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Biomedical subjects

Karen Olness

Publications and source records attributed to Karen Olness.

8 recordsLinked to original sources
PubMed2006

Health, neurologic, and cognitive status of HIV-infected, long-surviving, and antiretroviral-naive Ugandan children.

OBJECTIVE: The purpose of this study was to assess the health status and school-age neurodevelopmental progress of antiretroviral treatment (ARVT)-naive, HIV-infected Ugandan children who had been followed as part of cohorts of children born to HIV-infected and -noninfected mothers between 1989 and 1993. METHODS: Twenty-eight children, aged 6 to 12 years, vertically infected with HIV-1 and never treated with ARVT were evaluated in terms of health status, neurologic, and psychometric testing. A randomly selected group of 42 seroreverters and 37 HIV-1 negative children who were age- and gender-matched and who had been followed in the same cohorts were evaluated also. The families studied were homogenous in their socioeconomic status. None of the mothers or children had received ARVT or been exposed to illicit drugs. RESULTS: The HIV-infected children showed significantly more evidence of acute malnutrition. They also had more illness, especially parotitis, otitis media, upper respiratory infections, and lymphadenopathy. However, they did not differ significantly in neurologic and cognitive assessments when compared with age- and gender-matched seroreverter and HIV-negative children. They were in the normal range with respect to neurologic and psychometric development measures. CONCLUSIONS: These children seem to represent a significant subgroup of HIV-infected child survivors for whom the progress of the disease is less aggressive throughout early life. Given the fact that many infants, especially in developing countries, continue to be born without the benefit of perinatal ARVT, there will likely continue to be many older HIV-infected children in the same situation as those described in this follow-up study. They will not have been recognized as being HIV-infected. It is important that such children be identified and offered access to ARVT and other appropriate support services.

Anti-Retroviral Agents↗
PubMed2004

Coping with daily living: housing, finances, transportation, medical care.

Elderly adults with cognitive impairment may face considerable hurdles in navigating through the tasks of daily living. These difficulties may result from such factors as diminished organizational skills, reduced physical mobility, reduced financial resources, perceptual lapses, and reduced attention, among others. The individuals may find it particularly problematic to identify and maintain suitable housing to manage finances, to manage their transportation and/or utilize public transit. Individuals are also vulnerable to various forms of abuse and neglect due to their impairment. We present various cases to illustrate such situations and suggest strategies to ameliorate these difficulties.

Adaptation, Psychological↗
PubMed2003

Effects on brain development leading to cognitive impairment: a worldwide epidemic.

This article reviews causes of cognitive impairment in children with a focus on those in developing countries. The number of children with cognitive limitations is increasing, and for the majority there is little access to professional expertise. Causes include malnutrition, genetic diseases, infectious diseases such as meningitis, parasites, and cerebral malaria, in utero drug and alcohol exposure, newborn asphyxia, low birth weight, head injuries, and endocrine disorders. Many of these are preventable; however, resources for prevention are limited in most developing areas of the world. The challenge for this century is to encourage community leaders and government officials to take on the prevention of cognitive impairment as the highest priority for society. This article proposes that specialists in child behavior and development work with United Nations agencies to develop a "world cognitive impairment watch" to assess and assist each country annually in terms of risk factors, prevention programs, and early intervention programs.

Brain Damage, Chronic↗
PubMed2003

Dietary and socio-economic factors associated with beriberi in breastfed Lao infants.

A case-control study was conducted to investigate the dietary and socio-economic factors associated with beriberi in infants attending three public hospitals in Vientiane, Lao PDR. Forty-three breast-feeding infants with a median (range) age of 3 (1-9) months were admitted with beriberi. This was defined as the presence of signs of congestive heart failure or shock in the absence of fever or other signs of sepsis, hypovolaemia or cardiac abnormalities, with rapid clinical improvement following parenteral thiamine. Subjects were matched by age and diet to 43 breast-feeding healthy control infants. Compared with control mothers, mothers of infants with beriberi had significantly less diet diversity (p <0.001), soaked glutinous rice for significantly longer or were more likely to pour off excess water from non-glutinous rice (p =0.006), had fewer years of schooling (p <0.05), were more likely to report that income was inadequate for basic needs (p <0.001), to perform hard physical labour (p <0.01) and to be married to farmers (p <0.01). Clinically significant thiamine deficiency in breastfed infants in Lao relates to methods of preparing rice, the food selected by lactating mothers and the family's socio-economic status.

Adult↗
PubMed2003

Effect of chloroquine on human immunodeficiency virus (HIV) vertical transmission.

INTRODUCTION: Over 2 million children globally are HIV positive. More than 90% are infected in utero from their mothers. Current pharmacological methods to reduce the rate of vertical transmission are too expensive for the developing world. Chloroquine, a cheap, widely available drug, has anti-HIV properties. We conducted a pilot study to determine if chloroquine can reduce HIV vertical transmission. METHODS: 287 samples of stored, frozen cord blood from a cohort of Ugandan infants born to HIV positive mothers were analyzed for concentrations of chloroquine and its two major metabolites, monodesethylchloroquine and didesethylchloroquine. The HIV status of each infant was determined by ELISA with Western Blot confirmation at 15 and 18 months of age. RESULTS: 49% of samples had measurable chloroquine or metabolite. Of those with measurable drug, the higher concentrations of chloroquine and its metabolites were more frequently associated with HIV negative infants. However, only the median concentration of didesethylochloroquine was significantly higher in HIV negative infants vs. HIV positive infants (1.6 ng/ml vs. 0.9 ng/ml, p=0.05). CONCLUSIONS: Nearly half of all infants in a Ugandan cohort are exposed to chloroquine in the last trimester of pregnancy. Such random maternal chloroquine use may be associated with a decreased rate of HIV vertical transmission. The issue of maternal chloroquine use requires controlled study before any clinical conclusions may be drawn.

Animals↗
PubMedDate not supplied

Training of health care professionals on the special needs of children in the management of disasters: experience in Asia, Africa, and Latin America.

BACKGROUND: Although children are the most vulnerable group in any disaster, limited information exists regarding their unique needs in complex humanitarian emergencies. OBJECTIVE: To review the experiences gained in designing and implementing a training course for international health care professionals in disaster management focused on the needs of children. METHODS: The format, content, learning objectives, teaching methods, course evaluation, and feedback of a training course on managing complex humanitarian emergencies with a focus on the special needs of children were reviewed. RESULTS: The 5-day course was first conducted at Case Western Reserve University in 1996. Since then, it has been replicated 15 times, annually in the United States, and in 7 overseas venues, including Thailand, Pakistan, Ethiopia, Nicaragua, Panama, Syria, and India. Voluntary US and international faculty used a problem-based learning method to train health care workers from developing countries in providing rapid quality care to child disaster victims. The courses were well received in every venue, as evidenced by active participation of local medical professionals, who organized logistics, recruited participants, and led the process of adapting the course to local needs. A remarkable outcome of this training course has been the development of an international group of highly motivated professionals involved in disseminating information to relief workers at a local level and providing a supportive network among themselves. CONCLUSION: A comprehensive training program targeted for health care professionals, conducted by mutually respectful local and international faculty, is an effective instrument for disseminating information and enhancing competence to help children in disasters.

Africa↗