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Biomedical subjects

J M Kaczorowski

Publications and source records attributed to J M Kaczorowski.

6 recordsLinked to original sources

Iron deficiency and cognitive achievement among school-aged children and adolescents in the United States.

CONTEXT: Iron deficiency anemia in infants can cause developmental problems. However, the relationship between iron status and cognitive achievement in older children is less clear. OBJECTIVE: To investigate the relationship between iron deficiency and cognitive test scores among a nationally representative sample of school-aged children and adolescents. DESIGN: The National Health and Nutrition Examination Survey III 1988-1994 provides cross-sectional data for children 6 to 16 years old and contains measures of iron status including transferrin saturation, free erythrocyte protoporphyrin, and serum ferritin. Children were considered iron-deficient if any 2 of these values were abnormal for age and gender, and standard hemoglobin values were used to detect anemia. Scores from standardized tests were compared for children with normal iron status, iron deficiency without anemia, and iron deficiency with anemia. Logistic regression was used to estimate the association of iron status and below average test scores, controlling for confounding factors. RESULTS: Among the 5398 children in the sample, 3% were iron-deficient. The prevalence of iron deficiency was highest among adolescent girls (8.7%). Average math scores were lower for children with iron deficiency with and without anemia, compared with children with normal iron status (86.4 and 87.4 vs 93.7). By logistic regression, children with iron deficiency had greater than twice the risk of scoring below average in math than did children with normal iron status (odds ratio: 2.3; 95% confidence interval: 1.1-4.4). This elevated risk was present even for iron-deficient children without anemia (odds ratio: 2.4; 95% confidence interval: 1.1-5.2). CONCLUSIONS: We demonstrated lower standardized math scores among iron-deficient school-aged children and adolescents, including those with iron deficiency without anemia. Screening for iron deficiency without anemia may be warranted for children at risk.

Achievement↗

Five days of whole-bowel irrigation in a case of pediatric iron ingestion.

The maximum duration and volume of polyethylene glycol electrolyte solution (PEG-ELS) that can be safely administered during whole-bowel irrigation of the poisoned patient are poorly defined. We present a case of a 33-month-old boy who ingested at least 160 mg/kg elemental iron and received 44.3 L of PEG-ELS (2,953 ml/kg) over 5 days because of the persistence of iron tablets in teh gastrointestinal tract. The child remained clinically well after initiation of PEG-ELS therapy, and further significant iron absorption did not appear to occur. The rectal effluent cleared within 2 days of the start of PEG-ELS therapy despite the persistence of iron in the gastrointestinal tract as shown on radiography. No adverse effects resulted from teh large volume or duration of the PEG-ELS therapy. This is the greatest reported volume of PEG-ELS to be used for whole-bowel irrigation in the treatment of a toxic ingestion.

Child, Preschool↗

Spiritual well-being and anxiety in adults diagnosed with cancer.

Exploring the theory that anxiety is lower in highly spiritual persons confronting life-threatening illness, this correlational study was conducted with 114 adults who had been diagnosed with cancer. Relationships were measured between spiritual well-being and state-trait anxiety, using the Spiritual Well-Being Scale, which distinguishes between the religious and existential dimensions of spirituality, and the State-Trait Anxiety Inventory, which differentiates between transitory and characteristic anxiety. Efforts were made to identify demographic features of the sample which could influence spirituality and anxiety and their interactions. A consistent inverse relationship (p less than .001) was found between spiritual well-being and state-trait anxiety, regardless of influences of gender, age, marital status, diagnosis, group participation, and length of time since diagnosis. This supports the theory that persons with high levels of spiritual well-being have lower levels of anxiety. Controlled studies now are indicated, with attention to diversity and specificity of ethnic, socioeconomic, and religious backgrounds, as well as cancer type, stage, symptoms, and prognosis. The hospice community is challenged to undertake studies of the spiritual dimension and its healing potential.

Adult↗

School readiness among urban children with asthma.

BACKGROUND: Children with chronic illnesses, including asthma, are at risk for school problems. Developmental problems, however, may begin before school entry, and the developmental status of preschool children with asthma has not been evaluated. OBJECTIVE: To test the hypothesis that urban preschool children with asthma have lower parent-reported developmental scores compared with children without asthma. METHODS: A comprehensive survey of children beginning kindergarten in 1998 in the urban school system in Rochester, NY, collected parent reports of demographic, medical, and developmental data. We compared children with asthma with and without limitation of activity to children without asthma for motor, language, socioemotional, and school readiness skills and the need for extra help with learning. Linear and logistic regression were used to determine associations between asthma and developmental outcomes. RESULTS: Among the 1058 children in this sample, 9% had asthma, including 5% with asthma with limitation of activity. After adjustment for multiple potential confounding variables, the children with asthma with limitation had lower scores on school readiness skills compared with children without asthma (2.0 vs 2.5, P <.001). Further, the parents of children with asthma with limitation were substantially more likely (P <.05) to describe them as needing extra help with learning (74% vs 56%; odds ratio, 3.2; 95% confidence interval, 1.5--7.8). CONCLUSIONS: Urban preschool children with significant asthma had poorer parent-reported school readiness skills and a greater need for extra help with learning compared with children without asthma. This finding suggests that developmental problems for children with asthma may begin before school entry.

Asthma↗