Xu, Zhi-Da; Jia, Fei-Yong

2018-05-31

The aim of this study is to evaluate serum 25-hydroxyvitamin D[25(OH)D] levels in children with tic disorders and to explore the relationship between serum 25(OH)D level and tic severity. Children (n = 179, 31 females, 148 males, mean age at diagnosis: 8.0 ± 2.7 years old, age ranged from 3 to 14.5 years old) who were diagnosed with a tic disorder were enrolled as case group, 189 healthy children were recruited as control group. Serum level of 25(OH)D of each child was measured by high performance liquid chromatography and tandem mass spectrometry (HPLC-MS/MS). Yale Global Tic Severity Scale (YGTSS) was used to assess tic severity. Mean serum level of 25(OH)D in the case group was significantly lower than that of the control group. The serum 25(OH)D level was significantly associated with tic severity after adjusting for age and body mass index (BMI). This study identified a high prevalence of vitamin D insufficiency or deficiency in children with tic disorders, and there was a negative correlation between the serum 25(OH)D level and tic severity. In the future, large sample size studies are urgently needed to further clarify this correlation. Copyright © 2018. Published by Elsevier B.V.

Sleep disturbances in Parkinsonism.

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Askenasy, J J M

2003-02-01

according to the progression of the degenerative process of the disease will diminishe aggravation. The following types of sleep-arousal disturbances have to be considered in PD patients: - Sleep Disturbances, Light Fragmented Sleep (LFS), Abnormal Motor Activity During Sleep (AMADS), REM Behavior Disorders (RBD), Sleep Related Breathing Disorders (SRBD), Sleep Related Hallucinations (SRH), Sleep Related Psychotic Behavior (SRPB). - Arousal Disturbances, Sleep Attacks (SA), Excessive Daytime Sleepiness (EDS), Each syndrome has to receive a score according to its severity. III. The specific therapy consists in: LFS: Benzodiazepines & Nondiazepines. AMADS: Clonazepam, Opioid, Apomorphine infusion; RBD: Clonazepam and dopaminergic agonists; SRBD: CPAP, UPPP, nasal interventions, losing weight; SRH: Clozapine, Risperidone; SRPD: Nortriptyline, Clozapine, Olanzepine; SA-adjustment; EDS-arousing drugs. Each therapeutic approach must be tailored to the individual PD patient.

Anthropogenic disturbance on the vegetation in makurunge

African Journals Online (AJOL)

Mgina

landscape in Tanzania that has been severely affected by anthropogenic disturbance ... Fragmentation of habitats formed patches that have reduced plant species population sizes, and ... by the movement of the Inter-Tropical ..... of pollinators.

Adult Outcome of Children Reared for Long-Term Periods in Foster Families.

Science.gov (United States)

Dumaret, Annick-Camille; Coppel-Batsch, Marthe; Couraud, Simone

1997-01-01

Assessment of adult outcomes of 59 children from severely psychosocially dysfunctional families, who were placed in foster families for at least five years, found most had overcome their childhood adversities with 56% well-integrated socially and only 10% in situations of failure. Difficulties were linked to multiple family disturbances, traumatic…

Gaze-based assistive technology used in daily life by children with severe physical impairments - parents' experiences.

Science.gov (United States)

Borgestig, Maria; Rytterström, Patrik; Hemmingsson, Helena

2017-07-01

To describe and explore parents' experiences when their children with severe physical impairments receive gaze-based assistive technology (gaze-based assistive technology (AT)) for use in daily life. Semi-structured interviews were conducted twice, with one year in between, with parents of eight children with cerebral palsy that used gaze-based AT in their daily activities. To understand the parents' experiences, hermeneutical interpretations were used during data analysis. The findings demonstrate that for parents, children's gaze-based AT usage meant that children demonstrated agency, provided them with opportunities to show personality and competencies, and gave children possibilities to develop. Overall, children's gaze-based AT provides hope for a better future for their children with severe physical impairments; a future in which the children can develop and gain influence in life. Gaze-based AT provides children with new opportunities to perform activities and take initiatives to communicate, giving parents hope about the children's future.

Diagnostics Of Renal Hemodynamics Disturbance In Children And Teenagers With Chronic Constipation, Encopresis And Their Correction

Directory of Open Access Journals (Sweden)

A.L. Malykh

2009-12-01

Full Text Available The article gives the detailed issue of results of complex inspection of 90 children and teenagers aged 4-17 with problems of chronic constipation, incontinence and encopresis. Ultrasonic screening has shown various pathology in the functional condition of arterial renal vessels. The method of biological feedback has been considered as prospective method of treatment excluding medication of bladder and small bowel dysfunction. The efficiency of the method was marked at combination of encopresis and incontinence. The purpose of the present research was the study of renal hemodynamics disturbances and working out methods of their correction. The examination included ultrasonic investigation, electromyography and uroflowmetry. The study of functional condition of anterior abdominal wall muscles and pelvic floor muscles was performed by means of «Miomed - 938». All patients received complex therapy on the basis of which the method of biological feedback was used

Scholastic Attainment Following Severe Early Institutional Deprivation: A Study of Children Adopted from Romania

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Beckett, Celia; Maughan, Barbara; Rutter, Michael; Castle, Jenny; Colvert, Emma; Groothues, Christine; Hawkins, Amanda; Kreppner, Jana; O'Connor, Thomas G.; Stevens, Suzanne; Sonuga-Barke, Edmund J. S.

2007-01-01

The relationship between severe early institutional deprivation and scholastic attainment at age 11 in 127 children (68 girls and 59 boys) adopted from institutions in Romania was compared to the attainment of 49 children (17 girls and 32 boys) adopted within the UK from a non-institutional background. Overall, children adopted from Romania had…

Modeling biological disturbances in LANDIS: a module description and demonstration using spruce budworm

Science.gov (United States)

Brian R. Sturtevant; Eric J. Gustafson; Wei Li; Hong S. He

2004-01-01

Insects and diseases are common disturbance agents in forested ecosystems. Severe outbreaks can cause significant changes in tree species composition, age structure, and fuel conditions over broad areas. To investigate the role of biological disturbances in shaping forest landscapes over time, we constructed a new "biological disturbance agent" (BDA) module...

The relevance of basophil allergen sensitivity testing to distinguish between severe and mild peanut-allergic children.

Science.gov (United States)

Homšak, Matjaž; Silar, Mira; Berce, Vojko; Tomazin, Maja; Skerbinjek-Kavalar, Maja; Celesnik, Nina; Košnik, Mitja; Korošec, Peter

2013-01-01

Peanut sensitization is common in children. However, it is difficult to assess which children will react mildly and which severely. This study evaluated the relevance of basophil allergen sensitivity testing to distinguish the severity of peanut allergy in children. Twenty-seven peanut-sensitized children with symptoms varying from mild symptoms to severe anaphylaxis underwent peanut CD63 dose-response curve analysis with the inclusion of basophil allergen sensitivity calculation (CD-sens) and peanut component immunoglobulin E (IgE) testing. Eleven children who had experienced anaphylaxis to peanuts showed a markedly higher peanut CD63 response at submaximal allergen concentrations and CD-sens (median 1,667 vs. 0.5; p < 0.0001) than 16 children who experienced a milder reaction. Furthermore, a negative or low CD-sens to peanuts unambiguously excluded anaphylactic peanut allergy. Children with anaphylaxis have higher levels of Ara h 1, 2, 3 and 9 IgE, but comparable levels of IgE to Ara h 8 and whole-peanut extract. The diagnostic specificity calculated with a receiver operating characteristic analysis reached 100% for CD-sens and 73% for Ara h 2. We demonstrated that severe peanut allergy is significantly associated with higher basophil allergen sensitivity. This cellular test should facilitate a more accurate diagnosis of peanut allergy. © 2013 S. Karger AG, Basel.

Recovery of lotic macroinvertebrate communities from disturbance

Science.gov (United States)

Wallace, J. Bruce

1990-09-01

Ecosystem disturbances produce changes in macrobenthic community structure (abundances, biomass, and production) that persist for a few weeks to many decades. Examples of disturbances with extremely long-term effects on benthic communities include contamination by persistent toxic agents, physical changes in habitats, and altered energy inputs. Stream size, retention, and local geomorphology may ameliorate the influence of disturbances on invertebrates. Disturbances can alter food webs and may select for favorable genotypes (e.g., insecticidal resistance). Introductions of pesticides into lotic ecosystems, which do not result in major physical changes within habitats, illustrate several factors that influence invertebrate recovery time from disturbance. These include: (1) magnitude of original contamination, toxicity, and extent of continued use; (2) spatial scale of the disturbance; (3) persistence of the pesticide; (4) timing of the contamination in relation to the life history stages of the organisms; (5) vagility of populations influenced by pesticides; and (6) position within the drainage network. The ability of macroinvertebrates to recolonize denuded stream habitats may vary greatly depending on regional life histories, dispersal abilities, and position within the stream network (e.g., headwaters vs larger rivers). Although downstream drift is the most frequently cited mechanism of invertebrate recolonization following disturbance in middle- and larger-order streams, evidence is presented that shows aerial recolonization to be potentially important in headwater streams. There is an apparent stochastic element operating for aerial recolonization, depending on the timing of disturbance and flight periods of various taxa. Available evidence indicates that recolonization of invertebrate taxa without an aerial adult stage requires longer periods of time than for those that possess winged, terrestrial adult stages (i.e., most insects). Innovative, manipulative

[Severe nutritional rickets in young children: Resurgence of an old disease].

Science.gov (United States)

Estrade, S; Majorel, C; Tahhan, N; Dulac, Y; Baunin, C; Gennero, I; Chaix, Y; Salles, J-P; Edouard, T

2017-08-01

Nutritional rickets remains a significant public health issue for children worldwide. Although it has almost disappeared in industrialized countries following routine vitamin D supplementation, recent evidence suggests an increasing incidence, especially in young children. In addition to the classical clinical consequences on bone and the growth plate, rickets may also be associated with life-threatening neurological and cardiac complications in the most severe forms. Consequently, early screening and treatment are required. Here, we report the case of a 2-year-old child who presented with severe nutritional rickets associated with seizure and cardiomyopathy. Family screening revealed rickets in all the siblings. This case report emphasizes the importance of being aware of this disease, notably in population with sociocultural risk factors. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Disturbance and recovery of litter fauna: a contribution to environmental conservation

NARCIS (Netherlands)

Comor, V.N.R.

2013-01-01

Disturbances play a great role in ecosystem functioning and, with the increasing anthropogenic activities, they have more and more influence on ecosystems. They have been studied for several decades but recovery, the ecological phenomenon following a disturbance, has seldom been the focus of

Caudate volumes in childhood predict symptom severity in adults with Tourette syndrome.

Science.gov (United States)

Bloch, Michael H; Leckman, James F; Zhu, Hongtu; Peterson, Bradley S

2005-10-25

Most children with Tourette syndrome (TS) experience a marked decline in the severity of tic symptoms during adolescence. Currently no clinical measures can predict whose tic symptoms will persist into adulthood. Previous cross-sectional imaging studies have identified reduced caudate nucleus volumes in subjects with TS. To evaluate whether caudate nucleus volumes in childhood can predict the severity of tic or obsessive-compulsive symptoms at follow-up in early adulthood. In a prospective longitudinal study, clinical status and basal ganglia volumes of 43 children with TS were measured on high-resolution magnetic resonance images before age 14 years. Follow-up clinical assessments were conducted after age 16 years, an average of 7.5 years later. Linear regression and Tobit regression analyses were used to assess the association of basal ganglia volumes measured in childhood with the severity of tic and obsessive-compulsive disorder (OCD) symptoms at the time of childhood MRI and at follow-up in early adulthood. Volumes of the caudate nucleus correlated significantly and inversely with the severity of tic and OCD symptoms in early adulthood. Caudate volumes did not correlate with the severity of symptoms at the time of the MRI scan. Caudate volumes in children with Tourette syndrome predict the severity of tic and obsessive-compulsive symptoms in early adulthood. This study provides compelling evidence that morphologic disturbances of the caudate nucleus within cortico-striatal-thalamo-cortical circuits are central to the persistence of both tics and obsessive-compulsive symptoms into adulthood.

Energy expenditure in children with cerebral palsy and moderate / severe malnutrition during nutritional recovery.

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García-Contreras, Andrea A; Vásquez-Garibay, Edgar M; Romero-Velarde, Enrique; Ibarra-Gutierrez, Ana I; Troyo-Sanroman, Rogelio

2015-05-01

To analyze the total energy expenditure (TEE) and resting energy expenditure (REE) in children with cerebral palsy (CP) and moderate or severe malnutrition during nutritional recovery. In an intervention study, thirteen subjects with CP (10 females and 3 males with a mean age of 9y11m ± 2y3m), level V of the Gross Motor Function Classification System and moderate or severe malnutrition were included. Eight were fed by nasogastric tube and five by gastrostomy. They were compared with 57 healthy participants (31 females and 26 males with mean age of 8y7m ± 10m). Anthropometric measurements, body composition and energy expenditure by bioelectrical impedance analysis (BIA) and indirect calorimetry (IC) were performed in both groups. TEE and REE were higher in healthy children than in children with CP in kcal/d and kcal/cm/d but were lower in kcal/kg/d (p children with CP produced a significant increase in energy expenditure. TEE and REE, in children with CP, are lower than in healthy children. Estimating the REE in children with CP and malnutrition is better performed in kcal/kg/d than in kcal/cm/d. Fat-free mass (FFM) is a good predictor of the REE in healthy children and children with CP. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Cardiometabolic risk factors and quality of life in severely obese children and adolescents in The Netherlands

NARCIS (Netherlands)

Makkes, Sabine; Renders, Carry M; Bosmans, Judith E; van der Baan-Slootweg, Olga H; Seidell, Jacob C

2013-01-01

BACKGROUND: The prevalence of severe obesity in children and adolescents is increasing. However, little is known about cardiometabolic risk factors and quality of life of children with severe obesity.Therefore, the aim of this study was to assess the demographic characteristics and the prevalence of

Sleep, anxiety and psychiatric symptoms in children with Tourette syndrome and tic disorders.

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Modafferi, Sergio; Stornelli, Maddalena; Chiarotti, Flavia; Cardona, Francesco; Bruni, Oliviero

2016-09-01

The current study evaluated the relationship between tic, sleep disorders and specific psychiatric symptoms (anxiety, depression, obsessive compulsive symptoms). Assessment of 36 consecutive children and adolescents with tic disorders included: the Yale Global Tic Severity Scale (YGTSS) to assess the severity of tic symptoms; the Self-administered scale for children and adolescents (SAFA) to evaluate the psychopathological profile; a specific sleep questionnaire consisting of 45 items to assess the presence of sleep disorders. An age and sex-matched control group was used for comparisons. Sleep was significantly more disturbed in patients with tic disorders than in controls. Difficulties in initiating sleep and increased motor activity during sleep were the most frequent sleep disturbances found in our sample. Patients showed also symptoms of anxiety (SAFA A), depressed mood (SAFA D) and doubt-indecision (SAFA O). Additionally, difficulties in initiating sleep resulted associated with other SAFA subscales relative to obsessive-compulsive symptoms and depression symptoms. Furthermore, anxiety symptoms (SAFA A) resulted associated with increased motor activity during sleep. Findings confirm literature studies reporting high frequency of sleep problems, anxiety and other psychopathological symptoms in patients with tic disorders, and support the hypothesis that intrusive thoughts and other emotional disturbances might disrupt the sleep onset of these patients. These results suggest the importance of a thorough assessment of sleep and psychiatric disturbances in patients with tic disorders. Copyright © 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Children with severe acute malnutrition : New diagnostic and treatment strategies

NARCIS (Netherlands)

Bartels, R.H.

2018-01-01

Forty-five percent of worldwide deaths in children under-5 years of age is directly or indirectly attributable to poor nutrition. Tackling the global problem of malnutrition and of severe acute malnutrition (SAM) in particular, to increase health, quality of life, and to reduce under-5 mortality, is

Severe Impairments of Social Interaction and Associated Abnormalities in Children: Epidemiology and Classification.

Science.gov (United States)

Wing, Lorna; Gould, Judith

1979-01-01

The prevalence of severe impairments of social interaction, language abnormalities, and repetitive stereotyped behaviors was investigated in a group of 132 children under 15 years old, consisting of a socially impaired group (more than half of whom were severely retarded) and a comparison group of sociable severely mentally retarded. Author/DLS)

The clinical effectiveness of Movicol in children with severe constipation: an outcome audit.

Science.gov (United States)

Hanson, Sandra; Bansal, Nav

2006-03-01

This audit reviewed the clinical effectiveness of polyethylene glycol 3350 plus electrolytes (PEG+E, Movicol) in the management of severe paediatric constipation. A seven-day disimpaction regimen was initiated followed by a maintenance dose as appropriate. An information and support service was provided by the community children's nursing team (CCNT) at Darent Valley Hospital. Twenty-three parents completed questionnaires on their children's experiences with previous and current laxative treatments, bowel movement status, in-patient admissions or home visits required and the perceived value of the back up service. The mean age of children studied was 6.7 years. Prior to PEG+E treatment, 57 per cent of children were admitted to hospital and 26 per cent required home visits for constipation treatment. After treatment, no child needed either intervention. Thirty-nine percent of parents used the support service, of which 96 per cent rated the information it provided as adequate. When asked about their satisfaction with the control of their children's constipation, 96 per cent of parents were 'more than happy' after treatment with PEG+E. The treatment of severe paediatric constipation with PEG+E in conjunction with a support and advice service was both clinically and economically effective.

Ileus in children presenting with diarrhea and severe acute malnutrition: A chart review

Science.gov (United States)

Shahid, Abu SMSB; Shahunja, K. M.; Bardhan, Pradip Kumar; Faruque, Abu Syeed Golam; Shahrin, Lubaba; Das, Sumon Kumar; Barua, Dipesh Kumar; Hossain, Md Iqbal; Ahmed, Tahmeed

2017-01-01

Background Severely malnourished children aged under five years requiring hospital admission for diarrheal illness frequently develop ileus during hospitalization with often fatal outcomes. However, there is no data on risk factors and outcome of ileus in such children. We intended to evaluate predictive factors for ileus during hospitalization and their outcomes. Methodology/Principal findings This was a retrospective chart review that enrolled severely malnourished children under five years old with diarrhea, admitted to the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh between April 2011 and August 2012. We used electronic database to have our chart abstraction from previously admitted children in the hospital. The clinical and laboratory characteristics of children with (cases = 45), and without ileus (controls = 261) were compared. Cases were first identified by observation of abnormal bowel sounds on physical examination and confirmed with abdominal radiographs. For this comparison, Chi-square test was used to measure the difference in proportion, Student’s t-test to calculate the difference in mean for normally distributed data and Mann-Whitney test for data that were not normally distributed. Finally, in identifying independent risk factors for ileus, logistical regression analysis was performed. Ileus was defined if a child developed abdominal distension and had hyperactive or sluggish or absent bowel sound and a radiologic evidence of abdominal gas-fluid level during hospitalization. Logistic regression analysis adjusting for potential confounders revealed that the independent risk factors for admission for ileus were reluctance to feed (odds ratio [OR] = 3.22, 95% confidence interval [CI] = 1.24–8.39, p = 0.02), septic shock (OR = 3.62, 95% CI = 1.247–8.95, pp = 0.04). Mortality was significantly higher in cases compared to controls (22% vs. 8%, pp = 0.20). In a separate regression analysis model, after

Use of a novel laparoscopic gastrostomy technique in children with severe epidermolysis bullosa.

Science.gov (United States)

Patel, Kamlesh; Wells, Jonathan; Jones, Rosie; Browne, Fiona; Moss, Celia; Parikh, Dakshesh

2014-05-01

Supplementing nutrition in children with severe epidermolysis bullosa (EB) is challenging because of skin and mucosal fragility. Percutaneous endoscopic gastrostomy is contraindicated in EB, whereas more invasive open surgical gastrostomy placement can be complicated by chronic leakage. The aim of the study was to review the efficacy and acceptability, in children with severe EB, of our modified 2-port laparoscopic approach using the Seldinger technique with serial dilatation and tube insertion through a peel-away sheath. Retrospective review of children with EB who underwent laparoscopic feeding gastrostomy at our centre since 2009. Seven children (6 severe generalised recessive dystrophic EB, 1 non-Herlitz junctional EB; 2 girls, 5 boys) underwent modified laparoscopic gastrostomy placement at median age 4.85 years (range 1.0-8.8), with fundoplication for gastro-oesophageal reflux in 1 case, with follow-up for 0.3 to 3.9 years. The procedure was well tolerated with oral feeds usually given after 4 hours and whole protein gastrostomy feeds within 24 hours in 6 patients. Improved growth was reflected in mean weight and height z scores: -1.36 (range -2.6 to 0.5) to -0.61 (range -2.34 to 2.0) and -1.09 (range -2.42 to 1.0) to 0.71 (range -1.86 to 1.0), respectively. Postoperatively, 5 patients experienced minor local complications: minimal leakage without skin damage in 3 and transient peristomal granulation rapidly responsive to topical treatment in 2; this followed acute gastrostomy site infection in 1. There was no leakage after the immediate postoperative period. We conclude that our less-invasive laparoscopic gastrostomy technique is effective and better tolerated in children with severe EB, at least in the medium term, than open gastrostomy placement. Longer follow-up is required.

Sublingual sugar for hypoglycaemia in children with severe malaria: A pilot clinical study

Science.gov (United States)

Graz, Bertrand; Dicko, Moussa; Willcox, Merlin L; Lambert, Bernard; Falquet, Jacques; Forster, Mathieu; Giani, Sergio; Diakite, Chiaka; Dembele, Eugène M; Diallo, Drissa; Barennes, Hubert

2008-01-01

Background Hypoglycaemia is a poor prognostic indicator in severe malaria. Intravenous infusions are rarely feasible in rural areas. The efficacy of sublingual sugar (SLS) was assessed in a pilot randomized controlled trial among hypoglycaemic children with severe malaria in Mali. Methods Of 151 patients with presumed severe malaria, 23 children with blood glucose concentrations = 3.3 mmol/l (60 mg/dl) within 40 minutes after admission. Secondary outcome measures were early treatment response at 20 minutes, relapse (early and late), maximal BGC gain (CGmax), and treatment delay. Results There was no significant difference between the groups in the primary outcome measure. Treatment response occurred in 71% and 67% for SLS and IVG, respectively. Among the responders, relapses occurred in 30% on SLS at 40 minutes and in 17% on IVG at 20 minutes. There was one fatality in each group. Treatment failures in the SLS group were related to children with clenched teeth or swallowing the sugar, whereas in the IVG group, they were due to unavoidable delays in beginning an infusion (median time 17.5 min (range 3–40). Among SLS, the BGC increase was rapid among the nine patients who really kept the sugar sublingually. All but one increased their BGC by 10 minutes with a mean gain of 44 mg/dl (95%CI: 20.5–63.4). Conclusion Sublingual sugar appears to be a child-friendly, well-tolerated and effective promising method of raising blood glucose in severely ill children. More frequent repeated doses are needed to prevent relapse. Children should be monitored for early swallowing which leads to delayed absorption, and in this case another dose of sugar should be given. Sublingual sugar could be proposed as an immediate "first aid" measure while awaiting intravenous glucose. In many cases it may avert the need for intravenous glucose. PMID:19025610

Sublingual sugar for hypoglycaemia in children with severe malaria: A pilot clinical study

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Giani Sergio

2008-11-01

Full Text Available Abstract Background Hypoglycaemia is a poor prognostic indicator in severe malaria. Intravenous infusions are rarely feasible in rural areas. The efficacy of sublingual sugar (SLS was assessed in a pilot randomized controlled trial among hypoglycaemic children with severe malaria in Mali. Methods Of 151 patients with presumed severe malaria, 23 children with blood glucose concentrations = 3.3 mmol/l (60 mg/dl within 40 minutes after admission. Secondary outcome measures were early treatment response at 20 minutes, relapse (early and late, maximal BGC gain (CGmax, and treatment delay. Results There was no significant difference between the groups in the primary outcome measure. Treatment response occurred in 71% and 67% for SLS and IVG, respectively. Among the responders, relapses occurred in 30% on SLS at 40 minutes and in 17% on IVG at 20 minutes. There was one fatality in each group. Treatment failures in the SLS group were related to children with clenched teeth or swallowing the sugar, whereas in the IVG group, they were due to unavoidable delays in beginning an infusion (median time 17.5 min (range 3–40. Among SLS, the BGC increase was rapid among the nine patients who really kept the sugar sublingually. All but one increased their BGC by 10 minutes with a mean gain of 44 mg/dl (95%CI: 20.5–63.4. Conclusion Sublingual sugar appears to be a child-friendly, well-tolerated and effective promising method of raising blood glucose in severely ill children. More frequent repeated doses are needed to prevent relapse. Children should be monitored for early swallowing which leads to delayed absorption, and in this case another dose of sugar should be given. Sublingual sugar could be proposed as an immediate "first aid" measure while awaiting intravenous glucose. In many cases it may avert the need for intravenous glucose.

Unusually severe cases of Kingella kingae osteoarticular infections in children.

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Mallet, Cindy; Ceroni, Dimitri; Litzelmann, Estelle; Dubois-Ferriere, Victor; Lorrot, Mathie; Bonacorsi, Stéphane; Mazda, Keyvan; Ilharreborde, Brice

2014-01-01

With the development of molecular biology and specific polymerase chain reaction, Kingella kingae has become the primary diagnosis of osteoarticular infections in young children. Clinical features of these osteoarticular infections are typically mild, and outcome is almost always favorable. We report a series of unusually severe cases of K. kingae osteoarticular infections. All patients with severe osteoarticular infections at presentation were reviewed retrospectively in 2 European pediatric centers. K. kingae was identified using real-time polymerase chain reaction in blood, fluid joint or osseous samples. Clinical, laboratory tests and radiographic data during hospitalization and follow-up were analyzed. Ten children (mean age 21 ± 12 months) with severe osteoarticular infections caused by K. kingae were identified between 2008 and 2011. Diagnostic delay averaged 13.2 ± 8 days. Only 1 patient was febrile at admission, and 50% children had normal C-reactive protein values (≤10 mg/dL) at presentation. Surgical treatment was performed in all cases. Intravenous antibiotic therapy by cephalosporins for an average of 8 ± 6 days was followed by oral treatment for 27 ± 6 days. Mean follow-up was 24.8 ± 9 months, and satisfactory outcomes were reported in all cases. Two patients (20%) developed a central epiphysiodesis of the proximal humerus during follow-up, but without significant clinical consequence for the moment. Because of their mild clinical features at onset, diagnosis of K. kingae osteoarticular infections can be delayed. Care should be taken for early detection and treatment of these infections because bony lytic lesions and potentially definitive growth cartilage damage can occur.

Dysfunction of Right Heart in Attack Period of Bronchial Asthma in Children

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V.А. Kondratiev

2015-11-01

Full Text Available There were performed Doppler echocardiography investigations of functional state of the right heart in 42 children aged 5–17 years old in attack period of bronchial asthma of moderate to severe degree. Changes of intra-cardiac hemodynamics of the right heart in children in attack period of bronchial asthma were characterized by disturbance of systolic and diastolic function of the right ventricle and right atrium. Combined systolic-diastolic variant of the right ventricle dysfunction was typical for attack period of bronchial asthma in children and developed in 95.5 % of cases. Elevation of pressure in pulmonary artery was typical and significantly more often occurred in severe asthma attack, herewith pulmonary hypertension of the second degree predominated.

Effects of intermediate-severity disturbance on composition and structure in mixed Pinus-hardwood stands

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Benjamin Trammell; Justin Hart; Callie Schweitzer; Daniel C. Dey; Michael Steinberg

2017-01-01

Increasingly, forest managers intend to create or maintain mixed Pinus-hardwood stands. This stand assemblage may be driven by a variety of objectives but is often motivated by the desire to enhance native forest diversity and promote resilience to perturbations. Documenting the effects of natural disturbances on species composition and stand...

Treatment of severe psoriasis in children: recommendations of an Italian expert group.

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Fortina, Anna Belloni; Bardazzi, Federico; Berti, Samantha; Carnevale, Claudia; Di Lernia, Vito; El Hachem, Maya; Neri, Iria; Gelmetti, Carlo Mario; Lora, Viviana; Mazzatenta, Carlo; Milioto, Mirella; Moretta, Gaia; Patrizi, Annalisa; Peris, Ketty; Villani, Alberto

2017-10-01

This article provides comprehensive recommendations for the systemic treatment of severe pediatric psoriasis based on evidence obtained from a systematic review of the literature and the consensus opinion of expert dermatologists and pediatricians. For each systemic treatment, the grade of recommendation (A, B, C) based on the treatment's approval by the European Medicines Agency for childhood psoriasis and the experts' opinions is discussed. The grade of recommendation for narrow-band-ultraviolet B phototherapy, cyclosporine, and retinoids is C, while that for methotrexate is C/B. The use of adalimumab, etanercept, and ustekinumab has a grade A recommendation. No conventional systemic treatments are approved for pediatric psoriasis. Adalimumab is approved by the European Medicines Agency as a first-line treatment for severe chronic plaque psoriasis in children (≥ 4 years old) and adolescents. Etanercept and ustekinumab are approved as second-line therapy in children ≥ 6 and ≥ 12 years, respectively. A treatment algorithm as well as practical tools (i.e., tabular summaries of differential diagnoses, treatment mechanism of actions, dosing regimens, control parameters) are provided to assist in therapeutic reasoning and decision-making for individual patients. These treatment recommendations are endorsed by major Italian Pediatric and Dermatology Societies. What is Known: • Guidelines for the treatment of severe pediatric psoriasis are lacking and most traditional systemic treatments are not approved for use in young patients. Although there has been decades of experience with some of the traditional agents such as phototherapy, acitretin, and cyclosporine in children, there are no RCTs on their pediatric use while RCTs investigating new biologic agents have been performed. What is New: • In this manuscript, an Italian multidisciplinary team of experts focused on treatment recommendations for severe forms of psoriasis in children based on an up

A study on CT findings and electroencephalographic findings in severely handicapped children

International Nuclear Information System (INIS)

Nakashima, Masao; Nishimura, Masaaki; Kachi, Shozo; Sugimoto, Kimiyuki; Saito, Msahiko; Yamada, Shigeaki; Kameyama, Yoshio; Tanaka, Minoru; Hiraizumi, Yasuhisa.

1987-01-01

Sleep electroencephalographic (EEG) and computed tomographic (CT) features were examined in 40 institutionalized severely handicapped persons. Cranial CT appearance fell into five major types: (I) no abnormal findings (n=2), (II) generalized brain atrophy (n=16), (III) diffuse parenchymal disturbance (n=10), (IV) brain malformation (n=4), and (V) localized brain disturbance (n=8). In the I group, one person had normal EEG findings as well, but another person had the presence of focal spikes without spindles on EEG. Five of the II group had no abnormal EEG findings; ten had abnormality in basic waves and/or localized paroxysmal waves; and one had generalized spike-and-slow wave complex. All persons in the III group had flattening or disappearance of spindle waves. In the IV group, two persons with cerebral malformation and one with linear nevus sebaceous syndrome in association with hypoplasia of the cerebral hemisphere had abnormality in basic waves and localized paroxysmal waves. In the remaining one person with deficit of vermis cerebelli, there was no EEG abnormality. Among the last group of persons, there was no EEG abnormality corresponding to CT features. (Namekawa, K)

Mothers of Children with Severe Mental Retardation: Maternal Pessimism, Locus of Control and Perceived Social Support.

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Rimmerman, Arie

1991-01-01

This study, involving 24 Israeli mothers of children (average age 3.3) with severe mental retardation, found that the mothers' locus of control and perception of social support (belonging, appraisal, tangible support, and self-esteem) serve as buffers against parental pessimism concerning their severely handicapped children. (JDD)

Are sleep disturbances preclinical markers of Parkinson’s disease?

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Brito dos Santos, Altair; Kohlmeier, Kristi Anne; Barreto, George

2015-01-01

REM sleep behaviour and currently several other disturbances have gained importance as potential markers, such as excessive daytime sleepiness, restless legs syndrome and new evidence also points to changes in circadian rhythms. Here we present a brief review of the major evidence indicating......Parkinson’s disease (PD) is a neurobehavioral disorder characterized by motor symptoms and signs, and non-motor abnormalities such as olfactory dysfunction, pain, sleep disorders and cognitive impairment. Amongst these alterations, sleep disturbances play an important role in the pathology......, but presence of disturbed sleep is not currently considered in diagnosis. However, sleeping problems may precede by many years the classic motor abnormalities of PD and should be clinically evaluated as a potential marker before disease onset. The first disturbance reported with this potential was the disorder...

Analysis of Intentional Communication in Severely Handicapped Children with Cornelia-de-Lange Syndrome.

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Sarimski, Klaus

2002-01-01

Intentional communicative acts were assessed in 13 children (ages 2-8) with Cornelia-de-Lange syndrome with a severe mental disability and compared to children with Down and 5p syndromes. The mean number of intentional communicative acts was significantly lower. Analysis of play behaviors revealed the differences were specific for the…

Relationship of Renal Function Tests and Electrolyte Levels with Severity of Dehydration in Acute Diarrhea.

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Gauchan, E; Malla, K K

2015-01-01

Acute diarrheal illness constitutes a major cause of morbidity and mortality in children in developing countries. Most of the complications of diarrhea occur due to excessive fluid and electrolyte loss; adverse complications are seen more with increasing severity of dehydration. This study was conducted to identify the relation of renal function and electrolyte abnormalities in children with varying severity of dehydration. This study was carried out in Manipal Teaching Hospital, Pokhara, Nepal over duration of one year. The aims were to find out the association of renal function and electrolyte disturbances with type of diarrhea, severity of dehydration and their relation to outcome. All children more than one month and less than 15 years with acute diarrhea were included in the study. Data were entered and analyzed by SPSS version 19. Statistical analysis applied was Chi-square test. A p-value of Dehydration was associated more with Acute Watery Diarrhea than with Invasive Diarrhea. Renal function and electrolyte abnormalities were seen more in Acute Watery Diarrhea with increasing levels of blood urea, serum creatinine and abnormal levels of serum sodium seen with increased severity of dehydration. Abnormalities in renal function and electrolytes correlated significantly with severity of dehydration. The outcome of patients correlated with severity of dehydration with mortality occurring in 18.1% of patients with Severe dehydration, 0.8% of Some dehydration with no mortality in the No dehydration group.

Eye gaze performance for children with severe physical impairments using gaze-based assistive technology-A longitudinal study.

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Borgestig, Maria; Sandqvist, Jan; Parsons, Richard; Falkmer, Torbjörn; Hemmingsson, Helena

2016-01-01

Gaze-based assistive technology (gaze-based AT) has the potential to provide children affected by severe physical impairments with opportunities for communication and activities. This study aimed to examine changes in eye gaze performance over time (time on task and accuracy) in children with severe physical impairments, without speaking ability, using gaze-based AT. A longitudinal study with a before and after design was conducted on 10 children (aged 1-15 years) with severe physical impairments, who were beginners to gaze-based AT at baseline. Thereafter, all children used the gaze-based AT in daily activities over the course of the study. Compass computer software was used to measure time on task and accuracy with eye selection of targets on screen, and tests were performed with the children at baseline, after 5 months, 9-11 months, and after 15-20 months. Findings showed that the children improved in time on task after 5 months and became more accurate in selecting targets after 15-20 months. This study indicates that these children with severe physical impairments, who were unable to speak, could improve in eye gaze performance. However, the children needed time to practice on a long-term basis to acquire skills needed to develop fast and accurate eye gaze performance.

Pyrosequencing analysis of oral microbiota in children with severe early childhood dental caries.

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Jiang, Wen; Zhang, Jie; Chen, Hui

2013-11-01

Severe early childhood caries are a prevalent public health problem among preschool children throughout the world. However, little is known about the microbiota found in association with severe early childhood caries. Our study aimed to explore the bacterial microbiota of dental plaques to study the etiology of severe early childhood caries through pyrosequencing analysis based on 16S rRNA gene V1-V3 hypervariable regions. Forty participants were enrolled in the study, and we obtained twenty samples of supragingival plaque from caries-free subjects and twenty samples from subjects with severe early childhood caries. A total of 175,918 reads met the quality control standards, and the bacteria found belonged to fourteen phyla and sixty-three genera. Our results show the overall structure and microbial composition of oral bacterial communities, and they suggest that these bacteria may present a core microbiome in the dental plaque microbiota. Three genera, Streptococcus, Granulicatella, and Actinomyces, were increased significantly in children with severe dental cavities. These data may facilitate improvements in the prevention and treatment of severe early childhood caries.

A Perceptual Motor Intervention Improves Play Behavior In Children With Moderate To Severe Cerebral Palsy

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Brigette Oliver Ryalls

2016-05-01

Full Text Available For children with moderate or severe cerebral palsy (CP, a foundational early goal is independent sitting. Sitting offers additional opportunities for object exploration, play and social engagement. The achievement of sitting coincides with important milestones in other developmental areas, such as social engagement with others, understanding of spatial relationships, and the use of both hands to explore objects. These milestones are essential skills necessary for play behavior. However, little is known about how sitting and play behavior might be affected by a physical therapy intervention in children with moderate or severe CP. Therefore, our overall purpose in this study was to determine if sitting skill could be advanced in children with moderate to severe CP using a perceptual motor intervention, and if play skills would change significantly as sitting advanced. Thirty children between the ages of 18 months and 6 years who were able to hold prop sitting for at least 10 seconds were recruited for this study. Outcome measures were the sitting subsection of the Gross Motor Function Measure (GMFM, and the Play Assessment of Children with Motor Impairment (PACMI play assessment scale, which is a modified version of the Play in Early Childhood Evaluation System (PIECES. Significant improvements in GMFM sitting scores (p<0.001 and marginally significant improvement in play assessment scores (p=0.067 were found from pre- to post-intervention. Sitting change explained a significant portion of the variance in play change for children over the age of 3 years, who were more severely affected by CP. The results of this study indicate that advances in sitting skill may be a factor in supporting improvements in functional play, along with age and severity of physical impairment.

Sleep Health Issues for Children with FASD: Clinical Considerations

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Jan, James E.; Asante, Kwadwo O.; Conry, Julianne L.; Fast, Diane K.; Bax, Martin C. O.; Ipsiroglu, Osman S.; Bredberg, Elizabeth; Loock, Christine A.; Wasdell, Michael B.

2010-01-01

This article describes the combined clinical experience of a multidisciplinary group of professionals on the sleep disturbances of children with fetal alcohol spectrum disorders (FASD) focusing on sleep hygiene interventions. Such practical and comprehensive information is not available in the literature. Severe, persistent sleep difficulties are frequently associated with this condition but few health professionals are familiar with both FASD and sleep disorders. The sleep promotion techniqu...

Game Plans for Victors: New Skills for Severely Handicapped Children.

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Schoen, Sharon; And Others

The paper describes an approach in which games were planned to provide instruction for three severely handicapped children (5-6 years old) with few leisure, social, or academic skills and many aberrant behaviors. The first of two games involved a language program to teach verbal interactions, picture identification, and picture matching. The…

Stress and sleep disturbances in female college students.

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Lee, Shih-Yu; Wuertz, Caroline; Rogers, Rebecca; Chen, Yu-Ping

2013-11-01

To describe the sleep characteristics and examine the associations among perceived stress, sleep disturbances, depressive symptoms, and physical symptoms among female college students. A total of 103 students completed a battery of questionnaires. The students experienced high stress during the school year. The majority of them slept less than 6 hours during weekdays and experienced moderate fatigue. High stress levels are associated with sleep disturbances, less nocturnal total sleep time, higher fatigue severity, and more depressive symptoms. Perceived stress and sleep disturbances are significant predictors for depressive symptoms and physical symptoms. Compared to the good sleepers, the poor sleepers reported more daytime sleepiness, depressive symptoms, and physical symptoms. Interventions to reduce stress and improve sleep are critically needed in college education.

[Neurocognitive and behavioral disturbances after adenotonsillectomy in obstructive sleep apnea syndrome].

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Esteller, E; Barceló, M; Segarra, F; Estivill, E; Girabent-Farrés, M

2014-04-01

Adenotonsillectomy is an effective treatment for sleep-disordered breathing in children, but its ability to resolve neurocognitive issues, is not clear. To analyze the outcomes of cognitive and behavioral disorders after one year of adenotonsillectomy. We studied the behavioral and cognitive abnormalities in 45 children with obstructive sleep apnea and 30 healthy controls, aged 3 to 13 years. Psychological tests were performed in both groups at baseline and at 12 months. Preoperatively, all cognitive and behavioral disturbances were higher in the study group than in the control group: attention in 46.7% of cases in the study group versus 20% in the control group (P=.016), anxiety 60.9% versus 40.9% (not significant); memory 55.6% versus 36.7% (P=.019), spatial structuring 64.4% versus 36.7% (P=.017), hyperactivity 42.9% versus 12.5% (P=.016), and attention deficit 46.4% versus 8.3% (P=.003). After one year we observed more disturbances in all variables in the study group. However, significant differences remained only in spatial structure (31.3% versus 3.3%, P=.017), and attention deficit (40.5% versus 16.7%, P=.031). The percentages of patients that improved in one year were not significantly different between both groups. Behavioral and cognitive disturbances in children with sleep apnea were partially resolved following adenotonsillectomy. Improvements in the cognitive and behavioral variables did not differ significantly from those the normal evolution of the individual, and were independent of the resolution of respiratory disorders. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Comparison of clinical associations and laboratory abnormalities in children with moderate and severe dehydration.

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Hayajneh, Wail A; Jdaitawi, Hussein; Al Shurman, Abdullah; Hayajneh, Yaseen A

2010-03-01

To search for possible early clinical associations and laboratory abnormalities in children with severe dehydration in northern Jordan. We prospectively evaluated 251 children with acute gastroenteritis. Dehydration assessment was done following a known clinical scheme. Probable clinical associations and laboratory abnormalities were examined against the preassigned dehydration status. Children with severe dehydration had significantly more hypernatremia and hyperkalemia, less isonatremia, and higher mean levels of urea, creatinine, and glucose (P dehydration. Historic clinical characteristics of patients did not correlate to dehydration degree. Serum urea, creatinine, sodium, potassium, and glucose were useful independently in augmenting clinical examination to diagnose the degree of dehydration status among children presenting with gastroenteritis. Serum urea performed the best among all. On the contrary, none of the examined historical clinical patterns could be correlated to the dehydration status. Larger and multicenter studies are needed to validate our results and to examine their impact on final outcomes.

Sleep disturbances in restless legs syndrome

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Jović Jasmina

2018-01-01

Full Text Available Background/Aim. Resteless legs syndrome (RLS is chronical neurological disorder characterized by urge to move legs that is usually accompanied by unpleasant sensations in the lower extremities. Sleep disturbance is one of the main accompanying symptoms of RLS which exists in approximatelly 90% of patients. Impairment of sleep is related to daily sleepiness, depressive and anxiety disorders. The aim of this study was to detect frequency and characterisitics of sleep-related symptoms in patients with RLS, and its impairrment to daily sleepiness, fatique, anxiety and depression. Methods. We have examinated 94 patients with RLS. The diagnose of RLS was based on questionnaire with 4 specific questions according to the International Restless Legs Syndrome Study Group (IRLSSG criteria updated in 2003. Severity of symptoms was astimated with IRLSSG Rating Scale, depression and anxiety with Hamilton Depression Rating Scale (HDRS and Hamilton Anxiety Rating Scale (HARS and sleepiness with Epworth Sleepiness scale (ESS. We astimated sleep characteristics and disturbances with specific questionnaire. Results. In our study 79.9% of patients had sleep-related symptoms. Average sleep duration was 6.50 ± 1.42 hours, with average frequency of awakening 2.34 ± 1.69 times per night. Average ESS score was 5.12 ± 4.08 (0–17. Patients with more severe symptoms had higher degree of sleepiness (p = 0.005. Patients with higher symptoms frequency, significantly more often had sleep disturbance (p = 0.016, tiredness and daily sleepiness (p = 0.001. Daily sleepiness (ESS also significantly correlates with depression (p < 0.05 and anxiety (p = 0.012. Conclusion. Our results confirm that sleep disturbances are one of the key accompanying symptoms of RLS which cause daily sleepiness, tiredness, depression and anxiety. Therefore, their early recognition and appropriate treatment must be a priority in RLS patients.

Comparison of six-minute walk test in children with moderate/severe asthma with reference values for healthy children

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Lívia Barboza de Andrade

Full Text Available OBJECTIVE:to compare physical performance and cardiorespiratory responses in the six-minute walk test (6MWT in asthmatic children with reference values for healthy children in the same age group, and to correlate them with intervening variables.METHODS:this was a cross-sectional, prospective study that evaluated children with moderate/severe asthma, aged between 6 and 16 years, in outpatient follow-up. Demographic and spirometric test data were collected. All patients answered the pediatric asthma quality of life (QoL questionnaire (PAQLQ and level of basal physical activity. The 6MWT was performed, following the American Thoracic Society recommendations. Comparison of means was performed using Student's t-test and Pearson's correlation to analyze the 6MWT with study variables. The significance level was set at 5%.RESULTS:40 children with moderate or severe asthma were included, 52.5% males, 70% with normal weight and sedentary. Mean age was 11.3 ± 2.1 years, mean height was 1.5 ± 0.1 m, and mean weight was 40.8 ± 12.6 Kg. The mean distance walked in the 6MWT was significantly lower, corresponding to 71.9% ± 19.7% of predicted values; sedentary children had the worst values. The difference between the distance walked on the test and the predicted values showed positive correlation with age (r = 0.373, p = 0.018 and negative correlation with cardiac rate at the end of the test (r = -0.518, p < 0.001. Regarding QoL assessment, the values in the question about physical activity limitations showed the worst scores, with a negative correlation with walked distance difference (r = -0.311, p = 0.051.CONCLUSIONS:asthmatic children's performance in the 6MWT evaluated through distance walked is significantly lower than the predicted values for healthy children of the same age, and is directly influenced by sedentary life style.

Acceleration of Object Permanence with Severely and Profoundly Retarded Children.

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Kahn, James V.

Examined was the effectiveness of training four severely and profoundly retarded children (3-6 years old) to improve their level of functioning on a measure of object permanence and to demonstrate generalization to other areas of sensorimotor intelligence. Ss were given a pretest and posttest on the I. Uzgiris and J. Hunt instrument which consists…

ADHD severity as it relates to comorbid psychiatric symptomatology in children with Autism Spectrum Disorders (ASD).

Science.gov (United States)

Mansour, Rosleen; Dovi, Allison T; Lane, David M; Loveland, Katherine A; Pearson, Deborah A

2017-01-01

Comorbid diagnoses identified in pediatric samples have been correlated with a range of outcomes, including greater levels of emotional, behavioral, and educational impairment and the need for more intensive treatment. Given that previous research has documented high levels of comorbid Attention-Deficit/Hyperactivity Disorder (ADHD) in children with Autism Spectrum Disorders (ASD), this study closely examines the relationship between parent-reported ADHD symptoms (i.e., Conners' Parent Rating Scale, Revised [CPRS-R]) and the prevalence of additional comorbid psychiatric diagnoses in a pediatric ASD sample (n=99). Regression analyses revealed that greater severity of ADHD symptomatology was significantly related to a greater number of comorbid psychiatric diagnoses, as identified using the Diagnostic Interview for Children and adolescents, 4th Edition (DICA-IV). Additionally, more severe ADHD symptoms were also associated with higher levels of symptom severity on Child Behavior Checklist (CBCL) syndrome subscales. Interestingly, increasing severity of ASD symptomatology, as measured by the Autism Diagnostic Interview, Revised (ADI-R), was not associated with a higher prevalence of comorbid psychiatric diagnoses or CBCL syndrome severity. Our study concluded that higher levels of ADHD severity-not ASD severity-were associated with a higher prevalence of comorbid psychiatric symptomatology in school-age children with ASD. These findings may encourage clinicians to thoroughly assess ADHD symptomatology in ASD children to better inform treatment planning. Copyright © 2016 Elsevier Ltd. All rights reserved.

Genetic predisposition increases the tic severity, rate of comorbidities, and psychosocial and educational difficulties in children with Tourette syndrome.

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Eysturoy, Absalon Niclas; Skov, Liselotte; Debes, Nanette Mol

2015-03-01

This study aimed to examine whether there are differences in tic severity, comorbidities, and psychosocial and educational consequences in children with Tourette syndrome and genetic predisposition to Tourette syndrome compared with children with Tourette syndrome without genetic predisposition to Tourette syndrome. A total of 314 children diagnosed with Tourette syndrome participated in this study. Validated diagnostic tools were used to assess tic severity, comorbidities, and cognitive performance. A structured interview was used to evaluate psychosocial and educational consequences related to Tourette syndrome. The children with Tourette syndrome and genetic predisposition present with statistically significant differences in terms of severity of tics, comorbidities, and a range of psychosocial and educational factors compared with the children with Tourette syndrome without genetic predisposition. Professionals need to be aware of genetic predisposition to Tourette syndrome, as children with Tourette syndrome and genetic predisposition have more severe symptoms than those children with Tourette syndrome who are without genetic predisposition. © The Author(s) 2014.

Connectomic disturbances in attention-deficit/hyperactivity disorder: a whole-brain tractography analysis.

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Hong, Soon-Beom; Zalesky, Andrew; Fornito, Alex; Park, Subin; Yang, Young-Hui; Park, Min-Hyeon; Song, In-Chan; Sohn, Chul-Ho; Shin, Min-Sup; Kim, Bung-Nyun; Cho, Soo-Churl; Han, Doug Hyun; Cheong, Jae Hoon; Kim, Jae-Won

2014-10-15

Few studies have sought to identify, in a regionally unbiased way, the precise cortical and subcortical regions that are affected by white matter abnormalities in attention-deficit/hyperactivity disorder (ADHD). This study aimed to derive a comprehensive, whole-brain characterization of connectomic disturbances in ADHD. Using diffusion tensor imaging, whole-brain tractography, and an imaging connectomics approach, we characterized altered white matter connectivity in 71 children and adolescents with ADHD compared with 26 healthy control subjects. White matter differences were further delineated between patients with (n = 40) and without (n = 26) the predominantly hyperactive/impulsive subtype of ADHD. A significant network comprising 25 distinct fiber bundles linking 23 different brain regions spanning frontal, striatal, and cerebellar brain regions showed altered white matter structure in ADHD patients (p attentional disturbances. Attention-deficit/hyperactivity disorder subtypes were differentiated by a right-lateralized network (p attentional performance underscore the functional importance of these connectomic disturbances for the clinical phenotype of ADHD. A distributed pattern of white matter microstructural integrity separately involving frontal, striatal, and cerebellar brain regions, rather than direct frontostriatal connectivity, appears to be disrupted in children and adolescents with ADHD. Copyright © 2014 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Ileus in children presenting with diarrhea and severe acute malnutrition: A chart review.

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Chisti, Mohammod Jobayer; Shahid, Abu Smsb; Shahunja, K M; Bardhan, Pradip Kumar; Faruque, Abu Syeed Golam; Shahrin, Lubaba; Das, Sumon Kumar; Barua, Dipesh Kumar; Hossain, Md Iqbal; Ahmed, Tahmeed

2017-05-01

Severely malnourished children aged under five years requiring hospital admission for diarrheal illness frequently develop ileus during hospitalization with often fatal outcomes. However, there is no data on risk factors and outcome of ileus in such children. We intended to evaluate predictive factors for ileus during hospitalization and their outcomes. This was a retrospective chart review that enrolled severely malnourished children under five years old with diarrhea, admitted to the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh between April 2011 and August 2012. We used electronic database to have our chart abstraction from previously admitted children in the hospital. The clinical and laboratory characteristics of children with (cases = 45), and without ileus (controls = 261) were compared. Cases were first identified by observation of abnormal bowel sounds on physical examination and confirmed with abdominal radiographs. For this comparison, Chi-square test was used to measure the difference in proportion, Student's t-test to calculate the difference in mean for normally distributed data and Mann-Whitney test for data that were not normally distributed. Finally, in identifying independent risk factors for ileus, logistical regression analysis was performed. Ileus was defined if a child developed abdominal distension and had hyperactive or sluggish or absent bowel sound and a radiologic evidence of abdominal gas-fluid level during hospitalization. Logistic regression analysis adjusting for potential confounders revealed that the independent risk factors for admission for ileus were reluctance to feed (odds ratio [OR] = 3.22, 95% confidence interval [CI] = 1.24-8.39, p = 0.02), septic shock (OR = 3.62, 95% CI = 1.247-8.95, p<0.01), and hypokalemia (OR = 1.99, 95% CI = 1.03-3.86, p = 0.04). Mortality was significantly higher in cases compared to controls (22% vs. 8%, p<0.01) in univariate analysis; however, in

The relationship between the increased frequency of serum antineuronal antibodies and the severity of autism in children.

Science.gov (United States)

Mostafa, Gehan Ahmed; Al-Ayadhi, Laila Yousef

2012-09-01

Autism may involve an autoimmune pathogenesis. Immunotherapy may have a role in autistic children who have brain auto-antibodies. This study aimed to investigate the frequency of serum antineuronal auto-antibodies, as indicators of the presence of autoimmunity to brain, in a group of autistic children. We are the first to measure the relationship between these antibodies and the degree of the severity of autism. Serum antineuronal antibodies were measured, by indirect immunofluorescence technique, in 80 autistic children, aged between 6 and 12 years, in comparison to 80 healthy-matched children. The severity of autism was assessed by using the Childhood Autism Rating Scale. Autistic children had significantly higher percent positivity of serum antineuronal antibodies (62.5%) than healthy controls (5%), P<0.001. The frequency of the positivity of serum antineuronal antibodies was significantly higher in children with severe autism (87.5%) than children with mild to moderate autism (25%), P<0.001. Similarly, the frequency of the positivity of these antibodies was significantly higher in female children with autism (90%) than male autistic children (53.3%), P=0.001. Serum antineuronal antibodies were found in a subgroup of autistic children and they were significantly correlated to the severity of autism. Thus, autism may be, in part, one of the pediatric autoimmune neuropsychiatric disorders. Further wide-scale studies are warranted to shed light on the etiopathogenic role of antineuronal antibodies in autism. The role of immunotherapy in autistic patients, who are seropositive for antineuronal antibodies, should also be studied. Copyright © 2011 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Treatment Failure and Mortality amongst Children with Severe Acute Malnutrition Presenting with Cough or Respiratory Difficulty and Radiological Pneumonia

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Chisti, Mohammod Jobayer; Salam, Mohammed Abdus; Bardhan, Pradip Kumar; Faruque, Abu S. G.; Shahid, Abu S. M. S. B.; Shahunja, K. M.; Das, Sumon Kumar; Hossain, Md Iqbal; Ahmed, Tahmeed

2015-01-01

Background Appropriate intervention is critical in reducing deaths among under-five, severe acutely malnourished (SAM) children with danger signs of severe pneumonia; however, there is paucity of data on outcome of World Health Organisation (WHO) recommended interventions of SAM children with severe pneumonia. We sought to evaluate outcome of the interventions in such children. Methods We prospectively enrolled SAM children aged 0–59 months, admitted to the Intensive Care Unit (ICU) or Acute Respiratory Infection (ARI) ward of the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), between April 2011 and June 2012 with cough or respiratory difficulty and radiological pneumonia. All the enrolled children were treated with ampicillin and gentamicin, and micronutrients as recommended by the WHO. Comparison was made among pneumonic children with (n = 111) and without WHO defined danger signs of severe pneumonia (n = 296). The outcomes of interest were treatment failure (if a child required changing of antibiotics) and deaths during hospitalization. Further comparison was also made among those who developed treatment failure and who did not and among the survivors and deaths. Results SAM children with danger signs of severe pneumonia more often experienced treatment failure (58% vs. 20%; ppp<0.01). Conclusion and Significance The result suggests that SAM children with cough or respiratory difficulty and radiologic pneumonia who had WHO-defined danger signs of severe pneumonia more often had treatment failure and fatal outcome compared to those without the danger signs. In addition to danger signs of severe pneumonia, other common causes of both treatment failure and deaths were dehydration, hypocalcaemia, and bacteraemia on admission. The result underscores the importance for further research especially a randomized, controlled clinical trial to validate standard WHO therapy in SAM children with pneumonia especially with

[Neglect of Children--a neglected problem].

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Lucas, Steven; Jernbro, Carolina

2014-11-18

Although neglect is the most common form of child maltreatment in the home, it has received relatively little attention in both research and medical practice. Up to one in six children in the western world experience physical or psychological neglect during their upbringing. Severe neglect is associated with anatomical and physiological changes in the brain that in turn are coupled to cognitive impairment, impulsivity, and disturbances in concentration and social behavior. Reducing the risk of neglect requires the provision of preventive interventions at the individual and societal level, both universally and targeted to parents and children in need of special support. Health care services can play a key role in the prevention and early detection of neglect in childhood.

Etiology of severe pneumonia in Ecuadorian children.

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Sivani Jonnalagadda

Full Text Available In Latin America, community-acquired pneumonia remains a major cause of morbidity and mortality among children. Few studies have examined the etiology of pneumonia in Ecuador.This observational study was part of a randomized, double blind, placebo-controlled clinical trial conducted among children aged 2-59 months with severe pneumonia in Quito, Ecuador. Nasopharyngeal and blood samples were tested for bacterial and viral etiology by polymerase chain reaction. Risk factors for specific respiratory pathogens were also evaluated.Among 406 children tested, 159 (39.2% had respiratory syncytial virus (RSV, 71 (17.5% had human metapneumovirus (hMPV, and 62 (15.3% had adenovirus. Streptococcus pneumoniae was identified in 37 (9.2% samples and Mycoplasma pneumoniae in three (0.74% samples. The yearly circulation pattern of RSV (P = 0.0003 overlapped with S. pneumoniae, (P = 0.03 with most cases occurring in the rainy season. In multivariable analysis, risk factors for RSV included younger age (adjusted odds ratio [aOR] = 1.9, P = 0.01 and being underweight (aOR = 1.8, P = 0.04. Maternal education (aOR = 0.82, P = 0.003, pulse oximetry (aOR = 0.93, P = 0.005, and rales (aOR = 0.25, P = 0.007 were associated with influenza A. Younger age (aOR = 3.5, P = 0.007 and elevated baseline respiratory rate were associated with HPIV-3 infection (aOR = 0.94, P = 0.03.These results indicate the importance of RSV and influenza, and potentially modifiable risk factors including undernutrition and future use of a RSV vaccine, when an effective vaccine becomes available.ClinicalTrials.gov NCT 00513929.

C-reactive protein as a marker of infection in children with severe acute malnutrition in Khartoum state, Sudan

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Abdelmoneim E.M. Kheir

2017-08-01

Full Text Available Severe acute malnutrition and acute systemic infection are often synergistic in children and lead to considerable mortality. The main aim of this research was to determine whether children with severe acute malnutrition can mount an acute phase reactant response measured by C-reactive protein. This was a descriptive, cross-sectional, hospital-based study that was carried out in the five main children hospitals in Khartoum state, from November 1st, 2012 to March 1st, 2013. 132 children with severe acute malnutrition were included in the study. Data collection included history, examination and C-reactive protein measurement. The data were analyzed using Statistical Package for Social Sciences (SPSS for descriptive and inferential statistics. The main results revealed that 93(70.5% children between 12-23 months of age and most of them had marasmus. Diarrhoea was the commonest presenting symptoms in 86.4%, followed by fever and vomiting. Most of the children (82.6% had positive C-reactive protein with variable levels. In conclusion malnourished children are able to synthesize C-reactive protein in response to an infectious process and the magnitude of this response is increased in those with severe infections.

Intestinal mucosal permeability of severely underweight and nonmalnourished Bangladeshi children and effects of nutritional rehabilitation.

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Hossain, Md Iqbal; Nahar, Baitun; Hamadani, Jena D; Ahmed, Tahmeed; Roy, Anjan Kumar; Brown, Kenneth H

2010-11-01

Lactulose/mannitol (L/M) intestinal permeability tests were completed to compare the intestinal function of severely underweight children recovering from diarrhea and other illnesses and of nonmalnourished children from the same communities, and to evaluate the effects of food supplementation, with or without psychosocial stimulation, on the changes in intestinal function among the underweight children. Seventy-seven malnourished children completed intestinal permeability studies at baseline and 3 months after receiving 1 of the following randomly assigned treatment regimens: group-C--fortnightly follow-up at community-based follow-up units, including growth monitoring and promotion, health education, and micronutrient supplementation, n = 17; group-SF--same as group-C plus supplementary food (SF) to provide 150 to 300 kcal/day, n = 23; group-PS--same as group-C plus psychosocial stimulation (PS), n = 17; or group-SF + PS--same as group-C plus SF and PS, n = 20. Seventeen nonmalnourished children were included as comparison subjects. The malnourished children's mean ± SD initial age was 13.1 ± 4.0 months, their mean weight-for-age z score was -3.82 ± 0.61, and their median (interquartile range) urinary L/M recovery ratio was 0.16 (0.10-0.28). Eighty-four percent of the children had L/M ≥ 0.07, suggestive of impaired intestinal function. The median L/M of the malnourished children was significantly greater than that of 17 relatively well-nourished children (median 0.09; interquartile range 0.05-0.12; P = 0.001). There were no significant differences in baseline characteristics of the severely malnourished children by treatment group. Following treatment, the L/M ratio improved in all of the groups (P sugar permeability, is impaired among severely underweight children. Intestinal permeability improves in relation to weight gain, but intestinal mucosal recovery is not specifically related to the types or amount of food supplementation or PS provided in this trial.

A meta-analysis of soil microbial biomass responses to forest disturbances

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Sandra Robin Holden

2013-06-01

Full Text Available Climate warming is likely to increase the frequency and severity of forest disturbances, with uncertain consequences for soil microbial communities and their contribution to ecosystem C dynamics. To address this uncertainty, we conducted a meta-analysis of 139 published soil microbial responses to forest disturbances. These disturbances included abiotic (fire, harvesting, storm and biotic (insect, pathogen disturbances. We hypothesized that soil microbial biomass would decline following forest disturbances, but that abiotic disturbances would elicit greater reductions in microbial biomass than biotic disturbances. In support of this hypothesis, across all published studies, disturbances reduced soil microbial biomass by an average of 29.4%. However, microbial responses differed between abiotic and biotic disturbances. Microbial responses were significantly negative following fires, harvest, and storms (48.7%, 19.1%, and 41.7% reductions in microbial biomass, respectively. In contrast, changes in soil microbial biomass following insect infestation and pathogen-induced tree mortality were non-significant, although biotic disturbances were poorly represented in the literature. When measured separately, fungal and bacterial responses to disturbances mirrored the response of the microbial community as a whole. Changes in microbial abundance following disturbance were significantly positively correlated with changes in microbial respiration. We propose that the differential effect of abiotic and biotic disturbances on microbial biomass may be attributable to differences in soil disruption and organic C removal from forests among disturbance types. Altogether, these results suggest that abiotic forest disturbances may significantly decrease soil microbial abundance, with corresponding consequences for microbial respiration. Further studies are needed on the effect of biotic disturbances on forest soil microbial communities and soil C dynamics.

Gut Microbiota in Children Hospitalized with Oedematous and Non-Oedematous Severe Acute Malnutrition in Uganda

DEFF Research Database (Denmark)

Kristensen, Kia Hee Schultz; Wiese, Maria; Rytter, Maren Johanne Heilskov

2016-01-01

BACKGROUND: Severe acute malnutrition (SAM) among children remains a major health problem in many developing countries. SAM manifests in both an oedematous and a non-oedematous form, with oedematous malnutrition in its most severe form also known as kwashiorkor. The pathogenesis of both types...... of malnutrition in children remains largely unknown, but gut microbiota (GM) dysbiosis has recently been linked to oedematous malnutrition. In the present study we aimed to assess whether GM composition differed between Ugandan children suffering from either oedematous or non-oedematous malnutrition. METHODOLOGY......-encoded 16S rRNA gene-targeted high throughput amplicon sequencing. Alpha and beta diversity measures were determined along with ANOVA mean relative abundance and G-test of independence followed by comparisons between groups. Of the 87 SAM children included, 62% suffered from oedematous malnutrition, 66...

[Value of nutritional risk screening in evaluating adverse clinical outcomes in children with severe pneumonia].

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Guo, Xiao-Hui; Sun, Yan-Feng; Wang, Jiang-Bo; Han, Shu-Zhen; Miao, Jing; Cui, Min

2017-03-01

To investigate the nutritional risk in children with severe pneumonia using the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) and the association between nutritional risk and adverse clinical outcomes. According to the STAMP score, 216 children with severe pneumonia were classified into high nutritional risk group (HR group; n=98), moderate nutritional risk group (MR group; n=65), and low nutritional risk group (LR group; n=53). Fasting blood samples were collected to measure the levels of insulin-like growth factor-1 (IGF-1), adiponectin, leptin, non-esterified fatty acid (NEFA), albumin, transferrin, prealbumin, and retinol binding protein (RBP). The adverse clinical outcomes were recorded. Compared with the MR and LR groups, the HR group had significantly lower serum levels of IGF-1, leptin, adiponectin, prealbumin, and RBP, as well as a significantly higher serum level of NEFA (Prisk screening has an important value in evaluating the clinical outcome of children with severe pneumonia, and children at a higher nutritional risk tend to have more adverse clinical outcomes.

Microgravity Disturbance Predictions in the Combustion Integrated Rack

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Just, M.; Grodsinsky, Carlos M.

2002-01-01

This paper will focus on the approach used to characterize microgravity disturbances in the Combustion Integrated Rack (CIR), currently scheduled for launch to the International Space Station (ISS) in 2005. Microgravity experiments contained within the CIR are extremely sensitive to vibratory and transient disturbances originating on-board and off-board the rack. Therefore, several techniques are implemented to isolate the critical science locations from external vibration. A combined testing and analysis approach is utilized to predict the resulting microgravity levels at the critical science location. The major topics to be addressed are: 1) CIR Vibration Isolation Approaches, 2) Disturbance Sources and Characterization, 3) Microgravity Predictive Modeling, 4) Science Microgravity Requirements, 6) Microgravity Control, and 7) On-Orbit Disturbance Measurement. The CIR is using the Passive Rack Isolation System (PaRIS) to isolate the rack from offboard rack disturbances. By utilizing this system, CIR is connected to the U.S. Lab module structure by either 13 or 14 umbilical lines and 8 spring / damper isolators. Some on-board CIR disturbers are locally isolated by grommets or wire ropes. CIR's environmental and science on board support equipment such as air circulation fans, pumps, water flow, air flow, solenoid valves, and computer hard drives cause disturbances within the rack. These disturbers along with the rack structure must be characterized to predict whether the on-orbit vibration levels during experimentation exceed the specified science microgravity vibration level requirements. Both vibratory and transient disturbance conditions are addressed. Disturbance levels/analytical inputs are obtained for each individual disturber in a "free floating" condition in the Glenn Research Center (GRC) Microgravity Emissions Lab (MEL). Flight spare hardware is tested on an Orbital Replacement Unit (ORU) basis. Based on test and analysis, maximum disturbance level

TFIIH subunit alterations causing xeroderma pigmentosum and trichothiodystrophy specifically disturb several steps during transcription.

Science.gov (United States)

Singh, Amita; Compe, Emanuel; Le May, Nicolas; Egly, Jean-Marc

2015-02-05

Mutations in genes encoding the ERCC3 (XPB), ERCC2 (XPD), and GTF2H5 (p8 or TTD-A) subunits of the transcription and DNA-repair factor TFIIH lead to three autosomal-recessive disorders: xeroderma pigmentosum (XP), XP associated with Cockayne syndrome (XP/CS), and trichothiodystrophy (TTD). Although these diseases were originally associated with defects in DNA repair, transcription deficiencies might be also implicated. By using retinoic acid receptor beta isoform 2 (RARB2) as a model in several cells bearing mutations in genes encoding TFIIH subunits, we observed that (1) the recruitment of the TFIIH complex was altered at the activated RARB2 promoter, (2) TFIIH participated in the recruitment of nucleotide excision repair (NER) factors during transcription in a manner different from that observed during NER, and (3) the different TFIIH variants disturbed transcription by having distinct consequences on post-translational modifications of histones, DNA-break induction, DNA demethylation, and gene-loop formation. The transition from heterochromatin to euchromatin was disrupted depending on the variant, illustrating the fact that TFIIH, by contributing to NER factor recruitment, orchestrates chromatin remodeling. The subtle transcriptional differences found between various TFIIH variants thus participate in the phenotypic variability observed among XP, XP/CS, and TTD individuals. Copyright © 2015 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

Feasibility of bioelectrical impedance analysis in children with a severe generalized cerebral palsy

NARCIS (Netherlands)

R.J.G. Veugelers (Rebekka); C. Penning (Corine); L. van Gulik (Laura); D. Tibboel (Dick); H.M. Evenhuis (Heleen)

2006-01-01

textabstractObjective: The need is strong for an accurate and easy-to-perform test to evaluate the nutritional state of children who have a severe generalized cerebral palsy, defined as a severe motor handicap and an intellectual disability. For that purpose, we determined the feasibility of

Gender inequality and severe malnutrition among children in a remote rural area of Bangladesh.

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Choudhury, K K; Hanifi, M A; Rasheed, S; Bhuiya, A

2000-12-01

Bangladesh typifies many south-eastern countries where female children experience inferior health and uncertain survival, especially after the neonatal period. This paper attempts to study the gender inequality in nutritional status and the effects of various socioeconomic, demographic, and health-programme factors on gender inequality in a remote rural area of Bangladesh. Measurements of mid-upper arm circumference (MUAC) were taken from 2,016 children aged less than 5 years (50.8% male, 49.2% female) in 1994. Children were characterized as severely malnourished if MUAC was gender gap persisted in the multivariate situation, with female 1.44 times more likely to be severely malnourished. Other variables with a statistically significant relationship included the age of children, acceptance of DPT1, and education of household heads. The persistence of such a gender discrimination now when the country has achieved a lot in terms of child survival is striking. The issue is important and demands appropriate corrective actions.

Characteristics of Sleep Disturbances in Patients with Gastroesophageal Reflux Disease.

Science.gov (United States)

Iwakura, Narika; Fujiwara, Yasuhiro; Shiba, Masatsugu; Ochi, Masahiro; Fukuda, Takashi; Tanigawa, Tetsuya; Yamagami, Hirokazu; Tominaga, Kazunari; Watanabe, Toshio; Arakawa, Tetsuo

2016-01-01

Objective Gastroesophageal reflux disease (GERD) is strongly associated with sleep disturbances; however, the detailed differences in the characteristics of sleep disturbances between GERD and non-GERD patients are unknown. The aim of the present study was to analyze the clinical characteristics as well as health-related quality of life in GERD and non-GERD patients with sleep disturbances. Methods Three hundred and fifty patients, including 124 patients with GERD and 226 patients without GERD, completed a self-administered questionnaire that evaluated clinical information. The Pittsburg Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS) and 8-item Short-Form Health Survey (SF-8) were also used. Sleep disturbance was considered to be present if the PSQI was >5.5. Results The prevalence of sleep disturbances was significantly higher in the GERD patients (66/124, 53.9%) than in the non-GERD patients (89/226, 39.3%). Depression and anxiety were significantly more common in the subjects with sleep disturbances than in those without sleep disturbances, although there were no differences between the GERD and non-GERD patients. Among the subjects with sleep disturbances, daytime sleepiness was more common in the GERD patients than in the non-GERD patients. The subjects with sleep disturbances had a poorer health-related quality of life. The physical components of quality of life were impaired, particularly in the GERD patients with sleep disturbances. Conclusion GERD patients with sleep disturbances commonly experience daytime sleepiness and an impaired health-related quality of life, especially in terms of physical components.

Asthma, hay fever, and food allergy are associated with caregiver-reported speech disorders in US children.

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Strom, Mark A; Silverberg, Jonathan I

2016-09-01

Children with asthma, hay fever, and food allergy may have several factors that increase their risk of speech disorder, including allergic inflammation, ADD/ADHD, and sleep disturbance. However, few studies have examined a relationship between asthma, allergic disease, and speech disorder. We sought to determine whether asthma, hay fever, and food allergy are associated with speech disorder in children and whether disease severity, sleep disturbance, or ADD/ADHD modified such associations. We analyzed cross-sectional data on 337,285 children aged 2-17 years from 19 US population-based studies, including the 1997-2013 National Health Interview Survey and the 2003/4 and 2007/8 National Survey of Children's Health. In multivariate models, controlling for age, demographic factors, healthcare utilization, and history of eczema, lifetime history of asthma (odds ratio [95% confidence interval]: 1.18 [1.04-1.34], p = 0.01), and one-year history of hay fever (1.44 [1.28-1.62], p speech disorder. Children with current (1.37 [1.15-1.59] p = 0.0003) but not past (p = 0.06) asthma had increased risk of speech disorder. In one study that assessed caregiver-reported asthma severity, mild (1.58 [1.20-2.08], p = 0.001) and moderate (2.99 [1.54-3.41], p speech disorder; however, severe asthma was associated with the highest odds of speech disorder (5.70 [2.36-13.78], p = 0.0001). Childhood asthma, hay fever, and food allergy are associated with increased risk of speech disorder. Future prospective studies are needed to characterize the associations. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Using Lego robots to estimate cognitive ability in children who have severe physical disabilities.

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Cook, Albert M; Adams, Kim; Volden, Joanne; Harbottle, Norma; Harbottle, Cheryl

2011-01-01

To determine whether low-cost robots provide a means by which children with severe disabilities can demonstrate understanding of cognitive concepts. Ten children, ages 4 to 10, diagnosed with cerebral palsy and related motor conditions, participated. Participants had widely variable motor, cognitive and receptive language skills, but all were non-speaking. A Lego Invention 'roverbot' was used to carry out a range of functional tasks from single-switch replay of pre-stored movements to total control of the movement in two dimensions. The level of sophistication achieved on hierarchically arranged play tasks was used to estimate cognitive skills. The 10 children performed at one of the six hierarchically arranged levels from 'no interaction' through 'simple cause and effect' to 'development and execution of a plan'. Teacher interviews revealed that children were interested in the robot, enjoyed interacting with it and demonstrated changes in behaviour and social and language skills following interaction. Children with severe physical disabilities can control a Lego robot to perform un-structured play tasks. In some cases, they were able to display more sophisticated cognitive skills through manipulating the robot than in traditional standardised tests. Success with the robot could be a proxy measure for children who have cognitive abilities but cannot demonstrate them in standard testing.

Treatment of Severe Edema in Children with Nephrotic Syndrome with Diuretics Alone — A Prospective Study

Science.gov (United States)

Kapur, Gaurav; Valentini, Rudolph P.; Imam, Abubakr A.; Mattoo, Tej K.

2009-01-01

Background and objective: Severe edema in children with nephrotic syndrome (NS) may be associated with volume contraction (VC) or volume expansion (VE). Usually, severe edema in children is treated with intravenous (IV) albumin and diuretics, which is appropriate for VC patients. However, in VE patients, this can precipitate fluid overload. The objective of this study was to evaluate treatment of severe edema in NS with diuretics alone. Design, setting, participants, & measurements: Thirty NS patients with severe edema were enrolled in this prospective study in two phases. VC was diagnosed based on fractional excretion of sodium (FeNa) diuretics alone and 9 VC patients received albumin and furosemide. There was no difference in hospital stay and weight loss in VC and VE groups after treatment. Conclusions: FeNa is useful in distinguishing VC versus VE in NS children with severe edema. The use of diuretics alone in VE patients is safe and effective. PMID:19406963

Disturbed Desmoglein-2 in the intercalated disc of pediatric patients with dilated cardiomyopathy

NARCIS (Netherlands)

Kessler, Elise L.; Nikkels, Peter GJ; van Veen, Toon AB

2017-01-01

Dilated cardiomyopathy (DCM) leads to disturbed contraction and force transduction, and is associated with substantial mortality in all age groups. Involvement of a disrupted composition of the intercalated disc (ID) has been reported. However, in children, little is established about such

Treatment Failure and Mortality amongst Children with Severe Acute Malnutrition Presenting with Cough or Respiratory Difficulty and Radiological Pneumonia.

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Mohammod Jobayer Chisti

Full Text Available Appropriate intervention is critical in reducing deaths among under-five, severe acutely malnourished (SAM children with danger signs of severe pneumonia; however, there is paucity of data on outcome of World Health Organisation (WHO recommended interventions of SAM children with severe pneumonia. We sought to evaluate outcome of the interventions in such children.We prospectively enrolled SAM children aged 0-59 months, admitted to the Intensive Care Unit (ICU or Acute Respiratory Infection (ARI ward of the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b, between April 2011 and June 2012 with cough or respiratory difficulty and radiological pneumonia. All the enrolled children were treated with ampicillin and gentamicin, and micronutrients as recommended by the WHO. Comparison was made among pneumonic children with (n = 111 and without WHO defined danger signs of severe pneumonia (n = 296. The outcomes of interest were treatment failure (if a child required changing of antibiotics and deaths during hospitalization. Further comparison was also made among those who developed treatment failure and who did not and among the survivors and deaths.SAM children with danger signs of severe pneumonia more often experienced treatment failure (58% vs. 20%; p<0.001 and fatal outcome (21% vs. 4%; p<0.001 compared to those without danger signs. Only 6/111 (5.4% SAM children with danger signs of severe pneumonia and 12/296 (4.0% without danger signs had bacterial isolates from blood. In log-linear binomial regression analysis, after adjusting for potential confounders, danger signs of severe pneumonia, dehydration, hypocalcaemia, and bacteraemia were independently associated both with treatment failure and deaths in SAM children presenting with cough or respiratory difficulty and radiological pneumonia (p<0.01.The result suggests that SAM children with cough or respiratory difficulty and radiologic pneumonia who

Relationship between severe obesity and gut inflammation in children: what's next?

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Assante Luca

2010-10-01

Full Text Available Abstract Background Preliminary evidence suggests an association between obesity and gut inflammation. Aims To evaluate the frequency of glucose abnormalities and their correlation with systemic and intestinal inflammation in severely obese children. Patients and Methods Thirty-four children (25 males; median age 10.8 ± 3.4 yrs with severe obesity (BMI >95% were screened for diabetes with oral glucose tolerance test (OGTT, systemic inflammation with C-reactive protein (CRP and gut inflammation with rectal nitric oxide (NO and faecal calprotectin. Results BMI ranged from 23 to 44 kg/m2, and BMI z-score between 2.08 e 4.93 (median 2.69 ± 0.53. Glucose abnormalities were documented in 71% of patients: type 2 diabetes in 29%, impaired fasting glucose (IFG in 58%, and impaired glucose tolerance (IGT in 37.5%. Thirty-one patients (91% were hyperinsulinemic. CRP was increased in 73.5% with a correlation between BMI z-score and CRP (p 0.03. Faecal calprotectin was increased in 47% patients (mean 77 ± 68, and in 50% of children with abnormal glucose metabolism (mean 76 ± 68 μg/g, with a correlation with increasing BMI z-score. NO was pathological in 88%, and in 87.5% of glucose impairment (mean 6.8 ± 5 μM. Conclusions In this study, the prevalence of glucose abnormalities in obese children is higher than in other series; furthermore, a correlation is present between markers of systemic and intestinal inflammation and glucose abnormalities.

Association of Sleep Disturbances With Reduced Semen Quality

DEFF Research Database (Denmark)

Jensen, Tina Kold; Andersson, Anna-Maria; Skakkebæk, Niels Erik

2013-01-01

Several studies have found an association between sleep duration and morbidity and mortality, but no previous studies have examined the association between sleep disturbances and semen quality. We conducted a cross-sectional study among 953 young Danish men from the general population who were...... recruited in Copenhagen at the time of determination of fitness for military service between January 2008 and June 2011. All of the men delivered a semen sample, had a blood sample drawn, underwent a physical examination, and answered a questionnaire including information about sleep disturbances. Sleep...... score of 11-20. This appears to be the first study to find associations between sleep disturbances and semen quality. In future studies, investigators should attempt to elucidate mechanistic explanations and prospectively assess whether semen quality improves after interventions restoring a normal...

Composite control for raymond mill based on model predictive control and disturbance observer

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Dan Niu

2016-03-01

Full Text Available In the raymond mill grinding process, precise control of operating load is vital for the high product quality. However, strong external disturbances, such as variations of ore size and ore hardness, usually cause great performance degradation. It is not easy to control the current of raymond mill constant. Several control strategies have been proposed. However, most of them (such as proportional–integral–derivative and model predictive control reject disturbances just through feedback regulation, which may lead to poor control performance in the presence of strong disturbances. For improving disturbance rejection, a control method based on model predictive control and disturbance observer is put forward in this article. The scheme employs disturbance observer as feedforward compensation and model predictive control controller as feedback regulation. The test results illustrate that compared with model predictive control method, the proposed disturbance observer–model predictive control method can obtain significant superiority in disturbance rejection, such as shorter settling time and smaller peak overshoot under strong disturbances.

Relationship of serum ferritin level and tic severity in children with Tourette syndrome.

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Ghosh, Debabrata; Burkman, Elizabeth

2017-08-01

Tics can be considered hyperkinetic movements akin to restless leg syndrome (RLS). Drawing the analogy of iron deficiency as an etiology of RLS, it is conceivable that iron deficiency may underlie or worsen tics in Tourette syndrome (TS). The purpose of this study was to evaluate the relationship between serum ferritin levels and tic severity, as well as consequent impact on life, in children with TS. Children tic severity, impact on life, medication, comorbidities, blood count, and serum ferritin at diagnosis and follow-up. In fifty-seven patients, M:F = 2:1, serum ferritin was 48.0 ± 33.28 ng/mL, tic severity score 2.3 ± 0.80, impact on life score 2.2 ± 0.93, and composite score 4.57 ± 1.6. Serum ferritin was not influenced by comorbid obsessive compulsive disorder (OCD), attention deficit hyperactive disorder (ADHD), or anxiety (P > 0.16). Thirty-eight percent with low serum ferritin (≤50 ng/mL) (n = 37) had severe tics (>5 composite score), compared with 25% in normal ferritin group (n = 20). Over 6-12 months, tic severity score improved in both iron treated groups, deficient (2.70 to 1.90) and sufficient (2.40 to 1.95), whereas tics worsened or remained the same when not treated with iron. Our data suggest iron deficiency may be associated with more severe tics with higher impact on TS children, independent of the presence of OCD, ADHD, or anxiety. Iron supplementation showed a trend towards improvement of tic severity upon follow-up. We suggest a double-blind, placebo-controlled prospective study to reach a definite conclusion.

Horse-related injuries in children - unmounted injuries are more severe: A retrospective review.

Science.gov (United States)

Wolyncewicz, Grace E L; Palmer, Cameron S; Jowett, Helen E; Hutson, John M; King, Sebastian K; Teague, Warwick J

2018-05-01

Horse-related injuries account for one quarter of all paediatric sports fatalities. It is not known whether the pattern of injury spectrum and severity differ between children injured whilst mounted, compared with those injured unmounted around horses. We aimed to identify any distinctions between the demographic features, spectrum and severity of injuries for mounted versus unmounted patients. Trauma registry data were reviewed for 505 consecutive paediatric patients (agedinjuries over a 16-year period. Patients were classified into mounted and unmounted groups, and demographics, injury spectrum, injury severity, and helmet usage compared using odds ratios and Wilcoxon rank-sum tests. More patients (56%) were injured in a private setting than in a sporting or supervised context (23%). Overall, head injuries were the most common horse-related injury. Mounted patients comprised 77% of the cohort. Mounted patients were more likely to sustain upper limb fractures or spinal injuries, and more likely to wear helmets. Unmounted were more likely to be younger males, and more likely to sustain facial or abdominal injuries. Strikingly, unmounted children had significantly more severe and critical Injury Severity Scores (OR 2.6; 95% CI 1.5, 4.6) and longer hospital stay (2.0days vs 1.1days; pinjury. Horse-related injuries in children are serious. Unmounted patients are distinct from mounted patients in terms of gender, age, likelihood of personal protective equipment use, severity of injuries, and requirement for intensive or invasive care. This study highlights the importance of vigilance and other safety behaviours when unmounted and around horses, and proposes specific targets for future injury prevention campaigns, both in setting of organised and private equestrian activity. Copyright © 2017 Elsevier Ltd. All rights reserved.

Probiotics in antibiotic associated diarrhea in children

Directory of Open Access Journals (Sweden)

Matjaž Homan

2013-10-01

Full Text Available The use of antibiotics that disturb the gastrointestinal microbiota is associated with diarrhea, which occurs in up to half of treated children. Symptoms are usually mild and children do not need hospitalization. Probiotics are live microorganisms, which restore intestinal microbiota during antibiotic therapy through different mechanisms such as stimulation of immunity, secretion of anti-inflammatory factors, and production of antimicrobial substances. The use of different strains of probiotics in antibiotic-associated diarrhea was evaluated in several studies in adults but less frequently in pediatric population. They also confirmed the value of probiotics in the prevention of antibiotic-associated diarrhea in children, particularly Lactobacillus strain GG and Saccharomyces boulardii. The use of probiotics in childhood is safe. A proper strain must be introduced at the beginning of antibiotic treatment in a sufficient concentration.

Effect(s) of Language Tasks on Severity of Disfluencies in Preschool Children with Stuttering

Science.gov (United States)

Zamani, Peyman; Ravanbakhsh, Majid; Weisi, Farzad; Rashedi, Vahid; Naderi, Sara; Hosseinzadeh, Ayub; Rezaei, Mohammad

2017-01-01

Speech disfluency in children can be increased or decreased depending on the type of linguistic task presented to them. In this study, the effect of sentence imitation and sentence modeling on severity of speech disfluencies in preschool children with stuttering is investigated. In this cross-sectional descriptive analytical study, 58 children…

Using electronic storybooks to support word learning in children with severe language impairments.

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Smeets, Daisy J H; van Dijken, Marianne J; Bus, Adriana G

2014-01-01

Novel word learning is reported to be problematic for children with severe language impairments (SLI). In this study, we tested electronic storybooks as a tool to support vocabulary acquisition in SLI children. In Experiment 1, 29 kindergarten SLI children heard four e-books each four times: (a) two stories were presented as video books with motion pictures, music, and sounds, and (b) two stories included only static illustrations without music or sounds. Two other stories served as the control condition. Both static and video books were effective in increasing knowledge of unknown words, but static books were most effective. Experiment 2 was designed to examine which elements in video books interfere with word learning: video images or music or sounds. A total of 23 kindergarten SLI children heard 8 storybooks each four times: (a) two static stories without music or sounds, (b) two static stories with music or sounds, (c) two video stories without music or sounds, and (d) two video books with music or sounds. Video images and static illustrations were equally effective, but the presence of music or sounds moderated word learning. In children with severe SLI, background music interfered with learning. Problems with speech perception in noisy conditions may be an underlying factor of SLI and should be considered in selecting teaching aids and learning environments. © Hammill Institute on Disabilities 2012.

Effects of psychosocial stimulation on growth and development of severely malnourished children in a nutrition unit in Bangladesh.

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Nahar, B; Hamadani, J D; Ahmed, T; Tofail, F; Rahman, A; Huda, S N; Grantham-McGregor, S M

2009-06-01

Young children with severe malnutrition usually have poor mental development. Psychosocial stimulation may reduce their cognitive deficit, but it is not usually provided. The aim of the study was to incorporate stimulation into the routine treatment of severely malnourished children in a nutrition unit and evaluate the impact on their growth and development. Time-lagged controlled study. Nutritional Rehabilitation Unit (NRU) in ICDDR,B Dhaka Hospital. Severely malnourished children, aged 6-24 months, admitted to the NRU were enrolled. All received standard nutritional care. A control group of 43 children was studied initially, followed by an intervention group of 54 children. The intervened mothers and children participated in daily group meetings and individual play sessions for 2 weeks in hospital and were visited at home for 6 months. Children's growth was measured and development assessed using the Bayley Scales of Infant Development. Twenty-seven children were lost to the study. In the remaining children, both groups had similar developmental scores and anthropometry initially. After 6 months, the intervention group had improved more than the controls did by a mean of 6.9 (Pchildren in hospital, followed by home visits for 6 months, was effective in improving children's growth and development and should be an integral part of their treatment.

Incidence and predictors of severe anemia in Asian HIV-infected children using first-line antiretroviral therapy

NARCIS (Netherlands)

Bunupuradah, Torsak; Kariminia, Azar; Chan, Kwai-Cheng; Ramautarsing, Reshmie; Huy, Bui Vu; Han, Ning; Nallusamy, Revathy; Hansudewechakul, Rawiwan; Saphonn, Vonthanak; Sirisanthana, Virat; Chokephaibulkit, Kulkanya; Kurniati, Nia; Kumarasamy, Nagalingeswaran; Yusoff, Nik Khairulddin Nik; Razali, Kamarul; Fong, Siew Moy; Sohn, Annette H.; Lumbiganon, Pagakrong

2013-01-01

There are limited data on treatment-related anemia in Asian HIV-infected children. Data from Asian HIV-infected children aged <18 years on first-line highly active antiretroviral therapy (HAART) were used. Children who had pre-existing severe anemia at baseline were excluded. Anemia was graded using

Validating visual disturbance types and classes used for forest soil monitoring protocols

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D. S. Page-Dumroese; A. M. Abbott; M. P. Curran; M. F. Jurgensen

2012-01-01

We describe several methods for validating visual soil disturbance classes used during forest soil monitoring after specific management operations. Site-specific vegetative, soil, and hydrologic responses to soil disturbance are needed to identify sensitive and resilient soil properties and processes; therefore, validation of ecosystem responses can provide information...

Severe eosinophilic meningitis owing to Angiostrongylus cantonensis in young Jamaican children: case report and literature review.

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Evans-Gilbert, Tracy; Lindo, John F; Henry, Sonia; Brown, Paul; Christie, Celia D C

2014-05-01

Eosinophilic meningitis caused by Angiostrongylus cantonensis is an endemic and emerging disease that affects adults and children in Jamaica. Most cases resolve without sequelae, but young children are at high risk of neurological damage and death. Treatment with corticosteroids and albendazole is considered safe for adults and children, but protocols for its use in children have not been established. A 19-month-old infant with permanent neurological sequlae caused by Angiostrongylus cantonensis meningitis is reported, and five other Jamaican cases are summarized. A review of the literature of children with permanent neurological sequlae and death is presented. Children <5 years (especially <2) were at increased risk of incomplete recovery and death if they presented with bulbar signs, flaccid paresis and coma. None of the severe or fatal cases received early intervention with anthelminthics, and disease progression was not altered with corticosteroids. In view of the pathophysiology, necropsy reports and animal studies, it seems that the early use of larvicidals may change the course of severe presentations.

Sleep Disturbance During Smoking Cessation: Withdrawal or Side Effect of Treatment?

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Ashare, Rebecca L; Lerman, Caryn; Tyndale, Rachel F; Hawk, Larry W; George, Tony P; Cinciripini, Paul; Schnoll, Robert A

2017-06-01

The nicotine-metabolite ratio (NMR) predicts treatment response and is related to treatment side effect severity. Sleep disturbance may be one important side effect, but understanding sleep disturbance effects on smoking cessation is complicated by the fact that nicotine withdrawal also produces sleep disturbance. To evaluate the effects of withdrawal and treatment side effects on sleep disturbance. This is a secondary analysis of data from a clinical trial (Lerman et al., 2015) of 1,136 smokers randomised to placebo ( n = 363), transdermal nicotine (TN; n = 381), or varenicline ( n = 392) and stratified based on NMR (559 slow metabolisers; 577 normal metabolisers). Sleep disturbance was assessed at baseline and at 1-week following the target quit date (TQD). We also examined whether sleep disturbance predicted 7-day point-prevalence abstinence at end-of-treatment (EOT). The varenicline and TN groups exhibited greater increases in sleep disturbance (vs. placebo; treatment × time interaction; p = 0.005), particularly among those who quit smoking at 1-week post-TQD. There was a main effect of NMR ( p = 0.04), but no interactions with treatment. TN and varenicline attenuated withdrawal symptoms unrelated to sleep (vs. placebo). Greater baseline sleep disturbance predicted relapse at EOT ( p = 0.004). Existing treatments may not mitigate withdrawal-related sleep disturbance and adjunctive treatments that target sleep disturbance may improve abstinence rates.

Effect of context on respiratory rate measurement in identifying non-severe pneumonia in African children.

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Muro, Florida; Mtove, George; Mosha, Neema; Wangai, Hannah; Harrison, Nicole; Hildenwall, Helena; Schellenberg, David; Todd, Jim; Olomi, Raimos; Reyburn, Hugh

2015-06-01

Cough or difficult breathing and an increased respiratory rate for their age are the commonest indications for outpatient antibiotic treatment in African children. We aimed to determine whether respiratory rate was likely to be transiently raised by a number of contextual factors in a busy clinic leading to inaccurate diagnosis. Respiratory rates were recorded in children aged 2-59 months presenting with cough or difficulty breathing to one of the two busy outpatient clinics and then repeated at 10-min intervals over 1 h in a quiet setting. One hundred and sixty-seven children were enrolled with a mean age of 7.1 (SD ± 2.9) months in infants and 27.6 (SD ± 12.8) months in children aged 12-59 months. The mean respiratory rate declined from 42.3 and 33.6 breaths per minute (bpm) in the clinic to 39.1 and 32.6 bpm after 10 min in a quiet room and to 39.2 and 30.7 bpm (P pneumonia. In a random effects linear regression model, the variability in respiratory rate within children (42%) was almost as much as the variability between children (58%). Changing the respiratory rates cut-offs to higher thresholds resulted in a small reduction in the proportion of non-severe pneumonia mis-classifications in infants. Noise and other contextual factors may cause a transient increase in respiratory rate and consequently misclassification of non-severe pneumonia. However, this effect is less pronounced in older children than infants. Respiratory rate is a difficult sign to measure as the variation is large between and within children. More studies of the accuracy and utility of respiratory rate as a proxy for non-severe pneumonia diagnosis in a busy clinic are needed. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Plant hydraulic controls over ecosystem responses to climate-enhanced disturbances

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Mackay, D. S.; Ewers, B. E.; Reed, D. E.; Pendall, E.; McDowell, N. G.

2012-12-01

Climate-enhanced disturbances such as drought and insect infestation range in severity, contributing minor to severe stress to forests including forest mortality. While neither form of disturbance has been unambiguously implicated as a mechanism of mortality, both induce changes in water, carbon, and nutrient cycling that are key to understanding forest ecosystem response to, and recovery from, disturbance. Each disturbance type has different biophysical, ecohydrological, and biogeochemical signatures that potentially complicate interpretation and development of theory. Plant hydraulic function is arguably a unifying control over these responses to disturbance because it regulates stomatal conductance, leaf biochemistry, carbon (C) uptake and utilization, and nutrient cycling. We demonstrated this idea by focusing on water and C, including non-structural (NSC), resources, and nitrogen (N) uptake across a spectrum of forest ecosystems (e.g., northern temperate mixed forests, lodgepole pine forests in the Rocky Mountains, and pinon pine - juniper woodlands in New Mexico) using the Terrestrial Regional Ecosystem Exchange Simulator (TREES). TREES is grounded in the biophysics of water movement through soil and plants, respectively via hydraulic conductivity of the soil and cavitation of xylem. It combines this dynamic plant hydraulic conductance with canopy biochemical controls over photosynthesis, and the dynamics of structural and non-structural carbon through a carbon budget that responds to plant hydraulic status. As such, the model can be used to develop testable hypotheses on a multitude of disturbance and recovery responses including xylem dysfunction, stomatal and non-stomatal controls on photosynthesis and carbon allocation, respiration, and allocation to defense compounds. For each of the ecosystems we constrained and evaluated the model with allometry, sap flux and/or eddy covariance data, leaf gas exchange measurements, and vulnerability to cavitation data

Different Facets of Body Image Disturbance in Binge Eating Disorder: A Review

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Lewer, Merle; Bauer, Anika

2017-01-01

The goal of the present review is to give an overview of the current findings on various facets of body image disturbance in Binge Eating Disorder such as body dissatisfaction, overconcern with weight and shape, body-related checking and avoidance behavior, misperception of body size, and body-related cognitive bias. In addition, treatments for a disturbed body image in BED and evidence of body image disturbance in youth with binge eating are reviewed. The results show that a disturbed body image in BED is present in the form of overconcern with weight and shape. Furthermore, there are hints that body dissatisfaction, as well as body-related checking and avoidance behavior, are also impaired. Research concerning misperception of body size in BED has been neglected so far, but first findings show that individuals with BED rate their own body shape rather accurately. Furthermore, there are first hints that body-related cognitive biases are present in individuals with BED. Moreover, in children and adolescents, there are first hints that body dissatisfaction, as well as shape and weight concerns, seem to be associated with loss of control and binge eating. Treatments aimed directly at the convertibility of a disturbed body image in BED have revealed encouraging outcomes. In conclusion, body image disturbance seems to occur in BED, and first studies show that it can be treated effectively. PMID:29182531

Different Facets of Body Image Disturbance in Binge Eating Disorder: A Review

Directory of Open Access Journals (Sweden)

Merle Lewer

2017-11-01

Full Text Available The goal of the present review is to give an overview of the current findings on various facets of body image disturbance in Binge Eating Disorder such as body dissatisfaction, overconcern with weight and shape, body-related checking and avoidance behavior, misperception of body size, and body-related cognitive bias. In addition, treatments for a disturbed body image in BED and evidence of body image disturbance in youth with binge eating are reviewed. The results show that a disturbed body image in BED is present in the form of overconcern with weight and shape. Furthermore, there are hints that body dissatisfaction, as well as body-related checking and avoidance behavior, are also impaired. Research concerning misperception of body size in BED has been neglected so far, but first findings show that individuals with BED rate their own body shape rather accurately. Furthermore, there are first hints that body-related cognitive biases are present in individuals with BED. Moreover, in children and adolescents, there are first hints that body dissatisfaction, as well as shape and weight concerns, seem to be associated with loss of control and binge eating. Treatments aimed directly at the convertibility of a disturbed body image in BED have revealed encouraging outcomes. In conclusion, body image disturbance seems to occur in BED, and first studies show that it can be treated effectively.

Animal responses to natural disturbance and climate extremes: a review

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Sergio, Fabrizio; Blas, Julio; Hiraldo, Fernando

2018-02-01

Natural disturbances, such as droughts, fires or hurricanes, are key drivers of ecological heterogeneity and ecosystem function. The frequency and severity of these episodes is unequivocally expected to increase in the coming decades, through the concerted action of climate change and anthropogenic pressures. This will impose severe challenges for many biota through exposure to rapidly changing conditions never experienced in the preceding millennia. Thus, it is urgently needed to gain a thorough understanding of animal responses and adaptations to disturbances in order to better estimate potential future impacts. Here, we review such adjustments and find that animals may respond to disturbances through changes in: (1) behaviour, such as altered mobility, emigration, resource-switching, refuge use, suspended animation, or biotic interactions; (2) life history traits, such as survival, aging, longevity, recruitment, reproductive restraint, breeding output, phenology and bet-hedging tactics; (3) morphology, such as rapid evolution through size-dependent mortality or facultative metamorphosis; (4) physiology, such as altered body condition, pathogen prevalence and transmission, or adrenocortical modulation of stress responses to emergency conditions; (5) genetic structure, such as changes in frequency of polymorphic variants or diversity-modulation through mortality bottlenecks. Individual-level responses scale up to population and community responses, such as altered density, population dynamics, distribution, local extinction and colonization, or assemblage structure and diversity. Overall, disturbances have pervasive effects on individuals, populations and communities of vertebrates and invertebrates of all realms, biomes, continents and ecosystems. Their rapidly increasing incidence and severity will bring unique study opportunities for researchers and novel, unpredictable challenges for managers, while demanding tougher choices and more proactive crisis

Sleep and inflammatory bowel disease: exploring the relationship between sleep disturbances and inflammation.

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Kinnucan, Jami A; Rubin, David T; Ali, Tauseef

2013-11-01

Sleep disturbances are associated with a greater risk of serious adverse health events, economic consequences, and, most importantly, increased all-cause mortality. Several studies support the associations among sleep, immune function, and inflammation. The relationship between sleep disturbances and inflammatory conditions is complex and not completely understood. Sleep deprivation can lead to increased levels of inflammatory cytokines, including interleukin (IL)-1β IL-6, tumor necrosis factor-α and C-reactive protein, which can lead to further activation of the inflammatory cascade. The relevance of sleep in inflammatory bowel disease (IBD), a chronic immune-mediated inflammatory disease of the gastrointestinal tract, has recently received more attention. Several studies have shown that patients with both inactive and active IBD have self-reported sleep disturbances. Here, we present a concise review of sleep and its association with the immune system and the process of inflammation. We discuss the studies that have evaluated sleep in patients with IBD as well as possible treatment options for those patients with sleep disturbances. An algorithm for evaluating sleep disturbances in the IBD population is also proposed. Further research is still needed to better characterize sleep disturbances in the IBD population as well as to assess the effects of various therapeutic interventions to improve sleep quality. It is possible that the diagnosis and treatment of sleep disturbances in this population may provide an opportunity to alter disease outcomes.

Zinc as an adjunct therapy in the management of severe pneumonia among Gambian children: randomized controlled trial.

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Howie, Stephen; Bottomley, Christian; Chimah, Osaretin; Ideh, Readon; Ebruke, Bernard; Okomo, Uduak; Onyeama, Charles; Donkor, Simon; Rodrigues, Onike; Tapgun, Mary; Janneh, Marie; Oluwalana, Claire; Kuti, Bankole; Enwere, Godwin; Esangbedo, Pamela; Doherty, Conor; Mackenzie, Grant; Greenwood, Brian; Corrah, Tumani; Prentice, Andrew; Adegbola, Richard; Zaman, Syed

2018-06-01

The benefit of zinc as an adjunct therapy for severe pneumonia is not established. We assessed the benefit of adjunct zinc therapy for severe pneumonia in children and determined whether the study children were zinc deficient. This was a randomized, parallel group, double-blind, placebo-controlled trial with an allocation ratio of 1:1 conducted in children with severe pneumonia to evaluate the efficacy of daily zinc as an adjunct treatment in preventing 'treatment failure' (presence of any sign of severe pneumonia) on day-5 and day-10 and in reducing the time to resolution of signs of severe pneumonia. Six hundred and four children 2-59 months of age presenting with severe pneumonia at six urban and rural health care facilities in The Gambia were individually randomised to receive placebo (n = 301) or zinc (n = 303) for seven days. To determine if the study children were zinc deficient, supplementation was continued in a randomly selected subgroup of 121 children from each arm for six months post-enrolment, and height-gain, nutritional status, plasma zinc concentrations, and immune competence were compared. Percentage of treatment failure were similar in placebo and zinc arms both on day 5 (14.0% vs 14.1%) and day 10 (5.2% vs 5.9%). The time to recovery from lower chest wall indrawing and sternal retraction was longer in the placebo compared to zinc arm (24.4 vs 23.0 hours; P  = 0.011 and 18.7 vs 11.0 hours; P  = 0.006 respectively). The time to resolution for all respiratory symptoms of severity was not significantly different between placebo and zinc arms (42.3 vs 30.9 hours respectively; P  = 0.242). In the six months follow-up sub-group, there was no significant difference in height gain, height-for-age and weight-for-height Z-scores, mid upper arm circumference, plasma zinc concentrations, and anergy at six months post-enrolment. In this population, zinc given as an adjunct treatment for severe pneumonia showed no benefit in treatment

Ileus in children presenting with diarrhea and severe acute malnutrition: A chart review.

Directory of Open Access Journals (Sweden)

Mohammod Jobayer Chisti

2017-05-01

Full Text Available Severely malnourished children aged under five years requiring hospital admission for diarrheal illness frequently develop ileus during hospitalization with often fatal outcomes. However, there is no data on risk factors and outcome of ileus in such children. We intended to evaluate predictive factors for ileus during hospitalization and their outcomes.This was a retrospective chart review that enrolled severely malnourished children under five years old with diarrhea, admitted to the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh between April 2011 and August 2012. We used electronic database to have our chart abstraction from previously admitted children in the hospital. The clinical and laboratory characteristics of children with (cases = 45, and without ileus (controls = 261 were compared. Cases were first identified by observation of abnormal bowel sounds on physical examination and confirmed with abdominal radiographs. For this comparison, Chi-square test was used to measure the difference in proportion, Student's t-test to calculate the difference in mean for normally distributed data and Mann-Whitney test for data that were not normally distributed. Finally, in identifying independent risk factors for ileus, logistical regression analysis was performed. Ileus was defined if a child developed abdominal distension and had hyperactive or sluggish or absent bowel sound and a radiologic evidence of abdominal gas-fluid level during hospitalization. Logistic regression analysis adjusting for potential confounders revealed that the independent risk factors for admission for ileus were reluctance to feed (odds ratio [OR] = 3.22, 95% confidence interval [CI] = 1.24-8.39, p = 0.02, septic shock (OR = 3.62, 95% CI = 1.247-8.95, p<0.01, and hypokalemia (OR = 1.99, 95% CI = 1.03-3.86, p = 0.04. Mortality was significantly higher in cases compared to controls (22% vs. 8%, p<0.01 in univariate analysis; however

The Curriculum for Children with Severe and Profound Learning Difficulties at Stephen Hawking School

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Rayner, Matthew

2011-01-01

The increasing number of children with profound and multiple learning difficulties means that many schools for children with severe learning difficulties are having to review the curriculum that they offer. In addition, these schools are continuing to question whether a subject-based approach, in line with the National Curriculum, is the most…

Genetic Predisposition Increases the Tic Severity, Rate of Comorbidities, and Psychosocial and Educational Difficulties in Children With Tourette Syndrome

DEFF Research Database (Denmark)

Eysturoy, Absalon Niclas; Skov, Liselotte; Debes, Nanette Mol

2015-01-01

This study aimed to examine whether there are differences in tic severity, comorbidities, and psychosocial and educational consequences in children with Tourette syndrome and genetic predisposition to Tourette syndrome compared with children with Tourette syndrome without genetic predisposition...... to Tourette syndrome. A total of 314 children diagnosed with Tourette syndrome participated in this study. Validated diagnostic tools were used to assess tic severity, comorbidities, and cognitive performance. A structured interview was used to evaluate psychosocial and educational consequences related...... to Tourette syndrome. The children with Tourette syndrome and genetic predisposition present with statistically significant differences in terms of severity of tics, comorbidities, and a range of psychosocial and educational factors compared with the children with Tourette syndrome without genetic...

Solar-terrestrial disturbances of June-September 1982, 4

International Nuclear Information System (INIS)

Minakoshi, Hisamitsu; Sinno, Kenji; Nishimuta, Ichizo

1986-01-01

The ionospheric disturbances observed in and around Japan in association with the severe geomagnetic storm occurring on July 14 - 16, 1982 were investigated by using ionospheric total electron content (N t ) data obtained by the ETS-II beacon experiment and F region data obtained by the soundings at the latitude chain of the ionospheric stations situated nearly along 135 deg E. The most remarkable storm effect was of the negative disturbance, which is common at mid-latitudes in summer. The negative disturbance comprises the decreases in N t and peak electron density (N m ) and a marked increase in slab thickness. In addition, the following interesting events were observed during this storm: (1) sharp depressions in N t and N m occurred almost simultaneously in the regions from mid-latitudes to the equatorial latitude within a few hours after the storm sudden commencement (SSC), (2) some positive disturbances in the F region appeared during the recovery phase of the storm, and were prominent during the night at mid-latitudes and during the daytime at low latitudes, and (3) wavelike fluctuations of N t , which indicate the existence of a mediumscale traveling ionospheric disturbance (TID) with a nearly north to south direction of propagation, were observed during the main phase. (author)

Poor Executive Functions among Children with Moderate-into-Severe Asthma: Evidence from WCST Performance.

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Taha, Haitham

2017-01-01

Executive functions (EFs) measures of 27 asthmatic children, with general learning difficulties, were tested by using the Wisconsin card sorting test (WCST), and were compared to the performances of 30 non-asthmatic children with general learning difficulties. The results revealed that the asthmatic group has poor performance through all the WCST psychometric parameters and especially the perseverative errors one. The results were discussed in light of the postulation that poor EFs could be associated with the learning difficulties of asthmatic children. Neurophysiological framework has been suggested to explain the etiology of poor EFs among children with moderate into severe asthma.

Efficacy of Atomoxetine in Children with Severe Autistic Disorders and Symptoms of ADHD: An Open-Label Study

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Charnsil, Chawanun

2011-01-01

Objective: This study aims to examine the efficacy of atomoxetine in treating symptoms of attention deficit hyperactivity disorder (ADHD) in children with severe autistic disorder. Method: Children with severe autistic disorder who had symptoms of ADHD were given atomoxetine for 10 weeks. The efficacy of atomoxetine was evaluated by using the…

Serum phosphate and magnesium in children recovering from severe acute undernutrition in Ethiopia

DEFF Research Database (Denmark)

Hother, Anne-Louise; Girma, Tsinuel; Rytter, Maren Johanne Heilskov

2016-01-01

BACKGROUND: Children with severe acute malnutrition (SAM) have increased requirements for phosphorus and magnesium during recovery. If requirements are not met, the children may develop refeeding hypophosphatemia and hypomagnesemia. However, little is known about the effect of current therapeutic...... diets (F-75 and F-100) on serum phosphate (S-phosphate) and magnesium (S-magnesium) in children with SAM. METHODS: Prospective observational study, with measurements of S-phosphate and S-magnesium at admission, prior to rehabilitation phase and at discharge in children aged 6-59 months admitted with SAM...... to Jimma Hospital, Ethiopia. Due to shortage of F-75, 25 (35 %) children were stabilized with diluted F-100 (75 kcal/100 ml). RESULTS: Of 72 children enrolled, the mean age was 32 ± 14 months, and edema was present in 50 (69 %). At admission, mean S-phosphate was 0.92 ± 0.34 mmol/L, which was low compared...

Factors associated with low self-esteem in children with overweight.

Science.gov (United States)

Danielsen, Yngvild Sørebø; Stormark, Kjell Morten; Nordhus, Inger Hilde; Mæhle, Magne; Sand, Liv; Ekornås, Belinda; Pallesen, Ståle

2012-01-01

Low self-esteem is one of the main psychosocial factors related to childhood overweight. Yet not all overweight children are affected. Little is known about what characterises the group of overweight children with the lowest self-esteem. Our aim was to identify factors related to low domain-specific self-esteem in children with overweight/obesity. Children (aged 10-13; N = 5,185) and parents from a large population-based sample completed the Eating Disturbance Scale, the Self-Perception Profile for Children, and questions about bullying and socio-economic status (SES). Parents reported the child's weight and height. 545 children with overweight/obesity were identified in the overall sample and selected for the current analyses. Self-esteem scores from this group were compared to scores from children with normal weight. Factors examined in relation to self-esteem in children with overweight/obesity were: age, gender, SES, disturbed eating, bullying, parents' evaluation of weight status and degree of overweight. Children with overweight scored significantly lower than normal-weight children on all self-esteem domains. Athletic competence and physical appearance were most impaired. Disturbed eating and bullying were related to low physical appearance as well as scholastic, social and athletic self-esteem. Being female, a pre-teen, having a higher BMI and being evaluated as overweight by parents were associated with lower satisfaction with physical appearance. Disturbed eating and bullying are significantly related to low self-esteem in the overweight group. Copyright © 2012 S. Karger GmbH, Freiburg.

Severe bleeding events in adults and children with primary immune thrombocytopenia: a systematic review.

Science.gov (United States)

Neunert, C; Noroozi, N; Norman, G; Buchanan, G R; Goy, J; Nazi, I; Kelton, J G; Arnold, D M

2015-03-01

The burden of severe bleeding in adults and children with immune thrombocytopenia (ITP) has not been established. To describe the frequency and severity of bleeding events in patients with ITP, and the methods used to measure bleeding in ITP studies. We performed a systematic review of all prospective ITP studies that enrolled 20 or more patients. Two reviewers searched Medline, Embase, CINAHL and the Cochrane registry up to May 2014. Overall weighted proportions were estimated using a random effects model. Measurement properties of bleeding assessment tools were evaluated. We identified 118 studies that reported bleeding (n = 10 908 patients). Weighted proportions for intracerebral hemorrhage (ICH) were 1.4% for adults (95% confidence interval [CI], 0.9-2.1%) and 0.4% for children (95% CI, 0.2-0.7%; P bleeding was 9.6% for adults (95% CI, 4.1-17.1%) and 20.2% for children (95% CI, 10.0-32.9%; P bleeding were highly variable in primary studies. Two bleeding assessment tools (Buchanan 2002 for children; Page 2007 for adults) demonstrated adequate inter-rater reliability and validity in independent assessments. ICH was more common in adults and tended to occur during chronic ITP; other severe bleeds were more common in children and occurred at all stages of disease. Reporting of non-ICH bleeding was variable across studies. Further attention to ITP-specific bleeding measurement in clinical trials is needed to improve standardization of this important outcome for patients. © 2014 International Society on Thrombosis and Haemostasis.

Sleep disturbances and severe stress as glial activators: key targets for treating central sensitization in chronic pain patients?

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Nijs, Jo; Loggia, Marco L; Polli, Andrea; Moens, Maarten; Huysmans, Eva; Goudman, Lisa; Meeus, Mira; Vanderweeën, Luc; Ickmans, Kelly; Clauw, Daniel

2017-08-01

The mechanism of sensitization of the central nervous system partly explains the chronic pain experience in many patients, but the etiological mechanisms of this central nervous system dysfunction are poorly understood. Recently, an increasing number of studies suggest that aberrant glial activation takes part in the establishment and/or maintenance of central sensitization. Areas covered: This review focused on preclinical work and mostly on the neurobiochemistry studied in animals, with limited human studies available. Glial overactivation results in a low-grade neuroinflammatory state, characterized by high levels of BDNF, IL-1β, TNF-α, which in turn increases the excitability of the central nervous system neurons through mechanisms like long-term potentiation and increased synaptic efficiency. Aberrant glial activity in chronic pain might have been triggered by severe stress exposure, and/or sleeping disturbances, each of which are established initiating factors for chronic pain development. Expert opinion: Potential treatment avenues include several pharmacological options for diminishing glial activity, as well as conservative interventions like sleep management, stress management and exercise therapy. Pharmacological options include propentofylline, minocycline, β -adrenergic receptor antagonists, and cannabidiol. Before translating these findings from basic science to clinical settings, more human studies exploring the outlined mechanisms in chronic pain patients are needed.

Skeletal Maturation and Mineralisation of Children with Moderate to Severe Spastic Quadriplegia

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Sitaraman, Sadasivan

2016-01-01

Introduction Diminished bone mineral density and delayed skeletal maturation are common in children with spastic quadriplegia. Aim The purpose of our study was to evaluate the Bone Mineral Density (BMD) of children with moderate to severe spastic quadriplegia and its relationship with other variables like nutrition and growth. Materials and Methods This was a hospital based, cross- sectional, case-control study. Forty-two (28 males, 14 females) children with spastic quadriplegia and 42 (24 males, 18 females) healthy children were included in the study. BMD of cases and control were measured by Dual Energy X-ray Absorptiometry (DEXA). Radiographs of left hand and wrist of cases and controls were taken and bone age was determined. Results BMD values of upper extremity, lower extremity, thoraco-lumbar spine and pelvis in cases were lower than those of controls (p quadriplegia and nutritional status is an important contributing factor. PMID:27504366

Recent developments in the treatment of anxiety disorders in children and adolescents.

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Creswell, Cathy; Waite, Polly

2016-08-01

Anxiety disorders are among the most common emotional difficulties experienced by children and young people. They cause significant disturbance to the lives of young people and their families and present a risk for lifelong psychological disturbance. Effective psychological (ie, cognitive-behaviour therapy (CBT)) and pharmacological interventions (eg, selective serotonin reuptake inhibitors (SSRIs)) have been established. However, the risk of adverse effects and unknown long-term effects of using SSRIs has led to recommendations that CBT is delivered as a first-line intervention. Recent innovations have included the development of low-intensity CBT programmes, delivered briefly via parents or online. These hold promise to increase access to psychological therapies for children and young people with these common and severe difficulties. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Remote Sensing Assessment of Forest Disturbance across Complex Mountainous Terrain: The Pattern and Severity of Impacts of Tropical Cyclone Yasi on Australian Rainforests

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Robinson I. Negrón-Juárez

2014-06-01

Full Text Available Topography affects the patterns of forest disturbance produced by tropical cyclones. It determines the degree of exposure of a surface and can alter wind characteristics. Whether multispectral remote sensing data can sense the effect of topography on disturbance is a question that deserves attention given the multi-scale spatial coverage of these data and the projected increase in intensity of the strongest cyclones. Here, multispectral satellite data, topographic maps and cyclone surface wind data were used to study the patterns of disturbance in an Australian rainforest with complex mountainous terrain produced by tropical cyclone Yasi (2011. The cyclone surface wind data (H*wind was produced by the Hurricane Research Division of the National Oceanic and Atmospheric Administration (HRD/NOAA, and this was the first time that this data was produced for a cyclone outside of United States territory. A disturbance map was obtained by applying spectral mixture analyses on satellite data and presented a significant correlation with field-measured tree mortality. Our results showed that, consistent with cyclones in the southern hemisphere, multispectral data revealed that forest disturbance was higher on the left side of the cyclone track. The highest level of forest disturbance occurred in forests along the path of the cyclone track (±30°. Levels of forest disturbance decreased with decreasing slope and with an aspect facing off the track of the cyclone or away from the dominant surface winds. An increase in disturbance with surface elevation was also observed. However, areas affected by the same wind intensity presented increased levels of disturbance with increasing elevation suggesting that complex terrain interactions act to speed up wind at higher elevations. Yasi produced an important offset to Australia’s forest carbon sink in 2010. We concluded that multispectral data was sensitive to the main effects of complex topography on disturbance

Prevalence and outcome of severe malnutrition in children less than five-year-old in Omdurman Paediatric Hospital, Sudan.

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Kanan, Shaza O H; Swar, Mohammed Osman

2016-01-01

This is a retrospective observational hospital-based study aimed to determine the prevalence and outcome of severe acute malnutrition in children less than five years admitted to Omdurman Paediatric Hospital during the period January 2014 to December 2014. Data was collected from patient's hospital records during the study period. Ethical approval and permission to access patients' record were obtained. A total of 593 children with severe malnutrition were identified; 305 of cases were male (51.4%) with a male: female ratio of 1:0.9. The mean age these children was 22.3 months. Children 36-59 months were least affected. 35.4% were classified as low socioeconomic class, 22.9% classified as an average class and there were no sufficient data to classify the remaining. The overall prevalence of severe malnutrition was 6.5%, and the general mortality rate was 2.4% while mortality rate among children with severe malnutrition was 9.3%. Among the 593 admitted children with malnutrition, 407 (68.6%) had marasmus, 141 (23.8%) had kwashiorkor and 45 (7.6%) had marasmic-kwashiorkor. The highest prevalence and mortality rate occurred in September. The most common clinical presentations were gastroenteritis, malaria, urinary tract infections, giardiasis, tuberculosis and AIDS. Only 10.8% of the admitted children were exclusively breast fed for the first three months. 33% were fully vaccinated. Overall 75.7% improved and discharged, 15% discharged against medical advice and 9.3% died. We concluded that prevalence and mortality among children with acute severe malnutrition at Omdurman paediatrics hospital were high, and the current management strategies require review to identify the causes. We recommended adopting policies to manage malnutrition in the community and hospitals.

[Circadian blood pressure variation under several pathophysiological conditions including secondary hypertension].

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Imai, Yutaka; Hosaka, Miki; Satoh, Michihiro

2014-08-01

Abnormality of circadian blood pressure (BP) variation, i.e. non-dipper, riser, nocturnal hypertension etc, is brought by several pathophysiological conditions especially by secondary hypertension. These pathophysiological conditions are classified into several categories, i.e. disturbance of autonomic nervous system, metabolic disorder, endocrine disorder, disorder of Na and water excretion (e.g. sodium sensitivity), severe target organ damage and ischemia, cardiovascular complications and drug induced hypertension. Each pathophysiological condition which brings disturbance of circadian BP variation is included in several categories, e.g. diabetes mellitus is included in metabolic disorder, autonomic imbalance, sodium sensitivity and endocrine disorder. However, it seems that unified principle of the genesis of disturbance of circadian BP variation in many pathophysiological conditions is autonomic imbalance. Thus, it is concluded that disturbance of circadian BP variation is not purposive biological behavior but the result of autonomic imbalance which looks as if compensatory reaction such as exaggerated Na-water excretion during night in patient with Na-water retention who reveals disturbed circadian BP variation.

Infections in Children Admitted with Complicated Severe Acute Malnutrition in Niger

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Page, Anne-Laure; de Rekeneire, Nathalie; Sayadi, Sani; Aberrane, Said; Janssens, Ann-Carole; Rieux, Claire; Djibo, Ali; Manuguerra, Jean-Claude; Ducou-le-Pointe, Hubert; Grais, Rebecca F.; Schaefer, Myrto; Guerin, Philippe J.; Baron, Emmanuel

2013-01-01

Background Although malnutrition affects thousands of children throughout the Sahel each year and predisposes them to infections, there is little data on the etiology of infections in these populations. We present a clinical and biological characterization of infections in hospitalized children with complicated severe acute malnutrition (SAM) in Maradi, Niger. Methods Children with complicated SAM hospitalized in the intensive care unit of a therapeutic feeding center, with no antibiotics in the previous 7 days, were included. A clinical examination, blood, urine and stool cultures, and chest radiography were performed systematically on admission. Results Among the 311 children included in the study, gastroenteritis was the most frequent clinical diagnosis on admission, followed by respiratory tract infections and malaria. Blood or urine culture was positive in 17% and 16% of cases, respectively, and 36% had abnormal chest radiography. Enterobacteria were sensitive to most antibiotics, except amoxicillin and cotrimoxazole. Twenty-nine (9%) children died, most frequently from sepsis. Clinical signs were poor indicators of infection and initial diagnoses correlated poorly with biologically or radiography-confirmed diagnoses. Conclusions These data confirm the high level of infections and poor correlation with clinical signs in children with complicated SAM, and provide antibiotic resistance profiles from an area with limited microbiological data. These results contribute unique data to the ongoing debate on the use and choice of broad-spectrum antibiotics as first-line treatment in children with complicated SAM and reinforce the call for an update of international guidelines on management of complicated SAM based on more recent data. PMID:23874731

Developmental and behavioural problems in children with severe acute malnutrition in Malawi: A cross–sectional study

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van den Heuvel, Meta; Voskuijl, Wieger; Chidzalo, Kate; Kerac, Marko; Reijneveld, Sijmen A; Bandsma, Robert; Gladstone, Melissa

2017-01-01

Background Early childhood development provides an important foundation for the development of human capital. Although there is a clear relation between stunting and child development outcomes, less information is available about the developmental and behavioural outcomes of children with severe acute malnutrition (SAM). Particularly an important research gap exists in Sub–Saharan Africa where there is a high prevalence of SAM and a high rate of co–occurring HIV (human immune deficiency virus) infection. Our first objective was to assess the prevalence and severity of developmental and behavioural disorders on a cohort of children admitted to an inpatient nutritional rehabilitation centre in Malawi. Our second objective was to compare the developmental and behavioural profiles of children with the two main phenotypes of SAM: kwashiorkor and marasmus. Methods This was a cross–sectional observational study including all children hospitalized with complicated SAM in Blantyre, Malawi over an 8–month period from February to October 2015. At discharge, children were assessed with the well-validated Malawi Developmental Assessment Tool (MDAT) for gross motor, fine motor, language and social development. In children ≥24 months, emotional and behavioural problems were measured using the Strengths and Difficulties Questionnaire (SDQ). Results 150 children (55% boys) with SAM were recruited; mean age of 27.2 months (standard deviation 17.9), 27 children (18%) had pre–existing neurodisabilities (ND) and 34 (23%) had a co–occurring human immune deficiency virus (HIV) infection. All children with SAM experienced profound delays in the gross and fine motor, language and social domains. Linear regression analysis demonstrated that children with kwashiorkor scored 0.75 standard deviations lower (95% confidence interval –1.43 to –0.07) on language MDAT domain than children with marasmus when adjusted for covariates. The prosocial behaviour score of the SDQ was low

Engaging Preschool Children with Severe and Multiple Disabilities Using Books and iPad Apps

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Kemp, Coral; Stephenson, Jennifer; Cooper, Megan; Hodge, Kerry

2016-01-01

A single subject multiple treatment design was used to compare the engagement of 3 preschool children with severe and multiple disabilities, using 2 different stimuli: picture books and iPad apps matched for theme and content. Two of the 3 children had diagnoses of autism spectrum disorder in addition to their other disabilities. Sessions for each…

An exploration of mortality risk factors in non-severe pneumonia in children using clinical data from Kenya.

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Tuti, Timothy; Agweyu, Ambrose; Mwaniki, Paul; Peek, Niels; English, Mike

2017-11-13

Childhood pneumonia is the leading infectious cause of mortality in children younger than 5 years old. Recent updates to World Health Organization pneumonia guidelines recommend outpatient care for a population of children previously classified as high risk. This revision has been challenged by policymakers in Africa, where mortality related to pneumonia is higher than in other regions and often complicated by comorbidities. This study aimed to identify factors that best discriminate inpatient mortality risk in non-severe pneumonia and explore whether these factors offer any added benefit over the current criteria used to identify children with pneumonia requiring inpatient care. We undertook a retrospective cohort study of children aged 2-59 months admitted with a clinical diagnosis of pneumonia at 14 public hospitals in Kenya between February 2014 and February 2016. Using machine learning techniques, we analysed whether clinical characteristics and common comorbidities increased the risk of inpatient mortality for non-severe pneumonia. The topmost risk factors were subjected to decision curve analysis to explore if using them as admission criteria had any net benefit above the current criteria. Out of 16,162 children admitted with pneumonia during the study period, 10,687 were eligible for subsequent analysis. Inpatient mortality within this non-severe group was 252/10,687 (2.36%). Models demonstrated moderately good performance; the partial least squares discriminant analysis model had higher sensitivity for predicting mortality in comparison to logistic regression. Elevated respiratory rate (≥70 bpm), age 2-11 months and weight-for-age Z-score (WAZ) pneumonia. Of the population studied, 70.54% met at least one of these criteria. Sensitivity analyses indicated that the overall results were not significantly affected by variations in pneumonia severity classification criteria. Children with non-severe pneumonia aged 2-11 months or with respiratory rate�

Tic Severity and Treatment in Children: The Effect of Comorbid Attention Deficit Hyperactivity Disorder and Obsessive Compulsive Behaviors.

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Pringsheim, Tamara

2017-12-01

While attention deficit hyperactivity disorder (ADHD) and obsessive compulsive disorder have been shown to have major impacts on quality of life in individuals with Tourette syndrome, there is comparatively little data on how the presence of these comorbidities influence tic severity and treatment. 114 children (mean age 10.25 years) were extensively clinically phenotyped at a single specialty clinic. While there was no difference in Yale Global Tic Severity Scale (YGTSS) scores in children with versus without ADHD, children with obsessive compulsive behaviors had significantly higher YGTSS scores (p = 0.008). There was a significant correlation between YGTSS scores and age (r = 0.344, p tics within the first two years of diagnosis (OR 3.51, p = 0.009). As tic severity does not appear to be greater in children with ADHD, this association may relate to greater overall psychosocial impairment in children with this comorbidity.

High prevalence/low severity language delay in preschool children born very preterm.

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Foster-Cohen, Susan H; Friesen, Myron D; Champion, Patricia R; Woodward, Lianne J

2010-10-01

To examine the language development at corrected age 4 years of a regionally representative cohort of children born very preterm (VPT). Of particular interest was the identification of biological and socioenvironmental risk and protective factors that influence VPT children's early language development. Data were collected as part of a prospective longitudinal study of 110 VPT (VPT: ≤ 33 weeks gestation) and 113 full-term children (full term: 37-41 weeks gestation) born in Canterbury, New Zealand from 1998 to 2000. At corrected age 4 years, all children were assessed with the preschool version of the Clinical Evaluation of Language Fundamentals. Extensive information was also collected about children's family social background, perinatal health, childrearing environment, education/intervention exposures, and neurodevelopmental progress from birth to age 4. At the age of 4 years, VPT children were characterized by poorer receptive and expressive language development than full-term children. These differences persisted after exclusion of children with neurosensory impairment as well as statistical adjustment for the effects of social risk. Within the VPT group, the key predictors of children's overall language development were family social risk at birth (p =.05), severity of white matter abnormalities on neonatal magnetic resonance imaging (p =.49), observed parent-child synchrony (p =.001), and concurrent child cognitive ability (p =.001). Together, these factors accounted for 45% of the variance in children's total Clinical Evaluation of Language Fundamentals-Preschool scores. By preschool age, children born VPT show early emerging mild to moderate language delays that are likely to affect their school success and longer-term developmental progress. Findings highlight the importance of potentially modifiable factors such as early brain injury and parenting quality in predicting the language outcomes of children born VPT.

Automated radiogrammetry is a feasible method for measuring bone quality and bone maturation in severely disabled children

NARCIS (Netherlands)

Mergler, Sandra; de Man, Stella A.; Boot, Annemieke M; Bindels-de Heus, Karen G. C. B.; Huijbers, Wim A. R.; van Rijn, Rick R.; Penning, Corine; Evenhuis, Heleen M.

Children with severe neurological impairment and intellectual disability are prone to low bone quality and fractures. We studied the feasibility of automated radiogrammetry in assessing bone quality in this specific group of children. We measured outcome of bone quality and, because these children

School Rampage Shootings and Other Youth Disturbances: Early Preventative Interventions. Psychosocial Stress Series

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Nader, Kathleen, Ed.

2012-01-01

Together, "School Rampage Shootings and Other Youth Disturbances" and its accompanying CD provide a complete toolkit for using early preventative interventions with elementary-school age children. In ten thoughtful, clearly written chapters, both new and experienced practitioners will find a wealth of research- and evidence-based…

Social interaction and self-esteem of children with cerebral palsy after treatment for severe drooling.

NARCIS (Netherlands)

Burg, J.J.W. van der; Jongerius, P.H.; Limbeek, J. van; Hulst, K. van; Rotteveel, J.J.

2006-01-01

The impact of salivary flow reduction following medication (scopolamine and botulinum neurotoxin) on social interaction and emotional development (self-esteem) was evaluated in a group of 45 children with cerebral palsy who suffered from severe drooling. The children ranged in age from 3 to 16 years

Improving estimates of numbers of children with severe acute malnutrition using cohort and survey data

DEFF Research Database (Denmark)

Isanaka, Sheila; Boundy, Ellen O neal; Grais, Rebecca F

2016-01-01

Severe acute malnutrition (SAM) is reported to affect 19 million children worldwide. However, this estimate is based on prevalence data from cross-sectional surveys and can be expected to miss some children affected by an acute condition such as SAM. The burden of acute conditions is more...

Electronic monitoring of adherence to inhaled corticosteroids: an essential tool in identifying severe asthma in children.

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Jochmann, Anja; Artusio, Luca; Jamalzadeh, Angela; Nagakumar, Prasad; Delgado-Eckert, Edgar; Saglani, Sejal; Bush, Andrew; Frey, Urs; Fleming, Louise J

2017-12-01

International guidelines recommend that severe asthma can only be diagnosed after contributory factors, including adherence, have been addressed. Accurate assessment of adherence is difficult in clinical practice. We hypothesised that electronic monitoring in children would identify nonadherence, thus delineating the small number with true severe asthma.Asthmatic children already prescribed inhaled corticosteroids were prospectively recruited and persistence of adherence assessed using electronic monitoring devices. Spirometry, airway inflammation and asthma control were measured at the start and end of the monitoring period.93 children (62 male; median age 12.4 years) were monitored for a median of 92 days. Median (range) monitored adherence was 74% (21-99%). We identified four groups: 1) good adherence during monitoring with improved control, 24% (likely previous poor adherence); 2) good adherence with poor control, 18% (severe therapy-resistant asthma); 3) poor adherence with good control, 26% (likely overtreated); and 4) poor adherence with poor control, 32%. No clinical parameter prior to monitoring distinguished these groups.Electronic monitoring is a useful tool for identifying children in whom a step up in treatment is indicated. Different approaches are needed in those who are controlled when adherent or who are nonadherent. Electronic monitoring is essential in a paediatric severe asthma clinic. Copyright ©ERS 2017.

Gaze-based assistive technology in daily activities in children with severe physical impairments-An intervention study.

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Borgestig, Maria; Sandqvist, Jan; Ahlsten, Gunnar; Falkmer, Torbjörn; Hemmingsson, Helena

2017-04-01

To establish the impact of a gaze-based assistive technology (AT) intervention on activity repertoire, autonomous use, and goal attainment in children with severe physical impairments, and to examine parents' satisfaction with the gaze-based AT and with services related to the gaze-based AT intervention. Non-experimental multiple case study with before, after, and follow-up design. Ten children with severe physical impairments without speaking ability (aged 1-15 years) participated in gaze-based AT intervention for 9-10 months, during which period the gaze-based AT was implemented in daily activities. Repertoire of computer activities increased for seven children. All children had sustained usage of gaze-based AT in daily activities at follow-up, all had attained goals, and parents' satisfaction with the AT and with services was high. The gaze-based AT intervention was effective in guiding parents and teachers to continue supporting the children to perform activities with the AT after the intervention program.

Linking soils and streams: Response of soil solution chemistry to simulated hurricane disturbance mirrors stream chemistry following a severe hurricane

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William H. McDowell; Daniel Liptzin

2014-01-01

Understanding the drivers of forest ecosystem response to major disturbance events is an important topic in forest ecology and ecosystem management. Because of the multiple elements included in most major disturbances such as hurricanes, fires, or landslides, it is often difficult to ascribe a specific driver to the observed response. This is particularly true for the...

Description of oral motoric disorders in 2-4 years old children

Directory of Open Access Journals (Sweden)

Rossa Ayu Sabilah

2016-07-01

Full Text Available Introduction: Oral motor disorders, such as speech and swallowing disorders, often occur in children. Generally parents complain that children refuse to eat hard food, drooling excess, and unable to speak clearly. Oral motor disturbance can occur due to the unavailability of maturation of oral motor structure. This study was aimed to determine the description of oral motor disturbance in children aged 2-4 years in some Integrated Health Service (Posyandu in Bandung. Methods: Descriptive research with cross sectional design. The study was conducted on 100 parents who came to six posyandu in Bandung by using questionnaires through guided interviews by researchers. Samples were taken using multistage random sampling technique. The results will be presented in tabular form and assessed using Arikunto standard criteria. Results: The results showed a low percentage in oral motor disturbances. Indicators of oral motor disturbance in children aged 2 - 4 years included in either category. As for children who have oral motor disorders exhibit various manifestations. Conclusion: The description of oral motor disorders in children aged 2 - 4 years in Posyandu in Bandung was shown by various manifestations. Based on the number of populations taken, oral motor disorders in children aged 2-4 years included into either category.

[Analysis of individualized primary prophylactic treatment of 19 cases of children with severe hemophilia A].

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Liu, G Q; Tang, L; Wu, X Y; Zhen, Y Z; Li, G; Chen, Z P; Wang, Y; Zhang, N N; Zhang, J S; Yu, G X; Wu, R H

2016-12-02

Objective: To study the current situation of primary prophylaxis in severe hemophilia A children and to explore rational regimen in order to provide evidence for the development of primary prophylaxis in China. Method: A retrospective clinical data collection and analysis was conducted for 19 severe hemophilia A children who received primary prophylaxis in Beijing Children's Hospital outpatient clinic between February 2011 and September 2015 and evaluated the regimen and efficacy. Result: (1) Primary prophylaxis regimen: the median beginning age 1.8 (range 0.5-2.9) years, the median FⅧ preparation using dosage 16.7 (8.0-23.5) U/(kg·time), the median using frequency was 1.0 (1.0-3.0) time/week. Eight cases among the patients received escalation of treatment intensity because of the poor bleeding control. (2) Efficacy: the median annual bleeding rate (ABR) was 1.9 (0-6.0) times/year, the median annual joint bleeding rate (AJBR) was 0 (0-3.3) times/year, without life threatening bleeding. All of them kept in 4th scale of Beijing Children Hospital daily activity level. The median annual factor consumption was 1 844 (840-5 040) U/kg. Conclusion: Low-dose primary prophylaxis regimen which were in low-dose /low frequencies and adjusted by bleeding frequency could decrease bleeding and joint bleeding frequency significantly, maintained the normal daily activity capacity and saved the factor consumption compared to standard regimen in severe hemophilia A children.

Video Distraction and Parental Presence for the Management of Preoperative Anxiety and Postoperative Behavioral Disturbance in Children: A Randomized Controlled Trial.

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Kim, Hyuckgoo; Jung, Sung Mee; Yu, Hwarim; Park, Sang-Jin

2015-09-01

The anxiolytic efficacy of video watching, in the absence of parents, during the mask induction of anesthesia in young children with high separation anxiety has not been clearly established. We performed this study to determine whether the effect of video distraction on alleviating preoperative anxiety is independent of parental presence and whether a combination of both interventions is more effective than either single intervention in alleviating preoperative anxiety and postoperative behavioral disturbance in preschool children. In this prospective trial, 117 children aged 2 to 7 years scheduled for elective minor surgery were randomly allocated to 1 of 3 groups, a video distraction group (group V), a parental presence group (group P), or a combination of video distraction plus parental presence group (group VP) during induction of sevoflurane anesthesia. The Modified Yale Preoperative Anxiety Scale (mYPAS) was used to assess anxiety in the preoperative holding area (baseline), immediately after entry to the operating room, and during mask induction. Compliance during induction, emergence delirium during recovery, and negative behavioral changes at 1 day and 2 weeks postoperatively were also assessed. The mYPAS scores were comparable (P = 0.558), and the number of children exhibiting baseline anxiety (an mYPAS score > 30) were not different among the 3 groups in the preoperative holding area (P = 0.824). After intervention, the changes in mYPAS scores from baseline to induction were not different among the 3 groups (P = 0.049). The proportion of children with increased mYPAS scores was higher in group P compared with group V from baseline to operating room entry (Bonferroni-adjusted 95% confidence interval for difference, 2 to 49) but similar from baseline to induction in all 3 groups. Although children in group V were more cooperative during mask induction than those in the other 2 groups (P anxiety during inhaled induction of anesthesia and postoperative