Grandparents are a vital link for young families. The support grandparents can provide to the new family is now more important than ever. A creative grandparenting program can increase the likelihood that grandparent support is effective and welcomed. This article includes a discussion of such a program, suggested content areas to include, and the development of appropriate teaching strategies.

Adult↗

PubMedDate not supplied

Allergic manifestations as the results of a conditional autoimmune response.

By means of repertoire cloning we have isolated human anti-IgE antibodies as well as human anti-FcepsilonRI antibodies. Whether the naturally occurring anti-IgE autoantibodies play a pathophysiological role may be disputed, but the beneficial role of recombinant anti-IgE antibodies as a therapeutic agent has been shown. On the other hand, the natural antibodies isolated from an antibody library of a nonallergic individual against the FcepsilonRI alpha-chain are anaphylactogenic, if FcepsilonRI was not occupied. Thus, anti-FcepsilonRI autoantibodies may be part of a conditional autoimmune reaction, leading to urticaria if local IgE is consumed, e.g. after an immediate reaction. Thus, anti-FcepsilonRI antibodies may represent an amplification arm of the late reaction. The normal occurrence of anti-IgE and anti-IgE receptor autoantibodies may suggest that it might also be feasible to induce such autoantibodies by vaccination. In a monkey model using a mimotope of human IgE it was possible to induce a beneficial anti- IgE autoimmune response. The actual epitope of the IgE molecule was then also molecularly reconstructed by generating recombinant anti-idiotypic antibodies. These antibodies also induced effectively an anti-IgE response in monkeys, suggesting that not only mimotopes but also anti-idiotypic antibodies may be used to generate an autoimmune response. Both of our projects suggest that active immunization may be a new form of immunomodulation for the treatment of allergic disease.

Animals↗

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Leukemia in a child with a history of medulloblastoma.

Leukemia of mixed lineage, was diagnosed in a 6.5-year-old boy with a history of medulloblastoma, 38 months after his initial cancer diagnosis. Therapy had included craniospinal radiation and nitrosourea-based chemotherapy. In addition, onset of leukemia was preceded by therapy with recombinant growth hormone for short stature. Although rare, leukemia is a treatment-related complication for patients with past brain tumors whose follow-up should therefore include surveillance with complete blood counts.

Brain Neoplasms↗

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Idiopathic hypereosinophilic syndrome terminating in acute lymphoblastic leukemia.

Idiopathic hypereosinophilic syndrome (IHES) is a heterogeneous group of disorders characterized by multisystem dysfunction and persistent, extreme eosinophilia of unknown cause. We describe a 9-1/2-year-old boy whose course included several unusual clinical features and terminated 2 years after diagnosis in acute lymphoblastic leukemia (ALL). Serial studies suggest that leukemia was not present earlier in his course. We speculate that this child may have had an evolving lymphoproliferative syndrome with a terminal blast crisis to which the eosinophilia was a nonmalignant leukemoid reaction.

Antigens, Differentiation↗

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Children in homeless families in Melbourne: health status and use of health services.

OBJECTIVE: To determine the prevalence of health and behaviour problems in a sample of children in homeless families and of psychological problems in their parents, and to assess the use of health services by homeless families. DESIGN: A cross-sectional, questionnaire-based prevalence survey. SETTING: Supported accommodation provided by a welfare service in Melbourne between May 1994 and June 1995. SUBJECTS: 51 children from 31 families soon after housing crises. RESULTS: More than one-third of all children had total behaviour problems scores in the "deviant" range (i.e., requiring mental health referral). Intellectual disability/developmental delay, skin problems, vision problems, recurrent headache, and asthma or other breathing problems were more prevalent in these homeless children than in a large Australian normative population. Their mothers scored higher than a large normative sample on the mental health questionnaire, most markedly for "anxiety-insomnia", "severe depression" and total score. Cost of treatment and transport difficulties were seen as barriers to using health care services. RECOMMENDATIONS: Australian health-care practitioners should be aware of the health and health service access problems of children in homeless families, and work to minimise their physical, emotional, developmental and academic disadvantages. Psychological support services should be available for homeless families, particularly for mothers.

Adult↗

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Familial erythrophagocytic lymphohistiocytosis (Farquhar's disease): involvement of the central nervous system.

The clinical course and the postmortal pathological findings in a female newborn showing parental consanguinity are presented. One week afterbirth, the infant developed fever, hepatosplenomegaly and polyserositis. Rapidly progressing immunodeficiency due to pancytopenia led to pneumonia and untreatable respiratory distress with fatal outcome after 2 weeks. Autopsy findings revealed multisystem lymphohistiocytic infiltration with marked erythrophagocytosis. Neuropathological findings included lymphohistiocytic leptomeningitis, perivascular cuffing by lymphohistiocytic infiltrations in the cerebral white matter, predominantly in subependymal location, and multifocal lymphohistiocytic infiltrations of the cerebral grey matter and the cervical spinal cord. Erythrophagocytosis was the histopathological hallmark at all sites. Regarding the fatal clinical course, the medical history of parental consanguinity and the histopathological features, postmortem diagnosis was familial erythrophagocytic lymphohistiocytosis (FEL, Farquhar's disease). The present case is discussed with focus on CNS involvement in FEL by reviewing the relevant literature.

Central Nervous System↗

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Pediatric TB in the 1990s.

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AIDS-Related Opportunistic Infections↗