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Biomedical subjects

M Augustyn

Publications and source records attributed to M Augustyn.

At least 19 recordsLinked to original sources
PubMed2006

Validation of growth charts for girls with Turner syndrome.

Growth charts, which describe the natural course of growth in Turner syndrome (TS) patients, are commonly used in studies in lieu of control groups. While analysing data, various charts produce different final height estimations and height-gain predictions. The choice of an appropriate chart should be the first task when assessing effects of growth hormone treatment. The purpose of this study was to establish the most appropriate growth chart for the subsequent analysis of growth rate in the patients with TS observed initially for a short time without treatment in our clinic. We propose the criteria that a standardised chart should meet. The obtained height-standardised values (height standard deviation score -- Ht SDS) should represent normal distribution with a mean of 0 and standard deviation of 1; their initial mean value and mean change in these values during observation without treatment should not be different from 0. We studied 62 untreated girls with TS using three different growth charts. The values of Ht SDS based on the Lyon chart showed a significant difference from normal distribution (p < 0.05). Only the mean value of an initiaent from 0 (p = 0.088). The mean change of the Ht SDS value based on Lyon and Ranke charts during the follow-up period was not statistically different from 0 (p > 0.05), whereas the difference was statistically significant when the Wisniewski chart was used. Only the Ranke chart correctly characterised TS girls in our clinic. This analysis indicates the importance of careful selection of an appropriate growth chart for an observed population, before applying it to evaluate the effects of hormonal therapy.

Adolescent↗
PubMed2001

Growth, development, and behavior in early childhood following prenatal cocaine exposure: a systematic review.

CONTEXT: Despite recent studies that failed to show catastrophic effects of prenatal cocaine exposure, popular attitudes and public policies still reflect the belief that cocaine is a uniquely dangerous teratogen. OBJECTIVE: To critically review outcomes in early childhood after prenatal cocaine exposure in 5 domains: physical growth; cognition; language skills; motor skills; and behavior, attention, affect, and neurophysiology. DATA SOURCES: Search of MEDLINE and Psychological Abstracts from 1984 to October 2000. STUDY SELECTION: Studies selected for detailed review (1) were published in a peer-reviewed English-language journal; (2) included a comparison group; (3) recruited samples prospectively in the perinatal period; (4) used masked assessment; and (5) did not include a substantial proportion of subjects exposed in utero to opiates, amphetamines, phencyclidine, or maternal human immunodeficiency virus infection. DATA EXTRACTION: Thirty-six of 74 articles met criteria and were reviewed by 3 authors. Disagreements were resolved by consensus. DATA SYNTHESIS: After controlling for confounders, there was no consistent negative association between prenatal cocaine exposure and physical growth, developmental test scores, or receptive or expressive language. Less optimal motor scores have been found up to age 7 months but not thereafter, and may reflect heavy tobacco exposure. No independent cocaine effects have been shown on standardized parent and teacher reports of child behavior scored by accepted criteria. Experimental paradigms and novel statistical manipulations of standard instruments suggest an association between prenatal cocaine exposure and decreased attentiveness and emotional expressivity, as well as differences on neurophysiologic and attentional/affective findings. CONCLUSIONS: Among children aged 6 years or younger, there is no convincing evidence that prenatal cocaine exposure is associated with developmental toxic effects that are different in severity, scope, or kind from the sequelae of multiple other risk factors. Many findings once thought to be specific effects of in utero cocaine exposure are correlated with other factors, including prenatal exposure to tobacco, marijuana, or alcohol, and the quality of the child's environment. Further replication is required of preliminary neurologic findings.

Affect↗
PubMed2000

War trauma experience and behavioral screening of Bosnian refugee children resettled in Massachusetts.

The authors assessed war violence exposure and behavioral symptoms in Bosnian refugee children in Massachusetts and the utility of behavioral screening of refugees during the Refugee Health Assessment (RHA), required of newly arrived refugees. The study was a survey of 31 Bosnian refugee children in 1996 at the International Clinic of Boston Medical Center, the state's largest contracted provider of the RHA. Subjects were also offered referrals to appropriate mental health services. Sixty-eight percent experienced long-term separation from a parent. Eighty-one percent were directly exposed to armed combat. Seventy-one percent experienced the death of a close friend or relative. Fifty-two percent experienced economic deprivation. Families reported behavioral symptoms for 77% of children. Only one family expressed interest in psychosocial services of any kind. Large numbers of Bosnian refugees are likely to have experienced traumatic war violence and are at risk of behavioral symptoms. The RHA affords opportunities to screen for behavioral problems but not to intervene. Primary care providers and other clinicians should be aware of likely recurrences of symptoms in high-risk children such as these.

Adolescent↗
PubMed1999

Restraining orders: a frequent marker of adverse maternal health.

OBJECTIVE: Women with histories of interpersonal violence are poorly identified because of barriers in self-disclosure. This study identified differences on maternal health and child behavior between women who report filing a restraining order (RO) and those who do not among a nonreferred sample of women living in high-crime neighborhoods. METHODS: During a maternal interview mothers were asked whether they ever filed a RO, the victim/defendant relationship, the number of times, and the year of the filing. Four types of violence were coded independently based on maternal narratives: verbal harassment, verbal threats or intimidation, physical assault, and destruction of property. We controlled for differences between RO and non-RO groups regarding demographic background, partner characteristics, other types of maternal past victimization, and use of alcohol and illicit drugs. Outcomes for mothers include partner aggression (Conflict Tactics Scale-R), perception of health and bodily pain (SF-36 Health Survey), distress symptoms (SCL90-R), posttraumatic stress (PTS)-related symptoms, and partial posttraumatic stress disorder (PTSD) diagnosis (modified Diagnostic Interview Schedule PTSD-Module). Outcomes for the child include partner aggression (Conflict Tactic Scale-R), behavior problems (CBC 2-3 or Child Behavior Checklist), and PTS-related symptoms (PTS-related symptom checklist). PATIENTS: One hundred sixty patients between 3.0 to 6.1 years who resided within five residential ZIP codes with a high rate of local crime in the City of Boston were drawn from a pediatric care clinic practice. Patients were participants of a larger study about the impact of community violence on mother-child relations. RESULTS: Sixty-four (40%) of 160 mothers reported a history of filing a RO against a current boyfriend or husband (39%), ex-boyfriend or husband (44%), someone known (8%), or other (9%), with a mean of 3.9 years (standard deviation = 3.5 years) since RO filing. After controlling for covariates of marital status, immigrant status, public assistance, and lifetime sexual victimization, we found a significant multivariate analysis of covariance group effect on maternal outcomes. Analysis of covariance analyses indicated that mothers in the RO group experienced higher current partner verbal aggression and physical violence to mother, poorer health, and higher PTS-related symptoms, compared with mothers in the non-RO group. More mothers in the RO group met partial lifetime PTSD diagnosis. Unadjusted for maternal covariates, the multivariate analysis of variance analyses on child outcomes (partner aggression to child, behavior problems, and PTS-related symptoms) indicated a nonsignificant group effect. CONCLUSIONS: Among dyads residing in high-risk crime areas, the incidence of RO histories is substantive considering this was a nonshelter, nonreferred sample. The inquiry about the history of a RO may provide a new and efficient marker to quality of current partner relationship, maternal health, and maternal stress-related symptomatology.

Adult↗
PubMed1998

Neonatal neurobehavioral and neuroanatomic correlates of prenatal cocaine exposure. Problems of dose and confounding.

Complex methodologic challenges face researchers studying the effects of prenatal cocaine exposure on infant outcome. These include unavoidable imprecision in ascertaining the gestational timing and dose of cocaine to which the fetus was exposed and difficulties in identifying and quantifying the confounding, mediating, and moderating variables. Review of research on neonatal behavioral and cranial ultrasound findings following in utero cocaine exposure is used to illustrate these issues. We conclude that there are measurable but not dramatic dose-related effects of prenatal cocaine exposure on infant central nervous system structure and function. The effects of dose of prenatal cocaine exposure on later child development remain to be determined. Such research would be facilitated by a scientific consensus delineating relative doses of prenatal cocaine exposure.

Brain↗
PubMed1997

Promoting community-based maternal and child health services: a university-health department partnership.

OBJECTIVES: Funded by the Federal Maternal and Child Health Bureau, a partnership between the Johns Hopkins University School of Public Health, Department of Maternal and Child Health (JHU), and the Baltimore City Health Department (BCHD) identifies maternal and child health problems, and develops appropriate interventions. This paper presents the organization and activities of the JHU/BCHD Maternal and Child Community Health Science Consortium as a result of overcoming traditional barriers to collaborative efforts, and discusses what role the Consortium has had in its own collaborative success. METHOD: A review of the literature uncovered a number of barriers to productive interaction. A number of factors contributing to overcoming the barriers was also revealed. The organization and activities of the work of the JHU/BCHD Maternal and Child Community Health Science Consortium has been applied to these barriers and associated factors, and discussed in context of implications for future collaborative efforts. RESULTS: The Consortium has developed a fully integrated administrative structure bridging both the BCHD and JHU. The mission of the Consortium has been translated into four categories of work, each one designed to complement, extend, and augment the other. The infrastructure established in Baltimore, as a direct result of this partnership, has served to overcome traditional barriers to productive academic/agency collaboration, while promoting organizational productivity. This outcome is a result of overcoming the recognized barriers to collaboration. CONCLUSIONS: Health agencies and university public health programs must link resources and collaborate to address public health issues. Commitment to a collaborative approach to the public's health will determine its future.

Child↗
PubMed1996

Psychiatric comorbidity in childhood post traumatic stress disorder.

OBJECTIVE: The purpose of this study was to examine the psychiatric comorbidity between children presenting with Post Traumatic Stress Disorder (PTSD) and traumatized children not developing this disorder. DESIGN: One-hundred and seventeen severely maltreated children were examined for evidence of PTSD. Analyses probed for diagnostic relationship, between PTSD and other formal diagnoses on The Diagnostic Interview for Children and Adolescents, Revised Version (DICA-CR). PARTICIPANTS: All children presented before a juvenile/family court due to severe child maltreatment and psychological trauma. These children had been ordered removed from parental custody due to the trauma suffered by the child. For the purposes of analyses, this entire group of maltreated and traumatized children were dichotomized into a PTSD group and a non-PTSD group. Thirty-five percent (41 of 117) of the children met strict DICA criteria for PTSD. MEASUREMENTS: The children were examined by means of a structured clinical interview. The Diagnostic Interview for Children and Adolescents, revised version (DICA-Child-R), along with a more general psychiatric interview. The DICA-Child-R responses provided the only determination of whether the children met formal PTSD criteria. Data gathering on the sample also included a comprehensive review of risk factors for the development of PTSD, including demographics, and type(s) of trauma suffered. RESULTS: Findings revealed that the PTSD diagnosis was significantly correlated with: 1. Attention Deficit Hyperactivity Disorder (ADHD) 2. Other anxiety disorders 3. Brief Psychotic Disorder or Psychotic Disorder NOS 4. The presence of suicidal ideation 5. A trend toward mood disorders. There were no differences between the two samples on measures of age, race, and family income. CONCLUSIONS: Pediatric PTSD is a severe psychiatric disorder. In this study, PTSD was statistically related to other formal psychiatric diagnoses. The investigators attended to the issues relating to true comorbidity versus inaccurate diagnosis secondary to symptom overlap between different conditions. Applying strict criteria, the results suggest that the presence of PTSD in children confers a substantial likelihood of other formal diagnosis. Moreover, the symptom of suicidal ideation was overrepresented among PTSD subjects. Given these additional conditions, more extensive evaluation and specialized, multi-modal treatment should be considered in children presenting with PTSD.

Anxiety Disorders↗
PubMed1996

Persistence of pediatric post traumatic stress disorder after 2 years.

One-hundred and fifty-six children were randomly evaluated at an inner-city juvenile/family court. These children were removed from their parent's custody subsequent to a finding of severe child maltreatment. From our original sample of 156 children, 62 met strict criteria for Post Traumatic Stress Disorder (PTSD). Fifty-two of these 62 were successfully recruited and participated in the 2 year re-examination. Each PTSD diagnosis was conferred by the Diagnostic Interview for Children and Adolescents (DICA). From our sample of 52 PTSD children re-examined after 2 years, 17 (32.7%) retained the full PTSD diagnosis, while 67.3% did not meet criteria.

Adolescent↗
PubMed1996

[Effect of hemodialysis on the pituitary adrenocortical axis in patients with diabetic nephropathy].

Pituitary-adrenocortical axis is disturbed in patients with chronic renal failure. Such abnormalities have been described in diabetic patients, too. The studies were performed to answer the following questions: 1) Is there a difference in basal ACTH and cortisol plasma level between patients with diabetic nephropathy and normal subjects? 2) Does haemodialysis affect ACTH and cortisol plasma level in patients with diabetic nephropathy? 18 patients with diabetic nephropathy and 10 normal controls were the subjects of this study. Blood samples for ACTH and cortisol determination were collected from each patient with diabetic nephropathy four times: before haemodialysis from the arterial line of dialyzer (0a) after 60 minutes of haemodialysis from the arterial (60a) and the venous (60v) line of dialyzer and after 240 minutes of haemodialysis from the arterial line (240a). Blood samples from normal controls were collected at 6 a.m. to determine ACTH and cortisol level. All the diabetic patients were on chronic 4-hour-haemodialysis 3 times a week. An artificial kidney Fresenius 4008 E, polysulfone dialyzers F5 and acetate dialysing solution were used in the studies. Plasma samples were analyzed for cortisol and ACTH by RIA. The studies brought to following conclusions: 1) The basal ACTH plasma level is significantly higher in patients with diabetic nephropathy than in normal controls. There is no significant difference in cortisol plasma level between diabetic patients and the control group. 2) Haemodialysis effects significant decrease of ACTH in plasma of diabetic patients. There is no statistic significance in cortisol plasma level in diabetic patients during haemodialysis.

Adrenocorticotropic Hormone↗
PubMed1996

[The effect of hemodialysis with frequent use of cuprophan and polysulfone membranes on activation of complement in patients with chronic renal failure].

UNLABELLED: During haemodialysis in patients with chronic renal failure plasma proteins have contact with dialysis membranes. Complement activation is one of effects of this contact. Intensity of this activation depends on structure of material that the membrane is made of, and it is a determinant of hemocompatibility of dialysis membrane. Our studies were designed to evaluate complement activation during haemodialysis in patients with chronic renal failure and therefore measurements of concentration of C3c factor in serum of hemodialyzed patients were performed. Furthermore, changes in concentration of C3c factor in serum during first and second use of cuprophan and polysulfone dialysis membrane were compared. An artificial kidney Fresenius 4008E, polysulfone dialyzers F5, cuprophan dialyzers C121 and acetate dialysing solution were used in the study. For the purpose of our study we have selected 10 patients hemodialyzed three times a week for 4 hours (5 of them suffered from diabetic nephropathy and the rest of our patients had chronic pyelonephritis) and 10 healthy subjects. Serum concentration of C3c was measured before haemodialysis, in 15', 60' and 240' minute of haemodialysis; measurement were performed on first and second use (after reutilization) of polysulfone and cuprophan membranes, respectively. C3c concentration in blood samples was measured with special reagent kits (turbidometric method). Statistically significant increase of serum C3c level was observed in studied group of patients in 15th minute of first use of cuprophan dialysing membrane. When values of C3c concentration in patients' serum during 60' and 15' of haemodialysis on first use of cuprophan membrane were compared, it was shown that there was a statistically significant decrease of serum C3c level in 60th minute of haemodialysis. RESULTS: 1. Haemodialysis in patients with chronic renal failure is associated with complement activation via the alternative pathway. 2. Maximal activation of complement pathway takes place in 15th minute of the first haemodialysis with use of cuprophan membrane. 3. Usage of the polysulfone dialyzer has no influence on concentration of C3c factor in serum during haemodialysis 4. Polysulfone membranes are characterized with higher haemocompatibility than cuprophan membranes.

Adult↗
PubMed1995

Adolescent drinking and driving: etiology and interpretation.

In the adolescent population, drinking and driving is an important cause of injury, disability and premature death. A literature review of the demographics and etiology of drinking and drinking/driving reveals: 1) which subgroups of the adolescent population are more likely to drink and drink/drive; 2) where and why adolescents drink and drink/drive; 3) peer and family issues associated with adolescent drinking and drinking/driving; and 4) adolescent expectancies and perceived efficacies associated with drinking and drinking/driving. A discussion of the role of theory and the use of etiologic data in intervention research precedes an overview of several types of school-based alcohol-prevention programs and recommendations for more theory based interventions.

Accidents, Traffic↗
PubMed1995

Interim outcomes for a community-based program to prevent perinatal HIV transmission.

The AIDS Prevention for Pediatric Life Enrichment (APPLE) project is a community-based program to prevent perinatal HIV infection by preventing infection in women. One project component tested a primary prevention model developed from principles of cognitive social learning theory which used street outreach and community-targeted small media materials to increase the use of condoms. Formative research was used to explore community perceptions about HIV/AIDS and to design media materials. Program evaluation employed a two-community, time series, quasi-experimental design. Annual street surveys samples individuals in areas where they were likely to encounter outreach workers. Baseline surveys found substantial pre-programmatic behavior change. After two years considerable APPLE name recognition (40%), contact with media materials (63%), and contact with outreach workers (36%) were found and norms reflecting social acceptability of condoms were more positive among women in the intervention community. Condom use at last sexual encounter rose in both communities but was significantly higher in the intervention community. Condom use also was higher among women who reported exposure to either small media or small media plus street outreach. Other self-reported HIV-prevention behaviors did not show change in the initial period.

Adolescent↗
PubMed1988

Serum tissue polypeptide antigen (TPA) and prostatic acid phosphatase (PAP) in patients with prostatic cancer.

Concurrent measurements of serum TPA and PAP concentrations by double antibody radioimmunoassays were done in 49 patients with prostatic cancer in different clinical stages. The reference group comprised patients suffering from BPH. Positive TPA was found in 32.7% of cancer patients, the lowest percentage in stage A (11.1%) and the highest in stage D (55.6%). The additional value as a diagnostic aid of the TPA test was revealed on the basis of examination of the selected group of patients with not increased PAP. Positive TPA was found in 16.7% of patients: none in stage A, 22.2% in stage B, and 33.3% in stage D. Prostatic cancer remains the most common malignancy of the genitourinary tract. The improvement in the results of treatment involves not only a modernization of treatment modalities but also the introduction of laboratory tests which give the most ample information on the stage of tumour development and improve possibilities to control tumour therapy. Besides the refinement of the determination procedures of specific prostatic markers, prostatic acid phosphatase (PAP), through radio- and enzyme-immunological methods, there is a search for additional markers which might be helpful in diagnosis and follow-up of treatment.

Acid Phosphatase↗