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Biomedical subjects

E Tirosh

Publications and source records attributed to E Tirosh.

At least 55 records · Page 3Linked to original sources
PubMed1994

The relationship between joint hypermobility and neurodevelopmental attributes in elementary school children.

Joint hypermobility is associated with motor developmental delay in infancy. To assess this finding in school-aged children, 320 first- and second-grade elementary school children and 110 children attending a special education program were assessed. Joint hypermobility was found in 40 (12.4%) and seven (6.4%) of the children attending the regular and special education classes, respectively. No difference in the neurologic status or verbal and eye-hand coordination task performance was found between the children of the study group and their age- and sex-matched controls. It appears that joint hypermobility and neurodevelopmental dysfunctions are not causally related and have a different maturational course.

Child↗
PubMed1993

Effects of methylphenidate on sleep in children with attention-deficient hyperactivity disorder. An activity monitor study.

OBJECTIVE: To assess the effects of methylphenidate hydrochloride on sleep patterns in children diagnosed as having attention-deficit hyperactivity disorder (ADHD). DESIGN: A double-blind, controlled drug-placebo cross-over design. SETTING: Home. SUBJECTS: Ten children (aged 6 years 9 months to 12 years & months) diagnosed as having ADHD were consecutively recruited and compared with age- and sex-matched normal controls. TREATMENT: Methylphenidate hydrochloride (0.3 to 0.4 mg/kg) or placebo was administered at 7:30 AM. MEASUREMENTS AND RESULTS: Each child underwent activity monitoring at home during 6 days of no treatment (baseline) followed by placebo and methylphenidate treatment. The results of the three trial stages, as well as those of the 20 age- and sex-matched normal controls, were compared. A shorter total sleep duration was evident during the methylphenidate treatment compared with that of baseline and placebo treatment. The amount of quiet sleep was lower (however, not significantly) among the study group compared with controls, whereas no such difference was noted during methylphenidate treatment. Night-to-night sleep pattern stability was found. No other differences were found either between children with ADHD and controls or between on and off stages of methylphenidate treatment. CONCLUSIONS: These results support the notion that ADHD is a centrally generated disorder attributable to hypoarousal, which subsequently stimulates motor overactivity. Methylphenidate does not appear to affect sleep patterns adversely and possibly normalizes them in patients with ADHD.

Analysis of Variance↗
PubMed1993

The effects of illness on sleep behaviour in infants.

For the purpose of evaluating the association between health problems and sleep disturbances as part of a community survey of sleep patterns in childhood, a questionnaire was administered to 752 mothers of children between the ages of 4 months and 4 years, and to the nurses at their regular baby clinics. The questionnaire covered the areas of past and present sleep and settling behaviour, as well as health history and demographic data. The study group consisted of 66 (8.9%) children who had either chronic medical problems, or history of an illness requiring hospitalisation. Regular night waking was reported in 35% and 34% of the group with and without history of illness, respectively. The mean number of interrupted nights per week was similar in both groups and so were the sleep problems perceived by the mothers. We conclude that in this age group the results do not support an association between health problems and prolonged sleep disturbances.

Case-Control Studies↗
PubMed1993

An effective community-based approach to the identification of neurodevelopmental delay in childhood.

The contribution of specially trained developmental nurses (DNs) to the accuracy of developmental screening in well-baby units was assessed. Of 13,580 children between two and 48 months of age, the well-baby clinic identified definitive developmental delay in 310, and 357 children were classified as 'questionable'. After DN assessment at 12 months follow-up, only 31 per cent of the questionable group required referral to the Child Development Centre (CDC). Comparison of the original queried recommendations to the CDC with the DN's recommendation indicated a false-positive and -negative rate of 60 and 20 per cent, respectively. This procedure resulted in false-positive and -negative screening accuracies of 1.2 and 6 per cent, respectively, for the total cohort of children screened. The economic and clinical advantages of this model are discussed.

Child Development↗
PubMed1993

Sleep characteristics of asthmatics in the first four years of life: a comparative study.

The association between asthma and sleep disturbances was assessed as part of a community survey of sleep patterns in children aged 4-48 months. A questionnaire covering the area of past and present sleep and settling behaviour, as well as health history and demographic data, was administered to 752 mothers of children visiting 14 well baby clinics. Fifty one (6.8%) of the children who were diagnosed as having asthma by their paediatricians were compared with the remaining healthy controls (children with perinatal problems, other chronic illnesses, developmental problems, or repeat admissions to hospital were excluded). Thirty nine per cent of the children with asthma and 38% of the normal controls were identified as regular wakers. The number of interrupted nights each week, settling time, and sleep duration were comparable. In the children with asthma an uninterrupted night's sleep was acquired later than in the control group. Parental perception of the severity of the sleep problem was similar in the two groups, as were the calming techniques. It is concluded that this study does not support a significantly increased prevalence of sleep disturbances among young children with asthma compared with their healthy peers.

Asthma↗
PubMed1993

Developmental disabilities among children between birth and 3 years old in the Haifa district: a population study.

The incidence of major neurodevelopmental deficits among children between birth and 3 years of age in the Haifa district was evaluated. Routine standardized developmental screening at the well-baby clinics was employed. The records of all children referred to the only two child developmental centers in the district during a period of 4 years were analyzed. The overall incidence was 31 per 1000 and was lower than expected. The age at diagnosis and associated disorders are discussed. In 30% of the cohort the diagnosis was inaccurate, and a 22% false positive referral rate was noted. A more thorough training in the early diagnosis of psychomotor developmental problems in childhood in the well-baby clinics is indicated.

Child Behavior Disorders↗
PubMed1993

Autism with hyperlexia: a distinct syndrome?

Family and medical histories, autistic and dysmorphic features, and neurological status of 5 children with autism and hyperlexia and 5 sex and IQ-matched children with autism and no hyperlexia were compared. Results showed that the children with hyperlexia displayed more persistent echolalia, superior visual motor performance, and more favorable response to vestibular stimulation. These children performed better than did their matched controls in the physical and neurological assessment. Two of these children, one of whom had a sibling with hyperlexia, presented with macrocephaly. Both groups had a similar incidence of dysmorphic features, computerized tomographic and EEG abnormalities, and family morbidity. Results suggest that children with autism and hyperlexia probably represent part of the continuum of autism rather than a specific syndrome.

Adolescent↗
PubMed1993

Sleep patterns of children sleeping in residential care, in kibbutz dormitories and at home--a comparative study.

The present study compares sleep patterns of two groups of children sleeping away from their families, in residential care (n = 31, age 3.7 +/- 1.7 years) and kibbutz (n = 29, age 3.7 +/- 1.8 years) dormitories, with age-matched children sleeping at home (n = 21, age 3.7 +/- 1.8 years). Sleep was monitored by wrist-worn actigraphs for three consecutive nights and assessed by sleep questionnaires, which were completed by parents of the kibbutz children and caretakers at residential care. Children in the residential care settled to sleep significantly earlier and slept longer than those children living in a kibbutz or at home. The longest period of uninterrupted sleep was more extended for children sleeping at home, compared to those sleeping in communal dormitories. Correlation analysis between various assessments of sleep and waking behaviors revealed a different pattern for kibbutz and residential care children. For the kibbutz children, there were significant correlations between difficulties falling asleep and various attributes of daytime tiredness. Conversely, in the residential care, difficulties falling asleep were significantly and positively correlated with parameters associated with daytime alertness. This pattern of correlations and the actigraphic data indicate that difficulties in falling asleep for children in residential care are probably a consequence of being put to bed too early and according to a rigid schedule, and not the result of emotional factors.

Child Behavior↗
PubMed1992

[Masturbation in infancy simulating convulsive disorder].

We describe a 7-month-old girl referred for evaluation of a convulsive disorder. The tentative diagnosis of epilepsy was based on what were apparently paroxysmal events which occurred many times during a day. A cousin had suffered from infantile spasms and is mentally retarded. The episodic "attacks" in our patient consisted of sudden rhythmic body movements, crossing of thighs, altered awareness, glassy stare and profuse sweating. While the attacks subsided spontaneously, they could easily be aborted by changing the infant to a sitting position or by picking it up and holding it, when it would revert to completely normal behavior. A detailed history and personal observation of the "attacks" made it clear that they were really physical manifestations of masturbation. The diagnosis of epilepsy was therefore discarded. Awareness of masturbation in infants is essential for establishing the correct diagnosis, and spares infants and families many superfluous investigations and the anxiety associated with a diagnosis of convulsive disorder in children.

Diagnosis, Differential↗
PubMed1992

Toddlers' sleep and temperament: reporting bias or a valid link? A research note.

Objective sleep measures derived from a computerized movement detector attached to the child's leg, were obtained for a group of 31 toddlers (mean age: 18.5 months). The monitored sleep parameters were compared with maternal assessment of the child's sleep and her perception of his temperament. The validity of maternal diaries as a measure of the child's sleep was not supported. Nevertheless, a link between both subjective and objective sleep measures with temperament dimensions was indicated. The modest association between sleep and temperament may suggest either a continuity between some aspects of day- and night-time functioning or, alternatively, the influence of the child's sleep behavior in shaping the mother's perceptions of her toddler's temperament.

Child, Preschool↗
PubMed1992

Relationship between neonatal behavior and subsequent temperament.

The validity of the neonatal behavioral assessment scale in predicting later infant temperament is of theoretical and clinical importance. The scale was administered to 47 full-term healthy neonates. Of these, 40 were followed and the infant characteristics questionnaire was given at four months of age. Significant correlations were revealed between the neonatal assessment items from the clusters of orientation and motor maturity and the temperament factors "fussy-difficult" and "unpredictable". Items from the cluster of autonomic stability correlated with the temperament factor "unadaptable." These correlations possibly indicate that perceived temperament does reflect intrinsic infant qualities.

Adaptation, Physiological↗
PubMed1992

Neonatal behavior of Panamanian and Israeli infants: a cross-cultural study.

The behavior of third-generation Israeli neonates belonging to two ethnic groups--Ashkenazic infants (n = 20) and Sephardic infants (n = 20)--and the behavior of a group of full-term Panamanian infants (n = 30) were compared in order to examine cross-cultural and interethnic predispositions. The Israeli and Panamanian infants differed on 5 of a total of 27 neonatal behavioral assessment items: the difference in 3 of these items, representing the autonomic stability and motor clusters, exceeded 1 scale score. A comparison of the two Israeli ethnic subgroups with the Panamanian group (Duncan's multiple-range test) revealed significant differences between Ashkenazic and Sephardic infants on 2 auditory habituation items, whereas the Panamanian infants differed significantly from both Israeli subgroups on 10 of the items, representing the motor, range of state, and autonomic stability clusters. These results corroborate previous observations concerning cross-cultural neonatal behavioral differences and the possible role of environmental factors in the ongoing modeling process of human behavioral traits and personality.

Child Behavior↗
PubMed1992

Variability in head circumference growth rate during the first 2 years of life.

The head circumference (HC) curves were plotted for a group of 415 healthy full-term babies over the first 2 years of life. Two hundred ten (51%) of the cohort demonstrated HC variability, defined as an HC acceleration or deceleration of at least 1 centile curve for at least 2 months. Of these, the deceleration pattern was predominant (80.9%), and also frequently permanent (87%). The HCs of 3 (1.42%) of 210 infants with HC variability ended up with a deviation of 2 standard deviations or more from the mean. The onset of HC transition occurred from the mean age of 1.3 months, and the new curve had stabilized by age 13 months in 95% of the study group. Parallel changes occurred in body weight and body length in approximately 48% of the total cohort, but more frequently in the variable-HC group. The clinical interpretation of these findings is discussed.

Body Height↗
PubMed1991

Prognosis of motor development and joint hypermobility.

In a study of 59 infants aged 18 months there were 20 with joint hypermobility and delayed motor development, 19 with joint hypermobility and normal motor development, and 20 normal controls. They were reassessed for motor function 3.5 years later at the age of 5 years. Both gross and fine motor performance were significantly delayed in the group of children who exhibited joint hypermobility and motor delay in infancy. No significant delay was evident in those with joint hypermobility only. Joint hypermobility resolved more frequently in children who presented normal motor development at age 18 months. Infants with joint hypermobility and motor delay are a subgroup associated with a less favourable motor outcome and careful follow up is indicated.

Attitude to Health↗
PubMed1991

Relationship between neonatal excitability and respiratory habituation.

The Brazelton Neonatal Behavioral Assessment Scale was administered and analyzed in the cases of 25 full-term infants in order to assess the relationship between a behavioral measure of excitability and respiratory habituation. Sound and light stimuli were sequentially delivered, and prestimulus and poststimulus respiratory amplitude mean and standard deviation were analyzed. The stimulus with the least interperiod difference was considered as habituation. The correlation between arousal behavioral items and respiratory habituation ranged between 0.16 and 0.44. The two significant correlations were between peak of excitement and respiratory habituation to light (0.44) and between rapidity of buildup and respiratory habituation to sound (0.38). These results may indicate an interrelation in neonates between temperamental excitability attributes and respiratory regulation.

Acoustic Stimulation↗
PubMed1991

Actigraphic home-monitoring sleep-disturbed and control infants and young children: a new method for pediatric assessment of sleep-wake patterns.

Two studies were conducted to evaluate actigraphic home-monitoring for the assessment of infants' and children's sleep patterns. In the first study, 11 children (aged 12 to 48 months) were monitored in the laboratory by traditional polysomnography and by actigraphy for one night. Actigraphic automatic sleep-wake scorings were compared with those of the polysomnograph; total agreement rate was 85.3%. In the second study, sleep patterns of 63 sleep-disturbed and 34 control healthy children (aged 9 to 27 months) were compared. These children were home-monitored by actigraph for a mean of 4.45 nights (total 482 nights). Actigraphic data were analyzed by an automated scoring procedure. Sleep quality of the sleep-disturbed children, measured by actigraphically derived sleep percent and number of longer-than-5-minute wakings, was significantly lower than that of the control subjects (P less than .0001). Sleep measures showed significant night-to-night stability in both groups. The stability of specific measures and their age trends were different between the groups. Actigraphic sleep measures alone could discriminate between sleep-disturbed and control children with a highly correct assignment rate of 79.4% and 91.2%, respectively.

Age Factors↗
PubMed1990

New muscle power test in neuromuscular disease. Feasibility and reliability.

We studied the feasibility, reliability, and reproducibility of an "all-out" 30-second cycling or arm cranking test of muscle power and muscle endurance (the Wingate Anaerobic Test) in 66 girls and boys aged 5 to 18 years old who had cerebral palsy or a myopathy. The arm and leg tests, given in duplicate, were feasible in 94% and 61% of subjects, respectively. Reliability coefficients exceeded .95 in patients with spastic cerebral palsy and myopathies and were somewhat lower in those with athetotic cerebral palsy. Means and SDs were similar in both trials. We conclude that the Wingate Anaerobic Test is feasible, highly reliable, and reproducible in these patients.

Adolescent↗