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Sample records for pediatric subjects aged

  1. Pediatric Neuromodulation Comes of Age.

    PubMed

    Croarkin, Paul E; Rotenberg, Alexander

    2016-09-01

    This special issue surveys recent work and underscores the challenges of psychiatric brain stimulation research with child and adolescent populations. The field of child and adolescent psychopharmacology is replete with examples of potential pitfalls in the assumption that "children are little adults." Arguably, younger age portends more neurobiological and descriptive heterogeneity in research pursuits and clinical practice. For existing brain stimulation modalities, there are a paucity of translational models to design studies for youth and no well-studied dosing schemes. The long-term positive and negative effects of neuromodulation interventions in youth are unknown. Inherent pragmatic and ethical limitations often present barriers for participant recruitment and will necessitate innovative approaches to study design and team efforts. These challenges are not insurmountable, and sustained efforts will advance the growing field of pediatric neuromodulation. PMID:27604043

  2. Pediatric Neuromodulation Comes of Age.

    PubMed

    Croarkin, Paul E; Rotenberg, Alexander

    2016-09-01

    This special issue surveys recent work and underscores the challenges of psychiatric brain stimulation research with child and adolescent populations. The field of child and adolescent psychopharmacology is replete with examples of potential pitfalls in the assumption that "children are little adults." Arguably, younger age portends more neurobiological and descriptive heterogeneity in research pursuits and clinical practice. For existing brain stimulation modalities, there are a paucity of translational models to design studies for youth and no well-studied dosing schemes. The long-term positive and negative effects of neuromodulation interventions in youth are unknown. Inherent pragmatic and ethical limitations often present barriers for participant recruitment and will necessitate innovative approaches to study design and team efforts. These challenges are not insurmountable, and sustained efforts will advance the growing field of pediatric neuromodulation.

  3. Population pharmacokinetic analysis of voriconazole from a pharmacokinetic study with immunocompromised Japanese pediatric subjects.

    PubMed

    Muto, Chieko; Shoji, Satoshi; Tomono, Yoshiro; Liu, Ping

    2015-01-01

    A population pharmacokinetic (PK) analysis was conducted to characterize the voriconazole pharmacokinetic profiles in immunocompromised Japanese pediatric subjects and to compare them to those in immunocompromised non-Japanese pediatric subjects. A previously developed two-compartment pharmacokinetic model with first-order absorption and mixed linear and nonlinear elimination adequately described the voriconazole intravenous and oral data from Japanese pediatric subjects with few modifications. Bayesian priors were applied to this analysis by using the NONMEM routine NWPRI, which allowed priors for the fixed-effect parameter vector and variance matrix of the random-effect parameters to be a normal distribution and an inverse Wishart distribution, respectively. Large intersubject variabilities in oral bioavailability and voriconazole exposure were observed in these pediatric subjects. The mean oral bioavailability estimated in Japanese pediatric subjects was 73% (range, 17% to 99%), which is consistent with the reported estimates of 64% in the previous model and less than what was originally estimated for healthy adults-96%. Voriconazole exposures in Japanese pediatric subjects were generally comparable to those in non-Japanese pediatric subjects receiving the same dosing regimens, given the large intersubject variability. Consistent with the previous findings, the CYP2C19 genotyping status did not have a clinically relevant effect on voriconazole exposure in Japanese pediatric subjects, although it was identified as a covariate in the model to help explain the intersubject variability in voriconazole exposure. The CYP2C19 genotyping status alone does not warrant dose adjustment of voriconazole. No other factors besides age and weight were identified to explain the PK variability of voriconazole. PMID:25801557

  4. Population pharmacokinetic analysis of voriconazole from a pharmacokinetic study with immunocompromised Japanese pediatric subjects.

    PubMed

    Muto, Chieko; Shoji, Satoshi; Tomono, Yoshiro; Liu, Ping

    2015-01-01

    A population pharmacokinetic (PK) analysis was conducted to characterize the voriconazole pharmacokinetic profiles in immunocompromised Japanese pediatric subjects and to compare them to those in immunocompromised non-Japanese pediatric subjects. A previously developed two-compartment pharmacokinetic model with first-order absorption and mixed linear and nonlinear elimination adequately described the voriconazole intravenous and oral data from Japanese pediatric subjects with few modifications. Bayesian priors were applied to this analysis by using the NONMEM routine NWPRI, which allowed priors for the fixed-effect parameter vector and variance matrix of the random-effect parameters to be a normal distribution and an inverse Wishart distribution, respectively. Large intersubject variabilities in oral bioavailability and voriconazole exposure were observed in these pediatric subjects. The mean oral bioavailability estimated in Japanese pediatric subjects was 73% (range, 17% to 99%), which is consistent with the reported estimates of 64% in the previous model and less than what was originally estimated for healthy adults-96%. Voriconazole exposures in Japanese pediatric subjects were generally comparable to those in non-Japanese pediatric subjects receiving the same dosing regimens, given the large intersubject variability. Consistent with the previous findings, the CYP2C19 genotyping status did not have a clinically relevant effect on voriconazole exposure in Japanese pediatric subjects, although it was identified as a covariate in the model to help explain the intersubject variability in voriconazole exposure. The CYP2C19 genotyping status alone does not warrant dose adjustment of voriconazole. No other factors besides age and weight were identified to explain the PK variability of voriconazole.

  5. Unbiased Average Age-Appropriate Atlases for Pediatric Studies

    PubMed Central

    Fonov, Vladimir; Evans, Alan C.; Botteron, Kelly; Almli, C. Robert; McKinstry, Robert C.; Collins, D. Louis

    2010-01-01

    Spatial normalization, registration, and segmentation techniques for Magnetic Resonance Imaging (MRI) often use a target or template volume to facilitate processing, take advantage of prior information, and define a common coordinate system for analysis. In the neuroimaging literature, the MNI305 Talairach-like coordinate system is often used as a standard template. However, when studying pediatric populations, variation from the adult brain makes the MNI305 suboptimal for processing brain images of children. Morphological changes occurring during development render the use of age-appropriate templates desirable to reduce potential errors and minimize bias during processing of pediatric data. This paper presents the methods used to create unbiased, age-appropriate MRI atlas templates for pediatric studies that represent the average anatomy for the age range of 4.5–18.5 years, while maintaining a high level of anatomical detail and contrast. The creation of anatomical T1-weighted, T2-weighted, and proton density-weighted templates for specific developmentally important age-ranges, used data derived from the largest epidemiological, representative (healthy and normal) sample of the U.S. population, where each subject was carefully screened for medical and psychiatric factors and characterized using established neuropsychological and behavioral assessments. . Use of these age-specific templates was evaluated by computing average tissue maps for gray matter, white matter, and cerebrospinal fluid for each specific age range, and by conducting an exemplar voxel-wise deformation-based morphometry study using 66 young (4.5–6.9 years) participants to demonstrate the benefits of using the age-appropriate templates. The public availability of these atlases/templates will facilitate analysis of pediatric MRI data and enable comparison of results between studies in a common standardized space specific to pediatric research. PMID:20656036

  6. Collagenous gastritis in the pediatric age.

    PubMed

    Rosell-Camps, Antonio; Riera-Llodrá, Joana María; Colom-Segui, Marina; Zibetti, Sara; Amengual-Antich, Isabel

    2015-05-01

    Collagenous gastritis (CG) is an uncommon condition known in the pediatric age. It is characterized by the presence of subepithelial collagen bands (> 10 microm) associated with lymphoplasmacytic infiltration of the stomach's lamina propria. Symptoms manifested by patients with CG may be common with many other disorders. It typically manifests with epigastralgia, vomiting, and iron deficiency during pre-adolescence. This condition's pathophysiology remains unclear. In contrast to adults, where association with collagenous colitis and other autoimmune conditions is more common, pediatric involvement is usually confined to the stomach. Drugs of choice include proton pump inhibitors and corticoids. A case is reported of a 12-year-old girl with abdominal pain and ferritin deficiency who was diagnosed with CG based on gastric biopsy and experienced a favorable outcome. PMID:25952808

  7. Age and Gender Correlates of Pulling in Pediatric Trichotillomania

    ERIC Educational Resources Information Center

    Panza, Kaitlyn E.; Pittenger, Christopher; Bloch, Michael H.

    2013-01-01

    Objective: Our goals were to examine clinical characteristics and age and gender correlates in pediatric trichotillomania. Method: A total of 62 children (8-17 years of age) were recruited for a pediatric trichotillomania treatment trial and characterized using structured rating scales of symptoms of hairpulling and common comorbid conditions. We…

  8. Safety and Efficacy Study of Romiplostim to Treat ITP in Pediatric Subjects

    ClinicalTrials.gov

    2016-01-13

    Idiopathic Thrombocytopenic Purpura; Thrombocytopenia; Thrombocytopenia in Pediatric Subjects With Immune (Idiopathic) Thrombocytopenic Purpura (ITP); Thrombocytopenia in Subjects With Immune (Idiopathic) Thrombocytopenic Purpura (ITP); Thrombocytopenic Purpura; Immune Thrombocytopenia

  9. Safety and Efficacy Study of Romiplostim (AMG 531) to Treat ITP in Pediatric Subjects

    ClinicalTrials.gov

    2014-07-18

    Idiopathic Thrombocytopenic Purpura; Thrombocytopenia in Pediatric Subjects With Immune (Idiopathic) Thrombocytopenic Purpura (ITP); Thrombocytopenia in Subjects With Immune (Idiopathic) Thrombocytopenic Purpura (ITP)

  10. Age and disability biases in pediatric resuscitation among future physicians.

    PubMed

    Zhong, Rocksheng; Knobe, Joshua; Feigenson, Neal; Mercurio, Mark R

    2011-11-01

    This study examined whether biases concerning age and/or disability status influenced resuscitation decisions. Medical students were randomly chosen to read 1 of 4 vignettes, organized in a 2 (age: infant vs school-age) × 2 (disability: preexisting vs no preexisting) between-subjects design. The vignettes described a pediatric patient experiencing an acute episode who required resuscitation. Following resuscitation, patients with existing disability would continue to have disability, whereas those without would develop disability. Participants indicated whether they would resuscitate, given a 10% chance of success. There was a significant main effect of disability: Medical students displayed a preference for resuscitating previously disabled children compared with previously healthy children when prognosis was held constant, F(1, 121) = 4.89, p = .03. This differential treatment of the two groups cannot easily be morally justified and poses a quandary for educators.

  11. Idiopathic thoracic aortic aneurysm at pediatric age.

    PubMed

    Marín-Manzano, E; González-de-Olano, D; Haurie-Girelli, J; Herráiz-Sarachaga, J I; Bermúdez-Cañete, R; Tamariz-Martel, A; Cuesta-Gimeno, C; Pérez-de-León, J

    2009-03-01

    A 6-year-old-boy presented with epigastric pain and vomiting over 1 year. Chest X-ray and esophagogastric transit showed a mediastinal mass. A chest computerized tomography angiogram demonstrated a descending thoracic aortic aneurysm. Analytical determinations carried out were all negative. The aneurysm was surgically repaired using a Dacron patch. The anatomopathological study described atherosclerotic lesions with calcifications, compatible with an atherosclerotic aneurysm wall. Aneurysms are uncommon in the pediatric population. Usually, no pathogenesis can be determined, and thus, such cases are grouped as idiopathic. Direct repair with or without patch is a therapeutic alternative in pediatric aneurysms and can allow the growth of the aortic circumference.

  12. Protein and calorie intakes in adult and pediatric subjects with urea cycle disorders participating in clinical trials of glycerol phenylbutyrate☆

    PubMed Central

    Hook, Debra; Diaz, George A.; Lee, Brendan; Bartley, James; Longo, Nicola; Berquist, William; Le Mons, Cynthia; Rudolph-Angelich, Ingrid; Porter, Marty; Scharschmidt, Bruce F.; Mokhtarani, Masoud

    2016-01-01

    Background Little prospectively collected data are available comparing the dietary intake of urea cycle disorder (UCD) patients to UCD treatment guidelines or to healthy individuals. Objective To examine the protein and calorie intakes of UCD subjects who participated in clinical trials of glycerol phenylbutyrate (GPB) and compare these data to published UCD dietary guidelines and nutritional surveys. Design Dietary data were recorded for 45 adult and 49 pediatric UCD subjects in metabolic control during participation in clinical trials of GPB. Protein and calorie intakes were compared to UCD treatment guidelines, average nutrient intakes of a healthy US population based on the National Health and Nutrition Examination Survey (NHANES) and Recommended Daily Allowances (RDA). Results In adults, mean protein intake was higher than UCD recommendations but lower than RDA and NHANES values, while calorie intake was lower than UCD recommendations, RDA and NHANES. In pediatric subjects, prescribed protein intake was higher than UCD guidelines, similar to RDA, and lower than NHANES data for all age groups, while calorie intake was at the lower end of the recommended UCD range and close to RDA and NHANES data. In pediatric subjects height, weight, and body mass index (BMI) Z-scores were within normal range (− 2 to 2). Conclusions Pediatric patients treated with phenylbutyrate derivatives exhibited normal height and weight. Protein and calorie intakes in adult and pediatric UCD subjects differed from UCD dietary guidelines, suggesting that these guidelines may need to be reconsidered. PMID:27014577

  13. Narcolepsy in pediatric age - Experience of a tertiary pediatric hospital.

    PubMed

    Dias Costa, Filipa; Barreto, Maria Inês; Clemente, Vanda; Vasconcelos, Mónica; Estêvão, Maria Helena; Madureira, Núria

    2014-03-01

    Narcolepsy, a chronic disorder of the sleep-wake cycle of multifactorial etiology, is characterized by excessive daytime sleepiness, often associated with cataplexy, hypnagogic/hypnopompic hallucinations and sleep paralysis. Both early clinical suspicion and therapeutic approach are essential for promotion of cognitive development and social integration of these children. The authors present a descriptive retrospective study of a series of eight children in whom symptoms first started between 6.8 and 10.5 years of age. Diagnostic delay ranged from 4 months to 2 years. One child had H1N1 flu vaccination eight months before the clinical onset. The first multiple sleep latency test was positive in 6 of 8 cases. All cases were treated with methylphenidate, and venlafaxine was associated in 4 of them. In one case the initial therapy was exclusively behavioral. In all cases, symptomatic improvement, better school performance and social integration were achieved after therapeutic adjustment. PMID:26483902

  14. Subjective Age in Early Adolescence: Relationships with Chronological Age, Pubertal Timing, Desired Age, and Problem Behaviors

    ERIC Educational Resources Information Center

    Hubley, Anita M.; Arim, Rubab G.

    2012-01-01

    Subjective age generally refers to the age that one feels. In a cross-sectional questionnaire study of 245 adolescents ages 10-14 years, we examined (a) whether, and when, a cross-over in subjective age occurs, (b) differences in subjective age among pubertal timing groups, (c) correlations between subjective age and each of desired age and five…

  15. An evaluation of the safety and efficacy of bimatoprost for eyelash growth in pediatric subjects

    PubMed Central

    Borchert, Mark; Bruce, Suzanne; Wirta, David; Yoelin, Steven G; Lee, Sungwook; Mao, Cheri; VanDenburgh, Amanda

    2016-01-01

    Purpose Evaluate the safety and effectiveness of bimatoprost 0.03% for treatment of eyelash hypotrichosis in a pediatric population. Patients and methods This multicenter, randomized, double-masked, parallel-group study was conducted at seven sites in the US and Brazil. Subjects with eyelash hypotrichosis caused by chemotherapy or alopecia areata (aged 5–17 years) or healthy adolescents aged 15–17 years were enrolled (N=71). Subjects applied bimatoprost 0.03% or vehicle to upper eyelid margins once nightly for 4 months and were followed for 1 month post-treatment. Eyelash prominence was assessed using the validated 4-grade Global Eyelash Assessment scale with photonumeric guide. Changes in eyelash length, thickness, and darkness were measured by digital image analysis. Safety was assessed by adverse events and ophthalmic observations. Results Eyelash prominence improved in a significantly greater proportion of subjects treated with bimatoprost compared with vehicle at month 4 (70.8% versus 26.1%; P<0.001). This benefit was sustained at month 5 post-treatment assessment. Digital image analysis measures were significantly improved with bimatoprost. Significant treatment benefits with bimatoprost versus vehicle were evident among the healthy adolescents but not in the postchemotherapy or alopecia areata subgroups. The safety profile of bimatoprost was consistent with previous studies in adults. Conclusion Bimatoprost was safe and well tolerated in pediatric subjects with eyelash hypotrichosis. In this study with limited sample size, subgroup analyses showed that treatment was effective in healthy adolescents with no concurrent contributing medical condition, but not in those with eyelash hypotrichosis due to chemotherapy or alopecia areata. PMID:27022239

  16. Automated tissue classification of pediatric brains from magnetic resonance images using age-specific atlases

    NASA Astrophysics Data System (ADS)

    Metzger, Andrew; Benavides, Amanda; Nopoulos, Peg; Magnotta, Vincent

    2016-03-01

    The goal of this project was to develop two age appropriate atlases (neonatal and one year old) that account for the rapid growth and maturational changes that occur during early development. Tissue maps from this age group were initially created by manually correcting the resulting tissue maps after applying an expectation maximization (EM) algorithm and an adult atlas to pediatric subjects. The EM algorithm classified each voxel into one of ten possible tissue types including several subcortical structures. This was followed by a novel level set segmentation designed to improve differentiation between distal cortical gray matter and white matter. To minimize the req uired manual corrections, the adult atlas was registered to the pediatric scans using high -dimensional, symmetric image normalization (SyN) registration. The subject images were then mapped to an age specific atlas space, again using SyN registration, and the resulting transformation applied to the manually corrected tissue maps. The individual maps were averaged in the age specific atlas space and blurred to generate the age appropriate anatomical priors. The resulting anatomical priors were then used by the EM algorithm to re-segment the initial training set as well as an independent testing set. The results from the adult and age-specific anatomical priors were compared to the manually corrected results. The age appropriate atlas provided superior results as compared to the adult atlas. The image analysis pipeline used in this work was built using the open source software package BRAINSTools.

  17. Appendicitis in the Pediatric Age Group

    PubMed Central

    Rosser, Samuel B.; Nazem, Ahmad

    1988-01-01

    A retrospective analysis of 35 patients aged 2 to 20 years who were seen at the District of Columbia General Hospital and Howard University Hospital over a three-year period (1984 to 1986) was performed. All patients were operated on with a preoperative diagnosis of acute appendicitis. A normal appendix was found in 17 percent of patients, of which the majority was adolescent girls. Of those patients with acute appendicitis, 41 percent had perforated appendices, and one half of these were judged to be complicated. At diagnosis or at reoperation, one half of the patients were maintained on single-antibiotic therapy, the other half were maintained on triple-antibiotic therapy. The average hospital stay was 26.6 days, with no significant difference between those patients on single- or triple-antibiotic coverage. The average hospital stay for patients with uncomplicated appendicitis was six days. PMID:3385787

  18. Scurvy in pediatric age group – A disease often forgotten?

    PubMed Central

    Agarwal, Anil; Shaharyar, Abbas; Kumar, Anubrat; Bhat, Mohd Shafi; Mishra, Madhusudan

    2015-01-01

    Scurvy is caused by prolonged severe dietary deficiency of vitamin C. Being rare as compared to other nutritional deficiencies, it is seldom suspected and this frequently leads to delayed recognition of this disorder. Children with abnormal dietary habits, mental illness or physical disabilities are prone to develop this disease. The disease spectrum of scurvy is quite varied and includes dermatological, dental, bone and systemic manifestations. Subperiosteal hematoma, ring epiphysis, metaphyseal white line and rarefaction zone along with epiphyseal slips are common radiological findings. High index of suspicion, detailed history and bilateral limb radiographs aids physician in diagnosing this eternal masquerader. We searched Pubmed for recent literature (2009–2014) with search terms “scurvy” “vitamin C deficiency” “ascorbic acid deficiency” “scurvy and children” “scurvy and pediatric age group”. There were a total of 36 articles relevant to pediatric scurvy in children (7 reviews and 29 case reports) which were retrieved. The review briefly recapitulates the role of vitamin C, the various disease manifestations and the treatment of scurvy to create awareness of the disease which still is reported from our country, although sporadically. The recent advances related to scurvy and its management in pediatric age group are also incorporated. PMID:25983516

  19. Scurvy in pediatric age group - A disease often forgotten?

    PubMed

    Agarwal, Anil; Shaharyar, Abbas; Kumar, Anubrat; Bhat, Mohd Shafi; Mishra, Madhusudan

    2015-06-01

    Scurvy is caused by prolonged severe dietary deficiency of vitamin C. Being rare as compared to other nutritional deficiencies, it is seldom suspected and this frequently leads to delayed recognition of this disorder. Children with abnormal dietary habits, mental illness or physical disabilities are prone to develop this disease. The disease spectrum of scurvy is quite varied and includes dermatological, dental, bone and systemic manifestations. Subperiosteal hematoma, ring epiphysis, metaphyseal white line and rarefaction zone along with epiphyseal slips are common radiological findings. High index of suspicion, detailed history and bilateral limb radiographs aids physician in diagnosing this eternal masquerader. We searched Pubmed for recent literature (2009-2014) with search terms "scurvy" "vitamin C deficiency" "ascorbic acid deficiency" "scurvy and children" "scurvy and pediatric age group". There were a total of 36 articles relevant to pediatric scurvy in children (7 reviews and 29 case reports) which were retrieved. The review briefly recapitulates the role of vitamin C, the various disease manifestations and the treatment of scurvy to create awareness of the disease which still is reported from our country, although sporadically. The recent advances related to scurvy and its management in pediatric age group are also incorporated. PMID:25983516

  20. Scurvy in pediatric age group - A disease often forgotten?

    PubMed

    Agarwal, Anil; Shaharyar, Abbas; Kumar, Anubrat; Bhat, Mohd Shafi; Mishra, Madhusudan

    2015-06-01

    Scurvy is caused by prolonged severe dietary deficiency of vitamin C. Being rare as compared to other nutritional deficiencies, it is seldom suspected and this frequently leads to delayed recognition of this disorder. Children with abnormal dietary habits, mental illness or physical disabilities are prone to develop this disease. The disease spectrum of scurvy is quite varied and includes dermatological, dental, bone and systemic manifestations. Subperiosteal hematoma, ring epiphysis, metaphyseal white line and rarefaction zone along with epiphyseal slips are common radiological findings. High index of suspicion, detailed history and bilateral limb radiographs aids physician in diagnosing this eternal masquerader. We searched Pubmed for recent literature (2009-2014) with search terms "scurvy" "vitamin C deficiency" "ascorbic acid deficiency" "scurvy and children" "scurvy and pediatric age group". There were a total of 36 articles relevant to pediatric scurvy in children (7 reviews and 29 case reports) which were retrieved. The review briefly recapitulates the role of vitamin C, the various disease manifestations and the treatment of scurvy to create awareness of the disease which still is reported from our country, although sporadically. The recent advances related to scurvy and its management in pediatric age group are also incorporated.

  1. Child Development and Pediatric Sport and Recreational Injuries by Age

    PubMed Central

    Schwebel, David C.; Brezausek, Carl M.

    2014-01-01

    Context: In 2010, 8.6 million children were treated for unintentional injuries in American emergency departments. Child engagement in sports and recreation offers many health benefits but also exposure to injury risks. In this analysis, we consider possible developmental risk factors in a review of age, sex, and incidence of 39 sport and recreational injuries. Objective: To assess (1) how the incidence of 39 sport and recreational injuries changed through each year of child and adolescent development, ages 1 to 18 years, and (2) sex differences. Design Descriptive epidemiology study. Setting: Emergency department visits across the United States, as reported in the 2001–2008 National Electronic Injury Surveillance System database. Patients or Other Participants: Data represent population-wide emergency department visits in the United States. Main Outcome Measure(s) Pediatric sport- and recreation-related injuries requiring treatment in hospital emergency departments. Results: Almost 37 pediatric sport or recreational injuries are treated hourly in the United States. The incidence of sport- and recreation-related injuries peaks at widely different ages. Team-sport injuries tend to peak in the middle teen years, playground injuries peak in the early elementary ages and then drop off slowly, and bicycling injuries peak in the preteen years but are a common cause of injury throughout childhood and adolescence. Bowling injuries peaked at the earliest age (4 years), and injuries linked to camping and personal watercraft peaked at the oldest age (18 years). The 5 most common causes of sport and recreational injuries across development, in order, were basketball, football, bicycling, playgrounds, and soccer. Sex disparities were common in the incidence of pediatric sport and recreational injuries. Conclusions: Both biological and sociocultural factors likely influence the developmental aspects of pediatric sport and recreational injury risk. Biologically, changes in

  2. Incomplete RV Remodeling After Transcatheter ASD Closure in Pediatric Age.

    PubMed

    Agha, Hala M; El-Saiedi, Sonia A; Shaltout, Mohamed F; Hamza, Hala S; Nassar, Hayat H; Abdel-Aziz, Doaa M; Tantawy, Amira Esmat El

    2015-10-01

    Published data showing the intermediate effect of transcatheter device closure of atrial septal defect (ASD) in the pediatric age-group are scarce. The objective of the study was to assess the effects of transcatheter ASD closure on right and left ventricular functions by tissue Doppler imaging (TDI). The study included 37 consecutive patients diagnosed as ASD secundum by transthoracic echocardiography and TEE and referred for transcatheter closure at Cairo University Specialized Pediatric Hospital, Egypt, from October 2010 to July 2013. Thirty-seven age- and sex-matched controls were selected. TDI was obtained using the pulsed Doppler mode, interrogating the right cardiac border (the tricuspid annulus) and lateral mitral annulus, and myocardial performance index (MPI) was calculated at 1-, 3-, 6- and 12-month post-device closure. Transcatheter closure of ASD and echocardiographic examinations were successfully performed in all patients. There were no significant differences between two groups as regards the age, gender, weight or BSA. TDI showed that patients with ASD had significantly prolonged isovolumetric contraction, relaxation time and MPI compared with control group. Decreased tissue Doppler velocities of RV and LV began at one-month post-closure compared with the controls. Improvement in RVMPI and LVMPI began at 1-month post-closure, but they are still prolonged till 1 year. Reverse remodeling of right and left ventricles began 1 month after transcatheter ASD closure, but did not completely normalize even after 1 year of follow-up by tissue Doppler imaging.

  3. Bone health as a primary target in the pediatric age.

    PubMed

    Caradonna, P; Rigante, D

    2009-01-01

    Bone tissue is constantly renewed during childhood and adolescence to assure skeleton growth both in size and mineral density: up to 90 percent of peak bone mass is acquired by age 18 in girls and age 20 in boys, which makes youth the best time to "invest" in bone health. The reduction in bone mineral density leading to compromised strength and microarchitecture of bone tissue can favour the occurrence of fragility fractures in the pediatric age. Assessing the normality of bone density measurements in childhood by current methods is hampered by the lack of normative control data. The understanding of factors useful for maximizing peak bone mass, as well as the knowledge of diagnostic tools and therapeutic strategies for managing a state of reduced bone mineral density are crucial to prevent fractures throughout lifetime. PMID:19499847

  4. How Old Do You Feel? The Role of Age Discrimination and Biological Aging in Subjective Age

    PubMed Central

    Stephan, Yannick; Sutin, Angelina R.; Terracciano, Antonio

    2015-01-01

    Subjective age, or how young or old individuals experience themselves to be relative to their chronological age, is a crucial construct in gerontology. Subjective age is a significant predictor of important health outcomes, but little is known about the criteria by which individuals' subjectively evaluate their age. To identify psychosocial and biomedical factors linked to the subjective evaluation of age, this study examined whether perceived age discrimination and markers of biological aging are associated with subjective age. Participants were 4776 adults (Mage = 68) from the 2008 and 2010 waves of the Health and Retirement Study (HRS) who completed measures of subjective age, age discrimination, demographic variables, self-rated health and depression, and had physical health measures, including peak expiratory flow, grip strength, waist circumference, systolic and diastolic blood pressure. Telomere length was available for a subset of participants in the 2008 wave (n = 2214). Regression analysis indicated that perceived age discrimination, lower peak expiratory flow, lower grip strength, and higher waist circumference were associated with an older subjective age, controlling for sociodemographic factors, self-rated health, and depression. In contrast, blood pressure and telomere length were not related to subjective age. These findings are consistent with the hypothesis that how old a person feels depends in part on psychosocial and biomedical factors, including the experiences of ageism and perceptible indices of fitness and biological age. PMID:25738579

  5. Optimizing radiation dose by varying age at pediatric temporal bone CT.

    PubMed

    Noto, Daichi; Funama, Yoshinori; Kitajima, Mika; Utsunomiya, Daisuke; Oda, Seitaro; Yamashita, Yasuyuki

    2015-01-01

    We performed retrospective (first-step) and prospective (second-step) studies to evaluate the body information and noise on temporal bone computed tomography (CT) images in efforts to identify the optimized tube current yielding the greatest reduction in the radiation exposure of pediatric patients undergoing temporal bone CT studies. Our first-step study included 90 patients subjected to temporal bone CT. We recorded displayed volume CT dose index (CTDIvol), displayed dose-length product (DLP), image noise, and the patient age and sex. We then calculated the optimized tube current value with and without IR corresponding to the children's age based on the ratio of the noise on images from individuals older than 18 years. In our second-step study, we enrolled 23 pediatric patients and obtained CT scans using our optimized protocol. In both studies we applied identical analysis techniques. The diagnostic image quality was confirmed reading reports and a neuroradiologist. Our first-step study indicated that the mean image noise in children assigned to five ascending age groups from 2 to 12 years ranged from 167.59 to 211.44 Hounsfield units (HU). In the second-step study, the mean image noise in each age group was almost the same as the expected noise value and the diagnostic image quality was acceptable. The dose reduction was ranged from 57.5% to 37.5%. Optimization of the tube current-time product allows a radiation reduction without a loss in image quality in pediatric patients undergoing temporal bone CT. PMID:25679165

  6. Does Previous Abdominal Surgery Alter the Outcome of Pediatric Patients Subjected to Orthotopic Liver Transplantation?

    PubMed Central

    CUERVAS-MONS, VALENTIN; RIMOLA, ANTONI; VAN THIEL, DAVID H.; GAVALER, JUDITH S.; SCHADE, ROBERT R.; STARZL, THOMAS E.

    2010-01-01

    The medical, anesthesia, and surgical records of 89 consecutive pediatric patients who underwent an orthotopic hepatic transplantation procedure at the University of Pittsburgh from February 1981 to May 1984 were reviewed to evaluate the effect of prior abdominal surgery upon the morbidity and mortality of orthotopic liver transplantation in children. Fifty-seven children (group 1) had had prior abdominal surgery, whereas 32 (group 2) had not. The group 1 subjects were younger (p < 0.001), had better prothrombin times (p < 0.01), and better platelet counts (p < 0.02) than did those in group 2. No difference in the duration of anesthesia or intra-operative use of fresh frozen plasma or platelets was evident between the two groups. However, group 1 patients were given more red blood cells intraoperatively than were the group 2 patients (p < 0.01). The group 1 patients had more total postoperative infections (p < 0.05), which was due solely to a greater number of abdominal infections (p < 0.05), but similar total hospital and intensive care unit stays as did the group 2 patients. When those in group 1 were divided into those having a previous Kasai procedure versus those who did not, no differences between the two groups were apparent except for age. Based upon these data, we conclude that prior abdominal surgery does not affect mortality, the duration of hospital or intensive care unit stay, plasma or platelet requirements, and total anesthesia time required for orthotopic liver transplantation, but does enhance the number of red blood cell transfusions and infections, particularly abdominal infections, in children undergoing this procedure. PMID:3512356

  7. Toward an Etiologic Classification of Pediatric Social Illness: A Descriptive Epidemiology of Child Abuse and Neglect, Failure to Thrive, Accidents and Poisonings in Children Under Four Years of Age.

    ERIC Educational Resources Information Center

    Newberger, Eli H.; And Others

    This study examined the underlying common origins of pediatric social illnesses (i.e., child abuse and neglect, failure to thrive, accidents, and poisonings) in children under age 4. Subjects were 560 children admitted to the Children's Hospital Medical Center in Boston. Children admitted with pediatric social diagnoses were matched on the basis…

  8. Age-Dependent Cost-Utility of Pediatric Cochlear Implantation

    PubMed Central

    Semenov, Yevgeniy R.; Yeh, Susan T.; Seshamani, Meena; Wang, Nae-Yuh; Tobey, Emily A.; Eisenberg, Laurie S.; Quittner, Alexandra L.; Frick, Kevin D.; Niparko, John K.

    2013-01-01

    Objective Cochlear implantation has become the mainstay of treatment for children with severe-to-profound sensorineural hearing loss (SNHL). Yet, despite mounting evidence on the clinical benefits of early implantation, little data are available on the long-term societal benefits and comparative effectiveness of this procedure across various ages of implantation--a choice parameter for parents and clinicians with high prognostic value for clinical outcome. As such, the aim of the current study is to evaluate a model of the consequences of the timing of this intervention from a societal economic perspective. Average cost-utility of pediatric cochlear implantation by age at intervention will be analyzed. Design Prospective, longitudinal assessment of health-utility and educational placement outcomes in 175 children recruited from 6 US centers between November 2002 and December 2004, who had severe-to-profound SNHL onset within 1 year of age, underwent cochlear implantation before 5 years of age, and had up to 6 years of post-implant follow-up that ended in November 2008 to December 2011. Costs of care were collected retrospectively and stratified by pre-operative, operative, and post-operative expenditures. Incremental costs and benefits of implantation were compared between the three age groups and relative to a non-implantation baseline. Results Children implanted at <18 months of age gained an average of 10.7 QALYs over their projected lifetime as compared to 9.0 and 8.4 QALYs for those implanted between 18 and 36 months and at >36 months of age, respectively. Medical and surgical complication rates were not significantly different between the 3 age groups. Additionally, mean lifetime costs of implantation were similar between the 3 groups, at approximately $2,000/child/year (77.5 year life expectancy), yielding costs of $14,996, $17,849, and $19,173 per QALY for the youngest, middle, and oldest implant age groups, respectively. Full mainstream classroom

  9. Reevaluating the "subjective weathering" hypothesis: subjective aging, coping resources, and the stress process.

    PubMed

    Benson, Janel E

    2014-03-01

    The subjective weathering model contends that subjective aging is a key component of the stress process. This study reevaluates and extends this model by considering how adaptive capacities influence subjective aging and depressive symptoms in late adolescence and young adulthood. Using longitudinal data from the National Longitudinal Study of Adolescent Health (n = 7,230), I investigate how earlier stressors and coping resources contribute to older age identities (ages 18-22) and how these self-perceptions influence subsequent depressive symptoms (ages 25-29). The results show that subjective weathering alone does not lead to depressive symptoms; the critical issue is the level of psychosocial maturity that accompanies an older age identity. Those with high levels of psychosocial maturity, regardless of subjective age, were least likely to exhibit depressive symptoms. These results demonstrate that psychosocial maturity is an important adaptive resource that can shield young adults from the negative effects of "subjective weathering" or growing up fast.

  10. The responsible subject in the global age.

    PubMed

    Pulcini, Elena

    2010-09-01

    The first thesis of this article is that the concept of responsibility takes on an unprecedented meaning in the twentieth century resulting from the emergence of a new dimension of the other: to be responsible comes to mean not just to account for oneself in relation to the other, but also to take the other into account, to take care of the other-what I call responsibility towards (the other). The main reason for this change consists in the emergence of global risks and the necessity, as underlined by Hans Jonas, to be responsible for the destiny of the world and future generations. The problem, as explored in the article's second thesis, is that this implies the existence of a subject who is capable of responsibility. Jonas's insights on this point are insufficient, since he only recognizes duty as the fundament for his ethics of responsibility and thus neglects the problem of motivation. This is a particularly crucial problem today as we are witnessing the presence of a pathological subject, characterized by a split in his faculties (between doing and imagining, knowing and feeling). To underline this fact, this article makes use of Günther Anders's reflections, which provide a psycho-anthropological analysis of the subject, showing his pathologies and the necessity, from a moral perspective, to overcome his scission. Finally, this author suggests, as the article's third thesis, that this overcoming is the necessary fundament for the perception of risk, which in turn reinstates the subject's perception of his own vulnerability. Responsibility thus finds a motivation, which is neither altruistic nor duty-centred, in the awareness of our own vulnerability and the bond with the destiny of humankind as a whole.

  11. Age at Graft Loss after Pediatric Kidney Transplantation: Exploring the High-Risk Age Window

    PubMed Central

    Van Arendonk, Kyle J.; James, Nathan T.; Boyarsky, Brian J.; Garonzik-Wang, Jacqueline M.; Orandi, Babak J.; Magee, John C.; Smith, Jodi M.; Colombani, Paul M.

    2013-01-01

    Summary Background and objective The risk of graft loss after pediatric kidney transplantation increases during late adolescence and early adulthood, but the extent to which this phenomenon affects all recipients is unknown. This study explored interactions between recipient factors and this high-risk age window, searching for a recipient phenotype that may be less susceptible during this detrimental age interval. Design, setting, participants, & measurements With use of Scientific Registry of Transplant Recipients data from 1987 to 2010, risk of graft loss across recipient age was quantified using a multivariable piecewise-constant hazard rate model with time-varying coefficients for recipient risk factors. Results Among 16,266 recipients, graft loss during ages ≥17 and <24 years was greater than that for both 3–17 years (adjusted hazard ratio [aHR], 1.61; P<0.001) and ≥24 years (aHR, 1.28; P<0.001). This finding was consistent across age at transplantation, sex, race, cause of renal disease, insurance type, pretransplant dialysis history, previous transplant, peak panel-reactive antibody (PRA), and type of induction immunosuppression. The high-risk window was seen in both living-donor and deceased-donor transplant recipients, at all levels of HLA mismatch, regardless of centers’ pediatric transplant volume, and consistently over time. The relationship between graft loss risk and donor type, PRA, transplant history, insurance type, and cause of renal disease was diminished upon entry into the high-risk window. Conclusions No recipient subgroups are exempt from the dramatic increase in graft loss during late adolescence and early adulthood, a high-risk window that modifies the relationship between typical recipient risk factors and graft loss. PMID:23430210

  12. Pediatrics

    NASA Technical Reports Server (NTRS)

    Spackman, T. J.

    1978-01-01

    The utilization of the Lixiscope in pediatrics was investigated. The types of images that can presently be obtained are discussed along with the problems encountered. Speculative applications for the Lixiscope are also presented.

  13. Spectrum of heart diseases in children: an echocardiographic study of 1,666 subjects in a pediatric hospital, Yaounde, Cameroon

    PubMed Central

    Nguefack, Félicitée; Menanga, Alain P.; Ngo Um, Suzanne; Gody, Jean C.; Tatah, Sandra A.; Koki Ndombo, Paul O.

    2016-01-01

    Background Children’s health programs in Sub-Saharan Africa have always been oriented primarily to infectious diseases and malnutrition. We are witnessing in the early 21st century an epidemiological transition marked by the decline of old diseases and the identification of new diseases including heart disease. Therefore, it is necessary to describe the spectrum of these diseases in order to better prepare health workers to these new challenges. Methods We conducted a cross-sectional study focused on heart disease diagnosed by echocardiography in children seen from January 2006 to December 2014 in a pediatric hospital of Yaounde. We collected socio-demographic data and the types of heart disease from registers, patients files as well as the electronic database of echocardiographic records. Results A total of 2,235 patients underwent echocardiographic examination during the study period including 1,666 subjects with heart disease. Congenital cardiopathies were found in 1,230 (73.8%) patients and acquired abnormalities in 429 (25.8%). Seven children (0.4%) had a combination of both types. Congenital heart defects (CHD) were dominated by ventricular septal defect (VSD). Acquired heart disease was mostly rheumatic valvulopathies. Dyspnea on exertion was the most frequent presenting complaint (87.6%). Discovery of a heart murmur was the principal clinical finding on physical examination (81.4%). The median age was 9 months for congenital heart disease and 132 months for acquired heart disease. Conclusions As infectious diseases recede and the diagnostic facilities are improving, pediatric heart diseases occupy a more important position in the spectrum of pediatric diseases in our context. However, the ability to evoke the diagnosis remains unsatisfactory by the majority of health personnel and therefore needs to be improved. Apart from congenital heart diseases, the impact of acquired heart diseases, rheumatic valvulopathy being the highest ranking, is remarkable in

  14. Correlation of Salivary Alpha Amylase Level and Adenotonsillar Hypertrophy with Sleep Disordered Breathing in Pediatric Subjects

    PubMed Central

    Park, Chan-Soon; Guilleminault, Christian; Park, Hong-Jin; Cho, Jin-Hee; Lee, Heung-Ku; Son, Hye-Lim; Hwang, Se-Hwan

    2014-01-01

    Study Objectives: Obstructive sleep apnea syndrome (OSAS) and sleep disordered breathing (SDB) can affect the sympathetic adrenomedullary system (SAM). As a biomarker of SAM activity, salivary α-amylase (sAA) in pediatric subjects was evaluated whether it has any correlation with polysomnographic (PSG) parameters related to SDB. Methods: Sixty-seven children who attended our clinic during 1 year were enrolled prospectively and underwent clinical examinations and in-lab polysomnography. The sAA was measured at 2 points—at night before PSG and in the early morning after PSG Results: Subjects were divided into control (n = 26, apneahypopnea index [AHI] < 1) and OSAS (n = 41, AHI ≥ 1) groups. The OSAS group was subdivided according to AHI (mild-moderate, 1 ≤ AHI < 10; severe, AHI ≥ 10). The sAA subtraction and ratio (p = 0.014 and p < 0.001, respectively) were significantly higher in severe OSAS than in the mild-moderate and control groups. Although oxygen desaturation index (ODI) and AHI were significantly associated with sAA, sAA in the OSAS group was not related to lowest oxygen saturation or adenotonsillar hypertrophy. Conclusion: sAA was well related to polysomnographic (PSG) parameters related to SDB, such as AHI and ODI. Therefore, screening test for sAA in children suspected to have SBD may help to identify OSAS patients from control. Citation: Park CS, Guilleminault C, Park HJ, Cho JH, Lee HK, Son HL, Hwang SH. Correlation of salivary alpha amylase level and adenotonsillar hypertrophy with sleep disordered breathing in pediatric subjects. J Clin Sleep Med 2014;10(5):559-566. PMID:24812542

  15. Oral administration and younger age decrease plasma concentrations of voriconazole in pediatric patients.

    PubMed

    Kato, Karin; Nagao, Miki; Yamamoto, Masaki; Matsumura, Yasufumi; Takakura, Shunji; Fukuda, Kazuhiko; Ichiyama, Satoshi

    2016-01-01

    Voriconazole is used for treating or preventing invasive aspergillosis and other invasive fungal infections. To minimize adverse reactions and to maximize treatment effects, therapeutic drug monitoring should be performed. However, it is challenging to optimize daily voriconazole dosing because limited data have been published so far on pediatric patients. We retrospectively analyzed voriconazole concentrations in patients aged 0-18 years. In addition, a literature review was conducted. In our study cohort, younger age and oral administration were significantly associated with lower plasma voriconazole concentrations (P < 0.01). An unfavorable outcome was associated with low concentrations of voriconazole (P = 0.01). Reports of voriconazole administration in pediatric patients show that higher doses are required in younger children and in patients receiving oral administration. Hence, the current data suggest that we should escalate both initial and maintenance doses of voriconazole in pediatric patients, particularly in patients of younger age receiving an oral administration of voriconazole. PMID:26538245

  16. Weather: A Multi-Age, Integrated Subjects Curriculum Unit.

    ERIC Educational Resources Information Center

    Hall, William D.

    This multi-age integrated teaching unit on weather was developed by 19 rural teachers (grades K-8) from 12 Gallatin County (Montana) districts to associate all school subjects with a common theme, promote teaching efficiency by focusing on more than one subject at the same time, and increase student excitement. Topics explored by each grade level…

  17. Outer Space: A Multi-Age, Integrated Subjects Curriculum Unit.

    ERIC Educational Resources Information Center

    Hall, William D.

    This multi-age integrated teaching unit on outer space was developed by 19 rural teachers (grades K-8) from 12 Gallatin County (Montana) districts to associate all school subjects with a common theme, promote teaching efficiency by focusing on more than one subject at the same time, and increase student excitement. Topics explored by each grade…

  18. Subjective Age Bias: A Motivational and Information Processing Approach

    ERIC Educational Resources Information Center

    Teuscher, Ursina

    2009-01-01

    There is broad empirical evidence, but still a lack of theoretical explanations, for the phenomenon that most older people feel considerably younger than their real age. In this article, a measurement model of subjective age was assessed, and two independent theoretical approaches are proposed: (1) a motivational approach assuming that the age…

  19. Pediatric Biopharmaceutical Classification System: Using Age-Appropriate Initial Gastric Volume.

    PubMed

    Shawahna, Ramzi

    2016-05-01

    Development of optimized pediatric formulations for oral administration can be challenging, time consuming, and financially intensive process. Since its inception, the biopharmaceutical classification system (BCS) has facilitated the development of oral drug formulations destined for adults. At least theoretically, the BCS principles are applied also to pediatrics. A comprehensive age-appropriate BCS has not been fully developed. The objective of this work was to provisionally classify oral drugs listed on the latest World Health Organization's Essential Medicines List for Children into an age-appropriate BCS. A total of 38 orally administered drugs were included in this classification. Dose numbers were calculated using age-appropriate initial gastric volume for neonates, 6-month-old infants, and children aging 1 year through adulthood. Using age-appropriate initial gastric volume and British National Formulary age-specific dosing recommendations in the calculation of dose numbers, the solubility classes shifted from low to high in pediatric subpopulations of 12 years and older for amoxicillin, 5 years, 12 years and older for cephalexin, 9 years and older for chloramphenicol, 3-4 years, 9-11 and 15 years and older for diazepam, 18 years and older (adult) for doxycycline and erythromycin, 8 years and older for phenobarbital, 10 years and older for prednisolone, and 15 years and older for trimethoprim. Pediatric biopharmaceutics are not fully understood where several knowledge gaps have been recently emphasized. The current biowaiver criteria are not suitable for safe application in all pediatric populations.

  20. Pediatric Biopharmaceutical Classification System: Using Age-Appropriate Initial Gastric Volume.

    PubMed

    Shawahna, Ramzi

    2016-05-01

    Development of optimized pediatric formulations for oral administration can be challenging, time consuming, and financially intensive process. Since its inception, the biopharmaceutical classification system (BCS) has facilitated the development of oral drug formulations destined for adults. At least theoretically, the BCS principles are applied also to pediatrics. A comprehensive age-appropriate BCS has not been fully developed. The objective of this work was to provisionally classify oral drugs listed on the latest World Health Organization's Essential Medicines List for Children into an age-appropriate BCS. A total of 38 orally administered drugs were included in this classification. Dose numbers were calculated using age-appropriate initial gastric volume for neonates, 6-month-old infants, and children aging 1 year through adulthood. Using age-appropriate initial gastric volume and British National Formulary age-specific dosing recommendations in the calculation of dose numbers, the solubility classes shifted from low to high in pediatric subpopulations of 12 years and older for amoxicillin, 5 years, 12 years and older for cephalexin, 9 years and older for chloramphenicol, 3-4 years, 9-11 and 15 years and older for diazepam, 18 years and older (adult) for doxycycline and erythromycin, 8 years and older for phenobarbital, 10 years and older for prednisolone, and 15 years and older for trimethoprim. Pediatric biopharmaceutics are not fully understood where several knowledge gaps have been recently emphasized. The current biowaiver criteria are not suitable for safe application in all pediatric populations. PMID:26935428

  1. An Approach to the Management of Gonorrhea in the Pediatric Age Group

    PubMed Central

    Singleton, Alice Faye

    1981-01-01

    Gonorrhea is becoming more important to the pediatrician. Not only is the incidence of this disease greatest in the adolescent group, but it has become more frequent in young children as well. The author outlines an approach to managing gonococcal disease in the pediatric and adolescent age groups. PMID:7193742

  2. Cluster Headache: Special Considerations for Treatment of Female Patients of Reproductive Age and Pediatric Patients.

    PubMed

    VanderPluym, Juliana

    2016-01-01

    Cluster headache is a rare disorder that is more common in adult male patients. It has a unique phenotype of unilateral, severe, to very severe headaches lasting 15 to 180 min with ipsilateral autonomic symptoms. Time to correct diagnosis can be protracted. A number of treatment options exist for the standard cluster headache patient, but special considerations must be made for female patients of reproductive age and pediatric patients. The objective of this article is to explore the current literature pertaining to special considerations in cluster headache management, including treatment of pregnant or breastfeeding patients and pediatric patients. PMID:26711274

  3. [Thoracoscopic management of suspected thoraco-pulmonary malignant diseases in pediatric age].

    PubMed

    Lima, M; Bertozzi, M; Dòmini, M; Pession, A; Ruggeri, G; Libri, M; Antonellini, C; Pelusi, G; Messina, P; Fae, M

    2004-01-01

    Recent improvements and miniaturization of instruments have encouraged a wider use of thoracoscopy and laparoscopy as a modality for diagnostic and operative procedures in pediatric age. The utility of thoracoscopy in pediatric patients with suspected thoracopulmonary oncological diseases is shown by diagnostic accuracy and, if necessary, the possibility to perform at the meantime a mininvasive surgery. We report the experience of our Institution in 16 patients with suspected thoraco-pulmonary oncological diseases and treated for this reason with thoracoscopy. Thoracoscopic is indicated in cases of suspected oncological diseases in children both for diagnosis and treatment.

  4. Population Pharmacokinetics Analysis To Inform Efavirenz Dosing Recommendations in Pediatric HIV Patients Aged 3 Months to 3 Years.

    PubMed

    Luo, Man; Chapel, Sunny; Sevinsky, Heather; Savant, Ishani; Cirincione, Brenda; Bertz, Richard; Roy, Amit

    2016-06-01

    Efavirenz (EFV) is a nonnucleoside reverse transcriptase inhibitor approved worldwide for the treatment of HIV in adults and children over 3 years of age or weighing over 10 kg. Only recently EFV was approved in children over 3 months and weighing at least 3.5 kg in the United States and the European Union. The objective of this analysis was to support the selection of an appropriate dose for this younger pediatric population and to explore the impact of CYP2B6 genetic polymorphisms on EFV systemic exposures. A population pharmacokinetic (PPK) model was developed using data from three studies in HIV-1-infected pediatric subjects (n = 168) and one study in healthy adults (n = 24). The EFV concentration-time profile was best described by a two-compartment model with first-order absorption and elimination. Body weight was identified as a significant predictor of efavirenz apparent clearance (CL), oral central volume of distribution (VC), and absorption rate constant (Ka). The typical values of efavirenz apparent CL, VC, oral peripheral volume of distribution (VP), and Ka for a reference pediatric patient were 4.8 liters/h (4.5 to 5.1 liters/h), 84.9 liters (76.8 to 93.0 liters), 287 liters (252.6 to 321.4 liters), and 0.414 h(-1) (0.375 to 0.453 h(-1)), respectively. The final model was used to simulate steady-state efavirenz concentrations in pediatric patients weighing <10 kg to identify EFV doses that produce comparable exposure to adult and pediatric patients weighing ≥10 kg. Results suggest that administration of EFV doses of 100 mg once daily (QD) to children weighing ≥3.5 to <5 kg, 150 mg QD to children weighing ≥5 to <7.5 kg, and 200 mg QD to children weighing ≥7.5 to <10 kg produce exposures within the target range. Further evaluation of the impact of CYP2B6 polymorphisms on EFV PK showed that the identification of CYP2B6 genetic status is not predictive of EFV exposure and thus not informative to guide pediatric dosing regimens. PMID:27067333

  5. Population Pharmacokinetics Analysis To Inform Efavirenz Dosing Recommendations in Pediatric HIV Patients Aged 3 Months to 3 Years.

    PubMed

    Luo, Man; Chapel, Sunny; Sevinsky, Heather; Savant, Ishani; Cirincione, Brenda; Bertz, Richard; Roy, Amit

    2016-06-01

    Efavirenz (EFV) is a nonnucleoside reverse transcriptase inhibitor approved worldwide for the treatment of HIV in adults and children over 3 years of age or weighing over 10 kg. Only recently EFV was approved in children over 3 months and weighing at least 3.5 kg in the United States and the European Union. The objective of this analysis was to support the selection of an appropriate dose for this younger pediatric population and to explore the impact of CYP2B6 genetic polymorphisms on EFV systemic exposures. A population pharmacokinetic (PPK) model was developed using data from three studies in HIV-1-infected pediatric subjects (n = 168) and one study in healthy adults (n = 24). The EFV concentration-time profile was best described by a two-compartment model with first-order absorption and elimination. Body weight was identified as a significant predictor of efavirenz apparent clearance (CL), oral central volume of distribution (VC), and absorption rate constant (Ka). The typical values of efavirenz apparent CL, VC, oral peripheral volume of distribution (VP), and Ka for a reference pediatric patient were 4.8 liters/h (4.5 to 5.1 liters/h), 84.9 liters (76.8 to 93.0 liters), 287 liters (252.6 to 321.4 liters), and 0.414 h(-1) (0.375 to 0.453 h(-1)), respectively. The final model was used to simulate steady-state efavirenz concentrations in pediatric patients weighing <10 kg to identify EFV doses that produce comparable exposure to adult and pediatric patients weighing ≥10 kg. Results suggest that administration of EFV doses of 100 mg once daily (QD) to children weighing ≥3.5 to <5 kg, 150 mg QD to children weighing ≥5 to <7.5 kg, and 200 mg QD to children weighing ≥7.5 to <10 kg produce exposures within the target range. Further evaluation of the impact of CYP2B6 polymorphisms on EFV PK showed that the identification of CYP2B6 genetic status is not predictive of EFV exposure and thus not informative to guide pediatric dosing regimens.

  6. Population Pharmacokinetics Analysis To Inform Efavirenz Dosing Recommendations in Pediatric HIV Patients Aged 3 Months to 3 Years

    PubMed Central

    Luo, Man; Chapel, Sunny; Sevinsky, Heather; Savant, Ishani; Cirincione, Brenda; Bertz, Richard

    2016-01-01

    Efavirenz (EFV) is a nonnucleoside reverse transcriptase inhibitor approved worldwide for the treatment of HIV in adults and children over 3 years of age or weighing over 10 kg. Only recently EFV was approved in children over 3 months and weighing at least 3.5 kg in the United States and the European Union. The objective of this analysis was to support the selection of an appropriate dose for this younger pediatric population and to explore the impact of CYP2B6 genetic polymorphisms on EFV systemic exposures. A population pharmacokinetic (PPK) model was developed using data from three studies in HIV-1-infected pediatric subjects (n = 168) and one study in healthy adults (n = 24). The EFV concentration-time profile was best described by a two-compartment model with first-order absorption and elimination. Body weight was identified as a significant predictor of efavirenz apparent clearance (CL), oral central volume of distribution (VC), and absorption rate constant (Ka). The typical values of efavirenz apparent CL, VC, oral peripheral volume of distribution (VP), and Ka for a reference pediatric patient were 4.8 liters/h (4.5 to 5.1 liters/h), 84.9 liters (76.8 to 93.0 liters), 287 liters (252.6 to 321.4 liters), and 0.414 h−1 (0.375 to 0.453 h−1), respectively. The final model was used to simulate steady-state efavirenz concentrations in pediatric patients weighing <10 kg to identify EFV doses that produce comparable exposure to adult and pediatric patients weighing ≥10 kg. Results suggest that administration of EFV doses of 100 mg once daily (QD) to children weighing ≥3.5 to <5 kg, 150 mg QD to children weighing ≥5 to <7.5 kg, and 200 mg QD to children weighing ≥7.5 to <10 kg produce exposures within the target range. Further evaluation of the impact of CYP2B6 polymorphisms on EFV PK showed that the identification of CYP2B6 genetic status is not predictive of EFV exposure and thus not informative to guide pediatric dosing regimens. PMID:27067333

  7. Investigation of vibration-induced artifact in clinical diffusion-weighted imaging of pediatric subjects.

    PubMed

    Berl, Madison M; Walker, Lindsay; Modi, Pooja; Irfanoglu, M Okan; Sarlls, Joelle E; Nayak, Amritha; Pierpaoli, Carlo

    2015-12-01

    It has been reported that mechanical vibrations of the magnetic resonance imaging scanner could produce spurious signal dropouts in diffusion-weighted images resulting in artifactual anisotropy in certain regions of the brain with red appearance in the Directionally Encoded Color maps. We performed a review of the frequency of this artifact across pediatric studies, noting differences by scanner manufacturer, acquisition protocol, as well as weight and position of the subject. We also evaluated the ability of automated and quantitative methods to detect this artifact. We found that the artifact may be present in over 50% of data in certain protocols and is not limited to one scanner manufacturer. While a specific scanner had the highest incidence, low body weight and positioning were also associated with appearance of the artifact for both scanner types evaluated, making children potentially more susceptible than adults. Visual inspection remains the best method for artifact identification. Software for automated detection showed very low sensitivity (10%). The artifact may present inconsistently in longitudinal studies. We discuss a published case report that has been widely cited and used as evidence to set policy about diagnostic criteria for determining vegetative state. That report attributed longitudinal changes in anisotropy to white matter plasticity without considering the possibility that the changes were caused by this artifact. Our study underscores the need to check for the presence of this artifact in clinical studies, analyzes circumstances for when it may be more likely to occur, and suggests simple strategies to identify and potentially avoid its effects.

  8. Age-dependent B cell Autoimmunity to a Myelin Surface Antigen in Pediatric Multiple Sclerosis

    PubMed Central

    McLaughlin, Katherine A.; Chitnis, Tanuja; Newcombe, Jia; Franz, Bettina; Kennedy, Julia; McArdel, Shannon; Kuhle, Jens; Kappos, Ludwig; Rostasy, Kevin; Pohl, Daniela; Gagne, Donald; Ness, Jayne M.; Tenembaum, Silvia; O'Connor, Kevin C.; Viglietta, Vissia; Wong, Susan J.; Tavakoli, Norma P.; de Seze, Jerome; Khoury, Samia J.; Bar-Or, Amit; Hafler, David A.; Banwell, Brenda; Wucherpfennig, Kai W.

    2009-01-01

    Multiple sclerosis (MS) typically manifests in early to mid adulthood, but there is increasing recognition of pediatric-onset MS, aided by improvements in imaging techniques. The immunological mechanisms of disease are largely unexplored in pediatric-onset MS, in part because studies have historically focused on adult-onset disease. We investigated autoantibodies to myelin surface antigens in a large cohort of pediatric MS cases by flow cytometric labeling of transfectants that expressed different myelin proteins. While antibodies to native myelin oligodendrocyte glycoprotein (MOG) were uncommon among adult-onset patients, a subset of pediatric patients had serum antibodies that brightly labeled the MOG transfectant. Antibodies to two other myelin surface antigens were largely absent. Affinity purification of MOG antibodies as well as competition of binding with soluble MOG documented their binding specificity. The prevalence of such autoantibodies was highest among patients with a very early onset of MS: 38.7% of patients less than 10 years of age at disease onset had MOG antibodies, compared to 14.7% of patients in the 10–18 year age group. B cell autoimmunity to this myelin surface antigen is therefore most common in patients with a very early onset of MS. PMID:19687098

  9. Elevated fracture of skull in pediatric age group: A series of five patients with review of literature

    PubMed Central

    Kumar, Jayendra; Prakash, Anand; Harsh, Viraat; Kumar, Anil

    2016-01-01

    Elevated fractures of skull in pediatric age group are rarely reported in the literature. In view of rarity, we present a series of five cases of elevated skull fracture in pediatric age group. Over a period of 1-year, we operated on five such cases. In this article, we have discussed the mode, mechanism and extent of injury, its clinico-radiological findings, course of the disease, and the management outcome. Four out of five cases improved after surgery and did not suffer any complications. Early recognition and appropriate management of compound elevated fracture in pediatric age group comes with good outcome and prevents unwanted morbidity and mortality. PMID:26889296

  10. [EATING DISORDERS IN PEDIATRIC AGE: A BOOM PATHOLOGY].

    PubMed

    Dueñas Disotuar, Yunior; Murray Hurtado, Mercedes; Rubio Morell, Belén; Murjani Bharwani, Hima S; Jiménez Sosa, Alejandro

    2015-11-01

    Objetivos: determinar las características de los pacientes en edad pediátrica afectados de trastornos de la conducta alimentaria que requirieron ingreso en el Servicio de Pediatría del Complejo Hospitalario Universitario de Canarias (CHUC). Material y método: se realizó un estudio retrospectivo de una cohorte de pacientes pediátricos diagnosticados de trastornos de la conducta alimentaria e ingresados en planta de hospitalización pediátrica durante los últimos siete años. Resultados: de los 35 pacientes de la muestra, un 85,7% fueron mujeres, con una edad media al debut de 13,5 años. En el 77,1% de los casos el diagnóstico principal fue el de anorexia nerviosa de tipo restrictivo. Las alteraciones analíticas más frecuentes detectadas en el momento del ingreso consistieron en descenso de los niveles plasmáticos de proteína fijadora del retinol (RBP), presente en el 57,6% de los casos, e hipovitaminosis D, que en esta muestra estaba presente en el 46,9% de los casos. Se requirió el uso de suplementos hipercalóricos en el 71,4% de los pacientes durante la hospitalización. La ganancia ponderal media durante la estancia fue mayor cuanto menor era el índice de masa corporal (IMC) al ingreso (p = 0,006). Conclusiones: los TCA son enfermedades con incidencia creciente en la edad pediátrica. La pubertad constituye un momento de especial vulnerabilidad para el desarrollo de los TCA (así como de complicaciones médicas secundarias a la desnutrición). En muchos casos el ingreso hospitalario constituye una herramienta necesaria para un correcto manejo, instaurándose las medidas de control necesarias para la recuperación ponderal, la prevención de complicaciones del soporte nutricional y el abordaje de la psicopatología subyacente. El diagnóstico y tratamiento precoz resultan cruciales para evitar una excesiva pérdida ponderal y mayor incidencia de complicaciones.

  11. Photoplethysmographic Waveform as a Function of Subject's Age

    NASA Astrophysics Data System (ADS)

    Nippolainen, E.; Podolian, N. P.; Romashko, R. V.; Kulchin, Y. N.; Kamshilin, A. A.

    In this report we present the experimental study of imaging photoplethysmography in the area of the palm and wrist of fifty-six healthy subjects. We found that the amplitude of the PPG waveform is unevenly distributed over the studied area forming the hot spots with the elevated amplitude. There is clear tendency of the amplitude increasing in the hottest spots with the age of the subject. These observations support the recently proposed model of photoplethysmography in which pulse oscillations of the arterial transmural pressure deform the connective-tissue components of the dermis resulting in periodical changes of both the light scattering and absorption.

  12. Age, subjective stress, and depression after ischemic stroke.

    PubMed

    McCarthy, Michael J; Sucharew, Heidi J; Alwell, Kathleen; Moomaw, Charles J; Woo, Daniel; Flaherty, Matthew L; Khatri, Pooja; Ferioli, Simona; Adeoye, Opeolu; Kleindorfer, Dawn O; Kissela, Brett M

    2016-02-01

    The incidence of stroke among younger adults in the United States is increasing. Few studies have investigated the prevalence of depressive symptoms after stroke among different age groups or the extent to which subjective stress at the time of stroke interacts with age to contribute to post-stroke depression. The present study examined whether there exists an age gradient in survivors' level of depressive symptoms and explored the extent to which financial, family, and health-related stress may also impact on depression. Bivariate analyses (N = 322) indicated significant differences in depression and stress by age group, as well as differences in age and stress by 3-month depression status. Linear regression analyses indicated that survivors between the ages of 25-54 and 55-64 years old had, on average, significantly higher depressive symptom scores. Those with financial, family, and health-related stress at the time of stroke, irrespective of age, also had significantly higher scores.

  13. Narcolepsy in pediatric age – Experience of a tertiary pediatric hospital

    PubMed Central

    Dias Costa, Filipa; Barreto, Maria Inês; Clemente, Vanda; Vasconcelos, Mónica; Estêvão, Maria Helena; Madureira, Núria

    2014-01-01

    Narcolepsy, a chronic disorder of the sleep–wake cycle of multifactorial etiology, is characterized by excessive daytime sleepiness, often associated with cataplexy, hypnagogic/hypnopompic hallucinations and sleep paralysis. Both early clinical suspicion and therapeutic approach are essential for promotion of cognitive development and social integration of these children. The authors present a descriptive retrospective study of a series of eight children in whom symptoms first started between 6.8 and 10.5 years of age. Diagnostic delay ranged from 4 months to 2 years. One child had H1N1 flu vaccination eight months before the clinical onset. The first multiple sleep latency test was positive in 6 of 8 cases. All cases were treated with methylphenidate, and venlafaxine was associated in 4 of them. In one case the initial therapy was exclusively behavioral. In all cases, symptomatic improvement, better school performance and social integration were achieved after therapeutic adjustment. PMID:26483902

  14. Increased Bilateral Interactions in Middle-Aged Subjects

    PubMed Central

    Heetkamp, Jolien; Hortobágyi, Tibor; Zijdewind, Inge

    2014-01-01

    A hallmark of the age-related neural reorganization is that old versus young adults execute typical motor tasks by a more diffuse neural activation pattern including stronger ipsilateral activation during unilateral tasks. Whether such changes in neural activation are present already at middle age and affect bimanual interactions is unknown. We compared the amount of associated activity, i.e., muscle activity and force produced by the non-task hand and motor evoked potentials (MEPs) produced by magnetic brain stimulation between young (mean 24 years, n = 10) and middle-aged (mean 50 years, n = 10) subjects during brief unilateral (seven levels of % maximal voluntary contractions, MVCs) and bilateral contractions (4 × 7 levels of % MVC combinations), and during a 120-s-long MVC of sustained unilateral index finger abduction. During the force production, the excitability of the ipsilateral (iM1) or contralateral primary motor cortex (cM1) was assessed. The associated activity in the “resting” hand was ~2-fold higher in middle-aged (28% of MVC) versus young adults (11% of MVC) during brief unilateral MVCs. After controlling for the background muscle activity, MEPs in iM1 were similar in the two groups during brief unilateral contractions. Only at low (bilateral) forces, MEPs evoked in cM1 were 30% higher in the middle-aged versus young adults. At the start of the sustained contraction, the associated activity was higher in the middle-aged versus young subjects and increased progressively in both groups (30 versus 15% MVC at 120 s, respectively). MEPs were greater at the start of the sustained contraction in middle-aged subjects but increased further during the contraction only in young adults. Under these experimental conditions, the data provide evidence for the reorganization of neural control of unilateral force production as early as age 50. Future studies will determine if the altered neural control of such inter-manual interactions are of

  15. Pediatric Stroke

    PubMed Central

    Jeong, Goun; Lim, Byung Chan

    2015-01-01

    Pediatric stroke is relatively rare but may lead to significant morbidity and mortality. Along with the advance of brain imaging technology and clinical awareness, diagnosis of pediatric stroke is increasing wordwide. Pediatric stroke differs from adults in variable risk factor/etiologies, diverse and nonspecific clinical presentation depending on ages. This review will be discussed pediatric stroke focusing on their clinical presentations, diagnosis and etiologies/risk factors. PMID:26180605

  16. Family-centered rounds and medical student performance on the NBME pediatrics subject (shelf) examination: a retrospective cohort study

    PubMed Central

    Kimbrough, Tiffany N.; Heh, Victor; Wijesooriya, N. Romesh; Ryan, Michael S.

    2016-01-01

    Objective To determine the association between family-centered rounds (FCR) and medical student knowledge acquisition as assessed by the National Board of Medical Examiners (NBME) pediatric subject (shelf) exam. Methods A retrospective cohort study was conducted of third-year medical students who graduated from Virginia Commonwealth University School of Medicine between 2009 and 2014. This timeframe represented the transition from ‘traditional’ rounds to FCR on the pediatric inpatient unit. Data collected included demographics, United States Medical Licensing Examination (USMLE) Step 1 and 2 scores, and NBME subject examinations in pediatrics (PSE), medicine (MSE), and surgery (SSE). Results Eight hundred and sixteen participants were included in the analysis. Student performance on the PSE could not be statistically differentiated from performance on the MSE for any year except 2011 (z-score=−0.17, p=0.02). Average scores on PSE for years 2009, 2010, 2013, and 2014 were significantly higher than for SSE, but not significantly different for all other years. The PSE was highly correlated with USMLE Step 1 and Step 2 examinations (correlation range 0.56–0.77) for all years. Conclusions Our results showed no difference in PSE performance during a time in which our institution transitioned to FCR. These findings should be reassuring for students, attending physicians, and medical educators. PMID:27087016

  17. Internal derangements of the temporomandibular joint: findings in the pediatric age group

    SciTech Connect

    Katzberg, R.W.; Tallents, R.H.; Hayakawa, K.; Miller, T.L.; Goske, M.J.; Wood, B.P.

    1985-01-01

    Findings in 31 pediatric patients with pain and dysfunction of the temporomandibular joint (TMJ) are reported. The average age was 14 years and the average duration of symptoms was 21.4 months. Internal derangements were found in 29 patients (94%) and degenerative arthritis in 13 (42%). In 12 patients (39%), the problem could be traced to an injury to the jaw. Secondary condylar hypoplasia was associated with the meniscal abnormality in 3 patients (10%). Further awareness of internal derangements of the TMJ in the pediatric population should permit greater recognition of their etiology. It is important that threatment be initiated as soon as possible, not only to minimize the development of osseous disease in young adults but also to prevent facial growth deformities.

  18. Expiratory muscle endurance in middle-aged healthy subjects.

    PubMed

    Orozco-Levi, M; Gea, J; Ferrer, A; Mendez, R; Ramírez-Sarmiento, A; Maldonado, D; Broquetas, J

    2001-01-01

    To evaluate expiratory muscle endurance in middle-aged healthy subjects using incremental as well as constant expiratory loads, 14 healthy volunteers (51 +/- 16 years) were submitted to a specific endurance test, which was performed breathing against a threshold valve, and was divided into two parts. In part I, the load was progressively increased (50 g each 2 min) until task failure occurred. The mean mouth pressure generated against the highest load held for at least 60 sec was defined as the maximal expiratory sustainable pressure (Pth(max)). In part II, each subject breathed against a constant submaximal expiratory load (80% Pth(max)) until task failure occurred (expiratory endurance time or Tth(80)). Both parts of the test were repeated 24-48 h later. Progressive expiratory loading induced a linear increase in mouth expiratory pressure and the Pth(max) obtained was 141 +/- 43 cm H(2)O, representing 74 +/- 28% of the maximal expiratory pressure (PE(max)). Under constant loads, the Tth(80) was 17 +/- 9 min. At the end-point of both parts, the tension time index for expiratory muscles was dramatically increased (>0.25), and both EMG central frequency and PE(max) were decreased with no changes in maximal inspiratory pressure or inspiratory capacity. Extreme dyspnea was present in most of the subjects but no complications were observed. The endurance of expiratory muscles can be easily assessed in healthy subjects using this method, which has acceptable reproducibility and tolerance. PMID:11733852

  19. Safety of a Bioactive Polyphenol Dietary Supplement in Pediatric Subjects with Acute Diarrhoea

    PubMed Central

    Sarker, Shafiqul A.; Sultana, Shamima; Pietroni, Mark; Dover, Arthur

    2015-01-01

    The hematological and clinical chemistry profile for children aged 6 months to 5 years with acute diarrhoea was measured in a double blind clinical trial. Subjects were randomized to the study group (N = 44) given a bioactive polyphenol dietary supplement in oral rehydration solution (ORS) or to the control group (N = 41) given distilled water as a placebo in ORS twice daily for up to 4 days. All subjects received 10 mg zinc daily for the 4 days in the study. Venous blood was collected for complete blood count, electrolytes, liver function, and creatinine upon enrollment (baseline) and at the end of 4 days (end of study); mean values were compared by 95% confidence intervals. Overall, blood factors measured either remained the same over the 4 days or increased or decreased at the same levels between the two groups during the study period. All values were within accepted ranges for paediatric subjects except serum AST (SGOT), where the mean value of the study group approached the upper bound of the range on day 4 but was comparable to the value of the control group. Consumption of this supplement twice daily for 4 days is safe for children and infants. PMID:26435718

  20. Neuroanatomical correlates of olfactory loss in normal aged subjects.

    PubMed

    Segura, Bàrbara; Baggio, Hugo César; Solana, Elisabeth; Palacios, Eva M; Vendrell, Pere; Bargalló, Núria; Junqué, Carme

    2013-06-01

    In non-demented older persons, smell dysfunction, measured premortem, has been associated with postmortem brain degeneration similar to that of Alzheimer's disease. We hypothesized that distinct measures of gray and white matter integrity evaluated through magnetic resonance imaging (MRI) techniques could detect degenerative changes associated with age-related olfactory dysfunction. High-resolution T1-weighted images and diffusion-tensor images (DTI) of 30 clinically healthy subjects aged 51-77 were acquired with a 3-Tesla MRI scanner. Odor identification performance was assessed by means of the University of Pennsylvania Smell Identification Test (UPSIT). UPSIT scores correlated with right amygdalar volume and bilateral perirhinal and entorhinal cortices gray matter volume. Olfactory performance also correlated with postcentral gyrus cortical thickness and with fractional anisotropy and mean diffusivity levels in the splenium of the corpus callosum and the superior longitudinal fasciculi. Our results suggest that age-related olfactory loss is accompanied by diffuse degenerative changes that might correspond to the preclinical stages of neurodegenerative processes.

  1. Detection and Nonoperative Management of Pediatric Developmental Dysplasia of the Hip in Infants up to Six Months of Age.

    PubMed

    Mulpuri, Kishore; Song, Kit M; Goldberg, Michael J; Sevarino, Kaitlyn

    2015-03-01

    Detection and Nonoperative Management of Pediatric Developmental Dysplasia of the Hip in Infants up to Six Months of Age: Evidence-Based Clinical Practice Guideline is based on a systematic review of the current scientific and clinical research. This guideline has been endorsed by the Society of Diagnostic Medical Sonography, the Society for Pediatric Radiology, American Academy of Pediatrics, and the Pediatric Orthopaedic Society of North America. The purpose of this clinical practice guideline is to help improve treatment and management based on the current evidence. This guideline contains nine recommendations, including both diagnosis and treatment. In addition, the work group highlighted the need for better research in the early diagnosis and treatment of developmental dysplasia of the hip. PMID:25656273

  2. Age of onset as a moderator of cognitive decline in pediatric-onset multiple sclerosis.

    PubMed

    Hosseini, Banafsheh; Flora, David B; Banwell, Brenda L; Till, Christine

    2014-09-01

    Cognitive impairment is often reported in pediatric-onset multiple sclerosis (MS). Using serial cognitive data from 35 individuals with pediatric-onset MS, this study examined how age at disease-onset and proxies of cognitive reserve may impact cognitive maturation over the course of childhood and adolescence. Neuropsychological evaluations were conducted at baseline and up to four more assessments. Of the 35 participants, 7 completed only one assessment, 5 completed two assessments, 13 completed three assessments, 10 completed four or more assessments. Growth curve modeling was used to assess longitudinal trajectories on the Trail Making Test-Part B (TMT-B) and the Symbol Digit Modalities (SDMT; oral version) and to examine how age at disease onset, baseline Full Scale IQ, and social status may moderate rate of change on these measures. Mean number of evaluations completed per patient was 2.8. Younger age at disease onset was associated with a greater likelihood of cognitive decline on both the TMT-B (p=.001) and SDMT (p=.005). Baseline IQ and parental social status did not moderate any of the cognitive trajectories. Findings suggest that younger age at disease-onset increases the vulnerability for disrupted performance on measures of information processing, visual scanning, perceptual/motor speed, and working memory. Proxies of cognitive reserve did not protect against the progression of decline on these measures. Young patients with MS should be advised to seek follow-up cognitive evaluation to assess cognitive maturation and to screen for the potential late emergence of cognitive deficits. (JINS, 2014, 20, 1-9).

  3. Mutational Analysis in Pediatric Thyroid Cancer and Correlations with Age, Ethnicity, and Clinical Presentation

    PubMed Central

    Nikita, Maria Eleni; Jiang, Wen; Cheng, Shih-Min; Hantash, Feras M.; McPhaul, Michael J.; Newbury, Robert O.; Phillips, Susan A.; Reitz, Richard E.; Waldman, Frederic M.

    2016-01-01

    Background: Well-differentiated thyroid cancer (WDTC) incidence in pediatrics is rising, most being papillary thyroid carcinoma (PTC). The objective of the study was to assess the prevalence of different mutations in pediatric WDTC and correlate the genotype with the clinical phenotype. Methods: This is a single-center retrospective study. Thyroid tissue blocks from 42 consecutive pediatric WDTC patients who underwent thyroidectomy between 2001 and 2013 were analyzed at Quest Diagnostics for BRAFV600E, RAS mutations (N,K,H), and RET/PTC and PAX8/PPARγ rearrangements, using validated molecular methods. Thyroid carcinomas included PTC, follicular thyroid carcinoma (FTC), and follicular variant of PTC (FVPTC). Results: Thirty-nine samples (29 females) were genotyped. The mean age at diagnosis was 14.7 years (range 7.9–18.4 years), and most were Hispanic (56.4%) or Caucasian (35.9%). The mean follow-up period was 2.9 years. Mutations were noted in 21/39 (53.8%), with both BRAFV600E (n = 9), and RET/PTC (n = 6) detected only in PTC. Mutations were detected in 2/5 FTC (PAX8/PPARγ and NRAS) and 3/6 FVPTC cases (PAX8/PPARγ). Of 28 PTC patients, 57.1% had mutations: 32.1% with BRAFV600E, 21.4% with RET/PTC, and 3.6% with NRAS. Of patients with BRAFV600E, 77.8% were Hispanic and 88.9% were >15 years, while all RET/PTC-positive patients were ≤15 years (p = 0.003). Tumor size, lymph node involvement, and distant metastasis at diagnosis (or soon after 131I ablation) did not vary significantly based on the mutation. Conclusions: BRAFV600E was the most common mutation, especially in older and Hispanic adolescents. A larger, ethnically diverse pediatric cohort followed long term will enable the genotypic variability, clinical presentation, and response to therapy to be better assessed. PMID:26649796

  4. A clinic-based study of refractive errors, strabismus, and amblyopia in pediatric age-group

    PubMed Central

    Al-Tamimi, Elham R.; Shakeel, Ayisha; Yassin, Sanaa A.; Ali, Syed I.; Khan, Umar A.

    2015-01-01

    Purpose: The purpose of this cross-sectional observational study was to determine the distribution and patterns of refractive errors, strabismus, and amblyopia in children seen at a pediatric eye care. Materials and Methods: The study was conducted in a Private Hospital in Dammam, Kingdom of Saudi Arabia, from March to July 2013. During this period, a total of 1350 children, aged 1–15 years were seen at this Center's Pediatric Ophthalmology Unit. All the children underwent complete ophthalmic examination with cycloplegic refraction. Results: Refractive errors accounted for 44.4% of the cases, the predominant refractive error being hypermetropia which represented 83%. Strabismus and amblyopia were present in 38% and 9.1% of children, respectively. Conclusions: In this clinic-based study, the focus was on the frequency of refractive errors, strabismus, and amblyopia which were considerably high. Hypermetropia was the predominant refractive error in contrast to other studies in which myopia was more common. This could be attributed to the criteria for sample selection since it was clinic-based rather than a population-based study. However, it is important to promote public education on the significance of early detection of refractive errors, and have periodic screening in schools. PMID:26392796

  5. School Subject Preferences: Age and Gender Differences Revisited.

    ERIC Educational Resources Information Center

    Colley, Ann; Comber, Chris

    2003-01-01

    Presents a study that focused on the school subject preferences of 11-12 year old girls (n=144) and boys (n=218) and 15-16 year old girls (n=269) and boys (n=300). Reports that there are gender differences in subject preference, while more traditional subjects were favored. (CMK)

  6. Mitochondrial 12S rRNA variants in 1642 Han Chinese pediatric subjects with aminoglycoside-induced and nonsyndromic hearing loss

    PubMed Central

    Lu, Jianxin; Li, Zhiyuan; Zhu, Yi; Yang, Aifen; Li, Ronghua; Zheng, Jing; Cai, Qin; Peng, Guanghua; Zheng, Wuwei; Tang, Xiaowen; Chen, Bobei; Chen, Jianfu; Liao, Zhisu; Yang, Li; Li, Yongyan; You, Junyan; Ding, Yu; Yu, Hong; Wang, Jindan; Sun, Dongmei; Zhao, Jianyue; Xue, Ling; Wang, Jieying; Guan, Min-Xin

    2010-01-01

    In this report, we investigated the frequency and spectrum of mitochondrial 12S rRNA variants in a large cohort of 1642 Han Chinese pediatric subjects with aminoglycoside-induced and nonsyndromic hearing loss. Mutational analysis of 12S rRNA gene in these subjects identified 68 (54 known and 14 novel) variants. The frequencies of known 1555A>G and 1494C>T mutations were 3.96% and 0.18%, respectively, in this cohort with nonsyndromic and aminoglycoside-induced hearing loss. Prevalence of other putative deafness-associated mutation at positions 1095 and 961 were 0.61% and 1.7% in this cohort, respectively. Furthermore, the 745A>G, 792C>T, 801A>G, 839A>G, 856A>G, 1027A>G, 1192C>T, 1192C>A, 1310C>T, 1331A>G, 1374A>G and 1452T>C variants conferred increased sensitivity to ototoxic drugs or nonsyndromic deafness as they were absent in 449 Chinese controls and localized at highly conserved nucleotides of this rRNA. However, other variants appeared to be polymorphisms. Moreover, 65 Chinese subjects carrying the 1555A>G mutation exhibited bilateral and sensorineural hearing loss. A wide range of severity, age-of-onset and audiometric configuration was observed among these subjects. In particular, the sloping and flat shaped patterns were the common audiograms in individuals carrying the 1555A>G mutation. The phenotypic variability in subjects carrying these 12S rRNA mutations indicated the involvement of nuclear modifier genes, mitochondrial haplotypes, epigenetic and environmental factors in the phenotypic manifestation of these mutations. Therefore, our data demonstrated that mitochondrial 12S rRNA is the hot spot for mutations associated with aminoglycoside ototoxicity. PMID:20100600

  7. Using CD4 Percentage and Age to Optimize Pediatric Antiretroviral Therapy Initiation

    PubMed Central

    Warshaw, Meredith G.; Miller, William C.; Castro, Hannah; Fiscus, Susan A.; Harper, Lynda M.; Harrison, Linda J.; Klein, Nigel J.; Lewis, Joanna; Melvin, Ann J.; Tudor-Williams, Gareth; McKinney, Ross E.

    2014-01-01

    BACKGROUND: Quantifying pediatric immunologic recovery by highly active antiretroviral therapy (HAART) initiation at different CD4 percentage (CD4%) and age thresholds may inform decisions about timing of treatment initiation. METHODS: HIV-1-infected, HAART-naive children in Europe and the Americas were followed from 2002 through 2009 in PENPACT-1. Data from 162 vertically infected children, with at least World Health Organization “mild” immunosuppression and CD4% <10th percentile, were analyzed for improvement to a normal CD4% (≥10th percentile) within 4 years after HAART initiation. Data from 209 vertically infected children, regardless of immune status, were analyzed for CD4% outcomes at 4 years and viral failure within 4 years. RESULTS: Seventy-two percent of baseline immunosuppressed children recovered to normal within 4 years. Compared with “severe” immunosuppression, more children with “mild” immunosuppression (difference 36%, 95% confidence interval [CI]: 22% to 49%) or “advanced” immunosuppression (difference 20.8%, 95% CI: 5.8% to 35.9%) recovered a normal CD4%. For each 5-year increase in baseline age, the proportion of children achieving a normal CD4% declined by 19% (95% CI: 11% to 27%). Combining baseline CD4% and age effects resulted in >90% recovery when initiating HAART with “mild” immunosuppression at any age or “advanced” immunosuppression at age <3 years. Baseline CD4% effects became greater with increasing age (P = .02). At 4 years, most immunologic benefits were still significant but diminished. Viral failure was highest in infancy (56%) and adolescence (63%). CONCLUSIONS: Initiating HAART at higher CD4% and younger ages maximizes potential for immunologic recovery. Guidelines should weigh immunologic benefits against long-term risks. PMID:25266426

  8. Retrieval of famous names on a Rebus Riddle task by middle-aged and older subjects.

    PubMed

    Marshall, R C; Morelli, C A; Calise, G E; Phillips, D S

    1997-12-01

    This study compared the performances of 20 middle-aged and 20 older subjects on a Rebus Riddle task that required they retrieve the names of famous persons. Older subjects solved significantly more riddles and responded to prompts designed to aid riddle-solving efforts with significantly greater success than middle-aged subjects. Older subjects also had nonsignificantly faster riddle-solving times than middle-aged subjects. Similar riddles were difficult or easy for both groups. Superior performance of the older group appeared to be related to the age of the subject at the time the persons in the riddles had become famous.

  9. MO-E-17A-10: Evaluation of Body and Head Dimensions of Pediatric Patients as a Function of Age

    SciTech Connect

    Seibert, JA; Boone, JM

    2014-06-15

    Purpose: Phantom development in medical physics plays an important role in radiation dose assessment and image quality evaluation, and this is especially true in the pediatric patient population. The purpose of this investigation was to establish the relationship between patient age and patient size, focusing on the abdomen-pelvis and head effective diameters, for patients ranging in age from newborn to 18 years. Methods: A dose reporting tool for computed tomography systems was installed at our institution to achieve compliance with state law commencing on July 1, 2012. The software records a number of patient-specific data, and also reports CT dose metrics (CTDIvol and DLP) into the patients interpretive report. The database generated by the software was mined to determine patient effective diameter as a function of age for pediatric patients aged 0–18 years. CT protocols including abdomen-pelvis and routine head were evaluated, and specific to this study the patients age, gender and equivalent diameter were recorded. Results: Six age ranges were evaluated: A(0–3), B(4–6), C(7–9), D(10–12),E(13–15),F(16–18). For the torso in these groups based upon 694 patients, median effective diameters were 147, 167, 184, 214, 231, 246 mm, respectively. For the head (N=1833), median diameters were 143, 157, 162, 168, 174, and 174, respectively. Conclusion: A solid understanding of the approximate dimensions of pediatric patients as a function of age is useful in the development of age-based imaging protocols and dose assessments. CT dose-reporting tools generate a great deal of data with respect to body dimensions automatically. In this study, median equivalent diameters for the abdomen-pelvis and head of pediatric patients were evaluated. These data may prove useful in the development of both mathematical and physical phantoms for dosimetry and image quality assessment.

  10. Fresh frozen plasma in the pediatric age group and in congenital coagulation factor deficiency.

    PubMed

    Muntean, Wolfgang

    2002-10-31

    Generally, the rules of good practice in transfusion medicine apply also to the pediatric age group. However, the frequency of specific diseases that might necessitate the administration of fresh frozen plasma (FFP) differs from that in adults. Physiologic differences to the later age exist in the neonatal period and in young infants, especially with respect to the hemostatic system, that must be recognized when considering administration of FFP. The plasma levels of many procoagulant factors and important anticoagulants are lower in neonates than in other age groups. Despite these findings, healthy neonates show no easy bruising, no increased bleeding during surgery, and excellent wound healing. The same discrepancy obtains between in vitro and clinical findings with primary hemostasis in neonates. The good primary hemostasis in neonates despite poor in vitro platelet function seems to be due mainly to a very high von Willebrand factor and the presence of more high-multimeric subunits of von Willebrand factor than later in life. We must assume that these particular plasma levels of procoagulant and anticoagulant proteins are essential for the correct function of neonatal hemostasis. Evidence that the hemostatic system of neonates works best with physiologic concentrations of procoagulants and anticoagulants can also be inferred from studies where the administration of clotting factor concentrates gave poor results.Since healthy neonates and young infants have excellent hemostasis, there is absolutely no indication to 'correct' these values to adult's norms prior to invasive procedures by administering FFP. Indications for FFP, met more frequently in the pediatric age group than later in life, are exchange transfusion and extracorporeal membrane oxygenation. Indications applying equally to adults are other extracorporeal life support systems, disseminated intravascular coagulation, hepatic coagulopathy, and 'complex unclear coagulopathies'. In congenital clotting

  11. Pediatric cancer genetics research and an evolving preventive ethics approach for return of results after death of the subject

    PubMed Central

    Scollon, Sarah; Bergstrom, Katie; McCullough, Laurence B.; McGuire, Amy L.; Gutierrez, Stephanie; Kerstein, Robin; Parsons, D. Williams; Plon, Sharon E.

    2015-01-01

    Précis The return of genetic research results after death in the pediatric setting comes with unique complexities. Researchers must determine which results and through which processes results are returned. This paper discusses the experience over 15 years in pediatric cancer genetics research of returning research results after the death of a child and proposes a preventive ethics approach to protocol development in order to improve the quality of return of results in pediatric genomic settings. PMID:26479562

  12. Inventing the Educational Subject in the "Information Age"

    ERIC Educational Resources Information Center

    Bojesen, Emile

    2016-01-01

    This paper asks the question of how we can situate the educational subject in what Luciano Floridi has defined as an "informational ontology" (Floridi in "The philosophy of information." Oxford University Press, Oxford, 2011a). It will suggest that Jacques Derrida and Bernard Stiegler offer paths toward rethinking the…

  13. Team-based learning on a third-year pediatric clerkship improves NBME subject exam blood disorder scores

    PubMed Central

    Saudek, Kris; Treat, Robert

    2015-01-01

    Purpose At our institution, speculation amongst medical students and faculty exists as to whether team-based learning (TBL) can improve scores on high-stakes examinations over traditional didactic lectures. Faculty with experience using TBL developed and piloted a required TBL blood disorders (BD) module for third-year medical students on their pediatric clerkship. The purpose of this study is to analyze the BD scores from the NBME subject exams before and after the introduction of the module. Methods We analyzed institutional and national item difficulties for BD items from the NBME pediatrics content area item analysis reports from 2011 to 2014 before (pre) and after (post) the pilot (October 2012). Total scores of 590 NBME subject examination students from examinee performance profiles were analyzed pre/post. t-Tests and Cohen's d effect sizes were used to analyze item difficulties for institutional versus national scores and pre/post comparisons of item difficulties and total scores. Results BD scores for our institution were 0.65 (±0.19) compared to 0.62 (±0.15) nationally (P=0.346; Cohen's d=0.15). The average of post-consecutive BD scores for our students was 0.70 (±0.21) compared to examinees nationally [0.64 (±0.15)] with a significant mean difference (P=0.031; Cohen's d=0.43). The difference in our institutions pre [0.65 (±0.19)] and post [0.70 (±0.21)] BD scores trended higher (P=0.391; Cohen's d=0.27). Institutional BD scores were higher than national BD scores for both pre and post, with an effect size that tripled from pre to post scores. Institutional BD scores increased after the use of the TBL module, while overall exam scores remained steadily above national norms. Conclusions Institutional BD scores were higher than national BD scores for both pre and post, with an effect size that tripled from pre to post scores. Institutional BD scores increased after the use of the TBL module, while overall exam scores remained steadily above national

  14. Reduced Amygdalar Gray Matter Volume in Familial Pediatric Bipolar Disorder

    ERIC Educational Resources Information Center

    Chang, Kiki; Karchemskiy, Asya; Barnea-Goraly, Naama; Garrett, Amy; Simeonova, Diana Iorgova; Reiss, Allan

    2005-01-01

    Objective: Subcortical limbic structures have been proposed to be involved in the pathophysiology of adult and pediatric bipolar disorder (BD). We sought to study morphometric characteristics of these structures in pediatric subjects with familial BD compared with healthy controls. Method: Twenty children and adolescents with BD I (mean age = 14.6…

  15. Venlafaxine ER for the Treatment of Pediatric Subjects with Depression: Results of Two Placebo-Controlled Trials

    ERIC Educational Resources Information Center

    Emslie, Graham J.; Findling, Robert L.; Yeung, Paul P.; Kunz, Nadia R.; Li, Yunfeng

    2007-01-01

    Objective: The safety, efficacy, and tolerability of venlafaxine extended release (ER) in subjects ages 7 to 17 years with major depressive disorder were evaluated in two multicenter, randomized, double-blind, placebo-controlled trials conducted between October 1997 and August 2001. Method: Participants received venlafaxine ER (flexible dose,…

  16. Canine pulp ratios in estimating pensionable age in subjects with questionable documents of identification.

    PubMed

    Cameriere, Roberto; Ferrante, Luigi

    2011-03-20

    One of the most interesting reasons for needing to estimate age in adult subjects is to ascertain the age of a person of questionable pensionable age. This problem is becoming increasingly important in Europe, owing to the high number of immigrants without valid birth certificates. The aim of this paper is to evaluate the application of the apposition of secondary dentine of canines by the method of Cameriere et al. [10], in order to estimate the pensionable age of subjects without proper birth certificates. Periapical X-rays of 180 canines from 90 subjects aged between 50 and 79, 46 men and 44 women, were analysed. Estimated ages were used to test the medico-legal question as to whether an individual was older or younger than 65 years of age. In subjects under 65, age was correctly evaluated in 91% and 89% of individuals using maxillary and mandibular canines, respectively. In subjects over 65, of pensionable age, estimates were correct in 85% and 88% of cases, respectively. The proportion of individuals with correct classifications was 89% for both maxillary and mandibular canines taken together. In only four subjects, the results of maxillary and mandibular canines were discordant; in the other 86 subjects, the test of maxillary and mandibular canines yielded concordant results. Among the latter, the proportion of individuals who were really aged 65 years or older, and who were correctly estimated as such, was 94%, and the proportion of individuals younger than 65 years of age who were correctly estimated as such was 96%.

  17. Subjective Age in the Transition to Adulthood for Persons with and without Motor Disabilities

    ERIC Educational Resources Information Center

    Galambos, Nancy L.; Darrah, Johanna; Magill-Evans, Joyce

    2007-01-01

    This study examined subjective age (how old one feels) and associated variables in 148 emerging adults, ages 20-30 years. Seventy-six participants had a motor disability (cerebral palsy, spina bifida) and 72 had no motor disability. Participants completed questionnaires and were interviewed. There was no significant difference in subjective age…

  18. Intensity of ADHD Symptoms and Subjective Feelings of Competence in School Age Children

    ERIC Educational Resources Information Center

    Hanc, Tomasz; Brzezinska, Anna Izabela

    2009-01-01

    The aim of this investigation was to assess how different levels of intensity of ADHD symptoms influence the development of the subjective feeling of competence in school age children. The sample was comprised of 62 children age 11 to 13. For the purpose of estimation of the subjective feeling of competence, The Feeling of Competence Questionnaire…

  19. Percutaneous nephrolithotomy in pediatric age group: Assessment of effectiveness and complications

    PubMed Central

    Ozden, Ender; Mercimek, Mehmet Necmettin

    2016-01-01

    Management of kidney stone disease in pediatric population is a challenging condition in urology practice. While the incidence of kidney stone is increasing in those group, technological innovations have conrtibuted to the development of minimally invasive treatment of urinary stone disease such as mini-percutenous nephrolitotomy (mini-PCNL), micro-PCNL, ultra mini-PCNL. In this review we tried to evaluate the effect of new teratment techniques on pediatric kidney stones. PMID:26788467

  20. So You Think You Look Young? Matching Older Adults' Subjective Ages with Age Estimations Provided by Younger, Middle-Aged, and Older Adults

    ERIC Educational Resources Information Center

    Kotter-Gruhn, Dana; Hess, Thomas M.

    2012-01-01

    Perceived age plays an important role in the context of age identity and social interactions. To examine how accurate individuals are in estimating how old they look and how old others are, younger, middle-aged, and older adults rated photographs of older target persons (for whom we had information about objective and subjective age) in terms of…

  1. Turkish validity and reliability of a pediatric quality of life cancer module for children aged 8-12 and parents.

    PubMed

    Tanir, Meltem Kurtuncu; Kuguoglu, Sema

    2011-01-01

    This descriptive study was conducted to determine the validity and reliability in Turkey of the Pediatric Quality of Life Inventory Cancer Module (PedsQL 3.0) for children aged 8-12 in the hematology-oncology polyclinics of two university hospitals in Istanbul during the period 2006-2007. The data collection instruments were the Pediatric Quality of Life Inventory (PedsQL 4.0), the Pediatric Quality of Life Inventory Cancer Module (PedsQL 3.0) and a socio-demographic questionnaire, applied for 146 children diagnosed with cancer and 146 parents. Cronbach's alpha coefficients for the PedsQL 3.0 were found to be 0.602-0.982 for sub-groups with the children's form, 0.644-0.966 with the parents' form. The scale was found to give a significantly high level of reliability (0.60 ≤ ± < 0.80). Significant and directly proportional correlations were demonstrated between the forms for children and parents. It was concluded that the PedsQL 3.0 cancer module is a valid and reliable tool for assessing the quality of life of Turkish children, aged 8-12, diagnosed with cancer.

  2. Local patient dose diagnostic reference levels in pediatric interventional cardiology in Chile using age bands and patient weight values

    SciTech Connect

    Ubeda, Carlos; Miranda, Patricia; Vano, Eliseo

    2015-02-15

    Purpose: To present the results of a patient dose evaluation program in pediatric cardiology and propose local diagnostic reference levels (DRLs) for different types of procedure and age range, in addition to suggesting approaches to correlate patient dose values with patient weight. This study was the first conducted in Latin America for pediatric interventional cardiology under the auspices of the International Atomic Energy Agency. Methods: Over three years, the following data regarding demographic and patient dose values were collected: age, gender, weight, height, number of cine series, total number of cine frames, fluoroscopy time (FT), and two dosimetric quantities, dose-area product (DAP) and cumulative dose (CD), at the patient entrance reference point. The third quartile values for FT, DAP, CD, number of cine series, and the DAP/body weight ratio were proposed as the set of quantities to use as local DRLs. Results: Five hundred and seventeen patients were divided into four age groups. Sample sizes by age group were 120 for <1 yr; 213 for 1 to <5 yr; 82 for 5 to <10 yr; and 102 for 10 to <16 yr. The third quartile values obtained for DAP by diagnostic and therapeutic procedures and age range were 1.17 and 1.11 Gy cm{sup 2} for <1 yr; 1.74 and 1.90 Gy cm{sup 2} for 1 to <5 yr; 2.83 and 3.22 Gy cm{sup 2} for 5 to <10 yr; and 7.34 and 8.68 Gy cm{sup 2} for 10 to <16 yr, respectively. The third quartile value obtained for the DAP/body weight ratio for the full sample of procedures was 0.17 (Gy cm{sup 2}/kg) for diagnostic and therapeutic procedures. Conclusions: The data presented in this paper are an initial attempt at establishing local DRLs in pediatric interventional cardiology, from a large sample of procedures for the standard age bands used in Europe, complemented with the values of the ratio between DAP and patient weight. This permits a rough estimate of DRLs for different patient weights and the refining of these values for the age bands when there

  3. Dating, Sex, and Substance Use as Correlates of Adolescents' Subjective Experience of Age

    ERIC Educational Resources Information Center

    Arbeau, Kelly J.; Galambos, Nancy L.; Jansson, S. Mikael

    2007-01-01

    This study examined in a random community-based sample of 664 12-19-year-olds, the relation of subjective experience of age (SEA) with chronological age, dating experience, sexual activity, and substance use. The results revealed a positive linear relation between SEA and chronological age: individuals who were chronologically older felt…

  4. Computer-assisted analysis of cervical vertebral bone age using cephalometric radiographs in Brazilian subjects.

    PubMed

    Caldas, Maria de Paula; Ambrosano, Gláucia Maria Bovi; Haiter Neto, Francisco

    2010-01-01

    The aims of this study were to develop a computerized program for objectively evaluating skeletal maturation on cephalometric radiographs, and to apply the new method to Brazilian subjects. The samples were taken from the patient files of Oral Radiological Clinics from the North, Northeast, Midwest and South regions of the country. A total of 717 subjects aged 7.0 to 15.9 years who had lateral cephalometric radiographs and hand-wrist radiographs were selected. A cervical vertebral computerized analysis was created in the Radiocef Studio 2 computer software for digital cephalometric analysis, and cervical vertebral bone age was calculated using the formulas developed by Caldas et al.17 (2007). Hand-wrist bone age was evaluated by the TW3 method. Analysis of variance (ANOVA) and the Tukey test were used to compare cervical vertebral bone age, hand-wrist bone age and chronological age (P < 0.05). No significant difference was found between cervical vertebral bone age and chronological age in all regions studied. When analyzing bone age, it was possible to observe a statistically significant difference between cervical vertebral bone age and hand-wrist bone age for female and male subjects in the North and Northeast regions, as well as for male subjects in the Midwest region. No significant difference was observed between bone age and chronological age in all regions except for male subjects in the North and female subjects in the Northeast. Using cervical vertebral bone age, it might be possible to evaluate skeletal maturation in an objective manner using cephalometric radiographs.

  5. The influence of subjective aging on health and longevity: a meta-analysis of longitudinal data.

    PubMed

    Westerhof, Gerben J; Miche, Martina; Brothers, Allyson F; Barrett, Anne E; Diehl, Manfred; Montepare, Joann M; Wahl, Hans-Werner; Wurm, Susanne

    2014-12-01

    Evidence is accumulating on the effects of subjective aging-that is, how individuals perceive their own aging process-on health and survival in later life. The goal of this article is to synthesize findings of existing longitudinal studies through a meta-analysis. A systematic search in PsycInfo, Web of Science, Scopus, and Pubmed resulted in 19 longitudinal studies reporting effects of subjective aging on health, health behaviors, and longevity. The authors combine the outcomes reported in these studies using a random effects meta-analysis, assuming that there would be differences in effect sizes across studies. The meta-analysis resulted in an overall significant effect of subjective aging (likelihood ratio = 1.429; 95% confidence interval = 1.273-1.604; p < .001). The analyses revealed heterogeneity, with stronger effects for studies with a shorter period of follow-up, for studies of health versus survival, for studies with younger participants (average age of the studies varies between 57 and 85 years with a median of 63 years), and for studies in welfare systems where state provisions of welfare are minimal. However, effects did not vary either across different operationalizations of subjective aging or by study quality. Subjective aging has a small significant effect on health, health behaviors, and survival. Further theoretical conceptualizations and empirical studies are needed to determine how subjective aging contributes to health and survival.

  6. "Feeling younger, walking faster": subjective age and walking speed in older adults.

    PubMed

    Stephan, Yannick; Sutin, Angelina R; Terracciano, Antonio

    2015-10-01

    Walking speed is a key vital sign in older people. Given the implications of slower gait speed, a large literature has identified health-related, behavioral, cognitive, and biological factors that moderate age-related decline in mobility. The present study aims to contribute to existing knowledge by examining whether subjective age, how old or young individuals experience themselves to be relative to their chronological age, contributes to walking speed. Participants were drawn from the 2008 and 2012 waves of the Health and Retirement Study (HRS, N = 2970) and the 2011 and 2013 waves of the National Health and Aging Trends Study (NHATS, N = 5423). In both the HRS and the NHATS, linear regression analysis revealed that a younger subjective age was associated with faster walking speed at baseline and with less decline over time, controlling for age, sex, education, and race. These associations were partly accounted for by depressive symptoms, disease burden, physical activity, cognition, body mass index, and smoking. Additional analysis revealed that feeling younger than one's age was associated with a reduced risk of walking slower than the frailty-related threshold of 0.6 m/s at follow-up in the HRS. The present study provides novel and consistent evidence across two large prospective studies for an association between the subjective experience of age and walking speed of older adults. Subjective age may help identify individuals at risk for mobility limitations in old age and may be a target for interventions designed to mitigate functional decline. PMID:26296609

  7. "Feeling younger, walking faster": subjective age and walking speed in older adults.

    PubMed

    Stephan, Yannick; Sutin, Angelina R; Terracciano, Antonio

    2015-10-01

    Walking speed is a key vital sign in older people. Given the implications of slower gait speed, a large literature has identified health-related, behavioral, cognitive, and biological factors that moderate age-related decline in mobility. The present study aims to contribute to existing knowledge by examining whether subjective age, how old or young individuals experience themselves to be relative to their chronological age, contributes to walking speed. Participants were drawn from the 2008 and 2012 waves of the Health and Retirement Study (HRS, N = 2970) and the 2011 and 2013 waves of the National Health and Aging Trends Study (NHATS, N = 5423). In both the HRS and the NHATS, linear regression analysis revealed that a younger subjective age was associated with faster walking speed at baseline and with less decline over time, controlling for age, sex, education, and race. These associations were partly accounted for by depressive symptoms, disease burden, physical activity, cognition, body mass index, and smoking. Additional analysis revealed that feeling younger than one's age was associated with a reduced risk of walking slower than the frailty-related threshold of 0.6 m/s at follow-up in the HRS. The present study provides novel and consistent evidence across two large prospective studies for an association between the subjective experience of age and walking speed of older adults. Subjective age may help identify individuals at risk for mobility limitations in old age and may be a target for interventions designed to mitigate functional decline.

  8. A Clinico-Etiological Study of Dermatoses in Pediatric Age Group in Tertiary Health Care Center in South Gujarat Region

    PubMed Central

    Jawade, Sugat A; Chugh, Vishal S; Gohil, Sneha K; Mistry, Amit S; Umrigar, Dipak D

    2015-01-01

    Background: Dermatologic conditions have different presentation and management in pediatric age group from that in adult; this to be studied separately for statistical and population based analysis. Objective: To study the pattern of various dermatoses in infants and children in tertiary health care center in South Gujarat region. Materials and Methods: This is a prospective study; various dermatoses were studied in pediatric patients up to 14 years of age attending the Dermatology OPD of New Civil Hospital, Surat, Gujarat over a period of 12 months from June 2009 to June 2010. All patients were divided into four different study groups: <1 month (neonates), 1 month to 1 year, >1 to 6 years and 7 to 14 years. Results: There were 596 boys and 425 girls in total 1021 study populations. Majority of the skin conditions in neonates were erythema toxicum neonatorum (12.97%), scabies (9.92%), mongolian spot (9.16%), and seborrheic dermatitis (7.63%). In > 1 month to 14 years age group of children among infectious disorder, children were found to be affected most by scabies (24.49%), impetigo (5.96%), pyoderma (5.62%), molluscum contagiosum (5.39%), tinea capitis (4.49%), leprosy (2.02%), and viral warts (1.35%) while among non-infectious disorders, they were affected by atopic dermatitis (4.27%), pityriasis alba (4.16%), seborrheic dermatitis (3.60%), pityriasis rosea (3.15%), others (3.01%), phrynoderma (2.70%), lichen planus (2.58%), contact dermatitis (1.57%) and ichthyosis (1.45%). Conclusion: There is a need to emphasize on training the management of common pediatric dermatoses to dermatologists, general practitioners and pediatricians for early treatment. PMID:26677296

  9. Quantitative clinical pharmacology for size and age scaling in pediatric drug development: A systematic review.

    PubMed

    Samant, Tanay S; Mangal, Naveen; Lukacova, Viera; Schmidt, Stephan

    2015-11-01

    The establishment of drug dosing in children is often hindered by the lack of actual pediatric efficacy and safety data. To overcome this limitation, scaling approaches are frequently employed to leverage adult clinical information for informing pediatric dosing. The objective of this review is to provide a comprehensive overview of the different scaling approaches used in pediatric pharmacotherapy as well as their proper implementation in drug development and clinical use. We will start out with a brief overview of the current regulatory requirements in pediatric drug development, followed by a review of the most commonly employed scaling approaches in increasing order of complexity ranging from simple body weight-based dosing to physiologically-based pharmacokinetic (PBPK) modeling approaches. Each of the presented approaches has advantages and limitations, which will be highlighted throughout the course of the review by the use of clinically-relevant examples. The choice of the approach employed consequently depends on the clinical question at hand and the availability of sufficient clinical data. The main effort while establishing and qualifying these scaling approaches should be directed towards the development of safe and effective dosing regimens in children rather than identifying the best model, ie models should be fit for purpose.

  10. Trajectory of Life Satisfaction and Its Relationship with Subjective Economic Status and Successful Aging

    ERIC Educational Resources Information Center

    Hsu, Hui-Chuan

    2010-01-01

    The aim of the study was to explore the relationship between subjective economic status and indicators of successful aging to life satisfaction trajectories among the elderly in Taiwan. Data were from the four waves of "Survey of Health and Living Status of the Elderly in Taiwan". Hierarchical linear modeling was conducted. Subjective economic…

  11. Subjective Cognitive Complaints, Memory Performance, and Depressive Affect in Old Age: A Change-Oriented Approach

    ERIC Educational Resources Information Center

    Zimprich, Daniel; Martin, Mike; Kliegel, Matthias

    2003-01-01

    The question of whether and how subjective cognitive complaints are related to actual cognitive performance represents a central issue in applied cognitive aging research. Until recently, however, many studies have failed to find a strong association between subjective cognitive complaints and actual cognitive performance. In our study, we examine…

  12. Inaccuracy of age assessment from images of postpubescent subjects in cases of alleged child pornography.

    PubMed

    Rosenbloom, Arlan L

    2013-03-01

    Despite frequent medical expert testimony authoritatively stating that images of individuals who are postpubescent indicate age less than 18 and therefore, child pornography, developmental experts have noted that a scientific basis for such estimation is lacking. In fact, recent studies have demonstrated a high degree of inaccuracy in such estimates, and that the stage of breast development often used as indicative of age under 18 years is present in a substantial percentage of adult women. Ten images of adult women from legitimate pornographic sites promoting youthful images were shown to 16 pediatric endocrinologists expert in evaluating maturation, who determined whether or not the individuals represented were under 18 years of age. They also provided information about what features were most important in their evaluations. Sixty-nine percent of the 160 estimates were that the images represented females under 18 years of age. There was wide variability in the designation of importance of the various features of maturation in reaching conclusions, with breast development and facial appearance considered most important. This study confirms that medical testimony, even by experts in adolescent development, can deem images of adult women selected for their youthful appearance to be under age 18 two thirds of the time. Thus, important as prosecuting users of child pornographic material may be, justice requires the avoidance of testimony that is not scientifically based. PMID:22960879

  13. Inaccuracy of age assessment from images of postpubescent subjects in cases of alleged child pornography.

    PubMed

    Rosenbloom, Arlan L

    2013-03-01

    Despite frequent medical expert testimony authoritatively stating that images of individuals who are postpubescent indicate age less than 18 and therefore, child pornography, developmental experts have noted that a scientific basis for such estimation is lacking. In fact, recent studies have demonstrated a high degree of inaccuracy in such estimates, and that the stage of breast development often used as indicative of age under 18 years is present in a substantial percentage of adult women. Ten images of adult women from legitimate pornographic sites promoting youthful images were shown to 16 pediatric endocrinologists expert in evaluating maturation, who determined whether or not the individuals represented were under 18 years of age. They also provided information about what features were most important in their evaluations. Sixty-nine percent of the 160 estimates were that the images represented females under 18 years of age. There was wide variability in the designation of importance of the various features of maturation in reaching conclusions, with breast development and facial appearance considered most important. This study confirms that medical testimony, even by experts in adolescent development, can deem images of adult women selected for their youthful appearance to be under age 18 two thirds of the time. Thus, important as prosecuting users of child pornographic material may be, justice requires the avoidance of testimony that is not scientifically based.

  14. Younger age at onset of sporadic Parkinson's disease among subjects occupationally exposed to metals and pesticides

    PubMed Central

    Farb, David H.; Ozer, Josef; Feldman, Robert G.; Durso, Raymon

    2014-01-01

    An earlier age at onset of Parkinson's disease (PD) has been reported to be associated with occupational exposures to manganese and hydrocarbon solvents suggesting that exposure to neurotoxic chemicals may hasten the progression of idiopathic PD. In this study the role of occupational exposure to metals and pesticides in the progression of idiopathic PD was assessed by looking at age at disease onset. The effects of heritable genetic risk factors, which may also influence age at onset, was minimized by including only sporadic cases of PD with no family history of the disease (n=58). Independent samples Student t-test revealed that subjects with occupational exposure to metals and/or pesticides (n=36) were significantly (p=0.013) younger than unexposed controls (n=22). These subjects were then divided into three groups [high (n=18), low (n=18), and unexposed (n=22)] to ascertain if duration of exposure further influenced age at onset of PD. One-way ANOVA revealed that subjects in the high exposure group were significantly (p=0.0121) younger (mean age: 50.33 years) than unexposed subjects (mean age: 60.45 years). Subjects were also stratified by exposure type (metals vs. pesticides). These results suggest that chronic exposure to metals and pesticides is associated with a younger age at onset of PD among patients with no family history of the disease and that duration of exposure is a factor in the magnitude of this effect. PMID:26109889

  15. Chronological and subjective age differences in flourishing mental health and major depressive episode.

    PubMed

    Keyes, Corey L M; Westerhof, Gerben J

    2012-01-01

    Mental health is more than the absence of psychopathology, but few studies use positive mental health along with a measure of past year major depressive episode (MDE). This study addresses this gap by investigating the association of MDE and flourishing mental health (FMH) with chronological age and subjective (felt and ideal) age. Data are from the Midlife in the United States random digit dialing sample of adults ages 25 to 74, collected in 1995 (n = 3032). Rates of MDE were lowest, and FMH highest, among the three oldest age cohorts (45-54, 55-64, 65-74 years). Subjective age was linked with chronological age; with age, adults tend to feel younger, and want to be an age that is younger, than their actual age. As predicted by the model of subjective age as an adaptive strategy, feeling younger was related to a lower risk of MDE and a higher risk of FMH. However, wanting to be younger was related to a lower risk of FMH and unrelated to MDE. PMID:21780972

  16. Life Satisfaction, Self-Esteem, and Subjective Age in Women across the Life Span

    ERIC Educational Resources Information Center

    Borzumato-Gainey, Christine; Kennedy, Alison; McCabe, Beth; Degges-White, Suzanne

    2009-01-01

    A study of 320 women, ages 21 to 69, explored the relations among relationship status, subjective age, self-esteem, and life satisfaction. Women in married or partnered relationships had higher levels of life satisfaction than did single women. Women in their 30s and 40s had significantly lower levels of life satisfaction than did other age…

  17. Salivary alpha amylase activity in human beings of different age groups subjected to psychological stress.

    PubMed

    Sahu, Gopal K; Upadhyay, Seema; Panna, Shradha M

    2014-10-01

    Salivary alpha-amylase (sAA) has been proposed as a sensitive non-invasive biomarker for stress-induced changes in the body that reflect the activity of the sympathetic nervous system. Though several experiments have been conducted to determine the validity of this salivary component as a reliable stress marker in human subjects, the effect of stress induced changes on sAA level in different age groups is least studied. This article reports the activity of sAA in human subjects of different age groups subjected to psychological stress induced through stressful video clip. Differences in sAA level based on sex of different age groups under stress have also been studied. A total of 112 subjects consisting of both the male and female subjects, divided into two groups on basis of age were viewed a video clip of corneal transplant surgery as stressor. Activity of sAA from saliva samples of the stressed subjects were measured and compared with the activity of the samples collected from the subjects before viewing the clip. The age ranges of subjects were 18-25 and 40-60 years. The sAA level increased significantly in both the groups after viewing the stressful video. The increase was more pronounced in the younger subjects. The level of sAA was comparatively more in males than females in the respective groups. No significant change in sAA activity was observed after viewing the soothed video clip. Significant increase of sAA level in response to psychological stress suggests that it might act as a reliable sympathetic activity biochemical marker in different stages of human beings.

  18. Role of Quantitative Clinical Pharmacology in Pediatric Approval and Labeling.

    PubMed

    Mehrotra, Nitin; Bhattaram, Atul; Earp, Justin C; Florian, Jeffry; Krudys, Kevin; Lee, Jee Eun; Lee, Joo Yeon; Liu, Jiang; Mulugeta, Yeruk; Yu, Jingyu; Zhao, Ping; Sinha, Vikram

    2016-07-01

    Dose selection is one of the key decisions made during drug development in pediatrics. There are regulatory initiatives that promote the use of model-based drug development in pediatrics. Pharmacometrics or quantitative clinical pharmacology enables development of models that can describe factors affecting pharmacokinetics and/or pharmacodynamics in pediatric patients. This manuscript describes some examples in which pharmacometric analysis was used to support approval and labeling in pediatrics. In particular, the role of pharmacokinetic (PK) comparison of pediatric PK to adults and utilization of dose/exposure-response analysis for dose selection are highlighted. Dose selection for esomeprazole in pediatrics was based on PK matching to adults, whereas for adalimumab, exposure-response, PK, efficacy, and safety data together were useful to recommend doses for pediatric Crohn's disease. For vigabatrin, demonstration of similar dose-response between pediatrics and adults allowed for selection of a pediatric dose. Based on model-based pharmacokinetic simulations and safety data from darunavir pediatric clinical studies with a twice-daily regimen, different once-daily dosing regimens for treatment-naïve human immunodeficiency virus 1-infected pediatric subjects 3 to <12 years of age were evaluated. The role of physiologically based pharmacokinetic modeling (PBPK) in predicting pediatric PK is rapidly evolving. However, regulatory review experiences and an understanding of the state of science indicate that there is a lack of established predictive performance of PBPK in pediatric PK prediction. Moving forward, pharmacometrics will continue to play a key role in pediatric drug development contributing toward decisions pertaining to dose selection, trial designs, and assessing disease similarity to adults to support extrapolation of efficacy. PMID:27079249

  19. Age Identity in Context: Stress and the Subjective Side of Aging

    ERIC Educational Resources Information Center

    Schafer, Markus H.; Shippee, Tetyana Pylypiv

    2010-01-01

    The passage of time is fundamentally experienced through people's interaction with their social worlds. Life-course scholars acknowledge the multiple aspects of time-based experience but have given little attention to age identity in a dynamic context. Drawing from a stress-process model, we expected that turbulence within people's family…

  20. [The age-specific features of palm dermatoglyphics in the adults subjects].

    PubMed

    Teplov, K V; Bozhchenko, A P; Tolmachev, I A; Moiseenko, S A

    2016-01-01

    This article was designed to consider the congenital age-specific features of palm dermatoglyphics in the adults subjects (including the type of the papillary patterns, axial tri-radii, the termini of palmar main lines, the rudiments of palmar lines, the dermatoglyphic ridge count between the stable anatomical structures). The objective of the study was to look for the new diagnostic markers of the biological age. It included the identification of the palm prints obtained from 180 Caucasoid men and 120 women at the age varying from 16 to 80 years. The results of the mathematical and statistical analysis provided the basis for drawing up the list of 18 attributes of palm dermatoglyphics significantly (p<0.05) differing in the frequency of occurrence between the representatives of individual age groups. The methods are proposed allowing to use these findings for the expert evaluation of the age of unknown subjects.

  1. Subjective and Objective Memory Changes in Old Age across Five Years.

    PubMed

    Zimprich, Daniel; Kurtz, Tanja

    2015-01-01

    Typically, subjective memory assessments (be it in form of single items or questionnaires) in old age only weakly correlate with the performance in objective memory tests at cross-section. It thus appears as if individual differences in subjective memory assessments hardly reflect individual differences in memory in old age. A shortcoming of cross-sectional studies, however, is that subjective assessments may rely on different individual standards, which are not taken into account. One solution to this problem has been to investigate subjective and objective memory longitudinally, thereby focusing on individual differences in intraindividual changes. Results from studies using this approach have been mixed, with some studies showing a significantly stronger relation between changes than between levels, and other studies showing no such significant difference. Using data from the Zurich Longitudinal Study on Cognitive Aging (n=236), we find that 5-year changes in subjective assessments of memory capacity and memory changes correlate with objective memory changes of 0.54 and -0.44, respectively. These correlations are significantly stronger than at cross-section. After controlling for age, depressive affect, and subjective health at the first measurement occasion, correlations are slightly attenuated, but the basic findings remain the same. PMID:25791780

  2. Optimizing Imaging Quality and Radiation Dose by the Age-Dependent Setting of Tube Voltage in Pediatric Chest Digital Radiography

    PubMed Central

    Guo, Hui; Liu, Wen-Ya; He, Xiao-Ye; Zhou, Xiao-Shan; Zeng, Qun-Li

    2013-01-01

    Objective The quality and radiation dose of different tube voltage sets for chest digital radiography (DR) were compared in a series of pediatric age groups. Materials and Methods Forty-five hundred children aged 0-14 years (yr) were randomly divided into four groups according to the tube voltage protocols for chest DR: lower kilovoltage potential (kVp) (A), intermediate kVp (B), and higher kVp (C) groups, and the fixed high kVp group (controls). The results were analyzed among five different age groups (0-1 yr, 1-3 yr, 3-7 yr, 7-11 yr and 11-14 yr). The dose area product (DAP) and visual grading analysis score (VGAS) were determined and compared by using one-way analysis of variance. Results The mean DAP of protocol C was significantly lower as compared with protocols A, B and controls (p < 0.05). DAP was higher in protocol A than the controls (p <0.001), but it was not statistically significantly different between B and the controls (p = 0.976). Mean VGAS was lower in the controls than all three protocols (p < 0.001 for all). Mean VGAS did not differ between protocols A and B (p = 0.334), but was lower in protocol C than A (p = 0.008) and B (p = 0.049). Conclusion Protocol C (higher kVp) may help optimize the trade-off between radiation dose and image quality, and it may be acceptable for use in a pediatric age group from these results. PMID:23323043

  3. How avoidant attachment influences subjective well-being: an investigation about the age and gender differences.

    PubMed

    Li, Tianyuan; Fung, Helene H

    2014-01-01

    Intimate relationship is a significant factor that influences older adults' subjective well-being. Avoidant attachment reflects a basic working model regarding interpersonal relationships. The current study aims to test how age and gender moderate the effect of avoidant attachment to spouse on subjective well-being. Fifty-six married couples aged from 20 to 79 years in Hong Kong were recruited for the study. Their avoidant attachment to spouse and subjective well-being were measured by questionnaires. In general, avoidant attachment to spouse was found to undermine subjective well-being. More importantly, age significantly moderated the negative association between avoidant attachment and subjective well-being, but the direction of the moderating effect was opposite for husbands and wives. Compared with their younger counterparts, the detrimental effect of avoidant attachment on subjective well-being was weaker for older wives but stronger for older husbands. The results suggest that marital relationship may play different roles in different life stages for the two genders. In later adulthood, males may become more dependent on the marital relationship to maintain subjective well-being, whereas females can be relatively independent.

  4. Sensitivity of lymphocytes to prostaglandin E2 increases in subjects over age 70.

    PubMed Central

    Goodwin, J S; Messner, R P

    1979-01-01

    We examined the sensitivity of lymphocytes from different age groups to inhibition by prostaglandin E2. Phytohemagglutinin-stimulated cultures of peripheral blood mononuclear cells from 12 healthy subjects over the age of 70 were much more sensitive to inhibition by exogenously added prostaglandin E2 than were cells from 17 young controls (ID50 congruent to 10 nM for the subjects over 70 vs. greater than 3 micronM for the young controls). The more senstivie lymphocytes from a subject over 70 were to prostaglandin E2, the lower was his or her response to phytohemagglutinin (r = 0.75, P less than 0.01). The mean responses to phytohemagglutinin of the peripheral blood mononuclear cells from the subjects over 70 were significantly depressed compared to the young controls. Addition of indomethacin, a prostaglandin synthetase inhibitor, to the cultures resulted in an increase in [3H]thymidine incorporation of 140 +/- 16% in the cells of the subjects over 70 vs. a 36 +/- 3% increase in the young controls (mean +/- SEM, P less than 0.001). The mean phytohemagglutinin response of the subjects over 70 was 40% of the control response without indomethacin. With addition of indomethacin the response of subjects over 70 rose to 72% of control. Thus, increased sinsitivity to prostaglandin E2 appears to be responsible in part for the depressed mitogen response of peripheral blood mononuclear cells from healthy subjects over 70. PMID:457862

  5. Fosmidomycin plus Clindamycin for Treatment of Pediatric Patients Aged 1 to 14 Years with Plasmodium falciparum Malaria

    PubMed Central

    Borrmann, Steffen; Lundgren, Ingrid; Oyakhirome, Sunny; Impouma, Bénido; Matsiegui, Pierre-Blaise; Adegnika, Ayola A.; Issifou, Saadou; Kun, Jürgen F. J.; Hutchinson, David; Wiesner, Jochen; Jomaa, Hassan; Kremsner, Peter G.

    2006-01-01

    Fosmidomycin plus clindamycin was shown to be efficacious in the treatment of uncomplicated Plasmodium falciparum malaria in a small cohort of pediatric patients aged 7 to 14 years, but more data, including data on younger children with less antiparasitic immunity, are needed to determine the potential value of this new antimalarial combination. We conducted a single-arm study to improve the precision of efficacy estimates for an oral 3-day fixed-ratio combination of fosmidomycin and clindamycin at 30 and 10 mg/kg of body weight, respectively, every 12 hours for the treatment of uncomplicated P. falciparum malaria in 51 pediatric outpatients aged 1 to 14 years. Fosmidomycin plus clindamycin was generally well tolerated, but relatively high rates of treatment-associated neutropenia (8/51 [16%]) and falls of hemoglobin concentrations of ≥2 g/dl (7/51 [14%]) are of concern. Asexual parasites and fever were cleared within median periods of 42 h and 38 h, respectively. All patients who could be evaluated were parasitologically and clinically cured by day 14 (49/49; 95% confidence interval [CI], 93 to 100%). The per-protocol, PCR-adjusted day 28 cure rate was 89% (42/47; 95% CI, 77 to 96%). Efficacy appeared to be significantly reduced in children aged 1 to 2 years, with a day 28 cure rate of only 62% for this small subgroup (5/8). The inadequate efficacy in children of <3 years highlights the need for continued systematic studies of the current dosing regimen, which should include randomized trial designs. PMID:16870763

  6. A prospective study of young females' sexual subjectivity: associations with age, sexual behavior, and dating.

    PubMed

    Zimmer-Gembeck, Melanie J; Ducat, Wendy H; Boislard-Pepin, Marie-Aude

    2011-10-01

    Sexual self-perceptions are important aspects of sexuality, which can undergo significant change during adolescence and early adulthood. The purpose of this study was to describe these changes among girls (N = 251; ages 16-25) over one year, and to examine associations of sexual self-perceptions (sexual subjectivity) with age, sexual behavior, and romantic status. Sexual body-esteem, perceptions of entitlement to desire and pleasure, sexual efficacy, and sexual self-reflection were investigated as elements of sexual subjectivity. All sexual subjectivity elements were higher among girls who had more sexual experience and/or had steady romantic partners during the study. Perception of entitlement to desire and pleasure increased over time, whereas sexual body-esteem showed the most stability and had minimal associations with sexual or romantic experiences. The greatest increases in sexual subjectivity were found among girls who began the study with the least sociosexual experience and self-reflection also increased for girls who had first coitus after the start of the study. Overall, girls who had sexual intercourse the earliest (before age 16) had the highest sexual subjectivity, but sexual subjectivity increased the most among girls without coital experience or who had more recent first coitus.

  7. Pediatric Neurotrauma

    PubMed Central

    Kannan, Nithya; Ramaiah, Ramesh; Vavilala, Monica S.

    2014-01-01

    Traumatic brain injury (TBI) is the leading cause of death and disability in children over 1 year of age. Knowledge about the age-specific types of injury and how to manage children with neurotrauma is essential to understanding and recognizing the extent and degree of injury and to optimize outcomes. In this article, we review the epidemiology, pathophysiology, and clinical management of pediatric neurotrauma. PMID:25024940

  8. Dyspnea and dysphagia from upper airway obstruction after occipitocervical fusion in the pediatric age group.

    PubMed

    Huang, Meng; Gonda, David D; Briceño, Valentina; Lam, Sandi K; Luerssen, Thomas G; Jea, Andrew

    2015-04-01

    Upper airway obstruction resulting from overflexion of the craniocervical junction after occipitocervical fusion is a rare but potentially life-threatening complication and is associated with morbidity. The authors retrospectively reviewed the medical records and diagnostic images of 2 pediatric patients who underwent occipitocervical fusion by the Neuro-Spine Program at Texas Children's Hospital and experienced dyspnea and/or dysphagia from new upper airway obstruction in the postoperative period. Patient demographics, operative data, and preoperative and postoperative occiput-C2 angles were recorded. A review of the literature for similar complications after occipitocervical fusion was performed. A total of 13 cases of prolonged upper airway obstruction after occipitocervical fusion were analyzed. Most of these cases involved adults with rheumatoid arthritis. To the best of the authors' knowledge, there have been no previous reports of prolonged upper airway obstruction in children after an occipitocervical fusion. Fixation of the neck in increased flexion (-18° to -5°) was a common finding among these adult and pediatric cases. The authors' cases involved children with micrognathia and comparatively large tongues, which may predispose the oropharynx to obstruction with even the slightest amount of increased flexion. Close attention to a satisfactory fixation angle (occiput-C2 angle) is necessary to avoid airway obstruction after an occipitocervical fusion. Children with micrognathia are particularly sensitive to changes in flexion at the craniocervical junction after occipitocervical fixation. PMID:25828489

  9. Macular retinal sensitivity using MP-1 in healthy Malaysian subjects of different ages

    PubMed Central

    Ismail, Siti Aishah; Sharanjeet-Kaur; Mutalib, Haliza Abdul; Ngah, Nor Fariza

    2015-01-01

    Purpose To determine the influence of age and gender on macular sensitivity to light in healthy subjects of 4 age groups using the MP-1 microperimeter. Methods A prospective study was carried out on 50 healthy subjects (age range: 18–60 years) divided into 4 age groups; 18–30 years, 31–40 years, 41–50 years and 51–60 years. Full-threshold microperimetry of the central 10° of retina was performed utilizing 32 points with the MP-1. Macula area was divided into four quadrants, which were superior nasal (SN), inferior nasal (IN), inferior temporal (IT) and superior temporal (ST). Results Total mean sensitivity at 10° for age groups 18–30 years, 31–40 years, 41–50 years and 51–60 years were 19.46 ± 0.30, 19.40 ± 0.39, 19.47 ± 0.35 and 18.73 ± 0.75 (dB), respectively. There was a significant difference in total mean retinal sensitivity at 10° and at the four quadrants with age but not for gender. The retinal sensitivity was highest in the IT quadrant and lowest in the SN quadrant for all age groups. The linear regression analysis revealed that there was a 0.019 dB, 0.016 dB, 0.022 dB, 0.029 dB and 0.029 dB per year age-related decline in mean macular sensitivity within the central 10° diameter in the SN, IN, IT and ST quadrants respectively. Conclusion Among normal healthy subjects, there was a linear decline in retinal light sensitivity with increasing age with the highest reduction in the superior nasal quadrant and lowest in the inferior temporal quadrant. PMID:26025808

  10. The prognostic value of injury severity, location of event, and age at injury in pediatric traumatic head injuries

    PubMed Central

    Halldorsson, Jonas G; Flekkoy, Kjell M; Arnkelsson, Gudmundur B; Tomasson, Kristinn; Gudmundsson, Kristinn R; Arnarson, Eirikur Orn

    2008-01-01

    Aims To estimate the prognostic value of injury severity, location of event, and demographic parameters, for symptoms of pediatric traumatic head injury (THI) 4 years later. Methods Data were collected prospectively from Reykjavik City Hospital on all patients age 0–19 years, diagnosed with THI (n = 408) during one year. Information was collected on patient demographics, location of traumatic event, cause of injury, injury severity, and ICD-9 diagnosis. Injury severity was estimated according to the Head Injury Severity Scale (HISS). Four years post-injury, a questionnaire on late symptoms attributed to the THI was sent. Results Symptoms reported were more common among patients with moderate/severe THI than among others (p < 0.001). The event location had prognostic value (p < 0.05). Overall, 72% of patients with moderate/severe motor vehicle-related THI reported symptoms. There was a curvilinear age effect (p < 0.05). Symptoms were least frequent in the youngest age group, 0–4 years, and most frequent in the age group 5–14 years. Gender and urban/rural residence were not significantly related to symptoms. Conclusions Motor vehicle related moderate/severe THI resulted in a high rate of late symptoms. Location had a prognostic value. Patients with motor vehicle-related THI need special consideration regardless of injury severity. PMID:18728737

  11. Revisiting the Structure of Subjective Well-Being in Middle-Aged Adults

    ERIC Educational Resources Information Center

    Chmiel, Magda; Brunner, Martin; Martin, Romain; Schalke, Daniela

    2012-01-01

    Subjective well-being is a broad, multifaceted construct comprising general satisfaction with life, satisfaction with life domains (health, family, people, free time, self, housing, work, and finances), positive affect, and negative affect. Drawing on representative data from middle-aged adults (N = 738), the authors used three different…

  12. The Influence of Psychophysiological Variables on Aged Subjects' Functional Reading Achievement.

    ERIC Educational Resources Information Center

    Lovelace, Terry

    A study investigated the effects of selected psychophysiological factors known to affect cognitive functioning on the reading achievement of older adults. The subjects, 34 noninstitutionalized adults ranging in age from 50 to 88 years, completed measures of (1) self-reported mental and physical health, (2) nonverbal intelligence, (3) reading…

  13. Influence of Arousal, Previous Experience, and Age on Surgery Preparation of Same Day of Surgery and In-Hospital Pediatric Patients.

    ERIC Educational Resources Information Center

    Faust, Jan; Melamed, Barbara G.

    1984-01-01

    Studied two pediatric surgery populations (N=66) to determine differences in retention of preparatory information. Results showed that children exposed to a hospital-relevant film retained more information than those children not prepared regardless of age, IQ, previous experience, sex, and time of film preparation. (LLL)

  14. Profiling age-related epigenetic markers of stomach adenocarcinoma in young and old subjects.

    PubMed

    Kim, Byoung-Chul; Jeong, Hyoung Oh; Park, Daeui; Kim, Chul-Hong; Lee, Eun Kyeong; Kim, Dae Hyun; Im, Eunok; Kim, Nam Deuk; Lee, Sunghoon; Yu, Byung Pal; Bhak, Jong; Chung, Hae Young

    2015-01-01

    The purpose of our study is to identify epigenetic markers that are differently expressed in the stomach adenocarcinoma (STAD) condition. Based on data from The Cancer Genome Atlas (TCGA), we were able to detect an age-related difference in methylation patterns and changes in gene and miRNA expression levels in young (n = 14) and old (n = 70) STAD subjects. Our analysis identified 323 upregulated and 653 downregulated genes in old STAD subjects. We also found 76 miRNAs with age-related expression patterns and 113 differentially methylated genes (DMGs), respectively. Our further analysis revealed that significant upregulated genes (n = 35) were assigned to the cell cycle, while the muscle system process (n = 27) and cell adhesion-related genes (n = 57) were downregulated. In addition, by comparing gene and miRNA expression with methylation change, we identified that three upregulated genes (ELF3, IL1β, and MMP13) known to be involved in inflammatory responses and cell growth were significantly hypomethylated in the promoter region. We further detected target candidates for age-related, downregulated miRNAs (hsa-mir-124-3, hsa-mir-204, and hsa-mir-125b-2) in old STAD subjects. This is the first report of the results from a study exploring age-related epigenetic biomarkers of STAD using high-throughput data and provides evidence for a complex clinicopathological condition expressed by the age-related STAD progression.

  15. Aging Effects on Cardiac and Respiratory Dynamics in Healthy Subjects across Sleep Stages

    PubMed Central

    Schumann, Aicko Y.; Bartsch, Ronny P.; Penzel, Thomas; Ivanov, Plamen Ch.; Kantelhardt, Jan W.

    2010-01-01

    Study Objectives: Respiratory and heart rate variability exhibit fractal scaling behavior on certain time scales. We studied the short-term and long-term correlation properties of heartbeat and breathing-interval data from disease-free subjects focusing on the age-dependent fractal organization. We also studied differences across sleep stages and night-time wake and investigated quasi-periodic variations associated with cardiac risk. Design: Full-night polysomnograms were recorded during 2 nights, including electrocardiogram and oronasal airflow. Setting: Data were collected in 7 laboratories in 5 European countries. Participants: 180 subjects without health complaints (85 males, 95 females) aged from 20 to 89 years. Interventions: None. Measurements and Results: Short-term correlations in heartbeat intervals measured by the detrended fluctuation analysis (DFA) exponent α1 show characteristic age dependence with a maximum around 50–60 years disregarding the dependence on sleep and wake states. Long-term correlations measured by α2 differ in NREM sleep when compared with REM sleep and wake, besides weak age dependence. Results for respiratory intervals are similar to those for α2 of heartbeat intervals. Deceleration capacity (DC) decreases with age; it is lower during REM and deep sleep (compared with light sleep and wake). Conclusion: The age dependence of α1 should be considered when using this value for diagnostic purposes in post-infarction patients. Pronounced long-term correlations (larger α2) for heartbeat and respiration during REM sleep and wake indicate an enhanced control of higher brain regions, which is absent during NREM sleep. Reduced DC possibly indicates an increased cardiovascular risk with aging and during REM and deep sleep. Citation: Schumann AY; Bartsch RP; Penzel T; Ivanov PC; Kantelhardt JW. Aging effects on cardiac and respiratory dynamics in healthy subjects across sleep stages. SLEEP 2010;33(7):943-955. PMID:20614854

  16. The effect of age on diurnal variation in the pharmacokinetics of propranolol in hypertensive subjects.

    PubMed

    Shiga, T; Fujimura, A; Tateishi, T; Ohashi, K; Ebihara, A

    1993-01-01

    There is diurnal variation in the absorption rate of propranolol in younger subjects. This study was undertaken to examine the effect of age on the chronopharmacokinetics of propranolol. We gave 20 mg of propranolol orally to 13 younger and 11 older hypertensive subjects at 09.00 h (day study) or 21.00 h (night study) in a cross-over design. Plasma concentrations of propranolol and its metabolites, 4-hydroxypropranolol and naphthoxylactic acid, were determined just before and at 0.5, 1, 1.5, 2, 3, 4, 6, 12, and 24 h after dosage. In the younger subjects the absorption rate constant (ka) of propranolol and its maximum plasma concentration (Cmax) were significantly higher and the time to maximum concentration (tmax) was significantly shorter in the day than at night. There were similar time-variant changes in Cmax and tmax for 4-hydroxypropranolol and naphthoxylactic acid. In contrast, there were no time-variant changes in ka, Cmax and tmax of propranolol and its metabolites in the older subjects. These results suggest that propranolol is absorbed more rapidly after morning dosing than after night-time dosing in younger but not in older subjects. Based on these findings, we speculate that the time-variance in the absorption rate or first-pass elimination, or both, of propranolol diminish with age.

  17. Low grade astrocytoma in children under the age of three years: a report from the Canadian pediatric brain tumour consortium.

    PubMed

    Johnston, Donna L; Keene, Daniel; Bartels, Ute; Carret, Anne-Sophie; Crooks, Bruce; Eisenstat, David D; Fryer, Chris; Lafay-Cousin, Lucie; Larouche, Valerie; Moghrabi, Albert; Wilson, Beverly; Zelcer, Shayna; Silva, Mariana; Bouffet, Eric

    2015-08-01

    In children under the age of 3 years, the most common solid tumors are brain tumors. Low grade astrocytomas represent 30-40 % of brain tumours in this age group. This study reviewed the incidence, characteristics, therapy, and outcome of children less than 36 months of age diagnosed with a low grade astrocytoma from 1990 to 2005 in Canada. A data bank was established using data collected from Canadian pediatric oncology centers on children less than age 3 diagnosed with brain tumors between 1990 and 2005. Cases of low grade astrocytoma were extracted from this data bank and their characteristics summarized. From the 579 cases in the data bank, 153 cases of low grade astrocytoma (26 %) were identified. The mean duration of symptoms prior to presentation was 13 weeks, and 53 % of patients underwent a greater than 90 % resection of their tumor, while 30 % underwent 10-90 % resection. Seventy-one percent of patients received no further therapy after surgery and of the 45 who received therapy following surgery, 43 received chemotherapy, and 5 received radiation therapy. Sixty-eight patients had recurrence or progression of their tumor. Eighty-seven percent of patients were alive at the time of the survey with a 2 year survival rate of 95.3 ± 1.8 %, 5 year survival rate of 93.1 ± 2.1 % and 10 year survival rate of 89.1 ± 2.8 %. The 5 year survival rate for Canadian children less than 36 months of age with a low grade astrocytoma was 93.0 ± 2.8 % which is similar to that for older children with this tumor.

  18. Dual role of the caspase enzymes in satellite cells from aged and young subjects.

    PubMed

    Fulle, S; Sancilio, S; Mancinelli, R; Gatta, V; Di Pietro, R

    2013-01-01

    Satellite cell (SC) proliferation and differentiation have critical roles in skeletal muscle recovery after injury and adaptation in response to hypertrophic stimuli. Normal ageing hinders SC proliferation and differentiation, and is associated with increased expression of a number of pro-apoptotic factors in skeletal muscle. In light of previous studies that have demonstrated age-related altered expression of genes involved in SC antioxidant and repair activity, this investigation was aimed at evaluating the incidence of apoptotic features in human SCs. Primary cells were obtained from vastus lateralis of nine young (27.3±2.0 years old) and nine old (71.1±1.8 years old) subjects, and cultured in complete medium for analyses at 4, 24, 48, and 72 h. Apoptosis was assessed using AnnexinV/propidium iodide staining, the terminal deoxynucleotidyl transferase dUTP nick-end labelling technique, RT-PCR, DNA microarrays, flow cytometry, and immunofluorescence analysis. There was an increased rate of apoptotic cells in aged subjects at all of the experimental time points, with no direct correlation between AnnexinV-positive cells and caspase-8 activity. On the other hand, CASP2, CASP6, CASP7, and CASP9 and a number of cell death genes were upregulated in the aged SCs. Altogether, our data show age-related enhanced susceptibility of human SCs to apoptosis, which might be responsible for their reduced response to muscle damage. PMID:24336075

  19. Subjective Sleep Complaints in Pediatric Depression: A Controlled Study and Comparison with EEG Measures of Sleep and Waking

    ERIC Educational Resources Information Center

    Bertocci, Michele A.; Dahl, Ronald E.; Williamson, Douglas E.; Iosif, Ana-Maria; Birmaher, Boris; Axelson, David; Ryan, Neal D.

    2005-01-01

    Objective: Children with major depressive disorder (MDD) often complain of sleep disturbances; however, polysomnographic studies have failed to find objective evidence of these disturbances. This article examines subjective sleep reports of children with MDD and healthy controls focusing on comparing subjective and objective sleep measures.…

  20. Age influences the relation between subjective valence ratings and emotional word use during autobiographical memory retrieval.

    PubMed

    Ford, Jaclyn H; DiGirolamo, Marissa A; Kensinger, Elizabeth A

    2016-09-01

    Recent research reveals an age-related increase in positive autobiographical memory retrieval using a number of positivity measures, including valence ratings and positive word use. It is currently unclear whether the positivity shift in each of these measures co-occurs, or if age uniquely influences multiple components of autobiographical memory retrieval. The current study examined the correspondence between valence ratings and emotional word use in young and older adults' autobiographical memories. Positive word use in narratives was associated with valence ratings only in young adults' narratives. Older adults' narratives contained a consistent level of positive word use regardless of valence rating, suggesting that positive words and concepts may be chronically accessible to older adults during memory retrieval, regardless of subjective valence. Although a relation between negative word use in narratives and negative valence ratings was apparent in both young and older adults, it was stronger in older adults' narratives. These findings confirm that older adults do vary their word use in accordance with subjective valence, but they do so in a way that is different from young adults. The results also point to a potential dissociation between age-related changes in subjective valence and in positive word use. PMID:26274398

  1. Time Perspective and Emotion Regulation as Predictors of Age-Related Subjective Passage of Time.

    PubMed

    Wittmann, Marc; Rudolph, Tina; Linares Gutierrez, Damisela; Winkler, Isabell

    2015-12-17

    Hardly any empirical work exists concerning the relationship between the intra-individually stable time perspective relating to the past, present, and future and the subjective speed of time passing in everyday life. Moreover, studies consistently show that the subjective passage of time over the period of the last ten years speeds up as we get older. Modulating variables influencing this phenomenon are still unknown. To investigate these two unresolved issues, we conducted an online survey with n = 423 participants ranging in age between 17 and 81 assessing trait time perspective of the past, present, and future, and relating these subscales with a battery of measures pertaining to the subjective passage of time. Moreover, the subjective passage of time as an age-dependent variable was probed in relationship to emotion awareness, appraisal and regulation. Results show how present hedonism is linked with having fewer routines in life and a faster passage of the last week; the past negative perspective is related to time pressure, time expansion and more routine; a pronounced future perspective is related to a general faster passage of time. Importantly, increased emotion regulation and a balanced time perspective are related to a slower passage of the last ten years. These novel findings are discussed within models of time perception and the time perspective.

  2. Time Perspective and Emotion Regulation as Predictors of Age-Related Subjective Passage of Time.

    PubMed

    Wittmann, Marc; Rudolph, Tina; Linares Gutierrez, Damisela; Winkler, Isabell

    2015-12-01

    Hardly any empirical work exists concerning the relationship between the intra-individually stable time perspective relating to the past, present, and future and the subjective speed of time passing in everyday life. Moreover, studies consistently show that the subjective passage of time over the period of the last ten years speeds up as we get older. Modulating variables influencing this phenomenon are still unknown. To investigate these two unresolved issues, we conducted an online survey with n = 423 participants ranging in age between 17 and 81 assessing trait time perspective of the past, present, and future, and relating these subscales with a battery of measures pertaining to the subjective passage of time. Moreover, the subjective passage of time as an age-dependent variable was probed in relationship to emotion awareness, appraisal and regulation. Results show how present hedonism is linked with having fewer routines in life and a faster passage of the last week; the past negative perspective is related to time pressure, time expansion and more routine; a pronounced future perspective is related to a general faster passage of time. Importantly, increased emotion regulation and a balanced time perspective are related to a slower passage of the last ten years. These novel findings are discussed within models of time perception and the time perspective. PMID:26694439

  3. Time Perspective and Emotion Regulation as Predictors of Age-Related Subjective Passage of Time

    PubMed Central

    Wittmann, Marc; Rudolph, Tina; Linares Gutierrez, Damisela; Winkler, Isabell

    2015-01-01

    Hardly any empirical work exists concerning the relationship between the intra-individually stable time perspective relating to the past, present, and future and the subjective speed of time passing in everyday life. Moreover, studies consistently show that the subjective passage of time over the period of the last ten years speeds up as we get older. Modulating variables influencing this phenomenon are still unknown. To investigate these two unresolved issues, we conducted an online survey with n = 423 participants ranging in age between 17 and 81 assessing trait time perspective of the past, present, and future, and relating these subscales with a battery of measures pertaining to the subjective passage of time. Moreover, the subjective passage of time as an age-dependent variable was probed in relationship to emotion awareness, appraisal and regulation. Results show how present hedonism is linked with having fewer routines in life and a faster passage of the last week; the past negative perspective is related to time pressure, time expansion and more routine; a pronounced future perspective is related to a general faster passage of time. Importantly, increased emotion regulation and a balanced time perspective are related to a slower passage of the last ten years. These novel findings are discussed within models of time perception and the time perspective. PMID:26694439

  4. Effects of age of serotonin 5-HT2 receptors in cocaine abusers and normal subjects

    SciTech Connect

    Wang, G.J.; Volkow, N.D.; Logan, J.

    1995-05-01

    We measured the effect of age on serotonin 5-HT2 receptor availability and compared it with the effects on dopamine D2 receptors on 19 chronic cocaine abusers (35.2{plus_minus}9.8 years, range 18-54 years old) and 19 age matched normal controls using positron emission tomography (PET) and F-18 N-methylspiperone (NMS). 5-HT2 Receptor availability was measure din frontal (FR), occipital (OC), cingulate (CI) and orbitofrontal (OF) cortices using the ratio of the distribution volume in the region of interest to that in the cerebelium (CB) which is a function of Bmax/Kd. D2 receptor availability in the basal ganglia was measured using the {open_quotes}ratio index{close_quotes} (slope of striatum/CB versus time over 180 min of the scan) which is a function of Bmax. 5-HT2 Receptor availability differed among regions and were as follows: CI>OF>OC>FC.5-HT2 Receptor availability decreased significantly with age. This effect was more accentuated for 5-HT2 receptor availability in FR than in OC(df=1, p<0.025). Striatal dopamine D2 receptors were also found to decrease significantly with age (r=0.63, p<0.007). In a given subject, D2 receptor availability was significantly correlated with 5-HT2 receptor availability in FR (r=0.51, p<0.035) but not in OC. The values for 5-HT2 receptor availability were not different in normal subjects and cocaine abusers. These results document a decline in 5-HT2 and D2 receptors with age and document an association between frontal 5-HT2 and striatal D2 receptor availability. These results did not show any changes in 5-HT2 receptor availability in cocaine abusers as compared to control subjects.

  5. Emotional Intelligence Mediates the Relationship between Age and Subjective Well-Being.

    PubMed

    Chen, Yiwei; Peng, Yisheng; Fang, Ping

    2016-07-01

    Individuals' Subjective Well-being (SWB) increases as they grow older. Past literature suggests that emotional intelligence may increase with age and lead to higher levels of SWB in older adults. The primary purpose of the present study was to test whether emotional intelligence would mediate the relationship between age and SWB. A total of 360 Chinese adults (age range: 20 to 79 years old) participated in this study. They filled out questionnaires that assessed their age, life satisfaction (The Satisfaction with Life Scale), affective well-being (The Positive and Negative Affect Schedule), and emotional intelligence (The Wong and Law Emotional Intelligence Scale). Using Structural Equation Modeling, the mediation model was supported, χ(2) (75) = 194.21, p < .01; RMSEA = .07; CFI = .91. Emotional intelligence partially mediated the relationship between age and life satisfaction, and fully mediated the relationship between age and affective well-being. The findings suggest that older adults may use their increased emotional intelligence to enhance their SWB. PMID:27199490

  6. Phenolic compounds and browning in sherry wines subjected to oxidative and biological aging.

    PubMed

    Fabios, M; Lopez-Toledano, A; Mayen, M; Merida, J; Medina, M

    2000-06-01

    The composition in hydroxybenzoic and hydroxycinnamic acids, hydroxycinnamic esters, tyrosol, syringaldehyde, and flavan-3-ol derivatives of three different types of sherry wine obtained by aging of the same starting wine under different conditions was studied. So-called "fino" wine was obtained by biological aging under flor yeasts, "oloroso" wine by oxidative aging, and "amontillado" wine by a first stage of biological aging followed by a second oxidative step. On the basis of the results, the wines subjected to oxidative aging exhibited higher phenol contents, in addition to scarcely polar compounds absorbing at 420 nm that were absent in the wines obtained by biological aging. Taking into account that flavan-3-ol derivatives play an important role in wine browning, a model catechin solution was inoculated with flor yeast which, contrary to the findings of other authors in the absence of yeasts, formed no colored compounds. This different behavior may account for the resistance to browning of pale sherry wines in the presence of flor yeasts. PMID:10888514

  7. Emotional Intelligence Mediates the Relationship between Age and Subjective Well-Being.

    PubMed

    Chen, Yiwei; Peng, Yisheng; Fang, Ping

    2016-07-01

    Individuals' Subjective Well-being (SWB) increases as they grow older. Past literature suggests that emotional intelligence may increase with age and lead to higher levels of SWB in older adults. The primary purpose of the present study was to test whether emotional intelligence would mediate the relationship between age and SWB. A total of 360 Chinese adults (age range: 20 to 79 years old) participated in this study. They filled out questionnaires that assessed their age, life satisfaction (The Satisfaction with Life Scale), affective well-being (The Positive and Negative Affect Schedule), and emotional intelligence (The Wong and Law Emotional Intelligence Scale). Using Structural Equation Modeling, the mediation model was supported, χ(2) (75) = 194.21, p < .01; RMSEA = .07; CFI = .91. Emotional intelligence partially mediated the relationship between age and life satisfaction, and fully mediated the relationship between age and affective well-being. The findings suggest that older adults may use their increased emotional intelligence to enhance their SWB.

  8. Age and gender effects on nasal respiratory function in normal subjects.

    PubMed

    Vig, P S; Zajac, D J

    1993-05-01

    One hundred and ninety-seven normal individuals between the ages of 5 and 73 years were evaluated to determine nasal resistance, nasal cross-sectional area, and respiratory mode during quiet breathing. Subjects were categorized into three age groups. Nasal resistance and respiratory mode were directly determined using posterior rhinomanometry and the SNORT technique, respectively. Nasal cross-sectional area was estimated using the hydrokinetic equation. Results indicated significant effects of age on all variables; significant gender differences were found for respiratory mode. Weak correlations were found between respiratory mode and nasal resistance. The results are presented as normative data on nasorespiratory characteristics to facilitate diagnostic and treatment decisions relative to individuals with normal morphology as well as to patients with craniofacial anomalies. A fundamental issue of both clinical and theoretical importance arising from the study pertains to the definitions of normality and impairment.

  9. Age and gender effects on nasal respiratory function in normal subjects.

    PubMed

    Vig, P S; Zajac, D J

    1993-05-01

    One hundred and ninety-seven normal individuals between the ages of 5 and 73 years were evaluated to determine nasal resistance, nasal cross-sectional area, and respiratory mode during quiet breathing. Subjects were categorized into three age groups. Nasal resistance and respiratory mode were directly determined using posterior rhinomanometry and the SNORT technique, respectively. Nasal cross-sectional area was estimated using the hydrokinetic equation. Results indicated significant effects of age on all variables; significant gender differences were found for respiratory mode. Weak correlations were found between respiratory mode and nasal resistance. The results are presented as normative data on nasorespiratory characteristics to facilitate diagnostic and treatment decisions relative to individuals with normal morphology as well as to patients with craniofacial anomalies. A fundamental issue of both clinical and theoretical importance arising from the study pertains to the definitions of normality and impairment. PMID:8292136

  10. Maximal aerobic capacity in ageing subjects: actual measurements versus predicted values

    PubMed Central

    Pistea, Cristina; Lonsdorfer, Evelyne; Doutreleau, Stéphane; Oswald, Monique; Enache, Irina

    2016-01-01

    We evaluated the impact of selection of reference values on the categorisation of measured maximal oxygen consumption (V′O2peak) as “normal” or “abnormal” in an ageing population. We compared measured V′O2peak with predicted values and the lower limit of normal (LLN) calculated with five equations. 99 (58 males and 41 females) disease-free subjects aged ≥70 years completed an incremental maximal exercise test on a cycle ergometer. Mean V′O2peak was 1.88 L·min−1 in men and 1.26 L·min−1 in women. V′O2peak ranged from 89% to 108% of predicted in men, and from 88% to 164% of predicted in women, depending on the reference equation used. The proportion of subjects below the LLN ranged from 5% to 14% in men and 0–22% in women, depending on the reference equation. The LLN was lacking in one study, and was unsuitable for women in another. Most LLNs ranged between 53% and 73% of predicted. Therefore, choosing an 80% cut-off leads to overestimation of the proportion of “abnormal” subjects. To conclude, the proportion of subjects aged ≥70 years with a “low” V′O2peak differs markedly according to the chosen reference equations. In clinical practice, it is still relevant to test a sample of healthy volunteers and select the reference equations that better characterise this sample. PMID:27730176

  11. Age and Social Context Modulate the Effect of Anxiety on Risk-taking in Pediatric Samples

    PubMed Central

    Rosen, Dana; Patel, Nilam; Pavletic, Nevia; Grillon, Christian; Pine, Daniel S.

    2016-01-01

    Although risk-taking has been studied from a developmental perspective, no study has examined how anxiety, age, risk-valence and social context interact to modulate decision-making in youths. This study probes this question using a risk-taking task, the Stunt Task, in clinically anxious children (n=17, 10 F, age=8.3–12.1 years), healthy children (n=13, 4 F, age=9.3–12.2 years), clinically anxious adolescents (n=18, 6 F, age=12.3–17.7 years), and healthy adolescents (n =14, 10 F, age=12.5–17.3 years). Social context was manipulated: in one condition, participants were led to believe that a group of peers were observing and judging their performance (peer-judge), while, in the other condition, they were led to believe that peers were not observing them (control). Only anxious children showed an influence of social context on their risk-taking behavior. Specifically, anxious children bet significantly less and had slower reaction times (RT) during the peer-judge than control condition. However, across social conditions, risk-valence modulated RT differently in function of age and diagnosis. Anxious children were slower on the positive-valence risky trial, whereas anxious adolescents were slower on the negative-valence risky trials relative to their respective healthy peers. In conclusion, clinically anxious children were the only group that was sensitive (risk-averse) to the effect of a negative peer-judge context. The negative peer-judge context did not affect risky decision-making in adolescents, whether they were anxious or healthy. Future work using a stronger aversive social context might be more effective at influencing risky behavior in this age group. PMID:26659306

  12. Effects of Age, Sex, and Comorbidities on the Pediatric Outcomes Data Collection Instrument (PODCI) in the General Population

    PubMed Central

    Campbell, Susan R.

    2015-01-01

    Background: The Pediatric Outcomes Data Collection Instrument (PODCI) is an outcomes assessment tool developed to allow measurement of health-related quality of life in children with disorders having musculoskeletal impact. The instrument was tested by Hunsaker and colleagues on a large population-based sample of children (n=5300), and partial results of that survey were published in 2002. Further publication of the findings did not occur. The PODCI was designed to collect data on age, sex, comorbidities, race and ethnicity, makeup of the household, and other demographic data that could have an impact on function and psychosocial issues. This retrospective study evaluated the impact of age, sex, and health/comorbid conditions on the subscales of the PODCI. Methods: Using the database that was developed by Hunsaker and colleagues for the American Academy of Orthopaedic Surgeons, a 1-way multivariate analysis of variance was conducted to determine effects of prior comorbid condition versus no prior comorbid condition on the dependent variables of the PODCI Upper Extremity Function, Transfers and Basic Mobility, Sports and Physical Function, Comfort, and Happiness scales by parent respondent. A follow-up analysis of the health/comorbid condition, age, and sex of the child on the PODCI subscales using independent samples t tests was performed. Results: Significant differences in the PODCI subscales of Transfers and Basic Mobility, Sports and Physical Function, Comfort, and Happiness occurred between children with a prior comorbid condition versus no prior reported comorbid condition. The sex of the child with a comorbid condition versus without a comorbidity appears to affect the PODCI subscale scores except for the Upper Extremity Function subscale. PODCI scales show an initial increase with age. Age at plateau varies, as do patterns of scores after plateau, with gradual decreases in quality-of-life scales. Conclusions: With further exploration of the population

  13. The influence of depression on processing speed and executive function in nondemented subjects aged 75.

    PubMed

    Jungwirth, Susanne; Zehetmayer, Sonja; Hinterberger, Margareta; Kudrnovsky-Moser, Stephan; Weissgram, Silvia; Tragl, Karl Heinz; Fischer, Peter

    2011-09-01

    Neuropsychological deficits are commonly found to be part of depression in old age and might simultaneously represent early symptoms of dementia. We investigated the influence of depression on processing speed and executive function in subjects who did not develop dementia during the following 5 years to examine whether these neuropsychological dysfunctions are due to depression or are influenced by other causes (e.g., education, cerebral comorbidity). A total of 287 subjects aged 75 (mean: 75.76) were available for analyses. Processing speed was measured by the Trail Making Test-A, Executive Function by the Trail Making Test-B and Verbal Fluency. DSM-IV-criteria were used for diagnosing depression. Cerebral comorbidity (e.g., stroke, Parkinson's disease), sex, education, antidepressant, and/or benzodiazepine medication, and a history of depression were taken into account as covariates. Univariate analyses and multiple regression analyses were calculated. Higher education was strongly related to better performance in all three psychometric tests. Cerebral comorbidity significantly slowed TMT-A performance and reduced Verbal Fluency scores. In multiple regression analysis depression showed only a minor, slowing influence on TMT-A and TMT-B performance. Depression only had a minor influence on processing speed and executive function in this sample of nondemented subjects. By comparison, the influence of education and cerebral comorbidity was seen to be stronger.

  14. Aerobic exercise, subjective health and psychological well-being within age and gender subgroups.

    PubMed

    Ransford, H E; Palisi, B J

    1996-06-01

    This research examines relationships between different forms of aerobic exercise (swim, walk, jog, dance) and two measures of health: subjective health and psychological well-being. We hypothesize that the relationship between aerobic exercise and subjective health/well-being will be notably stronger for older than younger persons and females than males. This prediction is based on Homans' exchange theory of investments and rewards. Since social norms concerning aerobic exercise are likely to be weaker among older (than younger) persons and among women than men, older persons and women who do exercise are making special investments and should expect greater rewards (good health). The concept of 'exercise norms' implies social comparisons with others. Accordingly, age comparative data were analyzed to see if older persons who exercise see themselves as more active than their age peers than do younger persons. Data come from a national probability sample of 3025 adults (National Survey of Personal Health Practices and Consequences). As predicted, exercise was much more strongly related to subjective health and well-being among older than younger respondents. In the main, the gender hypothesis was not supported.

  15. Effects of diet and age on oxidative damage products in healthy subjects.

    PubMed

    Krajcovicová-Kudlácková, M; Valachovicová, M; Pauková, V; Dusinská, M

    2008-01-01

    Damage of molecules as a consequence of oxidative stress has been implicated in the pathogenesis of chronic diseases related to aging. Diet is a key environmental factor affecting the incidence of many chronic diseases. Antioxidant substances in diet enhance the DNA, lipid and protein protection by increasing the scavenging of free radicals. Products of oxidative damage of DNA (DNA strand breaks with oxidized purines or oxidized pyrimidines), lipids (conjugated dienes of fatty acids) and proteins (carbonyls) in relation to nutrition (vegetarian diet vs. non-vegetarian, traditional mixed diet) were measured in young women aged 20-30 years (46 vegetarians, 48 non-vegetarians) vs. older women aged 60-70 years (33 vegetarians, 34 non-vegetarians). In young subjects, no differences in values of oxidative damage as well as plasma values of antioxidative vitamins (C,beta-carotene) were observed between vegetarian and non-vegetarian groups. In older vegetarian group significantly reduced values of DNA breaks with oxidized purines, DNA breaks with oxidized pyrimidines and lipid peroxidation and on the other hand, significantly increased plasma values of vitamin C and beta-carotene were found compared to the respective non-vegetarian group. Significant age dependences of measured parameters (increase in all oxidative damage products and decrease in plasma vitamin concentrations in older women) were noted only in non-vegetarians. Vegetarian values of older women vs. young women were similar or non-significantly changed. The results suggest that increase of oxidative damage in aging may be prevented by vegetarian nutrition.

  16. A Case Series of Marijuana Exposures in Pediatric Patients Less than 5 Years of Age

    ERIC Educational Resources Information Center

    Wang, George Sam; Narang, Sandeep K.; Wells, Kathryn; Chuang, Ryan

    2011-01-01

    Objective: In Colorado, there has been a large increase in medical marijuana dispensaries and licenses for the use of medical marijuana over the past year. This is a retrospective case series of marijuana exposures that have presented to the emergency department (ED) in children less than 5 years of age. Methods: We performed a retrospective chart…

  17. Cribriform-morular variant of papillary thyroid carcinoma at pediatric age - case report and review of the literature.

    PubMed

    Brehar, Andreea Cristiana; Terzea, Dana Cristina; Ioachim, Dumitru Lucian; Procopiuc, Camelia; Brehar, Felix Mircea; Bulgăr, Alexandra Cătălina; Ghemigian, Mircea Vasile; Dumitrache, Constantin

    2016-01-01

    Cribriform-morular variant of papillary thyroid carcinoma (CMV-PTC) is a rare tumor, which exceptionally occurs at pediatric age. CMV-PTC may develop in patients with familial adenomatous polyposis (FAP) or may be a sporadic tumor. The authors present a case of CMV-PTC in a 10-year-old girl patient without FAP history, who presented with a left neck mass. The patient underwent total thyroidectomy with central compartment neck dissection. Histopathological diagnosis was compatible with cribriform-morular variant of papillary thyroid carcinoma and Hashimoto's thyroiditis. Immunostaining was positive for thyroglobulin, β-catenin, CD10 and p53. Molecular test showed the absence of BRAF, K-RAS mutations, deletions or duplications of APC (adenomatosis polyposis coli) gene and showed the presence of RET÷PTC (rearranged during transfection÷papillary thyroid carcinoma) rearrangements. At 32 months follow-up, the patient was without signs of recurrence. This particular form of thyroid carcinoma should raise suspicion of a possible familial cancer syndrome, therefore early diagnosis and thoroughly evaluation, which includes colonoscopy and genetic screening are mandatory. PMID:27516030

  18. Spontaneous thrombosis in giant aneurysm of the anterior communicating artery complex in pediatric age: five-year follow-up.

    PubMed

    Gonçalves, Vítor M; Cristino, N; Cunha E Sá, M

    2014-01-01

    Intracranial aneurysms are rare in the pediatric population, especially in infancy, representing less than 1% of all aneurysms. In this age group, they are more frequent at the carotid bifurcation and in the posterior circulation, with a greater number of giant aneurysms and spontaneous aneurysm thrombosis when compared with the adults. They are life-threatening, and, therefore, early investigation, characterization of the lesion, and treatment are essential. The appropriate management depends on the child's condition, aneurysm characteristics, and the experience of a multidisciplinary team. Noninvasive and radiation-free imagiological studies play an important role in the diagnosis and follow-up of these young patients. We present the case of a 3-month-old boy with an intracranial hemorrhage secondary to the rupture of a giant aneurysm of the anterior communicating artery complex, with spontaneous thrombosis, which is a rare situation due to its location. A conservative approach was assumed and noninvasive evolutive imagiological studies revealed a reduction in the thrombosed aneurysm size and no signs of recanalization. The child recovered to his baseline neurological condition and has had no rehemorrhage until 5 years of follow-up.

  19. Pediatric Injury

    MedlinePlus

    ... common causes, which are 1 , 2 , 3 : Motor vehicle accidents Suffocation (being unable to breathe) Drowning Poisoning ... gov/safechild [top] American Academy of Pediatrics. (2008). Management of pediatric trauma. Pediatrics, 121 , 849–854. [top] ...

  20. Pediatric MS

    MedlinePlus

    ... of the oral medications in the pediatric population. Network of Pediatric MS Centers The National MS Society ... MS Study Group (2004) and established a nationwide network of six Pediatric MS Centers of Excellence (2006) ...

  1. Bioaerosols in the lungs of subjects with different ages-part 1: deposition modeling

    PubMed Central

    2016-01-01

    Background In this contribution the inhalation and deposition of bioaerosols including particles with various shapes and sizes were investigated for probands with different ages (1, 5, 15 and 20 y). The study should help to increase our knowledge with regard to the behavior of variably shaped and sized particles in lungs being subject to different developmental stages. Methods Simulation of particle transport and deposition in single structures of the respiratory tract was conducted by using a stochastic model of the tracheobronchial tree and well-validated analytical and empirical deposition formulae. Possible effects of particle geometry on deposition were taken into consideration by application of the aerodynamic diameter concept. Age-dependent lung morphometry and breathing parameters were computed by using appropriate scaling factors. Results Theoretical simulations came to the result that bioparticle deposition in infants and children clearly differs from that in adolescents and adults insofar as the amount of deposited mass exhibits a positive correlation with age. Nose breathing results in higher extrathoracic deposition rates than mouth breathing and, as a consequence of that, lower particle amounts are enabled to enter the lung structures after passing the nasal airways. Under sitting breathing conditions highest alveolar deposition rates were calculated for particles adopting aerodynamic diameters of 10 nm and 4 µm, respectively. Conclusions The study comes to the conclusion that bioparticles have a lower chance to reach the alveoli in infants’ and children’s lungs, but show a higher alveolar deposition probability in the lungs of adolescents and adults. Despite of this circumstance also young subjects may increasingly suffer from biogenic particle burden, when they are subject to a long-term exposure to certain bioaerosols. PMID:27386485

  2. Decision Making after Pediatric Traumatic Brain Injury: Trajectory of Recovery and Relationship to Age and Gender

    PubMed Central

    Schmidt, Adam T.; Hanten, Gerri R.; Li, Xiaoqi; Vasquez, Ana C.; Wilde, Elisabeth A.; Chapman, Sandra B.; Levin, Harvey S.

    2012-01-01

    The aim of the study was to examine longitudinal patterns of decision making based on risk and reward using a modified version of the Iowa Gambling Task (IGT) in children who had sustained traumatic brain injury (TBI) and children with orthopedic injury (OI). Participants were 135 children and adolescents with TBI (n=71) or OI (n=64) who were 7 to 17 years at the time of injury were enrolled and assessed prospectively at baseline and at follow-up intervals of 3, 12, 18, and 24 months after injury. Groups were similar in age, socioeconomic status, and gender. Participants chose from four decks of cards with the aim of maximizing earnings across 100 trials. Two of the decks offered relatively small rewards and relatively small losses, but were advantageous over the course of the experiment. The other two decks offered large rewards, but also introduced occasional large losses, and were considered disadvantageous over the course of the experiment. The variable of interest was the proportion of advantageous decks chosen across trials. Longitudinal analysis of the pattern of change across two years revealed a three-way interaction among injury group, age, and the quadratic term of interval-since-injury,. In this interaction, the effect of age weakened in the TBI group across time, as compared to the OI group, which showed stronger quadratic patterns across the recovery intervals that differed by age. The OI group generally outperformed the TBI group. In addition, analyses revealed a three-way interaction among group, gender and the cubic term of post-injury interval, such that overall, males improved a great deal with time, but females showed small gains, regardless of injury group. PMID:22138008

  3. Cone photopigment in older subjects: decreased optical density in early age-related macular degeneration

    NASA Astrophysics Data System (ADS)

    Elsner, Ann E.; Burns, Stephen A.; Weiter, John J.

    2002-01-01

    We measured changes to cone photoreceptors in patients with early age-related macular degeneration. The data of 53 patients were compared with normative data for color matching measurements of long- and middle-wavelength-sensitive cones in the central macula. A four-parameter model quantified cone photopigment optical density and kinetics. Cone photopigment optical density was on average less for the patients than for normal subjects and was uncorrelated with visual acuity. More light was needed to reduce the photopigment density by 50% in the steady state for patients. These results imply that cone photopigment optical density is reduced by factors other than slowed kinetics.

  4. Cochlear Implants in Subjects Over Age 65: Quality of Life and Audiological Outcomes.

    PubMed

    Aimoni, Claudia; Ciorba, Andrea; Hatzopoulos, Stavros; Ramacciotti, Giulia; Mazzoli, Manuela; Bianchini, Chiara; Rosignoli, Monica; Skarżyński, Henryk; Skarżyński, Piotr H

    2016-01-01

    BACKGROUND Cochlear implants (CIs) have been recognized as a safe and effective means for profound hearing loss rehabilitation in children and adults and recently their use has been extended to subjects over 65 years of age. The aim of this paper was to assess indices related to changes in the quality of life (QoL) in elderly CI recipients. MATERIAL AND METHODS A case-control paradigm was used to assess the effects of CIs on the QoL. Forty-two subjects were assigned to the Case group and 15 subjects to the Control group. All 57 subjects were affected by profound hearing loss and had received a CI. Audiological data were collected from both groups at: (i) 1 month pre-implantation [T1]; (ii) 1 day pre- implantation [T2]; (iii) 30 days post-implantation, with CI used in free field [T3]; and (iv) 12 months post-implantation, with CI used in a free field [T4]. The QoL was assessed via a Glasgow Benefit Inventory (GBI) questionnaire, adapted to otolaryngology. To compare subjects across different ages with varying degrees of speech development, a perception parameter was used from the Speech Perception Categories test developed by Geers and Moog. RESULTS Hearing performance was considerably improved after CI. In relation to the hearing performance at time T1, statistically significant threshold gains were observed in both groups in the T3 and T4 observation windows. At time T4, a threshold gain of 70 dB HL in the Case group and a gain of 84 dB HL in the Control group were observed. With speech therapy rehabilitation, a perception level of 6 was reached by 80.0% of patients in the Case group and by 100% of patients in the Control group. In terms of QoL, both groups showed improved post-CI scores. Statistical differences were observed between the 2 groups, with the Control group outperforming the Case group in all but the social section. CONCLUSIONS Despite age-related changes in auditory system and prolonged hearing deprivation, CIs offer audiological and QoL benefits in

  5. Cochlear Implants in Subjects Over Age 65: Quality of Life and Audiological Outcomes

    PubMed Central

    Aimoni, Claudia; Ciorba, Andrea; Hatzopoulos, Stavros; Ramacciotti, Giulia; Mazzoli, Manuela; Bianchini, Chiara; Rosignoli, Monica; Skarżyński, Henryk; Skarżyński, Piotr H.

    2016-01-01

    Background Cochlear implants (CIs) have been recognized as a safe and effective means for profound hearing loss rehabilitation in children and adults and recently their use has been extended to subjects over 65 years of age. The aim of this paper was to assess indices related to changes in the quality of life (QoL) in elderly CI recipients. Material/Methods A case-control paradigm was used to assess the effects of CIs on the QoL. Forty-two subjects were assigned to the Case group and 15 subjects to the Control group. All 57 subjects were affected by profound hearing loss and had received a CI. Audiological data were collected from both groups at: (i) 1 month pre-implantation [T1]; (ii) 1 day pre- implantation [T2]; (iii) 30 days post-implantation, with CI used in free field [T3]; and (iv) 12 months post-implantation, with CI used in a free field [T4]. The QoL was assessed via a Glasgow Benefit Inventory (GBI) questionnaire, adapted to otolaryngology. To compare subjects across different ages with varying degrees of speech development, a perception parameter was used from the Speech Perception Categories test developed by Geers and Moog. Results Hearing performance was considerably improved after CI. In relation to the hearing performance at time T1, statistically significant threshold gains were observed in both groups in the T3 and T4 observation windows. At time T4, a threshold gain of 70 dB HL in the Case group and a gain of 84 dB HL in the Control group were observed. With speech therapy rehabilitation, a perception level of 6 was reached by 80.0% of patients in the Case group and by 100% of patients in the Control group. In terms of QoL, both groups showed improved post-CI scores. Statistical differences were observed between the 2 groups, with the Control group outperforming the Case group in all but the social section. Conclusions Despite age-related changes in auditory system and prolonged hearing deprivation, CIs offer audiological and QoL benefits in the

  6. Differential effects of chitooligosaccharides on serum cytokine levels in aged subjects.

    PubMed

    Kim, Hyung Min; Hong, Seung Heon; Yoo, Su Jin; Baek, Kyung Sin; Jeon, You Jin; Choung, Se Young

    2006-01-01

    Free amine chitooligosaccharides (FACOS, Kitto Life, Seoul, Republic of Korea) with an average molecular mass of 3.5 kDa were efficiently produced using an ultrafiltration membrane reactor system. To evaluate the effect of chitooligosaccharides on serum cytokine levels in elderly adults after oral intake, 5.1 g/day of FACOS was given to elderly (age range, 74-86 years; mean, 80 +/- 3 years) volunteers during an 8-week experimental period. Interleukin (IL)-12 and interferonã levels were significantly higher in the FACOS group than in the control group (P < .05). However, levels of the inflammatory cytokines IL-1beta and tumor necrosis factor-alpha decreased after FACOS intake during the experimental period. The results of this study suggest that the oral intake of chitooligosaccharides may have beneficial effects on specific cell-mediated immunity while also acting as an anti-inflammatory agent in aged subjects.

  7. Cardioprotective effect of a biofermented nutraceutical on endothelial function in healthy middle-aged subjects.

    PubMed

    Marotta, Francesco; Yadav, Hariom; Kumari, Archana; Catanzaro, Roberto; Jain, Shalini; Polimeni, Ascanio; Lorenzetti, Aldo; Soresi, Vincenzo

    2012-04-01

    We tested a biofermented nutraceutical (FPP) that has been previously shown to positively modulate nitric oxide (NO). Forty-two healthy middle-aged subjects were given 3 grams of FPP three times a day for 6 weeks, and tests were repeated at 3 and 6 weeks; the control group was given a placebo. Flow-mediated dilation (FMD) was measured together with NO compounds (nitrogen oxides [NOx]: NO(2)(-)+NO(3)(-)) plasma levels and asymmetrical dimethylarginine (ADMA). In the interventional group, overall FMD significantly increased from 4.2% to 7.3% (p<0.05 vs. placebo). A significant increase in plasma NO and a decrease in ADMA were detected after consumption of FPP (p<0.01). Although larger studies are awaited, it appears that, at least in healthy individuals, such nutraceutical intervention by positively acting on significant cardiovascular parameters can be considered in the armamentarium of a proactive age-management strategy. PMID:22533427

  8. Successful Aging and Subjective Well-Being Among Oldest-Old Adults

    PubMed Central

    Cho, Jinmyoung; Martin, Peter; Poon, Leonard W.

    2015-01-01

    Purpose of the Study: This research integrates successful aging and developmental adaptation models to empirically define the direct and indirect effects of 2 distal (i.e., education and past life experiences) and 5 proximal influences (i.e., physical functioning, cognitive functioning, physical health impairment, social resources, and perceived economic status) on subjective well-being. The proximal influences involved predictors outlined in most extant models of successful aging (e.g., Rowe & Kahn, 1998 [Rowe, J. W., & Kahn, R. L. (1998). Successful aging. New York: Pantheon Books.]). Our model extends such models by including distal impact as well as interactions between distal and proximal impacts. Design and Methods: Data were obtained from 234 centenarians and 72 octogenarians in the Georgia Centenarian Study. Structural equation modeling was conducted with Mplus 6.1. Results: Results showed significant direct effects of physical health impairment and social resources on positive aspects of subjective well-being among oldest-old adults. We also found significant indirect effects of cognitive functioning and education on positive affect among oldest-old adults. Social resources mediated the relationship between cognitive functioning and positive affect; and cognitive functioning and social resources mediated the relationship between education and positive affect. In addition, physical health impairment mediated the relationship between cognitive functioning and positive affect; and cognitive functioning and physical health impairment mediated the relationship between education and positive affect. Implications: Integrating 2 different models (i.e., successful aging and developmental adaptation) provided a comprehensive view of adaptation from a developmental perspective. PMID:25112594

  9. Editorial: subjective perceptions of memory functioning in old age - nature, correlates, and developmental trajectories.

    PubMed

    Hülür, Gizem; Gerstorf, Denis

    2015-01-01

    Subjective memory complaints are often used as diagnostic criteria for several neurocognitive disorders. Although a number of studies have examined subjective memory and its associations with memory functioning in adulthood and old age, it is still an open question whether subjective perceptions of one's memory indicate actual memory functioning or whether they are rather derived from factors other than memory, such as depressive symptoms. The studies in this special section examine subjective perceptions of memory functioning and their associations with objectively measured memory performance in general and in clinical populations. The four articles adopt cross-sectional and longitudinal methodologies and offer key insights into the nature, correlates, and developmental trajectories of subjective memory. To begin with, the studies compiled in this special section demonstrate that changes in subjective memory perceptions are indeed associated with changes in memory performance [Zimprich and Kurtz, this issue, pp. 223-231], but the size of associations between levels of and changes in subjective memory and memory performance is in part modulated by personality characteristics and depressive symptoms [Hülür et al., this issue, pp. 232-240]. Second, the studies compiled here show that factors other than memory are also closely associated with memory perceptions, including functional health as well as domain-general and health-specific control beliefs [Luszcz et al., this issue, pp. 241-250]. Third, the study by Thompson et al. [this issue, pp. 251-257] shows that self- and informant-reports of retrospective and prospective memory difficulties are not associated with performance-based measures and does not sufficiently differentiate between healthy controls and patients diagnosed with mild cognitive impairment or dementia. In our editorial, we put these findings in perspective and discuss implications for research and practice. To extend our knowledge, we conclude by

  10. [The specific age-related palmometric features of an adult subject].

    PubMed

    Nazarov, Yu V; Bozhchenko, A P; Tolmachev, I A; Moiseenko, S A

    2016-01-01

    In connection with the variability and as a consequence of the poor diagnostic value of the external (planimetric) parameters of the palm traces, the new system of absolute and relative dimensional attributes based on the stable palmoglyphic reference points is considered. The purpose of the present study was the search for the new biological markers of biological age. The material for the study consisted of the palm prints obtained from 180 men and 120 women of the Caucasoid stock at the age from 16 to 80 years. The use of the descriptive statistics methods yielded the basic statistical characteristics of the traits being investigated and revealed the limits of their variability in the groups of men and women belonging to the age groups from 16 to 29 and from 30 to 80 years. The method of threshold values made it possible to identify 13 attributes the excess of which allows, with the probability of no less than 0.95, to perform diagnostics of the age group of an unknown subject. PMID:27239767

  11. [The specific age-related palmometric features of an adult subject].

    PubMed

    Nazarov, Yu V; Bozhchenko, A P; Tolmachev, I A; Moiseenko, S A

    2016-01-01

    In connection with the variability and as a consequence of the poor diagnostic value of the external (planimetric) parameters of the palm traces, the new system of absolute and relative dimensional attributes based on the stable palmoglyphic reference points is considered. The purpose of the present study was the search for the new biological markers of biological age. The material for the study consisted of the palm prints obtained from 180 men and 120 women of the Caucasoid stock at the age from 16 to 80 years. The use of the descriptive statistics methods yielded the basic statistical characteristics of the traits being investigated and revealed the limits of their variability in the groups of men and women belonging to the age groups from 16 to 29 and from 30 to 80 years. The method of threshold values made it possible to identify 13 attributes the excess of which allows, with the probability of no less than 0.95, to perform diagnostics of the age group of an unknown subject.

  12. [Treatment of pediatric radial neck fractures: consideration of patient age and fracture dislocation].

    PubMed

    Eberl, R; Saxena, A; Fruhmann, J; Höllwarth, M E; Weinberg, A M

    2010-10-01

    Fractures of the radial neck represent approximately 5-10% of all injuries of the elbow in children. Depending on the degree of radial head displacement, either an operative intervention or conservative treatment is recommended. The medical records of 168 children treated between 1999 and 2008 were analyzed and fractures were classified according to the Judet classification system. The fractures were treated according to an algorithm depending on age and fracture dislocation and 103 type I, 21 type II, 30 type III and 14 type VI fractures were found. Conservative treatment was possible in 124 patients and 44 were treated operatively. The overall outcome was good. PMID:20237746

  13. Color stability of modern composites subjected to different periods of accelerated artificial aging.

    PubMed

    Drubi-Filho, Brahim; Garcia, Lucas da Fonseca Roberti; Cruvinel, Diogo Rodrigues; Sousa, Ana Beatriz Silva; Pires-de-Souza, Fernanda de Carvalho Panzeri

    2012-01-01

    The aim of this study was to evaluate the color stability of composites subjected to different periods of accelerated artificial aging (AAA). A polytetrafluorethylene matrix (10 x 2 mm) was used to fabricate 24 test specimens of three different composites (n=8): Tetric Ceram (Ivoclar/Vivadent); Filtek P90 and Z250 (3M ESPE), shade A3. After light activation for 20 s (FlashLite 1401), polishing and initial color readout (Spectrophotometer PCB 687; BYK Gardner), the test specimens were subjected to AAA (C-UV; Comexim), in 8-h cycles: 4 h exposure to UV-B rays at 50°C and 4 h condensation at 50°C. At the end of each cycle, color readouts were taken and the test ended when the mean value of ΔE attained a level ≥3.30. Tetric Ceram presented alteration in ΔE equal to 3.33 in the first aging cycle. For Filtek P90 and Z250, two (ΔE=3.60) and four (ΔE=3.42) AAA cycles were necessary. After each cycle, there was a reduction of luminosity in all the samples (ΔL). It was concluded that a short period of AAA was sufficient to promote clinically unacceptable color alteration in composites, and that this alteration was material-dependent. PMID:23306237

  14. Color stability of modern composites subjected to different periods of accelerated artificial aging.

    PubMed

    Drubi-Filho, Brahim; Garcia, Lucas da Fonseca Roberti; Cruvinel, Diogo Rodrigues; Sousa, Ana Beatriz Silva; Pires-de-Souza, Fernanda de Carvalho Panzeri

    2012-01-01

    The aim of this study was to evaluate the color stability of composites subjected to different periods of accelerated artificial aging (AAA). A polytetrafluorethylene matrix (10 x 2 mm) was used to fabricate 24 test specimens of three different composites (n=8): Tetric Ceram (Ivoclar/Vivadent); Filtek P90 and Z250 (3M ESPE), shade A3. After light activation for 20 s (FlashLite 1401), polishing and initial color readout (Spectrophotometer PCB 687; BYK Gardner), the test specimens were subjected to AAA (C-UV; Comexim), in 8-h cycles: 4 h exposure to UV-B rays at 50°C and 4 h condensation at 50°C. At the end of each cycle, color readouts were taken and the test ended when the mean value of ΔE attained a level ≥3.30. Tetric Ceram presented alteration in ΔE equal to 3.33 in the first aging cycle. For Filtek P90 and Z250, two (ΔE=3.60) and four (ΔE=3.42) AAA cycles were necessary. After each cycle, there was a reduction of luminosity in all the samples (ΔL). It was concluded that a short period of AAA was sufficient to promote clinically unacceptable color alteration in composites, and that this alteration was material-dependent.

  15. Triiodothyronine Levels Are Independently Associated with Metabolic Syndrome in Euthyroid Middle-Aged Subjects

    PubMed Central

    Kim, Hye Jeong; Park, Hyeong Kyu; Byun, Dong Won; Suh, Kyoil; Yoo, Myung Hi; Kim, Jae Hyeon; Min, Yong-Ki; Kim, Sun Wook

    2016-01-01

    Background Recent studies have shown an association between thyroid hormone levels and metabolic syndrome (MetS) among euthyroid individuals; however, there have been some inconsistencies between studies. Here, we evaluated the relationship between thyroid hormone levels and MetS in euthyroid middle-aged subjects in a large cohort. Methods A retrospective analysis of 13,496 euthyroid middle-aged subjects who participated in comprehensive health examinations was performed. Subjects were grouped according to thyroid stimulating hormone, total triiodothyronine (T3), total thyroxine (T4), and T3-to-T4 ratio quartile categories. We estimated the odds ratios (ORs) for MetS according to thyroid hormone quartiles using logistic regression models, adjusted for potential confounders. Results Of the study patients, 12% (n=1,664) had MetS. A higher T3 level and T3-to-T4 ratio were associated with unfavourable metabolic profiles, such as higher body mass index, systolic and diastolic blood pressure, triglycerides, fasting glucose and glycated hemoglobin, and lower high density lipoprotein cholesterol levels. The proportion of participants with MetS increased across the T3 quartile categories (P for trend <0.001) and the T3-to-T4 ratio quartile categories (P for trend <0.001). The multi-variate-adjusted OR (95% confidence interval) for MetS in the highest T3 quartile group was 1.249 (1.020 to 1.529) compared to the lowest T3 quartile group, and that in the highest T3-to-T4 ratio quartile group was 1.458 (1.141 to 1.863) compared to the lowest T3-to-T4 ratio quartile group, even after adjustment for potential confounders. Conclusion Serum T3 levels and T3-to-T4 ratio are independently associated with MetS in euthyroid middle-aged subjects. Longitudinal studies are needed to define this association and its potential health implications. PMID:27184017

  16. Impact of obesity on diastolic function in subjects < or = 16 years of age.

    PubMed

    Sharpe, Joan Andree; Naylor, Louise Haleh; Jones, Timothy William; Davis, Elizabeth Ann; O'Driscoll, Gerry; Ramsay, James Michael; Green, Daniel John

    2006-09-01

    The aim of this study was to investigate the impact of obesity on diastolic function in children and adolescents. Echocardiographic measurements were compared in 28 obese subjects (14 males, 14 females) and 15 age- and gender-matched lean controls (8 males, 7 females). Two-dimensional ultrasound imaging, M-mode imaging, and pulse-wave conventional and tissue Doppler measurements were used to assess cardiac structure and function at rest. No differences were evident between lean and obese subjects in age (13.3 +/- 0.5 vs 12.4 +/- 0.4 years), height (163 +/- 4 vs 159 +/- 2 cm), or systolic blood pressure (119 +/- 3 vs 123 +/- 2 mm Hg). Body mass (54.6 +/- 4.0 vs 85.8 +/- 3.6 kg, p < 0.0001) and body mass index (20.5 +/- 0.7 vs 33.3 +/- 1.0 kg/m2, p < 0.00001) were significantly greater in the obese subjects, whereas measurements of wall thickness (interventricular septal wall 0.86 +/- 0.04 vs 0.89 +/- 0.02 cm, posterior wall 0.83 +/- 0.04 vs 0.91 +/- 0.02 cm) and fractional shortening (38.6 +/- 1.2% vs 38.8 +/- 1.2%) did not significantly differ. The E/E' ratio (6.86 +/- 0.20 vs 8.30 +/- 0.32, p < 0.01), E' (13.93 +/- 0.38 vs 12.29 +/- 0.44 cm/s, p < 0.05), the E'/A' ratio (2.49 +/- 0.17 vs 2.05 +/- 0.09, p < 0.05), and the deceleration time of early transmitral blood flow velocity (125.3 +/- 7.7 vs 154.5 +/- 6.8 ms, p < 0.01) were significantly different between the groups, suggesting reduced diastolic function in the obese subjects. In conclusion, these data suggest that indexes of diastolic function, including tissue Doppler measures, are significantly impaired in obese young subjects.

  17. Oral submucous fibrosis at pediatric age, now time to think: Series of two cases

    PubMed Central

    Gupta, Vinay K.; Malhotra, Seema; Patil, Ranjit; Tripathi, Anurag

    2013-01-01

    The younger generation is consuming areca nut and areca nut products, which is coming in the market with different multicolored attractive pouches and easily available in each and every corner of the road. For the children from the lower socioeconomic strata, areca nut use is rampant. Alarmingly, it has been seen that the highest period of risk for engaging in areca nut alone is between the ages of 5 and 12. Oral submucous fibrosis associated with areca nut in children is a great concern for the Society and the Government. Factors associated with this report for consuming areca nut are levels of awareness, household environment, peer pressure, low cost, easy availability etc. PMID:24049299

  18. Nutritional deficiencies in the pediatric age group in a multicultural developed country, Israel

    PubMed Central

    Haimi, Motti; Lerner, Aaron

    2014-01-01

    Nutrient deficiencies are prevalent worldwide. Diseases and morbid conditions have been described to result from nutritional deficiencies. It is essential to address nutrient deficiencies as these may lead to chronic long-term health problems such as rickets, iron deficiency anemia, goiter, obesity, coronary heart disease, type 2 diabetes, stroke, cancer and osteoporosis. In the present review we surveyed the extent and severity of nutritional deficiencies in Israel through a selective and comprehensive Medline review of previous reports and studies performed during the last 40 years. Israeli populations have multiple nutritional deficiencies, including iron, calcium, zinc, folic acid, and vitamins B12, C, D and E, spanning all age groups, several minorities, and specific regions. In Israel, some of the nutrients are mandatorily implemented and many of them are implemented voluntarily by local industries. We suggest ways to prevent and treat the nutritional deficiencies, as a step to promote food fortification in Israel. PMID:24868510

  19. Nutritional deficiencies in the pediatric age group in a multicultural developed country, Israel.

    PubMed

    Haimi, Motti; Lerner, Aaron

    2014-05-16

    Nutrient deficiencies are prevalent worldwide. Diseases and morbid conditions have been described to result from nutritional deficiencies. It is essential to address nutrient deficiencies as these may lead to chronic long-term health problems such as rickets, iron deficiency anemia, goiter, obesity, coronary heart disease, type 2 diabetes, stroke, cancer and osteoporosis. In the present review we surveyed the extent and severity of nutritional deficiencies in Israel through a selective and comprehensive Medline review of previous reports and studies performed during the last 40 years. Israeli populations have multiple nutritional deficiencies, including iron, calcium, zinc, folic acid, and vitamins B12, C, D and E, spanning all age groups, several minorities, and specific regions. In Israel, some of the nutrients are mandatorily implemented and many of them are implemented voluntarily by local industries. We suggest ways to prevent and treat the nutritional deficiencies, as a step to promote food fortification in Israel.

  20. Age-related acceleration of endothelial dysfunction and subclinical atherosclerosis in subjects with coronary artery lesions after Kawasaki disease.

    PubMed

    Noto, Nobutaka; Okada, Tomoo; Karasawa, Kensuke; Ayusawa, Mamoru; Sumitomo, Naokata; Harada, Kensuke; Mugishima, Hideo

    2009-04-01

    The objective of this study was to test the hypothesis that accelerated endothelial dysfunction and the development of premature atherosclerosis are associated with age in subjects with coronary artery lesions after Kawasaki disease (KD). A case-control study was performed at a university hospital that included 35 post-KD subjects across a wide age range (range, 8-42 years) without traditional cardiovascular risk factors and 35 age- and sex-matched healthy control subjects (Cont). Flow-mediated dilatation (FMD) of the brachial artery-induced by reactive hyperemia, intima media thickness (IMT), and elastic modulus (Ep) of the common carotid artery were compared between KD and Cont subjects assessed against age. KD subjects had slightly higher levels of body mass index, lipid profile, and HbA1c than Cont subjects, but the differences were not significant. The mean IMT (p < 0.001), age-adjusted percentage normal IMT (%N IMT; p < 0.0001), and Ep (p < 0.001) were significantly higher in KD than Cont subjects, and the peak FMD% (p < 0.01) was significantly lower in KD than Cont subjects. There were significant correlations between FMD% and age (r = -0.51 p < 0.0001), IMT and age (r = 0.68, p < 0.001), and Ep and age (r = 0.58, p < 0.01) in KD but not Cont subjects. When the difference in FMD% between KD and matched Cont subjects (DeltaFMD%) was plotted against age, no significant relationship was found, although significant correlations between DeltaIMT and age (r = 0.52, p < 0.01) as well as between DeltaEp and age (r = 0.46, p < 0.05) were observed. When we defined values that were +2.0 SD over the mean control values (i.e., %N IMT >or= 120% and/or Ep >or= 50 kPa) as markers of subclinical atherosclerosis, 15 subjects met the criteria. Subjects over the age of 22 years were more likely to have (OR = 16.54, p = 0.0001) subclinical atherosclerosis in this cohort. Our results suggest that endothelial dysfunction and the development of premature atherosclerosis were

  1. Hand X-ray in pediatric endocrinology: Skeletal age assessment and beyond.

    PubMed

    De Sanctis, Vincenzo; Di Maio, Salvatore; Soliman, Ashraf T; Raiola, Giuseppe; Elalaily, Rania; Millimaggi, Giuseppe

    2014-11-01

    Skeletal age assessment (SAA) is a clinical procedure which is used in determining the SA of children and adolescents. Bone development is influenced by a number of factors, including nutrition, hormonal secretions, and genetics. There are several factors to be borne in mind when using methods of assessing skeletal maturity. These include: Variability among methods, degree of variability in the estimation of skeletal maturation, sources of low accuracy, and dispersion of the values of skeletal maturation. Currently, the main clinical methods for SAA are the Greulich and Pyle (GP) and Tanner and Whitehouse (TW) methods. The GP method has the advantage of being quick and easy to use. A well-trained radiologist takes few minutes to determine the bone age (BA) from a single hand radiograph. The method of TW, however, seems to be more reliable than the GP method. In recent years, the increasing speed in computer sciences and reduction of their cost has given the opportunity to create and use computerized BA estimation system. Despite the fact that the number of automated systems for BAA have increased, most are still within the experimental phase. The use of automated BA determination system, cleared for clinical use in Europe (BoneXpert), has been validated for various ethnicities and children with endocrine disorders. Ultrasound imaging has some limitations that include operator dependence, lower intra-rater and inter-rater reliability of assessment and difficulties with standardization of documentation and imaging transfer. Magnetic resonance imaging (MRI) is noninvasive alternative tool for SA assessment in children. However, few studies have been reported on this topic, and further research is needed to evaluate the reliability and validity of MRI BAAs. In conclusion, at present radiographic methods for the assessment of BA remain the gold standards. Whatever method one adopts, it is essential to minimize the causes of imprecision by taking care to consider the

  2. Ten-year experience in management of diabetic ketoacidosis and ketosis: 140 episodes at pediatric age.

    PubMed

    Yordam, Nuren; Gönç, E Nazli; Kandemir, Nurgün; Alikaşifoğlu, Ayfer; Ozön, Alev

    2005-01-01

    One hundred and forty episodes in 112 patients (58 boys) with diabetic ketoacidosis (96 episodes) and diabetic ketosis (44 episodes) were studied to elucidate the clinical and laboratory risk factors for altered level of consciousness at presentation and to analyze the outcome of a distinct protocol in the treatment of diabetic ketoacidosis. The patients were analyzed according to demographic data and clinical and laboratory findings at admission. The treatment protocol involved use of 0.45% sodium chloride (NaCl) in 2.5% dextrose as the initial fluid therapy following volume expansion. Dextrose content of the fluid was doubled once the serum glucose level fell below 250 mg/dl. The mean ages at presentation with diabetic ketoacidosis and ketosis were 10.3 +/- 4.4 and 10.2 +/- 4.0 years, respectively. Thirty-one percent of patients had altered consciousness at presentation. The level of consciousness correlated negatively with serum bicarbonate level (r=-0.485; p<0.001). A serum bicarbonate level below 15 mmol/L was a risk factor for altered consciousness. There was no correlation between effective osmolality and the level of consciousness. Serum effective osmolality above 320 mOsm/kg H2O did not appear to be a risk factor for altered consciousness. No mortality or any signs of clinical brain edema were observed in patients treated with the distinct treatment protocol. In conclusion, acidosis appears to be the major factor in the pathogenesis of altered consciousness at presentation. Serum effective osmolality does not seem to be a risk factor as suggested previously. Dextrose added to the infusion fluid early in treatment seems to prevent the development of brain edema, and this may be due to a protective effect of higher osmolality in the resultant solution.

  3. Effects of walking speed and age on the muscle forces of unimpaired gait subjects

    NASA Astrophysics Data System (ADS)

    Fliger, Carlos G.; Crespo, Marcos J.; Braidot, Ariel A.; Ravera, Emiliano P.

    2016-04-01

    Clinical gait analysis provides great contributions to the understanding of gait disorders and also provides a mean for a more comprehensive treatment plan. However, direct measures of muscle forces are difficult to obtain in clinical settings because it generally requires invasive techniques. Techniques of musculoskeletal modeling have been used for several decades to improve the benefits of clinical gait analysis, but many of the previous studies were focused on analyzing separately the muscle forces distribution of children or adult subjects with only one condition of walking speed. For these reason, the present study aims to enhance the current literature by describing the age and speed gait effects on muscle forces during walking. We used a musculoskeletal model with 23 degrees of freedom and 92 musculotendon actuators to represent 76 muscles in the lower extremities and torso. The computed muscle control algorithm was used to estimate the muscle forces from the kinematics and to adjust the model obtained in the residual reduction algorithm. We find that hamstrings has an important peak in the mid-stance phase in the adult group but this peak disappears in the children group with the same walking speed condition. Furthermore, the rectus femoris presents an increase in the muscle force during the pre- and mid-swing in concordance with the increment in the walking speed of subjects. This behavior could be associated with the role that the rectus femoris has in the acceleration of the knee joint. Finally, we show that the soleus is the muscle that perform the major force throughout the gait cycle regardless of age and walking speed.

  4. Improved insulin response and action by chronic magnesium administration in aged NIDDM subjects.

    PubMed

    Paolisso, G; Sgambato, S; Pizza, G; Passariello, N; Varricchio, M; D'Onofrio, F

    1989-04-01

    In eight aged non-insulin-dependent diabetes mellitus (NIDDM) subjects, insulin response and action were studied before and after chronic magnesium supplementation (2 g/day) to diet. Chronic magnesium supplementation to diet versus placebo produced 1) a significant increase in plasma (0.83 +/- 0.05 vs. 0.78 +/- 0.06 mM, P less than .05) and erythrocyte (2.03 +/- 0.06 vs. 1.88 +/- 0.09 mM, P less than .01) magnesium levels, 2) an increase in acute insulin response (AIR) (4.0 +/- 0.6 vs. -1.6 +/- 0.6 mU/L, P less than .05) to glucose pulse, and 3) an increase in glucose infusion rate (GIR) (3.6 +/- 0.6 vs. 2.9 +/- 0.5 mg.kg-1.min-1, P less than .025) calculated in the last 60 min of a euglycemic-hyperinsulinemic (100 mU.m2.min-1 during 180 min) glucose clamp. Net increase in AIR, glucose disappearance rate after glucose pulse, and GIR were significantly and positively correlated to the net increase in erythrocyte magnesium content calculated after chronic magnesium supplementation to diet. In conclusion, our data suggest that NIDDM subjects may benefit from therapeutic chronic administration of magnesium salts.

  5. Elbow pain in pediatrics.

    PubMed

    Crowther, Marshall

    2009-06-01

    The pediatric and adolescent elbow is subject to both acute and chronic overuse injuries. The practitioner should develop a classification system to evaluate all such injuries, with first focusing on whether the injury represents an acute episode or rather it represents a more chronic problem. In addition, localizing the area of pain as being either medial, lateral, or posterior can better help differentiate the diagnosis. Youth baseball pitchers and throwers are particularly at risk for overuse injuries of the elbow, most of which are related to an injury mechanism termed "valgus extension overload". The most common entity related to this is termed "Little Leaguer's Elbow." Treatment is usually conservative, but for some injuries surgery may be required, especially for displaced medial epicondylar avulsion fractures. Other acute injuries also should be easily recognizable by the general clinician including annular ligament displacement (nursemaid's elbow) which represents one of the most common upper extremity injuries presenting to emergency rooms in youngsters under the age of 6. Most studies seem to indicate a hyperpronation reduction technique may be more successful then the flexion/supination technique. It is also important to have an awareness of some of the common elbow fractures seen in the younger patient, in particularly supracondylar fractures owing to their high propensity for complications. When evaluating the elbow for fractures, it is necessary to have an understanding of the appearance of the ossification centers seen on the pediatric elbow.

  6. EquiTest modification with shank and hip angle measurements: differences with age among normal subjects.

    PubMed

    Speers, R A; Shepard, N T; Kuo, A D

    1999-01-01

    The Sensory Organization Test protocol of the EquiTest system (NeuroCom International, Clackamas Oregon) tests utilization of visual, vestibular, and proprioceptive sensors by manipulating the accuracy of visual and/or somatosensory inputs during quiet stance. In the standard Sensory Organization Test, both manipulation of sensory input (sway-referencing) and assessment of postural sway are based on ground reaction forces measured from a forceplate. The purpose of our investigation was to examine the use of kinematic measurements to provide a more direct feedback signal for sway-referencing and for assessment of sway. We compared three methods of sway-referencing: the standard EquiTest method based on ground reaction torque, kinematic feedback based on servo-controlling to shank motion, and a more complex kinematic feedback based on servo-controlling to follow position of the center of mass (COM) as calculated from a two-link biomechanical model. Fifty-one normal subjects (ages 20-79) performed the randomized protocol. When using either shank or COM angle for sway-referencing feedback as compared to the standard EquiTest protocol, the Equilibrium Quotient and Strategy Score assessments were decreased for all age groups in the platform sway-referenced conditions (SOT 4, 5, 6). For all groups of subjects, there were significant differences in one or more of the kinematic sway measures of shank, hip, or COM angle when using either of the alternative sway-referencing parameters as compared to the standard EquiTest protocol. The increased sensitivities arising from use of kinematics had the effect of amplifying differences with age. For sway-referencing, the direct kinematic feedback may enhance ability to reduce proprioceptive information by servo-controlling more closely to actual ankle motion. For assessment, kinematics measurements can potentially increase sensitivity for detection of balance disorders, because it may be possible to discriminate between body sway

  7. Effect of age and gender on sudomotor and cardiovagal function and blood pressure response to tilt in normal subjects

    NASA Technical Reports Server (NTRS)

    Low, P. A.; Denq, J. C.; Opfer-Gehrking, T. L.; Dyck, P. J.; O'Brien, P. C.; Slezak, J. M.

    1997-01-01

    Normative data are limited on autonomic function tests, especially beyond age 60 years. We therefore evaluated these tests in a total of 557 normal subjects evenly distributed by age and gender from 10 to 83 years. Heart rate (HR) response to deep breathing fell with increasing age. Valsalva ratio varied with both age and gender. QSART (quantitative sudomotor axon-reflex test) volume was consistently greater in men (approximately double) and progressively declined with age for all three lower extremity sites but not the forearm site. Orthostatic blood pressure reduction was greater with increasing age. HR at rest was significantly higher in women, and the increment with head-up tilt fell with increasing age. For no tests did we find a regression to zero, and some tests seem to level off with increasing age, indicating that diagnosis of autonomic failure was possible to over 80 years of age.

  8. Safety and Efficacy of Gadoxetate Disodium–Enhanced Liver MRI in Pediatric Patients Aged >2 Months to <18 Years—Results of a Retrospective, Multicenter Study

    PubMed Central

    Geller, James; Kasahara, Mureo; Martinez, Mercedes; Soresina, Annarosa; Kashanian, Fran; Endrikat, Jan

    2016-01-01

    PURPOSE To assess the safety and efficacy of gadoxetate disodium–enhanced liver MR imaging in pediatric patients. MATERIAL AND METHODS Retrospective, multicenter study including pediatric patients aged >2 months to <18 years who underwent contrast-enhanced liver MRI due to focal liver lesions. A single intravenous bolus injection of 0.025 to 0.05 mmol/kg body weight of gadoxetate disodium was administered. Adverse events (AEs) up to 24 hours after injection were recorded and a one-year follow-up was conducted for all serious and unexpected AEs. Efficacy was defined based on the additional diagnostic information obtained from the combined (pre- and postcontrast) image sets as compared with the precontrast image sets by blinded reading. RESULTS A total of 52 patients for safety and 51 patients for efficacy analyses were evaluated. Twenty-two patients (42.3%) reported a total of 51 serious AEs (SAEs) and one AE after one year. No SAE or AE was related to gadoxetate disodium injection. Gadoxetate disodium–related effects on vital signs were not seen. Additional diagnostic information was obtained for 86.3% of patients. The three most improved efficacy variables were lesion-to-background contrast, lesion characterization, and improved border delineation in 78.4%, 76.5%, and 70.6% of patients, respectively. CONCLUSION Gadoxetate disodium in pediatric patients did not raise any clinically significant safety concern. Contrast enhancement provided additional clinically relevant information. PMID:27478381

  9. The Impact of Subject Age, Gender, and Arch Length on Attitudes of Syrian Dentists towards Shortened Dental Arches.

    PubMed

    Nassani, Mohammad Zakaria; Al-Nahhal, Tammam Ibrahim; Kujan, Omar; Tarakji, Bassel; Kay, Elizabeth Jane

    2015-01-01

    Objective. This study aimed to investigate the impact of subject age, gender, and arch length on dentists' attitudes towards unrestored shortened dental arches. Materials and Methods. 93 Syrian dentists were interviewed and presented with 24 scenarios for male and female subjects of different ages and shortened dental arches of varying length. Participants were asked to indicate on a standardized visual analogue scale how they would value the health of the mouth if the posterior space was left unrestored. Results. A value of 0.0 represented the worst possible health state for a mouth and 1.0 represented the best. The highest mean value (0.73) was assigned to a shortened dental arch with missing second molar teeth in the mouth of a 70-year-old subject. A 35-year-old female subject with an extremely shortened dental arch (all molar and premolar teeth are missing) attracted the lowest mean value (0.26). The statistical analysis indicated a significant decrease in the value placed on unrestored shortened dental arches as the number of remaining teeth decreased (p < 0.008). While subject gender had almost no impact on dentists' attitudes towards shortened dental arches, the scenarios for the older shortened dental arch subjects attracted significantly higher values compared to the scenarios for the younger subjects (p < 0.017). Conclusion. Subject age and arch length affect dentists' attitudes towards shortened dental arches, but subject gender does not.

  10. It matters how old you feel: Antecedents and performance consequences of average relative subjective age in organizations.

    PubMed

    Kunze, Florian; Raes, Anneloes M L; Bruch, Heike

    2015-09-01

    This article extends the conceptual knowledge of average relative subjective age in organizations by exploring organizational-level antecedents and consequences of employees, on average, feeling younger than their chronological age. We draw from the theories of selection-optimization-compensation and socioemotional selectivity to build a theoretical framework for relative subjective age in organizations. We hypothesize that companies in which employees, on average, perceive themselves to be younger than they actually are have a higher average individual goal accomplishment and, in turn, experience higher company performance. We further hypothesize that employees' average experience of high work-related meaning relates to a lower subjective age in organizations. In addition, we assess the role of environmental dynamism and age-inclusive human resource management as moderators in this theoretical model. Through empirically testing this model in a multisource dataset, including 107 companies with 15,164 participating employees, we received support for the hypothesized relationships. Our results contribute to current debates in the scientific literature on age and have important practical implications in light of the demographic changes faced by many companies. This research indicates to both researchers and practitioners that it is not employees' chronological age but their subjective age, a factor that can be influenced, which drives organizational performance outcomes.

  11. It matters how old you feel: Antecedents and performance consequences of average relative subjective age in organizations.

    PubMed

    Kunze, Florian; Raes, Anneloes M L; Bruch, Heike

    2015-09-01

    This article extends the conceptual knowledge of average relative subjective age in organizations by exploring organizational-level antecedents and consequences of employees, on average, feeling younger than their chronological age. We draw from the theories of selection-optimization-compensation and socioemotional selectivity to build a theoretical framework for relative subjective age in organizations. We hypothesize that companies in which employees, on average, perceive themselves to be younger than they actually are have a higher average individual goal accomplishment and, in turn, experience higher company performance. We further hypothesize that employees' average experience of high work-related meaning relates to a lower subjective age in organizations. In addition, we assess the role of environmental dynamism and age-inclusive human resource management as moderators in this theoretical model. Through empirically testing this model in a multisource dataset, including 107 companies with 15,164 participating employees, we received support for the hypothesized relationships. Our results contribute to current debates in the scientific literature on age and have important practical implications in light of the demographic changes faced by many companies. This research indicates to both researchers and practitioners that it is not employees' chronological age but their subjective age, a factor that can be influenced, which drives organizational performance outcomes. PMID:25798554

  12. Age at Transition from Pediatric to Adult Care Has No Relationship with Mortality for Childhood-Onset Type 1 Diabetes in Japan: Diabetes Epidemiology Research International (DERI) Mortality Study

    PubMed Central

    Onda, Yoshiko; Nishimura, Rimei; Morimoto, Aya; Sano, Hironari; Utsunomiya, Kazunori; Tajima, Naoko

    2016-01-01

    Objective To follow up Japanese patients with type 1 diabetes for a maximum of 40 years to examine when they transitioned from pediatric care to adult care and to explore whether the attending physician, i.e., pediatrician or internist, was associated with prognosis. Methods Participants consisted of 1,299 patients who had been diagnosed as having type 1 diabetes at less than 15 years old between 1965 and 1979 identified through two nationwide surveys. Patients were classified as having received either pediatric care or adult care at the age of 15 and 30, and were compared for differences in mortality associated with the attending physician. Results The attending physicians were confirmed for a total of 1,093 patients at the age of 15. Of these patients, 43.8% and 40.3% received pediatric care and adult care, respectively. Of the 569 patients receiving pediatric care, 74.2%, 56.6%, 53.4%, and 51.3% continued with pediatric care at 20, 30, 40, and 50 years old, respectively. The attending physicians (pediatrician or internist) at the age of 15 and 30 had no significant impact on their survival (P = 0. 892, 0.411, respectively). Conclusions More than half of the patients who had received pediatric care at the age of 15 continued to receive pediatric care even after the age of 30, suggesting that their transition was far from smooth, while the attending physician at the age of both 15 and 30 was not a prognostic factor for mortality. Thus, the timing for transition to adult care in these patients has no relationship with mortality in Japan. PMID:26937952

  13. Peripheral Nerve Dysfunction in Middle-Aged Subjects Born with Thalidomide Embryopathy

    PubMed Central

    Nicotra, Alessia; Newman, Claus; Johnson, Martin; Eremin, Oleg; Friede, Tim; Malik, Omar; Nicholas, Richard

    2016-01-01

    Background Phocomelia is an extremely rare congenital malformation that emerged as one extreme of a range of defects resulting from in utero exposure to thalidomide. Individuals with thalidomide embryopathy (TE) have reported developing symptoms suggestive of peripheral nervous system dysfunction in the mal-developed limbs in later life. Methods Case control study comparing TE subjects with upper limb anomalies and neuropathic symptoms with healthy controls using standard neurophysiological testing. Other causes of a peripheral neuropathy were excluded prior to assessment. Results Clinical examination of 17 subjects with TE (aged 50.4±1.3 [mean±standard deviation] years, 10 females) and 17 controls (37.9±9.0 years; 8 females) demonstrated features of upper limb compressive neuropathy in three-quarters of subjects. Additionally there were examination findings suggestive of mild sensory neuropathy in the lower limbs (n = 1), L5 radiculopathic sensory impairment (n = 1) and cervical myelopathy (n = 1). In TE there were electrophysiological changes consistent with a median large fibre neuropathic abnormality (mean compound muscle action potential difference -6.3 mV ([-9.3, -3.3], p = 0.0002) ([95% CI], p-value)) and reduced sympathetic skin response amplitudes (-0.8 mV ([-1.5, -0.2], p = 0.0089)) in the affected upper limbs. In the lower limbs there was evidence of sural nerve dysfunction (sensory nerve action potential -5.8 μV ([-10.7, -0.8], p = 0.0232)) and impaired warm perception thresholds (+3.0°C ([0.6, 5.4], p = 0.0169)). Conclusions We found a range of clinical features relevant to individuals with TE beyond upper limb compressive neuropathies supporting the need for a detailed neurological examination to exclude other treatable pathologies. The electrophysiological evidence of large and small fibre axonal nerve dysfunction in symptomatic and asymptomatic limbs may be a result of the original insult and merits further investigation. PMID:27100829

  14. Multiple skin neoplasms in subjects under 40 years of age in Goiania, Brazil

    PubMed Central

    Pereira, Samir; Curado, Maria Paula; Ribeiro, Ana Maria Quinteiro

    2015-01-01

    OBJECTIVE To describe the trend for malignant skin neoplasms in subjects under 40 years of age in a region with high ultraviolet radiation indices. METHODS A descriptive epidemiological study on melanoma and nonmelanoma skin cancers that was conducted in Goiania, Midwest Brazil, with 1,688 people under 40 years of age, between 1988 and 2009. Cases were obtained from Registro de Câncer de Base Populacional de Goiânia (Goiania’s Population-Based Cancer File). Frequency, trends, and incidence of cases with single and multiple lesions were analyzed; transplants and genetic skin diseases were found in cases with multiple lesions. RESULTS Over the period, 1,995 skin cancer cases were observed to found, of which 1,524 (90.3%) cases had single lesions and 164 (9.7%) had multiple lesions. Regarding single lesions, incidence on men was observed to have risen from 2.4 to 3.1/100,000 inhabitants; it differed significantly for women, shifting from 2.3 to 5.3/100,000 (Annual percentage change – [APC] 3.0%, p = 0.006). Regarding multiple lesions, incidence on men was observed to have risen from 0.30 to 0.98/100,000 inhabitants; for women, it rose from 0.43 to 1.16/100,000 (APC 8.6%, p = 0.003). Genetic skin diseases or transplants were found to have been correlated with 10.0% of cases with multiple lesions – an average of 5.1 lesions per patient. The average was 2.5 in cases without that correlation. CONCLUSIONS Skin cancer on women under 40 years of age has been observed to be increasing for both cases with single and multiple lesions. It is not unusual to find multiple tumors in young people – in most cases, they are not associated with genetic skin diseases or transplants. It is necessary to avoid excessive exposure to ultraviolet radiation from childhood. PMID:26465667

  15. Vitamin B12 Levels of Subjects Aged 0-24 Year(s) in Konya, Turkey

    PubMed Central

    Yavuz, Haluk; Bodur, Said; Kiyici, Aysel

    2014-01-01

    ABSTRACT Research reports indicate that vitamin B12 levels show racial differences, which suggests that using the reference ranges of varied populations may lead to inaccurate results. This study aimed to determine normal serum levels of vitamin B12 among children and young people in the Konya region of Turkey. It evaluated 1,109 samples; 54 were from cord-blood and 1,055 were from healthy subjects aged 0-24 year(s), who were admitted to primary healthcare centres. The normal reference levels obtained for vitamin B12 at 2.5-97.5 percentile (P2.5-P97.5) range were 127-606 pg/mL for girls, 127-576 pg/mL for boys, and 127-590 pg/mL for the entire study group. The reported reference values for vitamin B12 in other studies were higher than the current results. Vitamin B12 levels vary from country to country; comparisons between countries may not be valid, and normal levels for each population should be obtained. PMID:25895195

  16. The continued use of sunscreen prevents the development of actinic keratosis in aged Japanese subjects.

    PubMed

    Kunimoto, Kayo; Furukawa, Fukumi; Uede, Mikiko; Mizuno, Makoto; Yamamoto, Yuki

    2016-08-01

    It is well known that the trigger for actinic keratosis (AK) mainly depends on UV exposure. We evaluated the effects of long-term use of sunscreen on the histopathological and dermoscopic changes of AK in aged patients. Eighteen months use of sunscreen produced no change in the number of actinic keratoses or the advancement of histological grade. Although a significant decrease was not observed in the number of positive cells of p53, Ki-67 and COX-2 of the subjects who used sunscreen for 18 months, the downward tendencies of these proteins were observed. The continued use of sunscreen decreased the number of CD31-positive vessels significantly using the Chalkley method, and a significant improvement in scaling and vessel dots was found by dermoscopic study. Moreover, a relationship was found in the amount of sunscreen use and the number of actinic keratoses. Considering these results, it was thought that application of sunscreen reduces the risk of advancement of AK to higher grade AK and squamous cell carcinoma. PMID:27539900

  17. Tuning to the Positive: Age-Related Differences in Subjective Perception of Facial Emotion

    PubMed Central

    Picardo, Rochelle; Baron, Andrew S.; Anderson, Adam K.; Todd, Rebecca M.

    2016-01-01

    Facial expressions aid social transactions and serve as socialization tools, with smiles signaling approval and reward, and angry faces signaling disapproval and punishment. The present study examined whether the subjective experience of positive vs. negative facial expressions differs between children and adults. Specifically, we examined age-related differences in biases toward happy and angry facial expressions. Young children (5–7 years) and young adults (18–29 years) rated the intensity of happy and angry expressions as well as levels of experienced arousal. Results showed that young children—but not young adults—rated happy facial expressions as both more intense and arousing than angry faces. This finding, which we replicated in two independent samples, was not due to differences in the ability to identify facial expressions, and suggests that children are more tuned to information in positive expressions. Together these studies provide evidence that children see unambiguous adult emotional expressions through rose-colored glasses, and suggest that what is emotionally relevant can shift with development. PMID:26734940

  18. Chemical-biological terrorism and its impact on children: a subject review. American Academy of Pediatrics. Committee on Environmental Health and Committee on Infectious Diseases.

    PubMed

    2000-03-01

    There is an increasing threat that chemical and biological weapons will be used on a civilian population in an act of domestic terrorism. Casualties among adults and children could be significant in such an event. Federal, state, and local authorities have begun extensive planning to meet a chemical-biological incident by developing methods of rapid identification of potential agents and protocols for management of victims without injury to health care personnel. Because children would be disproportionately affected by a chemical or biological weapons release, pediatricians must assist in planning for a domestic chemical-biological incident. Government agencies should seek input from pediatricians and pediatric subspecialists to ensure that the situations created by multiple pediatric casualties after a chemical-biological incident are considered. This statement reviews key aspects of chemical-biological agents, the consequences of their use, the potential impact of a chemical-biological attack on children, and issues to consider in disaster planning and management for pediatric patients.

  19. Measuring aging rates of mice subjected to caloric restriction and genetic disruption of growth hormone signaling.

    PubMed

    Koopman, Jacob J E; van Heemst, Diana; van Bodegom, David; Bonkowski, Michael S; Sun, Liou Y; Bartke, Andrzej

    2016-03-01

    Caloric restriction and genetic disruption of growth hormone signaling have been shown to counteract aging in mice. The effects of these interventions on aging are examined through age-dependent survival or through the increase in age-dependent mortality rates on a logarithmic scale fitted to the Gompertz model. However, these methods have limitations that impede a fully comprehensive disclosure of these effects. Here we examine the effects of these interventions on murine aging through the increase in age-dependent mortality rates on a linear scale without fitting them to a model like the Gompertz model. Whereas these interventions negligibly and non-consistently affected the aging rates when examined through the age-dependent mortality rates on a logarithmic scale, they caused the aging rates to increase at higher ages and to higher levels when examined through the age-dependent mortality rates on a linear scale. These results add to the debate whether these interventions postpone or slow aging and to the understanding of the mechanisms by which they affect aging. Since different methods yield different results, it is worthwhile to compare their results in future research to obtain further insights into the effects of dietary, genetic, and other interventions on the aging of mice and other species.

  20. Measuring aging rates of mice subjected to caloric restriction and genetic disruption of growth hormone signaling

    PubMed Central

    Koopman, Jacob J.E.; van Heemst, Diana; van Bodegom, David; Bonkowski, Michael S.; Sun, Liou Y.; Bartke, Andrzej

    2016-01-01

    Caloric restriction and genetic disruption of growth hormone signaling have been shown to counteract aging in mice. The effects of these interventions on aging are examined through age-dependent survival or through the increase in age-dependent mortality rates on a logarithmic scale fitted to the Gompertz model. However, these methods have limitations that impede a fully comprehensive disclosure of these effects. Here we examine the effects of these interventions on murine aging through the increase in age-dependent mortality rates on a linear scale without fitting them to a model like the Gompertz model. Whereas these interventions negligibly and non-consistently affected the aging rates when examined through the age-dependent mortality rates on a logarithmic scale, they caused the aging rates to increase at higher ages and to higher levels when examined through the age-dependent mortality rates on a linear scale. These results add to the debate whether these interventions postpone or slow aging and to the understanding of the mechanisms by which they affect aging. Since different methods yield different results, it is worthwhile to compare their results in future research to obtain further insights into the effects of dietary, genetic, and other interventions on the aging of mice and other species. PMID:26959761

  1. The interplay of subjective social status and essentialist beliefs about cognitive aging on cortisol reactivity to challenge in older adults.

    PubMed

    Weiss, David; Weiss, Mona

    2016-08-01

    Older adults are more likely than younger adults to experience stress when confronted with cognitive challenges. However, little is known about individual differences that might explain why some older adults exhibit stronger stress responses than others. We examined the interplay of two social-cognitive factors to explain older adults' cortisol reactivity: (1) subjective social status, and (2) essentialist beliefs about cognitive aging. We hypothesized that, depending on whether older adults believe that aging-related cognitive decline is inevitable versus modifiable, low subjective social status should lead to stronger or weaker cortisol reactivity. Using longitudinal data, we assessed the impact of cognitive challenges on stress reactivity in a sample of older adults (N = 389; 61-86 years). As predicted, regression analyses confirmed that 44 min after cognitively challenging tasks, older adults exhibited a significantly different cortisol reactivity depending on their subjective social status and their essentialist beliefs about cognitive aging. Specifically, older adults with low subjective social status and high essentialist beliefs showed a significantly elevated cortisol reactivity. We discuss the role of essentialist beliefs about cognitive aging to predict when and why high versus low subjective social status leads to stress responses in older adults.

  2. Pediatric anklebot.

    PubMed

    Krebs, Hermano I; Rossi, Stefano; Kim, Seung-Jae; Artemiadis, Panagiotis K; Williams, Dustin; Castelli, Enrico; Cappa, Paolo

    2011-01-01

    In this paper we present the alpha-prototype of a novel pediatric ankle robot. This lower-extremity robotic therapy module was developed at MIT to aid recovery of ankle function in children with cerebral palsy ages 5 to 8 years old. This lower-extremity robotic module will commence pilot testing with children with cerebral palsy at Blythedale Childrens Hospital (Valhalla, NY), Bambino Gesu Children's Hospital (Rome, Italy), Riley Children's Hospital (Indianapolis, IN). Its design follows the same guidelines as our upper-extremity robots and adult anklebot designs, i.e. it is a low friction, backdriveable device with intrinsically low mechanical impedance. We show the ankle robot characteristics and stability range. We also present pilot data with healthy children to demonstrate the potential of this device. PMID:22275613

  3. Aging Versus Postmenopausal Osteoporosis: Bone Composition and Maturation Kinetics at Actively-Forming Trabecular Surfaces of Female Subjects Aged 1 to 84 Years.

    PubMed

    Paschalis, Eleftherios P; Fratzl, Peter; Gamsjaeger, Sonja; Hassler, Norbert; Brozek, Wolfgang; Eriksen, Erik F; Rauch, Frank; Glorieux, Francis H; Shane, Elizabeth; Dempster, David; Cohen, Adi; Recker, Robert; Klaushofer, Klaus

    2016-02-01

    Bone strength depends on the amount of bone, typically expressed as bone mineral density (BMD), determined by dual-energy X-ray absorptiometry (DXA), and on bone quality. Bone quality is a multifactorial entity including bone structural and material compositional properties. The purpose of the present study was to examine whether bone material composition properties at actively-forming trabecular bone surfaces in health are dependent on subject age, and to contrast them with postmenopausal osteoporosis patients. To achieve this, we analyzed by Raman microspectroscopy iliac crest biopsy samples from healthy subjects aged 1.5 to 45.7 years, paired biopsy samples from females before and immediately after menopause aged 46.7 to 53.6 years, and biopsy samples from placebo-treated postmenopausal osteoporotic patients aged 66 to 84 years. The monitored parameters were as follows: the mineral/matrix ratio; the mineral maturity/crystallinity (MMC); nanoporosity; the glycosaminoglycan (GAG) content; the lipid content; and the pyridinoline (Pyd) content. The results indicate that these bone quality parameters in healthy, actively-forming trabecular bone surfaces are dependent on subject age at constant tissue age, suggesting that with advancing age the kinetics of maturation (either accumulation, or posttranslational modifications, or both) change. For most parameters, the extrapolation of models fitted to the individual age dependence of bone in healthy individuals was in rough agreement with their values in postmenopausal osteoporotic patients, except for MMC, lipid, and Pyd content. Among these three, Pyd content showed the greatest deviation between healthy aging and disease, highlighting its potential to be used as a discriminating factor.

  4. Posttraumatic Growth in Parents and Pediatric Patients

    PubMed Central

    Picoraro, Joseph A.; Womer, James W.; Kazak, Anne E.

    2014-01-01

    Abstract Background: Pediatric medical experiences are potentially traumatic but may lead to psychological growth. Objective: The study objective was to synthesize the published literature regarding posttraumatic growth (PTG) in parents and patients with serious pediatric illness (SPI) into a conceptual model. Methods: We systematically searched MEDLINE, CINAHL, PsychInfo, and Sociological Abstracts in December 2012 to identify articles on stress or trauma caused by medical events with PTG as an outcome, reviewing articles pertaining to the pediatric population. We additionally reviewed articles outside pediatric medicine that described a model of PTG. Results: Of the 605 articles identified, 55 met inclusion criteria, 26 of which examined parents or pediatric patients. Parents and children may experience PTG following medical trauma through a combination of cognitive and affective processing of their subjective experience. Components of SPI-PTG are unclear, but may include greater appreciation of life, improved interpersonal relationships, greater personal strength, recognition of new possibilities in one's life course, spiritual or religious growth, and reconstruction of a positive body image. Individual characteristics, and the level of social support, may affect the likelihood that SPI-PTG will occur. SPI-PTG in siblings and other family members has not been well studied. Conclusions: SPI-PTG is an important but understudied and inadequately understood phenomenon affecting children with SPI and their family members. Research should focus on clarifying SPI-PTG domains, creating measurement instruments, assessing SPI-PTG across the pediatric age range and among family members, and improving our understanding of and ability to positively intervene regarding the cognitive processes of rumination, sense making, and benefit finding. PMID:24443768

  5. Human Very Small Embryonic-Like Stem Cells Are Present in Normal Peripheral Blood of Young, Middle-Aged, and Aged Subjects.

    PubMed

    Sovalat, Hanna; Scrofani, Maurice; Eidenschenk, Antoinette; Hénon, Philippe

    2016-01-01

    The purpose of our study was to determine whether the number of human very small embryonic-like stem cells (huVSELs) would vary depending on the age of humans. HuVSELs frequency was evaluated into the steady-state (SS) peripheral blood (PB) of healthy volunteers using flow cytometry analysis. Their numbers were compared with volunteers' age. Blood samples were withdrawn from 28 volunteers (age ranging from 20 to 70 years), who were distributed among three groups of age: "young" (mean age, 27.8 years), "middle" (mean age, 49 years), and "older" (mean age, 64.2 years). Comparing the three groups, we did not observe any statistically significant difference in huVSELs numbers between them. The difference in mRNA expression for PSC markers as SSEA-4, Oct-4, Nanog, and Sox2 between the three groups of age was not statistically significant. A similar frequency of huVSELs into the SS-PB of young, middle-aged, and aged subjects may indicate that the VSELs pool persists all along the life as a reserve for tissue repair in case of minor injury and that there is a continuous efflux of these cells from the BM into the PB.

  6. Human Very Small Embryonic-Like Stem Cells Are Present in Normal Peripheral Blood of Young, Middle-Aged, and Aged Subjects

    PubMed Central

    Sovalat, Hanna; Scrofani, Maurice; Eidenschenk, Antoinette; Hénon, Philippe

    2016-01-01

    The purpose of our study was to determine whether the number of human very small embryonic-like stem cells (huVSELs) would vary depending on the age of humans. HuVSELs frequency was evaluated into the steady-state (SS) peripheral blood (PB) of healthy volunteers using flow cytometry analysis. Their numbers were compared with volunteers' age. Blood samples were withdrawn from 28 volunteers (age ranging from 20 to 70 years), who were distributed among three groups of age: “young” (mean age, 27.8 years), “middle” (mean age, 49 years), and “older” (mean age, 64.2 years). Comparing the three groups, we did not observe any statistically significant difference in huVSELs numbers between them. The difference in mRNA expression for PSC markers as SSEA-4, Oct-4, Nanog, and Sox2 between the three groups of age was not statistically significant. A similar frequency of huVSELs into the SS-PB of young, middle-aged, and aged subjects may indicate that the VSELs pool persists all along the life as a reserve for tissue repair in case of minor injury and that there is a continuous efflux of these cells from the BM into the PB. PMID:26633977

  7. The relation between overweight and subjective health according to age, social class, slimming behavior and smoking habits in Dutch adults.

    PubMed Central

    Seidell, J C; Bakx, K C; Deurenberg, P; Burema, J; Hautvast, J G; Huygen, F J

    1986-01-01

    Subjective health status was assessed in relation to overweight by administering a list of 51 health complaints to adult men and women who were either chronically overweight as defined by Body Mass Index (BMI) or not overweight, in a continuous morbidity registration in four general practices during the period 1967-83. Responses were received from 455 men (182 overweight) and 790 women (386 overweight), ages 26-66 years. Response rate (71 per cent) and age distribution (mean age 48) were similar in overweight and non-overweight groups of both sexes. BMI was correlated with the total number of complaints in women (r = 0.15) but not in men (r = 0.07). Multiple regression analysis revealed, however, that age was an effect modifier in this relation, there being a negative association between BMI and subjective health in younger men and a positive association in older men, whereas in women the association between BMI and subjective health was much more pronounced at younger ages than at older ages. In addition, current smoking habits and social class (in men and women) and reported slimming behavior (in women) had an independent relation to the total number of health complaints. BMI was also related to specific complaints and groups of complaints, particularly in women. PMID:3777287

  8. A pilot study on the effect of Lactobacillus casei Zhang on intestinal microbiota parameters in Chinese subjects of different age.

    PubMed

    Kwok, L Y; Wang, L; Zhang, J; Guo, Z; Zhang, H

    2014-09-01

    Ageing of the population is an imminent global problem. Lactobacillus casei Zhang (LcZ) was isolated from Inner Mongolian fermented milk, koumiss. LcZ possesses numerous probiotic properties in in vitro tests and in animal models. However, it has never been tested in any human trial. In the current study, the impact of oral consumption of LcZ on different age groups was tested. Chinese subjects, including 10 young, 7 middle-aged and 7 elderly volunteers (with mean age of 24.3, 47.6 and 64.7, respectively), were recruited. Each subject took 10.6 log10 cfu LcZ daily for a continuous period of 28 days. Several parameters, including the amounts of LcZ and four selected groups of bacteria, change of bacterial diversity, short chain fatty acids (SCFA) and total bile acids (TBA), were monitored in faecal samples collected from the subjects before starting, during and after stopping oral LcZ consumption. The consumption of LcZ exhibited beneficial effects to the subjects by modulating faecal microbiota in a temporal manner with a prolonged elevation of SCFA and reduction of TBA. The potentially harmful Pseudomonas and Acinetobacter genera were suppressed by the probiotic administration. Furthermore, a moderately divergent response was observed in the indigenous gut populations of Bifidobacterium and Bacteroides fragilis group in different age subjects. Taken together, the current study has provided proof on the positive effect of probiotic consumption and crucial insights into the design and application of probiotic-based products to users of different age segments. PMID:24854958

  9. The Development of NP Selection in School-Age Children: Reference and Spanish Subject Pronouns

    ERIC Educational Resources Information Center

    Shin, Naomi Lapidus; Cairns, Helen Smith

    2012-01-01

    To investigate the development of the NP selection process, preferences for overt or null Spanish subject pronouns were elicited from 139 children (5;09 to 15;08) and 30 adults in Mexico. Participants were told stories in which consecutive grammatical subjects shared the same referent (same-reference), or did not (switch-reference). In the…

  10. Personality, Aging Self-Perceptions, and Subjective Health: A Mediation Model

    ERIC Educational Resources Information Center

    Moor, Caroline; Zimprich, Daniel; Schmitt, Marina; Kliegel, Matthias

    2006-01-01

    Since the global item of subjective health has emerged as a strong predictor of important health outcomes such as mortality, there have been many attempts to uncover its correlates. In this study, we tested whether personality as assessed via the five-factor model of personality predicted subjective health when physician-rated health and…

  11. Pediatric trauma in sub-Saharan Africa: Challenges in overcoming the scourge

    PubMed Central

    Ademuyiwa, Adesoji O; Usang, Usang E; Oluwadiya, Kehinde S; Ogunlana, Dare I; Glover-Addy, Hope; Bode, Chris O; Arjan, B Van A S

    2012-01-01

    All over the world, pediatric trauma has emerged as an important public health problem. It accounts for the highest mortality in children and young adults in developed countries. Reports from Africa on trauma in the pediatric age group are few and most have been single center experience. In many low-and middle-income countries, the death rates from trauma in the pediatric age group exceed those found in developed countries. Much of this mortality is preventable by developing suitable preventive measures, implementing an effective trauma system and adapting interventions that have been implemented in developed countries that have led to significant reduction in both morbidity and mortality. This review of literature on the subject by pediatric and orthopedic surgeons from different centers in Africa aims to highlight the challenges faced in the care of these patients and proffer solutions to the scourge. PMID:22416156

  12. Persistent depression is a significant risk factor for the development of arteriosclerosis in middle-aged Japanese male subjects.

    PubMed

    Satoh, Hiroki; Fujii, Satoshi; Tsutsui, Hiroyuki

    2015-01-01

    Depression often coexists with hypertension and various cardiovascular diseases. However, the relationship between depression and the development of arteriosclerosis has not been fully established. We assessed depression and brachial-ankle pulse wave velocity (baPWV) in 828 middle-aged Japanese male subjects at baseline and during 3 years of follow-up. Depression was assessed using Center for Epidemiological Studies-Depression questionnaires, and the study subjects were divided into the following three groups: persistent depression, transient depression and no depression. The number (%) of subjects with persistent, transient and no depression were 104 (12.6), 76 (9.2) and 648 (78.2), respectively. Blood pressure and baPWV did not differ among the three groups at baseline. The changes in the baPWV values (⊿baPWV) correlated significantly and positively with age, body mass index, baseline systolic blood pressure and persistent depression (r = 0.32, P < 0.01). After 3 years of follow-up, the ⊿baPWV was significantly greater in subjects with persistent depression compared with those with no depression (36 ± 28 vs. 18 ± 10 cm s(-1), P = 0.02). After adjustment for conventional risk factors, persistent depression was significantly associated with ⊿baPWV by multiple regression analysis (β = 0.261, P < 0.01). To sum up, persistent depression was a significant risk factor for the development of arteriosclerosis in middle-aged Japanese male subjects.

  13. Distribution of age-related thymulin titres in normal subjects through the course of life

    PubMed Central

    Consolini, R; Legitimo, A; Calleri, A; Milani, M

    2000-01-01

    The thymus has a dominant immunological role in utero and in early childhood, being a primary source of T lymphopoiesis, and its investigation may be particularly relevant for the immunological study of paediatric patients. Thymulin, a nonapeptide secreted by the thymus, is an essential hormone for T lymphocyte differentiation and function. As thymulin values in the normal population have not been well documented, especially for children under the age of 1 year, we detail thymic endocrine function by presenting age-related plasma thymulin levels in a large series (n = 93) of healthy individuals, ranging from birth to old age. We demonstrate that thymulin is already detectable at birth; it then gradually increases with age, reaching the highest level in children aged 5–10 years. Starting at adolescence, thymulin titres gradually start to fall, reaching the lowest value at 36 years of age and remaining steady until 80 years (the oldest person tested). PMID:10971509

  14. Gender differences in health and aging of Atlantic cod subject to size selective fishery

    PubMed Central

    Carney Almroth, Bethanie; Sköld, Mattias; Nilsson Sköld, Helen

    2012-01-01

    Summary We have analyzed health and physiological aging parameters in male and female Atlantic cod, Gadus morhua, captured in Kattegat, Skagerrak and in Öresund. Gender differences were clearly evident in a number of variables. Males had longer liver telomeres and higher catalase activities than females, while females had higher superoxide dismutase activity, liver somatic index and condition factor. Effects of age were found for males where levels of the antioxidant glutathione and telomere length declined with age, indicating physiological aging. Liver somatic index increased and percentage oxidized glutathione decreased with age. Between-site comparisons of males show that percentage oxidized glutathione and catalase were lowest in Kattegat, whereas protein carbonyls and condition factor were higher in Skagerrak. Females, on the other hand, showed no differences between sites or indications of somatic aging or age-related effects in egg quality, indicating that older and larger female cod are healthy and show no changes in eggs with age. In contrast, males showed indications of physiological aging and lower condition than females. The results emphasize the importance of conserving old mature fish, in particular high egg-productive females, when managing fisheries. PMID:23213487

  15. Increasing burden, younger age at onset and worst metabolic control in migrant than in Italian children with type 1 diabetes: an emerging problem in pediatric clinics.

    PubMed

    Cadario, Francesco; Cerutti, Franco; Savastio, Silvia; Rabbone, Ivana; Tumini, Stefano; Bruno, Graziella

    2014-04-01

    To assess burden and clinical features of type 1 diabetes in migrant with respect to Italian children. Prevalent children with type 1 diabetes were identified through a multicenter study, including 46 pediatric outpatients diabetic clinics. A nested case-control study was also performed, comparing features at diabetes onset and after 1 year of insulin treatment in 84 migrants and 75 Italian children with onset in 2011, matched for age and sex. Out of 7,812 children cared for by pediatric diabetologists, 761 (10%) were migrant and 548 of them were born in Italy. Age at diagnosis was lower in migrants born in Italy (5.1 years, interquartile range (IQR) 2.2-7.7) than in those born in their original countries (7.8 years, IQR 5.3-10.3) and in Italians (9.8 years, IQR 5.9-13.0, p < 0.001). At diabetes onset, migrants had lower frequencies of positivities of markers of β-cell autoimmunity (96 vs. 99.5%, p < 0.01), higher values of weight loss (11 vs. 7%, p < 0.01), HbA1c (70 vs. 58 mmol/mol, p < 0.001), and insulin requirement (0.70 ± 0.03 vs. 0.63 ± 0.10 UI/kg/die, p = 0.05) and lower levels of 25-OH vitamin D3 (15.0 ± 2.8 vs. 20.8 ± 1.3, p = 0.03). Moreover, they experienced higher frequencies of hospitalizations during the first year of disease (19.2 vs. 2.7%, p < 0.001). Burden of type 1 diabetes in migrant children is increasing in Italy, with younger age at onset and different clinical features than in Italian children. Higher hospitalization rates and poorer glycemic control over the first year underline that approach to diabetes care in migrants needs to be improved. PMID:24065151

  16. Pediatric oncology in Turkey.

    PubMed

    Kebudi, Rejin

    2012-03-01

    The survival of children with cancer has increased dramatically in the last decades, as a result of advances in diagnosis, treatment and supportive care. Each year in Turkey, 2500-3000 new childhood cancer cases are expected. According to the Turkish Pediatric Oncology Group and Turkish Pediatric Hematology Societies Registry, about 2000 new pediatric cancer cases are reported each year. The population in Turkey is relatively young. One fourth of the population is younger than 15 years of age. According to childhood mortality, cancer is the fourth cause of death (7.2%) after infections, cardiac deaths and accidents. The major cancers in children in Turkey are leukemia (31%), lymphoma (19%), central nervous system (CNS) neoplasms (13%), neuroblastomas (7%), bone tumors (6.1%), soft tissue sarcomas (6%), followed by renal tumors, germ cell tumors, retinoblastoma, carcinomas-epithelial neoplasms, hepatic tumors and others. Lymphomas rank second in frequency as in many developing countries in contrast to West Europe or USA, where CNS neoplasms rank second in frequency. The seven-year survival rate in children with malignancies in Turkey is 65.8%. The history of modern Pediatric Oncology in Turkey dates back to the 1970's. Pediatric Oncology has been accepted as a subspecialty in Turkey since 1983. Pediatric Oncologists are all well trained and dedicated. All costs for the diagnosis and treatment of children with cancer is covered by the government. Education and infrastructure for palliative care needs improvement.

  17. PEDIATRIC PANCREATITIS

    PubMed Central

    Pohl, John F.; Uc, Aliye

    2015-01-01

    Purpose of Review The purpose of this review is to describe recent developments in pediatric pancreatitis and to discuss etiologies and current management. Recent Findings Although recent studies have estimated the annual incidence of pediatric acute pancreatitis approaching that of adults, there are no established guidelines about its diagnosis and treatment in children. Genetic and structural/congenital abnormalities are emerging as the primary risk factors for pediatric acute recurrent and chronic pancreatitis. Specifically, chronic pancreatitis is associated with a significant socioeconomic burden in children. Both medical and surgical therapies are proposed for pediatric chronic pancreatitis, but there is little evidence that they are beneficial. Summary Acute, acute recurrent and chronic pancreatitis create significant health issues in the pediatric population. Medical and surgical therapies exist to potentially treat these conditions, but the pediatric data is limited and the cohorts are small. A multidisciplinary and multicenter approach is necessary to better determine pancreatic disease processes and treatment options in children. PMID:26181572

  18. Chemical-biological terrorism and its impact on children: a subject review. American Academy of Pediatrics. Committee on Environmental Health and Committee on Infectious Diseases.

    PubMed

    2000-03-01

    There is an increasing threat that chemical and biological weapons will be used on a civilian population in an act of domestic terrorism. Casualties among adults and children could be significant in such an event. Federal, state, and local authorities have begun extensive planning to meet a chemical-biological incident by developing methods of rapid identification of potential agents and protocols for management of victims without injury to health care personnel. Because children would be disproportionately affected by a chemical or biological weapons release, pediatricians must assist in planning for a domestic chemical-biological incident. Government agencies should seek input from pediatricians and pediatric subspecialists to ensure that the situations created by multiple pediatric casualties after a chemical-biological incident are considered. This statement reviews key aspects of chemical-biological agents, the consequences of their use, the potential impact of a chemical-biological attack on children, and issues to consider in disaster planning and management for pediatric patients. PMID:10699130

  19. The reliability of chronological age determination by means of mandibular third molar development in subjects in Croatia.

    PubMed

    Legović, Mario; Sasso, Anja; Legović, Izak; Brumini, Gordana; Cabov, Tomislav; Slaj, Martina; Vancura, Irena; Lapter, Marina

    2010-01-01

    The aim of this study was to determine the development of the mandibular third molar and its relation to chronological age. The evaluated material consisted of 979 orthopantomograms of patients of Croatian Caucasian origin aged between 5.7 and 14.6 years. Third molar developmental stages were evaluated according to the stages proposed by Nolla. The frequencies of different stages of mineralization and the mean value of the mineralization of the mandibular third molars with regard to age, gender, and size of the mandible were determined and the coefficient of correlation determined between the age of the subject and the stage of development of the mandibular molars. Statistically significant correlation was determined between mineralization of the mandibular third molar and chronological age of the subjects (boys, mandibular left third molar r = 0.779, right third molar r = 0.793; girls, mandibular left third molar r = 0.746, right third molar r = 0.725). It can be concluded that the accuracy of age estimation based on Nolla's method is applicable for Croatian children.

  20. Dental Age Estimation: A Test of the Reliability of Correctly Identifying a Subject Over 18 Years of Age Using the Gold Standard of Chronological Age as the Comparator.

    PubMed

    Lucas, Victoria S; Andiappan, Manoharan; McDonald, Fraser; Roberts, Graham

    2016-09-01

    This study was designed to test the reliability of using the third molars to demarcate between child and adult status. A total of 2000 dental panoramic tomographs were used for assessment of the calculated age using the 8-stage system of tooth development and applied to all four third molars. The LL8 was also assessed using this 8-stage system. For each tooth development stage, the Normal distribution and percentile summary data were estimated. The calculated dental age compared with the chronological age was statistically significantly different (p < 0.001) for both females and males giving underestimates of the true age. Comparison of single tooth dental age and chronological age was only slightly different. The most important finding is that the assignment to above or below the 18-year threshold, in the age range 17 years to 19 years, could be wrong on up to 50% of occasions.

  1. Endocrine complications following pediatric bone marrow transplantation.

    PubMed

    Ho, Josephine; Lewis, Victor; Guilcher, Gregory M T; Stephure, David K; Pacaud, Danièle

    2011-01-01

    Pediatric bone marrow transplantation (BMT) for various diseases can lead to endocrine system dysfunction owing to preparative regimens involving chemotherapy and radiation therapy. We assessed the prevalence of post-BMT endocrine complications in children treated at the Alberta Children's Hospital (ACH) from 1991 to 2001. Time of onset of endocrine dysfunction, underlying disease processes, chemotherapy, radiation therapy and age at BMT were characterized. Subjects of <18 years of age at the time of allogeneic or autologous BMT for whom 1-year follow-up through the ACH and a chart were available for review were included in the study. Subjects with a pre-existing endocrine condition were excluded. Of the 194 pediatric BMT procedures performed at the ACH between January 1, 1991 and December 31, 2001, 150 complete charts were available for review. Sixty five subjects received follow-up care at other centers and were excluded. Therefore, a total of 85 subjects were included in the review. The prevalence of endocrine complications identified was: primary hypothyroidism 1.2%, compensated hypothyroidism 7.0%, hyperthyroidism 2.4%, hypergonadotrophic hypogonadism 22.4%, abnormal bone density 2.4%, and secondary diabetes mellitus 1.2%. These findings emphasize the need to screen for endocrine system dysfunction, particularly hypergonadotrophic hypogonadism, in children who have undergone BMT. Children need long-term follow-up so that endocrine complications can be diagnosed and treated promptly. PMID:21823531

  2. Three-dimensional analysis of the cervical spine kinematics: effect of age and gender in healthy subjects.

    PubMed

    Lansade, Céline; Laporte, Sébastien; Thoreux, Patricia; Rousseau, Marc-Antoine; Skalli, Wafa; Lavaste, François

    2009-12-15

    STUDY DESIGN.: A three-dimensional (3D) analysis of the cervical spine kinematics in vivo about a large asymptomatic database in order to evaluate the impact of age and gender on the neck's performances. OBJECTIVE.: To investigate the effect of age and gender on kinematical parameters of the cervical spine, specifically quantitative parameters concerning coupled movements and proprioception, using the infra-red POLARIS measurement system. SUMMARY OF BACKGROUND DATA.: Cervical spine kinematics has been investigated in vivo by numerous authors using various devices. However, few is known about the influence of gender and age on the 3D cervical biomechanics, specifically regarding coupled movements and proprioceptive abilities. METHODS.: A total of 140 asymptomatic volunteers (70 men and 70 women) aged 20 to 93 years old were enrolled. The noninvasive infrared system Polaris was used to quantify the 3D range of motion (ROM) of cervical spine and to evaluate proprioceptive abilities. For validating the protocol in terms of reproducibility, 12 volunteers were tested 3 times by 2 independent operators. RESULTS.: The standard error of measurement for the maximal ROM in the 3 space planes was 5%. Gender had no significant influence on the 3D cervical ROM, except for the "70-79 years old" group. Age had a significant influence on all main movements showing 0.55 degrees to 0.79 degrees magnitude decrease per decade. Age and gender had no significant influence on coupled movements. "Head-to-Target" proprioception was significantly affected by the age only in the horizontal plane. CONCLUSION.: A data base for cervical ROM, pattern of motion, and proprioceptive capability was established in population of 140 healthy subjects of various age and gender. Significant age-related decrease in ROM and proprioceptive abilities were observed in this study. Coupled movements did not vary with gender or age; however, their role in the cervical performance increased with age since main

  3. Direct percutaneous endoscopic jejunostomy in pediatric age with a pexies triangulation system: report of a case and literature review.

    PubMed

    Alberca-de-Las-Parras, Fernando; Navalón-Rubio, María; Egea-Valenzuela, Juan; Álvarez-Higueras, Francisco-Javier; Antón-Ródenas, Gonzalo; Alajarín-Cervera, Miriam; Serrano-Giménez, Andrés; Gil-Ortega, David; Muñoz-Tornero, María; Ono-Ono, Akiko; Carballo-Álvarez, Luis Fernando

    2015-04-01

    Direct percutaneous endoscopic jejunostomy (DPEJ) is an infrequent procedure as it is not always easy to obtain transillumination, being this the main reason for failure of this technique. In patients with previous surgery, this procedure is more complex and there are only 6 reported cases in pediatric population. In our case, we provide the use of an endoscopic triangulation system with "T" pexies not used before in these cases. With this technique, we guarantee not to replace the introduction system afterwards, obtaining the placement of a balloon fixation system initially. We also provide several improvements that helped us developing the procedure: Placement of the jejunostomy through a gastrostomy; use of water column to avoid penetration in hollow viscus; use of a guide wire, and a triangulation pexy system.

  4. A case of pediatric age anticholinergic intoxication due to accidental Datura stramonium ingestion admitting with visual hallucination.

    PubMed

    Şanlıdağ, Burçin; Derinöz, Okşan; Yıldız, Nagehan

    2014-01-01

    Datura stramonium (DS) is a hallucinogenic plant that can produce anticholinergic toxicity because of its significant concentrations of toxic alkaloids, such as atropine, hyoscyamine, and scopolamine. DS grows in both rural and urban areas in Turkey. Clinical findings of toxicity are similar to those of atropine toxicity. DS abuse is common among adolescents because of its hallucinatory effects. However, accidental DS poisoning from contaminated food is very rare. Accidental poisonings are commonly seen among children. Children are more prone to the toxic effects of atropine; ingestion of even a small amount can cause serious central nervous system symptoms. Treatment is supportive; antidote treatment is given rarely. An eight-year-old male with accidental DS poisoning who presented to the Pediatric Emergency Department with aggression, agitation, delirium, and visual hallucinations is reported. PMID:25341608

  5. The effect of age on illness cognition, subjective well-being and psychological distress among gastric cancer patients.

    PubMed

    Palgi, Yuval; Ben-Ezra, Menachem; Hamama-Raz, Yaira; Shacham Shmueli, Einat; Shrira, Amit

    2014-10-01

    The current study examined illness cognition-thoughts and perceptions-patients hold regarding their illness and psychological adaptation in various age groups. More specifically, we aimed to examine whether illness cognition among cancer patients is related to their age. In addition, such association of illness cognition and age was also examined with respect to subjective well-being and psychological distress. A cross-sectional sample comprised of 123 consecutive post-treatment gastric outpatients. Their mean age was 57.31 (SD = 12.74), 56.9% (n = 70) were men and 81.3% (n = 100) were married. The results indicated a higher level of acceptance and a lower level of psychological distress among the young-old participants (60-69) compared with their counterparts. The oldest group (70+ years) had the highest level of helplessness and psychological distress, and the lowest level of acceptance, satisfaction and affect balance compared with the young-old participants. Among gastric cancer patients, age was found to be a factor relevant to the understanding of illness cognitions (acceptance and sense of helplessness) along with subjective well-being and psychological distress. These findings have practical implications for working with older cancer patients. Implications of these results are discussed.

  6. Gonioscopic differences between eyes with primary open-angle glaucoma and normal eyes in subjects over the age of forty.

    PubMed Central

    Kimura, R; Levene, R Z

    1975-01-01

    Gonioscopy was performed on 110 patients with primary open-angle glaucoma over the age of 40 and an equal number of normal subjects matched by race and age. The frequency distribution of various angle features differed in two groups. In the glaucoma group there were more iris processes at all levels of insertion, a higher insertion of the iris root, and more trabecular pigmentation. We believe that a congenital angle anomaly is an important factor in the pathogenesis of the elevated intraocular pressure. PMID:1246817

  7. Pediatric Cushing's disease: Management Issues.

    PubMed

    Savage, Martin O; Storr, Helen L

    2012-12-01

    Cushing's disease (CD), caused by an ACTH-secreting pituitary corticotroph adenoma, is the commonest cause of Cushing syndrome in children over 5 years of age. It is rare in the pediatric age range and presents difficult diagnostic and therapeutic challenges. Key presenting features include weight gain, growth failure and change in facial appearance. Most pediatric endocrinologists have limited experience managing children or adolescents with CD and thus benefit from close consultation with adult colleagues. We describe a diagnostic protocol which broadly follows the model for adult patients. Treatment strategies are examined and appraised. The management of pediatric CD patients after cure is also discussed. PMID:23565371

  8. Age, cumulative (dis)advantage, and subjective well-being in employed and unemployed Germans: a moderated mediation model.

    PubMed

    Pavlova, Maria K; Silbereisen, Rainer K

    2012-01-01

    The negative impact of unemployment on subjective well-being (SWB) is well known, but the role of age in this relationship remains unclear. We suggest that cumulative advantage (or disadvantage) associated with the duration of current employment status may produce an age-related divergence in SWB between employed and unemployed individuals. We used cross-sectional data on employed (n = 1382) and unemployed (n = 254) Germans (age 18-42) surveyed in 2005. We found that, among currently employed individuals, relatively older age predicted longer employment duration (tenure), which was related to higher SWB via higher income and higher perceived occupational security. Among currently unemployed individuals, age predicted longer unemployment duration, which was associated with lower SWB via lower perceived social support. Thus, age was indirectly related to higher SWB in employed individuals and to lower SWB in unemployed individuals. In this way, cumulative advantage of long-term employment and cumulative disadvantage of long-term unemployment contributed to the age-related divergence in SWB between employed and unemployed Germans already in the first half of working life. PMID:22149203

  9. The measurement of open apices of teeth to test chronological age of over 14-year olds in living subjects.

    PubMed

    Cameriere, Roberto; Brkic, Hervoje; Ermenc, Branko; Ferrante, Luigi; Ovsenik, Maja; Cingolani, Mariano

    2008-01-30

    Age determination in living subjects is a problem of increasing interest in our community, due to the increasing numbers of individuals without identification papers, who have immigrated illegally or committed crimes, and for whom it is necessary to verify whether they have reached the age of 14 years in order to be charged legally. Although the most widespread methods for age estimation refer to skeletal or dental analysis, these methods do present some drawbacks for identification of the age of 14. The aim of the present study is to discriminate between children who are or are not 14 years of age or older by measuring the open apices of teeth. We evaluated the OPGs of 447 persons aged between 12 and 16 years, of Italian, Croatian and Slovenian nationality. For each individual, dental maturity was estimated using the number of the seven left permanent mandibular teeth with root development complete, and normalized measurement of the open apices of the third molar. The results revealed that an individual is considered to be 14 years of age or older if all seven left permanent mandibular teeth have closed apices and the normalized measurement of open apices of the third molar is lower than 1.1.

  10. Relationship between cognitive function, growth hormone and insulin-like growth factor I plasma levels in aged subjects.

    PubMed

    Rollero, A; Murialdo, G; Fonzi, S; Garrone, S; Gianelli, M V; Gazzerro, E; Barreca, A; Polleri, A

    1998-01-01

    Basal growth hormone (GH) and insulin-like growth factor I (IGF-I) as well as GH responses to GH-releasing hormone (GHRH) were studied in 22 subjects (7 females, 15 males), aged between 65 and 86 years. The study was aimed at investigating the possible correlations between the age-dependent GH-IGF-I axis decline and the cognitive function - assessed by the Mini Mental State Examination (MMSE). The relationship between hormonal data, cognition and age, body weight, body mass index (BMI), some nutritional indices (triceps skinfolds, TSF, mid-arm circumference, MAC), and physical activity - quantified by the physical functioning index (PFI)--were also analyzed. GH basal levels were within the normal range, while GH responses to GHRH were blunted in most cases. GH peaks after GHRH were directly correlated with GH basal values. IGF-I serum levels were found to be in the lower part of the reference range for adult subjects or below it. GH responses to GHRH, but not GH and IGF-I basal levels, were inversely correlated with subject age. GH secretion areas after GHRH were inversely correlated with BMI, but no further correlations between GH data and clinical or nutritional parameters were found. MMSE values directly correlated with MAC and PFI values. IGF-I levels were directly correlated with MMSE scores, being lowered in patients with more advanced cognitive deterioration, and with MAC values--the decrease of which is thought to reflect protein caloric malnutrition--but not with body weight, BMI, TSF and PFI. MMSE-related protein caloric malnutrition and decreased physical activity possibly take part in affecting IGF- I function in subjects with mild cognitive impairment and, reciprocally, IGF-I decrement might affect neuronal function. PMID:9732206

  11. Differentiation in Self-Perceived Adulthood: Extending the Confluence Model of Subjective Age Identity

    ERIC Educational Resources Information Center

    Johnson, Monica Kirkpatrick; Berg, Justin Allen; Sirotzki, Toni

    2007-01-01

    This study examines and extends the confluence model of age identity by testing whether young people's self-perceptions as adults are linked to role transitions, self-assessed personal qualities, and social location. We propose that young people's sense of adulthood and the factors associated with it vary based on socially structured experience…

  12. Time-Lag Bias in Trials of Pediatric Antidepressants: A Systematic Review and Meta-Analysis

    ERIC Educational Resources Information Center

    Reyes, Magdalena M.; Panza, Kaitlyn E.; Martin, Andres; Bloch, Michael H.

    2011-01-01

    Objective: To determine whether there is evidence of a time-lag bias in the publication of pediatric antidepressant trials. Method: We conducted a meta-analysis of published and unpublished randomized placebo-controlled trials of serotonin reuptake inhibitors (SRIs) in subjects less than 18 years of age with major depressive disorder. Our main…

  13. Attitudes to aging mediate the relationship between older peoples’ subjective health and quality of life in 20 countries

    PubMed Central

    2013-01-01

    s perceptions of health-related circumstances, and attitudes toward physical and psychosocial aspects of the aging self. A prospective study of the linkages between older peoples’ subjective views of health and attitudes toward the aging self over time using multiple subjective measures of health is warranted. Understanding these linkages may help practitioners and policy makers consider strategies to enhance quality of life. PMID:23984754

  14. Influence of dietary habits, age and gender on plasma fatty acids levels in a population of healthy Tunisian subjects.

    PubMed

    Sfar, Sonia; Laporte, François; Braham, Hamadi; Jawed, Abdelhafidh; Amor, Salah; Kerkeni, Abdelhamid

    2010-09-01

    The fatty acids composition of circulating blood lipids is expected to be altered by many factors (ageing, dietary intake, lifestyle...). In addition to the ageing consequences on their lipid status, elderly subjects represent a population at risk of nutritional imbalance. The main objective of the present study was to investigate the associations between dietary habits and the plasma fatty acids patterns in a healthy Tunisian population with an emphasis on the gender and ageing differences for the 6-desaturase activity and the EFA proportions. Nutritional habits and plasma fatty acids compositions have been therefore evaluated in 200 healthy volunteers (104 women and 96 men) aged between 40 and 82years old. The findings revealed that the 6-desaturase activity was reduced in elderly subjects (by 24% and 10% in women and men respectively). Moreover, DHA (C22:6n-3) and AA (C20:4n-6) were found to increase respectively in high fish and meat consumers. Plasma fatty acids composition could be sensitive to dietary habits according to particular food items and should then help for the establishment of optimal nutritional proportions.

  15. Esthesioneuroblastoma in pediatric and adolescent age. A report from the TREP project in cooperation with the Italian Neuroblastoma and Soft Tissue Sarcoma Committees

    PubMed Central

    2012-01-01

    Background Esthesioneuroblastoma (ENB) is a rare, aggressive tumor with no established treatment in children. We analyzed a series of pediatric ENB patients with the aim of improving our knowledge of this disease. Methods 9 patients (6 males; age 0.9-18 years, median 9.9) were identified by searching the AIEOP (Italian Association of Pediatric Hematology and Oncology) registry and the national databases of rare tumors, soft tissue sarcomas (STS) and neuroblastomas. The data on the cases included in STS treatment protocols were collected prospectively and histology was centrally reviewed; the data and histology concerning the other children were reviewed for the purpose of this analysis. Results All tumors occurred in the sinonasal region with bone erosion (7 patients) and intracranial (4) or intraorbital (4) extension. Three patients were in Kadish stage B, and 6 in stage C. Complete tumor resection was very difficult to achieve, but adding chemotherapy and radiotherapy enabled tumor control in 8 patients. Response to chemotherapy was evident in 5/7 evaluable cases. Radiotherapy (48.5-60 Gy) was delivered in all children but one, due to early disease progression. With a median follow-up of 13.4 years (range 9.2-22.9), 7 patients are alive in 1st and one in 2nd complete remission. All surviving patients developed treatment-related sequelae, the most frequent being endocrine dysfunctions (4 patients) and craniofacial growth impairments (4 patients). Conclusions Our findings confirm that ENB in children has an aggressive presentation, but multimodal therapy can cure most patients. Our results are encouraging but future strategies must optimize treatment in terms of survival and related morbidities. PMID:22443159

  16. Controversies in Pediatric Perioperative Airways

    PubMed Central

    Klučka, Jozef; Štourač, Petr; Štoudek, Roman; Ťoukálková, Michaela; Harazim, Hana; Kosinová, Martina

    2015-01-01

    Pediatric airway management is a challenge in routine anesthesia practice. Any airway-related complication due to improper procedure can have catastrophic consequences in pediatric patients. The authors reviewed the current relevant literature using the following data bases: Google Scholar, PubMed, Medline (OVID SP), and Dynamed, and the following keywords: Airway/s, Children, Pediatric, Difficult Airways, and Controversies. From a summary of the data, we identified several controversies: difficult airway prediction, difficult airway management, cuffed versus uncuffed endotracheal tubes for securing pediatric airways, rapid sequence induction (RSI), laryngeal mask versus endotracheal tube, and extubation timing. The data show that pediatric anesthesia practice in perioperative airway management is currently lacking the strong evidence-based medicine (EBM) data that is available for adult subpopulations. A number of procedural steps in airway management are derived only from adult populations. However, the objective is the same irrespective of patient age: proper securing of the airway and oxygenation of the patient. PMID:26759809

  17. Prevalence of Decreased Visual Acuity among Preschool Aged Children in an American Urban Population: The Baltimore Pediatric Eye Disease Study, Methods and Results

    PubMed Central

    Friedman, David S.; Repka, Michael X.; Katz, Joanne; Giordano, Lydia; Ibironke, Josephine; Hawes, Patricia; Burkom, Diane; Tielsch, James M.

    2008-01-01

    Objective To determine the age- and ethnicity-specific prevalence of decreased visual acuity (VA) in White and African-American preschool aged children. Design Cross-sectional study. Participants The Baltimore Pediatric Eye Disease Study is a population-based evaluation of the prevalence of ocular disorders in children aged 6 through 71 months in Baltimore, Maryland, United States. Among 4,132 children identified, 3,990 eligible children (97%) were enrolled and 2,546 children (62%) were examined. This report focuses on 1,714 of 2,546 examined children (67%) who were aged 30 through 71 months. Methods Field staff identified 63,737 occupied dwelling units in 54 census tracts. Parents or guardians of eligible participants underwent an in-home interview and eligible children underwent a comprehensive eye examination including optotype VA in children aged 30 months and older with protocol-specified retesting of children with VA worse than an age-appropriate standard. Main Outcome Measures The proportion of children aged 30 through 71 months testable for VA and the proportion with decreased VA as defined by preset criteria. Results VA was testable in 1,504 of 1,714 children (87.7%) 30 through 71 months of age. It was decreased at the initial test (wearing glasses if brought to the clinic) in both eyes of 7 of 577 White children (1.21%, 95% Confidence Interval [CI] = 0.49, 2.50) and 13 of 725 African-American children (1.79%, 95% CI = 0.95, 3.08), a difference that is not statistically significant. Decreased VA in both eyes after retesting was found in 3 of 598 White children (0.50%, 95% CI = 0.10, 1.48) and 8 of 757 African-American children (1.06%, 95% CI = 0.45, 2.10), also not statistically significantly different. Uncorrected ametropia explained the decreased VA on initial testing in ten of the twenty children. Conclusions Decreased VA in both eyes of children 30 through 71 months of age at presentation in urban Baltimore was 1.2% among White children and 1.8% among

  18. Pediatric perspective on pharmacogenomics.

    PubMed

    Stevens, Adam; De Leonibus, Chiara; Hanson, Daniel; Whatmore, Andrew; Murray, Philip; Donn, Rachelle; Meyer, Stefan; Chatelain, Pierre; Clayton, Peter

    2013-11-01

    The advances in high-throughput genomic technologies have improved the understanding of disease pathophysiology and have allowed a better characterization of drug response and toxicity based on individual genetic make up. Pharmacogenomics is being recognized as a valid approach used to identify patients who are more likely to respond to medication, or those in whom there is a high probability of developing severe adverse drug reactions. An increasing number of pharmacogenomic studies are being published, most include only adults. A few studies have shown the impact of pharmacogenomics in pediatrics, highlighting a key difference between children and adults, which is the contribution of developmental changes to therapeutic responses across different age groups. This review focuses on pharmacogenomic research in pediatrics, providing examples from common pediatric conditions and emphasizing their developmental context.

  19. Pulsatile Stress in Middle-Aged Patients With Type 1 or Type 2 Diabetes Compared With Nondiabetic Control Subjects

    PubMed Central

    Philips, Jean-Christophe; Marchand, Monique; Scheen, André J.

    2010-01-01

    OBJECTIVE Arterial pulse pressure is considered to be an independent cardiovascular risk factor. We compared pulse pressure during an active orthostatic test in middle-aged patients with type 1 diabetes and with type 2 diabetes and corresponding nondiabetic control subjects. RESEARCH DESIGN AND METHODS Forty patients with type 1 diabetes (mean age 50 years, diabetes duration 23 years, and BMI 23.0 kg/m2) were compared with 40 nonhypertensive patients with type 2 diabetes (respectively, 50 years, 8 years, and 29.7 kg/m2). Patients taking antihypertensive agents or with renal insufficiency were excluded. All patients were evaluated with a continuous noninvasive arterial blood pressure monitoring (Finapres) in standing (1 min), squatting (1 min), and again standing position (1 min). Patients with type 1 or type 2 diabetes were compared with two groups of 40 age-, sex- and BMI-matched healthy subjects. RESULTS Patients with type 1 diabetes and patients with type 2 diabetes showed significantly higher pulse pressure, heart rate, and double product of pulse pressure and heart rate (PP×HR) (type 1: 5,263 vs. 4,121 mmHg/min, P = 0.0004; type 2: 5,359 vs. 4,321 mmHg, P = 0.0023) levels than corresponding control subjects. There were no significant differences between patients with type 1 diabetes and type 2 diabetes regarding pulse pressure (59 vs. 58 mmHg), heart rate (89 vs. 88/min), and PP×HR (5,263 vs. 5,359 mmHg/min). CONCLUSIONS Patients with type 1 diabetes have increased levels of peripheral PP, an indirect marker of arterial stiffness, and PP×HR, an index of pulsatile stress, comparable to those of nonhypertensive patients with type 2 diabetes at similar mean age of 50 years. PMID:20693351

  20. Age-related differences in celiac disease: Specific characteristics of adult presentation

    PubMed Central

    Vivas, Santiago; Vaquero, Luis; Rodríguez-Martín, Laura; Caminero, Alberto

    2015-01-01

    Celiac disease may appear both in early childhood and in elderly subjects. Current knowledge of the disease has revealed some differences associated to the age of presentation. Furthermore, monitoring and prognosis of celiac subjects can vary depending on the pediatric or adult stage. The main objective of this review is to provide guidance for the adult diagnostic and follow-up processes, which must be tailored specifically for adults and be different from pediatric patients. PMID:26558154

  1. Strength Properties of Aged Poled Lead Zirconate Titanate Subjected to Electromechanical Loadings

    SciTech Connect

    Zhang, Kewei; Zeng, Fan W; Wang, Hong; Lin, Hua-Tay

    2012-01-01

    Electric field and aging time are two important factors that affect the mechanical strength and long-term reliability of lead zirconate titanate or PZT actuators. In the present work, a commercial PZT-5A aged four years was examined using ball-on-ring (BoR) mechanical testing under coupled electric fields. The electric field range of -3E{sub c} to +3E{sub c} (E{sub c}, coercive electric field) was studied (i.e., -3E{sub c}, -E{sub c}, 0, +E{sub c}, +2E{sub c}, and +3E{sub c}) with a controlled electric loading path. A Weibull distribution was used to interpret the mechanical strength data. With an electric field preloaded from 0 to -3E{sub c}, it was found that subsequent increases in the electric field resulted in an asymmetrical V-shaped curve of mechanical strength against the electric field. The bottom of the V curve was located near the zero electric field level. Microscopy analysis showed that pores were the strength limiter for the tested PZT under electromechanical loadings.

  2. Diet-microbiota-health interactions in older subjects: implications for healthy aging.

    PubMed

    Lynch, D B; Jeffery, I B; Cusack, S; O'Connor, E M; O'Toole, P W

    2015-01-01

    With modern medicine and an awareness of healthy lifestyle practices, people are living longer and generally healthier lives than their ancestors. These successes of modern medicine have resulted in an increasing proportion of elderly in society. Research groups around the world have investigated the contribution of gut microbial communities to human health and well-being. It was established that the microbiota composition of the human gut is modulated by lifestyle factors, especially diet. The microbiota composition and function, acting in concert with direct and indirect effects of habitual diet, is of great importance in remaining healthy and active. This is not a new concept, but until now the scale of the potential microbiota contribution was not appreciated. There are an estimated ten times more bacteria in an individual than human cells. The bacterial population is relatively stable in adults, but the age-related changes that occur later in life can have a negative impact on host health. This loss of the adult-associated microbiota correlates with measures of markers of inflammation, frailty, co-morbidity and nutritional status. This effect may be greater than that of diet or in some cases genetics alone. Collectively, the recent studies show the importance of the microbiota and associated metabolites in healthy aging and the importance of diet in its modulation.

  3. Cerebrospinal fluid norepinephrine and cognition in subjects across the adult age span.

    PubMed

    Wang, Lucy Y; Murphy, Richard R; Hanscom, Brett; Li, Ge; Millard, Steven P; Petrie, Eric C; Galasko, Douglas R; Sikkema, Carl; Raskind, Murray A; Wilkinson, Charles W; Peskind, Elaine R

    2013-10-01

    Adequate central nervous system noradrenergic activity enhances cognition, but excessive noradrenergic activity may have adverse effects on cognition. Previous studies have also demonstrated that noradrenergic activity is higher in older than younger adults. We aimed to determine relationships between cerebrospinal fluid (CSF) norepinephrine (NE) concentration and cognitive performance by using data from a CSF bank that includes samples from 258 cognitively normal participants aged 21-100 years. After adjusting for age, gender, education, and ethnicity, higher CSF NE levels (units of 100 pg/mL) are associated with poorer performance on tests of attention, processing speed, and executive function (Trail Making A: regression coefficient 1.5, standard error [SE] 0.77, p = 0.046; Trail Making B: regression coefficient 5.0, SE 2.2, p = 0.024; Stroop Word-Color Interference task: regression coefficient 6.1, SE 2.0, p = 0.003). Findings are consistent with the earlier literature relating excess noradrenergic activity with cognitive impairment.

  4. Physical aging and structural recovery in a colloidal glass subjected to volume-fraction jump conditions.

    PubMed

    Peng, Xiaoguang; McKenna, Gregory B

    2016-04-01

    Three important kinetic phenomena have been cataloged by Kovacs in the investigation of molecular glasses during structural recovery or physical aging. These are responses to temperature-jump histories referred to as intrinsic isotherms, asymmetry of approach, and memory effect. Here we use a thermosensitive polystyrene-poly (N-isopropylacrylamide)-poly (acrylic acid) core-shell particle-based dispersion as a colloidal model and by working at a constant number concentration of particles we use temperature changes to create volume-fraction changes. This imposes conditions similar to those defined by Kovacs on the colloidal system. We use creep experiments to probe the physical aging and structural recovery behavior of colloidal glasses in the Kovacs-type histories and compare the results with those seen in molecular glasses. We find that there are similarities in aging dynamics between molecular glasses and colloidal glasses, but differences also persist. For the intrinsic isotherms, the times t_{eq} needed for relaxing or evolving into the equilibrium (or stationary) state are relatively insensitive to the volume fraction and the values of t_{eq} are longer than the α-relaxation time τ_{α} at the same volume fraction. On the other hand, both of these times grow at least exponentially with decreasing temperature in molecular glasses. For the asymmetry of approach, similar nonlinear behavior is observed for both colloidal and molecular glasses. However, the equilibration time t_{eq} is the same for both volume-fraction up-jump and down-jump experiments, different from the finding in molecular glasses that it takes longer for the structure to evolve into equilibrium for the temperature up-jump condition than for the temperature down-jump condition. For the two-step volume-fraction jumps, a memory response is observed that is different from observations of structural recovery in two-step temperature histories in molecular glasses. The concentration dependence of the

  5. Physical aging and structural recovery in a colloidal glass subjected to volume-fraction jump conditions

    NASA Astrophysics Data System (ADS)

    Peng, Xiaoguang; McKenna, Gregory B.

    2016-04-01

    Three important kinetic phenomena have been cataloged by Kovacs in the investigation of molecular glasses during structural recovery or physical aging. These are responses to temperature-jump histories referred to as intrinsic isotherms, asymmetry of approach, and memory effect. Here we use a thermosensitive polystyrene-poly (N -isopropylacrylamide)-poly (acrylic acid) core-shell particle-based dispersion as a colloidal model and by working at a constant number concentration of particles we use temperature changes to create volume-fraction changes. This imposes conditions similar to those defined by Kovacs on the colloidal system. We use creep experiments to probe the physical aging and structural recovery behavior of colloidal glasses in the Kovacs-type histories and compare the results with those seen in molecular glasses. We find that there are similarities in aging dynamics between molecular glasses and colloidal glasses, but differences also persist. For the intrinsic isotherms, the times teq needed for relaxing or evolving into the equilibrium (or stationary) state are relatively insensitive to the volume fraction and the values of teq are longer than the α -relaxation time τα at the same volume fraction. On the other hand, both of these times grow at least exponentially with decreasing temperature in molecular glasses. For the asymmetry of approach, similar nonlinear behavior is observed for both colloidal and molecular glasses. However, the equilibration time teq is the same for both volume-fraction up-jump and down-jump experiments, different from the finding in molecular glasses that it takes longer for the structure to evolve into equilibrium for the temperature up-jump condition than for the temperature down-jump condition. For the two-step volume-fraction jumps, a memory response is observed that is different from observations of structural recovery in two-step temperature histories in molecular glasses. The concentration dependence of the dynamics

  6. The risk of shorter fasting time for pediatric deep sedation

    PubMed Central

    Clark, Mathew; Birisci, Esma; Anderson, Jordan E.; Anliker, Christina M.; Bryant, Micheal A.; Downs, Craig; Dalabih, Abdallah

    2016-01-01

    Background: Current guidelines adopted by the American Academy of Pediatrics calls for prolonged fasting times before performing pediatric procedural sedation and analgesia (PSA). PSA is increasingly provided to children outside of the operating theater by sedation trained pediatric providers and does not require airway manipulation. We investigated the safety of a shorter fasting time compared to a longer and guideline compliant fasting time. We tried to identify the association between fasting time and sedation-related complications. Methods: This is a prospective observational study that included children 2 months to 18 years of age and had an American Society of Anesthesiologists physical status classification of I or II, who underwent deep sedation for elective procedures, performed by pediatric critical care providers. Procedures included radiologic imaging studies, electroencephalograms, auditory brainstem response, echocardiograms, Botox injections, and other minor surgical procedures. Subjects were divided into two groups depending on the length of their fasting time (4–6 h and >6 h). Complication rates were calculated and compared between the three groups. Results: In the studied group of 2487 subjects, 1007 (40.5%) had fasting time of 4–6 h and the remaining 1480 (59.5%) subjects had fasted for >6 h. There were no statistically significant differences in any of the studied complications between the two groups. Conclusions: This study found no difference in complication rate in regard to the fasting time among our subjects cohort, which included only healthy children receiving elective procedures performed by sedation trained pediatric critical care providers. This suggests that using shorter fasting time may be safe for procedures performed outside of the operating theater that does not involve high-risk patients or airway manipulation. PMID:27746560

  7. Pediatric Terminology

    Cancer.gov

    The National Institute of Child Health and Human Development (NICHD) is working with NCI Enterprise Vocabulary Services (EVS) to provide standardized terminology for coding pediatric clinical trials and other resea

  8. Pediatric Specialists

    MedlinePlus

    ... Life Family Life Family Life Medical Home Family Dynamics Media Work & Play Getting Involved in Your Community ... Life Medical Home Health Insurance Pediatric Specialists Family Dynamics Media Work & Play Getting Involved in Your Community ...

  9. Virtual Pediatric Hospital

    MedlinePlus

    ... Assistant™ Last revised on February 12, 2016 Related Digital Libraries Pediatric GeneralPediatrics.com - the general pediatrician's view of the Internet PediatricEducation.org - a pediatric digital library and learning collaboratory intended to serve as a ...

  10. Microstructure and mechanical properties of composite resins subjected to accelerated artificial aging.

    PubMed

    dos Reis, Andréa Cândido; de Castro, Denise Tornavoi; Schiavon, Marco Antônio; da Silva, Leandro Jardel; Agnelli, José Augusto Marcondes

    2013-01-01

    The aim of this study was to investigate the influence of accelerated artificial aging (AAA) on the microstructure and mechanical properties of the Filtek Z250, Filtek Supreme, 4 Seasons, Herculite, P60, Tetric Ceram, Charisma and Filtek Z100. composite resins. The composites were characterized by Fourier-transform Infrared spectroscopy (FTIR) and thermal analyses (Differential Scanning Calorimetry - DSC and Thermogravimetry - TG). The microstructure of the materials was examined by scanning electron microscopy. Surface hardness and compressive strength data of the resins were recorded and the mean values were analyzed statistically by ANOVA and Tukey's test (α=0.05). The results showed significant differences among the commercial brands for surface hardness (F=86.74, p<0.0001) and compressive strength (F=40.31, p<0.0001), but AAA did not affect the properties (surface hardness: F=0.39, p=0.53; compressive strength: F=2.82, p=0.09) of any of the composite resins. FTIR, DSC and TG analyses showed that resin polymerization was complete, and there were no differences between the spectra and thermal curve profiles of the materials obtained before and after AAA. TG confirmed the absence of volatile compounds and evidenced good thermal stability up to 200 °C, and similar amounts of residues were found in all resins evaluated before and after AAA. The AAA treatment did not significantly affect resin surface. Therefore, regardless of the resin brand, AAA did not influence the microstructure or the mechanical properties.

  11. Pediatric Anthropometry

    NASA Astrophysics Data System (ADS)

    Klinich, Kathleen D.; Reed, Matthew P.

    Anthropometry is the measurement of human size, shape, and physical capabilities. Most pediatric anthropometry data are gathered to describe child growth patterns, but data on body size, mass distribution, range of motion, and posture are used to develop crash test dummies and computational models of child occupants. Pediatric anthropometry data are also used to determine child restraint dimensions, so they will accommodate the applicable population of child occupants.

  12. Pediatric Traumatic Brain Injury.

    PubMed

    Schaller, Alexandra L; Lakhani, Saquib A; Hsu, Benson S

    2015-10-01

    The purpose of this article is to provide a better understanding of pediatric traumatic brain injury and its management. Within the pediatric age group, ages 1 to 19, injuries are the number one cause of death with traumatic brain injury being involved in almost 50 percent of these cases. This, along with the fact that the medical system spends over $1 billion annually on pediatric traumatic brain injury, makes this issue both timely and relevant to health care providers. Over the course of this article the epidemiology, physiology, pathophysiology, and treatment of pediatric traumatic brain injury will be explored. Emphasis will be placed on the role of the early responder and the immediate interventions that should be considered and/or performed. The management discussed in this article follows the most recent recommendations from the 2012 edition of the Guidelines for the Acute Medical Management of Severe Traumatic Brain Injury in Infants, Children, and Adolescents. Despite the focus of this article, it is important not to lose sight of the fact that an ounce of prevention is worth a pound--or, to be more precise and use the average human's brain measurements, just above three pounds--of cure. PMID:26630835

  13. Neuroprognostication After Pediatric Cardiac Arrest

    PubMed Central

    Kirschen, Matthew P.; Topjian, Alexis A.; Hammond, Rachel; Illes, Judy; Abend, Nicholas S.

    2014-01-01

    BACKGROUND Management decisions and parental counseling after pediatric cardiac arrest depend on the ability of physicians to make accurate and timely predictions regarding neurological recovery. We evaluated neurologists and intensivists performing neuroprognostication after cardiac arrest to determine prediction agreement, accuracy, and confidence. METHODS Pediatric neurologists (n = 10) and intensivists (n = 9) reviewed 18 cases of children successfully resuscitated from a cardiac arrest and managed in the pediatric intensive care unit. Cases were sequentially presented (after arrest day 1, days 2–4, and days 5–7), with updated examinations, neurophysiologic data, and neuroimaging data. At each time period, physicians predicted outcome by Pediatric Cerebral Performance Category and specified prediction confidence. RESULTS Predicted discharge Pediatric Cerebral Performance Category versus actual hospital discharge Pediatric Cerebral Performance Category outcomes were compared. Exact (Predicted Pediatric Cerebral Performance Category – Actual Pediatric Cerebral Performance Category = 0) and close (Predicted Pediatric Cerebral Performance Category – Actual Pediatric Cerebral Performance Category = ±1) outcome prediction accuracies for all physicians improved over successive periods (P < 0.05). Prediction accuracy did not differ significantly between physician groups at any period or overall. Agreement improved over time among neurologists (day 1 Kappa [κ], 0.28; days 2–4 κ, 0.43; days 5–7 κ, 0.68) and among intensivists (day 1 κ, 0.30; days 2–4 κ, 0.44; days 5–7 κ, 0.57). Prediction confidence increased over time (P < 0.001) and did not differ between physician groups. CONCLUSIONS Inter-rater agreement among neurologists and among intensivists improved over time and reached moderate levels. For all physicians, prediction accuracy and confidence improved over time. Further prospective research is needed to better characterize how physicians

  14. Pediatric Ingestions: Emergency Department Management.

    PubMed

    Tarango Md, Stacy M; Liu Md, Deborah R

    2016-04-01

    Pediatric ingestions present a common challenge for emergency clinicians. Each year, more than 50,000 children aged less than 5 years present to emergency departments with concern for unintentional medication exposure, and nearly half of all calls to poison centers are for children aged less than 6 years. Ingestion of magnetic objects and button batteries has also become an increasing source of morbidity and mortality. Although fatal pediatric ingestions are rare, the prescription medications most responsible for injury and fatality in children include opioids, sedative/hypnotics, and cardiovascular drugs. Evidence regarding the evaluation and management of common pediatric ingestions is comprised largely of case reports and retrospective studies. This issue provides a review of these studies as well as consensus guidelines addressing the initial resuscitation, diagnosis, and treatment of common pediatric ingestions. Also discussed are current recommendations for decontamination, administration of antidotes for specific toxins, and management of ingested foreign bodies.

  15. Severity of pediatric pain in relation to school-related functioning and teacher support: an epidemiological study among school-aged children and adolescents.

    PubMed

    Vervoort, Tine; Logan, Deirdre E; Goubert, Liesbet; De Clercq, Bart; Hublet, Anne

    2014-06-01

    The current cross-sectional study examined child and adolescent pain severity in relation to various domains of school functioning and, in line with self-determination theory, the potentially protective role of perceived teacher support of child/adolescent autonomy and competence. Data from a large representative sample of Flemish school children and adolescents (N=10650; 50.8% boys; age range 10-21years; mean age=14.33) was collected as part of the World Health Organization (WHO) collaborative Health Behaviour in School-Aged Children (HBSC) survey. Child/adolescent pain severity was graded based on a pediatric pain classification system adapted from that of Von Korff et al. The current study thus provided insight regarding the prevalence of pain among Flemish children/adolescents and, extending the limitations of existing literature, examined the specific role of pain severity across various domains of school functioning. Findings indicated that a sizeable proportion of children reported moderate to severe pain problems (ie, about 14% of children and adolescents were classified in the highest pain grades: ie, grade III or IV). Furthermore, higher pain grades were associated with poorer outcomes across all indices of school functioning (ie, school absenteeism, school-related pressure and satisfaction, and bullying experiences), with the exception of academic performance. However, the association between pain grade and school absenteeism was less pronounced when children perceived their teachers to be highly supportive of competence and autonomy. Furthermore, teacher support of competence appeared to buffer against the harmful effects of severe pain upon instances of bullying experiences at school. Future research directions and implications for school-based interventions are discussed.

  16. In-office survey of children's hazard exposure in the Chicago area: age-specific exposure information and methodological lessons. Pediatric Practice Research Group.

    PubMed

    Senturia, Y D; Binns, H J; Christoffel, K K; Tanz, R R

    1993-06-01

    Anticipatory guidance on injury prevention should reflect the risks children face, yet hazard exposure information is generally unavailable. The objectives of this study were (1) to obtain information on age-specific exposure of Chicago-area children to amusement park rides, sleds, snow discs, bunkbeds, skateboards, fireworks, toboggans, and air guns and (2) to assess methodological issues in gathering exposure information by parental survey in pediatric practices. Questionnaires were received from 679 families, including 1469 children. The proportion of families with at least one exposed child varied: amusement park rides (94%), sleds (67%), snow discs (25%), bunkbeds (24%), skateboards (22%), fireworks (17%), toboggans (15%), and air guns and rifles (6%). Use of skateboards, air guns and rifles, and bunkbeds was highest in males. Use of skateboards, air guns and rifles, and snow discs peaked among young adolescents (ages 10 to 14), whereas use of sleds, toboggans and amusement park rides peaked among young children (ages 5 to 9) and young adolescents. Use of bunkbeds peaked among young children. Log linear analyses found: the likelihood of exposure to sleds and snow discs was highest in rural communities and for families owning their own home; toboggan exposure was highest among home owners; air gun and rifle exposure was highest in rural areas; fireworks exposure decreased with increased paternal education; exposure to skateboards was highest in single family dwellings and suburban home owners. This study generates the only available current estimates for use of these products, and demonstrates that in-office parental surveys concerning exposure are feasible. The findings can help guide future hazard exposure research and may affect anticipatory guidance in some settings.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Pediatric intestinal motility disorders

    PubMed Central

    Gfroerer, Stefan; Rolle, Udo

    2015-01-01

    Pediatric intestinal motility disorders affect many children and thus not only impose a significant impact on pediatric health care in general but also on the quality of life of the affected patient. Furthermore, some of these conditions might also have implications for adulthood. Pediatric intestinal motility disorders frequently present as chronic constipation in toddler age children. Most of these conditions are functional, meaning that constipation does not have an organic etiology, but in 5% of the cases, an underlying, clearly organic disorder can be identified. Patients with organic causes for intestinal motility disorders usually present in early infancy or even right after birth. The most striking clinical feature of children with severe intestinal motility disorders is the delayed passage of meconium in the newborn period. This sign is highly indicative of the presence of Hirschsprung disease (HD), which is the most frequent congenital disorder of intestinal motility. HD is a rare but important congenital disease and the most significant entity of pediatric intestinal motility disorders. The etiology and pathogenesis of HD have been extensively studied over the last several decades. A defect in neural crest derived cell migration has been proven as an underlying cause of HD, leading to an aganglionic distal end of the gut. Numerous basic science and clinical research related studies have been conducted to better diagnose and treat HD. Resection of the aganglionic bowel remains the gold standard for treatment of HD. Most recent studies show, at least experimentally, the possibility of a stem cell based therapy for HD. This editorial also includes rare causes of pediatric intestinal motility disorders such as hypoganglionosis, dysganglionosis, chronic intestinal pseudo-obstruction and ganglioneuromatosis in multiple endocrine metaplasia. Underlying organic pathologies are rare in pediatric intestinal motility disorders but must be recognized as early as

  18. Reliving lifelong episodic autobiographical memories via the hippocampus: a correlative resting PET study in healthy middle-aged subjects.

    PubMed

    Piolino, Pascale; Desgranges, Béatrice; Hubert, Valérie; Bernard, Frédéric A; Matuszewski, Vanessa; Chételat, Gaël; Baron, Jean-Claude; Eustache, Francis

    2008-01-01

    We aimed at identifying the cerebral structures whose synaptic function subserves the recollection of lifetime's episodic autobiographical memory (AM) via autonoetic consciousness. Twelve healthy middle-aged subjects (mean age: 59 years +/- 2.5) underwent a specially designed cognitive test to assess the ability to relive richly detailed episodic autobiographical memories from five time periods using the Remember/Know procedure. We computed an index of episodicity (number of Remember responses justified by the recall of specific events and details) and an index of retrieval spontaneity, and additionally an index of semanticized memories (number of Know responses). The regional cerebral blood flow (rCBF) was measured in the resting state, with H(2)O(15) as part of an activation PET study. The indexes were correlated with blood flow using volumes of interest in frontotemporal regions, including hippocampus and voxel-wise analyses in SPM. With both analyses, significant correlations were mainly found between the index of episodicity and rCBF in the medial temporal lobe, including hippocampus, across the five time periods (unlike the index of semanticized memories) and between the spontaneity index and rCBF in the prefrontal areas. These results highlight, in healthy subjects, the distinct role of these two structures in AM retrieval and support the view that the hippocampus is needed for reexperiencing detailed episodic memories no matter how old they are. PMID:18240320

  19. Socioeconomic Factors Impact Inpatient Mortality in Pediatric Lymphoma Patients

    PubMed Central

    Puckett, Yana

    2016-01-01

    Purpose: Our objective was to determine the risk factors for inpatient mortality of pediatric patients diagnosed with lymphoma through the utilization of a large national pediatric database. Methods: This cross-sectional study uses data from the Healthcare Cost and Utilization Project Kids' Inpatient Database (HCUP KID) for the year of 2012 to estimate the risk factors for inpatient mortality for pediatric patients diagnosed with lymphoma. All patients diagnosed with lymphoma between the ages of one and 18 years were included. Chi-square test was used to analyze categorical variables. Independent t-test was used to analyze continuous variables. Results: A total of 2,908 study subjects with lymphoma were analyzed. Of those, 56.1% were male and the average age was three years old. Total inpatient mortality was 1.2% or 34 patients. We found that patients with four or more chronic conditions were much more likely to die while hospitalized (p < 0.0001). In addition, we also saw that patients with median household incomes below $47,999 dollars (p = 0.05) having a need for a major procedure (p = 0.008) were associated with inpatient mortality. Congestive heart failure, renal failure, coagulopathy, metastatic disease, and electrolyte abnormalities were all found to be associated with inpatient mortality. Conclusions: Pediatric lymphoma mortality in children is not only influenced by their medical condition but also by their socioeconomic condition as well. PMID:27433403

  20. The Madrid Affective Database for Spanish (MADS): Ratings of Dominance, Familiarity, Subjective Age of Acquisition and Sensory Experience.

    PubMed

    Hinojosa, José A; Rincón-Pérez, Irene; Romero-Ferreiro, M Verónica; Martínez-García, Natalia; Villalba-García, Cristina; Montoro, Pedro R; Pozo, Miguel A

    2016-01-01

    The current study presents ratings by 540 Spanish native speakers for dominance, familiarity, subjective age of acquisition (AoA), and sensory experience (SER) for the 875 Spanish words included in the Madrid Affective Database for Spanish (MADS). The norms can be downloaded as supplementary materials for this manuscript from https://figshare.com/s/8e7b445b729527262c88 These ratings may be of potential relevance to researches who are interested in characterizing the interplay between language and emotion. Additionally, with the aim of investigating how the affective features interact with the lexicosemantic properties of words, we performed correlational analyses between norms for familiarity, subjective AoA and SER, and scores for those affective variables which are currently included in the MADs. A distinct pattern of significant correlations with affective features was found for different lexicosemantic variables. These results show that familiarity, subjective AoA and SERs may have independent effects on the processing of emotional words. They also suggest that these psycholinguistic variables should be fully considered when formulating theoretical approaches to the processing of affective language. PMID:27227521

  1. The Madrid Affective Database for Spanish (MADS): Ratings of Dominance, Familiarity, Subjective Age of Acquisition and Sensory Experience

    PubMed Central

    Hinojosa, José A.; Rincón-Pérez, Irene; Romero-Ferreiro, Mª Verónica; Martínez-García, Natalia; Villalba-García, Cristina; Montoro, Pedro R.; Pozo, Miguel A.

    2016-01-01

    The current study presents ratings by 540 Spanish native speakers for dominance, familiarity, subjective age of acquisition (AoA), and sensory experience (SER) for the 875 Spanish words included in the Madrid Affective Database for Spanish (MADS). The norms can be downloaded as supplementary materials for this manuscript from https://figshare.com/s/8e7b445b729527262c88 These ratings may be of potential relevance to researches who are interested in characterizing the interplay between language and emotion. Additionally, with the aim of investigating how the affective features interact with the lexicosemantic properties of words, we performed correlational analyses between norms for familiarity, subjective AoA and SER, and scores for those affective variables which are currently included in the MADs. A distinct pattern of significant correlations with affective features was found for different lexicosemantic variables. These results show that familiarity, subjective AoA and SERs may have independent effects on the processing of emotional words. They also suggest that these psycholinguistic variables should be fully considered when formulating theoretical approaches to the processing of affective language. PMID:27227521

  2. Choroidal volume variations with age, axial length, and sex in healthy subjects: a three-dimensional analysis

    PubMed Central

    Barteselli, Giulio; Chhablani, Jay; El-Emam, Sharif; Wang, Haiyan; Chuang, Janne; Kozak, Igor; Cheng, Lingyun; Bartsch, Dirk-Uwe; Freeman, William R.

    2012-01-01

    Purpose To demonstrate the three-dimensional choroidal volume distribution in healthy subjects using enhanced depth imaging (EDI) spectral-domain optical coherence tomography (SD-OCT) and to evaluate its association with age, sex, and axial length. Design Retrospective case series. Participants One hundred and seventy six eyes from 114 subjects with no retinal or choroidal disease. Methods EDI SD-OCT imaging studies for healthy patients who had undergone a 31-raster scanning protocol on a commercial SD-OCT device were reviewed. Manual segmentation of the choroid was performed by two retinal specialists. Macular choroidal volume map and three-dimensional topography were automatically created by the built-in software of the device. Mean choroidal volume was calculated for each Early Treatment Diabetic Retinopathy Study (ETDRS) subfield. Regression analyses were used to evaluate the correlation between macular choroidal volume and age, sex, and axial length. Main Outcome Measures Three-dimensional topography and ETDRS-style volume map of the choroid. Results Three-dimensional topography of the choroid and volume map was obtained in all cases. The mean choroidal volume was 0.228 ± 0.077 mm3 for the center ring and 7.374 ± 2.181 mm3 for the total ETDRS grid. The nasal quadrant showed the lowest choroidal volume, and the superior quadrant the highest. The temporal and inferior quadrants did not show different choroidal volume values. Choroidal volume in all the EDTRS rings was significantly correlated with axial length after adjustment for age (P<0.0001), with age after adjustment for axial length (P<0.0001) and with sex after adjustment for axial length (P<0.05). Choroidal volume decreases by 0.54 mm3 (7.32%) for every decade and by 0.56 mm3 (7.59%) for every mm of axial length. Males have a 7.37% greater choroidal volume compared to that of females. Conclusions EDI SD-OCT is non-invasive and well-tolerated procedure with an excellent ability to visualize three

  3. Morphometric evaluation of the frontal sinus in relation to age and gender in subjects residing in Davangere, Karnataka

    PubMed Central

    Soman, Bhakti A.; Sujatha, G. P.; Lingappa, Ashok

    2016-01-01

    Objective: The main objective of the study was morphometric evaluation of the frontal sinus in relation to age and gender and to establish its forensic importance and application. Materials and Method: The study group consisted of 200 subjects (100 males and 100 females) in the age groups 14-20 years, 21-30 years, 31-45 years, 45 years and above. Posteroanterior (PA) cephalogram radiographs were taken using standardized technique. The processed films were traced and frontal sinus pattern was established as per Yoshino's classification system. Results: The mean values for length, width, and area of the frontal sinus were found to be higher in males as compared to females and area of frontal sinuses increase with age except in males who were 45 years and above. The left width, left area, and bilateral asymmetry in relation to gender was found to be statistically significant. Conclusion: The morphologic evaluation of frontal sinus is a useful technique to determine gender and seems promising in personal identification. PMID:27051227

  4. Effects of Age, Sex, and Obesity on the Single-Dose Pharmacokinetics of Omarigliptin in Healthy Subjects.

    PubMed

    Addy, Carol; Tatosian, Daniel A; Glasgow, Xiaoli S; Iii, Isaias Noel Gendrano; Sisk, Christine McCrary; Kauh, Eunkyung A; Stoch, S Aubrey; Wagner, John A

    2016-09-01

    Omarigliptin is being developed as a potent, once-weekly, oral dipeptidyl peptidase-4 inhibitor for the treatment of type 2 diabetes. This double-blind, randomized, placebo-controlled study evaluated the effects of age, sex, and obesity on the pharmacokinetics of omarigliptin in healthy subjects. A single oral dose of omarigliptin 10 mg (n = 6/panel) or placebo (n = 2/panel) was administered in the fasted state to elderly nonobese men and women, young obese (30 ≤ body mass index [BMI] ≤ 35 kg/m(2) ) men and women, and young nonobese women of nonchildbearing potential. Plasma was collected at selected postdose times for evaluation of omarigliptin concentrations. Pharmacokinetic parameters were compared with historical data from a previously-conducted single-dose study in young, healthy, nonobese men. There were no clinically significant differences in omarigliptin AUC0-∞ , the primary pharmacokinetic parameter for assessing efficacy and safety, based on age, sex, or BMI (pooled nonobese elderly versus pooled nonobese young, young nonobese female versus young nonobese male, and pooled young obese versus pooled young nonobese). There were no serious adverse events or hypoglycemic events attributable to omarigliptin administration. Demographic factors and BMI had no meaningful effect on omarigliptin pharmacokinetics, suggesting that dose adjustment based on age, sex, or obesity is not required. PMID:27627193

  5. A comparative study of 10% KOH solution and 5% imiquimod cream for the treatment of Molluscum contagiosum in the pediatric age group

    PubMed Central

    Chathra, Namitha; Sukumar, D.; Bhat, Ramesh M.; Kishore, B. Nanda; Martis, Jacintha; Kamath, Ganesh; Srinath, M. K.; Monteiro, Rochelle

    2015-01-01

    Background: Although Molluscum contagiosum (MC) is a self-limiting condition, active therapy could prevent further spread and improve cosmesis. Most of the available treatment modalities traumatize the lesions and have to be undertaken in the hospital, therefore evoking panic in children. In the quest for an alternative therapy, this study comparing 10% potassium hydroxide (KOH) solution and 5% imiquimod cream was taken up. Aims and Objectives: To compare the efficacy and tolerability of 10% KOH and 5% imiquimod in the treatment of MC. Materials and Methods: This comparative study was conducted over a period of 18 months from October 2011 to March 2013, 40 patients between the age group of 1-18 years with clinically diagnosed MC were divided into two groups (lottery method), 20 patients were treated with 5% imiquimod cream (Group A) and the other 20 were treated with 10% KOH solution (Group B). Patients were followed up on the 4th, 8th and 12th week of treatment. Results: At the end of 12 weeks, out of 20 patients who received 10% KOH, 17 patients showed complete disappearance, whereas out of 20 patients who received 5% imiquimod, only 10 patients showed total clearance of the lesions. Adverse events were more frequent with 10% KOH, pigmentary disturbances being the most common. Conclusion: With only minor adverse effects, 10% KOH is an inexpensive and efficient modality for the treatment of MC in the pediatric age group. Although 5% imiquimod was effective in clearing the lesions with minimal adverse effects, the longer duration required for its efficacy may deter its wider use. PMID:25821725

  6. Development of a Behavioral Sleep Intervention as a Novel Approach for Pediatric Obesity in School-aged Children.

    PubMed

    Hart, Chantelle N; Hawley, Nicola L; Wing, Rena R

    2016-06-01

    Despite being the focus of widespread public health efforts, childhood obesity remains an epidemic worldwide. Given the now well-documented consequences of obesity for childhood health and psychosocial functioning, as well as associated morbidity in adulthood, identifying novel, modifiable behaviors that can be targeted to improve weight control is imperative. Enhancing children's sleep may show promise in assisting with weight regulation. The present paper describes the development of a brief behavioral sleep intervention for school-aged children, including preliminary findings of this work as well as areas for future study. PMID:27261547

  7. Pediatric Burn Resuscitation.

    PubMed

    Palmieri, Tina L

    2016-10-01

    Children have unique physiologic, physical, psychological, and social needs compared with adults. Although adhering to the basic tenets of burn resuscitation, resuscitation of the burned child should be modified based on the child's age, physiology, and response to injury. This article outlines the unique characteristics of burned children and describes the fundamental principles of pediatric burn resuscitation in terms of airway, circulatory, neurologic, and cutaneous injury management. PMID:27600126

  8. Verification on the use of the Inoue method for precisely determining glomerular filtration rate in Philippine pediatrics

    NASA Astrophysics Data System (ADS)

    Magcase, M. J. D. J.; Duyan, A. Q.; Carpio, J.; Carbonell, C. A.; Trono, J. D.

    2015-06-01

    The objective of this study is to validate the Inoue method so that it would be the preferential choice in determining glomerular filtration rate (GFR) in Philippine pediatrics. The study consisted of 36 patients ranging from ages 2 months to 19 years old. The subjects used were those who were previously subjected to in-vitro method. The scintigrams of the invitro method was obtained and processed for split percentage uptake and for parameters needed to obtain Inoue GFR. The result of this paper correlates the Inoue GFR and In-vitro method (r = 0.926). Thus, Inoue method is a viable, simple, and practical technique in determining GFR in pediatric patients.

  9. The relationship between psychosocial stress, age, BMI, CRP, lifestyle, and the metabolic syndrome in apparently healthy subjects.

    PubMed

    Yamamoto, Kazuhiko; Okazaki, Ai; Ohmori, Susumu

    2011-01-01

    The aim of this cross-sectional study was to examine the factors which may be associated with the metabolic syndrome by exploring the relationship between psychosocial stress, age, body mass index (BMI), C-reactive protein (CRP), lifestyle factors, and the components of the metabolic syndrome, such as glycated hemoglobin (HbA1c), fasting blood sugar (FBS), body fat percentage, and triglyceride concentration, among apparently healthy subjects. Psychosocial stress was measured by the use of the inventory to measure psychosocial stress (IMPS). One thousand four hundred and ninety-nine people out of 1,941 public school workers admitted to a hospital for a medical check-up responded to the IMPS, yielding a response rate of 77.2%. A total of 1,201 workers excluding 298 who were taking medication for various diseases were analyzed with the use of hierarchical multiple regression models. It was found that IMPS-measured stress score, age, BMI, and smoking habit were associated with an increase in glycated hemoglobin among men, while alcohol consumption was associated with a decrease in glycated hemoglobin. Stress score, age, BMI, and alcohol consumption were found to be associated with an increase in FBS among men, while smoking and exercise habits were associated with a decrease in FBS. CRP was found to be associated with an increase in body fat percentage among men, though stress score was not associated with an increase in body fat percentage. Stress score, age, and BMI were associated with an increase in triglyceride concentration among women. The findings of the present study seem to be in line with the hypothesis that psychosocial stress plays an important role in developing the metabolic syndrome, which may be associated with inflammatory processes in the vascular wall, resulting in atherosclerosis and cardiovascular disease.

  10. Pediatric Sarcomas.

    PubMed

    Williams, Regan F; Fernandez-Pineda, Israel; Gosain, Ankush

    2016-10-01

    Pediatric sarcomas are a heterogeneous group of tumors accounting for approximately 10% of childhood solid tumors. Treatment is focused on multimodality therapy, which has improved the prognosis over the past two decades. Current regimens focus on decreasing treatment for low-risk patients to decrease the long-term side effects while maximizing therapy for patients with metastatic disease to improve survival. Pediatric sarcomas can be divided into soft tissue sarcomas and osseous tumors. Soft tissue sarcomas are further delineated into rhabdomyosarcomas, which affect young children and nonrhabdomyosarcomas, which are most common in adolescents. The most common bone sarcomas are osteosarcomas and Ewing's sarcoma. PMID:27542645

  11. Pediatric rosacea.

    PubMed

    Kellen, Roselyn; Silverberg, Nanette B

    2016-07-01

    Because rosacea is uncommon in the pediatric population, care must be taken to exclude other papulopustular disorders. Children can present with vascular, papulopustular, and/or ocular findings. Importantly, ocular symptoms can appear before the cutaneous symptoms of rosacea, leading to misdiagnosis. Rosacea is a clinical diagnosis, but histopathologic examination typically reveals dilated vessels, perivascular lymphohistiocytic infiltrates in the upper dermis, elastosis, and disorganization of the upper dermal connective tissue. Treatment involves avoiding known triggers and utilizing topical and/or systemic therapies. Although treatment can control flares, pediatric rosacea often persists into adulthood. PMID:27529708

  12. Comparison of real-life accidental falls in older people with experimental falls in middle-aged test subjects.

    PubMed

    Kangas, M; Vikman, I; Nyberg, L; Korpelainen, R; Lindblom, J; Jämsä, T

    2012-03-01

    Falling is a common accident among older people. Automatic fall detectors are one method of improving security. However, in most cases, fall detectors are designed and tested with data from experimental falls in younger people. This study is one of the first to provide fall-related acceleration data obtained from real-life falls. Wireless sensors were used to collect acceleration data during a six-month test period in older people. Data from five events representing forward falls, a sideways fall, a backwards fall, and a fall out of bed were collected and compared with experimental falls performed by middle-aged test subjects. The signals from real-life falls had similar features to those from intentional falls. Real-life forward, sideways and backward falls all showed a pre impact phase and an impact phase that were in keeping with the model that was based on experimental falls. In addition, the fall out of bed had a similar acceleration profile as the experimental falls of the same type. However, there were differences in the parameters that were used for the detection of the fall phases. The beginning of the fall was detected in all of the real-life falls starting from a standing posture, whereas the high pre impact velocity was not. In some real-life falls, multiple impacts suggested protective actions. In conclusion, this study demonstrated similarities between real-life falls of older people and experimental falls of middle-aged subjects. However, some fall characteristics detected from experimental falls were not detectable in acceleration signals from corresponding heterogeneous real-life falls.

  13. What is the subjective cost of cognitive effort? Load, trait, and aging effects revealed by economic preference.

    PubMed

    Westbrook, Andrew; Kester, Daria; Braver, Todd S

    2013-01-01

    It has long been assumed that people treat cognitive effort as costly, but also that such effort costs may vary greatly across individuals. Individual differences in subjective effort could present a major and pervasive confound in behavioral and neuroscience assessments, by conflating cognitive ability with cognitive motivation. Self-report cognitive effort scales have been developed, but objective measures are lacking. In this study, we use the behavioral economic approach of revealed preferences to quantify subjective effort. Specifically, we adapted a well-established discounting paradigm to measure the extent to which cognitive effort causes participants to discount monetary rewards. The resulting metrics are sensitive to both within-individual factors, including objective load and reward amount, and between-individual factors, including age and trait cognitive engagement. We further validate cognitive effort discounting by benchmarking it against well-established measures of delay discounting. The results highlight the promise and utility of behavioral economic tools for assessing trait and state influences on cognitive motivation.

  14. Inhibition of ACE Retards Tau Hyperphosphorylation and Signs of Neuronal Degeneration in Aged Rats Subjected to Chronic Mild Stress.

    PubMed

    AbdAlla, Said; El Hakim, Ahmed; Abdelbaset, Ahmed; Elfaramawy, Yasser; Quitterer, Ursula

    2015-01-01

    With increasing life expectancy, Alzheimer's disease (AD) and other types of age-associated dementia are on the rise worldwide. Treatment approaches for dementia are insufficient and novel therapies are not readily available. In this context repurposing of established drugs appears attractive. A well-established class of cardiovascular drugs, which targets the angiotensin II system, is such a candidate, which currently undergoes a paradigm shift with regard to the potential benefit for treatment of neurodegenerative symptoms. In search for additional evidence, we subjected aged rats to chronic unpredictable mild stress, which is known to enhance the development of AD-related neuropathological features. We report here that four weeks of chronic mild stress induced a strong upregulation of the hippocampal angiotensin-converting enzyme (Ace) at gene expression and protein level. Concomitantly, tau protein hyperphosphorylation developed. Signs of neurodegeneration were detected by the significant downregulation of neuronal structure proteins such as microtubule-associated protein 2 (Map2) and synuclein-gamma (Sncg). Ace was involved in neurodegenerative symptoms because treatment with the brain-penetrating ACE inhibitor, captopril, retarded tau hyperphosphorylation and signs of neurodegeneration. Moreover, ACE inhibitor treatment could counteract glutamate neurotoxicity by preventing the downregulation of glutamate decarboxylase 2 (Gad2). Taken together, ACE inhibition targets neurodegeneration triggered by environmental stress. PMID:26697495

  15. Inhibition of ACE Retards Tau Hyperphosphorylation and Signs of Neuronal Degeneration in Aged Rats Subjected to Chronic Mild Stress

    PubMed Central

    AbdAlla, Said; el Hakim, Ahmed; Abdelbaset, Ahmed; Elfaramawy, Yasser; Quitterer, Ursula

    2015-01-01

    With increasing life expectancy, Alzheimer's disease (AD) and other types of age-associated dementia are on the rise worldwide. Treatment approaches for dementia are insufficient and novel therapies are not readily available. In this context repurposing of established drugs appears attractive. A well-established class of cardiovascular drugs, which targets the angiotensin II system, is such a candidate, which currently undergoes a paradigm shift with regard to the potential benefit for treatment of neurodegenerative symptoms. In search for additional evidence, we subjected aged rats to chronic unpredictable mild stress, which is known to enhance the development of AD-related neuropathological features. We report here that four weeks of chronic mild stress induced a strong upregulation of the hippocampal angiotensin-converting enzyme (Ace) at gene expression and protein level. Concomitantly, tau protein hyperphosphorylation developed. Signs of neurodegeneration were detected by the significant downregulation of neuronal structure proteins such as microtubule-associated protein 2 (Map2) and synuclein-gamma (Sncg). Ace was involved in neurodegenerative symptoms because treatment with the brain-penetrating ACE inhibitor, captopril, retarded tau hyperphosphorylation and signs of neurodegeneration. Moreover, ACE inhibitor treatment could counteract glutamate neurotoxicity by preventing the downregulation of glutamate decarboxylase 2 (Gad2). Taken together, ACE inhibition targets neurodegeneration triggered by environmental stress. PMID:26697495

  16. Pediatric trichotillomania.

    PubMed

    Harrison, J P; Franklin, M E

    2012-06-01

    Trichotillomania (TTM) is an impulse control disorder characterized by chronic hair-pulling, distress, and impairment. Although the negative effects of TTM are documented and often readily evident, there remains a paucity of psychopathology and treatment research on this disorder, particularly in pediatric populations. In an effort to improve assessment of pediatric TTM, several TTM-specific instruments for youth have now been developed to reliably identify symptoms and examine related phenomenology. Instrument development has now yielded instruments to evaluate TTM and related symptoms in the context of clinical trials of youth, and the first randomized controlled trial of any treatment for pediatric TTM was recently published. Using the initial pediatric TTM studies as building blocks, future research is now needed to create a stronger body of knowledge about the relative and combined efficacy of potential interventions for TTM in youth, as well as to examine the effects of TTM phenomenology and comorbidity on treatment outcome. Dissemination efforts must also be heightened for this knowledge to best reach these vulnerable populations. PMID:22437627

  17. Pneumococcal nasopharyngeal carriage in children <5  years of age visiting the pediatric emergency room in relation to PCV7 and PCV13 introduction in southern Israel

    PubMed Central

    Ben-Shimol, Shalom; Givon-Lavi, Noga; Greenberg, David; Dagan, Ron

    2016-01-01

    ABSTRACT The 7-valent and the 13-valent pneumococcal conjugate vaccines (PCV7 and PCV13, respectively) were introduced to the Israeli National Immunization plan in July 2009 and November 2010, respectively. Our aim was to assess pneumococcal conjugate vaccines (PCVs) uptake and dynamics in serotype-specific pneumococcal nasopharyngeal (NP) carriage in children <5  years old in southern Israel, during the immediate 5 y following PCV introduction. This was an ongoing, prospective, population-based, active surveillance, from July 2009 through December 2014. PCVs uptake and NP cultures were obtained daily from children seen at the Pediatric Emergency Room for any reason. Overall, 10,702 vaccine status and 7,610 NP swabs were obtained. Both PCV7 and PCV13 uptake were high, reaching ˜90% by July 2012 and December 2013, respectively. All-pneumococcal carriage rates significantly declined by 10%, from 54.3% in the early-PCV7 period, to 49.1% in the PCV13 impact period. The respective declines for PCV7, 6A and additional PCV13 serotypes carriage rates were 76%, 90% and 66%. In contrast, non-PCV13 serotypes carriage rates increased significantly throughout the study by 71%. All-pneumococcal carriage rates in children <12  months old decreased significantly by 15%, with similar trends observed in other age groups. Initially, all-pneumococcal carriage rates were 45.7%, and 61.9% in Jewish and Bedouin children, respectively (P < 0.001), with a significant 17% reduction throughout the study observed only in Bedouins. While early carriage rates were higher in unvaccinated children compared to vaccinated children, PCV impact on carriage were similar in both groups. In conclusion, a relatively moderate decline in pneumococcal carriage rates, facilitated by a substantial decrease of vaccine-serotypes and increase of non-vaccine serotypes was observed in the immediate period following PCVs introduction in southern Israel. PMID:26430921

  18. Perturbed reward processing in pediatric bipolar disorder: an antisaccade study.

    PubMed

    Mueller, Sven C; Ng, Pamela; Temple, Veronica; Hardin, Michael G; Pine, Daniel S; Leibenluft, Ellen; Ernst, Monique

    2010-12-01

    Pediatric bipolar disorder is a severe and impairing illness. Characterizing the impact of pediatric bipolar disorder on cognitive function might aid in understanding the phenomenology of the disorder. While previous studies of pediatric bipolar disorder have reported deficits in cognitive control and reward behavior, little is understood about how affective processes influence behavioral control. Relative to prior studies using manual-response paradigms, eye movement tasks provide a more precise assessment of reward sensitivity and cognitive and motor control. The current study compares 20 youths with bipolar disorder (mean age = 13.9 years ± 2.22) and 23 healthy subjects (mean age = 13.8 years ± 2.49) on a mixed pro-antisaccade task with monetary incentives. On both types of saccades, participants were presented with three types of incentives: those where subjects can win money, lose money, or neither win nor lose money. Impaired reward processing was found in youths with bipolar disorder relative to controls, particularly on antisaccades. This difference was reflected in lower error rates during incentive trials in the control but not in the bipolar disorder group. By comparison, no group differences were found on prosaccade trials. The results provide further evidence for deficits in cognitive and reward processing in bipolar disorder. PMID:20080923

  19. Incident Subjective Cognitive Decline Does Not Predict Mortality in the Elderly – Results from the Longitudinal German Study on Ageing, Cognition, and Dementia (AgeCoDe)

    PubMed Central

    Roehr, Susanne; Luck, Tobias; Heser, Kathrin; Fuchs, Angela; Ernst, Annette; Wiese, Birgitt; Werle, Jochen; Bickel, Horst; Brettschneider, Christian; Koppara, Alexander; Pentzek, Michael; Lange, Carolin; Prokein, Jana; Weyerer, Siegfried; Mösch, Edelgard; König, Hans-Helmut; Maier, Wolfgang; Scherer, Martin

    2016-01-01

    Objective Subjective cognitive decline (SCD) might represent the first symptomatic representation of Alzheimer’s disease (AD), which is associated with increased mortality. Only few studies, however, have analyzed the association of SCD and mortality, and if so, based on prevalent cases. Thus, we investigated incident SCD in memory and mortality. Methods Data were derived from the German AgeCoDe study, a prospective longitudinal study on the epidemiology of mild cognitive impairment (MCI) and dementia in primary care patients over 75 years covering an observation period of 7.5 years. We used univariate and multivariate Cox regression analyses to examine the relationship of SCD and mortality. Further, we estimated survival times by the Kaplan Meier method and case-fatality rates with regard to SCD. Results Among 971 individuals without objective cognitive impairment, 233 (24.0%) incidentally expressed SCD at follow-up I. Incident SCD was not significantly associated with increased mortality in the univariate (HR = 1.0, 95% confidence interval = 0.8–1.3, p = .90) as well as in the multivariate analysis (HR = 0.9, 95% confidence interval = 0.7–1.2, p = .40). The same applied for SCD in relation to concerns. Mean survival time with SCD was 8.0 years (SD = 0.1) after onset. Conclusion Incident SCD in memory in individuals with unimpaired cognitive performance does not predict mortality. The main reason might be that SCD does not ultimately lead into future cognitive decline in any case. However, as prevalence studies suggest, subjectively perceived decline in non-memory cognitive domains might be associated with increased mortality. Future studies may address mortality in such other cognitive domains of SCD in incident cases. PMID:26766555

  20. Age, Cumulative Trauma and Stressful Life Events, and Post-Traumatic Stress Symptoms among Older Adults in Prison: Do Subjective Impressions Matter?

    ERIC Educational Resources Information Center

    Maschi, Tina; Morgen, Keith; Zgoba, Kristen; Courtney, Deborah; Ristow, Jennifer

    2011-01-01

    Background: The aging prison population in the United States presents a significant public health challenge with high rates of trauma and mental health issues that the correctional system alone is ill-prepared to address. The purpose of this study was to examine the relationship of age, objective, and subjective measures of trauma and stressful…

  1. Scientific advances provide opportunities to improve pediatric environmental health

    USGS Publications Warehouse

    Reddy, Michael M.; Reddy, Micaela B.; Reddy, Carol F.

    2004-01-01

    The health consequences of contaminants in the environment, with respect to the health of children and infants, recently have been dramatically brought to public attention by the motion pictures Erin Brockovich and A Civil Action. These productions focused public attention on the potential link between water contaminants and pediatric health, a continuing subject of public concern. As a consequence of the increasing production of new commercial chemicals, many chemicals have appeared in the scientific and public awareness as potential threats to health. These new or novel compounds eventually distribute in the environment and often are termed emerging contaminants. Gitterman and Bearer stated, "Children may serve as unwitting sentinels for society; they are often the youngest exposed to many environmental toxicants and may become the youngest in age to manifest adverse responses." The discipline of pediatric environmental health is still in its adolescence, but it will be increasingly important as new chemicals are generated and as more is learned about the health effects of chemicals already in commerce. Here, we provide an overview of recent advances in biomonitoring and environmental monitoring of environmental contaminants including emerging contaminants. Our purpose in writing this commentary is to make pediatricians aware of the current resources available for learning about pediatric environmental health and of ongoing research initiatives that provide opportunities to improve pediatric environmental health.

  2. Pediatric Stroke: A Review

    PubMed Central

    Tsze, Daniel S.; Valente, Jonathan H.

    2011-01-01

    Stroke is relatively rare in children, but can lead to significant morbidity and mortality. Understanding that children with strokes present differently than adults and often present with unique risk factors will optimize outcomes in children. Despite an increased incidence of pediatric stroke, there is often a delay in diagnosis, and cases may still remain under- or misdiagnosed. Clinical presentation will vary based on the child's age, and children will have risk factors for stroke that are less common than in adults. Management strategies in children are extrapolated primarily from adult studies, but with different considerations regarding short-term anticoagulation and guarded recommendations regarding thrombolytics. Although most recommendations for management are extrapolated from adult populations, they still remain useful, in conjunction with pediatric-specific considerations. PMID:22254140

  3. Normative perceptual estimates for 91 healthy subjects age 60–75: impact of age, education, employment, physical exercise, alcohol, and video gaming

    PubMed Central

    Wilms, Inge L.; Nielsen, Simon

    2014-01-01

    Visual perception serves as the basis for much of the higher level cognitive processing as well as human activity in general. Here we present normative estimates for the following components of visual perception: the visual perceptual threshold, the visual short-term memory (VSTM) capacity and the visual perceptual encoding/decoding speed (processing speed) of VSTM based on an assessment of 91 healthy subjects aged 60–75. The estimates were modeled from input from a whole-report assessment based on a theory of visual attention. In addition to the estimates themselves, we present correlational data, and multiple regression analyses between the estimates and self-reported demographic data and lifestyle variables. The regression statistics suggest that education level, video gaming activity, and employment status may significantly impact the encoding/decoding speed of VTSM but not the capacity of VSTM nor the visual perceptual threshold. The estimates will be useful for future studies into the effects of various types of intervention and training on cognition in general and visual attention in particular. PMID:25339932

  4. Pediatric fire deaths in Ontario

    PubMed Central

    Chen, Yingming Amy; Bridgman-Acker, Karen; Edwards, Jim; Lauwers, Albert Edward

    2011-01-01

    Abstract Objective To identify the predictors of residential fire deaths in the Ontario pediatric population using systematically collected data from the Office of the Chief Coroner. Design Retrospective cohort study. Setting Ontario. Participants Children younger than 16 years of age who died in accidental residential fires in Ontario between January 1, 2001, and December 31, 2006. Main outcome measures The study retrospectively reviewed the coroner’s case files for 60 subjects who qualified according to the selection criteria. Reviewed documents included the coroner’s investigation statements, autopsy reports, toxicology reports, fire marshal’s reports, police reports, and Children’s Aid Society (CAS) reports. Information on a range of demographic, behavioural, social, and environmental factors was collected. Statistical tests, including relative risk, relative risk confidence intervals, and χ2 tests were performed to determine the correlation between factors of interest and to establish their significance. Results Thirty-nine fire events resulting in 60 deaths occurred between 2001 and 2006. Fire play and electrical failures were the top 2 causes of residential fires. More fires occurred during the night (midnight to 9 am) than during the day (9 am to midnight). Nighttime fires were most commonly due to electrical failures or unattended candles, whereas daytime fires were primarily caused by unsupervised fire play and stove fires. Smoke alarms were present at 32 of 39 fire events (82%), but overall alarm functionality was only 54%. Children from families with a history of CAS involvement were approximately 32 times more likely to die in fires. Conclusion Risk factors for pediatric fire death in Ontario include smoke alarm functionality, fire play, fire escape behaviour, and CAS involvement. Efforts to prevent residential fire deaths should target these populations and risk factors, and primary care physicians should consider education around these

  5. Assessment of the contralesional corticospinal tract in early-onset pediatric hemiplegia: Preliminary findings.

    PubMed

    Hawe, Rachel L; Dewald, Jules P A

    2014-01-01

    While pediatric hemiplegia results from a unilateral lesion, the immature state of the brain at the time of injury increases the likelihood of observing changes in the non-lesioned hemisphere as well. The purpose of this preliminary study was to use diffusion tensor imaging to evaluate the contralesional corticospinal tracts in individuals with early-onset pediatric hemiplegia. Twelve individuals with pediatric hemiplegia and ten age-matched controls underwent diffusion tensor imaging (DTI). Corticospinal projections were reconstructed using probabilistic tractography for both the lesioned and contralesional side in pediatric hemiplegia as well as the dominant and non-dominant sides in control subjects. The contralesional tract was found to have decreased white matter integrity relative to control subjects. Compared to controls, the contralesional tract also showed increased tract volume. The increase in volume suggests the presence of ipsilateral corticospinal projections from the contralesional hemisphere that are maintained during development to control the paretic extremities. Decreases in integrity may be explained by diffuse damage or incomplete maturation. The findings of this study support the notion of bilateral motor involvement in pediatric hemiplegia, and the need to address bilateral neural changes as well as motor deficits in this population. PMID:25571199

  6. Pediatric sleep apnea

    MedlinePlus

    Sleep apnea - pediatric; Apnea - pediatric sleep apnea syndrome; Sleep-disordered breathing - pediatric ... During sleep, all of the muscles in the body become more relaxed. This includes the muscles that help keep ...

  7. Land cover transformation in two post-mining landscapes subjected to different ages of reclamation since dumping of spoils.

    PubMed

    Antwi, Effah K; Boakye-Danquah, John; Asabere, Stephen B; Takeuchi, Kazuhiko; Wiegleb, Gerhard

    2014-01-01

    Transformation of natural land cover (LC) into modified LC has become inevitable due to growing human needs. Nevertheless, landscape transformational patterns during reclamation of mine damaged lands remain vague. Our hypothesis was that post-mining landscapes with different ages since dumping become more diverse in LC transformation over time. The aim was to study the impact of landscape reclamation on land cover changes (LCC) in two post-mining landscapes. Land cover maps of 1988, 1991, 1995, 1998, 2000 and 2003 were produced from LANDSAT TM images of Schlabendorf Nord and Schlabendorf Süd and used to survey the changing landscape. Change detection extension was used to identify changes among land cover types (LCTs). Detrended correspondence analyses (DCA) ordination technique (CANOCO) aided study of similarity among LC distribution. Soil pH analysis was carried out to study effect of soil and climate conditions on LCC. The results show that visible patterns of increase and decrease in the LCTs occurred in both landscapes. Given two post-mining landscapes subjected to different ages of reclamation, clear differences in vegetation growth and LCC pattern would occur. At early stages of restoration, LCTs often have unstable conditions and experience more acute transformation depending on the level of land use intensity in space and time. LCCs were mostly due to progressive and reversed succession. Due to variation in post-mining landscape soil conditions, soil treatment during reclamation should be site specific. The comparative analysis of LCCs in Schlabendorf provides a framework for prioritizing land use planning options for sustainable management of post-mining landscapes in temperate ecosystems.

  8. Pediatric nutrition.

    PubMed

    Greco, Deborah S

    2014-03-01

    This article discusses pediatric nutrition in puppies and kittens. Supplementation of basic nutrients such as fat, protein, minerals, vitamins, and essential fatty acids of the bitch is essential for the proper growth and development of puppies during the lactation period. Milk replacers are compared for use in puppies and kittens. Supplements such as colostrum and probiotics for promotion of a healthy immune system and prevention or treatment of stress-induced and weaning diarrhea are also discussed. PMID:24580990

  9. Pediatric nutrition.

    PubMed

    Greco, Deborah S

    2014-03-01

    This article discusses pediatric nutrition in puppies and kittens. Supplementation of basic nutrients such as fat, protein, minerals, vitamins, and essential fatty acids of the bitch is essential for the proper growth and development of puppies during the lactation period. Milk replacers are compared for use in puppies and kittens. Supplements such as colostrum and probiotics for promotion of a healthy immune system and prevention or treatment of stress-induced and weaning diarrhea are also discussed.

  10. Loosely coupled level sets for retinal layers and drusen segmentation in subjects with dry age-related macular degeneration

    NASA Astrophysics Data System (ADS)

    Novosel, Jelena; Wang, Ziyuan; de Jong, Henk; Vermeer, Koenraad A.; van Vliet, Lucas J.

    2016-03-01

    Optical coherence tomography (OCT) is used to produce high-resolution three-dimensional images of the retina, which permit the investigation of retinal irregularities. In dry age-related macular degeneration (AMD), a chronic eye disease that causes central vision loss, disruptions such as drusen and changes in retinal layer thicknesses occur which could be used as biomarkers for disease monitoring and diagnosis. Due to the topology disrupting pathology, existing segmentation methods often fail. Here, we present a solution for the segmentation of retinal layers in dry AMD subjects by extending our previously presented loosely coupled level sets framework which operates on attenuation coefficients. In eyes affected by AMD, Bruch's membrane becomes visible only below the drusen and our segmentation framework is adapted to delineate such a partially discernible interface. Furthermore, the initialization stage, which tentatively segments five interfaces, is modified to accommodate the appearance of drusen. This stage is based on Dijkstra's algorithm and combines prior knowledge on the shape of the interface, gradient and attenuation coefficient in the newly proposed cost function. This prior knowledge is incorporated by varying the weights for horizontal, diagonal and vertical edges. Finally, quantitative evaluation of the accuracy shows a good agreement between manual and automated segmentation.

  11. Influence of Different Types of Resin Luting Agents on Color Stability of Ceramic Laminate Veneers Subjected to Accelerated Artificial Aging.

    PubMed

    Silami, Francisca Daniele Jardilino; Tonani, Rafaella; Alandia-Román, Carla Cecilia; Pires-de-Souza, Fernanda de Carvalho Panzeri

    2016-01-01

    The aim of this study was to evaluate the influence of accelerated aging (AAA) on the color stability of resin cements for bonding ceramic laminate veneers of different thicknesses. The occlusal surfaces of 80 healthy human molars were flattened. Ceramic laminate veneers (IPS e-max Ceram) of two thicknesses (0.5 and 1.0 mm) were bonded with three types of luting agents: light-cured, conventional dual and self-adhesive dual cement. Teeth without restorations and cement samples (0.5 mm) were used as control. After initial color evaluations, the samples were subjected to AAA for 580 h. After this, new color readouts were made, and the color stability (ΔE) and luminosity (ΔL) data were analyzed. The greatest color changes (p<0.05) occurred when 0.5 mm veneers were fixed with light-cured cement and the lowest when 1.0 mm veneers were fixed with conventional dual cement. There was no influence of the restoration thickness when the self-adhesive dual cement was used. When veneers were compared with the control groups, it was verified that the cement samples presented the greatest alterations (p<0.05) in comparison with both substrates and restored teeth. Therefore, it was concluded that the thickness of the restoration influences color and luminosity changes for conventional dual and light-cured cements. The changes in self-adhesive cement do not depend on restoration thickness.

  12. Electrically evoked and voluntary maximal isometric tension in relation to dynamic muscle performance in elderly male subjects, aged 69 years.

    PubMed

    Davies, C T; White, M J; Young, K

    1983-01-01

    The dynamic performance and electrically evoked mechanical properties of elderly triceps surae muscle have been investigated in 9 men, aged 69 yr. Dynamic performance consisted of cycling on a force bicycle and a vertical jump off two feet from a force platform. The results showed that the time to peak tension (TPT) and half relaxation time (1/2 RT) were significantly greater (p less than 0.001) by 30 ms and 22 ms and the supramaximal twitch (Pt) and tetanic (20 Hz-P020) tensions and maximal voluntary contraction (MVC) were less by 45 N (-33%), 708 N (-49%), and 899 N (-43%) in the elderly compared with young male control subjects. On the force platform, the height jumped (Ht), maximal force exerted (P), take-off velocity (VT), net impulse (NI) and peak power output (W) were less by 18.6 cm, 173 N, 0.9 ms-1, 52 Ns and 1120 w respectively. Similar differences of power, force and velocity were observed on the force bicycle. The reduction of W in the elderly was associated with the contractile characteristics of the leg muscle. The loss of contractile speed and capacity to to generate force in old people was reflected in their inability to develop power during the performance of a maximal vertical jump and cycling.

  13. Influence of Different Types of Resin Luting Agents on Color Stability of Ceramic Laminate Veneers Subjected to Accelerated Artificial Aging.

    PubMed

    Silami, Francisca Daniele Jardilino; Tonani, Rafaella; Alandia-Román, Carla Cecilia; Pires-de-Souza, Fernanda de Carvalho Panzeri

    2016-01-01

    The aim of this study was to evaluate the influence of accelerated aging (AAA) on the color stability of resin cements for bonding ceramic laminate veneers of different thicknesses. The occlusal surfaces of 80 healthy human molars were flattened. Ceramic laminate veneers (IPS e-max Ceram) of two thicknesses (0.5 and 1.0 mm) were bonded with three types of luting agents: light-cured, conventional dual and self-adhesive dual cement. Teeth without restorations and cement samples (0.5 mm) were used as control. After initial color evaluations, the samples were subjected to AAA for 580 h. After this, new color readouts were made, and the color stability (ΔE) and luminosity (ΔL) data were analyzed. The greatest color changes (p<0.05) occurred when 0.5 mm veneers were fixed with light-cured cement and the lowest when 1.0 mm veneers were fixed with conventional dual cement. There was no influence of the restoration thickness when the self-adhesive dual cement was used. When veneers were compared with the control groups, it was verified that the cement samples presented the greatest alterations (p<0.05) in comparison with both substrates and restored teeth. Therefore, it was concluded that the thickness of the restoration influences color and luminosity changes for conventional dual and light-cured cements. The changes in self-adhesive cement do not depend on restoration thickness. PMID:27007354

  14. Impact of malnutrition on pediatric risk of mortality score and outcome in Pediatric Intensive Care Unit

    PubMed Central

    Nangalu, Romi; Pooni, Puneet Aulakh; Bhargav, Siddharth; Bains, Harmesh Singh

    2016-01-01

    Objectives: This study was done to determine the effect of malnutrition on mortality in Pediatric Intensive Care Unit (PICU) and on the pediatric risk of mortality (PRISM) scoring. Subjects and Methods: This was a prospective study done over 1 year. There were total 400 patients (1 month 14 years), who were divided into cases with weight for age <3rd centile and controls with ≥3rd centile of WHO charts. Cases were subdivided into mild/moderate (61–80% of expected weight for age) and severe malnutrition (<60%). Results: Out of total, 38.5% patients were underweight, and malnutrition was more in infancy, 61/104, i.e. 58.5% (P - 0.003). There was no significant difference in vitals at admission. Cases needed prolonged mechanical ventilation (P - 0.0063) and hospital stay (P - 0.0332) compared to controls. Mean and median PRISM scores were comparable in both the groups, but mortality was significantly higher in severely malnourished (P value 0.027). Conclusion: Severe malnutrition is independently associated with higher mortality even with similar PRISM score. There is need to give an additional score to children with weight for age <60% of expected. PMID:27555691

  15. An emerging field of research: challenges in pediatric decision making.

    PubMed

    Lipstein, Ellen A; Brinkman, William B; Fiks, Alexander G; Hendrix, Kristin S; Kryworuchko, Jennifer; Miller, Victoria A; Prosser, Lisa A; Ungar, Wendy J; Fox, David

    2015-04-01

    There is growing interest in pediatric decision science, spurred by policies advocating for children's involvement in medical decision making. Challenges specific to pediatric decision research include the dynamic nature of child participation in decisions due to the growth and development of children, the family context of all pediatric decisions, and the measurement of preferences and outcomes that may inform decision making in the pediatric setting. The objectives of this article are to describe each of these challenges, to provide decision researchers with insight into pediatric decision making, and to establish a blueprint for future research that will contribute to high-quality pediatric medical decision making. Much work has been done to address gaps in pediatric decision science, but substantial work remains. Understanding and addressing the challenges that exist in pediatric decision making may foster medical decision-making science across the age spectrum.

  16. Pediatric suprasellar lesions

    PubMed Central

    Deopujari, C. E.; Kumar, Ashish; Karmarkar, V. S.; Biyani, N. K.; Mhatre, M.; Shah, N. J.

    2011-01-01

    Pediatric brain tumors have always been challenging as well as intriguing in their anatomical, surgical, and postsurgical management-related issues. They are a heterogeneous set of pathologies involving different age groups in childhood and also differ widely from their adult counterparts as far as adjuvant therapies are concerned. Though neurosurgeons across the world are radical in surgery for most of the pediatric tumors, it can often be at the cost of future quality of life in suprasellar tumors. As the time has gone by, the pendulum has swung toward rather conservative and maximal safe surgical resections with adjuvant therapies coming to the forefront. Hence, the aim is to achieve a good quality of life for these children along with a control of tumor growth (rather than cure) and to again tackle the tumors, if required, once these children reach adolescence or adulthood. We have reviewed the literature for different pediatric suprasellar tumors and discussed their current management giving our perspective with illustrative cases. PMID:22069431

  17. Changing policy and practice in the control of pediatric schistosomiasis.

    PubMed

    Mutapi, Francisca

    2015-03-01

    Schistosomiasis is a chronic disease that affects ∼200 million people. The extended health impact of the disease has been estimated to exceed that of malaria or tuberculosis and to be nearer to that of HIV/AIDS. Within endemic areas, children carry the heaviest burden of infection. Infection/disease is controlled by the treatment of infected subjects with the anthelminthic drug praziquantel. Global initiatives from Partners of Parasite Control, including the World Health Organization (WHO), advocate regular school-based deworming strategies to reduce the development of severe morbidity, promote school-child health and development, and improve the cognitive potential of children. Until recently, preschool-aged children were excluded from schistosome treatment, creating a health inequity in affected populations. In 2010, the WHO updated their recommendations for the treatment of schistosomiasis in preschool-aged children (ie, children aged ≤5 years). This change was the culmination of several decades of research on schistosome epidemiology, immunology, and pathology in this age group. The recent development of a pediatric formulation of praziquantel (soon to enter clinical trials) should advance control efforts in preschool-aged children, with the goal of including these children in preventative chemotherapy (as currently occurs for soil-transmitted helminths). This review discusses the research work supporting the WHO revision of recommendations for treating preschool-aged children, as well as current barriers and knowledge gaps in pediatric schistosomiasis control.

  18. The l-Isoaspartyl Protein Repair Methyltransferase Enhances Survival of Aging Escherichia coli Subjected to Secondary Environmental Stresses

    PubMed Central

    Visick, Jonathan E.; Cai, Hui; Clarke, Steven

    1998-01-01

    Like its homologs throughout the biological world, the l-isoaspartyl protein repair methyltransferase of Escherichia coli, encoded by the pcm gene, can convert abnormal l-isoaspartyl residues in proteins (which form spontaneously from asparaginyl or aspartyl residues) to normal aspartyl residues. Mutations in pcm were reported to greatly reduce survival in stationary phase and when cells were subjected to heat or osmotic stresses (C. Li and S. Clarke, Proc. Natl. Acad. Sci. USA 89:9885–9889, 1992). However, we subsequently demonstrated that those strains had a secondary mutation in rpoS, which encodes a stationary-phase-specific sigma factor (J. E. Visick and S. Clarke, J. Bacteriol. 179:4158–4163, 1997). We now show that the rpoS mutation, resulting in a 90% decrease in HPII catalase activity, can account for the previously observed phenotypes. We further demonstrate that a new pcm mutant lacks these phenotypes. Interestingly, the newly constructed pcm mutant, when maintained in stationary phase for extended periods, is susceptible to environmental stresses, including exposure to methanol, oxygen radical generation by paraquat, high salt concentrations, and repeated heating to 42°C. The pcm mutation also results in a competitive disadvantage in stationary-phase cells. All of these phenotypes can be complemented by a functional pcm gene integrated elsewhere in the chromosome. These data suggest that protein denaturation and isoaspartyl formation may act synergistically to the detriment of aging E. coli and that the repair methyltransferase can play a role in limiting the accumulation of the potentially disruptive isoaspartyl residues in vivo. PMID:9573145

  19. Gender Bias in U.S. Pediatric Growth Hormone Treatment.

    PubMed

    Grimberg, Adda; Huerta-Saenz, Lina; Grundmeier, Robert; Ramos, Mark Jason; Pati, Susmita; Cucchiara, Andrew J; Stallings, Virginia A

    2015-06-09

    Growth hormone (GH) treatment of idiopathic short stature (ISS), defined as height <-2.25 standard deviations (SD), is approved by U.S. FDA. This study determined the gender-specific prevalence of height <-2.25 SD in a pediatric primary care population, and compared it to demographics of U.S. pediatric GH recipients. Data were extracted from health records of all patients age 0.5-20 years with ≥ 1 recorded height measurement in 28 regional primary care practices and from the four U.S. GH registries. Height <-2.25 SD was modeled by multivariable logistic regression against gender and other characteristics. Of the 189,280 subjects, 2073 (1.1%) had height <-2.25 SD. No gender differences in prevalence of height <-2.25 SD or distribution of height Z-scores were found. In contrast, males comprised 74% of GH recipients for ISS and 66% for all indications. Short stature was associated (P < 0.0001) with history of prematurity, race/ethnicity, age and Medicaid insurance, and inversely related (P < 0.0001) with BMI Z-score. In conclusion, males outnumbered females almost 3:1 for ISS and 2:1 for all indications in U.S. pediatric GH registries despite no gender difference in height <-2.25 SD in a large primary care population. Treatment and/or referral bias was the likely cause of male predominance among GH recipients.

  20. Pediatric Genitourinary Oncology

    PubMed Central

    Dénes, Francisco Tibor; Duarte, Ricardo Jordão; Cristófani, Lílian Maria; Lopes, Roberto Iglesias

    2013-01-01

    Tumors of the kidney, bladder, prostate, testis, and adrenal represent a large part of the adult urologic practice, but are relatively infrequent in children. The natural history and management of these tumors in the pediatric age is different from that of the adults. As result of the successful work of several clinical trial groups in recent decades, there has been a significant improvement in their cure rates. The aim of this article is to review their most significant clinical aspects, as well as to present an update in their management. PMID:24400293

  1. Pediatric vitiligo.

    PubMed

    Silverberg, Nanette B

    2014-04-01

    Vitiligo is a disease of pigment loss. Most investigators currently consider vitiligo to be a disorder that occurs as a result of autoimmune destruction of melanocytes, supported by identification of antimelanocyte antibodies in many patients, and the presence of comorbid autoimmune disease in patients with and family members of individuals with vitiligo. One-half of vitiligo cases are of childhood onset. This article presents a current overview of pediatric vitiligo including comorbidities of general health, psychological factors, therapeutic options, and long-term health considerations.

  2. Older age is associated with greater central aortic blood pressure following the exercise stress test in subjects with similar brachial systolic blood pressure.

    PubMed

    Kobayashi, Masatake; Oshima, Kazutaka; Iwasaki, Yoichi; Kumai, Yuto; Avolio, Alberto; Yamashina, Akira; Takazawa, Kenji

    2016-08-01

    Brachial systolic pressure (BSP) is often monitored during exercise by the stress test; however, central systolic pressure (CSP) is thought to be a more direct measure of cardiovascular events. Although some studies reported that exercise and aging may play roles in changes of both BSP and CSP, the relationship between BSP and CSP with age following the exercise stress test remains unclear. The aim of this study was to evaluate the effect of age on the relationship between BSP and CSP measured after exercise. Ninety-six subjects underwent the diagnostic treadmill exercise stress test, and we retrospectively divided them into the following 3 groups by age: the younger age group (43 ± 4 years), middle age group (58 ± 4 years), and older age group (70 ± 4 years). Subjects exercised according to the Bruce protocol, to achieve 85 % of their age-predicted maximum heart rate or until the appearance of exercise-associated symptoms. BSP, CSP, and pulse rate (PR) were measured using a HEM-9000AI (Omron Healthcare, Japan) at rest and after exercise. BSP, CSP, and PR at rest were not significantly different among the 3 groups (p = 0.92, 0.21, and 0.99, respectively). BSP and PR immediately after exercise were not significantly different among the groups (p = 0.70 and 0.38, respectively). However, CSP immediately after exercise was 144 ± 18 mmHg (younger age), 149 ± 17 mmHg (middle age), and 158 ± 19 mmHg (older age). CSP in the older age group was significantly higher than that in the younger age group (p < 0.01). Despite similar BSPs in all age groups after exercise, CSP was higher in the older age group. Therefore, older subjects have a higher CSP after exercise, which is not readily assessed by conventional measurements of BSP.

  3. Pediatric Catheterization Protocol.

    PubMed

    Sheikh, N

    2015-07-01

    During the last decade, significant technological progress has taken place in the pediatric cardiac catheterization laboratory. Improved noninvasive diagnostic techniques have narrowed down the indications for diagnostic cardiac catheterization, and these techniques are now increasingly being applied to therapeutic procedures. Recently, concern has been raised about the appropriateness of some these applications in pediatric therapeutic cardiac catheterization because of sheer increase in number of techniques being applied, the increase in the number of persons and centers using these techniques, and the increase in the number of lesion types thought to be amenable to catheter therapy. In comparison to diagnostic cardiac catheterization, therapeutic catheterization require more time and resources, involve higher cost and risk, and demand more technical competence and expertise. Higher level of skill and competency is requirement for the operator who performs the various therapeutic catheterization techniques. These procedures should only be performed in institutions equipped with appropriate facilities, personnel, and programs. These considerations, combined with the rapid increase in the number of laboratories and cardiologists performing therapeutic catheterization procedures, raises concern about the safety of patients and human subjects as well as credentials of hospital and level of training and skill of physician involved. Therapeutic catheterization training programs vary in type, extent, and quality. Due to the complexity and potential risks of these procedures, specific skill and competency benchmark should be developed for personnel undergoing training in therapeutic catheterization as well as for those who continue to perform various procedures. Competency in therapeutic catheterization in children requires specific training. Pediatric cardiology fellows should receive therapeutic catheterization training in one or more centers that specializes in

  4. Coming of Age of Human Biology: A Study of the Birth and Growth of a Subject in the School Curriculum.

    ERIC Educational Resources Information Center

    Denny, M.

    1983-01-01

    Human biology is a school subject whose utilitarian/pedagogical traditions enjoy support at the School Certificate level but whose academic tradition is under threat at the General Certificate of Education level. An interpretation of the issues involved are discussed in terms of the subject's historical background. (JN)

  5. The urinary metabolomic profile following the intake of meals supplemented with a cocoa extract in middle-aged obese subjects.

    PubMed

    Ibero-Baraibar, Idoia; Romo-Hualde, Ana; Gonzalez-Navarro, Carlos J; Zulet, M Angeles; Martinez, J Alfredo

    2016-04-01

    Metabolomics is used to assess the compliance and bioavailability of food components, as well as to evaluate the metabolic changes associated with food consumption. This study aimed to analyze the effect of consuming ready-to-eat meals containing a cocoa extract, within an energy restricted diet on urinary metabolomic changes. Fifty middle-aged volunteers [30.6 (2.3) kg m(-2)] participated in a 4-week randomised, parallel and double-blind study. Half consumed meals supplemented with 1.4 g of cocoa extract (645 mg polyphenols) while the remaining subjects received meals without cocoa supplementation. Ready-to-eat meals were included within a 15% energy restricted diet. Urine samples (24 h) were collected at baseline and after 4 weeks and were analyzed by high-performance-liquid chromatography-time-of-flight-mass-spectrometry (HPLC-TOF-MS) in negative and positive ionization modes followed by multivariate analysis. The relationship between urinary metabolites was evaluated by the Spearman correlation test. Interestingly, the principal component analysis discriminated among the baseline group, control group at the endpoint and cocoa group at the endpoint (p < 0.01), although in the positive ionization mode the baseline and control groups were not well distinguished. Metabolites were related to theobromine metabolism (3-methylxanthine and 3-methyluric acid), food processing (L-beta-aspartyl-L-phenylalanine), flavonoids (2,5,7,3',4'-pentahydroxyflavanone-5-O-glucoside and 7,4'-dimethoxy-6-C-methylflavanone), catecholamine (3-methoxy-4-hydroxyphenylglycol-sulphate) and endogenous metabolism (uridine monophosphate). These metabolites were present in higher (p < 0.001) amounts in the cocoa group. 3-Methylxanthine and l-beta-aspartyl-L-phenylalanine were confirmed with standards. Interestingly, 3-methoxy-4-hydroxyphenylglycol-sulphate was positively correlated with 3-methylxanthine (rho = 0.552; p < 0.001) and 7,4'-dimethoxy-6-C-methylflavanone (rho = 447; p = 0.002). In

  6. Constructing and assessing brain templates from Chinese pediatric MRI data using SPM

    NASA Astrophysics Data System (ADS)

    Yin, Qingjie; Ye, Qing; Yao, Li; Chen, Kewei; Jin, Zhen; Liu, Gang; Wu, Xingchun; Wang, Tingting

    2005-04-01

    Spatial normalization is a very important step in the processing of magnetic resonance imaging (MRI) data. So the quality of brain templates is crucial for the accuracy of MRI analysis. In this paper, using the classical protocol and the optimized protocol plus nonlinear deformation, we constructed the T1 whole brain templates and apriori brain tissue data from 69 Chinese pediatric MRI data (age 7-16 years). Then we proposed a new assessment method to evaluate our templates. 10 pediatric subjects were chosen to do the assessment as the following steps. First, the cerebellum region, the region of interest (ROI), was located on both the pediatric volume and the template volume by an experienced neuroanatomist. Second, the pediatric whole brain was mapped to the template with affine and nonlinear deformation. Third, the parameter, derived from the second step, was used to only normalize the ROI of the child to the ROI of the template. Last, the overlapping ratio, which described the overlapping rate between the ROI of the template and the normalized ROI of the child, was calculated. The mean of overlapping ratio normalized to the classical template was 0.9687, and the mean normalized to the optimized template was 0.9713. The results show that the two Chinese pediatric brain templates are comparable and their accuracy is adequate to our studies.

  7. [Slowing down the rate of irreversible age-related atrophy of the thymus gland by atopic autotransplantation of its tissue, subjected to long-term cryoconservation].

    PubMed

    Kulikov, A V; Arkhipova, L V; Smirnova, G N; Novoselova, E G; Shpurova, N A; Shishova, N V; Sukhikh, G T

    2010-01-01

    An experimental procedure has been developed enabling to slow down the rate of irreversible atrophy of the thymus gland. The atopic autotransplantation of its tissue subjected to prolonged cryoconservation enables one to inhibit the aging of the organism with respect to several biochemical and immunological indicators.

  8. Age and gender correlation of gonial angle, ramus height and bigonial width in dentate subjects in a dental school in Far North Queensland

    PubMed Central

    Leversha, Jodi; McKeough, Glen; Myrteza, Adriana; Skjellrup-Wakefiled, Hannah; Welsh, Jordan

    2016-01-01

    Background This study aimed to determine if mandibular parameters (gonial angle, bigonial width and ramus height) measured from panoramic radiographs, can be used to determine a correlation with an individual’s age and gender in dentate subjects in Far North Queensland. Material and Methods The study utilised 2699 randomly selected panoramic radiographs of patients between the ages of 19-69 years, from which 220 fulfilled the inclusion criteria. Each panoramic radiograph was analysed and the above three parameters recorded and measured. These values were collated into appropriate age and gender groups and subjected to statistical analysis. Results The mean age of the participants was 44.1±14.41, with males being shown to have a statistically significant larger ramus height and bigonial width than females (P<0.0001 for both). Females, on the other hand, were shown to have a significantly larger gonial angle than males (P<0.0002). General trends revealed gonial angle to increase with age, whilst bigonial width and ramus height were shown to decrease with age. Conclusions The assessment of mandibular morphology through radiographic measurements may be useful in estimating an individual’s age and gender when comparing to a known population standard. Key words:Bigonial width, gonial angle, panoramic radiograph, ramus height. PMID:26855706

  9. Functional capacity of people with early osteoarthritis: a comparison between subjects from the cohort hip and cohort knee (CHECK) and healthy ageing workers

    PubMed Central

    van Ittersum, M. W.; Groothoff, J. W.; Oostveen, J. C. M.; Oosterveld, F. G. J.; van der Schans, C. P.; Soer, R.; Reneman, M. F.

    2010-01-01

    Objective The prevalence of osteoarthritis (OA) increases, but the impact of the disorder on peoples’ functional capacity is not known. Therefore, the objective of this study was to compare self-reported health status and functional capacity of subjects with early OA of hip and/or knee to reference data of healthy working subjects and to assess whether this capacity is sufficient to meet physical job demands. Methods Self-reported health status and functional capacity of 93 subjects from the Cohort Hip and Cohort Knee (CHECK) were measured using the Short-Form 36 Health Survey and 6 tests of the Work Well Systems Functional Capacity Evaluation. Results were compared with reference data from 275 healthy workers, using t-tests. To compare the functional capacity with job demands, the proportions of subjects with OA performing lower than the p5 of reference data were calculated. Results Compared to healthy workers, the subjects (mean age 56) from CHECK at baseline reported a significantly worse physical health status, whereas the women (n = 78) also reported a worse mental health status. On the FCE female OA subjects performed significantly lower than their healthy working counterparts on all 6 tests. Male OA subjects performed lower than male workers on 3 tests. A substantial proportion of women demonstrated functional capacities that could be considered insufficient to perform jobs with low physical demands. Conclusions Functional capacity and self-reported health of subjects with early OA of the hips and knees were worse compared to healthy ageing workers. A substantial proportion of female subjects did not meet physical job demands. PMID:20490537

  10. Pediatric en bloc kidney transplantation into pediatric recipients.

    PubMed

    Lau, Keith K; Berg, Gerre M; Schjoneman, Yolanda G; Perez, Richard V; Butani, Lavjay

    2010-02-01

    As a result of the ongoing shortage in organ supply, en bloc renal transplantation from small donors has become more common for adult recipients with ESRD. However, because of concern for higher complication rates and sub-optimal outcomes, it is not being performed in every center, and data describing its use in pediatric recipients are even more limited. We retrospectively studied three patients who have undergone en bloc renal transplantation at our center. Median age at transplantation was 16.7 yr with a median follow-up of 1.2 yr. Donor age ranged from nine to 49 months with weight ranging from 10 to 22 kg. There were no post-operative thrombotic complications. All grafts showed increased renal size at follow-up by ultrasound. There was no clinical or histological rejection at last follow-up. To the best of our knowledge, this is the first report on the outcomes of en bloc kidney transplantation from pediatric donors into pediatric recipients. Based on our experience, albeit very limited, we feel that en bloc renal transplantation from young donors is an acceptable and safe procedure with low complication rates in pediatric recipients and should be given consideration to minimize wait times on the wait list and to improve quality of life.

  11. Influence of aging temperature on the structure and mechanical properties of titanium alloy VT22 subjected to helical rolling

    NASA Astrophysics Data System (ADS)

    Mishin, I. P.; Naydenkin, E. V.; Ratochka, I. V.; Lykova, O. N.; Balushkina, M. A.

    2015-10-01

    The structure and mechanical properties of titanium alloy VT22 after helical rolling and subsequent aging was investigated. It is shown that the treatment leads to the formation of ultra-fine grain/subgrain structure in the alloy. The subsequent aging increases the ultimate strength and yield strength to 1640 and 1590 MPa respectively, while saving satisfactory plasticity (δ > 5%).

  12. Pediatric tracheomalacia.

    PubMed

    Fraga, Jose Carlos; Jennings, Russell W; Kim, Peter C W

    2016-06-01

    Tracheomalacia (TM) is defined as an increased collapsibility of the trachea due to structural anomalies of the tracheal cartilage and/or posterior membrane. Tracheomalacia has a wide range of etiologies but is most commonly present in children born with esophageal atresia and tracheal esophageal fistula. Clinical symptoms can range from minor expiratory stridor with typical barking cough to severe respiratory distress episodes to acute life-threatening events (ALTE). Although the majority of children have mild-to-moderate symptoms and will not need surgical intervention, some will need life-changing surgical treatment. This article examines the published pediatric literature on TM, discusses the details of clinical presentation, evaluation, diagnosis, and a variety of treatments. PMID:27301602

  13. Utility of hand-held echocardiography in outpatient pediatric cardiology management.

    PubMed

    Riley, Alan; Sable, Craig; Prasad, Aparna; Spurney, Christopher; Harahsheh, Ashraf; Clauss, Sarah; Colyer, Jessica; Gierdalski, Marcin; Johnson, Ashley; Pearson, Gail D; Rosenthal, Joanna

    2014-12-01

    Adult patient series have shown hand-held echocardiography (echo) units (HHE) to be accurate for rapid diagnosis and triage. This is the first study to evaluate the ability of HHE to inform decision making in outpatient pediatric cardiology. New pediatric cardiology patients in outpatient clinics staffed by six pediatric cardiologists (experience 1-17 years) were prospectively enrolled if an echocardiogram (echo) was ordered during their initial visit. After history and physical examination and before a standard echo, the cardiologists performed a bedside HHE examination (GE Vscan 1.7-3.8 MHz), documented findings, and made a clinical decision. Diagnoses and decisions based on HHE were compared with final management after the standard echo. The study enrolled 101 subjects (ages 9 days to 19 years). The cardiologists considered HHE imaging adequate for decision making for 80 of the 101 subjects. For 77 of the 80 subjects with acceptable HHE imaging (68/68 normal and 9/12 abnormal standard echoes), the HHE-based primary diagnoses and decisions agreed with the final management. The sensitivity of HHE was 75 % (95 % confidence interval [CI] 43-94 %) and the positive predictive value 100 % (95 % CI 66-100 %) for pediatric heart disease. The agreement between standard echocardiography and HHE imaging was substantial (κ = 0.82). Excluding one of the least experienced cardiologists, HHE provided the basis for correct cardiac diagnoses and management for all the subjects with acceptable HHE imaging (58/58 normal and 9/9 abnormal echoes). In outpatient pediatric cardiology, HHE has potential as a tool to complement physical examination. Further investigation is needed to evaluate how value improves with clinical experience.

  14. Current Treatment Strategies in Pediatric Alopecia Areata

    PubMed Central

    Wang, Etienne; Lee, Joyce SS; Tang, Mark

    2012-01-01

    Alopecia areata (AA) is a non-scarring autoimmune disease of the hair follicle that can present at any age. Pediatric cases are commonly seen in a dermatology clinic, and management can potentially be challenging, with a small proportion of cases experiencing a chronic relapsing course marked by distressing hair loss that can bring about significant psychosocial morbidity. We review the established treatments for pediatric alopecia areata, alongside second and third line therapies that have shown to be efficacious. We also offer a treatment algorithm as a guide to the treatment of pediatric AA. PMID:23248364

  15. Variations of the histomorphological characteristics of human skin of different body regions in subjects of different age.

    PubMed

    Kakasheva-Mazhenkovska, L; Milenkova, L; Gjokik, G; Janevska, V

    2011-01-01

    The aim of this paper was to create a reference model for the qualitative and quantitative characteristics of healthy human skin in different body regions and different life periods. For this purpose we have taken skin biopsy specimens from 15 different body regions: capillitium, forehead, cheeks, anterior neck, thorax, axilla, abdomen, back, gluteus, anterior arm, anterior forearm, palm, anterior leg, anterior lower leg and sole. The biopsies were histologically elaborated according to a standard paraffin technique, and the obtained histological slides were qualitatively and quantitatively analysed with the use of a computer system for image processing and analysis (Lucia M, Version 3, System for Image Processing and Analysis). The examinees were divided by age into five groups: from full-term infants up to the age of 1 year; from the age of 2 up to the age of 12 years; from the age of 13 up to the age of 22; from the age of 23 up to the age of 55; from the age of 56 up to the age of 73. In each exemplar were determined: the total skin thickness in each region at each age group, total thickness of the epidermis, total thickness of the corium, thickness of the papillary and reticular layers of the corium. In this period the thickening is about 4-4.5 times. The growth of the thickness comes as a result of the growth of the thickness of the reticular corium, values of which grow by 4-5 times. The height of the epidermis in newborns shows higher values than the second group (childhood). In the third and fourth group the values of the epidermis are from 1.5 to 2.5 times higher on those parts of the body which are uncovered and exposed to externalities. The essence of the changes that happen to the skin is structural final formation, which is turbulent and targeted in youth (in order to harmonize structural and functional abilities of the human organism) and in mature age to synchronize the function of the skin with the other systems of the organism.

  16. Radiation-induced meningiomas in pediatric patients

    SciTech Connect

    Moss, S.D.; Rockswold, G.L.; Chou, S.N.; Yock, D.; Berger, M.S.

    1988-04-01

    Radiation-induced meningiomas rarely have latency periods short enough from the time of irradiation to the clinical presentation of the tumor to present in the pediatric patient. Three cases of radiation-induced intracranial meningiomas in pediatric patients are presented. The first involved a meningioma of the right frontal region in a 10-year-old boy 6 years after the resection and irradiation of a 4th ventricular medulloblastoma. Review of our pediatric tumor cases produced a second case of a left temporal fossa meningioma presenting in a 15-year-old boy with a history of irradiation for retinoblastoma at age 3 years and a third case of a right frontoparietal meningioma in a 15-year-old girl after irradiation for acute lymphoblastic leukemia. Only three cases of meningiomas presenting in the pediatric age group after radiation therapy to the head were detected in our review of the literature.

  17. A prospective study of magnetic resonance imaging patterns of central nervous system infections in pediatric age group and young adults and their clinico-biochemical correlation

    PubMed Central

    Gupta, Kamini; Banerjee, Avik; Saggar, Kavita; Ahluwalia, Archana; Saggar, Karan

    2016-01-01

    Background: Infections of the central nervous system (CNS) are common and routinely encountered. Our aim was to evaluate the neuroimaging features of the various infections of the CNS so as to differentiate them from tumoral, vascular, and other entities that warrant a different line of therapy. Aims: Our aim was to analyze the biochemical and magnetic resonance imaging (MRI) features in CNS infections. Settings and Design: This was a longitudinal, prospective study over a period of 1½ years. Subjects and Methods: We studied cerebrospinal fluid (CSF) findings and MRI patterns in 27 patients of 0–20 years age group with clinical features of CNS infections. MRI was performed on MAGNETOM Avanto 18 Channel 1.5 Tesla MR machine by Siemens India Ltd. The MRI protocol consisted of diffusion-weighted and apparent diffusion coefficient imaging, turbo spin echo T2-weighted, spin echo T1-weighted, fluid-attenuated inversion recovery (FLAIR), and gradient-echo in axial, FLAIR in coronal, and T2-weighted in sagittal plane. Contrast-enhanced T1-weighted sequence and MR spectroscopy were done whenever indicated. Results and Conclusions: We found that most of the children belong to 1–10 years age group. Fungal infections were uncommon, mean CSF adenosine deaminase values specific for tuberculosis and mean CSF glucose-lowered in pyogenic. Hemorrhagic involvement of thalamus with/without basal ganglia and brainstem involvement may indicate Japanese encephalitis or dengue encephalitis. Diffusion restriction or hemorrhage in not expected in the brainstem afflicted lesions of rabies. Congenital cytomegalovirus can cause cortical malformations. T1 hyperintensities with diffusion restriction may represent viral encephalitis. Lesions of acute disseminated encephalomyelitis (ADEM) may mimic viral encephalitis. Leptomeningeal enhancement is predominant in pyogenic meningitis. Basilar meningitis in the presence of tuberculomas is highly sensitive and specific for tuberculosis. PMID

  18. Patterns of pulmonary perfusion scans in normal subjects. IV. The prevalence of abnormal scans in smokers 30 to 49 years of age

    SciTech Connect

    Fedullo, P.F.; Kapitan, K.S.; Brewer, N.S.; Ashburn, W.L.; Hartman, M.T.; Moser, K.M.

    1989-05-01

    The usefulness of ventilation-perfusion scans in the diagnosis of pulmonary embolism is limited by the wide range of pulmonary diseases that are associated with abnormal scans, and by the largely undetermined prevalence of abnormal scans in persons without cardiopulmonary disease. In prior studies, we found perfusion defects to be rarely present in young persons and in older nonsmokers. To determine if normal older smokers have a higher prevalence of abnormal ventilation and perfusion scans, we performed six-view /sup 99m/Tc perfusion (Q) scans and /sup 133/Xe ventilation (V) scans in 40 subjects 30 to 49 yr of age who had no known cardiopulmonary disease. Each subject had undergone a history, physical examination, electrocardiogram, spirometry, and posteroanterior chest roentgenogram prior to scanning. All V and Q scans were interpreted blindly and independently by two experienced readers. No subject demonstrated a lobar or segmental defect on two views. One subject had a matched subsegmental defect, and one subject had delayed washout from a subsegmental area of the right upper lobe during V scanning, with a normal Q scan. We conclude that abnormal V and Q scans are uncommon among normal smokers 30 to 49 yr of age.

  19. Determination of Appropriate Weight-Based Cutoffs for Empiric Cefazolin Dosing Using Data from a Phase 1 Pharmacokinetics and Safety Study of Cefazolin Administered for Surgical Prophylaxis in Pediatric Patients Aged 10 to 12 Years

    PubMed Central

    Schmitz, Michael L.; Blumer, Jeffrey L.; Cetnarowski, Wes

    2015-01-01

    Despite over 40 years of worldwide usage, relatively few data have been published on the pharmacokinetics of cefazolin in pediatric surgical patients. The primary objectives of this study were to examine the pharmacokinetics and safety of cefazolin in children 10 to 12 years of age (inclusive) receiving 1 or 2 g of cefazolin, based on body weight. This multiple-center, open-label study enrolled pediatric patients electively scheduled for surgical procedures who required cefazolin as part of their routine clinical management. Patients weighing ≥25 to <50 kg received a 1-g dose, and patients weighing ≥50 to ≤85 kg received a 2-g dose. Postdose pharmacokinetic and safety assessments were conducted following drug administration. Cefazolin concentration-time data were analyzed by using both noncompartmental and population pharmacokinetics methods. Monte Carlo simulations were performed to identify appropriate weight-based cutoffs for the dosing of children aged 10 to 17 years of age. Twelve patients were enrolled in this study and provided the requisite pharmacokinetic data. In general, cefazolin was well tolerated. The mean cefazolin terminal elimination half-life, clearance, and area under the concentration-time curve from time zero to infinity in this population were 1.95 h, 0.804 ml/min/kg, and 607 mg · h/liter, respectively. Patients weighing 50 to 60 kg exhibited elevated cefazolin exposures. Observed pharmacokinetic parameters and simulation results indicated that a weight-based cutoff of 60 kg is predicted to provide cefazolin exposure consistent with that observed in normal, healthy adults at recommended doses for surgical prophylaxis. (This study has been registered at ClinicalTrials.gov under registration no. NCT01904357.) PMID:25941220

  20. The Effects of Passive Smoking on the Six-Minute Walk Test in Obese Pediatric Cases

    PubMed Central

    Kaymaz, Nazan; Yıldırım, Şule; Tekin, Mustafa; Aylanç, Hakan; Battal, Fatih; Topaloğlu, Naci; Binnetoğlu, Fatih; Akbal, Ayla

    2014-01-01

    Objective: The aim of this study was to evaluate whether exposure to second-hand smoke affected the six-minute walk test (6MWT) of obese non-asthmatic pediatric cases. Methods: Obese pediatric patients (body mass index >95th p) with no existing co-morbidities were included in the study. Smoke exposure was assessed with a self-reported questionnaire completed by the parents. The subjects were divided into two groups: Group 1 consisting of obese children exposed to passive smoking and Group 2 of obese children not exposed to passive smoking. In addition to 6MWT, spirometric flow and volume, including forced expiratory volume in 1 s and peak expiratory flow rate, were also measured in all subjects. The results of the 6MWT were assessed to determine any association with passive smoking. Results: The study included 75 obese pediatric cases (40 male, 35 female) with a mean age of 9.06±0.97 years. The 6MWT results in Group 1 was 501.88±62.12 meters and in Group 2 559.63±72.93 meters. The difference was statistically significant (p=0.001). Conclusions: Passive smoking may negatively affect the respiratory and cardiovascular capacity in obese children, who are already at risk of lower cardiopulmonary function. The evaluation of 6MWT in these pediatric patients may be useful for monitoring and families should be warned about potential problems due to smoking. PMID:25541896

  1. Microstructure Evolution in a Cu-0.5Cr-0.2Zr Alloy Subjected to Equal Channel Angular Pressing, Rolling or Aging

    NASA Astrophysics Data System (ADS)

    Alexandrov, Igor V.; Sitdikov, Vil D.; Abramova, Marina M.; Sarkeeva, Elena A.; Wei, Kun Xia; Wei, Wei

    2016-10-01

    The evolution of microstructure in the Cu-0.5%Cr-0.2%Zr alloy subjected to thermomechanical treatment has been studied by means of the x-ray analysis. The workpieces have been subjected to 1, 2, 4 and 8 passes of equal channel angular pressing, plain cold rolling and aging treatment. The results of the XRD investigations reflect the evolution of the lattice parameter, the size of coherently scattering domains, the elastic microdistortions and the dislocation density in Cu matrix. The observed changes in the microstructure are explained by the competition between the developing defects and precipitation of the Cr phase particles from the Cu matrix.

  2. Microstructure Evolution in a Cu-0.5Cr-0.2Zr Alloy Subjected to Equal Channel Angular Pressing, Rolling or Aging

    NASA Astrophysics Data System (ADS)

    Alexandrov, Igor V.; Sitdikov, Vil D.; Abramova, Marina M.; Sarkeeva, Elena A.; Wei, Kun Xia; Wei, Wei

    2016-08-01

    The evolution of microstructure in the Cu-0.5%Cr-0.2%Zr alloy subjected to thermomechanical treatment has been studied by means of the x-ray analysis. The workpieces have been subjected to 1, 2, 4 and 8 passes of equal channel angular pressing, plain cold rolling and aging treatment. The results of the XRD investigations reflect the evolution of the lattice parameter, the size of coherently scattering domains, the elastic microdistortions and the dislocation density in Cu matrix. The observed changes in the microstructure are explained by the competition between the developing defects and precipitation of the Cr phase particles from the Cu matrix.

  3. [Pediatric retroperitoneal tumors].

    PubMed

    Benicio dos Santos, I; Benicio dos Santos, M

    1980-01-01

    The author has based his work "Retroperitoneals tumors in infancy and childhood" in 65 cases observed at "Hospital Martagao Gesteira", Salvador, Bahia, Brasil. 32 of the retroperitoneals tumors, either intrarenals or extrarenals, observed in infancy and childhood were Wilm's tumor, 22 neuroblastoma, 5 hydronephrosis, 2 multicystic kidney, 1 policystic kidney, 2 pancreatic cyst and 1 biliar cyst. Wilm's tumor had the highest incidence - 32 cases (49,2%); neuroblastoma was in the second place in incidence - 22 (33,8%) of the 65 cases of retroperitoneals tumors studied, were neuroblastoma. As registered by the author in previous paper, the neuroblastoma, on contrary of what is established in the specialized literature, not was: the most frequent abdominal tumors, in infancy and childhood, neither it was also the abdominal pediatric tumor which could match Wilm's tumor in incidence. The plain X ray film of the abdomen, the Excretory Urography, the Cavography and Arteriography, the Radiological Examination of the Stomach and Duodenum, of the Small Intestine and the Colons, contribute in a very important way to establish the topography (retro or intraperitoneal) of the pediatric abdominal tumors. The author emphasizes that the plain X ray film of the abdomen supply important elements for the conclusion concerning the localization of abdominal tumors, from the observation of a simple criterion - the retroperitoneals tumors obliterate the border of kidney, because they are placed in the same plan of the kidney, data which is not pointed out sufficiently by the authors who have studied the subject.

  4. The Relative Contribution of Health Status and Quality of Life Domains in Subjective Health in Old Age

    ERIC Educational Resources Information Center

    Prieto-Flores, Maria-Eugenia; Moreno-Jimenez, Antonio; Fernandez-Mayoralas, Gloria; Rojo-Perez, Fermina; Forjaz, Maria Joao

    2012-01-01

    To analyze the influence of different health status dimensions and quality of life (QoL) domains on older adults' subjective health, and to assess the role that residential satisfaction plays in these relationships. A QoL survey was conducted on a representative sample of the community-dwelling older adult population in Madrid province (Spain).…

  5. PEDIATRIC DELIRIUM AND ASSOCIATED RISK FACTORS: A SINGLE-CENTER PROSPECTIVE OBSERVATIONAL STUDY

    PubMed Central

    Gerber, Linda M.; Sun, Xuming; Kearney, Julia; Patel, Anita; Greenwald, Bruce

    2016-01-01

    Objective To describe a single-institution pilot study regarding prevalence and risk factors for delirium in critically ill children. Design A prospective observational study, with secondary analysis of data collected during the validation of a pediatric delirium screening tool, the Cornell Assessment of Pediatric Delirium (CAPD). Setting This study took place in the pediatric intensive care unit (PICU) at an urban academic medical center. Patients 99 consecutive patients, ages newborn to 21 years. Intervention Subjects underwent a psychiatric evaluation for delirium based on the DSM-IV criteria. Measurements and Main Results Prevalence of delirium in this sample was 21%. In multivariate analysis, risk factors associated with the diagnosis of delirium were presence of developmental delay, need for mechanical ventilation, and age 2-5 years. Conclusions In our institution, pediatric delirium is a prevalent problem, with identifiable risk factors. Further large-scale prospective studies are required to explore multi-institutional prevalence, modifiable risk factors, therapeutic interventions, and effect on long-term outcomes. PMID:25647240

  6. Centenarians’ offspring as a model of healthy aging: a reappraisal of the data on Italian subjects and a comprehensive overview

    PubMed Central

    Cevenini, Elisa; Pini, Elisa; Scurti, Maria; Vitale, Giovanni; Mari, Daniela; Caruso, Calogero; Sansoni, Paolo; Fanelli, Flaminia; Pasquali, Renato; Gueresi, Paola; Franceschi, Claudio; Monti, Daniela

    2016-01-01

    Within the scenario of an increasing life expectancy worldwide it is mandatory to identify determinants of healthy aging. Centenarian offspring (CO) is one of the most informative model to identify trajectories of healthy aging and their determinants (genetic and environmental), being representative of elderly in their 70th whose lifestyle can be still modified to attain a better health. This study is the first comprehensive investigation of the health status of 267 CO (mean age: 70.2 years) and adopts the innovative approach of comparing CO with 107 age-matched offspring of non-long-lived parents (hereafter indicated as NCO controls), recruited according to strict inclusion demographic criteria of Italian population. We adopted a multidimensional approach which integrates functional and cognitive assessment together with epidemiological and clinical data, including pro- and anti-inflammatory cytokines and adipokines, lipid profile, and insulin resistance. CO have a lower prevalence of stroke, cerebral thrombosis-hemorrhage, hypertension, hypercholesterolemia, and other minor diseases, lower BMI and waist circumference, a better functional and cognitive status and lower plasma level of FT4 compared to NCO controls. We conclude that a multidimensional approach is a reliable strategy to identify the health status of elderly at an age when interventions to modify their health trajectory are feasible. PMID:26979133

  7. Centenarians' offspring as a model of healthy aging: a reappraisal of the data on Italian subjects and a comprehensive overview.

    PubMed

    Bucci, Laura; Ostan, Rita; Cevenini, Elisa; Pini, Elisa; Scurti, Maria; Vitale, Giovanni; Mari, Daniela; Caruso, Calogero; Sansoni, Paolo; Fanelli, Flaminia; Pasquali, Renato; Gueresi, Paola; Franceschi, Claudio; Monti, Daniela

    2016-03-01

    Within the scenario of an increasing life expectancy worldwide it is mandatory to identify determinants of healthy aging. Centenarian offspring (CO) is one of the most informative model to identify trajectories of healthy aging and their determinants (genetic and environmental), being representative of elderly in their 70th whose lifestyle can be still modified to attain a better health. This study is the first comprehensive investigation of the health status of 267 CO (mean age: 70.2 years) and adopts the innovative approach of comparing CO with 107 age-matched offspring of non-long-lived parents (hereafter indicated as NCO controls), recruited according to strict inclusion demographic criteria of Italian population. We adopted a multidimensional approach which integrates functional and cognitive assessment together with epidemiological and clinical data, including pro- and anti-inflammatory cytokines and adipokines, lipid profile, and insulin resistance. CO have a lower prevalence of stroke, cerebral thrombosis-hemorrhage, hypertension, hypercholesterolemia, and other minor diseases, lower BMI and waist circumference, a better functional and cognitive status and lower plasma level of FT4 compared to NCO controls. We conclude that a multidimensional approach is a reliable strategy to identify the health status of elderly at an age when interventions to modify their health trajectory are feasible. PMID:26979133

  8. Sensitivity of plain radiography for pediatric cervical spine injury.

    PubMed

    Cui, Li W; Probst, Marc A; Hoffman, Jerome R; Mower, William R

    2016-10-01

    Pediatric patients with suspected cervical spine injuries (CSI) often receive a computed tomography (CT) scan as an initial diagnostic imaging test. While sensitive, CT of the cervical spine carries significant radiation and risk of lethal malignant transformation later in life. Plain radiographs carry significantly less radiation and could serve as the preferred screening tool, provided they have a high functional sensitivity in detecting pediatric patients with CSI. We hypothesize that plain cervical spine radiographs can reliably detect pediatric patients with CSI and seek to quantify the functional sensitivity of plain radiography as compared to CT. We analyzed data from the NEXUS cervical spine study to assess the sensitivity of plain radiographs in the evaluation of CSI. We identified all pediatric patients who underwent plain radiographic imaging, and all pediatric patients found to have CSI. We then determined the sensitivity of plain radiographs in detecting pediatric patients with CSI. We identified 44 pediatric patients with CSI in the dataset with age ranging from 2 to 18 years old. Thirty-two of the 44 pediatric patients received cervical spine plain films as a part of their workup. Plain films were able to identify all 32 pediatric patients with CSI to yield a sensitivity of 100 % in detecting injury victims (95 % confidence interval 89.1-100.0 %). Plain radiography was highly sensitive for the identification of CSI in our cohort of pediatric patients and is useful as a screening tool in the evaluation of pediatric CSI. PMID:27321014

  9. The Biology of Aging: Citizen Scientists and Their Pets as a Bridge Between Research on Model Organisms and Human Subjects.

    PubMed

    Kaeberlein, M

    2016-03-01

    A fundamental goal of research into the basic mechanisms of aging is to develop translational strategies that improve human health by delaying the onset and progression of age-related pathology. Several interventions have been discovered that increase life span in invertebrate organisms, some of which have similar effects in mice. These include dietary restriction and inhibition of the mechanistic target of rapamycin by treatment with rapamycin. Key challenges moving forward will be to assess the extent to which these and other interventions improve healthy longevity and increase life span in mice and to develop practical strategies for extending this work to the clinic. Companion animals may provide an optimal intermediate between laboratory models and humans. By improving healthy longevity in companion animals, important insights will be gained regarding human aging while improving the quality of life for people and their pets. PMID:26077786

  10. Find a Pediatric Dentist

    MedlinePlus

    ... Litch's Law Log HIPAA Forms Practice Management and Marketing Newsletter Webinar Materials Member Resources Membership Directory Awards ... Archives Access Pediatric Dentistry Today Practice Management and Marketing Newsletter Pediatric Dentistry Journal Open Access Articles Policies & ...

  11. Nuances in pediatric trauma.

    PubMed

    Kenefake, Mary Ella; Swarm, Matthew; Walthall, Jennifer

    2013-08-01

    Pediatric trauma evaluation mimics adult stabilization in that it is best accomplished with a focused and systematic approach. Attention to developmental differences, anatomic and physiologic nuances, and patterns of injury equip emergency physicians to stabilize and manage pediatric injury.

  12. Therapeutic Hypothermia after Pediatric Cardiac Arrest Trials: The Vanguard Phase Experience and Implications for Other Trials

    PubMed Central

    Pemberton, Victoria L.; Browning, Brittan; Webster, Angie; Dean, J. Michael; Moler, Frank W.

    2012-01-01

    Objective To determine whether an 18-month vanguard phase, in the Therapeutic Hypothermia after Pediatric Cardiac Arrest (THAPCA) trials, confirmed study feasibility and patient safety, a prerequisite to continued funding by the sponsor. Design Randomized controlled trial Setting Pediatric intensive care and pediatric cardiac care units in 15 clinical sites in the United States and Canada Patients Children, aged 48 hours to 18 years of age, with return of circulation after cardiac arrest Interventions Therapeutic hypothermia versus therapeutic normothermia Measurements and Main Results The first 15 of 20 potential sites to obtain IRB and subcontract approvals were selected as vanguard sites. IRB approvals were obtained 92 days (median, interquartile range [IQR] 65–114) and subcontracts signed 34 days (IQR 20–48) after distribution. Sites screened subjects 13 days (IQR 9–21) and enrolled the first subjects 64 days (IQR 13–154) after study launch. The recruitment milestone was reached four months ahead of schedule with no safety concerns identified. Overall recruitment in this ongoing trial remains on target. Conclusions The THAPCA vanguard phase proved beneficial for the investigators and funding agency. Since complex multicenter trials are rarely ready to launch when grant funds are received, the vanguard allowed time to refine the protocol and recruitment approaches. Competition for vanguard positions led to expedient IRB and subcontract completion. Early success and sustained momentum contributed to recruitment at or above goals. Financial risks to the sponsor were minimized by tying funding for the full trial to achieving pre-specified milestones. A vanguard phase may be a desirable strategy for the successful conduct of other complex clinical trials. Clinical Trial Registration NCT00880087 and NCT00878644 http://clinicaltrials.gov/ct2/show/NCT00880087?term=pediatric+hypothermia&rank=4 http://clinicaltrials.gov/ct2/show/NCT00878644?term=pediatric

  13. Precipitation of β' phase and hardening in dental-casting Ag-20Pd-12Au-14.5Cu alloys subjected to aging treatments.

    PubMed

    Kim, Yonghwan; Niinomi, Mitsuo; Hieda, Junko; Nakai, Masaaki; Cho, Ken; Fukui, Hisao

    2014-03-01

    The age-hardening behavior of the dental-casting Ag-20Pd-12Au-14.5Cu alloy subjected to aging treatment at around 673K is well known, and this hardening has been widely employed in various applications. To date, the age-hardening of this alloy has been explained to attribute to the precipitation of a β phase, which is a B2-type ordered CuPd phase or PdCuxZn1-x phase. In this study, results obtained from microstructural observations using a transmission electron microscopy and a scanning transmission electron microscopy revealed that a fine L10-type ordered β' phase precipitated in the matrix and a coarse-structure region (consisting of Ag- and Cu-rich regions) appeared after aging treatment at 673K and contributed to increase in hardness. The microstructure of the coarse β phase, which existed before aging treatment, did not change by aging treatment. Thus, it is concluded that the fine β' phase precipitated by aging treatment contributed more to increase in hardness than the coarse-structure region and coarse β phase.

  14. Pediatric spinal trauma.

    PubMed

    Huisman, Thierry A G M; Wagner, Matthias W; Bosemani, Thangamadhan; Tekes, Aylin; Poretti, Andrea

    2015-01-01

    Pediatric spinal trauma is unique. The developing pediatric spinal column and spinal cord deal with direct impact and indirect acceleration/deceleration or shear forces very different compared to adult patients. In addition children are exposed to different kind of traumas. Moreover, each age group has its unique patterns of injury. Familiarity with the normal developing spinal anatomy and kind of traumas is essential to correctly diagnose injury. Various imaging modalities can be used. Ultrasound is limited to the neonatal time period; plain radiography and computer tomography are typically used in the acute work-up and give highly detailed information about the osseous lesions. Magnetic resonance imaging is more sensitive for disco-ligamentous and spinal cord injuries. Depending on the clinical presentation and timing of trauma the various imaging modalities will be employed. In the current review article, a summary of the epidemiology and distribution of posttraumatic lesions is discussed in the context of the normal anatomical variations due to progressing development of the child. PMID:25512255

  15. Pediatric optic neuritis.

    PubMed

    Yeh, E Ann; Graves, Jennifer S; Benson, Leslie A; Wassmer, Evangeline; Waldman, Amy

    2016-08-30

    Optic neuritis (ON) is a common presenting symptom in pediatric CNS demyelinating disorders and may be associated with dramatic visual loss. Knowledge regarding clinical presentation, associated diseases, therapy, and outcomes in ON in children has grown over the past decade. These studies have shown that younger children (<10 years of age) are more likely to present with bilateral ON and older children with unilateral ON. Furthermore, studies focusing on visual recovery have shown excellent recovery of high-contrast visual acuity in the majority of children, but functional and structural studies have shown evidence of irreversible injury and functional decline after ON in children. Although randomized controlled treatment trials have not been performed in children and adolescents with ON, standard of care suggests that the use of high-dose pulse steroids is safe and likely effective. This article reviews current knowledge about the clinical presentation and management of pediatric ON, with attention to associated syndromes and evaluative tools that may inform diagnosis and interventions. PMID:27572862

  16. Abdominal emergencies in pediatrics.

    PubMed

    Coca Robinot, D; Liébana de Rojas, C; Aguirre Pascual, E

    2016-05-01

    Abdominal symptoms are among the most common reasons for pediatric emergency department visits, and abdominal pain is the most frequently reported symptom. Thorough history taking and physical examination can often reach the correct diagnosis. Knowing the abdominal conditions that are most common in each age group can help radiologists narrow the differential diagnosis. When imaging tests are indicated, ultrasonography is usually the first-line technique, enabling the diagnosis or adding relevant information with the well-known advantages of this technique. Nowadays, plain-film X-ray studies are reserved for cases in which perforation, bowel obstruction, or foreign body ingestion is suspected. It is also important to remember that abdominal pain can also occur secondary to basal pneumonia. CT is reserved for specific indications and in individual cases, for example, in patients with high clinical suspicion of abdominal disease and inconclusive findings at ultrasonography. We review some of the most common conditions in pediatric emergencies, the different imaging tests indicated in each case, and the imaging signs in each condition.

  17. The Bender Gestalt Test: A Review of Reported Research with School-Age Subjects, 1966-1977

    ERIC Educational Resources Information Center

    Buckley, Pepper D.

    1978-01-01

    The past 11 years of published research investigating the use of the Bender Gestalt Test with school-age children are reviewed. Seen as a psychometric instrument, scored according to standardized procedures, this recent work does not conclusively support use of the test for prediction of school achievement or emotional disturbance. (Author)

  18. The Relationship Between Maillard Reaction Product Formation and the Strength of Griege Yarns Subjected to Accelerated Ageing Conditions

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Previous work examining the effect of ageing on cotton fiber surface chemical and HVI properties, yarn processing performance, and yarn quality showed that cotton bales stored for extended periods exhibit significant changes in a number of these variables including primarily surface sugar content, H...

  19. Orange juice improved lipid profile and blood lactate of overweight middle-aged women subjected to aerobic training

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This study evaluated the influence of regular consumption of orange juice associated with aerobic exercise on the lipid profile of middle aged women, previously sedentary. Twenty-six women, 30 to 55 years old, volunteered to consume orange juice daily for 3 months and participate in an aerobic train...

  20. Digestible Lysine Requirements of Male Broilers From 14 to 28 Days of Age Subjected to Different Environmental Conditions

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Dietary amino acid requirements are influenced by environmental conditions. Two experiments examined growth responses of Ross × Ross TP 16 male broilers fed diets varying in digestible (dig) Lys concentrations from 14 to 28 d of age under different environmental conditions. Experiment 1 was conduc...

  1. Dietary Lysine Responses of Male Broilers From 14 to 28 Days of Age Subjected to Different Environmental Conditions

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Dietary amino acid requirements are influenced by environmental conditions. Two experiments examined growth responses of Ross × Ross TP 16 male broilers fed diets varying in digestible (dig) Lys concentrations from 14 to 28 days of age under different environmental conditions. Experiment 1 was condu...

  2. Modulation of the phenolic composition and colour of red wines subjected to accelerated ageing by controlling process variables.

    PubMed

    González-Sáiz, J M; Esteban-Díez, I; Rodríguez-Tecedor, S; Pérez-Del-Notario, N; Arenzana-Rámila, I; Pizarro, C

    2014-12-15

    The aim of the present work was to evaluate the effect of the main factors conditioning accelerated ageing processes (oxygen dose, chip dose, wood origin, toasting degree and maceration time) on the phenolic and chromatic profiles of red wines by using a multivariate strategy based on experimental design methodology. The results obtained revealed that the concentrations of monomeric anthocyanins and flavan-3-ols could be modified through the application of particular experimental conditions. This fact was particularly remarkable since changes in phenolic profile were closely linked to changes observed in chromatic parameters. The main strength of this study lies in the possibility of using its conclusions as a basis to make wines with specific colour properties based on quality criteria. To our knowledge, the influence of such a large number of alternative ageing parameters on wine phenolic composition and chromatic attributes has not been studied previously using a comprehensive experimental design methodology.

  3. Relation of optic disc topography and age to thickness of retinal nerve fibre layer as measured using scanning laser polarimetry, in normal subjects

    PubMed Central

    Toprak, A. B.; Yilmaz, O. F.

    2000-01-01

    AIMS—To evaluate the relation of the optic nerve head topographic measurements and age with the thickness of the retinal nerve fibre layer (RNFL) in normal Caucasoid subjects by means of scanning laser polarimetry and tomography.
METHODS—Topographic optic disc measurements and RNFL thickness values of 38 normal Caucasoid subjects of both sexes aged 20 to 78 were measured using a confocal scanning laser ophthalmoscope and a confocal scanning laser polarimeter. One eye was randomly selected for statistical analysis. The effects of optic disc size, age, and optic disc head topographic measurements of total and regional RNFL thickness were evaluated.
RESULTS—Age showed a significant correlation with the integral of the total RNFL thickness (R=−0.341, p<0.05). The optic disc size showed a significant correlation with the integral of the total, superior, and inferior quadrant RNFL thickness (R=0.425, p<0.01), (R=0.361, p<0.05), (R=0.468, p<0.05). Neuroretinal rim area (NRA) had a correlation with the superior and inferior quadrant RNFL thickness values (R=0.339, p<0.05) (R=0.393, p<0.05). There was no significant correlation between the other optic disc topographic measurements and RNFL thickness values (p>0.05).
CONCLUSION—The thickness of total as well as superior and inferior quadrant peripapillary RNFL as measured by scanning laser polarimetry increased significantly with an increase in optic disc size. The cross sectional area occupied by superior and inferior polar RNFL increased significantly with an increase in NRA. The total cross sectional area occupied by RNFL decreased significantly with an increase in age. The effects of optic disc size, age, and NRA should be considered when the peripapillary RNFL thickness is evaluated.

 PMID:10781510

  4. Ultrasound assessment of the caliber of the arteries in the lower extremities in healthy persons – the dependency on age, sex and morphological parameters of the subjects

    PubMed Central

    Ustymowicz, Andrzej; Krysiuk, Kamil; Witkowski, Paweł; Zonenberg, Mateusz; Dobrzycki, Konrad; Łebkowska, Urszula

    2012-01-01

    Aim The aim of this paper was to evaluate the caliber of the following arteries in the lower extremities: the common femoral artery, superficial femoral artery, popliteal artery, posterior tibial artery and dorsalis pedis artery and to determine the relation of the calibers to age, sex and morphological parameters of the body such as weight, height and BMI of the subject. Material Two hundred and twenty-eight healthy persons aged 18–81 were examined (average ±SD; 43.1±16.71): 134 women aged 19–74 (43.2±15.63) and 94 men aged 18–81 (43±18.22). Methods The study was conducted with the use of a linear probe of 7.5 MHz frequency. The vascular caliber was assessed after the color map (color Doppler) was placed on a B-mode image. Results The average and standard deviation values for the calibers of examined vessels were determined. The calibers of all vessels examined in the group of men were statistically significantly larger than those in the group of women. No statistically significant differences between the calibers of the right and left sides were determined. The statistically significant correlations were specified between the age and the caliber of the examined vessels; positive for large femoral arteries and negative for the arteries of the crus and foot. Positive, statistically significant correlations between the caliber and the height, weight and BMI were also reported. Conclusions The reported calibers of the arteries in the lower extremities and their relation to age, sex and morphological parameters of the subjects enable the differentiation of the physiological remodeling of the vessels from the pathological processes in e.g. atherosclerosis or hypertension. PMID:26675343

  5. Effectiveness of zinc gluconate glycine lozenges (Cold-Eeze) against the common cold in school-aged subjects: a retrospective chart review.

    PubMed

    McElroy, Betty Howell; Miller, Shelley Porter

    2002-01-01

    Of the 62 million common colds requiring medical attention in the United States each year, more than 80% affect school-aged children. Controlled clinical trials have demonstrated the effectiveness of zinc gluconate glycine lozenges (Cold-Eeze) in reducing cold duration. The objective of this study was to determine the effectiveness of zinc gluconate glycine lozenges in reducing the duration and severity of colds in school-aged subjects and to identify the benefits of prophylactic administration of zinc gluconate glycine lozenges in reducing the occurrence of colds. The medical charts of subjects enrolled at Utah's Heritage Center before and after the introduction of zinc gluconate glycine lozenges (between January 1998 and August 2001) were reviewed to identify those who experienced cold signs or symptoms. Two or more prespecified signs or symptoms on the same day identified a cold and, along with patient or medical staff reports and use of cold medications, were used to determine cold start and resolution dates. Results from subjects who did or did not take study treatment were compared statistically to determine the prophylactic effects of lozenge use. Effects of zinc gluconate glycine lozenges on the need for antibiotic therapy were also analyzed. The review encompassed 496 records. Treatment with zinc gluconate glycine lozenges significantly decreased cold duration (7.5 versus 9.0 days for nonuse; P < 0.0001). Prophylaxis also significantly reduced the median number of colds per year (0.0 versus 1.3; P < 0.001) and concomitant antibiotic use to manage colds (4.1% versus 36.2%; P < 0.0001). Therapy with zinc gluconate glycine lozenges significantly reduced cold duration and antibiotic use in school-aged subjects. Prophylactic administration also significantly decreased cold frequency. PMID:12424502

  6. Normal weight obesity and mortality in United States subjects ≥60 years of age (from the Third National Health and Nutrition Examination Survey).

    PubMed

    Batsis, John A; Sahakyan, Karine R; Rodriguez-Escudero, Juan P; Bartels, Stephen J; Somers, Virend K; Lopez-Jimenez, Francisco

    2013-11-15

    Current body mass index (BMI) strata likely misrepresent the accuracy of true adiposity in older adults. Subjects with normal BMI with elevated body fat may metabolically have higher cardiovascular and overall mortality than previously suspected. We identified 4,489 subjects aged ≥60 years (BMI = 18.5 to 25 kg/m(2)) with anthropometric and bioelectrical impedance measurements from the National Health and Nutrition Examination Surveys III (1988 to 1994) and mortality data linked to the National Death Index. Normal weight obesity (NWO) was classified in 2 ways: creation of tertiles with highest percentage of body fat and body fat percent cutoffs (men >25% and women >35%). We compared overall and cardiovascular mortality rates, models adjusted for age, gender, smoking, race, diabetes, and BMI. The final sample included 1,528 subjects, mean age was 70 years, median (interquartile range) follow-up was 12.9 years (range 7.5 to 15.3) with 902 deaths (46.5% cardiovascular). Prevalence of NWO was 27.9% and 21.4% in men and 20.4% and 31.3% in women using tertiles and cutoffs, respectively. Subjects with NWO had higher rates of abnormal cardiovascular risk factors. Lean mass decreased, whereas leptin increased with increasing tertile. There were no gender-specific differences in overall mortality. Short-term mortality (<140 person-months) was higher in women, whereas long-term mortality (>140 person-months) was higher in men. We highlight the importance of considering body fat in gender-specific risk stratification in older adults with normal weight. In conclusion, NWO in older adults is associated with cardiometabolic dysregulation and is a risk for cardiovascular mortality independent of BMI and central fat distribution.

  7. Resources for pediatric drug information.

    PubMed

    Zenk, K E

    1990-10-01

    Finding information on the use of drugs fro infants and children is becoming easier with the publication of excellent resources for pediatric and neonatal drug information. Useful pediatric texts and journals are listed. Texts are graded A and B. Category A books would be useful to include in a basic pharmacy library; Category B books are more comprehensive but expensive, or texts that are not as highly recommended as those in Category A. Some of the resources listed include: (1) Pediatrics--Nelson Textbook of Pediatrics, Rudolph's Pediatrics, Current Pediatric Diagnosis and Treatment, Manual of Pediatric Therapeutics; (2) Dosage Guides--The Pediatric Drug Handbook, Harriet Lane Handbook, Problems in Pediatric Drug THerapy; (3) Intensive Care--Textbook of Pediatric Intensive Care; (4) Infectious Disease--Report of the Committee on Infectious Diseases, Pocketbook of Pediatric Antimicrobial Therapy; (5) Poisoning--Handbook of Poisoning, Medical Toxicology; (6) Parenteral Nutrition--Manual of Pediatric Parenteral Nutrition; (7) Pregnancy and Lactation--Drugs in Pregnancy and Lactation; (8) Compounding--Handbook on Extemporaneous Formulation; (9) IV Administration--Guidelines for Administration of Intravenous Medications to Pediatric Patients; (1) Neonatology--Schaffers Diseases of the Newborn, Neonatology, Basic Management, On-Call Problems, Diseases, Drugs, Drug Therapy in Infants; (11) Pediatric Journals--Pediatrics, Journal of Pediatrics, American Journal of Diseases of Children, Pediatric Infectious Disease Journal, Pediatric Alert, Clinics in Perinatology, Pediatric Clinics of North America, Pediatric Clinical Oncology Journal, and Pediatric Surgery.

  8. Inflammatory cytokines in pediatric obstructive sleep apnea

    PubMed Central

    Huang, Yu-Shu; Guilleminault, Christian; Hwang, Fang-Ming; Cheng, Chuan; Lin, Cheng-Hui; Li, Hsueh-Yu; Lee, Li-Ang

    2016-01-01

    Abstract Pediatric obstructive sleep apnea (OSA) is associated with chronic systemic inflammation and with cognitive impairments. This study aimed to investigate the status of proinflammatory cytokines, particularly interleukin 17 (IL-17) and interleukin 23 (IL-23) and cognition in pediatric OSA. Controls and OSA children participated in the study. Exclusion criteria were adenotonsillectomy, heart, neurological and severe psychiatric diseases, craniofacial syndromes, and obesity. Polysomnogram was followed by serum testing for inflammatory markers and neurocognitive tests such as continuous performance task (CPT) and Wisconsin card sorting test, questionnaires, analyses of plasma high-sensitivity C-reactive protein (HS-CRP), tumor necrosis factor alpha (TNF-α), interleukin 1 (IL-1), interleukin 6 (IL-6), IL-17, and IL-23. Seventy-nine, 4 to 12-year-old subjects in 2 groups ended the study: 47 nonobese OSA children (mean age = 7.84 ± 0.56 years, body mass index [BMI] = 16.95 ± 0.47 kg/m2, BMI z-score = 0.15 ± 0.21, and mean apnea–hypopnea index [AHI] = 9.13 ± 1.67 events/h) and 32 healthy control children (mean age = 7.02 ± 0.65 years, with BMI = 16.55 ± 0.58 kg/m2, BMI z-score = −0.12 ± 0.27, and mean AHI = 0.41 ± 0.07 event/h) were enrolled. Serum cytokine analyses showed significantly higher levels of HS-CRP, IL-17, and IL-23 in OSA children (P = 0.002, P = 0.024, and P = 0.047). Regression test showed significant influence of HS-CRP, TNF-α, IL-6, IL-17, and specifically IL-23, with the continuous performance test and Wisconsin card sorting test. OSA children have abnormal levels of IL-17, an interleukin related to T helper 17 cells, a T helper cell involved in development of autoimmunity and inflammation. This high expression level may contribute to the complications of pediatric OSA; we also found a significant influence of inflammatory cytokines, particularly IL-23, on abnormal neurocognitive testing. PMID

  9. NOx Storage-Reduction Characteristics of Ba-Based Lean NOx Trap Catalysts Subjected to Simulated Road Aging

    SciTech Connect

    Ji, Yaying; Fisk, Courtney; Easterling, Vencon; Graham, Uschi; Poole, Adam; Crocker, Mark; Choi, Jae-Soon; Partridge Jr, William P; Wilson, Karen

    2010-01-01

    Although Lean NO{sub x} Trap (LNT) catalyst technology has made significant strides in recent years, the issue of LNT durability remains problematic. Following on from our previous research concerning the effect of ceria addition on LNT preformance, in this study we focus on the role of ceria in ameliorating the deterioration of Ba-based LNT catalysts during aging. Indeed, we have observed that spectacular improvements in LNT durability can be achieved through the incorporation of CeO{sub 2}-ZrO{sub 2} into the LNT formulation, and, to a lesser extent, La-stabilized ceria.

  10. Income and Subjective Well-Being: New Insights from Relatively Healthy American Women, Ages 49-79

    PubMed Central

    Wyshak, Grace

    2016-01-01

    The interests of economists, psychologists, social scientists and others on the relations of income, demographics, religion and subjective well-being, have generated a vast global literature. It is apparent that biomedical research has focused on white with men. The Women’s Health Initiative and Observational Study (WHI OS) was initiated in 1992. The OS represents the scientific need for social priorities to improve the health and welfare of women; it includes 93.676 relatively healthy postmenopausal women, 49 to 79, from diverse backgrounds. The objective of this study is to examine how lifestyle and other factors influence women’s health. Data from the WHI OS questionnaire were analyzed. Statistical methods included descriptive statistics square, correlations, linear regression and analyses of covariance (GLM). New findings and insights relate primarily to general health, religion, club attendance, and likelihood of depression. The most important predictor of excellent or very good health is quality of life and general health is a major predictor of quality of life. A great deal of strength and comfort from religion was reported by 62.98% of the women, with little variation by denomination. More from religion related to poorer health, and less likelihood of depression. Religion and lower income are in accord with of across country studies. Attendance at clubs was associated with religion and with all factors associated with religion, except income. Though general health and likelihood of depression are highly correlated, better health is associated with higher income; however, likelihood of depression is not associated with income—contrary to conventional wisdom about socioeconomic disparities and mental health. Subjective well-being variables, with the exception of quality of life, were not associated with income. Social networks—religion and clubs—among a diverse population, warrant further attention from economists, psychologists, sociologists, and

  11. Income and Subjective Well-Being: New Insights from Relatively Healthy American Women, Ages 49-79.

    PubMed

    Wyshak, Grace

    2016-01-01

    The interests of economists, psychologists, social scientists and others on the relations of income, demographics, religion and subjective well-being, have generated a vast global literature. It is apparent that biomedical research has focused on white with men. The Women's Health Initiative and Observational Study (WHI OS) was initiated in 1992. The OS represents the scientific need for social priorities to improve the health and welfare of women; it includes 93.676 relatively healthy postmenopausal women, 49 to 79, from diverse backgrounds. The objective of this study is to examine how lifestyle and other factors influence women's health. Data from the WHI OS questionnaire were analyzed. Statistical methods included descriptive statistics square, correlations, linear regression and analyses of covariance (GLM). New findings and insights relate primarily to general health, religion, club attendance, and likelihood of depression. The most important predictor of excellent or very good health is quality of life and general health is a major predictor of quality of life. A great deal of strength and comfort from religion was reported by 62.98% of the women, with little variation by denomination. More from religion related to poorer health, and less likelihood of depression. Religion and lower income are in accord with of across country studies. Attendance at clubs was associated with religion and with all factors associated with religion, except income. Though general health and likelihood of depression are highly correlated, better health is associated with higher income; however, likelihood of depression is not associated with income--contrary to conventional wisdom about socioeconomic disparities and mental health. Subjective well-being variables, with the exception of quality of life, were not associated with income. Social networks--religion and clubs--among a diverse population, warrant further attention from economists, psychologists, sociologists, and others

  12. Antibody Persistence at 1 and 4 Years Following a Single Dose of MenAfriVac or Quadrivalent Polysaccharide Vaccine in Healthy Subjects Aged 2–29 Years

    PubMed Central

    Diallo, Aldiouma; Sow, Samba O.; Idoko, Olubukola T.; Hirve, Siddhivinayak; Findlow, Helen; Preziosi, Marie-Pierre; Elie, Cheryl; Kulkarni, Prasad S.; Parulekar, Varsha; Diarra, Bou; Cheick Haidara, Fadima; Diallo, Fatoumata; Tapia, Milagritos; Akinsola, Adebayo K.; Adegbola, Richard A.; Bavdekar, Ashish; Juvekar, Sanjay; Chaumont, Julie; Martellet, Lionel; Marchetti, Elisa; LaForce, Marc F.; Plikaytis, Brian D.; Enwere, Godwin C.; Tang, Yuxiao; Borrow, Ray; Carlone, George; Viviani, Simonetta

    2015-01-01

    Background. Mass vaccination campaigns of the population aged 1–29 years with 1 dose of group A meningococcal (MenA) conjugate vaccine (PsA-TT, MenAfriVac) in African meningitis belt countries has resulted in the near-disappearance of MenA. The vaccine was tested in clinical trials in Africa and in India and found to be safe and highly immunogenic compared with the group A component of the licensed quadrivalent polysaccharide vaccine (PsACWY). Antibody persistence in Africa and in India was investigated. Methods. A total of 900 subjects aged 2–29 years were followed up for 4 years in Senegal, Mali, and The Gambia (study A). A total of 340 subjects aged 2–10 years were followed up for 1 year in India (study B). In study A, subjects were randomized in a 2:1 ratio, and in study B a 1:1 ratio to receive either PsA-TT or PsACWY. Immunogenicity was evaluated by measuring MenA serum bactericidal antibody (SBA) with rabbit complement and by a group A–specific immunoglobulin G (IgG) enzyme-linked immunosorbent assay. Results. In both studies, substantial SBA decay was observed at 6 months postvaccination in both vaccine groups, although more marked in the PsACWY group. At 1 year and 4 years (only for study A) postvaccination, SBA titers were relatively sustained in the PsA-TT group, whereas a slight increasing trend, more pronounced among the youngest, was observed in the participants aged <18 years in the PsACWY groups. The SBA titers were significantly higher in the PsA-TT group than in the PsACWY group at any time point, and the majority of subjects in the PsA-TT group had SBA titers ≥128 and group A–specific IgG concentrations ≥2 µg/mL at any point in time in both the African and Indian study populations. Conclusions. Four years after vaccination with a single dose of PsA-TT vaccine in Africa, most subjects are considered protected from MenA disease. Clinical Trials Registration. PsA-TT-003 (ISRCTN87739946); PsA-TT-003a (ISRCTN46335400). PMID

  13. Laser speckle contrast imaging: age-related changes in microvascular blood flow and correlation with pulse-wave velocity in healthy subjects

    NASA Astrophysics Data System (ADS)

    Khalil, Adil; Humeau-Heurtier, Anne; Mahé, Guillaume; Abraham, Pierre

    2015-05-01

    In the cardiovascular system, the macrocirculation and microcirculation-two subsystems-can be affected by aging. Laser speckle contrast imaging (LSCI) is an emerging noninvasive optical technique that allows the monitoring of microvascular function and can help, using specific data processing, to understand the relationship between the subsystems. Using LSCI, the goals of this study are: (i) to assess the aging effect over microvascular parameters (perfusion and moving blood cells velocity, MBCV) and macrocirculation parameters (pulse-wave velocity, PWV) and (ii) to study the relationship between these parameters. In 16 healthy subjects (20 to 62 years old), perfusion and MBCV computed from LSCI are studied in three physiological states: rest, vascular occlusion, and post-occlusive reactive hyperaemia (PORH). MBCV is computed from a model of velocity distribution. During PORH, the experimental results show a relationship between perfusion and age (R2=0.67) and between MBCV and age (R2=0.72), as well as between PWV and age at rest (R2=0.91). A relationship is also found between perfusion and MBCV for all physiological states (R2=0.98). Relationships between microcirculation and macrocirculation (perfusion-PWV or MBCV-PWV) are found only during PORH with R2=0.76 and R2=0.77, respectively. This approach may prove useful for investigating dysregulation in blood flow.

  14. Reliability of Schmeling's stages of ossification of medial clavicular epiphyses and its validity to assess 18 years of age in living subjects.

    PubMed

    Cameriere, R; De Luca, S; De Angelis, D; Merelli, V; Giuliodori, A; Cingolani, M; Cattaneo, C; Ferrante, L

    2012-11-01

    Nowadays, due to the global increase in migration movements, forensic age estimation of living young adults has become an important focus of interest. Minors often have no identification documents providing their correct birth dates. Establishing the age of majority is therefore fundamental in order to determine whether juvenile penal systems or penal systems in force for adults are to be applied. Radiological examination of the clavicles is one of the methods recommended by the Study Group on Forensic Age Diagnostics. In this retrospective study, a sample of chest radiographs of 274 subjects, aged between 12 and 25 years, was studied according to Schmeling's method in order to examine the ossification of both medial clavicular epiphyses. All stage classifications were evaluated by five examiners. Intra- and inter-examiner reliability was analysed by Cohen's K statistic. Intra-examiner agreement was insufficient for two of the experts. Inter-examiner agreement, among the other three operators, was moderate (K = 0.509). Study of reliability highlighted difficulties in interpretation, the need to select qualified personnel and choice of the best radiographic image in order to reduce any anatomic overlaps. Although ossification of the medial clavicular epiphyses is recommended to assess whether an individual has already reached the age of majority or not, these results suggested that it is very difficult to clearly identify the five stages of ossification by using conventional chest radiography.

  15. Speech Production Intelligibility of Early Implanted Pediatric Cochlear Implant Users

    PubMed Central

    Habib, Mirette G.; Waltzman, Susan B.; Tajudeen, Bobby; Svirsky, Mario A.

    2010-01-01

    Objectives To investigate the influence of age, and age at implantation, on speech production intelligibility in prelingually deaf pediatric cochlear implant recipients. Methods Forty prelingually, profoundly deaf children who received cochlear implants between 8 and 40 months of age. Their age at testing ranged between 2.5 – 18 years. Children were recorded repeating the ten sentences in the Beginner’s Intelligibility Test. These recordings were played back to normal-hearing listeners who were unfamiliar with deaf speech and who were instructed to write down what they heard. They also rated each subject for the intelligibility of their speech production on a 5-point rating scale. The main outcome measures were the percentage of target words correctly transcribed, and the intelligibility ratings, in both cases averaged across three normal-hearing listeners. Results The data showed a strong effect of age at testing, with older children being more intelligible. This effect was particularly pronounced for children implanted in the first 24 months of life, all of whom had speech production intelligibility scores of 80% or higher when they were tested at age 5.5 years or older. This was true for only five out of nine children implanted at age 25 to 36 months. Conclusions Profoundly deaf children who receive cochlear implants in the first two years of life produce highly intelligible speech before age 6. This is also true for most, but not all children implanted in their third year. PMID:20472308

  16. Efficiency of upper gastrointestinal endoscopy in pediatric surgical practice

    PubMed Central

    Temiz, Abdulkerim

    2015-01-01

    After the introduction of flexible fiber optic endoscopy to pediatric gastroenterology in the 1970s, upper gastrointestinal (UGI) endoscopy can be performed for the diagnosis and treatment of all age groups of children. We review indications, contraindications, preparation of patients for the procedure, and details of diagnostic and therapeutic UGI endoscopy used in pediatric surgery. We also discuss potential complications of endoscopy. PMID:26566483

  17. A Study of Hospital Admission Rules During Pediatric Residency Training.

    ERIC Educational Resources Information Center

    Ferguson, Jane; Alpert, Joel J.

    1980-01-01

    A survey of U.S. pediatric training programs to determine the role of rules in the hospital admission of pediatric patients is reported. The results support the hypothesis that rules are a widely used teaching tool. The rules relate to such factors as fevers, age, specific diseases, administrative concerns, head traumas, and poisonings. (JMD)

  18. Pediatric Mediastinal Tumors and Tumor-Like Lesions.

    PubMed

    Singh, Achint K; Sargar, Kiran; Restrepo, Carlos S

    2016-06-01

    This article reviews the imaging findings of pediatric mediastinal tumors and tumor-like lesions. The classification of the mediastinum is discussed with normal imaging appearance of the thymus in pediatric age group followed by a discussion on multiple mediastinal lesions in different compartments with emphasis on their imaging characteristics.

  19. Dry Eye in Pediatric Contact Lens Wearers

    PubMed Central

    Greiner, Katie L.; Walline, Jeffrey J.

    2015-01-01

    Objectives To determine whether children who wear contact lenses truly have fewer dry eye complaints than adults. Methods Ninety-four pediatric contact lens wearers, ages 8 to 14 years, were recruited and given the Contact Lens Dry Eye Questionnaire (CLDEQ) short form. The survey is designed to diagnose dry eye syndrome by obtaining information on the frequency of dryness and light sensitivity and their corresponding intensity levels within the first two hours of putting in the lenses, in the middle of the day, and at the end of the day. The responses were scored by multiplying the frequency by the average intensity and a constant. A composite score was calculated by subtracting the photophobia score from the dryness score, and the results were compared to adult samples from the literature. The questionnaire also asked whether the subject thought he/she had dry eyes while wearing contact lenses. Subjects that thought they had dry eyes and had a CLDEQ composite score >0.03 were diagnosed with dry eye. Subjects who were unsure if they dry eye or said they did not have dry eye but scored >1.29 were also diagnosed with dry eye. Results The average (± SD) age of the sample was 11.7 ± 1.5 years, 56.4% were female, 59.6% were white, and 19.1% were black. The mean (± SD) CLDEQ composite score was 0.25 ±0.50 (range= -1.20 to 1.45). In the literature, the adult mean (± SD) CLDEQ composite score was 1.02 ±0.80 (range= -0.74 to 4.50). Of the 94 surveys collected, 4.3% of children were categorized with dry eye compared to 56.2% of adults who completed the CLDEQ survey in the adult study. Conclusions Pediatric contact lens wearers have fewer complaints about dry eyes than adult contact lens wearers, which may be due to improved tear film, differences in reporting of symptoms, or modality of contact lens wear. PMID:21060258

  20. Distortion-product otoacoustic emissions in middle-aged subjects with normal versus potentially presbyacusic high-frequency hearing loss.

    PubMed

    Nieschalk, M; Hustert, B; Stoll, W

    1998-01-01

    Distortion-product otoacoustic emissions (DPOAEs) are still undergoing evaluation for clinical use. Although the effects of ageing on otoacoustic emissions have been studied quite extensively in the past, DPOAE response-growth or input-output (I-O) measures, which are well suited as an objective method for monitoring cochlear function at specific frequencies, have been less thoroughly examined. The aim of the present study was to assess the 2f1-f2 DPOAEs in a clinical setting in order to examine the response of 20 normally hearing middle-aged adults and to compare the results with those of 20 people of the same age with ears of sensorineural high-frequency hearing loss (HL). The experiment consisted of two stages. First, the DPOAE-gram was recorded in 1-4-octave steps at a stimulus level of 70 dB SPL over a frequency range of the f2 primary tone which extended from 1.001 to 6.299 kHz. Secondly, in order to elicit DPOAE I-O functions, the two primary stimuli were presented at equilevel intensities ranging from 20 to 71 dB SPL. The stimulus-level step size was 3 dB. The I-O functions were recorded at five separate DPOAE frequencies, with the f2 frequency most closely related to the clinical audiogram (f2 = 1.0, 1.5, 2.0, 4.0 and 6.0 kHz). Two clearly separated portions in the form of the I-O function for normally hearing ears were found. The first portion, in response to primary levels of 60 dB SPL and below, showed a plateau (saturating) behaviour. If primary levels exceeded 60 dB SPL, I-O functions became more linear. The attenuation of the saturation portion of the I-O function in ears with high-frequency HL across the frequency-test range is difficult to explain because elevated behavioural thresholds were observed only for frequencies > 1.5 kHz. Thus, the more linear I-Os associated with the hearing-loss frequencies may indicate deficiencies in the active properties of outer hair cells (OHCs), whereas those for I-Os < 1.5 kHz, where hearing was normal, may

  1. Estimating the Burden of Leptospirosis among Febrile Subjects Aged below 20 Years in Kampong Cham Communities, Cambodia, 2007-2009

    PubMed Central

    Hem, Sopheak; Ly, Sowath; Votsi, Irene; Vogt, Florian; Asgari, Nima; Buchy, Philippe; Heng, Seiha; Picardeau, Mathieu; Sok, Touch; Ly, Sovann; Huy, Rekol; Guillard, Bertrand; Cauchemez, Simon; Tarantola, Arnaud

    2016-01-01

    Background Leptospirosis is an emerging but neglected public health challenge in the Asia/Pacific Region with an annual incidence estimated at 10–100 per 100,000 population. No accurate data, however, are available for at-risk rural Cambodian communities. Method We conducted anonymous, unlinked testing for IgM antibodies to Leptospira spp. on paired sera of Cambodian patients <20 years of age between 2007–2009 collected through active, community-based surveillance for febrile illnesses in a convenience sample of 27 rural and semi-rural villages in four districts of Kampong Cham province, Cambodia. Leptospirosis testing was done on paired serological samples negative for Dengue, Japanese encephalitis and Chikungunya viruses after random selection. Convalescent samples found positive while initial samples were negative were considered as proof of acute infection. We then applied a mathematical model to estimate the risk of fever caused by leptospirosis, dengue or other causes in rural Cambodia. Results A total of 630 samples are coming from a randomly selected subset of 2358 samples. IgM positive were found on the convalescent serum sample, among which 100 (15.8%) samples were IgM negative on an earlier sample. Seventeen of these 100 seroconversions were confirmed using a Microagglutination Test. We estimated the probability of having a fever due to leptospirosis at 1. 03% (95% Credible Interval CI: 0. 95%–1. 22%) per semester. In comparison, this probability was 2. 61% (95% CI: 2. 55%, 2. 83%) for dengue and 17. 65% (95% CI: 17. 49%, 18. 08%) for other causes. Conclusion Our data from febrile cases aged below 20 years suggest that the burden of leptospirosis is high in rural Cambodian communities. This is especially true during the rainy season, even in the absence of identified epidemics. PMID:27043016

  2. Automated Assay of Telomere Length Measurement and Informatics for 100,000 Subjects in the Genetic Epidemiology Research on Adult Health and Aging (GERA) Cohort

    PubMed Central

    Lapham, Kyle; Kvale, Mark N.; Lin, Jue; Connell, Sheryl; Croen, Lisa A.; Dispensa, Brad P.; Fang, Lynn; Hesselson, Stephanie; Hoffmann, Thomas J.; Iribarren, Carlos; Jorgenson, Eric; Kushi, Lawrence H.; Ludwig, Dana; Matsuguchi, Tetsuya; McGuire, William B.; Miles, Sunita; Quesenberry, Charles P.; Rowell, Sarah; Sadler, Marianne; Sakoda, Lori C.; Smethurst, David; Somkin, Carol P.; Van Den Eeden, Stephen K.; Walter, Lawrence; Whitmer, Rachel A.; Kwok, Pui-Yan; Risch, Neil; Schaefer, Catherine; Blackburn, Elizabeth H.

    2015-01-01

    The Kaiser Permanente Research Program on Genes, Environment, and Health (RPGEH) Genetic Epidemiology Research on Adult Health and Aging (GERA) cohort includes DNA specimens extracted from saliva samples of 110,266 individuals. Because of its relationship to aging, telomere length measurement was considered an important biomarker to develop on these subjects. To assay relative telomere length (TL) on this large cohort over a short time period, we created a novel high throughput robotic system for TL analysis and informatics. Samples were run in triplicate, along with control samples, in a randomized design. As part of quality control, we determined the within-sample variability and employed thresholds for the elimination of outlying measurements. Of 106,902 samples assayed, 105,539 (98.7%) passed all quality control (QC) measures. As expected, TL in general showed a decline with age and a sex difference. While telomeres showed a negative correlation with age up to 75 years, in those older than 75 years, age positively correlated with longer telomeres, indicative of an association of longer telomeres with more years of survival in those older than 75. Furthermore, while females in general had longer telomeres than males, this difference was significant only for those older than age 50. An additional novel finding was that the variance of TL between individuals increased with age. This study establishes reliable assay and analysis methodologies for measurement of TL in large, population-based human studies. The GERA cohort represents the largest currently available such resource, linked to comprehensive electronic health and genotype data for analysis. PMID:26092717

  3. Plating of open pediatric tibia fractures.

    PubMed

    Head, James; Lewis, T R; Puffinbarger, William; Garbrecht, Erika

    2014-07-01

    This study is a single center retrospective chart and radiographic review of patients with open tibia fractures under the age of 16 years of age over past 10 years. The purpose of this study is to investigate the treatment of open pediatric tibia fractures with plating in regards to time to ambulation, time to union, and deformity in comparison to other treatment options. We found that plating open pediatric tibia fractures is a safe treatment option that can lead to excellent results with low risk of complications. PMID:25223152

  4. Cryptosporidiosis in pediatric patients.

    PubMed

    Saredi, N; Bava, J

    1998-01-01

    Cryptosporidium was detected in 21 (3.8%) individual stool samples collected from 553 pediatric patients hospitalized in our center employing a Telemann concentration technique (formalin-ether-centrifugation) and stained with the modified Kinyoun method. The mean age of populations with Cryptosporidiosis (16 boys and 5 girls) was 11 months; 15 months for girls and 6.5 for boys. Ages of 81% of them were less than 19 months. Seventy-six per cent of patients lived on the outskirts of Buenos Aires and 71% lacked pretreated running water at home. In 62% of the cases parasitological diagnoses coincided with warm seasons. At diagnosis mucous (63%) or watery (36%) diarrhea was presented in 90% of the patients with a median of 5 (3-8) bowel movements per day. Fever was presented in 66% of patients while abdominal pain and vomits in 60% and 52%, respectively. The median time from hospitalization up to parasitologic diagnosis was 20 days. Concomitant diseases observed were malnutrition, acute leukemia, bronchiolitis, HIV infection, anemia, celiac disease, myelofibrosis, vitelline sac tumor, neutropenia, osteosarcoma and dehydration. Cryptosporidiosis in our environment seems to occur more frequently in children younger than 18 months of age; who present diarrhea; are immunodeficient; come from a low socioeconomical background; and who live in poor sanitary conditions with no potable running water.

  5. Common pediatric epilepsy syndromes.

    PubMed

    Park, Jun T; Shahid, Asim M; Jammoul, Adham

    2015-02-01

    Benign rolandic epilepsy (BRE), childhood idiopathic occipital epilepsy (CIOE), childhood absence epilepsy (CAE), and juvenile myoclonic epilepsy (JME) are some of the common epilepsy syndromes in the pediatric age group. Among the four, BRE is the most commonly encountered. BRE remits by age 16 years with many children requiring no treatment. Seizures in CAE also remit at the rate of approximately 80%; whereas, JME is considered a lifelong condition even with the use of antiepileptic drugs (AEDs). Neonates and infants may also present with seizures that are self-limited with no associated psychomotor disturbances. Benign familial neonatal convulsions caused by a channelopathy, and inherited in an autosomal dominant manner, have a favorable outcome with spontaneous resolution. Benign idiopathic neonatal seizures, also referred to as "fifth-day fits," are an example of another epilepsy syndrome in infants that carries a good prognosis. BRE, CIOE, benign familial neonatal convulsions, benign idiopathic neonatal seizures, and benign myoclonic epilepsy in infancy are characterized as "benign" idiopathic age-related epilepsies as they have favorable implications, no structural brain abnormality, are sensitive to AEDs, have a high remission rate, and have no associated psychomotor disturbances. However, sometimes selected patients may have associated comorbidities such as cognitive and language delay for which the term "benign" may not be appropriate.

  6. Physical activity completed when young has residual bone benefits at 94 years of age: a within-subject controlled case study.

    PubMed

    Warden, S J; Mantila Roosa, S M

    2014-06-01

    Physical activity is recommended for skeletal health because bones adapt to mechanical loading. The young skeleton shows greatest plasticity to physical activity-related mechanical loads, but bones are most at risk of failure later in life. The discrepancy raises the question of whether the skeletal benefits of physical activity completed when young persist with aging. Here we present a unique case wherein the cortical bone benefit of physical activity completed over five decades earlier could be established within an individual aged in their tenth decade of life. Specifically, we compared bone properties at the midshaft humerus between the throwing and nonthrowing arms of a 94-year-old former Major League Baseball player who ceased throwing 55 years earlier. By performing analyses within-subject, the long-term skeletal benefit of physical activity completed when young could be assessed independent of inherited and systemic traits. Also, as the subject threw left-handed during his throwing career, but was right-hand dominant in all other activities throughout life, any lasting skeletal benefits in favor of the throwing arm could not be attributable to simple arm dominance. Analyses indicated that any cortical bone mass, area and thickness benefits of throwing-related physical activity completed when young were lost with aging, possibly due to accelerated intracortical remodeling. In contrast, the subject's throwing (nondominant) arm had greater total cross-sectional area and estimated strength (polar moment of inertia) than in his dominant arm, despite muscle indices favoring the latter. These data indicate that physical activity completed when young can have lasting benefits on bone size and strength, independent of the maintenance of bone mass benefits.

  7. Pediatric biobanking: a pilot qualitative survey of practices, rules, and researcher opinions in ten European countries.

    PubMed

    Salvaterra, Elena; Giorda, Roberto; Bassi, Maria T; Borgatti, Renato; Knudsen, Lisbeth E; Martinuzzi, Andrea; Nobile, Maria; Pozzoli, Uberto; Ramelli, Gian P; Reni, Gianl L; Rivolta, Damiano; Stazi, Maria A; Strazzer, Sandra; Thijs, Carel; Toccaceli, Virgilia; Trabacca, Antonio; Turconi, Anna C; Zanini, Sergio; Zucca, Claudio; Bresolin, Nereo; Lenzi On Behalf Of The Pediatric Biobank Elsi Working Group, Leonardo

    2012-02-01

    Ethical, legal, and social issues related to the collection, storage, and use of biospecimens and data derived from children raise critical concerns in the international debate. So far, a number of studies have considered a variety of the individual issues crucial to pediatric biobanking such as decision making, privacy protection, minor recontact, and research withdrawal by focusing on theoretical or empirical perspectives. Our research attempted to analyze such issues in a comprehensive manner by exploring practices, rules, and researcher opinions regarding proxy consent, minor assent, specimens and data handling, and return of results as faced in 10 European countries. Because of the lack of comparative analyses of these topics, a pilot study was designed. Following a qualitative methodology, a questionnaire draft mostly including open-ended queries was developed, tested, and sent by e-mail to a selected group of researchers dealing with pediatric biobanking (n=57). Returned questionnaires (n=31) highlighted that the collection, storage, distribution, and use of biospecimens and data from children were widely practiced in the contacted laboratories. In most cases, pediatric biobanking was subjected to national or local regulations covering adult biobanks (n=26). Informed consent was generally given by parents or legal representatives (n=17). Children's opinions were frequently sought and taken into account (n=16). However, minors were usually not recontacted at the age of maturity to express their own choices (n=26). Based on the collected data, dedicated recommendations are needed to govern unique ethical and regulatory issues surrounding pediatric biobanking.

  8. Hippocampal activation for autobiographical memories over the entire lifetime in healthy aged subjects: an fMRI study

    PubMed Central

    Viard, Armelle; Piolino, Pascale; Desgranges, Beatrice; Chetelat, Gael; Lebreton, Karine; Landeau, Brigitte; Young, Alan; De La Sayette, Vincent; Eustache, Francis

    2007-01-01

    Summary We used functional MRI to determine the cerebral structures required during the recollection of episodic autobiographical memories according to five time-periods covering the whole lifespan to test the two concurring models of memory consolidation which propose either a temporary (standard model) or a permanent (multiple-trace model) role of the hippocampus in episodic memory retrieval. The experimental paradigm was specially designed to engage subjects (67.17 ± 5.22 years old) in the retrieval of episodic autobiographical memories, whatever the time-period, from personally relevant cues selected by questioning a family member. Moreover, the nature of the memories was checked at debriefing by means of behavioral measures to control the degree of episodicity. Behavioral data showed that recollected memories were characterized by specificity and details whatever their remoteness. Main neuroimaging data (SPM99) revealed the activation of a network including the left superior frontal gyri, bilateral precuneus/posterior cingulate and lingual gyri, left angular gyrus and left hippocampus, although the subtraction analyses detected subtle differences between certain time-periods. Small volume correction (SVC) centered on the hippocampus detected left hippocampal activation for all time-periods and additional right hippocampal activation for the intermediate periods. Further confirmation was provided by using a three-way ANOVA on BOLD values which revealed hippocampal activation, whatever the time-interval. The present data challenge the standard model of memory consolidation and support the multiple-trace model, instead. The comparison with previous literature stresses the idea that a bilateral involvement of the hippocampus characterizes rich episodic autobiographical memory recollection. PMID:17204823

  9. [The sexual peculiarities of aging changes in circannual rhythms of pineal gland, hypophysis, adrenal cortex and thymus functions in healthy subjects].

    PubMed

    Labunets, I F

    2013-01-01

    The interrelations of circannual rhythms of the functional state of pineal gland, hypophysis, adrenal cortex, thymus in healthy women and men from 20 to 79 years were studied. Fluctuations of melatonin, ACTH, cortisol and thymic serum factor, which were exchanged in aging (the season peaks of hormones and its acrophase) were found in blood of healthy 20-29 years old people. The changes of rhythmicity of indices were in male earlier (pineal gland and hypophysis over 30 years, thymus and adrenal cortex over 40 years) and more impressive than in women. The aging changes of pineal gland function's rhythm in healthy subjects have important role for changes of interrelations of circannual rhythms hypophysis, adrenal cortex and thymus.

  10. Case Study: Videogame Distraction Reduces Behavioral Distress in a Preschool-Aged Child Undergoing Repeated Burn Dressing Changes: A Single-Subject Design

    PubMed Central

    Sil, Soumitri; Burns, Andrew J.

    2013-01-01

    Objective This single-subject design study evaluated the feasibility and efficacy of passive and interactive videogame distraction on behavioral distress for a preschool-aged child receiving repeated burn dressing changes. Method A 4-year-old girl underwent 3 baseline and 10 videogame distraction sessions (5 passive and 5 interactive) using a restricted alternating treatments design. Observed behavioral distress was coded, and parents and nurses rated the child’s distress and cooperative behavior. Results Relative to baseline, behavioral distress decreased and cooperative behavior increased immediately after the onset of videogame distraction. Single Case Randomization Tests revealed significantly lower behavioral distress and greater cooperation during interactive videogame distraction relative to passive videogame distraction. Conclusions Interactive videogame distraction appears to be a feasible and effective pain management strategy for a preschool-aged child undergoing repeated painful medical procedures. PMID:23248343

  11. Clinical phenotype and diagnosis of arrhythmogenic right ventricular cardiomyopathy in pediatric patients carrying desmosomal gene mutations

    PubMed Central

    Bauce, Barbara; Rampazzo, Alessandra; Basso, Cristina; Mazzotti, Elisa; Rigato, Ilaria; Steriotis, Alexandros; Beffagna, Giorgia; Lorenzon, Alessandra; De Bortoli, Marzia; Pilichou, Kalliopi; Marra, Martina Perazzolo; Corbetti, Francesco; Daliento, Luciano; Iliceto, Sabino; Corrado, Domenico; Thiene, Gaetano; Nava, Andrea

    2011-01-01

    Background Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited heart muscle disease carrying a risk of sudden death. Information about the clinical features during childhood and the age at disease onset is scanty. Objective The aim of the study was to describe the ARVC phenotype as its initial clinical manifestation in a pediatric population (<18 years) with desmosomal gene mutations. Methods Fifty-three ARVC desmosomal gene mutation carriers (mean age 12.3 ± 3.9 years) were investigated by electrocardiogram (ECG), signal-averaged ECG, 24-hour Holter, echocardiogram, and contrast-enhanced cardiac magnetic resonance (CMR). Results None of the children ≤10 years old fulfilled the 1994 criteria, as opposed to six (33%) aged 11–14 years and eight aged >14 years (42%). At the end of follow-up (9 ± 7 years), 21 (40%) fulfilled the 1994 diagnostic criteria (mean age 16 ± 4 years). By using the 2010 criteria in subjects aged ≤18 years, 53% were unaffected, versus 62% by using the traditional criteria. More than two-thirds of affected subjects had moderate-severe forms of the disease. Contrast-enhanced CMR was performed in 21 (40%); of 13 unaffected gene mutation carriers, six showed ARVC morphological and/or tissue abnormalities. Conclusion In pediatric ARVC mutation carriers, a diagnosis was achieved in 40% of cases, confirming that the disease usually develops during adolescence and young adulthood. The 2010 modified criteria seem to be more sensitive than the 1994 ones in identifying familial pediatric cases. Contrast-enhanced CMR can provide diagnostic information on gene mutation carriers not fulfilling either traditional or modified criteria. Management of asymptomatic gene mutation carriers remains the main clinical challenge. PMID:21723241

  12. Pediatric Reference Intervals for Free Thyroxine and Free Triiodothyronine by Equilibrium Dialysis-Liquid Chromatography-Tandem Mass Spectrometry

    PubMed Central

    La’ulu, Sonia L.; Rasmussen, Kyle J.; Straseski, Joely A.

    2016-01-01

    Objective: Thyroid hormone concentrations fluctuate during growth and development. To accurately diagnose thyroid disease in pediatric patients, reference intervals (RIs) should be established with appropriate age groups from an adequate number of healthy subjects using the most exact methods possible. Obtaining statistically useful numbers of healthy patients is particularly challenging for pediatric populations. The objective of this study was to determine non-parametric RIs for free thyroxine (fT4) and free triiodothyronine (fT3) using equilibrium dialysis-high performance liquid chromatography-tandem mass spectrometry with over 2200 healthy children 6 months-17 years of age. Methods: Subjects were negative for both thyroglobulin and thyroid peroxidase autoantibodies and had normal thyrotropin concentrations. The study included 2213 children (1129 boys and 1084 girls), with at least 120 subjects (average of 125) from each year of life, except for the 6 month to 1 year age group (n=96). Results: Non-parametric RIs (95th percentile) for fT4 were: 18.0-34.7 pmol/L (boys and girls, 6 months-6 years) and 14.2-25.7 pmol/L (boys and girls, 7-17 years). RIs for fT3 were: 5.8-13.1 pmol/L (girls, 6 months-6 years); 5.7-11.8 pmol/L (boys, 6 months-6 years); 5.7-10.0 pmol/L (boys and girls, 7-12 years); 4.5-8.6 pmol/L (girls, 13-17 years); and 5.2-9.4 pmol/L (boys, 13-17 years). Conclusion: Numerous significant differences were observed between pediatric age groups and previously established adult ranges. This emphasizes the need for well-characterized RIs for thyroid hormones in the pediatric population. PMID:26758817

  13. Multidrug resistance in pediatric urinary tract infections.

    PubMed

    Gaspari, Romolo J; Dickson, Eric; Karlowsky, James; Doern, Gary

    2006-01-01

    Urinary tract infections (UTIs) represent a common infection in the pediatric population. Escherichia coli is the most common uropathogen in children, and antimicrobial resistance in this species complicates the treatment of pediatric UTIs. Despite the impact of resistance on empiric antibiotic choice, there is little data on multidrug resistance in pediatric patients. In this paper, we describe characteristics of multidrug-resistant E. coli in pediatric patients using a large national database of uropathogens antimicrobial sensitivities. Antimicrobial susceptibility patterns to commonly prescribed antibiotics were performed on uropathogens isolated from children presenting to participating hospitals between 1999 and 2001. Data were analyzed separately for four pediatric age groups. Single and multidrug resistance to ampicillin, amoxicillin-clavulanate, cefazolin, ciprofloxacin, nitrofurantoin, and trimethoprim-sulfamethoxazole (TMP-SMX) were performed on all specimens. There were a total of 11,341 E. coli urine cultures from 343 infants (0-4 weeks), 1,801 toddlers (5 weeks-24 months), 6,742 preteens (2-12 years), and 2,455 teens (13-17 years). E. coli resistance to ampicillin peaked in toddlers (52.8%) but was high in preteens (52.1%), infants (50.4%), and teens (40.6%). Resistance to two or more antibiotics varied across age groups, with toddlers (27%) leading preteens (23.1%), infants (21%), and teens (15.9%). Resistance to three or more antibiotics was low in all age groups (range 3.1-5.2%). The most common co-resistance in all age groups was ampicillin/TMP-SMZ. In conclusion, less than half of all pediatric UTIs are susceptible to all commonly used antibiotics. In some age groups, there is a significant percentage of co-resistance between the two most commonly used antibiotics (ampicillin and TMP-SMZ).

  14. Multidrug resistance in pediatric urinary tract infections.

    PubMed

    Gaspari, Romolo J; Dickson, Eric; Karlowsky, James; Doern, Gary

    2006-01-01

    Urinary tract infections (UTIs) represent a common infection in the pediatric population. Escherichia coli is the most common uropathogen in children, and antimicrobial resistance in this species complicates the treatment of pediatric UTIs. Despite the impact of resistance on empiric antibiotic choice, there is little data on multidrug resistance in pediatric patients. In this paper, we describe characteristics of multidrug-resistant E. coli in pediatric patients using a large national database of uropathogens antimicrobial sensitivities. Antimicrobial susceptibility patterns to commonly prescribed antibiotics were performed on uropathogens isolated from children presenting to participating hospitals between 1999 and 2001. Data were analyzed separately for four pediatric age groups. Single and multidrug resistance to ampicillin, amoxicillin-clavulanate, cefazolin, ciprofloxacin, nitrofurantoin, and trimethoprim-sulfamethoxazole (TMP-SMX) were performed on all specimens. There were a total of 11,341 E. coli urine cultures from 343 infants (0-4 weeks), 1,801 toddlers (5 weeks-24 months), 6,742 preteens (2-12 years), and 2,455 teens (13-17 years). E. coli resistance to ampicillin peaked in toddlers (52.8%) but was high in preteens (52.1%), infants (50.4%), and teens (40.6%). Resistance to two or more antibiotics varied across age groups, with toddlers (27%) leading preteens (23.1%), infants (21%), and teens (15.9%). Resistance to three or more antibiotics was low in all age groups (range 3.1-5.2%). The most common co-resistance in all age groups was ampicillin/TMP-SMZ. In conclusion, less than half of all pediatric UTIs are susceptible to all commonly used antibiotics. In some age groups, there is a significant percentage of co-resistance between the two most commonly used antibiotics (ampicillin and TMP-SMZ). PMID:16922629

  15. Role of Pro-Inflammatory Cytokines and Biochemical Markers in the Pathogenesis of Type 1 Diabetes: Correlation with Age and Glycemic Condition in Diabetic Human Subjects

    PubMed Central

    Zubair, Swaleha; Ajmal, Mohd; Siddiqui, Sheelu Shafiq; Moin, Shagufta; Owais, Mohammad

    2016-01-01

    Background Type 1 diabetes mellitus is a chronic inflammatory disease involving insulin producing β-cells destroyed by the conjoined action of auto reactive T-cells, inflammatory cytokines and monocytic cells. The aim of this study was to elucidate the status of pro-inflammatory cytokines and biochemical markers and possible correlation of these factors towards outcome of the disease. Methods The study was carried out on 29 T1D subjects and 20 healthy subjects. Plasma levels of oxidative stress markers, enzymatic and non-enzymatic antioxidants were estimated employing biochemical assays. The levels of pro-inflammatory cytokines such as by IL-1β & IL-17 in the serum were determined by ELISA, while the expression of TNF-α, IL-23 & IFN-γ was ascertained by qRT-PCR. Results The onset of T1D disease was accompanied with elevation in levels of Plasma malondialdehyde, protein carbonyl content and nitric oxide while plasma vitamin C, reduced glutathione and erythrocyte sulfhydryl groups were found to be significantly decreased in T1D patients as compared to healthy control subjects. Activity of antioxidant enzymes, superoxide dismutase, catalase, glutathione reductase and glutathione-s-transferase showed a significant suppression in the erythrocytes of T1D patients as compared to healthy subjects. Nevertheless, the levels of pro-inflammatory cytokines IL-1β and IL-17A were significantly augmented (***p≤.001) on one hand, while expression of T cell based cytokines IFN-γ, TNF-α and IL-23 was also up-regulated (*p≤.05) as compared to healthy human subjects. Conclusion The level of pro-inflammatory cytokines and specific biochemical markers in the serum of the patient can be exploited as potential markers for type 1 diabetes pathogenesis. The study suggests that level of inflammatory markers is up-regulated in T1D patients in an age dependent manner. PMID:27575603

  16. Long-term cognitive outcomes after pediatric stroke.

    PubMed

    Kolk, Anneli; Ennok, Margus; Laugesaar, Rael; Kaldoja, Mari-Liis; Talvik, Tiina

    2011-02-01

    This study assessed neurocognitive and neurologic outcomes of children with neonatal and childhood strokes. Twenty-one children with neonatal (mean age, 6.86 years) and 10 children with childhood (mean age, 8.21 years) strokes, identified via the Estonian Pediatric Stroke Database (1995-2006), participated. A developmental neuropsychologic assessment was used for neurocognitive outcomes, and the Paediatric Stroke Outcome Measure for neurologic outcomes. Neuromotor impairment was evident in 62% of children with neonatal strokes, and in 70% of children with childhood strokes. Compared with control subjects, children with strokes exhibited worse attention, language, memory, and sensorimotor functions. The sensorimotor domain comprised the most impaired neurocognitive area, whereas executive functions remained intact in both stroke groups. A well-preserved executive function may account for the normal range of intelligence in children with strokes. More severe impairment in neurocognitive skills was evident after neonatal strokes, and the visuospatial domain was more impaired than in children from the childhood group. Prognoses were worse after left hemisphere strokes associated with epilepsy. Our results on emerging neurocognitive deficits in several areas underline the importance of neuropsychologic testing and the follow-up of children with pediatric strokes. PMID:21215909

  17. Gender Bias in U.S. Pediatric Growth Hormone Treatment

    PubMed Central

    Grimberg, Adda; Huerta-Saenz, Lina; Grundmeier, Robert; Ramos, Mark Jason; Pati, Susmita; Cucchiara, Andrew J.; Stallings, Virginia A.

    2015-01-01

    Growth hormone (GH) treatment of idiopathic short stature (ISS), defined as height <−2.25 standard deviations (SD), is approved by U.S. FDA. This study determined the gender-specific prevalence of height <−2.25 SD in a pediatric primary care population, and compared it to demographics of U.S. pediatric GH recipients. Data were extracted from health records of all patients age 0.5–20 years with ≥ 1 recorded height measurement in 28 regional primary care practices and from the four U.S. GH registries. Height <−2.25 SD was modeled by multivariable logistic regression against gender and other characteristics. Of the 189,280 subjects, 2073 (1.1%) had height <−2.25 SD. No gender differences in prevalence of height <−2.25 SD or distribution of height Z-scores were found. In contrast, males comprised 74% of GH recipients for ISS and 66% for all indications. Short stature was associated (P < 0.0001) with history of prematurity, race/ethnicity, age and Medicaid insurance, and inversely related (P < 0.0001) with BMI Z-score. In conclusion, males outnumbered females almost 3:1 for ISS and 2:1 for all indications in U.S. pediatric GH registries despite no gender difference in height <−2.25 SD in a large primary care population. Treatment and/or referral bias was the likely cause of male predominance among GH recipients. PMID:26057697

  18. A correlation analysis of Broselow™ Pediatric Emergency Tape-determined pediatric weight with actual pediatric weight in India

    PubMed Central

    Mishra, Deepak Geetaprasad; Kole, Tamorish; Nagpal, Rahul; Smith, Jeffery Paul

    2016-01-01

    BACKGROUND: The Broselow™ Pediatric Emergency Tape indicates standardized, pre-calculated medication doses, dose delivery volumes, and equipment sizes using color-coded zones based on height-weight correlations. The present study attempted to provide more evidence on the effectiveness of the Broselow™ Pediatric Emergency Tape by comparing the tape-estimated weights with actual weights. We hypothesized that the Broselow™ Pediatric Emergency Tape would overestimate weights in Indian children aged<10 years, leading to inaccurate dosing and equipment sizing in the emergency setting. METHODS: This prospective study of pediatric patients aged <10 years who were divided into three groups based on actual body weight: <10 kg, 10–18 kg, and >18 kg. We calculated the percentage difference between the Broselow-predicted weight and the measured weight as a measure of tape bias. Concordant results were those with a mean percent difference within 3%. Standard deviation was measured to determine precision. Accuracy was determined as color-coded zone prediction and measured weight concordance, including the percentage overestimation by 1–2 zones. RESULTS: The male-to-female ratio of the patients was 1.3:1. Total agreement between color-coding was 63.18% (κ=0.582). The Broselow™ color-coded zone agreement was 74.8% in the <10 kg group, 61.24% in the 10–18 kg group, and 53.42% in the >18 kg group. CONCLUSIONS: The Broselow™ Pediatric Emergency Tape showed good evidence for being more reliable in children of the <10 kg and 10–18 kg groups. However, as pediatric weight increased, predictive reliability decreased. This raises concerns over the use of the Broselow™ Pediatric Emergency Tape in Indian children because body weight was overestimated in those weighing >18 kg. PMID:27006737

  19. Pediatric facial nerve rehabilitation.

    PubMed

    Banks, Caroline A; Hadlock, Tessa A

    2014-11-01

    Facial paralysis is a rare but severe condition in the pediatric population. Impaired facial movement has multiple causes and varied presentations, therefore individualized treatment plans are essential for optimal results. Advances in facial reanimation over the past 4 decades have given rise to new treatments designed to restore balance and function in pediatric patients with facial paralysis. This article provides a comprehensive review of pediatric facial rehabilitation and describes a zone-based approach to assessment and treatment of impaired facial movement.

  20. Pediatric Hand Injuries.

    PubMed

    Sullivan, Matthew A; Cogan, Charles J; Adkinson, Joshua M

    2016-01-01

    Pediatric hand injuries are extremely common. Although many hand injuries are adequately managed in the emergency department, some may need evaluation and treatment by a pediatric hand surgeon to ensure a good functional outcome. This article discusses the diagnosis and management of the most common pediatric hand maladies: fingertip injuries/amputation, tendon injuries, and phalangeal and metacarpal fractures. The plastic surgery nurse should be familiar with hand injuries that require intervention to facilitate efficient management and optimal postoperative care. PMID:27606586

  1. Pediatric heart allocation and transplantation in Eurotransplant.

    PubMed

    Smits, Jacqueline M; Thul, Josef; De Pauw, Michel; Delmo Walter, Eva; Strelniece, Agita; Green, Dave; de Vries, Erwin; Rahmel, Axel; Bauer, Juergen; Laufer, Guenther; Hetzer, Roland; Reichenspurner, Hermann; Meiser, Bruno

    2014-09-01

    Pediatric heart allocation in Eurotransplant (ET) has evolved over the past decades to better serve patients and improve utilization. Pediatric heart transplants (HT) account for 6% of the annual transplant volume in ET. Death rates on the pediatric heart transplant waiting list have decreased over the years, from 25% in 1997 to 18% in 2011. Within the first year after listing, 32% of all infants (<12 months), 20% of all children aged 1-10 years, and 15% of all children aged 11-15 years died without having received a heart transplant. Survival after transplantation improved over the years, and in almost a decade, the 1-year survival went from 83% to 89%, and the 3-year rates increased from 81% to 85%. Improved medical management of heart failure patients and the availability of mechanical support for children have significantly improved the prospects for children on the heart transplant waiting list.

  2. A comparative evaluation of the reliability of three methods of assessing gingival biotype in dentate subjects in different age groups: An in vivo study

    PubMed Central

    Memon, Sarfaraz; Patel, Jayanti R.; Sethuraman, Rajesh; Patel, Ravi; Arora, Himanshu

    2015-01-01

    Introduction: In the modern competitive society, a pleasing appearance often dictates the difference between success and failure in both our personal and professional lives. Evaluation of gingival biotype is very important from the start of treatment plan to the final restorative placement to provide excellent esthetics. Materials and Methodology: For the study, subjects were divided into 4 groups of different ages, from 20-30, 31-40, 41-50 and 51-60 years. 30 subjects (15 men and 15 women) were selected in each group for the study. Examination of the thickness of Gingival Biotype was done in 3 different ways; - Direct visual, William's Graduated Probe and Using modified wax caliper. Results: The McNemar test showed statistically significant differences in the way gingival biotype was identified when comparing visual assessment with assessment using direct measurement (P < 0.001). And there was no statistically significant difference when assessment using a periodontal probe was compared to direct measurement (P < 0.676). There is no correlation for the Biotype among the different age groups. Conclusion: Gingival biotype identification by visual assessment is statistically significantly different from assessment with direct measurement. Gingival biotype identification by assessment with a periodontal probe is not statistically significantly different from direct measurement. PMID:26929533

  3. Do We Really Need Additional Contrast-Enhanced Abdominal Computed Tomography for Differential Diagnosis in Triage of Middle-Aged Subjects With Suspected Biliary Pain

    PubMed Central

    Hwang, In Kyeom; Lee, Yoon Suk; Kim, Jaihwan; Lee, Yoon Jin; Park, Ji Hoon; Hwang, Jin-Hyeok

    2015-01-01

    Abstract Enhanced computed tomography (CT) is widely used for evaluating acute biliary pain in the emergency department (ED). However, concern about radiation exposure from CT has also increased. We investigated the usefulness of pre-contrast CT for differential diagnosis in middle-aged subjects with suspected biliary pain. A total of 183 subjects, who visited the ED for suspected biliary pain from January 2011 to December 2012, were included. Retrospectively, pre-contrast phase and multiphase CT findings were reviewed and the detection rate of findings suggesting disease requiring significant treatment by noncontrast CT (NCCT) was compared with cases detected by multiphase CT. Approximately 70% of total subjects had a significant condition, including 1 case of gallbladder cancer and 126 (68.8%) cases requiring intervention (122 biliary stone-related diseases, 3 liver abscesses, and 1 liver hemangioma). The rate of overlooking malignancy without contrast enhancement was calculated to be 0% to 1.5%. Biliary stones and liver space-occupying lesions were found equally on NCCT and multiphase CT. Calculated probable rates of overlooking acute cholecystitis and biliary obstruction were maximally 6.8% and 4.2% respectively. Incidental significant finding unrelated with pain consisted of 1 case of adrenal incidentaloma, which was also observed in NCCT. NCCT might be sufficient to detect life-threatening or significant disease requiring early treatment in young adults with biliary pain. PMID:25700321

  4. Clinical consequences of human herpesvirus-6 DNAemia in peripheral blood in pediatric liver transplant recipients.

    PubMed

    Al Fawaz, Tariq; Ng, Vicky; Richardson, Susan E; Barton, Michelle; Allen, Upton

    2014-02-01

    The significance of HHV6 DNAemia after solid organ transplantation has not been fully determined. Our objectives were to determine the prevalence of HHV6 DNAemia in pediatric liver transplant recipients and to describe the associated clinical characteristics and outcomes. This was a retrospective case-control study. Eligible liver transplant patients aged ≤ 18 yr with HHV6 DNAemia were matched with two subjects without HHV6 DNAemia. Matching was by age ± 6 months. Among 154 subjects, 25 patients (16%) had HHV6 DNAemia detected by PCR in whole blood or plasma (M:F ratio = 0.9:1). While 28% of subjects with DNAemia (7/25) had symptoms consistent with HHV6 infection, active infection was detected in only four subjects (2.6% of liver transplant patients). The major symptoms/signs were fever, vomiting, lethargy, splenomegaly, bone marrow suppression, and elevated transaminases. The prevalence of DNAemia due to other herpesviruses in cases vs. controls was EBV 56% vs. 60%, CMV 12% vs. 12%, HHV7 20% vs. 12%; p value is not significant for all pairwise comparisons. HHV6 DNAemia in pediatric liver transplant patients is not an uncommon entity. While the clinical relevance is still not entirely established, active HHV6 infection and attributable symptoms are relatively rare.

  5. Comparison of time-resolved autofluorescence in the eye-ground of healthy subjects and patients suffering from age-related macular degeneration

    NASA Astrophysics Data System (ADS)

    Schweitzer, Dietrich; Schweitzer, Frank; Hammer, Martin; Schenke, Stefan; Richter, Sandra

    2005-08-01

    Age-related macular degeneration (AMD) is the most frequent cause for blindness for person older than 65 years in western countries. Besides the subjective pain, it is also an economic problem in the ageing population. As the pathomechanism is unknown, no curative treatment is possible. International research for discovering of early age-related alterations at the fundus is directed on in vivo measurements of autofluorescence. One way is the measurement of fluorescence spectra. Unfortunately, any selective excitation of fluorophores is excluded by the absorption edge of the ocular media at 400 nm. Furthermore, the shape of fluorescence spectra is influenced by the spectral absorption of layers in front of the emitting fluorophore. Weakly emitting fluorophores are covered by intensive emitting substances. The most serious limitation in fluorescence measurements of the living human fundus is the maximal permissible exposure. For that reason, fluorescence spectra of the fundus can not be detected with a high spatial resolution. The detection of dynamic fluorescence provides substance-specific lifetimes Ti, amplitudes Ai, and information about the relative contribution Qi of components in fluorescence images. As these parameters are calculated for each image point, diagrams of Ti vs. Tj, Ai vs. Aj, and Qi vs. Qj can be drawn, in which specific clusters appear for healthy subjects or AMD - patients. The projection of lifetime - clusters onto corresponding axis represents histogram of the considered lifetime. The slope in the correlation between Ai and Aj can also be used as a discriminating mark. Considering image lines as intersection through characteristic anatomical structures (optic disc, macula) profiles of Ti, Ai, or Qi show changes of these parameters (e.g. depigmentation) as function of location, which might be specific for AMD.

  6. Structure and Properties of Ti-19.7Nb-5.8Ta Shape Memory Alloy Subjected to Thermomechanical Processing Including Aging

    NASA Astrophysics Data System (ADS)

    Dubinskiy, S.; Brailovski, Vladimir; Prokoshkin, S.; Pushin, V.; Inaekyan, K.; Sheremetyev, V.; Petrzhik, M.; Filonov, M.

    2013-09-01

    In this work, the ternary Ti-19.7Nb-5.8Ta (at.%) alloy for biomedical applications was studied. The ingot was manufactured by vacuum arc melting with a consumable electrode and then subjected to hot forging. Specimens were cut from the ingot and processed by cold rolling with e = 0.37 of logarithmic thickness reduction and post-deformation annealing (PDA) between 400 and 750 °C (1 h). Selected samples were subjected to aging at 300 °C (10 min to 3 h). The influence of the thermomechanical processing on the alloy's structure, phase composition, and mechanical and functional properties was studied. It was shown that thermomechanical processing leads to the formation of a nanosubgrained structure (polygonized with subgrains below 100 nm) in the 500-600 °C PDA range, which transforms to a recrystallized structure of β-phase when PDA temperature increases. Simultaneously, the phase composition and the β → α″ transformation kinetics vary. It was found that after conventional cold rolling and PDA, Ti-Nb-Ta alloy manifests superelastic and shape memory behaviors. During aging at 300 °C (1 h), an important quantity of randomly scattered equiaxed ω-precipitates forms, which results in improved superelastic cyclic properties. On the other hand, aging at 300 °C (3 h) changes the ω-precipitates' particle morphology from equiaxed to elongated and leads to their coarsening, which negatively affects the superelastic and shape memory functional properties of Ti-Nb-Ta alloy.

  7. Effect of genotype and age on some carcass and meat quality traits of beef carcasses subjected to the South African classification system.

    PubMed

    Soji, Z; Muchenje, V

    2016-07-01

    Genotype and age effects on pH24, L*, a*, b*, tenderness (WBSF), cooking (CL %), and thawing loss (TL %) of beef carcasses subjected to the South African classification system were determined. Carcass traits (bruising, subcutaneous fat (SF), and conformation) were also measured. Meat quality measurements were taken on the longissimus thoracis et lumborum (n=175) of A, AB, B, and C carcasses from Angus, Bonsmara, Fleckvieh, Non-descript, and Simmental genotypes. No bruises were evident in all carcasses. All carcasses scored medium conformation (class 3) while in SF classification, class 2 had the greatest frequency (66.3%). Genotypic effects (P<0.05) were observed for a*, hue angle (HA), pH24, TL%, CL%, and WBSF between steers with six, seven, and eight incisors. Notable differences (P<0.05) were observed for tenderness where Angus and Simmental had least tender meat while Non-descript and Fleckvieh had the tenderest meat within the C-age class. Meat quality varied within animals of the same age-class across genotypes. PMID:26995775

  8. Effects of nocturnal railway noise on sleep fragmentation in young and middle-aged subjects as a function of type of train and sound level.

    PubMed

    Saremi, Mahnaz; Grenèche, Jérôme; Bonnefond, Anne; Rohmer, Odile; Eschenlauer, Arnaud; Tassi, Patricia

    2008-12-01

    Due to undisputable effects of noise on sleep structure, especially in terms of sleep fragmentation, the expected development of railway transportation in the next few years might represent a potential risk factor for people living alongside the rail tracks. The aim of this study was to compare the effects of different types of train (freight, automotive, passenger) on arousal from sleep and to determine any differential impact as a function of sound level and age. Twenty young (16 women, 4 men; 25.8 years+/-2.6) and 18 middle-aged (15 women, 3 men; 52.2 years+/-2.5) healthy subjects participated in three whole-night polysomnographic recordings including one control night (35 dBA), and two noisy nights with equivalent noise levels of 40 or 50 dB(A), respectively. Arousal responsiveness increased with sound level. It was the highest in S2 and the lowest in REM sleep. Micro-arousals (3-10 s) occurred at a rate of 25-30%, irrespective of the type of train. Awakenings (>10 s) were produced more frequently by freight train than by automotive and passenger trains. Normal age-related changes in sleep were observed, but they were not aggravated by railway noise, thus questioning whether older persons are less sensitive to noise during sleep. These evidences led to the conclusion that microscopic detection of sleep fragmentation may provide advantageous information on sleep disturbances caused by environmental noises. PMID:18773929

  9. Cancer prevention trial of a synergistic mixture of green tea concentrate plus Capsicum (CAPSOL-T) in a random population of subjects ages 40-84

    PubMed Central

    2014-01-01

    Background Experts agree that one of the more promising strategies in cancer management is early detection coupled with early intervention. In this study, we evaluated an early cancer detection strategy of cancer presence based on serum levels of the cancer-specific transcript variants of ENOX2 in serum coupled with an ENOX2-targeted nutraceutical preparation of green tea concentrate plus Capsicum (Capsol-T®) as a strategy of Curative Prevention® involving early detection coupled with early intervention in early stage cancer when in its most susceptible and manageable stages. Experimental design One hundred ten (110) subjects were tested for cancer presence using the ONCOblot® Tissue of Origin 2-D gel/western blot protocol for detection of serum presence of transcript variants of the ENOX2 protein. Subjects testing positive for ENOX2 received 350 mg of Capsol-T® in capsule form every 4 h including during the night for periods of at least 3 to 6 months or longer after which they were again tested for ENOX2 presence using the ONCOblot® Tissue of Origin Cancer Test protocol. Results Of the 110 subjects, both male and female, ages 40 to 84, with no evidence of clinical symptoms of cancer, 40% were positive for ENOX2 presence in the ONCOblot® Tissue of Origin Cancer Test. After completion of 3 to 17 months of Capsol-T® use, 94% of subjects subsequently tested negative for ENOX2 presence. Conclusions Oral Capsol-T® is well tolerated and, for ENOX2 presence in serum in the absence of clinical cancer symptoms, is consistently effective in reducing the serum ENOX2 levels to below detectable limits. PMID:24393573

  10. Pediatric surgeons on the Internet: a multi-institutional experience.

    PubMed

    Wulkan, M L; Smith, S D; Whalen, T V; Hardin, W D

    1997-04-01

    An estimated 24 million people, or 11% of the North American population over 16 years of age, use the Internet. An estimated 40% of households have computers, and 37 million people have Internet access. The experience of three pediatric surgery Internet sites are reviewed to evaluate current practices and future potential of the Internet to practicing pediatric surgeons. The sites reviewed are the Pediatric Surgery Bulletin Board System (BBS), the Pediatric Surgery List Server, and the Pediatric Surgery Website. Statistics were collected at each site to characterize the number of users, traffic load, topics of interest, and times of peak use. There are currently 79 subscribers to the Pediatric Surgery BBS and 100 subscribers to the Pediatric Surgery List Server. The average user of the BBS is a young man who has placed an average of 52 calls to the BBS since joining. There have been 1413 Internet electronic mail messages sent. Twenty-five percent of the traffic has been related to clinical problems and 5% to research, teaching, and career issues. Traffic at this site has been increasing exponentially with most of the dialogue concentrated on clinical issues and problem cases. In a 3-month period the Pediatric Surgery Website received 16,270 hits. The most commonly accessed areas include an electronic mail directory, case studies, the job board, information on the pediatric surgical residency, and information on upcoming meetings. Pediatric surgeons are exploring the Internet and using available pediatric surgery resources. The scope of professional information available to pediatric surgeons on the Internet is still limited but is increasing rapidly. The Internet will impact the way physicians practice medicine through education and communication. PMID:9126766

  11. Posttransplant metabolic syndrome in the withdrawal of immunosuppression in Pediatric Liver Transplant Recipients (WISP-R) pilot trial.

    PubMed

    Perito, E R; Mohammad, S; Rosenthal, P; Alonso, E M; Ekong, U D; Lobritto, S J; Feng, S

    2015-03-01

    Posttransplant metabolic syndrome (PTMS)-obesity, hypertension, elevated triglycerides, low HDL and glucose intolerance-is a major contributor to morbidity after adult liver transplant. This analysis of the Withdrawal of Immunosuppression in Pediatric Liver Transplant Recipients (WISP-R) pilot trial is the first prospective study of PTMS after pediatric liver transplant. Twenty children were enrolled in WISP-R, at median age 8.5 years (IQR 6.4-10.8), and weaned from calcineurin-inhibitor monotherapy. The 12 children who tolerated complete immunosuppression withdrawal were compared to matched historical controls. At baseline, 45% of WISP-R subjects and 58% of controls had at least one component of PTMS. Calcineurin-inhibitor withdrawal in the WISP-R subjects did not impact the prevalence of PTMS components compared to controls. At 5 years, despite weaning off of immunosuppression, 92% of the 12 tolerant WISP-R subjects had at least one PTMS component and 58% had at least two; 33% were overweight or obese, 50% had dyslipidemia, 33% glucose intolerance and 42% systolic hypertension. Overweight/obesity increased the risk of hypertension in all children. Compared to controls, WISP-R tolerant subjects had similar GFR at baseline but did have higher GFR at 2, 3 and 4 years. Further study of PTMS and immunosuppression withdrawal after pediatric liver transplant is warranted.

  12. Memory and Learning in Pediatric Bipolar Disorder.

    ERIC Educational Resources Information Center

    McClure, Erin B.; Treland, Julia E.; Snow, Joseph; Dickstein, Daniel P.; Towbin, Kenneth E.; Charney, Dennis S.; Pine, Daniel S.; Leibenluft, Ellen

    2005-01-01

    Objective: To test the hypothesis that patients with pediatric bipolar disorder (PBPD) would demonstrate impairment relative to diagnosis-free controls of comparable age, gender, and IQ on measures of memory functioning. Method: The authors administered a battery of verbal and visuospatial memory tests to 35 outpatients with PBPD and 20 healthy…

  13. Pediatric HIV Infection and Developmental Disabilities.

    ERIC Educational Resources Information Center

    Seidel, John F.

    This paper presents an overview of the developmental disabilities associated with pediatric Human Immunodeficiency Virus (HIV) infection, and examines efficacious practices for assessment and intervention programming. The focus population is early childhood into school age. The paper describes the complex array of challenges presented by these…

  14. Evoked potentials in pediatrics: economic audit.

    PubMed

    Chiozza, M L; Suppiej, A; Zacchello, F

    1997-03-01

    In the present era of resource management, there is increasing emphasis on the need to make the best possible use of available resources. We therefore measured the productive factors directly involved in performance of 59 evoked potential examinations (brainstem auditory evoked potentials, BAEPs; flash visual evoked potentials, F-VEPs; and electroretinograms, ERGs) in different pediatric age groups. In order to ascertain the gap between the costs of instrumental examinations performed in our service on children and the fees reimbursed by the Italian national health service (NHS) a breakdown was made of the costs of tests and their scheduling in relation to the different age variables involved. It was found that the fees reimbursed do not cover the real costs, because they underestimate the actual consumption of resources. The findings recorded indicate that for pediatric tests the economic audit should be graded according to the ages of the children examined and should include an analysis of different test phases. The economic audit should also be considered a preliminary step in clinical audit. It is concluded that it is financially punitive to reimburse a pediatric service with a fee based on the examination of adults, because in pediatrics the variable "age" influences the duration and complexity of tests and also their interpretation.

  15. Pediatric cataracts.

    PubMed

    Wright, K W

    1997-02-01

    Posterior chamber intraocular lenses are a well-accepted treatment of aphakia in children 2 years of age and older, with many now considering them as the treatment of choice. Infants, however, are usually treated with contact lens, rather than intraocular lens implantation, as the infant eye undergoes significant axial elongation. The use of intraocular lenses in children with cataracts associated with juvenile rheumatoid arthritis remains controversial, but a recent article [9] describes good results in these patients, who historically have a poor prognosis. The management of amblyopia associated with unilateral congenital cataracts is evolving. In the 1970s and 1980s, full-time occlusion of the sound eye was advocated for infants with unilateral congenital cataracts. It was also taught that binocular fusion was impossible to obtain, and children with unilateral cataracts inevitably develop strabismus. Recent studies have shown that part-time occlusion may in fact yield better results, allowing the development of binocular vision and stereopsis and reducing the incidence of strabismus. PMID:10168274

  16. Informed consent in pediatric research.

    PubMed

    Leibson, Tom; Koren, Gideon

    2015-02-01

    Pediatric drug research is gradually becoming more and more accepted as the norm for assessing whether a drug is safe and efficacious for infants and children. The process of informed consent and assent for these trials presents a major challenge. The aim of this review is to map historical, ethical and legal aspects relevant to the challenges of informed consent in the setting of pediatric drug research. The impact of age, level of maturity and life circumstances on the process of obtaining informed consent as well as the relations between consent and assent are discussed. There appears to be a lack of regulatory clarity in the area of pediatric clinical trials; while numerous statements have been made regarding children's rights to autonomy and their ability to care for themselves and for younger ones, the ever changing status of adolescence is still difficult to translate to informed consent. This may delay scientific and clinical advancement for children who are at the very junction of being independent and not needing parental permission. Obtaining consent and assent for pediatric clinical trials is a delicate matter, as both parent and child need to agree to participate. The appropriate transfer of information to guardians and the children, especially concerning potential risks and benefits, is at the heart of informed consent, as it serves to protect both patient and physician. As many adults lack health literacy, one must ensure that guardians receive relevant information at a level and in forms they can understand regarding the trials their children are asked to participate in.

  17. Pediatric Endocrinology Nurses Society

    MedlinePlus

    ... for PENS Minneapolis 2017! Wednesday, April 26, 2017 ​​​​​​​​​​​​​​​​​​​​​​​​​​​ Journal of Pediatric Nursing The Journal of Pediatric Nursing provides original, peer-reviewed research ...

  18. Pediatric Salivary Gland Malignancies.

    PubMed

    Ord, Robert A; Carlson, Eric R

    2016-02-01

    Pediatric malignant salivary gland tumors are extremely rare. The percentage of malignant tumors is higher than that seen in adults, although the outcomes in terms of survival are better in pediatric patients. The mainstay of treatment is surgical excision with negative margins. This article reviews current concepts in demographics, etiology, management, and outcomes of malignant salivary tumors in children.

  19. Pediatric Odontogenic Tumors.

    PubMed

    Abrahams, Joshua M; McClure, Shawn A

    2016-02-01

    Pediatric odontogenic tumors are rare, and are often associated with impacted teeth. Although they can develop anywhere in the jaws, odontogenic tumors mainly occur in the posterior mandible. This article discusses the diagnosis and treatment of the most common pediatric odontogenic tumors, such as ameloblastoma, keratocystic odontogenic tumor, odontoma, and cementoblastoma.

  20. Teaching Prevention in Pediatrics.

    ERIC Educational Resources Information Center

    Cheng, Tina L.; Greenberg, Larrie; Loeser, Helen; Keller, David

    2000-01-01

    Reviews methods of teaching preventive medicine in pediatrics and highlights innovative programs. Methods of teaching prevention in pediatrics include patient interactions, self-directed learning, case-based learning, small-group learning, standardized patients, computer-assisted instruction, the Internet, student-centered learning, and lectures.…

  1. [Research in pediatrics].

    PubMed

    Herrera-Márquez, Julia Rocío; González-Cabello, Héctor Jaime

    2015-01-01

    In the interest of encouraging the promotion of research done by physicians of the Instituto Mexicano del Seguro Social, in this supplement we publish articles written by residents of different specialties related to critical themes on pediatrics. These residents are guided by affiliated physicians from the Hospital de Pediatría del Centro Médico Nacional Siglo XXI.

  2. Feasibility of Screening for Type 1 Diabetes and Celiac Disease in a Pediatric Clinic Setting

    PubMed Central

    Gesualdo, Patricia D.; Bautista, Kimberly A.; Waugh, Kathleen C.; Yu, Liping; Norris, Jill M.; Rewers, Marian J.; Baxter, Judith

    2016-01-01

    Objective Type 1 diabetes (T1D) or celiac disease (CD) develops in at least 2% of the general population. Early detection of disease-specific autoimmunity and subsequent monitoring would be possible if screening tests were more widely available. Currently screening for islet autoimmunity is available only in a research setting and CD-specific autoimmunity screening is limited to those in high risk groups. This study assessed the feasibility of incorporating T1D and CD autoantibody screening into a pediatric practice. Methods Patient engagement strategies, blood collection preference, blood sample volume, rate of autoantibody detection in the general population, and parental satisfaction were assessed. Over 5 weeks, research staff recruited 200 patients aged 2–6 yr from two pediatric practices in the Denver area to be screened for six islet autoantibodies (IAs) and the transglutaminase antibody. Results Of the 765 parents approached, 200 (26%) completed the same day screening. Of the 565 subjects who did not complete the screening, 345 expressed interest, but were unable to make a participation decision. A finger stick, compared to a venous draw, was the preferred method of sample collection. Both methods yielded sufficient volume for autoantibody determination. IAs or the transglutaminase antibody were detected in 11 subjects. Parents expressed satisfaction with all aspects of participation. Conclusion The results of this study suggest that it is feasible to conduct this type of screening in a pediatric clinic. Such screening could lead to increased disease awareness and the possible benefits that can result from early detection. PMID:26251221

  3. Children with a Prepubertal and Early Adolescent Bipolar Disorder Phenotype from Pediatric Versus Psychiatric Facilities

    ERIC Educational Resources Information Center

    Tillman, Rebecca; Geller, Barbara; Frazier, Jeanne; Beringer, Linda; Zimerman, Betsy; Klages, Tricia; Bolhofner, Kristine

    2005-01-01

    Objective: To examine characteristics between subjects with a prepubertal and early adolescent bipolar disorder phenotype from pediatric versus psychiatric venues. Method: Subjects (N = 93) with a prepubertal and early adolescent bipolar disorder phenotype were obtained through consecutive new case ascertainment from designated pediatric and…

  4. 20 Years of Pediatric Benchmarking in Germany and Austria: Age-Dependent Analysis of Longitudinal Follow-Up in 63,967 Children and Adolescents with Type 1 Diabetes

    PubMed Central

    Bohn, Barbara; Karges, Beate; Vogel, Christian; Otto, Klaus-Peter; Marg, Wolfgang; Hofer, Sabine E.; Fröhlich-Reiterer, Elke; Holder, Martin; Plamper, Michaela; Wabitsch, Martin; Kerner, Wolfgang; Holl, Reinhard W.

    2016-01-01

    Background To investigate changes in diabetes treatment over the last two decades in three age-groups of children and adolescents with type 1 diabetes (T1D) from Germany and Austria. Methods 63,967 subjects (<18yr) with T1D documented between 1995 and 2014 from the DPV-database were included and stratified according to age (0.5-<6, 6-<12, 12-<18yr). Regression models were applied for insulin regimens (<3 and ≥4 injection time points/day, or continuous subcutaneous insulin infusion (CSII)), use of rapid- and long acting insulin analogues, NPH insulin, and frequency of self-monitoring of blood glucose (SMBG)/day. Models were adjusted for sex, diabetes duration, and migration background. P-value for trend was given. Findings The number of subjects with <3 injection time points/day decreased from 1995 to 2014 to <5% in all age-groups (p<0.0001). Proportion of patients with ≥4 injections/day increased until the early 2000s, and then declined until 2014. This trend was not found in 6-<12yr olds (p = 0.3403). CSII increased in all age-groups (p<0.0001) with the highest increase in children <6 years (from 0.4% to 79.2%), and the lowest increase in 12-<18 year olds (from 1.0% to 38.9%). NPH insulin decreased in all age-groups (p<0.0001). Insulin analogues, especially rapid-acting, became more frequent in all age-groups (p<0.0001), accounting for 78.4% in 2014 for all subjects. The highest use was found in the youngest children (in 2014: 85.6%), the lowest use in 6-<12 year olds (in 2014: 72.9%). The number of SMBG/day increased from 2.2 to 6.4 with a similar rise in all age-groups (p<0.0001). Frequency was highest in subjects <6yr. Conclusions In all age-groups, T1D treatment was intensified over the last 20 years. Age-specific differences in trends were particularly observed in the number of patients on CSII, in the number of patients with 4 or more injections/day, and in the frequency of SMBG/day. PMID:27532627

  5. Pediatric lung transplantation: 10 years of experience

    PubMed Central

    Camargo, Priscila C. L. B.; Pato, Eduardo Z. S.; Campos, Silvia V.; Afonso, José E.; Carraro, Rafael M.; Costa, André N.; Teixeira, Ricardo H. O. B.; Samano, Marcos N.; Pêgo-Fernandes, Paulo M.

    2014-01-01

    Lung transplantation is a well-established treatment for advanced lung diseases. In children, the diseases that most commonly lead to the need for a transplantation are cystic fibrosis, pulmonary hypertension, and bronchiolitis. However, the number of pediatric lung transplantations being performed is low compared with the number of transplants performed in the adult age group. The objective of this study was to demonstrate our experience with pediatric lung transplants over a 10-year period in a program initially designed for adults. PMID:24860860

  6. Total and Envelope Protein-Specific Antibody-Secreting Cell Response in Pediatric Dengue Is Highly Modulated by Age and Subsequent Infections.

    PubMed

    Toro, Jessica F; Salgado, Doris M; Vega, Rocío; Rodríguez, Jairo A; Rodríguez, Luz-Stella; Angel, Juana; Franco, Manuel A; Greenberg, Harry B; Narváez, Carlos F

    2016-01-01

    The response of antibody-secreting cells (ASC) induced by dengue has only recently started to be characterized. We propose that young age and previous infections could be simple factors that affect this response. Here, we evaluated the primary and secondary responses of circulating ASC in infants (6-12 months old) and children (1-14 years old) infected with dengue showing different degrees of clinical severity. The ASC response was delayed and of lower magnitude in infants, compared with older children. In primary infection (PI), the total and envelope (E) protein-specific IgM ASC were dominant in infants but not in children, and a negative correlation was found between age and the number of IgM ASC (rho = -0.59, P = 0.03). However, infants with plasma dengue-specific IgG detectable in the acute phase developed an intense ASC response largely dominated by IgG and comparable to that of children with secondary infection (SI). IgM and IgG produced by ASC circulating in PI or SI were highly cross-reactive among the four serotypes. Dengue infection caused the disturbance of B cell subsets, particularly a decrease in the relative frequency of naïve B cells. Higher frequencies of total and E protein-specific IgM ASC in the infants and IgG in the children were associated with clinically severe forms of infection. Therefore, the ASC response induced by dengue is highly influenced by the age at which infection occurs and previous immune status, and its magnitude is a relevant element in the clinical outcome. These results are important in the search for correlates of protection and for determining the ideal age for vaccinating against dengue. PMID:27560782

  7. Total and Envelope Protein-Specific Antibody-Secreting Cell Response in Pediatric Dengue Is Highly Modulated by Age and Subsequent Infections

    PubMed Central

    Toro, Jessica F.; Salgado, Doris M.; Vega, Rocío; Rodríguez, Jairo A.; Rodríguez, Luz-Stella; Angel, Juana; Franco, Manuel A.; Greenberg, Harry B.; Narváez, Carlos F.

    2016-01-01

    The response of antibody-secreting cells (ASC) induced by dengue has only recently started to be characterized. We propose that young age and previous infections could be simple factors that affect this response. Here, we evaluated the primary and secondary responses of circulating ASC in infants (6–12 months old) and children (1–14 years old) infected with dengue showing different degrees of clinical severity. The ASC response was delayed and of lower magnitude in infants, compared with older children. In primary infection (PI), the total and envelope (E) protein-specific IgM ASC were dominant in infants but not in children, and a negative correlation was found between age and the number of IgM ASC (rho = −0.59, P = 0.03). However, infants with plasma dengue-specific IgG detectable in the acute phase developed an intense ASC response largely dominated by IgG and comparable to that of children with secondary infection (SI). IgM and IgG produced by ASC circulating in PI or SI were highly cross-reactive among the four serotypes. Dengue infection caused the disturbance of B cell subsets, particularly a decrease in the relative frequency of naïve B cells. Higher frequencies of total and E protein-specific IgM ASC in the infants and IgG in the children were associated with clinically severe forms of infection. Therefore, the ASC response induced by dengue is highly influenced by the age at which infection occurs and previous immune status, and its magnitude is a relevant element in the clinical outcome. These results are important in the search for correlates of protection and for determining the ideal age for vaccinating against dengue. PMID:27560782

  8. Platelet microparticles in immune thrombocytopenic purpura in pediatrics.

    PubMed

    Tantawy, Azza A G; Matter, Randa M; Hamed, Ahmed A; Shams El Din El Telbany, Manal A

    2010-05-01

    Immune thrombocytopenic purpura (ITP) is one of the most common hemorrhagic disorders in childhood. Platelet microparticles (PMPs) arise with platelet activation with procoagulant activity. Elevated PMP levels in adult ITP were reported to be thrombogenic in certain settings. However, their clinical significance in pediatric ITP was not studied. The aims of this study were to assess PMP levels in ITP in children and adolescents, and its correlation with clinical status and bleeding score. The study included 40 ITP patients (20 acute aged 9 +/- 2.19 years and 20 chronic aged 10.8 +/- 4.7 years) randomly selected from the Hematology Clinic, Children's Hospital, Ain Shams University, Cairo, Egypt, and 30 sex- and age-matched healthy controls aged 9 +/- 3.28 years. Patients were subjected to detailed history, assessment of bleeding score, complete hemogram, cytological bone marrow examination, and PMP quantification in peripheral blood by flow cytometry. Acute ITP patients had significant increase in PMPs, PMP/platelet count, and PMP percent compared to controls (P = .002, P < .0001, P < .0001, respectively) and compared to chronic ITP patients (P < .0001, P < .0001, P < .0001, respectively). PMPs were significantly decreased in chronic ITP patients compared to controls (P = .001), but PMP/platelet and PMP percent showed highly significant increase in chronic ITP (P < .0001). No correlation was evident between PMP levels and platelet count in either group (P > .05). Neither higher bleeding score nor thrombotic manifestations were observed in the studied ITP patients with high PMP levels. Elevated PMP levels may be protective against severe bleeding events in pediatric ITP. The role of PMP studies in deciding the management plan of childhood and adolescent ITP needs further evaluation.

  9. Comparison of plasma lipids and vitamin E in young and middle-aged subjects on potato crisps fried in palmolein and highly oleic sunflower oil.

    PubMed

    Choudhury, N; Truswell, A S; McNeil, Y

    1997-01-01

    We previously found no difference in healthy young adults' plasma cholesterols between palmolein and olive oil as the major dietary lipid, although the former is high in palmitic acid (16:0) but the latter in oleic acid (18:1 cis). In the experiment reported here we compared the effects of palmolein against another monounsaturated oil, highly oleic sunflower oil (HOSO), on plasma cholesterol in both young and middle-aged healthy adults. The test oils were provided as frying oil of potato crisps (150 g/day in men; 100 g/day in women) against low-fat background diets in free-living motivated volunteers. The design was a randomised double-blind 4-week/3-week crossover trial. Compliance was monitored with continuous dietary diaries and by measuring (fasting) plasma lipid fatty-acid pattern. Plasma lipids and vitamin-E compounds were measured at the start and twice at the end of each test period. In combined young plus older subjects (n = 42) mean plasma total and low-density-lipoprotein cholesterol (LDL-c) values were both 7% (significantly) lower on HOSO than on palmolein, but because high-density-lipoprotein cholesterol (HDL-c) was also 5% lower, the LDL-c/HDL-c ratio was only 3% lower on HOSO than on palmolein. The difference between the present results with HOSO and previous results with olive oil both compared against palmolein suggest that olive oil is associated with higher plasma cholesterols than other monounsaturated oils. In both the young and older subgroup, LDL-c was lower on HOSO but because HDL-c moved down too in the young subgroup, the LDL-c/HDL-c ratio was lower on HOSO only in the older subjects. Palmolein has an unusual pattern of E vitamins, with a high content of tocotrienols, notably the gamma-isomer. Unlike alpha-tocopherol however, there was no sign of these tocotrienols in subjects' plasmas. PMID:9286464

  10. A Double-Blind, Rct Testing Beneficial Modulation of Bdnf in Middle-Aged, Life Style-Stressed Subjects: A Clue to Brain Protection?

    PubMed Central

    Marcellino, M; Marotta, F; Sweed, H; Solimene, U; Vignali, AI; Xiao, W; Ayala, A; Cagnuolo, U; Zerbinati, N

    2014-01-01

    Introduction: The aim of this prospective study was to see whether LD-1227, a quality-controlled marine nutraceuticals shown to protect experimental stress-induced hyppocampal degeneration, could beneficially modulate BDNF, as measured in the serum, in otherwise healthy but work-stressed individuals. Materials and Methods: Forty-eight men and women between the ages of 38 and 62 reporting high-demanding work activity but with an overall positive attitude towards their personal life were recruited. Subjects were divided in two group (24 patients each) and blindly supplemented for 2 month with: a) LD-1227 400mg or b) placebo. A third group of healthy non-stressed subjects was used as well. Blood samples were taken before and after the supplementation period. Unstimulated saliva was collected and tested for amylase while serum levels were used to measure BDNF. State Trait Anxiety Inventory (STAI), Pittsburgh Sleep Quality Index (PSQI) and psychological well-being assessment (PSWB) were measured too. Patients with Val66Met functional polymorphism of BDNF excluded those given their reported association with an impaired release of BDNF. Results: Results showed that, as compared to healthy, non-stressed individuals, stressed ones has a trend decrease of BDNF and this was significantly increased by LD 12-1227 supplementation and the same inverse phenomenon occurred to salivary amylase (p<0.05). No change was noted in the PSQI score but, either STAI or PSWB tests scored better in LD-1227 supplemented subjects. Conclusion: The present data suggest that LD-1227 is beneficially affecting neuromodulation and related symptoms during common stressful life conditions and may have the potential as tools in a neuroprotective clinical strategy. PMID:25584253

  11. Efficacy of the FEV1/FEV6 ratio compared to the FEV1/FVC ratio for the diagnosis of airway obstruction in subjects aged 40 years or over.

    PubMed

    Rosa, F W; Perez-Padilla, R; Camelier, A; Nascimento, O A; Menezes, A M B; Jardim, J R

    2007-12-01

    The present cross-sectional, population-based study was designed to evaluate the performance of the FEV1/FEV6 ratio for the detection of airway-obstructed subjects compared to the FEV1/FVC <0.70 fixed ratio test, as well as the lower limit of normality (LLN) for 1000 subjects (3)40 years of age in the metropolitan area of São Paulo, SP, Brazil. After the exclusion of 37 (3.7%) spirometries, a total of 963 pre-bronchodilator (BD) and 918 post-BD curves were constructed. The majority of the post-BD curves (93.1%) were of very good quality and achieved grade A (762 curves) or B (93 curves). The FEV1/FEV6 and FEV1/FVC ratios were highly correlated (r(2) = 0.92, P < 0.000). Two receiver operator characteristic curves were constructed in order to express the imbalance between the sensitivity and specificity of the FEV1/FEV6 ratio compared to two FEV1/FVC cut-off points for airway obstruction: equal to 70 (area under the curve = 0.98, P < 0.0001) and the LLN (area under the curve = 0.97, P < 0.0001), in the post-BD curves. According to an FEV1/FVC <0.70, the cut-off point for the FEV1/FEV6 ratio with the highest sum for sensitivity and specificity was 0.75. The FEV1/FEV6 ratio can be considered to be a good alternative to the FEV1/FVC ratio for the diagnosis of airway obstruction, both using a fixed cut-off point or below the LLN as reference. The FEV1/FEV6 ratio has the additional advantage of being an easier maneuver for the subjects and for the lung function technicians, providing a higher reproducibility than traditional spirometry maneuvers.

  12. Pediatric oncology in Morocco: achievements and challenges.

    PubMed

    Hessissen, Laila; Madani, Abdellah

    2012-03-01

    Cancer in children is quickly becoming one of the leading causes of non traumatic death among children. In pediatric oncology, palliative care is a primary component of the cancer control plan. In low income countries also known as emerging nations or developing countries access to adequate care remains a challenge for most pediatric oncology patients. In Morocco the situation has dramatically improved in the last few years as both the government and NGOs have become more aware of the importance and urgency of the issue. The incidence of cancer in patients under 15 years of age in Morocco is estimated to be 1000 new cases per year and the incidence of leukemia to be 100 new cases diagnosed per year. Pediatric cancer patients are mostly managed by public hospitals. Thus they are highly influenced by the Moroccan public health system, which is now considering cancer management a priority. Since health cover is very limited, most chemotherapy drugs were purchased by local parent associations. Recently, a new large Moroccan NGO (ALSC) provides anti-cancer drugs to all government-run oncology units. Despite all the progress, Morocco has witnessed in the pediatric oncology field, the palliative aspect of the care is not yet organized. Pediatric oncology is supported by the work of the National Society of Pediatric Oncolgy. The opioide therapy is available. However its use is strongly limited by the current restrictive and obsolete legislation which represents a major barrier to care. Despite the latest progress, pediatric oncology in Morocco still needs to improve in order to achieve performances comparable to those of the developed world. These improvements include better survival rates, less treatment abandonment, developing new techniques, improving quality of life and creating data collection teams. In order for this action to succeed all the stakeholders (government, NGOs, medical societies, oncology teams) must work together and coordinate their efforts.

  13. Relation Between Epicardial Adipose and Aortic Valve and Mitral Annular Calcium Determined by Computed Tomography in Subjects Aged ≥65 Years.

    PubMed

    Alnabelsi, Talal S; Alhamshari, Yaser; Mulki, Ramzi H; Codolosa, Jose N; Koshkelashvili, Nikoloz; Goykhman, Igor; Pressman, Gregg S; Romero-Corral, Abel

    2016-10-01

    Epicardial adipose tissue (EAT) has been linked to coronary artery calcium deposits and atherosclerotic disease. Mitral annular (MAC) and aortic valve calcium (AVC) have also been associated with atherosclerosis. This study examined the possible relation between EAT thickness and valvular calcium deposits. We included 294 patients aged ≥65 years who had noncontrast computed tomography scans of the chest. Mean age was 76 ± 7 years; 47% were men. Using reconstructed images, EAT thickness was measured at various locations. MAC and AVC were quantified by Agatston technique. The sum of AVC and MAC was reported as the grand total score (GTS). Subjects were divided into 2 groups based on the value of GTS; GTS = 0, no cardiac calcification and GTS ≥1, cardiac calcification group. Epicardial fat (left and right atrioventricular grooves and superior interventricular groove) was significantly greater in the cardiac calcification group compared with the no cardiac calcification (all values, p <0.05). After adjusting for clinical variables including BMI, EAT at the superior interventricular groove remained significantly associated with total calcium. Left atrioventricular groove EAT demonstrated a trend toward an association with total calcium, but this did not reach statistical significance. In conclusion, epicardial fat is associated with calcium deposits of the mitral annulus and aortic valve. PMID:27521222

  14. Bispectral Index Monitoring: validity and utility in pediatric dentistry.

    PubMed

    Goyal, Ashima; Mittal, Neeti; Mittal, Parteek; Gauba, K

    2014-01-01

    Reliable and safe provision of sedation and general anesthesia is dependent on continuous vigilance of patient's sedation depth. Failure to do so may result in unintended oversedation or undersedation. It is a common practice to observe sedation depth by applying subjective sedation scales and in case of general anesthesia, practitioner is dependent on vital sign assessment. The Bispectral Index System (BIS) is a recently introduced objective, quantitative, easy to use, and free from observer bias, and clinically useful tool to assess sedation depth and it precludes the need to stimulate the patient to assess his sedation level. The present article is an attempt to orient the readers towards utility and validity of BIS for sedation and general anesthesia in pediatric dentistry. In this article, we attempt to make the readers understand the principle of BIS, its variation across sedation continuum, its validity across different age groups and for a variety of sedative drugs.

  15. Evaluation and management of pediatric rhegmatogenous retinal detachment

    PubMed Central

    Wenick, Adam S.; Barañano, David E.

    2012-01-01

    Pediatric rhegmatogenous retinal detachments are rare, accounting for less than ten percent of all rhegmatogenous retinal detachments. While most retinal detachments in the adult population are related to posterior vitreous detachment, pediatric retinal detachment are often related to trauma or an underlying congenital abnormalities or genetic syndrome. The anatomy of pediatric eyes, the often late presentation of the disease, and the high incidence of bilateral pathology in children all pose significant challenges in the management of these patients. We discuss the epidemiology of pediatric rhegmatogenous retinal detachment, review the genetic syndromes associated with a high incidence of retinal detachment, and examine other common causes of retinal detachment in this age group. We then outline an approach to evaluation and management and describe the expected outcomes of repair of retinal detachment in the pediatric population. PMID:23961003

  16. Pediatric guidelines for dyslipidemia.

    PubMed

    Daniels, Stephen R

    2015-01-01

    Clinical guidelines are developed to assist clinicians in complex clinical decision making. Modern guideline development includes a systematic review and grading of relevant literature and then using the evidence review to construct recommendations for clinical care which are also graded regarding the level of evidence supporting them. Pediatric guidelines for dyslipidemia were first published in 1992. There was then a gap during which no formal guidelines were developed. In 2011, the National Heart, Lung, and Blood Institute Integrated Guidelines for Cardiovascular Disease Risk Reduction in Children were published. This included an evidence review and clinical recommendations regarding dyslipidemia. This review process began in 2006. The evidence review ended in 2008, and they were published in 2011 because of an extensive and prolonged review process. These guidelines recommend universal screening for dyslipidemia at age 9 to 11 y with a focus on identifying young individuals with genetic dyslipidemia such as familial hypercholesterolemia. The guidelines also include lifestyle recommendations and recommendations for pharmacologic treatment for children with markedly elevated low-density lipoprotein cholesterol. The guideline process should include review of the implementation of guidelines in practice and should also include ongoing review of the guidelines with respect to a growing evidence base with new research findings.

  17. An evaluation of pediatric asthma educational resources.

    PubMed

    Nicholas, David B; Dell, Sharon D; Fleming-Carroll, Bonnie; Selkirk, Enid K

    2009-01-01

    The purpose of this study was to evaluate newly developed educational resources for children with asthma. Children with asthma, their parents, and pediatric health care professionals were invited to review age-appropriate asthma resources. Key findings revealed: (1) the perceived usefulness of these resources, particularly for creating discussion opportunities between children and their caregivers through implemented resource use; (2) the need for health education materials to balance goals of depth of information versus child enjoyment in order to increase effective knowledge transfer and application; and (3) a renewed call for future educational resources to be both relevant and interactive in their outreach and engagement of children, potentially involving mediums of advanced technology. Clinical experience and the literature note a current lack of pediatric asthma education materials. The positive findings of this review of novel educational materials in asthma address an important gap relative to pediatric practice, resource evaluation, and knowledge translation. PMID:19396712

  18. Changes in leisure-time physical activity and sedentary behaviour at retirement: a prospective study in middle-aged French subjects

    PubMed Central

    2010-01-01

    Background Longitudinal studies on physical activity patterns around retirement age are scarce and provide divergent findings. Little is known about changes in sedentary behaviour in this context. Our aim was to investigate relationships between retirement and 3-year changes in leisure-time physical activity (LTPA) patterns and sedentary behaviour in middle-aged French adults. Methods Past-year LTPA and sedentary behaviour (watching television) were assessed in 1998 and 2001 using the Modifiable Activity Questionnaire on participants in the SU.VI.MAX (Supplementation with Antioxidants and Minerals) study. A total of 698 men and 691 women aged 45-64 were included in this analysis. Comparisons were made between subjects who had retired between 1998 and 2001 and those who continued to work, using the Chi-square test, Student t-test, Wilcoxon rank test or covariance analysis where appropriate. Results 20.1% of men and 15.6% of women retired during follow-up. The baseline LTPA level was similar between subjects who retired during follow-up and those who continued to work. Mean LTPA increased by about 2 h/week in men and women who had retired, whereas no change was observed in employed persons. The positive change in LTPA following retirement was mainly related to an increase in activities of moderate intensity, such as walking. Retirement did not modify the ranking of the most frequently performed LTPAs, but the number of participants and the duration increased through retirement. In men, the increase in time spent watching TV was more than twice as high in retirees as in workers (+40.5 vs. +15.0 min/day, P < 0.0001). The same tendency was observed among women, but was borderline non-significant (+33.5 vs. +19.9 min/day, P = 0.05). In women, retirees who increased their walking duration by 2 h/week or more also decreased time spent watching TV by 11.5 min/day. Conclusions Retirement was associated with both an increase in LTPAs and in time spent watching TV, suggesting

  19. Circadian Phase Preference in Pediatric Bipolar Disorder

    PubMed Central

    Kim, Kerri L.; Weissman, Alexandra B.; Puzia, Megan E.; Cushman, Grace K.; Seymour, Karen E.; Wegbreit, Ezra; Carskadon, Mary A.; Dickstein, Daniel P.

    2014-01-01

    Pediatric bipolar disorder (BD) rates have notably increased over the past three decades. Given the significant morbidity and mortality associated with BD, efforts are needed to identify factors useful in earlier detection to help address this serious public health concern. Sleep is particularly important to consider given the sequelae of disrupted sleep on normative functioning and that sleep is included in diagnostic criteria for both Major Depressive and Manic Episodes. Here, we examine one component of sleep—i.e., circadian phase preference with the behavioral construct of morningness/eveningness (M/E). In comparing 30 BD and 45 typically developing control (TDC) participants, ages 7–17 years, on the Morningness-Eveningness Scale for Children (MESC), no between-group differences emerged. Similar results were found when comparing three groups (BD−ADHD; BD+ADHD; TDC). Consistent with data available on circadian phase preference in adults with BD, however, we found that BD adolescents, ages 13 years and older, endorsed significantly greater eveningness compared to their TDC peers. While the current findings are limited by reliance on subjective report and the high-rate of comorbid ADHD among the BD group, this finding that BD teens demonstrate an exaggerated shift towards eveningness than would be developmentally expected is important. Future studies should compare the circadian rhythms across the lifespan for individuals diagnosed with BD, as well as identify the point at which BD youth part ways with their healthy peers in terms of phase preference. In addition, given our BD sample was overall euthymic, it may be that M/E is more state vs. trait specific in latency age youth. Further work would benefit from assessing circadian functioning using a combination of rating forms and laboratory-based measures. Improved understanding of sleep in BD may identify behavioral targets for inclusion in prevention and intervention protocols. PMID:26237260

  20. Pediatric Multiple Sclerosis.

    PubMed

    Lee, Ji Y; Chitnis, Tanuja

    2016-04-01

    Pediatric multiple sclerosis (MS) is a chronic inflammatory neurologic disease that is challenging to diagnose and treat. Although there are many clinical parallels between pediatric-onset MS and adult-onset MS, there is also accumulating evidence of distinguishing clinical features that may, in part, arise from development-specific, neuroimmune processes governing MS pathogenesis in children. Here the authors describe the clinical features, diagnosis, and treatment of pediatric MS, with a particular focus on describing clinical features and highlighting new developments that promise a better understanding of pediatric MS pathogenesis. An important task that lies ahead for pediatric neurologists is better understanding the early gene-environment interaction that precipitates the first demyelinating event in pediatric MS. This area is of particular importance for understanding the MS etiology and the natural history of pediatric MS. Such understanding should in turn inform new developments in diagnostic tools, long-term therapies, and much-needed biomarkers. Such biomarkers are not only valuable for defining the disease onset, but also for monitoring both the treatment response and a disease evolution that spans multiple decades in children with MS. PMID:27116721

  1. Outpatient Management of Pediatric Type 1 Diabetes

    PubMed Central

    Cogen, Fran R.

    2015-01-01

    The incidence of both type 1 and type 2 diabetes (T1DM and T2DM) continues to rise within the pediatric population. However, T1DM remains the most prevalent form diagnosed in children. It is critical that health-care professionals understand the types of diabetes diagnosed in pediatrics, especially the distinguishing features between T1DM and T2DM, to ensure proper treatment. Similar to all individuals with T1DM, lifelong administration of exogenous insulin is necessary for survival. However, children have very distinct needs and challenges compared to those in the adult diabetes population. Accordingly, treatment, goals, and age-appropriate requirements must be individually addressed. The main objectives for the treatment of pediatric T1DM include maintaining glucose levels as close to normal as possible, avoiding acute complications, and preventing long-term complications. In addition, unique to pediatrics, facilitating normal growth and development is important to comprehensive care. To achieve these goals, a careful balance of insulin therapy, medical nutrition therapy, and exercise or activity is necessary. Pharmacological treatment options consist of various insulin products aimed at mimicking prior endogenous insulin secretion while minimizing adverse effects. This review focuses on the management of pediatric T1DM in the outpatient environment, highlighting pharmacotherapy management strategies. PMID:26472948

  2. Pediatric autonomic disorders.

    PubMed

    Axelrod, Felicia B; Chelimsky, Gisela G; Weese-Mayer, Debra E

    2006-07-01

    The scope of pediatric autonomic disorders is not well recognized. The goal of this review is to increase awareness of the expanding spectrum of pediatric autonomic disorders by providing an overview of the autonomic nervous system, including the roles of its various components and its pervasive influence, as well as its intimate relationship with sensory function. To illustrate further the breadth and complexities of autonomic dysfunction, some pediatric disorders are described, concentrating on those that present at birth or appear in early childhood. PMID:16818580

  3. Genetic pediatric retinal diseases

    PubMed Central

    Say, Emil Anthony T.

    2014-01-01

    Hereditary pediatric retinal diseases are a diverse group of disorders with pathologies affecting different cellular structures or retinal development. Many can mimic typical pediatric retinal disease such as retinopathy of prematurity, vitreous hemorrhage, retinal detachment and cystoid macular edema. Multisystem involvement is frequently seen in hereditary pediatric retinal disease. A thorough history coupled with a good physical examination can oftentimes lead the ophthalmologist or pediatrician to the correct genetic test and correct diagnosis. In some instances, evaluation of parents or siblings may be required to determine familial involvement when the history is inconclusive or insufficient and clinical suspicion is high.

  4. Pediatric uveitis: An update

    PubMed Central

    Majumder, Parthopratim Dutta; Biswas, Jyotirmay

    2013-01-01

    Because of their varied spectrum of clinical presentation and difficulty in management, pediatric uveitis remains a challenge to the ophthalmologist. Variations in clinical presentation, difficulties in eye examination, extended burden of the inflammation over quality of life, limited treatment modalities, risk of amblyopia are the main challenges in the management of pediatric uveitis. Pediatric uveitis is a cause of significant ocular morbidity and severe vision loss is found in 25-33% of such cases. This article summarizes the common causes of uveitis in children with special approach to the evaluation and diagnosis of each clinical entity. PMID:24379547

  5. [Robotics in pediatric surgery].

    PubMed

    Camps, J I

    2011-10-01

    Despite the extensive use of robotics in the adult population, the use of robotics in pediatrics has not been well accepted. There is still a lack of awareness from pediatric surgeons on how to use the robotic equipment, its advantages and indications. Benefit is still controversial. Dexterity and better visualization of the surgical field are one of the strong values. Conversely, cost and a lack of small instruments prevent the use of robotics in the smaller patients. The aim of this manuscript is to present the controversies about the use of robotics in pediatric surgery.

  6. Genetic pediatric retinal diseases.

    PubMed

    Say, Emil Anthony T

    2014-12-01

    Hereditary pediatric retinal diseases are a diverse group of disorders with pathologies affecting different cellular structures or retinal development. Many can mimic typical pediatric retinal disease such as retinopathy of prematurity, vitreous hemorrhage, retinal detachment and cystoid macular edema. Multisystem involvement is frequently seen in hereditary pediatric retinal disease. A thorough history coupled with a good physical examination can oftentimes lead the ophthalmologist or pediatrician to the correct genetic test and correct diagnosis. In some instances, evaluation of parents or siblings may be required to determine familial involvement when the history is inconclusive or insufficient and clinical suspicion is high. PMID:27625880

  7. Recent consensus statements in pediatric endocrinology: a selective review.

    PubMed

    Klein, Michelle; Sathasivam, Anpalakan; Novoa, Yeray; Rapaport, Robert

    2011-10-01

    Clinical guidelines and consensus statements serve to summarize and organize current knowledge on diverse subjects and provide practical guidelines for proper clinical management. Recommendations should be based on research and evidence derived from appropriate sources. In 2008, more than 20 consensus statements were published in the pediatric literature alone. This article summarizes the salient points of the latest consensus statements jointly developed by multiple endocrine societies including the Lawson Wilkins Society for Pediatric Endocrinology and the European Society for Pediatric Endocrinology. As much as possible, the original intent and language of the statements was respected and paraphrased.

  8. Screening of Viral Pathogens from Pediatric Ileal Tissue Samples after Vaccination

    DOE PAGESBeta

    Hewitson, Laura; Thissen, James B.; Gardner, Shea N.; McLoughlin, Kevin S.; Glausser, Margaret K.; Jaing, Crystal J.

    2014-01-01

    In 2010, researchers reported that the two US-licensed rotavirus vaccines contained DNA or DNA fragments from porcine circovirus (PCV). Although PCV, a common virus among pigs, is not thought to cause illness in humans, these findings raised several safety concerns. In this study, we sought to determine whether viruses, including PCV, could be detected in ileal tissue samples of children vaccinated with one of the two rotavirus vaccines. A broad spectrum, novel DNA detection technology, the Lawrence Livermore Microbial Detection Array (LLMDA), was utilized, and confirmation of viral pathogens using the polymerase chain reaction (PCR) was conducted. The LLMDAmore » technology was recently used to identify PCV from one rotavirus vaccine. Ileal tissue samples were analyzed from 21 subjects, aged 15–62 months. PCV was not detected in any ileal tissue samples by the LLMDA or PCR. LLMDA identified a human rotavirus A from one of the vaccinated subjects, which is likely due to a recent infection from a wild type rotavirus. LLMDA also identified human parechovirus, a common gastroenteritis viral infection, from two subjects. Additionally, LLMDA detected common gastrointestinal bacterial organisms from the Enterobacteriaceae , Bacteroidaceae , and Streptococcaceae families from several subjects. This study provides a survey of viral and bacterial pathogens from pediatric ileal samples, and may shed light on future studies to identify pathogen associations with pediatric vaccinations.« less

  9. Performance of the Pediatric Index of Mortality 2 in a pediatric intensive care unit

    PubMed Central

    Lima, Antônio; Muniz, Virginia Maria; Zandonade, Eliana; Maciel, Ethel Leonor Noia; Bortolozzo, Rodrigo Nichio; Costa, Nélio Ferreira; Limongi, Rosane da Silva de Araujo

    2014-01-01

    Objective To assess the discrimination and calibration of the Pediatric Index of Mortality 2 in patients admitted to a pediatric intensive care unit. Methods The study was conducted with a contemporary cohort from November 2005 to November 2006. Patients aged 29 days to 18 years were included in the study. Patients who died within 12 hours of admission and cases of readmission were excluded from the study. The performance of the Pediatric Index of Mortality 2 was assessed by means of the Hosmer-Lemeshow goodness-of-fit test, the standardized mortality ratio and the area under receiver operating characteristic (ROC) curve with 95% confidence interval. The significance level was established as 5%. Results A total of 276 admissions to the pediatric intensive care unit were included in the analysis. The mortality rate was 14.13%, and the efficiency of admission 0.88%. The median age of the sample was 42.22 months, and most participants were male (60.1%). Most admissions were referrals from the emergency department. The mean duration of stay in pediatric intensive care unit was 6.43±5.23 days. Approximately 72.46% of admissions were for clinical reasons and exhibited an association with the outcome death (odds ratio: 2.9; 95%CI: 1.09-7.74; p=0.017). Calibration of the Pediatric Index of Mortality 2 with the chi-square statistic was 12.2686 (p=0.1396) in the Hosmer-Lemeshow goodness-of-fit test, and the standardized mortality ratio was 1.0. The area under the ROC curve assessing model discrimination was 0.778. Conclusion Pediatric Index of Mortality 2 exhibited satisfactory performance. PMID:24770688

  10. Pediatric Sudden Sensorineural Hearing Loss.

    PubMed

    Kizilay, Ahmet; Koca, Çiğdem Firat

    2016-06-01

    Sudden sensorineural hearing loss is defined as sudden unilateral or bilateral sensorineural hearing loss with at least 30 dB decrease in threshold in 3 contiguous test frequencies occurring over 72 hours or less. It is rare among children. The mechanism of the process and prognosis of the disorder remains unclear. The current incidence of sudden sensorineural hearing loss among pediatric population is unknown. The authors carried out a retrospective chart analysis of patients under 15 years of age from 2004 to 2015, who consulted to the Otolaryngology Head and Neck Surgery Department of Inonu University Medical Faculty. Age, sex, number of affected ear and side, audiometric evaluations, medical follow-up, treatment method, duration of treatment recovery, associated complaints; tinnitus and/or vertigo, presence of mumps disease were recorded for each patient. A 4-frequency pure-tone average (500, 1000, 2000, and 4000 Hz) was calculated for each ear. Complete recovery, defined as some hearing level compared with the nonaffected ear, was observed in 3 patients (21.4 %) and there was no partial hearing recovery. The hearing loss of 11 patient remained unchanged after prednisolone treatment. Two of the 11 patients had bilaterally total sensorineural hearing loss and evaluated as appropriate for cochlear implantation. Sex of patient and laterality of hearing loss were not correlated with hearing recovery. Sensorineural hearing loss among pediatrics has been the issue of otolaryngologists. The incidence, etiology, and treatment methods should be more studied.

  11. [Takayasu arteritis in pediatric patients].

    PubMed

    Katsicas, María Martha; Pompozi, Luis; Russo, Ricardo

    2012-01-01

    Takayasu's arteritis is a chronic inflammatory disease that primarily affects the large vessels, such as the aorta and its branches. It represents the third most frequent vasculitis during pediatric age. Our objective was to describe clinical and complementary exams features as well as treatment modalities of a case series of pediatric patients. We present 11 patients (10 girls) with median age at onset of 8 years (range: 2-15). The median diagnosis delay was 16 months (range: 2-96). Clinical presentations were lower limb claudication, arterial hypertension, CNS involvement, presence of murmurs, systemic symptoms, lymphadenopathy, chest pain, abdominal pain and arthritis. Laboratory tests showed: elevated ESR, anemia and trombocytosis. Vascular imaging studies exhibited stenosis, dilatation, occlussion and aneurysms. The outcome of the disease was persistent active condition (1 patient), relapse (4 patients), remission (3 patients), motor sequelae (1 patient) and death (2 patients). All patients were treated with steroids and immunosuppressants. Takayasu 's arteritis is a condition that can potentially be life-threatening. The diagnosis should be suspected in a variety of clinical manifestations during childhood.

  12. American Pediatric Surgical Association

    MedlinePlus

    ... Us Login The Hendren Project Resources Research Continuing Education Residents / Fellows Membership About APSA American Pediatric Surgical Association One Parkview Plaza, Suite 800 Oakbrook Terrace, IL 60181 USA Phone: +1-847-686-2237 Fax: +1-847- ...

  13. Pediatric Brain Tumor Foundation

    MedlinePlus

    ... you insights into your child's treatment. LEARN MORE Brain tumors and their treatment can be deadly so ... Cancer Foundation joins the PBTF Read more >> Pediatric Brain Tumor Foundation 302 Ridgefield Court, Asheville, NC 28806 ...

  14. Imaging Pediatric Vascular Lesions

    PubMed Central

    Nguyen, Tuyet A.; Krakowski, Andrew C.; Naheedy, John H.; Kruk, Peter G.

    2015-01-01

    Vascular anomalies are commonly encountered in pediatric and dermatology practices. Most of these lesions are benign and easy to diagnose based on history and clinical exam alone. However, in some cases the diagnosis may not be clear. This may be of particular concern given that vascular anomalies may occasionally be associated with an underlying syndrome, congenital disease, or serious, life-threatening condition. Defining the type of vascular lesion early and correctly is particularly important to determine the optimal approach to management and treatment of each patient. The care of pediatric patients often requires collaboration from a multitude of specialties including pediatrics, dermatology, plastic surgery, radiology, ophthalmology, and neurology. Although early characterization of vascular lesions is important, consensus guidelines regarding the evaluation and imaging of vascular anomalies does not exist to date. Here, the authors provide an overview of pediatric vascular lesions, current classification systems for characterizing these lesions, the various imaging modalities available, and recommendations for appropriate imaging evaluation. PMID:26705446

  15. Pediatric heart surgery

    MedlinePlus

    Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... after the baby is born. For others, your child may be able to safely wait for months ...

  16. American Academy of Pediatrics

    MedlinePlus

    ... Advocacy Community Pediatrics Grants Database Building Effective Partnerships Obesity Advocacy at the Community Level AAP Health Initiatives Clinical Resources Community Programs Prevention Quality Improvement Media School & Child Care Special Populations shopAAP About the AAP AAP ...

  17. [Complications in pediatric anesthesia].

    PubMed

    Becke, K

    2014-07-01

    As in adult anesthesia, morbidity and mortality could be significantly reduced in pediatric anesthesia in recent decades. This fact cannot conceal the fact that the incidence of anesthetic complications in children is still much more common than in adults and sometimes with a severe outcome. Newborns and infants in particular but also children with emergency interventions and severe comorbidities are at increased risk of potential complications. Typical complications in pediatric anesthesia are respiratory problems, medication errors, difficulties with the intravenous puncture and pulmonal aspiration. In the postoperative setting, nausea and vomiting, pain, and emergence delirium can be mentioned as typical complications. In addition to the systematic prevention of complications in pediatric anesthesia, it is important to quickly recognize disturbances of homeostasis and treat them promptly and appropriately. In addition to the expertise of the performing anesthesia team, the institutional structure in particular can improve quality and safety in pediatric anesthesia. PMID:25004872

  18. NIH Pediatric Rheumatology Clinic

    MedlinePlus

    ... patients without discrimination on the basis of race, religion, ethnic group, citizenship, or residence. We can provide ... studies to help understand pediatric rheumatic diseases. Natural history studies, for example, are designed to study how ...

  19. Pediatric liver transplantation

    PubMed Central

    Spada, Marco; Riva, Silvia; Maggiore, Giuseppe; Cintorino, Davide; Gridelli, Bruno

    2009-01-01

    In previous decades, pediatric liver transplantation has become a state-of-the-art operation with excellent success and limited mortality. Graft and patient survival have continued to improve as a result of improvements in medical, surgical and anesthetic management, organ availability, immunosuppression, and identification and treatment of postoperative complications. The utilization of split-liver grafts and living-related donors has provided more organs for pediatric patients. Newer immunosuppression regimens, including induction therapy, have had a significant impact on graft and patient survival. Future developments of pediatric liver transplantation will deal with long-term follow-up, with prevention of immunosuppression-related complications and promotion of as normal growth as possible. This review describes the state-of-the-art in pediatric liver transplantation. PMID:19222089

  20. Pediatric Celiac Disease

    MedlinePlus

    ... Sprue Association/USA Gluten Intoloerance Group of North America NASPGHAN Foundation Supporters Educational support for the NASPGHAN ... NASPGHAN) Celiac Disease Eosinophilic Esophagitis Pediatric IBD Nutrition & Obesity Reflux & GERD Research & Grants Our Supporters Site Map © ...

  1. Clinical excellence in pediatrics.

    PubMed

    Mote, Phillip C; Solomon, Barry S; Wright, Scott M; Crocetti, Michael

    2014-08-01

    The 7 core domains of clinical excellence in academic medicine, as defined by the Miller-Coulson Academy of Clinical Excellence at Johns Hopkins, are applicable to the field of pediatrics. The authors use published case reports and teaching models from the pediatric literature to illustrate how thoughtful clinicians have realized distinction in each of the 7 clinical excellence domains, recognizing excellent pediatric patient care serves to strengthen all 3 arms of the tripartite academic mission. Clinicians who feel valued by their institution may be more likely to remain in an academic clinical setting, where they promote the health and well-being of their patients, provide support to families and caregivers, serve as role models for pediatric trainees, and integrate research into their practice with the overall aim of improving patient outcomes.

  2. Risk Factors for End-Stage Kidney Disease after Pediatric Liver Transplantation

    PubMed Central

    Ruebner, RL; Reese, PP; Denburg, MR; Rand, EB; Abt, PL; Furth, SL

    2015-01-01

    Adult liver transplant (LT) recipients commonly develop advanced kidney disease. However, burden of end-stage kidney disease (ESKD) after pediatric LT has not been well-described. We performed a retrospective cohort study of pediatric LTs in the US from 1990–2010. Multivariable Cox regression models were fit to determine risk factors for ESKD and death. 8976 children received LTs. During median follow-up of 7.8 years, 2005 (22%) subjects died (mortality rate 26.1 cases/1000 person-years); 167 (2%) developed ESKD (incidence rate 2.2 cases/1000 person-years). Risk factors for ESKD included older age at LT (highest risk age>15 vs <5 years, HR=4.94, p<0.001), hepatitis C (HR 2.79, p=0.004), liver re-transplant (HR 2.67, p<0.001), eGFR pre-LT <60 vs ≥60 (HR 2.37, p<0.001), hepatitis B (HR 2.25, p=0.027), black race (HR 1.46, p=0.046), and male sex (HR 1.44, p=0.022). LT recipients with ESKD had increased risk of mortality (HR 2.37, p<0.001). Among pediatric LT recipients, rate of ESKD was lower than among adults and far exceeded by rate of death, however follow-up time in this study may underestimate lifetime burden of ESKD. Although uncommon, ESKD was highly associated with mortality. Pediatric LT recipients should be routinely monitored for kidney disease, particularly those at highest risk of ESKD. PMID:22994862

  3. [The Bridge between Pediatric and Adult Neurology].

    PubMed

    Hirayama, Keizo

    2016-06-01

    Pediatric and adult departments are differentiated based on a cutoff age of approximately 15-17 years. In clinical neurology, there are certain disorders and related problems that overlap these age-determined boundaries. In this review, the following three themes are discussed. (1) Manual dexterity: Considering motor skills through the developmental stages of a child and manual impairment due to localized brain damage in adults, manual dexterity has been reviewed extensively from the perspective of cortical association areas. (2) Hepatolenticular degeneration: Wilson's disease (children) and Westphal-Strümpell pseudosclerosis (adults) are compared and assessed based on the age of onset to identify differences in clinical symptoms and pathological findings. (3) Hirayama disease: This disease has been identified as an adult neurological disorder. Since the onset of Hirayama disease occurs around puberty in children and adolescents, it provides a connecting link between pediatric and adult neurology. PMID:27279163

  4. Opportunistic detection of atrial fibrillation in subjects aged 65 years or older in primare care: a randomised clinical trial of efficacy. DOFA-AP study protocol

    PubMed Central

    2012-01-01

    Background Clinical Practice Guidelines recommend using peripheral blood pulse measuring as a screening test for Atrial Fibrillation. However, there is no adequate evidence supporting the efficacy of such procedure in primary care clinical practice. This paper describes a study protocol designed to verify whether early opportunistic screening for Atrial Fibrillation by measuring blood pulse is more effective than regular practice in subjects aged 65 years attending primary care centers. Methods/design An cluster-randomized controlled trial conducted in Primary Care Centers of the Spanish National Health Service. A total of 269 physicians and nurses will be allocated to one of the two arms of the trial by stratified randomization with a 3:2 ratio (three practitioners will be assigned to the Control Group for every two practitioners assigned to the Experimental Group). As many as 12 870 patients aged 65 years or older and meeting eligibility criteria will be recruited (8 580 will be allocated to the Experimental Group and 4 290 to the Control Group). Randomization and allocation to trial groups will be carried out by a central computer system. The Experimental Group practitioners will conduct an opportunistic case finding for patients with Atrial Fibrillation, while the Control Group practitioners will follow the regular guidelines. The first step will be finding new Atrial Fibrillation cases. A descriptive inferential analysis will be performed (bivariate and multivariate by multilevel logistic regression analysis). Discussion If our hypothesis is confirmed, we expect Primary Care professionals to take a more proactive approach and adopt a new protocol when a patient meeting the established screening criteria is identified. Finally, we expect this measure to be incorporated into Clinical Practice Guidelines. Trial registration The study is registered as NCT01291953 (ClinicalTrials.gob) PMID:23130754

  5. Liability for pediatric care.

    PubMed

    Classé, J G

    1996-01-01

    Liability claims involving eye care for pediatric patients may constitute as much as 20% of claims against optometrists, with the most common sources of litigation being failure to detect tumors affecting the visual system, improper diagnosis and management of binocular vision disorders, and injuries from shattered spectacle lenses. Claims for pediatric patients tend to allege large damages, partially because of the significant effect exerted by lifelong vision impairment or loss of vision.

  6. Pediatric AIDS: psychosocial impact.

    PubMed

    Mangos, J A; Doran, T; Aranda-Naranjo, B; Rodriguez-Escobar, Y; Scott, A; Setzer, J R

    1990-06-01

    There is no question that the domain of the American family has been invaded by the HIV infection/AIDS epidemic. The disease, and particularly its form affecting children (pediatric AIDS), has had marked psychosocial impact on patients and families (intellectual/cognitive, emotional/behavioral, spiritual, and financial) and on our society in general (adverse or favorable). These impacts of pediatric AIDS are discussed in the present communication. PMID:2371699

  7. Pediatric allergy and immunology in Italy.

    PubMed

    Tozzi, Alberto E; Armenio, Lucio; Bernardini, Roberto; Boner, Attilio; Calvani, Mauro; Cardinale, Fabio; Cavagni, Giovanni; Dondi, Arianna; Duse, Marzia; Fiocchi, Alessandro; Marseglia, Gian L; del Giudice, Michele Miraglia; Muraro, Antonella; Pajno, Giovanni B; Paravati, Francesco; Peroni, Diego; Tripodi, Salvatore; Ugazio, Alberto G; Indinnimeo, Luciana

    2011-05-01

    In Italy, according to the International Study on Asthma and Allergies in Childhood study, the prevalence of current asthma, allergic rhinoconjunctivitis, and atopic eczema in 2006 was 7.9%, 6.5%, and 10.1% among children aged 6-7 and 8.4%, 15.5%, and 7.75% among children aged 13-14 yr. University education in this field is provided by the Postgraduate Schools of Pediatrics and those of Allergology and Clinical Immunology, as well as several annual Master courses. The Italian Society of Pediatric Allergology and Immunology (SIAIP) was founded in 1996 and counts about 1000 members. SIAIP promotes evidence-based management of allergic children and disseminates information to patients and their families through a quite innovative website and the National Journal 'Rivista Italiana di Allergologia Pediatrica'. In the last decade, four major regional, inter-regional, and national web-based networks have been created to link pediatric allergy centers and to share their clinical protocols and epidemiologic data. In addition, National Registers of Primary Immune-deficiencies and on Pediatric HIV link all clinical excellence centers. Research projects in the field of pediatric allergy and immunology are founded by the Italian Ministry of Education, University and Research (MIUR) and by the National Research Council (CNR), but the overall investments in this research area are quite low. Only a handful Italian excellence centers participate in European Projects on Pediatric Allergy and Immunology within the 7th Framework Program. The European Academy of Allergy and Clinical Immunology currently hosts two Italians in its Executive Committee (EC) and one in the EC of the Pediatric Section; moreover, major European Academy of Allergy and Clinical Immunology meetings and courses in the area of pediatrics (e.g., PAAM, Venice, 2009) have been held in Italy in the last 3 yr. Italian hallmarks in the management of allergic diseases in childhood are a quite alive and spread interest in

  8. Neurocognitive functions in pediatric renal transplant patients.

    PubMed

    Gulleroglu, K; Baskin, E; Bayrakci, U S; Aydogan, M; Alehan, F; Kantar, A; Karakayali, F; Moray, G; Haberal, M

    2013-01-01

    Neurocognitive dysfunction is one of the major complications of chronic renal failure (CRF). Uremic state during CRF encompasses a wide spectrum of neurobehavioral and neurological disturbances. Recent studies showed that the pathophysiology of neurocognitive dysfunction in CRF is related to plasma levels of uremic solutes. Successful renal transplantation improves renal, metabolic, and endocrine functions and the quality of life. The aim of our study was to determine the state of neurocognitive function in pediatric renal transplant recipients. We prospectively performed a neurological examination and neuropsychological test battery (Bender-Gestalt Test, Cancellation Test, and Visual and Auditory Number Assay Test) in 20 pediatric renal transplant recipients between 6 and 16 years of age. Twenty healthy children and 20 children with CRF were included in the study as the control groups. Mean age of the renal transplant recipients was 13.50 ± 3.40 years old. Mean evaluation time after transplantation was 2.0 ± 0.5 years. Bender-Gestalt Test result was abnormal in 40% of patients. The results of the Cancellation Test and the Visual and Auditory Number Assay Test showed significant decline in pediatric renal transplant patients when compared with the control. We found that neurocognitive dysfunction was frequent in pediatric renal transplantation patients. Awareness of this potential problem may be helpful for early recognition and treatment. Our findings suggest that periodic neurocognitive assessments may be indicated in transplant recipients. PMID:24314945

  9. [A clinical investigation of pediatric patients with sleep-disordered breathing who suffered perioperative respiratory complications of adenotonsillectomy].

    PubMed

    Ogawa, Makoto; Hosokawa, Kiyohito; Inohara, Hidenori

    2014-03-01

    The aim of this study was to investigate the clinical background and identify the risk factors for perioperative respiratory complication in pediatric patients with sleep-disordered breathing (SDB) who underwent adenotonsillectomy (AT). Of the 186 pediatric subjects (male: 131, female: 55) undergoing AT as the first surgical treatment for SDB, 14 patients (male: 9, female: 5) fulfilled the following criteria: 1) disturbed ventilation, 2) cyanosis with an oxygen saturation of less than 90% on pulse oximetry during the perioperative period and 3) the subsequent need for medical intervention, including immediate intubation, continuous positive airway pressure (CPAP) or airway insertion. Among these 14 patients, nine were less than 3 years of age. In addition, 5 and 3 patients had hypotonia due to cerebral paralysis and metabolic disturbances, respectively. Seven had a short stature with an SD of worse than - 1.5. A statistical analysis showed that cases with either an age of less than 3 years, hypotonia or a short stature had a high risk for suffering from respiratory complications, and suggested that low body weight and a high value for preoperative apnea-hypopnea index were additional risk factors. However, a chart review exhibited that, of the 14 cases with respiratory complications, the 8 cases whose age was under 3 years had either of hypotonia or a short stature. In thirteen of the 14 cases, respiratory complications were associated with the process of general anesthesia, and ten patients exhibited pharyngeal collapse. After surgery, 7 and 3 patients required intensive care in the ICU and the pediatric recovery unit, respectively. Based on these results, it is suggested that pediatric SDB cases under 3 years of age and either with hypotonia or a short stature have a high risk for respiratory complications associated with AT, and therefore AT for such patients should only be performed in medical facilities with an ICU or an equivalent department. PMID:24783453

  10. Experimental Injury Biomechanics of the Pediatric Head and Brain

    NASA Astrophysics Data System (ADS)

    Margulies, Susan; Coats, Brittany

    Traumatic brain injury (TBI) is a leading cause of death and disability among children and young adults in the United States and results in over 2,500 childhood deaths, 37,000 hospitalizations, and 435,000 emergency department visits each year (Langlois et al. 2004). Computational models of the head have proven to be powerful tools to help us understand mechanisms of adult TBI and to determine load thresholds for injuries specific to adult TBI. Similar models need to be developed for children and young adults to identify age-specific mechanisms and injury tolerances appropriate for children and young adults. The reliability of these tools, however, depends heavily on the availability of pediatric tissue material property data. To date the majority of material and structural properties used in pediatric computer models have been scaled from adult human data. Studies have shown significant age-related differences in brain and skull properties (Prange and Margulies 2002; Coats and Margulies 2006a, b), indicating that the pediatric head cannot be modeled as a miniature adult head, and pediatric computer models incorporating age-specific data are necessary to accurately mimic the pediatric head response to impact or rotation. This chapter details the developmental changes of the pediatric head and summarizes human pediatric properties currently available in the literature. Because there is a paucity of human pediatric data, material properties derived from animal tissue are also presented to demonstrate possible age-related differences in the heterogeneity and rate dependence of tissue properties. The chapter is divided into three main sections: (1) brain, meninges, and cerebral spinal fluid (CSF); (2) skull; and (3) scalp.

  11. Immunopathophysiology of pediatric CNS inflammatory demyelinating diseases.

    PubMed

    Bar-Or, Amit; Hintzen, Rogier Q; Dale, Russell C; Rostasy, Kevin; Brück, Wolfgang; Chitnis, Tanuja

    2016-08-30

    Elucidating pathophysiologic mechanisms underlying the spectrum of pediatric-onset CNS demyelinating diseases, particularly those that may distinguish multiple sclerosis (MS) from other entities, promises to both improve diagnostics and guide more-informed therapeutic decisions. Observations that pediatric- and adult-onset MS share the same genetic and environmental risk factors support the view that these conditions represent essentially the same illness manifesting at different ages. Nonetheless, special consideration must be given when CNS inflammation manifests in early life, at a time when multiple organs (including immune and nervous systems) are actively maturing. CSF analysis in pediatric-onset MS points to chronic CNS inflammation, supported by observations from limited pathologic material available for study. Emerging results implicate abnormalities in both effector and regulatory T cell subsets, and potentially immune senescence, in children with MS. Although CNS-directed antibodies (including antibodies recognizing myelin antigens; Kir4.1) can be documented in pediatric-onset MS, their pathophysiologic significance (as in adults) remains unclear. This is in contrast to the presence of serum and/or CSF antibodies recognizing aquaporin-4, which, when measured using validated cell-based assays, supports the diagnosis of a neuromyelitis optica spectrum disorder, distinct from MS. Presence of anti-myelin oligodendrocyte glycoprotein antibodies documented with similar cell-based assays may also be associated with pathophysiologically distinct disease phenotypes in children. The substantial impact of pediatric-onset MS on normal brain development and function underscores the importance of elucidating both the immunobiology and neurobiology of disease. Ongoing efforts are aimed at developing and validating biological measures that define pathophysiologically distinct monophasic and chronic forms of pediatric CNS demyelination. PMID:27572856

  12. Pediatric malaria in Houston, Texas.

    PubMed

    Rivera-Matos, I R; Atkins, J T; Doerr, C A; White, A C

    1997-11-01

    We retrospectively reviewed the medical records of all infants and children (< 18 years of age) with the discharge diagnosis of malaria who were admitted to the four major pediatric teaching hospitals in Houston, Texas from January 1988 through December 1993. Thirty-four cases of pediatric malaria were identified in three newborns, 22 travelers, and nine recent immigrants. The travel destination was West Africa in 68%, Central America in 14%, India in 14%, and unknown in 4%. The location of the child's and parents' birthplace was available in 77% of the travel-related cases and in all cases the destination of travel was the parents' country of origin. The peak incident of the travel-related cases was late summer and early January corresponding to return from summer or Christmas vacation. Sixteen (75%) of the 22 travel-related cases had received either no prophylaxis (12 of 22) or inadequate (4 of 22) chemoprophylaxis. Half of the patients who were given appropriate chemoprophylaxis admitted to poor compliance. The clinical presentation was usually nonspecific. Fever was the most common symptom (97%) and was paroxysmal in one-third. Splenomegaly was the most common physical finding (68%). The malaria species identified included Plasmodium falciparum (56%), P. vivax (23%), P. malariae (3%), and unidentified (18%). Moderate anemia (hemoglobin level = 7.0-10 g/dL) occurred in 38% and severe anemia (hemoglobin level < 7.0 g/dL) in 29%. Three patients required transfusion. There were no end-organ complications. In summary, pediatric malaria in Houston was primarily seen in immigrants or children of immigrants who returned to their native country. Education and preventive strategies should target these families and should be part of the routine well child care of these children.

  13. Medication Repurposing in Pediatric Patients: Teaching Old Drugs New Tricks

    PubMed Central

    2016-01-01

    OBJECTIVES: Gaps in pediatric therapeutics often result in off-label use and specifically, novel uses for existing medications, termed “drug repurposing.” Drug Information (DI) queries to a Pediatric Medication Resource Center of a large metropolitan pediatric hospital in New York and inherent difficulties in retrieving evidence-based information prompted a review of current medication repurposing for pediatric patients. The objective included characterization of innovative off-label use of medications Food and Drug Administration (FDA)-approved for 1 or more indications to treat a totally different disorder or indication in pediatric patients. METHODS: A systematic literature review was conducted to retrieve publications describing repurposed medications in pediatric patients. Excluded was FDA-approved indications used off-label in pediatric patients (e.g., different dose), preclinical data, adult use only, and experimental use. Evidence quality was classified using a modified American Academy of Neurology Level of Evidence. Results were analyzed using χ2 at p < 0.05. RESULTS: Over 2000 references were retrieved and reviewed. A total of 101 medications repurposed for novel off-label uses for pediatric patients were identified: 38 for neonates, 74 for children, and 52 for adolescents. Neonates and infants were least likely to receive a medication for a repurposed use. Strong or intermediate evidence existed in 80.2% of cases. The evidence was weak in 19.8%. No significant relationship was observed between the pediatric age group and strength of the literature. Most repurposed uses pertained to generic or widely used medications. Less than 5% of medications were first marketed after 2011. CONCLUSIONS: While not exhaustive, the present study represents the most comprehensive listing of novel uses exclusive to pediatric patients. Further research is needed to identify the frequency of repurposed uses. The valuable DI role of pharmacists in assessing repurposed

  14. The Pediatric Risk of Mortality Score: Update 2015

    PubMed Central

    Pollack, Murray M.; Holubkov, Richard; Funai, Tomohiko; Dean, J. Michael; Berger, John T.; Wessel, David L.; Meert, Kathleen; Berg, Robert A.; Newth, Christopher J. L.; Harrison, Rick E.; Carcillo, Joseph; Dalton, Heidi; Shanley, Thomas; Jenkins, Tammara L.; Tamburro, Robert

    2016-01-01

    Objectives Severity of illness measures have long been used in pediatric critical care. The Pediatric Risk of Mortality is a physiologically based score used to quantify physiologic status, and when combined with other independent variables, it can compute expected mortality risk and expected morbidity risk. Although the physiologic ranges for the Pediatric Risk of Mortality variables have not changed, recent Pediatric Risk of Mortality data collection improvements have been made to adapt to new practice patterns, minimize bias, and reduce potential sources of error. These include changing the outcome to hospital survival/death for the first PICU admission only, shortening the data collection period and altering the Pediatric Risk of Mortality data collection period for patients admitted for “optimizing” care before cardiac surgery or interventional catheterization. This analysis incorporates those changes, assesses the potential for Pediatric Risk of Mortality physiologic variable subcategories to improve score performance, and recalibrates the Pediatric Risk of Mortality score, placing the algorithms (Pediatric Risk of Mortality IV) in the public domain. Design Prospective cohort study from December 4, 2011, to April 7, 2013. Measurements and Main Results Among 10,078 admissions, the unadjusted mortality rate was 2.7% (site range, 1.3–5.0%). Data were divided into derivation (75%) and validation (25%) sets. The new Pediatric Risk of Mortality prediction algorithm (Pediatric Risk of Mortality IV) includes the same Pediatric Risk of Mortality physiologic variable ranges with the subcategories of neurologic and nonneurologic Pediatric Risk of Mortality scores, age, admission source, cardiopulmonary arrest within 24 hours before admission, cancer, and low-risk systems of primary dysfunction. The area under the receiver operating characteristic curve for the development and validation sets was 0.88 ± 0.013 and 0.90 ± 0.018, respectively. The Hosmer

  15. Lenticulostriate arterial distribution pathology may underlie pediatric anoxic brain injury in drowning

    PubMed Central

    Ishaque, Mariam; Manning, Janessa H.; Woolsey, Mary D.; Franklin, Crystal G.; Tullis, Elizabeth W.; Fox, Peter T.

    2016-01-01

    Drowning is a leading cause of neurological morbidity and mortality in young children. Anoxic brain injury (ABI) can result from nonfatal drowning and typically entails substantial neurological impairment. The neuropathology of drowning-induced pediatric ABI is not well established. Specifically, quantitative characterization of the spatial extent and tissue distribution of anoxic damage in pediatric nonfatal drowning has not previously been reported but could clarify the underlying pathophysiological processes and inform clinical management. To this end, we used voxel-based morphometric (VBM) analyses to quantify the extent and spatial distribution of consistent, between-subject alterations in gray and white matter volume. Whole-brain, high-resolution T1-weighted MRI datasets were acquired in 11 children with chronic ABI and 11 age- and gender-matched neurotypical controls (4–12 years). Group-wise VBM analyses demonstrated predominantly central subcortical pathology in the ABI group in both gray matter (bilateral basal ganglia nuclei) and white matter (bilateral external and posterior internal capsules) (P < 0.001); minimal damage was found outside of these deep subcortical regions. These highly spatially convergent gray and white matter findings reflect the vascular distribution of perforating lenticulostriate arteries, an end-arterial watershed zone, and suggest that vascular distribution may be a more important determinant of tissue loss than oxygen metabolic rate in pediatric ABI. Further, these results inform future directions for diagnostic and therapeutic modalities. PMID:26937385

  16. Pediatric oral conscious sedation: changes to come.

    PubMed

    Malamed, S F; Reggiardo, P

    1999-11-01

    Recent media attention has focused the public's attention on issues surrounding pediatric oral conscious sedation. Under a law passed in 1998 and taking affect on Jan. 1, 2000, California dentists will be subject to certification and procedural provisions designed to ensure the educational qualification of the provider and the standards under which the procedure is performed. This article discusses the history of concern and regulation regarding sedation of children in the dental office.

  17. Comparison of Pediatric and Adult Tonsillectomies Performed by Thermal Welding System

    PubMed Central

    Ersözlü, Tolga; Yıldırım, Yavuz Selim; Sarica, Selman

    2013-01-01

    Objective. To compare pediatric and adult age groups in terms of postoperative bleeding and pain following tonsillectomy performed by thermal welding system (TWS). Method. The study consisted of 213 patients, of whom 178 were children and 35 were adults. The mean age of the pediatric patients (81 girls and 97 females) was 6.7 ± 2.4 years (range 3–13 years) and the mean age of the adults (20 males and 15 females) was 21.8 ± 7.07 years (range 15–41 years). All of the patients were evaluated in terms of postoperative bleeding and pain following tonsillectomy performed by TWS. Results. Bleeding was detected in the late postoperative period in 11 pediatric and 7 adult patients and of them 2 pediatric and 3 adult patients controlled under general. Postoperative bleeding was significantly less prevalent in the pediatric age group compared to the adult age group (P = 0.04). Likewise, postoperative pain was significantly less prevalent in the pediatric age group as compared to the adult age group (P < 0.001). Conclusion. Both postoperative bleeding and pain following tonsillectomy performed by TWS were more prevalent in the adult age group compared to the pediatric age group. PMID:24369468

  18. Pharmacokinetics and safety of voriconazole intravenous-to-oral switch regimens in immunocompromised Japanese pediatric patients.

    PubMed

    Mori, Masaaki; Kobayashi, Ryoji; Kato, Koji; Maeda, Naoko; Fukushima, Keitaro; Goto, Hiroaki; Inoue, Masami; Muto, Chieko; Okayama, Akifumi; Watanabe, Kenichi; Liu, Ping

    2015-02-01

    The aim of this study was to investigate the pharmacokinetics, safety, and tolerability of voriconazole following intravenous-to-oral switch regimens used with immunocompromised Japanese pediatric subjects (age 2 to <15 years) at high risk for systemic fungal infection. Twenty-one patients received intravenous-to-oral switch regimens based on a recent population pharmacokinetic modeling; they were given 9 mg/kg of body weight followed by 8 mg/kg of intravenous (i.v.) voriconazole every 12 h (q12h), and 9 mg/kg (maximum, 350 mg) of oral voriconazole q12h (for patients age 2 to <12 or 12 to <15 years and <50 kg) or 6 mg/kg followed by 4 mg/kg of i.v. voriconazole q12h and 200 mg of oral voriconazole q12h (for patients age 12 to <15 years and ≥50 kg). The steady-state area under the curve over the 12-h dosing interval (AUC0-12,ss) was calculated using the noncompartmental method and compared with the predicted exposures in Western pediatric subjects based on the abovementioned modeling. The geometric mean (coefficient of variation) AUC0-12,ss values for the intravenous and oral regimens were 51.1 μg · h/ml (68%) and 45.8 μg·h/ml (90%), respectively; there was a high correlation between AUC0-12,ss and trough concentration. Although the average exposures were higher in the Japanese patients than those in the Western pediatric subjects, the overall voriconazole exposures were comparable between these two groups due to large interindividual variability. The exposures in the 2 cytochrome P450 2C19 poor metabolizers were among the highest. Voriconazole was well tolerated. The most common treatment-related adverse events were photophobia and abnormal hepatic function. These recommended doses derived from the modeling appear to be appropriate for Japanese pediatric patients, showing no additional safety risks compared to those with adult patients. (This study has been registered at ClinicalTrials.gov under registration no. NCT01383993.).

  19. American Academy of Pediatric Dentistry

    MedlinePlus

    ... Litch's Law Log HIPAA Forms Practice Management and Marketing Newsletter Webinar Materials Member Resources Membership Directory Awards ... Archives Access Pediatric Dentistry Today Practice Management and Marketing Newsletter Pediatric Dentistry Journal Open Access Articles Policies & ...

  20. [The preceptor in medical residencies in Pediatrics: main attributes

    PubMed

    Wuillaume, S M; Batista, N A

    2000-01-01

    OBJECTIVE: To analyze the profile of the preceptors and the attributes they consider important for the exercise of that activity, in two medical residency programs in Pediatrics in Rio de Janeiro METHODS: Through a questionnaire answered by each of the preceptors in two medical residency programs in Pediatrics in Rio de Janeiro, one of them connected to a university and the other one not, information was obtained on gender, age, time since graduation, how long they have been acting as preceptors, graduation titles, specific teaching training, and the listing of up to five attributes believed to be necessary to a good preceptor. The results were consolidated and discussed in the text. RESULTS: Of the 90 participants, 70% were woman, 74% were between 30 and 49 years old, 87% graduated between 10 and 29 years ago. Half of them said they did not have any specific teaching training and the other half had attended courses on Medical Pedagogy and Special Didactics during their respective graduate studies. The attribute categories most frequently mentioned were the exercise of tutorship, Ethics and Humanism, mastery of the subject area, capacity of permanent education, and didactic abilities. CONCLUSION: The preceptors pointed to the challenge of exercising preceptorship based on a medical practice where professional responsibilities, human relationship, organizational skills, evaluation techniques, and mastery of the subject area make the main guiding axes of the practice itself. To these axes they added the ethical and humanistic aspects and their permanent education capacities. They feel, however, the need for a didactic qualification in order to accomplish their duties. PMID:14647641

  1. Household pesticides and risk of pediatric brain tumors.

    PubMed Central

    Pogoda, J M; Preston-Martin, S

    1997-01-01

    A follow-up to a population-based case-control study of pediatric brain tumors in Los Angeles County, California, involving mothers of 224 cases and 218 controls, investigated the risk of household pesticide use from pregnancy to diagnosis. Risk was significantly elevated for prenatal exposure to flea/tick pesticides -odds ratio (OR) = 1.7; 95% confidence interval (CI), 1.1-2.6-, particularly among subjects less than 5 years old at diagnosis (OR = 2.5; CI, 1. 2-5.5). Prenatal risk was highest for mothers who prepared, applied, or cleaned up flea/tick products themselves (OR = 2.2; CI, 1.1-4.2; for subjects <5 years of age, OR = 5.4; CI, 1.3-22.3). A significant trend of increased risk with increased exposure was observed for number of pets treated (p = 0.04). Multivariate analysis of types of flea/tick products indicated that sprays/foggers were the only products significantly related to risk (OR =10.8; CI, 1.3-89.1). Elevated risks were not observed for termite or lice treatments, pesticides for nuisance pests, or yard and garden insecticides, herbicides, fungicides, or snail killer. Certain precautions,if ignored, were associated with significant increased risk: evacuating the house after spraying or dusting for pests (OR = 1.6; CI, 1.0-2.6), delaying the harvest of food after pesticide treatment (OR = 3.6; CI, 1.0-13.7), and following instructions on pesticide labels (OR = 3. 7;CI, 1.5-9.6). These findings indicate that chemicals used in flea/tick products may increase risk of pediatric brain tumors and suggest that further research be done to pinpoint specific chemicals involved. PMID:9370522

  2. Pediatric automotive restraints, pediatricians, and the academy.

    PubMed

    Lieberman, H M; Emmet, W L; Coulson, A H

    1976-09-01

    Over 70% of the 192 Southern California Academy pediatricians responding to a survey teach parents about pediatric automotive safety devices but less than 3% do so on every visit. To test two methods of increasing the frequency of teaching, these pediatricians were randomly assigned to either a mailing from the Academy's local chapter (mail group) or a brief presentation by a local pharmaceutical representative at his regular visit (interview group); a follow-up was conducted one month later by mail. Sixty-one percent of the mail group and 49% of the interview group claimed that their teaching on this subject had increased since the original contact. While this difference did not reach statistical significance, it was in the same direction as the preferences for sources of pediatric information expressed by both groups of pediatricians. A special letter from the Academy was ranked most effective and a visit from the pharmaceutical representative was judged least effective. Because of the magnitude of the problem, availability of a solution, proof that pediatricians can influence health behavior related to children and acknowledgment of the Academy's role in pediatric education, an appeal is made for an all-out campaign by the Academy and its members to promote use of appropriate pediatric automotive safety devices.

  3. Characterizing Race/Ethnicity and Genetic Ancestry for 100,000 Subjects in the Genetic Epidemiology Research on Adult Health and Aging (GERA) Cohort.

    PubMed

    Banda, Yambazi; Kvale, Mark N; Hoffmann, Thomas J; Hesselson, Stephanie E; Ranatunga, Dilrini; Tang, Hua; Sabatti, Chiara; Croen, Lisa A; Dispensa, Brad P; Henderson, Mary; Iribarren, Carlos; Jorgenson, Eric; Kushi, Lawrence H; Ludwig, Dana; Olberg, Diane; Quesenberry, Charles P; Rowell, Sarah; Sadler, Marianne; Sakoda, Lori C; Sciortino, Stanley; Shen, Ling; Smethurst, David; Somkin, Carol P; Van Den Eeden, Stephen K; Walter, Lawrence; Whitmer, Rachel A; Kwok, Pui-Yan; Schaefer, Catherine; Risch, Neil

    2015-08-01

    Using genome-wide genotypes, we characterized the genetic structure of 103,006 participants in the Kaiser Permanente Northern California multi-ethnic Genetic Epidemiology Research on Adult Health and Aging Cohort and analyzed the relationship to self-reported race/ethnicity. Participants endorsed any of 23 race/ethnicity/nationality categories, which were collapsed into seven major race/ethnicity groups. By self-report the cohort is 80.8% white and 19.2% minority; 93.8% endorsed a single race/ethnicity group, while 6.2% endorsed two or more. Principal component (PC) and admixture analyses were generally consistent with prior studies. Approximately 17% of subjects had genetic ancestry from more than one continent, and 12% were genetically admixed, considering only nonadjacent geographical origins. Self-reported whites were spread on a continuum along the first two PCs, indicating extensive mixing among European nationalities. Self-identified East Asian nationalities correlated with genetic clustering, consistent with extensive endogamy. Individuals of mixed East Asian-European genetic ancestry were easily identified; we also observed a modest amount of European genetic ancestry in individuals self-identified as Filipinos. Self-reported African Americans and Latinos showed extensive European and African genetic ancestry, and Native American genetic ancestry for the latter. Among 3741 genetically identified parent-child pairs, 93% were concordant for self-reported race/ethnicity; among 2018 genetically identified full-sib pairs, 96% were concordant; the lower rate for parent-child pairs was largely due to intermarriage. The parent-child pairs revealed a trend toward increasing exogamy over time; the presence in the cohort of individuals endorsing multiple race/ethnicity categories creates interesting challenges and future opportunities for genetic epidemiologic studies. PMID:26092716

  4. Characterizing Race/Ethnicity and Genetic Ancestry for 100,000 Subjects in the Genetic Epidemiology Research on Adult Health and Aging (GERA) Cohort

    PubMed Central

    Banda, Yambazi; Kvale, Mark N.; Hoffmann, Thomas J.; Hesselson, Stephanie E.; Ranatunga, Dilrini; Tang, Hua; Sabatti, Chiara; Croen, Lisa A.; Dispensa, Brad P.; Henderson, Mary; Iribarren, Carlos; Jorgenson, Eric; Kushi, Lawrence H.; Ludwig, Dana; Olberg, Diane; Quesenberry, Charles P.; Rowell, Sarah; Sadler, Marianne; Sakoda, Lori C.; Sciortino, Stanley; Shen, Ling; Smethurst, David; Somkin, Carol P.; Van Den Eeden, Stephen K.; Walter, Lawrence; Whitmer, Rachel A.; Kwok, Pui-Yan; Schaefer, Catherine; Risch, Neil

    2015-01-01

    Using genome-wide genotypes, we characterized the genetic structure of 103,006 participants in the Kaiser Permanente Northern California multi-ethnic Genetic Epidemiology Research on Adult Health and Aging Cohort and analyzed the relationship to self-reported race/ethnicity. Participants endorsed any of 23 race/ethnicity/nationality categories, which were collapsed into seven major race/ethnicity groups. By self-report the cohort is 80.8% white and 19.2% minority; 93.8% endorsed a single race/ethnicity group, while 6.2% endorsed two or more. Principal component (PC) and admixture analyses were generally consistent with prior studies. Approximately 17% of subjects had genetic ancestry from more than one continent, and 12% were genetically admixed, considering only nonadjacent geographical origins. Self-reported whites were spread on a continuum along the first two PCs, indicating extensive mixing among European nationalities. Self-identified East Asian nationalities correlated with genetic clustering, consistent with extensive endogamy. Individuals of mixed East Asian–European genetic ancestry were easily identified; we also observed a modest amount of European genetic ancestry in individuals self-identified as Filipinos. Self-reported African Americans and Latinos showed extensive European and African genetic ancestry, and Native American genetic ancestry for the latter. Among 3741 genetically identified parent–child pairs, 93% were concordant for self-reported race/ethnicity; among 2018 genetically identified full-sib pairs, 96% were concordant; the lower rate for parent–child pairs was largely due to intermarriage. The parent–child pairs revealed a trend toward increasing exogamy over time; the presence in the cohort of individuals endorsing multiple race/ethnicity categories creates interesting challenges and future opportunities for genetic epidemiologic studies. PMID:26092716

  5. Genotyping Informatics and Quality Control for 100,000 Subjects in the Genetic Epidemiology Research on Adult Health and Aging (GERA) Cohort

    PubMed Central

    Kvale, Mark N.; Hesselson, Stephanie; Hoffmann, Thomas J.; Cao, Yang; Chan, David; Connell, Sheryl; Croen, Lisa A.; Dispensa, Brad P.; Eshragh, Jasmin; Finn, Andrea; Gollub, Jeremy; Iribarren, Carlos; Jorgenson, Eric; Kushi, Lawrence H.; Lao, Richard; Lu, Yontao; Ludwig, Dana; Mathauda, Gurpreet K.; McGuire, William B.; Mei, Gangwu; Miles, Sunita; Mittman, Michael; Patil, Mohini; Quesenberry, Charles P.; Ranatunga, Dilrini; Rowell, Sarah; Sadler, Marianne; Sakoda, Lori C.; Shapero, Michael; Shen, Ling; Shenoy, Tanu; Smethurst, David; Somkin, Carol P.; Van Den Eeden, Stephen K.; Walter, Lawrence; Wan, Eunice; Webster, Teresa; Whitmer, Rachel A.; Wong, Simon; Zau, Chia; Zhan, Yiping; Schaefer, Catherine; Kwok, Pui-Yan; Risch, Neil

    2015-01-01

    The Kaiser Permanente (KP) Research Program on Genes, Environment and Health (RPGEH), in collaboration with the University of California—San Francisco, undertook genome-wide genotyping of >100,000 subjects that constitute the Genetic Epidemiology Research on Adult Health and Aging (GERA) cohort. The project, which generated >70 billion genotypes, represents the first large-scale use of the Affymetrix Axiom Genotyping Solution. Because genotyping took place over a short 14-month period, creating a near-real-time analysis pipeline for experimental assay quality control and final optimized analyses was critical. Because of the multi-ethnic nature of the cohort, four different ethnic-specific arrays were employed to enhance genome-wide coverage. All assays were performed on DNA extracted from saliva samples. To improve sample call rates and significantly increase genotype concordance, we partitioned the cohort into disjoint packages of plates with similar assay contexts. Using strict QC criteria, the overall genotyping success rate was 103,067 of 109,837 samples assayed (93.8%), with a range of 92.1–95.4% for the four different arrays. Similarly, the SNP genotyping success rate ranged from 98.1 to 99.4% across the four arrays, the variation depending mostly on how many SNPs were included as single copy vs. double copy on a particular array. The high quality and large scale of genotype data created on this cohort, in conjunction with comprehensive longitudinal data from the KP electronic health records of participants, will enable a broad range of highly powered genome-wide association studies on a diversity of traits and conditions. PMID:26092718

  6. Experimental Injury Biomechanics of the Pediatric Extremities and Pelvis

    NASA Astrophysics Data System (ADS)

    Ivarsson, Johan; Okamoto, Masayoshi; Takahashi, Yukou

    The paucity of pediatric postmortem human subjects (PMHS) for biomechanical research has led to the development of biofidelity requirements and injury assessment reference values (IARVs) for pediatric anthropomorphic test devices (ATDs) through geometrical scaling of adult PMHS data. Geometrical scaling relies on the assumption of geometrical similarity between the adult and child and does not account for any differences in tissue material properties. Attempts have been made to improve the accuracy of the scaled responses and IARVs by also accounting for the difference in Young's modulus between adult and pediatric bone (Irwin and Mertz 1997; van Ratingen et al. 1997; Mertz et al. 2001; Ivarsson et al. 2004a, b). However, the development of more biofidelic pediatric ATDs and accurate IARVs requires access to validation data that do not rely on the assumptions and simplifications associated with scaling. Access to accurate data from testing of pediatric tissues and anatomical structures would also facilitate the development of computational models for simulation of the response and injury of pediatric subjects in various loading situations.

  7. Two randomized, double-blind, placebo-controlled studies of fluticasone propionate lotion 0.05% for the treatment of atopic dermatitis in subjects from 3 months of age.

    PubMed

    Eichenfield, Lawrence F; Miller, B H

    2006-04-01

    A novel lotion formulation of fluticasone propionate 0.05% has recently become available. Two large, randomized, placebo-controlled, double-blind studies involving 438 subjects demonstrated its efficacy and safety when applied once daily in the treatment of atopic dermatitis in subjects from 3 months to 87 years of age. The studies were limited to 4 weeks duration of use of fluticasone lotion and did not assess longer term efficacy or side effects.

  8. What Is a Pediatric Endocrinologist?

    MedlinePlus

    ... dealing with children and in treating children with endocrine disorders and hormonal problems. If your pediatrician suggests that your child see a pediatric endocrinologist, you can be assured that your child will receive the best possible care. To find a pediatrician or pediatric specialist in ... © Copyright 2016 American Academy of Pediatrics. All rights reserved.

  9. Pediatric urologic radiology. Intervention and endourology

    SciTech Connect

    Mandell, V.S.; Mandell, J.; Gaisie, G.

    1985-02-01

    Over the past 10 years new imaging and interventional techniques have drastically changed the ease and scope of urologic diagnosis and treatment. It is both rewarding and exciting to approach each clinical problem with a broad armamentarium of available studies, always seeking the most efficient and direct route to diagnosis. Similarly, radiologic interventional techniques are potentially applicable to a multitude of problems and should be innovatively considered in the urologic patient including patients in the pediatric age group.

  10. Drug shortages and implications for pediatric patients.

    PubMed

    Butterfield, Lindsay; Cash, Jared; Pham, Kathy

    2015-01-01

    Drug shortages in the United States continue to be a significant problem that negatively impacts pediatric patients of all ages. These shortages have been associated with a higher rate of relapse among children with cancer, substitution of less effective agents, and greater risk for short- and long-term toxicity. Effective prevention and management of any drug shortage must include considerations for issues specific to pediatric patients; hence, the Pediatric Pharmacy Advocacy Group (PPAG) strongly supports the effective management of shortages by institutions caring for pediatric patients. Recommendations published by groups such as the American Society of Health-System Pharmacists and the American Society for Parenteral and Enteral Nutrition should be incorporated into drug shortage management policies. PPAG also supports the efforts of the Food and Drug Administration (FDA) to not only address but prevent drug shortages caused by manufacturing and quality problems, delays in production, and discontinuations. Prevention, mitigation, and effective management of drug shortages pose significant challenges that require effective communication; hence, PPAG encourages enhanced and early dialogue between the FDA, pharmaceutical manufacturers, professional organizations, and health care institutions.

  11. Current Management of Pediatric Vitiligo.

    PubMed

    Van Driessche, Freya; Silverberg, Nanette

    2015-08-01

    Vitiligo is a common inflammatory disorder with worldwide prevalence of 0.4-2 % of the population, with half of cases beginning in childhood. The management of childhood vitiligo should be tailored to avoid negative effects on the overall growth and psychological development of the patient. Therapy of vitiligo in childhood is chosen based on the location of the lesions, lesion age, and extent of lesions in the context of the child's age and the developmental status of the child. There are four age categories in childhood vitiligo: [1] infantile and toddler (rare) (ages 0-3 years), [2] ages 4-8 years, [3] ages 9-12 years, and [4] 13+ years of age, based on developmental stage, psychological maturation, and ability to comply or participate in therapy. These categories are also differentiated psychologically by susceptibility to bullying, self-image development, and personal concern with lesion appearance, which increases with time. Intervention is advisable in cases with facial and leg involvement due to prominence of lesions and cosmetic defect. Medical interventions are largely the usage of topical therapies including corticosteroids and calcineurin inhibitors, some vitamin therapy (oral and topical vitamin D), and judicious introduction of phototherapy sources based on age and severity. Screening and appropriate subspecialist referral for co-morbidities (e.g., thyroid disease, celiac disease, psychological distress, and vitamin D deficiency) may enhance overall health. Cosmesis and camouflage are generally safe in childhood and have been noted to improve overall quality of life in this grouping. Genetic transmission of vitiligo is minimal at 5-6 % in first-degree relatives. This article reviews the therapeutics of pediatric vitiligo from the perspective of developmental stages and response to therapy. PMID:26022363

  12. Current Management of Pediatric Vitiligo.

    PubMed

    Van Driessche, Freya; Silverberg, Nanette

    2015-08-01

    Vitiligo is a common inflammatory disorder with worldwide prevalence of 0.4-2 % of the population, with half of cases beginning in childhood. The management of childhood vitiligo should be tailored to avoid negative effects on the overall growth and psychological development of the patient. Therapy of vitiligo in childhood is chosen based on the location of the lesions, lesion age, and extent of lesions in the context of the child's age and the developmental status of the child. There are four age categories in childhood vitiligo: [1] infantile and toddler (rare) (ages 0-3 years), [2] ages 4-8 years, [3] ages 9-12 years, and [4] 13+ years of age, based on developmental stage, psychological maturation, and ability to comply or participate in therapy. These categories are also differentiated psychologically by susceptibility to bullying, self-image development, and personal concern with lesion appearance, which increases with time. Intervention is advisable in cases with facial and leg involvement due to prominence of lesions and cosmetic defect. Medical interventions are largely the usage of topical therapies including corticosteroids and calcineurin inhibitors, some vitamin therapy (oral and topical vitamin D), and judicious introduction of phototherapy sources based on age and severity. Screening and appropriate subspecialist referral for co-morbidities (e.g., thyroid disease, celiac disease, psychological distress, and vitamin D deficiency) may enhance overall health. Cosmesis and camouflage are generally safe in childhood and have been noted to improve overall quality of life in this grouping. Genetic transmission of vitiligo is minimal at 5-6 % in first-degree relatives. This article reviews the therapeutics of pediatric vitiligo from the perspective of developmental stages and response to therapy.

  13. [Treatment of pediatric epilepsy].

    PubMed

    Ito, Susumu; Oguni, Hirokazu

    2014-05-01

    Recently, the treatment strategy for pediatric epilepsy has been dramatically changed in Japan, because of the approval of new-generation antiepileptic drugs. Since 2006, a total of 6 new antiepileptic drugs, including gabapentin (GBP; adults/pediatric patients: 2006/2011 [year of approval]), topiramate (TPM; 2007/2013), lamotrigine (LTG; 2008/2008), levetiracetam (LEV; 2010/2013), stiripentol (STP; 2012/2012), and rufinamide (RUF; 2013/2013), have been introduced. Thus far, valproate (VPA) and carbamazepine (CBZ) have been first indicated for "generalized" epilepsy and "focal" epilepsy syndromes/types, respectively, in Japan. However, the approval of these new drugs could allow us to choose more effective and less toxic ones at an early stage of treatment. In this chapter, we describe the latest domestic and foreign guidelines for the treatment of pediatric epilepsy. PMID:24912285

  14. [Treatment of pediatric epilepsy].

    PubMed

    Ito, Susumu; Oguni, Hirokazu

    2014-05-01

    Recently, the treatment strategy for pediatric epilepsy has been dramatically changed in Japan, because of the approval of new-generation antiepileptic drugs. Since 2006, a total of 6 new antiepileptic drugs, including gabapentin (GBP; adults/pediatric patients: 2006/2011 [year of approval]), topiramate (TPM; 2007/2013), lamotrigine (LTG; 2008/2008), levetiracetam (LEV; 2010/2013), stiripentol (STP; 2012/2012), and rufinamide (RUF; 2013/2013), have been introduced. Thus far, valproate (VPA) and carbamazepine (CBZ) have been first indicated for "generalized" epilepsy and "focal" epilepsy syndromes/types, respectively, in Japan. However, the approval of these new drugs could allow us to choose more effective and less toxic ones at an early stage of treatment. In this chapter, we describe the latest domestic and foreign guidelines for the treatment of pediatric epilepsy.

  15. Pediatric nuclear medicine

    SciTech Connect

    Not Available

    1986-01-01

    This symposium presented the latest techniques and approaches to the proper medical application of radionuclides in pediatrics. An expert faculty, comprised of specialists in the field of pediatric nuclear medicine, discussed the major indications as well as the advantages and potential hazards of nuclear medicine procedures compared to other diagnostic modalities. In recent years, newer radiopharmaceuticals labeled with technetium-99m and other short-lived radionuclides with relatively favorable radiation characteristics have permitted a variety of diagnostic studies that are very useful clinically and carry a substantially lower radiation burden then many comparable X-ray studies. This new battery of nuclear medicine procedures is now widely available for diagnosis and management of pediatric patients. Many recent research studies in children have yielded data concerning the effacacy of these procedures, and current recommendations will be presented by those involved in conducting such studies. Individual papers are processed separately for the Energy Data Base.

  16. The pediatric Internet.

    PubMed

    Spooner, S A

    1996-12-01

    The Internet is a set of rules for computer communications that has created easy access to electronic mail, electronic mailing lists, and the World Wide Web. The "pediatric Internet" consists of a growing collection of Internet resources that deal specifically with the health care of the young. Locating this information, judging its quality, and determining its appropriate use presents difficulties, but the ubiquity of the Internet makes it imperative for child health professionals to learn the skills necessary to access and provide information via this medium. The Internet will be used increasingly for scientific publishing, the original purpose of the World Wide Web. This article presents basic definitions for the Internet, some characteristics of the pediatric Internet, guidance on how to locate information, and what the future of the pediatric Internet holds. PMID:8951274

  17. Nelson Textbook of Pediatrics.

    PubMed

    Pomerance, Herbert H

    1997-03-01

    The dedication of this volume states:To the physicians and nurses who care for children in many different circumstances throughout the world and who, by their efforts and commitment, make the world a better place for children.I have used the Nelson Textbook of Pediatrics since its third edition. It remains a source of amazement to me, as I witness the evolution of the book and of the knowledge that dictates its scope. From the days when a textbook was written by 1 or 2 authors, we have progressed to the point where this would be impossible. Three editors preside over this volume; they are also counted among the 212 contributors that lend special expertise to the work, continuing the volume as one of the traditions of pediatrics.The tremendous and rapid explosion in the amount of knowledge in pediatrics made a revision of the total material and even of.

  18. Geospatial Analysis of Pediatric EMS Run Density and Endotracheal Intubation

    PubMed Central

    Hansen, Matthew; Loker, William; Warden, Craig

    2016-01-01

    Introduction The association between geographic factors, including transport distance, and pediatric emergency medical services (EMS) run clustering on out-of-hospital pediatric endotracheal intubation is unclear. The objective of this study was to determine if endotracheal intubation procedures are more likely to occur at greater distances from the hospital and near clusters of pediatric calls. Methods This was a retrospective observational study including all EMS runs for patients less than 18 years of age from 2008 to 2014 in a geographically large and diverse Oregon county that includes densely populated urban areas near Portland and remote rural areas. We geocoded scene addresses using the automated address locator created in the cloud-based mapping platform ArcGIS, supplemented with manual address geocoding for remaining cases. We then use the Getis-Ord Gi spatial statistic feature in ArcGIS to map statistically significant spatial clusters (hot spots) of pediatric EMS runs throughout the county. We then superimposed all intubation procedures performed during the study period on maps of pediatric EMS-run hot spots, pediatric population density, fire stations, and hospitals. We also performed multivariable logistic regression to determine if distance traveled to the hospital was associated with intubation after controlling for several confounding variables. Results We identified a total of 7,797 pediatric EMS runs during the study period and 38 endotracheal intubations. In univariate analysis we found that patients who were intubated were similar to those who were not in gender and whether or not they were transported to a children’s hospital. Intubated patients tended to be transported shorter distances and were older than non-intubated patients. Increased distance from the hospital was associated with reduced odds of intubation after controlling for age, sex, scene location, and trauma system entry status in a multivariate logistic regression. The

  19. The Accuracy of Broselow Tape Weight Estimate among Pediatric Population

    PubMed Central

    AlGarni, Abdullaziz; AlGamdi, Fasial; Jawish, Mona; Wani, Tariq Ahmad

    2016-01-01

    Objective. To determine the accuracy of the Broselow Tape (BT) versions 2007 and 2011 in estimating weight among pediatric population. Methods. A cross-sectional study was conducted at King Fahad Medical City and six schools across Riyadh province on 1–143-month-old children. BT 2007 and 2011 estimated weights were recorded. Both tapes via the child's height produce an estimated weight, which was compared with the actual weight. Results. A total of 3537 children were recruited. The height (cm) of the subjects was 97.7 ± 24.1 and the actual weight (kg) was 16.07 ± 8.9, whereas the estimated weight determined by BT 2007 was 15.87 ± 7.56 and by BT 2011 was 16.38 ± 7.95. Across all the five age groups, correlation between actual weight and BT 2007 ranged between 0.702 and 0.788, while correlation between actual weight and BT 2011 ranged between 0.698 and 0.788. Correlation between BT 2007 and BT 2011 across all the five age groups ranged from 0.979 to 0.989. Accuracy of both the tape versions was adversely affected when age was >95 months and body weight was >26 kilograms. Conclusions. Our study showed that BT 2007 and 2011 provided accurate estimation of the body weight based on measured body height. However, 2011 version provided more precise estimate for weight. PMID:27668258

  20. The Accuracy of Broselow Tape Weight Estimate among Pediatric Population

    PubMed Central

    AlGarni, Abdullaziz; AlGamdi, Fasial; Jawish, Mona; Wani, Tariq Ahmad

    2016-01-01

    Objective. To determine the accuracy of the Broselow Tape (BT) versions 2007 and 2011 in estimating weight among pediatric population. Methods. A cross-sectional study was conducted at King Fahad Medical City and six schools across Riyadh province on 1–143-month-old children. BT 2007 and 2011 estimated weights were recorded. Both tapes via the child's height produce an estimated weight, which was compared with the actual weight. Results. A total of 3537 children were recruited. The height (cm) of the subjects was 97.7 ± 24.1 and the actual weight (kg) was 16.07 ± 8.9, whereas the estimated weight determined by BT 2007 was 15.87 ± 7.56 and by BT 2011 was 16.38 ± 7.95. Across all the five age groups, correlation between actual weight and BT 2007 ranged between 0.702 and 0.788, while correlation between actual weight and BT 2011 ranged between 0.698 and 0.788. Correlation between BT 2007 and BT 2011 across all the five age groups ranged from 0.979 to 0.989. Accuracy of both the tape versions was adversely affected when age was >95 months and body weight was >26 kilograms. Conclusions. Our study showed that BT 2007 and 2011 provided accurate estimation of the body weight based on measured body height. However, 2011 version provided more precise estimate for weight.

  1. Utilization of stainless steel crowns by general dentists and pediatric dental specialists in Indiana.

    PubMed

    Kowolik, Joan; Kozlowski, Diana; Jones, James E

    2007-01-01

    The purpose of this study was to evaluate utilization of the stainless steel crown by both the general and pediatric dentists in Indiana. Although reports indicate that there has been a dramatic reduction in dental caries in the US, almost 20 percent of children have dental decay by age four, with almost 80 percent having a cavity by 17 years of age. After reviewing the literature, Seale has recommended that the stainless steel crown is the most successful restoration for children with a rate of high caries. All dental schools in North America teach the value of using stainless steel crowns and the method of tooth preparation. We hypothesized that greater use of the stainless steel crowns would be made by specialists than by general dentists. In this study, of the 200 questionnaires distributed, 62.5 percent were returned and analyzed. The results imply that stainless steel crowns are being significantly underutilized in general dental practice. It is interesting, and perhaps of concern, that the general dentists are not interested in continuing education courses about this subject. Over the next few years, with the aging of the pediatric dental community in Indiana, general (not specialty) dentists will treat most of the children. Because of this, pre-doctoral education needs to place more emphasis on preparation and utilization of the stainless steel crown.

  2. Pediatric Day Case Surgical Practice at a Tertiary Hospital in Lagos: How Have We Faired?

    PubMed Central

    Elebute, OA; Ademuyiwa, AO; Bode, CO; Idiodi-Thomas, HOI

    2014-01-01

    Background: There has been a gradual increase in the number of patients treated as a day case surgery in our center. This study has been conducted to audit pediatric day case surgery practice at the Lagos University Teaching Hospital. Aims: The aim of the following study is to determine the morbidity and mortality from day case surgery in our center. Subjects and Methods: The type of study was a prospective study over a 2½ year period at the Lagos University Teaching Hospital. The patients scheduled for surgeries were assessed in the pediatric outpatient clinic and information obtained for each of the patients included age, sex, diagnosis and operation planned. Additional information collected included the (1) type of anesthesia (2) post-operative complications and the cadre of the surgeon. The data was analyzed using SPSS version 19 (IBM Corp. Released 2010. IBM SPSS Statistics for Windows, Version 19.0. Armonk, NY: IBM Corp, USA). Result: A total of 381 patients were operated during the study period. The age range of patients was 2 weeks to 15 years and the mean age was 2.9 years (3.0). There were 338 male patients (88.7%;338/381) and 43 females (11.3%;43/381). Inguinal hernias and hydroceles constituted almost half of the cases treated while 16.0% of cases were undescended testis. There were four morbidities and no mortality. Conclusion: Day case surgery is associated with a low morbidity and no mortality in our center. PMID:25221704

  3. Pediatric Extranodal Lymphoma.

    PubMed

    Chung, Ellen M; Pavio, Michael

    2016-07-01

    Lymphoma is the third most common pediatric neoplasm. Non-Hodgkin lymphoma (NHL) accounts for nearly half of cases and commonly involves extranodal sites. Compared with adults, this histologic spectrum of pediatric NHL is very narrow and consists of aggressive tumors. Patients typically present with widespread disease. Generally, NHL occurring in children includes Burkitt lymphoma, lymphoblastic lymphoma, diffuse large B-cell lymphoma, and anaplastic large cell lymphoma. Staging and assessment of therapeutic response are usually based on FDG-PET/CT. Due to the increased susceptibility of young patients to the effects of ionizing radiation, alternative methods of imaging are being explored.

  4. Contact Dermatitis in Pediatrics.

    PubMed

    Pelletier, Janice L; Perez, Caroline; Jacob, Sharon E

    2016-08-01

    Contact dermatitis is an umbrella term that describes the skin's reaction to contacted noxious or allergenic substances. The two main categories of contact dermatitis are irritant type and allergic type. This review discusses the signs, symptoms, causes, and complications of contact dermatitis. It addresses the testing, treatment, and prevention of contact dermatitis. Proper management of contact dermatitis includes avoidance measures for susceptible children. Implementation of a nickel directive (regulating the use of nickel in jewelry and other products that come into contact with the skin) could further reduce exposure to the most common allergens in the pediatric population. [Pediatr Ann. 2016;45(8):e287-e292.]. PMID:27517356

  5. Pediatric palliative care.

    PubMed

    Moody, Karen; Siegel, Linda; Scharbach, Kathryn; Cunningham, Leslie; Cantor, Rabbi Mollie

    2011-06-01

    Progress in pediatric palliative care has gained momentum, but there remain significant barriers to the appropriate provision of palliative care to ill and dying children, including the lack of properly trained health care professionals, resources to finance such care, and scientific research, as well as a continued cultural denial of death in children. This article reviews the epidemiology of pediatric palliative care, special communication concerns, decision making, ethical and legal considerations, symptom assessment and management, psychosocial issues, provision of care across settings, end-of-life care, and bereavement. Educational and supportive resources for health care practitioners and families, respectively, are included.

  6. Pediatric Orbital Fractures

    PubMed Central

    Oppenheimer, Adam J.; Monson, Laura A.; Buchman, Steven R.

    2013-01-01

    It is wise to recall the dictum “children are not small adults” when managing pediatric orbital fractures. In a child, the craniofacial skeleton undergoes significant changes in size, shape, and proportion as it grows into maturity. Accordingly, the craniomaxillofacial surgeon must select an appropriate treatment strategy that considers both the nature of the injury and the child's stage of growth. The following review will discuss the management of pediatric orbital fractures, with an emphasis on clinically oriented anatomy and development. PMID:24436730

  7. Venovenous Extracorporeal Membrane Oxygenation in Pediatric Respiratory Failure.

    PubMed

    Ham, P Benson; Hwang, Brice; Wise, Linda J; Walters, K Christian; Pipkin, Walter L; Howell, Charles G; Bhatia, Jatinder; Hatley, Robyn

    2016-09-01

    Conventional treatment of respiratory failure involves positive pressure ventilation that can worsen lung damage. Extracorporeal membrane oxygenation (ECMO) is typically used when conventional therapy fails. In this study, we evaluated the use of venovenous (VV)-ECMO for the treatment of severe pediatric respiratory failure at our institution. A retrospective analysis of pediatric patients (age 1-18) placed on ECMO in the last 15 years (1999-2014) by the pediatric surgery team for respiratory failure was performed. Five pediatric patients underwent ECMO (mean age 10 years; range, 2-16). All underwent VV-ECMO. Diagnoses were status asthmaticus (2), acute respiratory distress syndrome due to septic shock (1), aspergillus pneumonia (1), and respiratory failure due to parainfluenza (1). Two patients had severe barotrauma prior to ECMO initiation. Average oxygenation index (OI) prior to cannulation was 74 (range 23-122). No patients required conversion to VA-ECMO. The average ECMO run time was 4.4 days (range 2-6). The average number of days on the ventilator was 15 (range 4-27). There were no major complications due to the procedure. Survival to discharge was 100%. Average follow up is 4.4 years (range 1-15). A short run of VV-ECMO can be lifesaving for pediatric patients in respiratory failure. Survival is excellent despite severely elevated oxygen indices. VV-ECMO may be well tolerated and can be considered for severe pediatric respiratory failure. PMID:27670564

  8. Potential bacteremia in pediatric practice.

    PubMed

    Hoekelman, R; Lewin, E B; Shapira, M B; Sutherland, S A

    1979-10-01

    The potential consequences of bacteremia are considerable in all infants but particularly in those from 3 to 24 months of age with temperatures of 38.3 degrees C or more. Physicians have been advised to scrutinize these patients carefully with a variety of diagnostic tests and to treat their conditions vigorously if bacteremia is seriously considered or proved. We undertook to determine how often primary care pediatric practitioners encounter such patients "at risk" for bacteremia. Among the practices of nine pediatricians in Monroe County, New York, involving 220 practice days throughout 1977 and 4,151 patient visits, we found 145 instances of potential bacteremia. Depending, then, on the season of the year, practitioners may face this diagnostic and management dilemma as often as once each day. Therefore, laboratory means for determining those infants at highest risk for bacteremia or for rapidly diagnosing bacteremia will need to be readily available to practitioners.

  9. Neural Correlates of Symptom Dimensions in Pediatric Obsessive-Compulsive Disorder: A Functional Magnetic Resonance Imaging Study

    ERIC Educational Resources Information Center

    Gilbert, Andrew R.; Akkal, Dalila; Almeida, Jorge R. C.; Mataix-Cols, David; Kalas, Catherine; Devlin, Bernie; Birmaher, Boris; Phillips, Mary L.

    2009-01-01

    The use of functional magnetic resonance imaging on a group of pediatric subjects with obsessive compulsive disorder reveals that this group has reduced activity in neural regions underlying emotional processing, cognitive processing, and motor performance as compared to control subjects.

  10. Pediatric sexology and hermaphroditism.

    PubMed

    Money, J

    1985-01-01

    Lacking an empirically based theory of erotosexual development and health in childhood, pediatrics too easily falls back on reductionistic hypotheses of the nature versus nurture type. A new, three-term paradigm, namely, nature/critical-period/nurture, is needed to explain, for example, the phenomenology of hermaphroditism, and the differentiation of gender-identity/role (G-I/R) in individual cases. In 30 young women with a history of the early-treated, 46,XX congenital virilizing adrenal hyperplasia (CVAH) syndrome, 37% (N = 11) had a history of bisexual imagery or practice, as compared with 7% in the control patients (chi 2 = 17.7; p less than .001); and 5 of these 11 rated themselves as exclusively or predominantly lesbian. In Kinsey's sample, 15% of females reported homoerotic imagery by age 20, and 2 out of 3 of them also had homoerotic partner contact. The CVAH finding may be a function of prenatal and/or neonatal brain androgenization, but other variables, such as the history of juvenile erotosexual rehearsal play, cannot be ruled out. Among adolescents with a history of hermaphroditism, sex-reassignment applications are honored predominantly if they are made by 46,XY hermaphrodites assigned neonatally as girls and with nonfeminizing hormonal puberty, as medical and folk traditions both favor approval of such applicants more than others. Parthenogenic whiptail lizards that alternately simulate the male and female mating behavior of related diecious species provide an animal model that demonstrates the existence of both male and female sexual schemas in the same brain. In human beings, the irreducible sex differences are that males impregnate, and females menstruate, gestate, and lactate. Otherwise, sexual dimorphism that is programmed into the brain under the influence of prenatal hormones appears to be not sex-irreducible, but sex-shared and threshold-dimorphic. A complete theory of the differentiation of all the constituents of masculinity or femininity of

  11. Pharmacotherapy of Pediatric Insomnia

    ERIC Educational Resources Information Center

    Owens, Judith A.

    2009-01-01

    General guidelines for the use of medication to treat pediatric insomnia are presented. It should be noted that medication is not the first treatment choice and should be viewed within the context of a more comprehensive treatment plan. The pharmacological and clinical properties of over the counter medications and FDA-approved insomnia drugs are…

  12. Pediatric functional gastrointestinal disorders

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Functional gastrointestinal disorders continue to be a prevalent set of conditions faced by the healthcare team and have a significant emotional and economic impact. In this review, the authors highlight some of the common functional disorders seen in pediatric patients (functional dyspepsia, irrita...

  13. Pediatric Low Vision

    MedlinePlus

    ... Asked Questions Español Condiciones Chinese Conditions Pediatric Low Vision What is Low Vision? Partial vision loss that cannot be corrected causes ... and play. What are the signs of Low Vision? Some signs of low vision include difficulty recognizing ...

  14. Update on pediatric hyperhidrosis.

    PubMed

    Gordon, Jennifer R S; Hill, Samantha E

    2013-01-01

    Hyperhidrosis is a common and under-recognized disease in the pediatric population that has a significant impact on quality of life. Focal and generalized forms of hyperhidrosis exist, which can be idiopathic or secondary to underlying medical conditions or medications. Treatment is tailored to the specific patient needs, characteristics and goals. These include topical preparations, iontophoresis, botulinum toxin and anticholinergic medications. PMID:24552408

  15. Anticoagulant therapy in pediatrics

    PubMed Central

    Dabbous, Mariam K.; Sakr, Fouad R.; Malaeb, Diana N.

    2014-01-01

    Thromboembolic episodes are disorders encountered in both children and adults, but relatively more common in adults. However, the occurrence of venous thromboembolism and use of anticoagulants in pediatrics are increasing. Unfractionated Heparin (UH) is used as a treatment and prevention of thrombosis in adults and critically ill children. Heparin utilization in pediatric is limited by many factors and the most important ones are Heparin Induced Thrombocytopenia (HIT) and anaphylaxis. However, Low Molecular Weight Heparin (LMWH) appears to be an effective and safe alternative treatment. Hence, it is preferred over than UH due to favorable pharmacokinetic and side effect profile. Direct Thrombin Inhibitors (DTI) is a promising class over the other anticoagulants since it offers potential advantages. The aim of this review is to discuss the differences between adult and pediatric thromboembolism and to review the current anticoagulants in terms of pharmacological action, doses, drug reactions, pharmacokinetics, interactions, and parameters. This review also highlights the differences between old and new anticoagulant therapy in pediatrics. PMID:25031496

  16. Pediatric Psychotropic Polypharmacy

    PubMed Central

    Zonfrillo, Mark R.; Leonard, Henrietta L.

    2005-01-01

    Study Objective: This study was a literature review designed to assess the rates of psychotropic “polypharmacy” in the pediatric population. Psychotropic polypharmacy was defined as the practice of prescribing two or more medications (e.g. concomitant psychotropic medications) for one or more diagnosed psychiatric conditions and/or behavioral symptoms. Methods: A literature review of relevant articles pertaining to polypharmacy was completed using the Pub Med database from 1994 through April 2004 for pediatric populations under 18 years old. Results: Studies were reviewed from various pediatric settings. While the extent of polypharmacy varied from the different populations, all the studies comparing these rates across time showed an increase in this practice. The use of stimulants with another psychotropic medication was the most frequent combination. Conclusions: There is limited information about the actual rates of psychotropic polypharmacy in the pediatric population. However, the data that are available demonstrate that this practice is on the rise. This is of specific concern due to the increase of adverse events with polypharmacy. The implications of polypharmacy, including efficacy and side effects, are generally unknown and may vary by specific combination. Therefore, these prescribing practices should be conducted with caution, and systematic research is needed. PMID:21152168

  17. Update on pediatric hyperhidrosis.

    PubMed

    Gordon, Jennifer R S; Hill, Samantha E

    2013-01-01

    Hyperhidrosis is a common and under-recognized disease in the pediatric population that has a significant impact on quality of life. Focal and generalized forms of hyperhidrosis exist, which can be idiopathic or secondary to underlying medical conditions or medications. Treatment is tailored to the specific patient needs, characteristics and goals. These include topical preparations, iontophoresis, botulinum toxin and anticholinergic medications.

  18. Pediatric brainstem oligodendroglioma

    PubMed Central

    Mohindra, Sandeep; Savardekar, Amey; Bal, Amanjit

    2012-01-01

    The authors present the first report of pediatric brainstem oligodendroglioma, infiltrating midbrain, and medulla oblongata. The report details clinical features, radiological findings, and surgical steps. As this entity is exceedingly uncommon, the overall epidemiology, prognosis, and long-term outcome remain far from established. PMID:22346193

  19. Analysis of Electrocardiographic Data Following Use of Paroxetine in Pediatric Depression and Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Krulewicz, Stan; Carpenter, David J.; Fong, Regan; Horrigan, Joseph P.; Lipschitz, Alan; Perera, Philip; Wagner, Karen Dineen

    2006-01-01

    Objective: This retrospective analysis of electrocardiographic (ECG) data investigated the cardiovascular effects of paroxetine 10-50 mg/day in pediatric patients (7-18 years of age). Data were collected from three 8- to 10-week, randomized, placebo-controlled, double-blind trials of paroxetine in pediatric patients with major depressive disorder…

  20. Length of Stay of Pediatric Mental Health Emergency Department Visits in the United States

    ERIC Educational Resources Information Center

    Case, Sarah D.; Case, Brady G.; Olfson, Mark; Linakis, James G.; Laska, Eugene M.

    2011-01-01

    Objective: To compare pediatric mental health emergency department visits to other pediatric emergency department visits, focusing on length of stay. Method: We analyzed data from the National Hospital Ambulatory Medical Care Survey, a nationally representative sample of US emergency department visits from 2001 to 2008, for patients aged less than…

  1. Emergency Management of Sexually Abused Children. The Role of the Pediatric Resident.

    ERIC Educational Resources Information Center

    Orr, Donald P.; Prietto, Susan V.

    1979-01-01

    A program for the initial pediatric evaluation and management of sexually abused children is offered as one possible model for other training centers. Cases of 100 sexually abused children (mean age 9.2 years) seen by pediatric residents are reviewed. Journal availability: American Medical Association, 535 North Dearborn Street, Chicago, Illinois…

  2. Pediatric neuroradiology: Cerebral and cranial diseases

    SciTech Connect

    Diebler, C.; Dulac, O.

    1987-01-01

    In this book, a neuroradiologist and a neuropediatrician have combined forces to provide the widest possible knowledge in investigating cranial and cerebral disorders in infancy and childhood. Based on more than 20,000 pediatric CT examinations, with a follow-up time often exceeding ten years, the book aims to bridge interdisciplinary gaps and help radiologists, pediatricians and neurosurgeons solve the various problems of pediatric neuroradiology that frequently confront them. For each disease, the etiology, clinical manifestation, pathological lesions and radiological presentations are discussed, supported by extensive illustrations. Malformative, vascular, traumatic, tumoral, infectious and metabolic diseases are reviewed. Miscellaneous conditions presenting particular symptoms or syndromes are also studied, such as hydrocephalus and neurological complications of leukemia. Contents: Cerebral and cranial malformations; neurocutaneous syndromes; inherited metabolic diseases; infectious diseases - vascular disorders; intracranial tumors; cranial trauma - miscellaneous and subject index.

  3. Comparison of arm and calf automatic noninvasive blood pressures in pediatric intensive care patients.

    PubMed

    Schell, Kathleen; Briening, Eileen; Lebet, Ruth; Pruden, Kelly; Rawheiser, Steven; Jackson, Barbara

    2011-02-01

    The purpose of this study was to compare upper arm and calf automatic blood pressures (BPs) in a convenience sample of 221 children, ages 1 to 8 years, admitted to a pediatric intensive care unit of a 180-bed teaching hospital in the Mid-Atlantic region of the United States. Subjects were positioned in bed, with the head of bed elevated 30° and extremities resting on the bed. BP cuff size was based on arm and calf circumferences. BPs were measured simultaneously using bedside and portable Spacelabs monitors. Calf BPs were greater than arm BPs in approximately 73% of the sample. Paired t tests show statistically significant differences for systolic BPs and mean arterial pressures. Influence of demographics, agitation levels, medical diagnoses, and current medications was explored. Calf and arm BPs were not interchangeable in acutely ill children, ages 1 to 8 years. PMID:21256407

  4. How to perform Subjective Global Nutritional assessment in children.

    PubMed

    Secker, Donna J; Jeejeebhoy, Khursheed N

    2012-03-01

    Subjective Global Assessment (SGA) is a method for evaluating nutritional status based on a practitioner's clinical judgment rather than objective, quantitative measurements. Encompassing historical, symptomatic, and physical parameters, SGA aims to identify an individual's initial nutrition state and consider the interplay of factors influencing the progression or regression of nutrition abnormalities. SGA has been widely used for more than 25 years to assess the nutritional status of adults in both clinical and research settings. Perceiving multiple benefits of its use in children, we recently adapted and validated the SGA tool for use in a pediatric population, demonstrating its ability to identify the nutritional status of children undergoing surgery and their risk of developing nutrition-associated complications postoperatively. Objective measures of nutritional status, on the other hand, showed no association with outcomes. The purpose of this article is to describe in detail the methods used in conducting nutrition-focused physical examinations and the medical history components of a pediatric Subjective Global Nutritional Assessment tool. Guidelines are given for performing and interpreting physical examinations that look for evidence of loss of subcutaneous fat, muscle wasting, and/or edema in children of different ages. Age-related questionnaires are offered to guide history taking and the rating of growth, weight changes, dietary intake, gastrointestinal symptoms, functional capacity, and any metabolic stress. Finally, the associated rating form is provided, along with direction for how to consider all components of a physical exam and history in the context of each other, to assign an overall rating of normal/well nourished, moderate malnutrition, or severe malnutrition. With this information, interested health professionals will be able to perform Subjective Global Nutritional Assessment to determine a global rating of nutritional status for infants

  5. Pediatric Procedural Pain-How Far Have We Come? An Ethnographic Account

    PubMed Central

    Cummings, Jo Ann F

    2014-01-01

    In this ethnographic study, the author explores the pediatric procedural pain management practice of healthcare providers in a non-pediatric emergency department. Data were collected for 5 months with over 100 hours of observation. Six key informants were interviewed, and 44 pediatric procedural interactions with 27 healthcare providers during the treatment of children two to eight years of age undergoing procedures were observed. Other information gathered included documents from the institution, and pain related information from the patient’s medical record. Two major themes with categories are discussed, the treatment of pain, and procedural pain. The findings of this study provide insight to the everyday practice of emergency department healthcare providers for pediatric pain in a non-pediatric setting, and identify practice issues that may adversely affect the management of pediatric procedural pain, notably the non-use of pharmacological techniques for simple needle procedures and the common use of physical restraint during painful procedures. PMID:26025793

  6. Diagnosis and Management of Pediatric and Adolescent Varicocele: A Survey of Pediatric Urologists in Korea

    PubMed Central

    Lee, Tae Ho; Jung, Jay Ho

    2016-01-01

    The aim of this study was to evaluate current practice patterns on diagnosis and management of pediatric varicoceles. Questionnaires of approaches to diagnosis and management of pediatric varicoceles were sent electronically to pediatric urologists. Of the 70 questionnaires e-mailed, 37 (53%) responded to the survey. 10 respondents (27%) chose to operate on varicoceles, whereas 9 (24%) chose to observe, and 18 (49%) chose to decide upon treatment depending on the clinical situation. The most important indication for varicocelectomy was a decrease in ipsilateral testicular size (n=29, 78%) followed by testicular or scrotal pain (n=4, 11%) and varicocele grade (n=4, 11%). The optimal age for varicocelectomy was answered as 13.8±2.3 years mean. 32 respondents (86%) have used ultrasonography to aid in the diagnosis of varicoceles, and 26 respondents (70%) have considered repairing varicocele incidentally detected on ultrasonography. In an otherwise asymptomatic patient with varicocele, 17 respondents (46%) considered surgery for grade 3, but 15 respondents (41%) would not repair the varicocele. The most commonly used surgical approach was subinguinal microsurgical (n=19, 51%), followed by inguinal (n=9, 24%) and laparascopic (n=5, 14%) procedures. The most commonly experienced post-operative complication was recurrence (n=22, 59%) followed by persistence (n=13, 35%) and hydrocele (n=10, 27%). 28 respondents (76%) did not have long-term follow-up data including regarding fertility on their varicocele patients. Our survey demonstrates that there is lack of consensus on diagnosis and management of pediatric and adolescent varicoceles among pediatric urologists. A prospective randomized study of pediatric and adolescent varicoceles is needed to assess the outcomes and develop universal management guidelines. PMID:27689031

  7. Diagnosis and Management of Pediatric and Adolescent Varicocele: A Survey of Pediatric Urologists in Korea.

    PubMed

    Lee, Tae Ho; Jung, Jay Ho; Hong, Young Kwon

    2016-09-01

    The aim of this study was to evaluate current practice patterns on diagnosis and management of pediatric varicoceles. Questionnaires of approaches to diagnosis and management of pediatric varicoceles were sent electronically to pediatric urologists. Of the 70 questionnaires e-mailed, 37 (53%) responded to the survey. 10 respondents (27%) chose to operate on varicoceles, whereas 9 (24%) chose to observe, and 18 (49%) chose to decide upon treatment depending on the clinical situation. The most important indication for varicocelectomy was a decrease in ipsilateral testicular size (n=29, 78%) followed by testicular or scrotal pain (n=4, 11%) and varicocele grade (n=4, 11%). The optimal age for varicocelectomy was answered as 13.8±2.3 years mean. 32 respondents (86%) have used ultrasonography to aid in the diagnosis of varicoceles, and 26 respondents (70%) have considered repairing varicocele incidentally detected on ultrasonography. In an otherwise asymptomatic patient with varicocele, 17 respondents (46%) considered surgery for grade 3, but 15 respondents (41%) would not repair the varicocele. The most commonly used surgical approach was subinguinal microsurgical (n=19, 51%), followed by inguinal (n=9, 24%) and laparascopic (n=5, 14%) procedures. The most commonly experienced post-operative complication was recurrence (n=22, 59%) followed by persistence (n=13, 35%) and hydrocele (n=10, 27%). 28 respondents (76%) did not have long-term follow-up data including regarding fertility on their varicocele patients. Our survey demonstrates that there is lack of consensus on diagnosis and management of pediatric and adolescent varicoceles among pediatric urologists. A prospective randomized study of pediatric and adolescent varicoceles is needed to assess the outcomes and develop universal management guidelines. PMID:27689031

  8. Diagnosis and Management of Pediatric and Adolescent Varicocele: A Survey of Pediatric Urologists in Korea

    PubMed Central

    Lee, Tae Ho; Jung, Jay Ho

    2016-01-01

    The aim of this study was to evaluate current practice patterns on diagnosis and management of pediatric varicoceles. Questionnaires of approaches to diagnosis and management of pediatric varicoceles were sent electronically to pediatric urologists. Of the 70 questionnaires e-mailed, 37 (53%) responded to the survey. 10 respondents (27%) chose to operate on varicoceles, whereas 9 (24%) chose to observe, and 18 (49%) chose to decide upon treatment depending on the clinical situation. The most important indication for varicocelectomy was a decrease in ipsilateral testicular size (n=29, 78%) followed by testicular or scrotal pain (n=4, 11%) and varicocele grade (n=4, 11%). The optimal age for varicocelectomy was answered as 13.8±2.3 years mean. 32 respondents (86%) have used ultrasonography to aid in the diagnosis of varicoceles, and 26 respondents (70%) have considered repairing varicocele incidentally detected on ultrasonography. In an otherwise asymptomatic patient with varicocele, 17 respondents (46%) considered surgery for grade 3, but 15 respondents (41%) would not repair the varicocele. The most commonly used surgical approach was subinguinal microsurgical (n=19, 51%), followed by inguinal (n=9, 24%) and laparascopic (n=5, 14%) procedures. The most commonly experienced post-operative complication was recurrence (n=22, 59%) followed by persistence (n=13, 35%) and hydrocele (n=10, 27%). 28 respondents (76%) did not have long-term follow-up data including regarding fertility on their varicocele patients. Our survey demonstrates that there is lack of consensus on diagnosis and management of pediatric and adolescent varicoceles among pediatric urologists. A prospective randomized study of pediatric and adolescent varicoceles is needed to assess the outcomes and develop universal management guidelines.

  9. Pediatric Healthcare Response to Pandemic (H1N1) 2009 Influenza Stakeholder Meeting - Summary of Proceedings

    SciTech Connect

    HCTT CHE

    2010-01-01

    The goal of the meeting was to bring together subject matter experts to develop tools and resources for use by the pediatric healthcare community in response to 2009 (H1N1) pandemic influenza activity during the 2009 influenza season.

  10. Baastrup's disease in the pediatric spine

    PubMed Central

    Singh, Suryapratap

    2016-01-01

    Baastrup's disease is an uncommon entity in the elderly spine and it is very rare in the pediatric age group. There are only few case reports in the literature containing Baastrup's disease in pediatric spine. Baastrup's disease is also known as kissing spine because the posterior spinous processes touch or “kiss” one another, characterized by enlarged posterior spinous projections with normal neuroforamina and normal spinal disk height. There are various pathological and etiological hypotheses behind Baastrup's disease. Backache is one of the most common causes of morbidity in these patients and but sometimes patient can be asymptomatic with or without swelling on the back. Here, we present a case of 10-year-old female child with silent swelling on low back region diagnose as Baastrup's disease.

  11. Can We Tune Our Pediatric Patients?

    PubMed Central

    Kaur, Rajwinder

    2011-01-01

    For the pedodontic team, a child’s dental anxiety poses major management problems. Previously, wide variety of aversive techniques have been used with varying success rates to manage anxious child patients. The present trend advocates the use of nonaversive techniques like distraction in the management of anxious pediatric patients. So the aim of this study is to compare the effect of audio distraction with the normal set up operatory. Thirty patients of age between 4 and 8 years were included in the study. Each patient had gone through four dental visits. Anxiety was measured using Venham’s picture test. The values obtained were tabulated and statistical analysis and concluded that audio distraction did decrease the level of anxiety in anxious pediatric dental patients to a significant level during the restorative procedure visit (3rd) and invasive procedure visit (4th).

  12. Baastrup's disease in the pediatric spine

    PubMed Central

    Singh, Suryapratap

    2016-01-01

    Baastrup's disease is an uncommon entity in the elderly spine and it is very rare in the pediatric age group. There are only few case reports in the literature containing Baastrup's disease in pediatric spine. Baastrup's disease is also known as kissing spine because the posterior spinous processes touch or “kiss” one another, characterized by enlarged posterior spinous projections with normal neuroforamina and normal spinal disk height. There are various pathological and etiological hypotheses behind Baastrup's disease. Backache is one of the most common causes of morbidity in these patients and but sometimes patient can be asymptomatic with or without swelling on the back. Here, we present a case of 10-year-old female child with silent swelling on low back region diagnose as Baastrup's disease. PMID:27695557

  13. Can We Tune Our Pediatric Patients?

    PubMed

    Jindal, Ritu; Kaur, Rajwinder

    2011-01-01

    For the pedodontic team, a child's dental anxiety poses major management problems. Previously, wide variety of aversive techniques have been used with varying success rates to manage anxious child patients. The present trend advocates the use of nonaversive techniques like distraction in the management of anxious pediatric patients. So the aim of this study is to compare the effect of audio distraction with the normal set up operatory. Thirty patients of age between 4 and 8 years were included in the study. Each patient had gone through four dental visits. Anxiety was measured using Venham's picture test. The values obtained were tabulated and statistical analysis and concluded that audio distraction did decrease the level of anxiety in anxious pediatric dental patients to a significant level during the restorative procedure visit (3rd) and invasive procedure visit (4th).

  14. The comparison between measurement of open apices of third molars and Demirjian stages to test chronological age of over 18 year olds in living subjects.

    PubMed

    Cameriere, R; Ferrante, L; De Angelis, D; Scarpino, F; Galli, F

    2008-11-01

    This paper concerns a method for assessing adult age based on the relationship between age and the third molar maturity index (I(3M)), which is related to the measurement of the open apices of the third molar. Furthermore, this method was compared to those based on Demirjian's stages G and H. The sample consisted of 906 Caucasian individuals aged between 14 and 23 years (53.6% females and 46.4% males). Orthopantomographs were analyzed by two observers and calibrated by means of the concordance correlation coefficient for the reproducibility of the third molar maturity index (I(3M)) and kappa statistics for reproducibility of the Demirjian stages. Probabilities for an individual to be older than 18 years of age (adult age) were derived using the measurements of the third molar maturity index (I(3M)). These results were exploited to set out a threshold value to assign an individual to juvenile or adult age. A cutoff value of I(3M) = 0.08 was taken. The sensitivity of this test was 70% and specificity was 98%. Furthermore, the proportion of individuals with a correct classification was 83%. The results of the test showed a better specificity when compared to the choice of stage G and a better sensitivity when compared to the choice of stage H for adult age.

  15. Subject Classification.

    ERIC Educational Resources Information Center

    Thompson, Gayle; And Others

    Three newspaper librarians described how they manage the files of newspaper clippings which are a necessary part of their collections. The development of a new subject classification system for the clippings files was outlined. The new subject headings were based on standard subject heading lists and on local need. It was decided to use a computer…

  16. Structural and functional imaging correlates for age-related changes in the brain.

    PubMed

    Tumeh, Paul C; Alavi, Abass; Houseni, Mohamed; Greenfield, Antje; Chryssikos, Timothy; Newberg, Andrew; Torigian, Drew A; Moonis, Gul

    2007-03-01

    In recent years, investigators have made significant progress in documenting brain structure and function as it relates to aging by using positron emission tomography, conventional magnetic resonance (MR) imaging, advanced MR techniques, and functional MR imaging. This review summarizes the latest advances in understanding physiologic maturation and aging as detected by these neuroimaging modalities. We also present our experience with MR volumetric and positron emission tomography analysis in separate cohorts of healthy subjects in the pediatric and adult age groups respectively. Our results are consistent with previous studies and include the following: total brain volume was found to increase with age (up to 20 years of age). Whole brain metabolism and frontal lobe metabolism both decrease significantly with age (38% and 42%, respectively), whereas cerebellar metabolism does not show a significant decline with age. Defining normal alterations in brain function and structure allows early detection of disorders such as Alzheimer's and Parkinson's diseases, which are commonly associated with normal aging. PMID:17289456

  17. Extracorporeal shockwave lithotripsy in pediatrics.

    PubMed

    D'Addessi, Alessandro; Bongiovanni, Luca; Sasso, Francesco; Gulino, Gaetano; Falabella, Roberto; Bassi, Pierfrancesco

    2008-01-01

    Since its introduction in 1980, extracorporeal shockwave lithotripsy (SWL) has become the first therapeutic option in most cases of upper-tract urolithiasis, and the technique has been used for pediatric renal stones since the first report of success in 1986. Lithotripter effectiveness depends on the power expressed at the focal point. Closely correlated with the power is the pain produced by the shockwaves. By reducing the dimensions of the focus, it becomes possible to treat the patient without anesthesia or analgesia but at the cost of a higher re-treatment rate. Older children often tolerate SWL under intravenous sedation, and minimal anesthesia is applicable for most patients treated with second- and third-generation lithotripters. Ureteral stenting before SWL has been controversial. Current data suggest that preoperative stent placement should be reserved for a few specific cases. Stone-free rates in pediatric SWL exceed 70% at 3 months, with the rate reaching 100% in many series. Even the low-birth-weight infant can be treated with a stone-free as high as 100%. How can one explain the good results? Possible explanations include the lesser length of the child's ureter, which partially compensates for the narrower lumen. Moreover, the pediatric ureter is more elastic and distensible, which facilitates passage of stone fragments and prevents impaction. Another factor is shockwave reproduction in the body: there is a 10% to 20% damping of shockwave energy as it travels through 6 cm of body tissue, so the small body volume of the child allows the shockwaves to be transmitted with little loss of energy. There are several concerns regarding the possible detrimental effect of shockwaves on growing kidneys. Various renal injures have been documented with all type of lithotripters. On the other hand, several studies have not shown adverse effects. In general, SWL is considered to be the method of choice for managing the majority of urinary stones in children of all

  18. Human Subjects Issues in AIDS Research.

    ERIC Educational Resources Information Center

    Bayer, Ronald, Ed.

    1990-01-01

    Six articles are presented on the use of human subjects in research on acquired immune deficiency syndrome (AIDS). Topics include the ethics of human experimentation, female and pediatric AIDS patients, Human Immunodeficiency Virus (HIV) infection and AIDS among correctional inmates, community-based AIDS research, and clinical trials of HIV…

  19. Minor surgery procedures: A retrospective review and prospective survey in a pediatric population

    PubMed Central

    Chan, Emily; Bucevska, Marija; Verchere, Cynthia

    2015-01-01

    OBJECTIVE: The present study evaluated minor surgery procedures undertaken by a single plastic surgeon at BC Children’s Hospital (Vancouver, British Columbia) for patient and physician satisfaction, parent impressions, psychological concerns and complications. METHODS: Data were collected from a retrospective chart review and a prospective patient survey. Eligible subjects for the retrospective study included all pediatric patients undergoing minor surgery between May 2011 and April 2013. Parameters of interest included patient demographics, minor surgery specifics, complications and outcomes. Eligible subjects for the prospective patient survey included consecutive patients undergoing minor surgery between June 2013 and August 2013, as well as their parents. RESULTS: A total of 219 procedures were included in the retrospective review. The mean age of subjects was 13.1 years (range two weeks to 18 years). The median length of follow-up was 46 days (range four to 606 days). There were no major complications; however, 45 minor complications in 36 patients were found. Complications included crusting (4.6%), delayed wound healing (3.2%), hypersensitivity (2.3%), scar hypertrophy (1.8%), infection (0.9%) and other (7.8%). Outcomes were categorized as one of four outcomes: both satisfied (89.9%); patient satisfied but physician unsatisfied (0.8%); patient unsatisfied and physician satisfied (3.1%); and both unsatisfied (6.2%). In the prospective study, 32 subjects consented to participate in the survey. Of these subjects, 10 children and 12 parents responded to the questionnaires. Eighty-three percent of respondents indicated that their goals were accomplished by their procedure and that they would be willing to undergo minor surgery again. CONCLUSION: Minor surgery is possible and practical in pediatric plastic surgery clinics, with few complications and high patient and surgeon satisfaction. PMID:26361627

  20. What Is a Pediatric Infectious Diseases Specialist?

    MedlinePlus

    ... Size Email Print Share What is a Pediatric Infectious Diseases Specialist? Page Content Article Body If your child ... teen years. What Kind of Training Do Pediatric Infectious Diseases Specialists Have? Pediatric infectious diseases specialists are medical ...