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PubMed1980

Reactive hypoglycemia.

The clinical characteristics and scores on the Minnesota Multiphasic Personality Inventory (MMPI) of 192 patients undergoing a five-hour oral glucose tolerance test (OGTT) for evaluation of reactive hypoglycemia were assessed. There were twice as many women as men. One hundred twenty-nine patients had spells of light-headedness, shakiness, diaphoresis, weakness, and fatigue. Hypoglycemic symptoms occurring during the test were not related to level of plasma glucose nadir or to rate of descent of glucose level. Hypoglycemia was not found when glucose levels were measured during occurrence of spontaneous symptoms in 86 patients. MMPI scores were significantly different from those of general medical patients. Both men and women evinced a conversion V profile. The five-hour OGTT seems unreliable for the diagnosis of reactive hypoglycemia, and most patients with symptoms suggestive of hypoglycemia may have emotional disturbances.

Adolescent↗
PubMed2000

A case-study of PTSD in infancy: diagnostic, neurophysiological, developmental and therapeutic aspects.

Post-traumatic Stress Disorder of Infancy has become accepted as a nosological entity. Assessment guidelines and diagnostic criteria have been defined, taking into account the impact of development on the expression of post-traumatic symptoms. Therapeutic reenactment has been considered the cornerstone of the therapeutic process. The issue of deciding what is the optimal time for therapist-induced reenactment of the trauma remains ill-defined. The less verbal and the more avoidant the traumatized infant is, the more directive the therapist needs to be, meaning he will not necessarily get clues from the infant of his readiness for reenactment. The therapist will need to introduce the trauma, at the risk of provoking a massive "flight or fight" reaction, as is illustrated by the case study of a two-and-a-half-year-old post-traumatic preverbal boy and his mother. Issues relating to conditions under which reenactment stops causing reactivation of the trauma and starts being a process of therapeutic desensitization are raised. We suggest that integration of psychodynamic and neurodevelopmental concepts might be useful in deepening the understanding of the impact of therapeutic reenactment in PTSD of Infancy.

Arousal↗
PubMed1998

Humoral and cell-mediated immunity in malnourished children in Ghana.

OBJECTIVE: To examine the relationship between immunological variables and the different types and severity of malnutrition in Ghanaian children. DESIGN: Case-control study. SETTING: The study was done at Princess Marie Louise Hospital, Accra, Ghana. SUBJECTS: One hundred and seventy children, aged 8-36 months, were recruited at the clinical ward and public health service section of the hospital: 61 normal children, 49 moderately malnourished (underweight) children and 60 severely malnourished children (19 kwashiorkor, 30 marasmus, and 11 marasmic kwashiorkor children). METHOD: The children underwent clinical observations, anthropometric measurements and blood sampling for biochemical analysis to evaluate their nutritional and immunological status. Serum immunoglobulins (IgA subclasses, IgG subclasses and IgM), complements (C3 and C4) and lymphocyte subpopulations (T cells, B cells, CD4+, CD8+, NK cells and HLADR) were determined for the assessment of humoral and cell-mediated immunity. RESULTS: Serum levels of IgA1, IgA2 and C4 tended to be higher in severely malnourished children than in normal children, while serum level of C3 and the proportion of B cells were significantly lower in the severely malnourished children than in the normal children (P < 0.05). There were no notable differences in most immunological parameters among the three severely malnourished groups. No differences were observed in the immunological parameters except for the proportion of B cells between normal and moderately malnourished children. Factor analysis revealed that C3 levels were positively correlated with a factor which was strongly associated with weight-for-height z-score and biochemical indicators for evaluating protein nutrition. In addition, IgA2, IgG1 and IgM levels were positively correlated with a factor which was associated with C-reactive protein. CONCLUSION: Several immunological variables responded positively or negatively with the different levels of severity of malnutrition, but most variables did not on the different types of malnutrition. The changes of C3 level were more associated with the severity of malnutrition.

Antibody Formation↗
PubMed2006

[Primary cytomegalovirus infection in the postnatal period].

A male infant born vaginally after a gestation period of 25 4/7 weeks with a birth weight of 875 g underwent surgical correction for oesophageal atresia with a distal tracheo-oesophageal fistula. Postoperative complications included seam leakage, mediastinitis with sepsis, transient elevated diaphragm, recurrent fistula and seam stenosis. Persistent ductus arteriosus was closed surgically. The further course of disease was characterised by periventricular haemorrhage, recurrent infections, bronchopulmonary dysplasia and retinopathy. Anaemia caused by the premature birth and frequent blood sampling necessitated multiple transfusions of filtered, Cytomegalovirus(CMV)-free erythrocyte concentrate. At the age of 3 months, the patient developed cholestatic jaundice that was attributed to a CMV infection contracted through breast milk. The patient recovered spontaneously. At the age of 2 years, the patient had mildly impaired psychomotor development. Reactivation of CMV during lactation is common in CMV-seropositive women. This carries a high risk of transmission of the virus through breast milk, especially for extremely premature neonates. In these infants, an early acquired postnatal CMV infection may lead to serious disorders.

Adult↗
PubMed2005

[The EEG correlates of delayed mental development in adolescents].

Fifty-eight male adolescents aged 15-17 years have been divided into 3 groups: 31 patients with mental infantilism syndrome were included in the study group, 14 with organic brain disorders--in the comparison group and 13 psychiatrically and neurologically normal subjects--in the control group. EEG was recorded from 12 leads monopolarly at rest, during hemisphere-specific cognitive tasks performance and exposure to aversive sound stimulation. Two-Hz wide EEG spectral ranges--A, theta1, theta2, alpha1 and alpha2--were analyzed. Only in the study group, there were decreased values of alpha2 spectral power (SP) and reduced reactivity to functional tests and insufficient lateral differentiation of the reactions during the cognitive tasks performance. Maximal deviation of the SP reactivity indices as compared to the comparison group was found in alpha2 range. The disturbances obtained indicate the delay of brain maturation and retardation in formation of specific neural networks. The results of the study demonstrate that indices of alpha2 SP may be considered as objective criteria of delayed mental maturation.

Adolescent↗
PubMed1980

Differential autonomic responses of autistic and normal children.

The autonomic responses of 10 autistic and 10 normal children were compared using auditory stimuli varying in social relevance. Consistent differences in heart rate response and skin conductance level were found between the groups. The results suggest that the autistic subjects exhibited deficits in psychophysiological reactivity to a range of environmental stimuli. Findings are discussed in terms of the information-processing capabilities of autistic children, and probable physiological correlates. Implications for treatment are considered.

Acoustic Stimulation↗
PubMedDate not supplied

[Integrative model of the ontogeny and destruction of human behavior].

In a review of the data in the literature completed with authors own researches (concerned with twins, chromosome abnormalities, incestuous descent, socially assisted children etc.) an integrative model regarding the ontogenesis and destruction of human behaviour is presented. According to this model, behaviour appears as a hierarchical and integrated system expressing the process of its development from automatic and reactive to noologic and reflexive. The integrative, systemic concept promotes, theoretically and methodologically, the understanding and competent investigation of human behaviour in its two fundamental states, integrated and destructive.

Behavior↗
PubMedDate not supplied

[Changes in immunologic indices in patients with brain tumors].

Patients with tumors of the brain underwent complex immunological examination. Anticerebral antibodies were discovered and the IgM and IgG levels were found to be diminished. Reduction of the T lymphocyte content was paralleled by the compensatory increase of the B lymphocyte level in the blood. It is shown that according to the findings of some allergic tests, neurosensitization develops; the tests employed were the leukocyte injury, leukocyte agglomeration, and leukocyte migration inhibition. The immune disorders and the autoimmune shifts correlate with the stage of the organism compensation, the degree of tumor malignancy, and the efficacy of the operation.

Adolescent↗
PubMed2000

Clinical course and treatment of haemorrhagic cystitis associated with BK type of human polyomavirus in nine paediatric recipients of allogeneic bone marrow transplants.

UNLABELLED: Of a total of 117 bone marrow transplant (BMT) recipients in the period from August 1988 to November 1995, 9 (7.7%) developed haemorrhagic cystitis. This condition was characterized in all nine patients by late onset (day +24 to +50 post-BMT), long duration (1 to 7 weeks), and the excretion of BK virus in the urine, as confirmed by electron microscopy, DNA hybridization and PCR analysis. Adenovirus was not involved. The serological assessment of BK virus-specific IgM and IgG pre- and post-BMT is consistent with viral reactivation in all patients, although a primary infection cannot be absolutely excluded in a single patient. A significant correlation between the use of high-dose busulphan (16 mg/kg) in the preparative regimen and development of haemorrhagic cystitis (P = 0. 0003) was evident. The severe course of the disease in two patients resulted in bladder tamponade; bleeding could not be inhibited with coagulation and laser treatment. Deterioration was prevented by bladder irrigation via a suprapubic catheter. Remission occurred spontaneously in all patients. CONCLUSION: BK virus induced haemorrhagic cystitis in a paediatric bone marrow transplantation recipients is characterized by late onset, long duration, viral reactivation and correlates to high-dose busulphan. Severe bleeding could not be influenced by surgical intervention.

Adolescent↗
PubMed2006

Examining genetic and environmental effects on reactive versus proactive aggression.

This study compared the contribution of genes and environment to teacher-rated reactive and proactive aggression in 6-year-old twin pairs (172 pairs: 55 monozygotic girls, 48 monozygotic boys, 33 dizygotic girls, 36 dizygotic boys). Genetic effects accounted for 39% of the variance of reactive aggression and for 41% of the variance of proactive aggression. The remainder of the variance was explained by unique environmental effects. Genetic as well as unique environmental effects were significantly correlated across reactive and proactive aggression (genetic correlation = .87, environmental correlation = .34), but this overlap was largely due to a common underlying form of aggression (i.e., teacher-rated physical aggression). Once common etiological factors due to physical aggression were accounted for, reactive and proactive aggression shared no other genes and only a few environmental influences, although additional specific genetic and environmental effects were observed for both reactive and proactive aggression. These specific effects indicate that both reactive and proactive aggression may be influenced mostly by socialization experiences that are specific to each type of aggression and only to a very small degree by specific genes.

Age Factors↗
PubMed1999

Vitamin E treatment of focal segmental glomerulosclerosis: results of an open-label study.

Experimental data indicate that excessive production of reactive oxygen molecules contributes to progressive renal injury and that treatment with antioxidants attenuates this damage. Therefore, we investigated whether vitamin E supplementation could ameliorate renal disease and reduce proteinuria in children with a variety of kidney disorders. Vitamin E, 200 IU twice daily, was administered orally to 11 children with focal segmental glomerulosclerosis (FSGS) (group A) and 9 patients with miscellaneous kidney diseases (group B) [Henoch-Schönlein purpura nephritis (n=3), urinary tract anomalies (n=2), non-specific immune complex glomerulonephritis (n=2), IgA nephropathy (n=1), and reflux nephropathy (n=1)]. The duration of vitamin E treatment, when no other therapy was introduced, was 2.9+/-0.4 months. Proteinuria was determined by measuring the protein:creatinine ratio (mg/mg) in an early morning urine specimen. In children with FSGS, administration of vitamin E lowered the protein:creatinine ratio in 10 of 11 patients from 9. 7+/-5.1 to 4.1+/-1.1 (P<0.005). In contrast, among children with miscellaneous renal diseases, vitamin E had no beneficial impact on urinary protein excretion-protein:creatinine ratio 2.5+/-1.0 pre versus 2.4+/-1.2 post antioxidant. Vitamin E supplementation had no effect on glomerular filtration rate, serum albumin, or cholesterol concentration in either group of patients. These findings suggest that reactive oxygen molecules may play a more-prominent role in causing renal injury in patients with FSGS than in other kidney disorders. Antioxidant therapy may be a useful adjunct in the treatment of children with FSGS and proteinuria that is refractory to standard medical management.

Adolescent↗
PubMed1977

[Juvenile depressive syndromes].

Depressive states can appear in different phases of life. They differ in their phenomenology according to type, dynamics and power of the etiologic factors, as well as to the moment of their appearance in a child's life. Therefore, depressive syndromes during infancy and childhood are very diverse. Depression in childhood is psychopathologically more complex than it is in adulthood, because it occurs in a developing organism. A differential typologic order according to nosologic aspects is difficult to establish. A division into psychogen-reactive, neurotic, organic, structural and endogenous-psychotic depression is only an attempt toward a rough orientation. Contrary to depressive illnesses in adulthood, anaclitic, reactive and neurotic depressions are most frequent in childhood. They are always due to inconvenient relations to and identification with the significant other of the child. There are dynamic interrelations between the different depressive states in childhood. Already in the early phases of development, the foundations are laid for the possible later development in melancholia.

Adjustment Disorders↗
PubMed2006

Early childhood externalising behaviour problems: child, parenting, and family-related predictors over time.

This study examined the dynamic relationships between child, parenting, and family-related predictor variables and early childhood externalising behaviour problems. A community sample of 395 Australian children was followed longitudinally, and assessed at 4 and 6 years with the Child Behavior Checklist, Teacher Report Form, and standard measures of parenting, temperament, and familial adversity. Variables based on the average scores across the two assessments and the change in scores between assessments were utilised as predictors of parent-reported and teacher-reported externalising behaviour problems at age 6. It was hypothesised that both higher average scores and more detrimental changes in scores, would independently predict externalising problems at age 6. Multivariable analyses found that the presence of parent-reported child externalising problems in six-year-olds were predicted by: (i) the presence of parent-reported child externalising problems at age 4, (ii) higher average "teacher-reported child externalising behaviour," "inflexible temperament," "non-persistent temperament," and "over-reactive parenting," and (iii) an increased "inflexible temperament" score between age 4 and age 6. The presence of teacher-reported child externalising problems at age 6 was predicted by higher average "parent-reported child externalising behaviour," and "over-reactive parenting." The results provide further evidence of the adverse impact of continuing high levels of temperament difficulties and over-reactive parenting on externalising behaviour in early childhood. However, contrary to expectations, the contribution of including the dynamic change scores was limited.

Child Behavior Disorders↗
PubMed2006

The efficacy and tolerability of quetiapine versus divalproex for the treatment of impulsivity and reactive aggression in adolescents with co-occurring bipolar disorder and disruptive behavior disorder(s).

OBJECTIVE: The aim of this study was to compare the efficacy and tolerability of quetiapine and divalproex for the treatment of impulsivity and reactive aggression in adolescents with co-occurring bipolar disorder and disruptive behavior disorders. METHOD: Patients were included in this post hoc analysis if they scored > or = 14 on the Positive and Negative Syndrome Scale (PANSS) Excited Component (EC) and > or = 4 on at least one of the PANSS EC items, had a current diagnosis of bipolar I disorder, manic or mixed episode, and had a lifetime and/or current diagnosis of a disruptive behavioral disorder (DBD) [conduct disorder (CD) or oppositional defiant disorder (ODD)]. Thirty-three (92%) of the 36 subjects with bipolar disorder and DBD met the PANSS EC inclusion criteria. These thirty-three adolescents were randomized to quetiapine (400-600 mg/day) or divalproex (serum level 80-120 microg/mL) for 28 days in this double-blinded study. The primary efficacy measure was change in PANSS Excited Component (EC) score over the study period and at each time point. RESULTS: Repeated measures analysis of variance (ANOVA) demonstrated statistically significant within-treatment-group effects for divalproex (baseline = 20.6, end point = 13.3, p < 0.0001) and quetiapine (baseline = 18.8, end point = 10.8, p < 0.0001) for the PANSS EC. There were no statistically significant treatment group differences in PANSS EC changes from baseline to end point scores (p = 0.7, d = 0.14). Mixed regression analyses (comparison of slopes, DAY*TREATMENT) revealed that there was no significant difference in the rate of improvement in the PANSS EC scores between the two treatment groups [F(1,31) = 0.78, p = 0.39, d = 0.28]. CONCLUSIONS: Quetiapine and divalproex showed similar efficacy for the treatment of impulsivity and reactive aggression related to co-occurring bipolar and disruptive behavior disorders in adolescents. Quetiapine and divalproex are both useful as monotherapy for the treatment of impulsivity and reactive aggression in adolescents with bipolar and disruptive behavior disorders. Placebo-controlled studies are necessary.

Adolescent↗
PubMed1995

Assessment of cell proliferation in normal and pathological bone marrow biopsies: a study using double sequential immunophenotyping on paraffin sections.

The proliferative activity of the haematopoietic and plasma cells in bone marrow was evaluated under normal and neoplastic conditions, by means of a sequential double immunostaining technique, using monoclonal antibody MIB-1 recognizing the cell proliferation-associated nuclear antigen Ki-67, and antibodies against glycophorin-C, myeloperoxidase, factor VIII-related antigen, and immunoglobulin light chains. Fifty-eight B5 fixed, paraffin-embedded bone marrow biopsies were analysed, including 11 normal controls. 10 cases of myelodysplasia, 14 cases of chronic myeloproliferative disorder, eight cases of acute non-lymphoid leukaemia, and 15 cases of myeloma. In normal marrows, the highest proliferative activity was noticed in the erythroid cells (75% to 95%; mean 90%), in comparison with myeloid precursors (15% to 80%; mean 38%), and megakaryocytes (10% to 20%; mean 14%): no Ki-67 positive plasma cells were found. In all investigated haematological disorders, the expression of MIB-1 by erythroid cells was similar to that observed in controls. Similarly, the percentage of MIB-1 + myeloid precursors in chronic myeloproliferative disorders and myelodysplasia largely overlapped the values observed in normals, and comparable values were also found in the blast cells from acute non-lymphoid leukaemia type M1 and M2. These findings suggest that the evaluation of either erythroid or myeloid proliferative activity is of little value in the differential diagnosis between these myeloproliferative disorders. By contrast, the obvious increase of Ki-67 expression of megakaryocytes in chronic myeloproliferative disorders, with labelling also of micro-megakaryocytes, might sustain the diagnosis in controversial cases. Since cases of mature myeloma showed less than 2% of Ki-67 positive cells, evaluation of proliferative activity is of no value in the differential diagnosis with reactive plasmacytosis. The sequential double immunophenotyping for Ki-67 antigen and for haematopoietic cell lineage-associated markers can be applied in a consistent manner to routine bone marrow biopsies to evaluate proliferating cells in normal and neoplastic conditions.

Adolescent↗
PubMed2001

Assessing the need for reactive behaviour management strategies in children with intellectual disability and severe challenging behaviour.

The need for reactive behavioural management strategies for aggressive behaviours in adults with intellectual disability has been clearly established, but equivalent information concerning children with challenging behaviour is lacking by comparison. The present study was conducted in order to assess this need. A retrospective study was conducted to ascertain the nature of aggressive behaviours amongst a cohort children referred to a specialist support service. Aggressive behaviours were found to occur at high rates within the study group. Almost 60% of the children displayed aggression that occurred at least daily, and the behaviours resulted in serious consequences for carers in almost one-third of the group. Physical interventions were already in use in 56% of cases, but were largely improvised by carers. The need to include reactive behavioural training as part of an overall intervention package for carers of children with challenging behaviour appeared to be supported by the present results. The implications for training design are discussed.

Adolescent↗
PubMed2006

Children's subjective emotional reactivity to affective pictures: gender differences and their antisocial correlates in an unselected sample of 7-11-year-olds.

BACKGROUND: Differential responses in terms of gender and antisocial behaviour in emotional reactivity to affective pictures using the International Affective Picture System (IAPS) have been demonstrated in adult and adolescent samples. Moreover, a quadratic relationship between the arousal (intensity) and valence (degree of unpleasantness) has been suggested. The picture perception methodology has rarely been applied to middle school-aged children. We examined the subjective ratings of emotional reactivity in children for: i) the relationship between arousal and valence, ii) gender differences, and iii) its association with measures of antisocial behaviour. METHOD: Twenty-seven IAPS pictures were selected to cover a wide range of affective content and were individually administered to a non-referred community sample of 659 7-11-year-old children using a paper-and-pencil version. Concurrent symptoms of conduct disorder, oppositional defiance and psychopathy were collected from multiple sources (teacher-, parent- and self-report). RESULTS: A quadratic relationship between arousal and valence, similar to that previously reported in adults, was demonstrated. A gender difference was found for valence ratings, with girls rating aversive pictures more unpleasant than boys. No gender differences for arousal ratings were found. A significant difference was found between groups scoring above and below cut-off scores on measures of antisocial behaviour. Children above cut-off reported lower arousal to unpleasant pictures, but higher arousal to pleasant pictures. CONCLUSIONS: We confirmed that a paper-and-pencil version of the IAPS for evaluating emotion response to affectively valent and arousing stimuli can be used in school settings and that comparable gender differences in emotional reactivity can be found in children. The differential emotional reactivity of children above cut-off on measures of antisocial behaviour suggested these symptoms to be associated with a combination of increased reward and decreased punishment sensitivity.

Affect↗
PubMed2001

Prospective monitoring of the Epstein-Barr virus DNA by a real-time quantitative polymerase chain reaction after allogenic stem cell transplantation.

Epstein-Barr virus (EBV)-related lymphoproliferative disorder (LPD) is a serious complication of haematopoietic stem cell transplantation (HSCT). To clarify the frequency, natural course and risk factors for LPD, we prospectively monitored 38 allogeneic (allo)-HSCT patients, focusing on the use of anti-thymocyte globulin (ATG). We used a recently developed real-time polymerase chain reaction assay to monitor EBV genome load. The subjects consisted of 19 patients given ATG for conditioning and 19 patients not given ATG. Of the 19 patients given ATG, 47.4% (nine patients) had a significant increase in EBV genome load (10(2.5) copies/microg DNA). Of these nine patients, two developed LPD. Therefore, 10.5% of the patients receiving allo-HSCT with ATG developed LPD. In contrast, none of the 19 patients without ATG had a significantly increased EBV load. The increases in viral load were observed in the second or third month after HSCT. We found that the peak viral loads of LPD patients were > 10(4.0 ) copies/microg DNA. On the other hand, the viral loads of most patients with no symptoms were < 10(2.5) copies/microg DNA. In conclusion, routine monitoring of EBV load during the second and third months after transplantation may benefit patients undergoing HSCT with ATG. We propose that an EBV load > 10(2.5) copies/microg DNA is the reactivation of EBV, and that an EBV load > 10(4.0) copies/microg DNA is indicative of developing LPD.

Adolescent↗