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Biomedical subjects

T Fenton

Publications and source records attributed to T Fenton.

72 records · Page 4Linked to original sources

Metabolism of tumor regression from angiogenesis inhibition: 31P magnetic resonance spectroscopy.

31P NMR spectroscopy was used to analyzed the in vivo metabolism of reticulum cell sarcoma of mice. The ratio of high- to low-energy phosphates ATPB/(Pi + PME) was measured to reflect the relative metabolic state in the tumor. Of the 34 mice studied, 26 were treated with an antiangiogenesis regimen of heparin and cortisone. Eighty-two percent of the tumors treated eventually decreased in volume (P less than 0.01). Volumes and spectroscopic information of 20 tumors were analyzed. Although the average untreated volume was similar to the volume after 3 days of treatment, the average ATPB/(Pi + PME) ratio rose from 0.34 +/- 0.10 to 0.47 +/- 0.07 (P = 0.02). However, after 6 days of treatment, the volume significantly decreased (P less than 0.0001) but the ratio did not significantly rise further (P = 0.06). The rise in the high-energy phosphate preceded a significant decrease in volume of the tumors. In addition, the replenishment of high-energy stores with tumor regression coincided with the histologic findings of a decrease in the number of tumor cells, a decrease of the mitotic index, and a decrease of the number of necrotic cells present with ongoing treatment. Our data suggest that noninvasive methods of assessing early biochemical response of tumor regression may be possible.

Animals↗

Dimensions of the trachea to age 6 years related to height.

In an effort to establish normal values for both investigational and patient care purposes, computed tomography was used to determine the length, diameters, cross-sectional area, and volume of the tracheas of 34 children up to the age of 6 years. The measurements were taken when patients were asleep or resting quietly during tidal breathing, at perhaps 30-60% of total lung capacity. The results were related to body height (in infancy, to body length). There was virtually no difference between boys and girls. Each mean diameter correlated well with mean cross-sectional area. Tracheal diameters and area were reasonably constant over the length of individual tracheas. The slopes of the functions relating height to tracheal dimensions in these 34 infants and young children were slightly less steep than those previously measured near total lung capacity in 90 older children and adolescents.

Analysis of Variance↗

Parental compliance to court-ordered treatment interventions in cases of child maltreatment.

The authors reviewed 136 court cases representing 218 parents of children maltreated enough to warrant custodial transfer of the child from the parents to the state. The court's psychotherapeutic treatment orders were noted and parental compliance with those orders documented and analyzed. The court issued one or more specific treatment orders to 87.26% of all parents. The most common referrals were those for drug or alcohol treatment (61.9%), individual psychotherapy (60.6%), and family treatment (29.4%). Treatment compliance was significantly lowered in those parents presenting with substance abuse. Compliance was also significantly lower among those parents who sexually and/or physically maltreated their children than among parents who neglected but did not physically or sexually maltreat their children.

Attitude↗

Clinical evaluation of juvenile delinquents: who gets court referred?

This study examines which alleged delinquents in a large urban juvenile court are selected for referral to the court's psychiatric clinic. A number of demographic factors, probation officer impressions, index charges, and past delinquency record variables were examined for all minor delinquency cases referred in a six-month period and for a random selection of nonreferred cases. In general, referral was associated with lower socioeconomic status (SES), and with a variety of probation impressions of child and family dysfunction. Little relation to index charge or past record was found. The authors interpret these results as showing that probation referrals appear to be made more on the basis of high risk than on the basis of favorable prognosis for treatment.

Adolescent↗

Propranolol treatment for childhood posttraumatic stress disorder, acute type. A pilot study.

We report 11 cases of posttraumatic stress disorder. Each child had been physically abused or sexually abused or both and presented in an agitated, hyperaroused state. Using a B-A-B (off-on-off) medication design in a clinical setting, the children were treated with the beta-adrenergic antagonist propranolol. Scores on an inventory of symptoms of posttraumatic stress disorder indicated that patients exhibited significantly fewer symptoms while receiving medication than either before or after they received medication.

Child↗

Pediatric Symptom Checklist: screening school-age children for psychosocial dysfunction.

The Pediatric Symptom Checklist (PSC) is a 35-item screening questionnaire that is completed by parents and designed to help pediatricians in outpatient practice identify school-age children with difficulties in psychosocial functioning. The current study assessed the validity of the PSC by screening 300 children in two pediatric practices, a middle-class group practice and an urban health maintenance organization. Validity was established by comparing the results of PSC screening of 48 children with in-depth interview assessments and pediatricians' ratings. Results indicate that the PSC has a specificity of 0.68 and a sensitivity of 0.95. The screening process was well accepted by parents and pediatricians. Several children whose pediatricians' ratings had indicated adequate functioning were identified by the PSC as having substantial psychosocial dysfunction and requiring further evaluation.

Child↗

Variability of transient myocardial ischemia in ambulatory patients with coronary artery disease.

Ambulatory electrocardiographic (ECG) monitoring of patients with chronic stable angina has demonstrated frequent and prolonged episodes of ischemic ST segment depression, but its clinical use requires an understanding of the components and extent of variability. Therefore, variations in the frequency and duration of episodes of ST segment depression were evaluated with ambulatory ECG recording at daily, weekly, and monthly intervals in 42 patients with chronic stable angina and known coronary artery disease. Data were analyzed with a nested analysis of variance design that yields estimates of variance components. From the estimates of variance components, power calculations and minimum significant percent reductions in frequency and duration of ischemia were derived. During 4,656 hours of ambulatory ECG monitoring, 1,262 episodes of ischemic ST segment depression were detected. The frequency of episodes was 6.3 +/- 0.45/24 hr (mean +/- SEM), and the duration of episodes was 18.3 +/- 2.8/24 hr. Because of variability over time, the ability to detect significant changes was dependent upon the number of subjects, length of monitoring period, and intervals between monitoring periods. In a clinical trial, for example, a sample size of 25 patients monitored for 48 hours with 1 week between control and test conditions would require a 65% reduction in frequency, whereas a sample size of 50 patients monitored under similar conditions would require a 46% reduction in frequency, to attribute the change with 90% power to a therapeutic intervention rather than to a spontaneous variation. When monitoring a single patient for 48 hours with 1 week or 1 month between control and repeat monitoring sessions, episodes of ischemic ST depression must be eliminated to detect significant therapeutic changes in ischemic activity at the 95% confidence level.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Neurodevelopmental readiness for adolescence: studies of an assessment instrument for 9- to 14-year-old children.

The Pediatric Examination of Educational Readiness at Middle Childhood (PEERAMID) is a neurodevelopmental examination for 9- to 14-year-old children. The examination was designed largely for use by developmental-behavioral pediatricians as a way of assessing certain critical developmental functions, including attention, memory, language, and motor coordination in children with school problems. Preliminary field testing of the PEERAMID was carried out in one community, and subsequently a revised version was standardized on randomly selected subjects from three communities near Boston, Massachusetts, and on groups of children from those towns said to be having significant problems at school. Additionally, the examination was used for the evaluation of 106 consecutive patients referred to the School Function Program at The Children's Hospital in Boston. Statistically significant performance differences discriminated between children with normal academic performance and those with school problems in the community as well as in the referral setting. It was discovered that children with school problems tended to have clusters of dysfunction, whereas normally achieving youngsters more often harbored no developmental dysfunctions or perhaps one or two areas of difficulty. It is believed that the PEERAMID can be a useful instrument in serving as part of a pediatric contribution to a multidisciplinary assessment in children in this age group.

Adolescent↗

The effect of methylphenidate on school grades in children with attention deficit disorder without hyperactivity: a preliminary report.

Ten children, aged 7-12 years, were diagnosed by DSM-III criteria for attention deficit disorder (ADD) without hyperactivity. Each child was treated with methylphenidate for one academic grading period. School grades were obtained for the grading periods before, during, and after drug treatment. Correlated t tests revealed that academic performance during drug treatment was significantly superior to that during the preceding grading period (p less than .01) and the period following drug treatment (p less than .001). ADD without hyperactivity may represent a potentially drug-treatable disorder in children.

Achievement↗

Locus of control as predictor of compliance and outcome in treatment of encopresis.

We examined the effectiveness of instruments that describe a child's locus of control and perceived self-competence as predictors of outcome in the treatment of encopresis. Fifty children 9 to 12 years of age completed such instruments prior to clinical interview. Clinicians were blind as to the results of these questionnaires and administered a standard encopresis protocol to all patients. Six to 17 months later, 45 (90%) of the patient's parents were interviewed to assess compliance and treatment outcome. Children who significantly improved had a more internal locus of control (P less than 0.05) and better compliance (P less than 0.05) as determined by two separate outcome variables. Locus of control and compliance were not, however, significantly correlated with each other; each appeared to have an independent association with outcome. There was no association between perceived self-competence and outcome. The positive association between locus of control and outcome was not mediated by socioeconomic status, age, duration of encopresis, severity of encopresis, gender, or time between initiation of treatment and follow-up. Measurement of locus of control in children with encopresis appears to be helpful in identifing a group at high risk for resistance of treatment.

Child↗

Minor neurological indicators and developmental function in preschool children.

An attempt was made to determine whether neuromaturational indicators (soft neurological signs) were associated consistently with specific areas of developmental function in 5-year-old children. Fifty-eight children were assessed over two diagnostic sessions. One involved administration of the Pediatric Exam of Educational Readiness (PEER) by pediatric fellows; the other consisted of administration of the McCarthy Scales of Children's Abilities (MSCA) by trained psychoeducational specialists. Data indicate that children who exhibited a greater number of minor neurological indicators had a high likelihood of experiencing difficulty with visual-perceptual, fine motor, and gross motor tasks of the PEER and the MSCA. What is more important, no relationship was found between aggregates of minor neurological indicators and performance on linguistic, memory, sequencing, quantitative, verbal, or preacademic sections of these diagnostic instruments. This information suggests that physicians should limit their interpretation of such signs when evaluating young children with academic difficulties. Additional data must be accumulated before the role of neuromaturational signs can be fully understood.

Child, Preschool↗

Locus of control and self-esteem in children with encopresis.

Children with encopresis were compared to children with other "high prevalence low-severity" disorders on measures of locus of control and self-esteem. Children with encopresis tended to feel less in control of positive life events, had lower self-worth, and were more apt to want to change and be different than children with other chronic symptoms. Data tend to contradict traditional interpretations of encopresis as a system of unconscious motives involving independence and control. Also, this information adds to the clinical impression culled from experience that active intensive remediation is the appropriate clinical response when treating children with encopresis.

Child↗

Estimating personal performance: a problem for children with school dysfunction.

Children with school dysfunction typically do limited planning and fail to use potentially beneficial mediational strategies on cognitive tasks. This study tested the hypothesis that these children are poor at assessing their own performance capabilities, a deficit which might contribute to this passive learning style. Thirty children, 9-12 years old, attending a multidisciplinary clinic in a pediatric setting for school underachievement, and 30 age, grade, and socioeconomic status (SES)-matched controls were asked to predict their performance in four domains of function before they were given the opportunity to perform the tasks. Clinic subjects overestimated their performance to a greater degree than controls in two domains. This performance resembles the performance of younger children on related tasks and may be amenable to therapeutic or educational intervention.

Child↗

Cognitive and learning profiles of delinquent and learning-disabled adolescents.

The association between juvenile delinquency and learning disabilities has been a focus of considerable discussion and controversy. Nevertheless, only a limited number of investigators have directly contrasted these two populations. In those studies which have examined the link between antisocial behavior and school problems, research methodology has varied, resulting in conflicting evidence and limited consensus. The present study was designed to address this issue by comparing the cognitive and learning profiles of delinquents and learning-disabled adolescents. Specifically, 53 delinquents, 26 learning-disabled adolescents, and 50 average achievers were evaluated with newly developed educational and cognitive inventories. These assessment techniques were used to analyze several functional areas including processing efficiency, problem solving, and response style. Application of discriminant analysis to the cognitive and educational profiles of these adolescents suggested the existence of various subtypes of delinquency. Learning disabilities characterized one of these subgroups. It was concluded that more specific descriptions of the learning profiles of adolescent delinquents holds promise for rehabilitation and, perhaps, prevention of juvenile delinquency.

Achievement↗

A study of risk factor complexes in early adolescent delinquency.

A study was undertaken to document the existence of multiple forms of risk among a sample of 53 delinquents between the ages of 11 and 16 years. When compared with an age-matched comparison group from the same region, the delinquent youngsters were far more likely to show clusters of vulnerability in the areas studied (medical, neurodevelopmental, educational, behavioral, socioeconomic status, family disruption, and cognitive). When cluster analysis was applied to the delinquent group, three subgroups emerged sharing certain traits and accounting for 70% of the cohort. The early identification of so-called risk factor complexes may be helpful in the prevention of delinquency.

Adolescent↗

Parental substance abuse and the nature of child maltreatment.

The authors reviewed 190 randomly selected records from the case load of a large juvenile court. These records involved cases in which the state took legal custody of the children following a finding of significant child maltreatment, based on a "clear and convincing" standard of evidence. Sixty-seven percent (127/190) of these cases involved parents who were classified as substance abusers. The results of this study revealed specific associations between (a) alcohol abuse and physical maltreatment and (b) cocaine abuse and sexual maltreatment. Logistic analyses, testing for the effects of polysubstance abuse, revealed that additional forms of substance abuse failed to add significantly to the effects of alcohol in predicting physical maltreatment or cocaine in predicting sexual maltreatment.

Adolescent↗

Prevalence of medical technology assistance among children in Massachusetts in 1987 and 1990.

In 1987 and 1990 in Massachusetts, surveys were conducted to determine the size, pattern of distribution, and trends in the population of children assisted by medical technology. The authors obtained an unduplicated count of all Massachusetts children from 3 months to 18 years of age who used one or more of the following: tracheostomy, respirator, oxygen, suctioning, gastrostomy, jejunal or nasogastric feedings, ostomies, urethral catheterization, ureteral diversion, intravenous access, or dialysis. By comparing counts obtained from medical and educational sources, the authors were able to perform a capture-recapture analysis to estimate the overall number of children dependent upon these technologies. The number of children identified in our surveys increased from 1,085 in 1987 to 1,540 in 1990. However, the capture-recapture analysis yielded estimates of 2,147 plus or minus 230 for 1987 and 2,237 plus or minus 131 for 1990. This suggests that the population of children dependent upon medical technology was essentially stable during this period, and that the 42 percent increase in the number of children identified in our survey reflected improved sampling techniques. During the 3 years, shifts in the pattern of technology use were noted, however. Use of oxygen and gastrostomy increased, and urostomy use declined. A change in the age distribution of the children was also documented, with a shift in the preponderence of technology use from 12 to 24 months in 1987 to children in the first year of life in 1990. Using the 1990 estimate and the 1990 U.S. census figures, an overall prevalence estimate of 0.16 percent was calculated. Applying this to the U.S.child population yields an estimate of 101,800 children assisted by medical technology nationwide(assuming comparable technology use in other States). This information will facilitate policy analysis and program planning on regional and national levels for this medically complex group of children.

Adolescent↗