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Biomedical subjects

B Y Whitman

Publications and source records attributed to B Y Whitman.

At least 19 recordsLinked to original sources
PubMed1999

Growth hormone improves body composition, fat utilization, physical strength and agility, and growth in Prader-Willi syndrome: A controlled study.

BACKGROUND: Obesity and hypotonia in children with Prader-Willi syndrome (PWS) are accompanied by abnormal body composition and diminished energy expenditure resembling a growth hormone deficient state. Hypothalamic dysfunction in PWS often includes decreased growth hormone (GH) secretion, suggesting a possible therapeutic role for exogenous GH treatment. OBJECTIVES AND METHODS: After 6 months of observation to determine baseline growth rate, and with the use of a 12-month randomized controlled study design, the effects of GH treatment (1 mg/m2/d) on growth, body composition, strength and agility, pulmonary function, resting energy expenditure (REE), and fat utilization were assessed in 54 children with PWS (n = 35 treatment and n = 19 control). Percent body fat and bone mineral density were measured by dual x-ray absorptiometry. Indirect calorimetry was used to determine REE and to calculate respiratory quotients. RESULTS: Stimulated levels of GH in response to clonidine testing were low in all patients (peak, 2.0 ng/mL). After 12 months, GH-treated subjects showed significantly increased height velocity Z scores (mean, 1.0 1.7 to 4.6 2.9; P <.001), decreased percent body fat (mean, 46.3% 8.4% to 38.3% 10.7%; P <.001), and improved respiratory muscle function, physical strength, and agility (sit-ups, weight-lifts, running speed, and coordination). A significant decline in respiratory quotients occurred during GH therapy (0.81 to 0.77, P <.001), but total REE did not change. CONCLUSIONS: GH treatment of children with PWS accelerated growth, decreased percent body fat, and increased fat oxidation but did not significantly increase total REE. Improvements in respiratory muscle strength, physical strength, and agility also occurred, suggesting that GH treatment may have value in reducing some physical disabilities experienced by children with PWS.

Adipose Tissue↗
PubMed1997

Maternally reported fetal activity levels and developmental diagnoses.

Retrospective maternal report of fetal activity level was compared with developmental diagnosis in 608 consecutively referred children. Maternal history of fetal activity level was also obtained from 140 unmatched well children in a general pediatric clinic. Fetal hyperactivity was positively associated with a diagnosis of child hyperactivity, and fetal hypoactivity was positively associated with a diagnosis of mental retardation in the children. Maternal histories of fetal activity level in the control group weakened the strength of the association between fetal hyperactivity and child hyperactivity but did not affect the association between fetal hypoactivity and mental retardation in children.

Apgar Score↗
PubMed1993

Prader-Willi syndrome: consensus diagnostic criteria.

The diagnosis of Prader-Willi syndrome (PWS) is based on clinical findings that change with age. Hypotonia is prominent in infancy. Obesity, mild mental retardation or learning disability, and behavior problems, especially in association with food and eating, result in a debilitating physical and developmental disability in adolescence and adulthood. No consistent biological marker is yet available for PWS in spite of recent research activity in cytogenetics and molecular genetics. Diagnostic criteria for PWS were developed by consensus of seven clinicians experienced with the syndrome in consultation with national and international experts. Two scoring systems are provided: one for children aged 0 to 36 months and another one for children aged 3 years to adults. These criteria will aid in recognition of the syndrome in hypotonic infants and in obese, mildly retarded, behaviorally disturbed adolescents and adults. They will also ensure uniform diagnosis for future clinical and laboratory research in PWS.

Adolescent↗
PubMed1991

Minor malformations, hyperactivity, and learning disabilities.

Standardized minor malformation scores have been reported to predict and identify children with attentional problems and hyperactivity. The reason why this marker works for only a subset of children with attention deficit hyperactivity disorder remains unclear. The dysmorphology scores on all children presenting for a multidisciplinary team evaluation of developmental disorders were examined for diagnostic correlations after children with chromosomal disorders and recognized dysmorphic syndromes were excluded. For 1233 subjects, the mean minor malformation score was 2.94 (SD = 2.05). A significant association between minor malformation scores and IQ (mean = 80.95, SD = 23.67) was accounted for by the group with IQs greater than 100 exhibiting the higher dysmorphology scores. An analysis of variance revealed no significant association between minor malformation scores and hyperactivity or attention deficit disorder. Indeed, the presence of an attention deficit disorder yielded lower mean dysmorphology scores. When the minor malformation scores were compared for those subgroups of children with and without specific learning disabilities, the learning-disabled subjects had significantly higher dysmorphology scores. Minor dysmorphic features do not relate to the presence or absence of attentional problems or hyperactivity in referred children. Rather they appear to characterize that subpopulation of children with attention deficit disorder and learning disabilities as well as a group of learning-disabled children without attentional disorders.

Adolescent↗
PubMed1991

Multiple personality disorder: a risk indicator, diagnostic marker and psychiatric outcome for severe child abuse.

Recent studies suggest that multiple personality disorder (MPD) is not as rare as previously believed. Indeed, it may represent a relatively common (as many as 25% of cases) outcome of severe physical and sexual abuse of children. Because diagnosis and treatment offer the best prognosis, it is important for the pediatric clinician to become familiar with both the at risk situations (such as cult practices and multigenerational sexual abuse) as well as the more unusual behavioral presentations of this disorder.

Adolescent↗
PubMed1990

Autistic disorder in Sotos syndrome: a case report.

A case study of a child with Sotos syndrome, normal intelligence, and autistic disorder is presented. Initial descriptions of Sotos syndrome included severe to mild mental retardation. More recent studies indicate language and learning disabilities with normal intelligence. Our patient met criteria for a diagnosis of autistic disorder. Sotos syndrome is another genetic and neurodevelopmental syndrome that can be associated with autistic as well as communication and language disorders.

Autistic Disorder↗
PubMed1990

Homelessness and cognitive performance in children: a possible link.

The developmental impact of homelessness on children was assessed by using a screening battery to measure cognitive and language delays as well as emotional status. The results of testing 88 children in a family shelter program indicate a possible significant impact of homelessness on both the cognitive and language development of these children, with language more severely affected. Emotional pathology, however, was not detected with the screening instruments used. Most service providers who deal with homeless children fail to recognize their special programming needs. It is important for the social worker to advocate with the educational system for these children's special needs.

Child↗
PubMed1990

Disorders of attention and activity level in a referral population.

Of 614 children referred for an evaluation of hyperactivity and inattention, the 422 (68.7%) who qualified for a diagnosis of attention deficit disorder (ADD) were compared with the 192 (31.3%) who did not. The children with ADD had significantly higher full-scale IQ scores, verbal scores, and parental educational levels. They also had a significantly higher incidence of specific learning disabilities (73.7%). The absence of hyperactivity in children with ADD further exaggerated the differences in learning disability between the two groups. Cognitive limitation, severe parental psychopathology, and child neglect/abuse were significantly higher in the group without ADD. The two groups did not differ in the incidence of parental or child depressive symptomatology, motor diagnoses, language disorders, conduct disorders, and psychosomatic complaints. That only 29 children in whom ADD was absent (4.7% of all referrals) had been given a trial of stimulant medication does not support the presence of a major abuse of such drugs in the community.

Adolescent↗
PubMed1987

Emotional symptoms in Prader-Willi syndrome adolescents.

Clinical observations and parental reports on the behavior of Prader-Willi syndrome (PWS) patients suggest the development of a wide variety of psychiatric disorders as the PWS child enters adolescence. Documentation of these emotional disorders remains unsystematic. Here we describe the results of administering the Survey Diagnostic Instrument (SDI) to the parents of 35 PWS adolescents. The questionnaire data were supplemented by additional selected demographic and clinical data. The SDI is a 134 item questionnaire filled out by one parent. It screens for the DSM-III criterion-based diagnostic categories of neurosis (dysphoric, compulsive, anxious), somatization, conduct disorder (antisocial, violent), and hyperactivity. The following diagnostic pattern resulted: neurosis, dysphoric, (1 probable); neurosis, compulsive, 3 (6 probable); neurosis, anxious, 4 (and 10 probable); somatization, 0; conduct disorder, violent 0; conduct disorder, antisocial, 0; hyperactivity, 1 (and 1 probable). An odds ratio algorithm is used to uncover possible predisposing factors, and the results are discussed in the context of organic versus psychiatric causes.

Adolescent↗
PubMed1987

Mentally retarded parents in the community: identification method and needs assessment survey.

Mentally retarded parents in the community represent a relatively new and increasing population. Due to the parents' limitations, the children are at significant risk for medical, emotional, and cognitive delays and neglect. An estimate of the size of this population that comes to agency attention is needed in order to program supportive services. The methodology and results of a community-based survey to determine the size of this population receiving agency services in a large metropolitan area are described as are the results of a survey interview with a subset of these parents and their children to determine services needed from the parents' perspective.

Child↗
PubMed1983

Association of alcoholism and antisocial personality in a narcotic-dependent population: the Lexington addicts.

Men with antisocial personality have a higher prevalence of alcoholism than men without. This relationship was examined in a narcotic-dependent sample, and it was found that narcotic-dependent men with antisocial personality had a rate of alcoholism comparable to that of narcotic-dependent men without antisocial personality. The methodological and clinical explanations for this finding are discussed along with the neurophysiological implications.

Adult↗
PubMed1982

The use of epidemiologic methods as the bridge between prevention and social work practice.

The concepts, scope and methods of epidemiology as well as the application of these tools to preventive social work practice for both policy setting and case management are described. Using data concerning lead poisoning, two areas are discussed. These are: 1) the stages of prevention and its implication for practice, and 2) definitions of the epidemiologic concepts of population-at-risk, prevalence, incidence, case rate, relative risk, attributable risk, and epidemiologic causal models. Finally, suggestions for using epidemiologic knowledge and methods in formulating policy for, and programs pertaining to, prevention in social work practice are set forth.

Child↗
PubMed1982

Psychiatric illness in male and female narcotic addicts.

This report describes the results of initial psychiatric interviews on 100 male and 100 female narcotic addicts who were matched by age, race, and geographic origin. The majority met criteria for antisocial personality whereas about one in four males and one in seven females met criteria for alcoholism. Between one-third and one-half of the subjects met criteria for secondary depression. Bipolar affective disorder and schizophrenia rates were not elevated. Males significantly more often were diagnosed as having antisocial personality and alcoholism whereas females significantly more often were diagnosed as having a non-drug depression. Treatment implications of the observed differences between males and females are discussed.

Adult↗
PubMed1982

Psychiatric diagnosis and prediction of drug and alcohol dependence.

Some sociodemographic variables that have distinguished the future addict from the general population have not been found to predict outcome in those already dependent. This study demonstrates that a past history of specific psychiatric disorders is predictive of outcome in narcotic addicts. Future research should focus on interactions among past histories, past and present personality and motivation, and situational variables in the search for reliable clinical prognostic factors.

Alcoholism↗
PubMed1981

Alcoholism and alcohol dependence in narcotic addicts: a prospective study with a five-year follow-up.

In this paper we report on the prediction of mortality, alcohol dependence, and the rate of previously undiagnosed alcoholism in male and female narcotic addicts. These subjects (N = 200) were initially interviewed upon admission to the Clinical Research Center, National Institute of Mental Health, Lexington, Kentucky, and prospectively followed-up and reinterviewed 5 years later (N = 187). The results indicate that alcoholism and alcohol dependence are very prevalent in this sample of addicts. A history of diagnosable alcoholism obtained at admission was a significant predictor of mortality during the follow-up period whereas a history of heavy drinking was associated with increased mortality but not significantly. About one-half of the males and one-quarter of the females met criteria for alcohol dependence during the follow-up period. Both a prior diagnosis of alcoholism and a history of heavy drinking were significant predictors of episodes of alcohol dependence during the follow-up period. In addition, the proportion of subjects positive for alcoholism increased between two- and threefold during the 5-year period. Finally, a history of heavy drinking at any time within the 4 years immediately prior to admission significantly predicted subsequent episodes during the follow-up period.

Alcoholism↗