bluuebunny/crossref_metadata_2025 huggingface dataset:
Childrearing Discussions in Families of Nonproblem Children and ADHD Children With Higher and Lower Levels of Aggresive-Defiant Behavior
Authors: Johnston Charlotte , Behrenz Kim
Published: March 2008

The authors examined childrearing discussions in 14 couples with nonproblem children (NO), 14 couples with ADHD children with relatively little aggressive-defiant behavior (ADHD-LAD), and 14 couples with ADHD children with more aggressive-defiant behavior (ADHD-HAD). Discussions foucsed on attention deficit, oppositional, and conduct problem child behaviors. Couples' discussions were coded for the childrearing strategies suggested and the communication style. The groups did not differ in their suggested strategies, although more punishing responses were elicited by conduct problems and more proactive, preventive strategies by attention deficit behaviors. Couples in both ADHD groups were less positive in discussions of all behaviors and more negative in discussions of conduct problems than the NO couples. Couples with aggressize-defiant ADHD children were more negative than either the NO or ADHD-LAD group in disuccsions of ADHD behaviors. The implications for understanding interactions in families of ADHD children are discussed, as are suggestions for interventions designed to enhance couples' collaborative childrearing efforts.
Neurocognitive Approach to Remediation: The PREP Model
Authors: Das J.P.
Published: March 2008

The article establishes that a paradigm shift has occurred in assessment of intellectual abilities that may change the practice of IQ testing in school psychology. It discusses a reconceptualization of intelligence in terms of four major cognitive processes, Planning, Arousal-Attention, Simultaneous, and Successive (PASS), which have their base in neuropsychology and cognitive psychology. This PASS model is utilized for understanding reading. Specific reading disability is then considered for remediation. A remedial program, PREP (PASS remedial program), is described. Its success in improving both deficient word-reading and its underlying cognitive processes are examined. The advantage of first obtaining a cognitive profile of children who experience reading difficulty and subsequently proceeding with a rationally derived remediation program is discussed.
Identification of Students with Academic Difficulties: Implications for Research and Practice
Authors: Saint-Laurent Lise , Hébert Martine , Royer Égide , Pierard Brigitte
Published: March 2008

Many students with academic difficulties are not identified by schools as needing assistance. The traditional learning disabilities category appears to be less and less suitable given recent developments in special education that favor inclusion. Thus it is necessary to rethink procedures to identify students needing support and the implications of this for research and practice. This research was designed to examine the relationship between three procedures to identify students with academic difficulties in Quebec schools: teacher ratings, curriculum-based achievement tests, and identification of LD (learning disabilities) by the school. Results reveal that agreement between school identification and teacher rating is low. This agreement increased with subjects who had the lowest achievement test results. On the other hand, school identification and achievement scores are moderately associated. Finally, although achievement scores and teacher ratings are significantly correlated, only 50% of students with the lowest achievement test results are recognized by their teachers as having academic difficulties. The article concludes that further research is necessary to conceptualize in a new way the identification of students who need academic support.
Multidisciplinary School Teams: A Five-Year Follow-up Study
Authors: Cole Ester , Brown Rob
Published: March 2008

A total of 341 multidisciplinary staff members in 55 elenwntary and secondary schools participated in a 1995 study that identified the characteristics of students referred to school teams. The study was in part a replication of one done in 1990, with additional focus on team recommendations formulated during consultation. Many of the findings indicate that over the past five years, teams continued to focus on the same needs and the same model of service. The number of individual students referred to teams has somewhat increased, from a mean of 66 to a mean of 72 per year. The characteristics of sfudents referred to teams continue to emphasize academic performance deficits and social-emotional needs. Secondary teams were more likely to focus on school recommendations, whereas elententary teams were more likely to concentrate on class recommendations. Consultation with parents was viewed by team participants as highly important. Implications and suggestions for the practice of school psychology and multidisciplinary teams are discussed.
Styles of Thinking and Learning
Authors: Sternberg Robert J.
Published: March 2008

This article argues for the importance of thinking and learning styles. First, it describes the nature of styles of thinking and learning. Second, it briefly reviews some of the literature on styles. Third, it presents a theory of styles of thinking and learning. Fourth, it describes some of the measures we have used to assess these styles. Finally, it summarizes data we have collected to test and utilize the theory of styles.
Clinical Evaluation of Conversational Speech Fluency in the Acute Phase of Acquired Childhood Aphasia: Does a Fluency/Nonfluency Dichotomy Exist?
Authors: van Dongen Hugo R. , Paquier Philippe F. , Creten Wouter L. , van Borsel John , Catsman-Berrevoets Coriene E.
Published: March 2008

Traditional neurologic tenets claim that the clinical picture of acquired childhood aphasia is nonfluent irrespective of lesion location. In the past 20 years, however, several case studies have shown that fluent aphasic patterns can be observed in children with acquired childhood aphasia. But the question remains open as to whether the pattern of their speech characteristics is similar to the one described in adult aphasics as studies addressing spontaneous speech fluency characteristics in larger series of children with acquired childhood aphasia are scarce. The objective of this study was to investigate whether an analysis of spontaneous speech fluency as has previously been performed in adult aphasics by other investigators would also yield two distinct groups of aphasic children and, if so, whether the distribution of the different speech characteristics in both groups would reflect the rank order found in adults, that is, whether nonfluent verbal output characteristics would predominate in one group and fluent features in the other. Audiotaped and videotaped recordings of 24 cooperative children with acute acquired childhood aphasia unselected for age, gender, etiology, and aphasia severity ratings were analyzed according to 10 different speech characteristics. A cluster analysis (two-means clustering) was performed to seek the existence of two distinct groups of aphasic children. Results were confirmed, and exact P values were computed with Mann-Whitney U-tests. A two-means clustering created two distinct classes. Mann-Whitney U-tests ranked the speech characteristics according to their discriminating power between clusters. Comparing this rank order with the one previously found in adults revealed a high correlation (Spearman's rank correlation: rs = .915, P < < .005), thus indicating that the clusters we found were highly similar to the adult clusters. Thus, the use of the speech variables proposed to evaluate adult aphasic spontaneous speech enabled us to demonstrate a fluent/nonfluent dichotomy in a childhood aphasic population as well. This study shows that the traditional views on the uniformity of the clinical picture of acquired childhood aphasia are obsolete. Our findings corroborate data issued from several case reports of fluent acquired childhood aphasia and from the few studies focusing on speech fluency in acquired childhood aphasia, which all point to the existence of an adultlike heterogeneity of childhood aphasic syndromes. Current clinical evidence no longer supports the hypotheses of equipotentiality and progressive lateralization but favors the notion that the anatomic substrate for language representation in the child is similar to that in adults, even in young subjects. (J Child Neurol 2001;16:345-351).
Recurrence in Pituitary Adenomas in Childhood and Adolescence
Authors: Espay Alberto J. , Azzarelli Biagio , Williams Linda S. , Bodensteiner John B.
Published: March 2008

Pediatric pituitary adenomas are thought to behave more aggressively than their adult counterparts, and the ability to predict the degree of such behavior remains elusive. Proliferation marker Ki-67 and tumor suppressor gene p53 mutations have been used in adults to assist in the evaluation of invasiveness and recurrence; however, their use in childhood and adolescence remains anecdotal. Our study evaluates the proliferative potential in pituitary adenomas of five patients and its relationship with recurrence or persistence of endocrinologic or clinical abnormalities. For such assessment, tissues were stained with monoclonal antibodies BP53-12 for p53 tumor suppressor gene mutation and MIB-1, which binds to cell cycle-specific nuclear antigen Ki-67. In our series, one patient with recurrent adenoma demonstrated the highest (50%) p53 immunoreactivity. Ki-67-stained nuclei ranged from 0 to 2%, failing to identify the recurrent tumor. Therefore, p53 immunoreactivity, rather than Ki-67 nuclear stain, may be useful for identification of recurrent pituitary adenomas in childhood and adolescence. (J Child Neurol 2001;16:364-367).
Langerhans' Cell Histiocytosis Presenting as Intracranial Hypertension
Authors: Modan-Moses Dalit , Ben-Zeev Bruria , Feldman Ze'ev
Published: March 2008

Benign intracranial hypertension is known to be associated with obesity, endocrine abnormalities, various medications, and cerebral venous sinus thrombosis. We report a patient presenting with headaches and vomiting attributed to benign intracranial hypertension. The diagnostic work-up revealed Langerhans' cell histiocytosis of the occipital bone. There was no evidence for cerebral vein thrombosis by cranial computed tomography scan, Doppler ultrasonography, planar and single photon emission computed tomography technetium 99m-labelled red blood cell scintigraphy, and magnetic resonance angiography. Excision of the occipital bone lesion and a short course of acetazolamide and prednisone were curative. We hypothesize that cytokines secreted by the tumor were responsible for the development of intracranial hypertension. (J Child Neurol 2001;16:414-416).
Interleukin-1β, Interleukin-1 Receptor Antagonist Levels in Patients With Subacute Sclerosing Panencephalitis and the Effects of Different Treatment Protocols
Authors: Haspolat Senay , Anlar Banu , Köse Gülsen , Coskun Mesut , Yegin Olcay
Published: March 2008

Subacute sclerosing panencephalitis is a rare progressive inflammatory disease of the central nervous system caused by a persistent aberrant measles virus infection. Cytokines are polypeptides that regulate immune responses and inflammatory reactions. Interleuldn-1β has been implicated as a central mediator of tissue damage and destruction in a number of central nervous system diseases. Interleukin-1 receptor antagonist could function as an important anti-inflammatory cytokine. We studied interleukin-1β and interleukin-1 receptor antagonist levels in the cerebrospinal fluids of patients with subacute sclerosing panencephalitis and evaluated the effects of different treatment protocols on these cytokines. Interleukin-1β and interleukin-1 receptor antagonist levels were measured in 15 patients who had a recent diagnosis of subacute sclerosing panencephalitis (group 1), 6 patients who had been treated with isoprinosine (group 2), 5 patients with intraventricular interferon-α (group 3), and 6 patients with interferon-β (group 4). The results were compared within the groups and also with the results of 10 patients with other neurologic disease (group 5).The interleukin-1β concentrations in cerebrospinal fluid and sera were all below the detection limits (3.9 pg/mL). Interleukin-1 receptor antagonist levels were not statistically different, except for the group treated with intraventricular interferon-α. Interleukin-1 receptor antagonist levels were 170 ± 52, 175 ± 58, 1605 ± 518, 77.5 ± 24, and 108 ± 18 pg/mL in groups 1 to 5, respectively. Interleukin-1 receptor antagonist levels and cerebrospinal fluid serum ratios were significantly increased during interferon-α treatment. In conclusion, interleukin-1 and interleukin-1 receptor antagonist levels were not elevated in the patients with subacute sclerosing panencephalitis. The only treatment protocol that affects interleukin-1 receptor antagonist levels in cerebrospinal fluid was intraventricular interferon-α. Further studies on higher numbers of patients may better document the immunologic status of patients with subacute sclerosing panencephalitis and the effects of different treatment modes. (J Child Neurol 2001;16:417-420).
Association Between Electroencephalographic Findings and Neurologic Status in Infants With Congenital Heart Defects
Authors: Limperopoulos Catherine , Majnemer Annette , Rosenblatt Bernard , Shevell Michael I. , Rohlicek Charles , Tchervenkov Christo , Gottesman Ronald
Published: March 2008

Neurologic status is of concern in infants with congenital heart defects undergoing open heart surgery. The association between perioperative electroencephalography (EEG) with acute neurologic status and subsequent outcome was examined in a cohort of 60 infants. Preoperative EEG and neurologic examinations were performed within 1 to 2 days prior to surgery (n = 27) and postoperatively (n = 47). Prior to surgery, 15 of 27 infants had normal EEG, whereas 5 had epileptiform activity and 9 had disturbances in background activity that were primarily moderate (8/9) and diffuse (7/9). Postoperatively, only 17 of 47 infants had normal recordings. Newborns (<1 month) were more likely (P < .001) to demonstrate EEG abnormalities than infants. Epileptiform activity was documented in 15, whereas 28 had background abnormalities that were moderate-severe (22/28) and diffuse (20/28) in most. Epileptiform activity prior to surgery was always associated with an abnormal neurologic examination, and this association persisted postoperatively (86%). Moderate to severe background abnormalities in the postoperative EEG was also strongly associated with acute neurologic abnormalities (93%). Severe background abnormalities (n = 5) were 100% predictive of death or severe disability. Long-term follow-up revealed that all children with normal postoperative EEGs had positive neurologic outcomes (P = .04); however, there were many false positives. Perioperative EEG abnormalities increased the likelihood for acute neurologic findings, whereas normal recordings following surgery were reassuring with regard to a favorable outcome. (J Child Neurol 2001;16:471-476).
Leigh Disease: Clinical, Neuroradiologic, and Biochemical Study of Three New Cases With Cytochrome c Oxidase Deficiency
Authors: Savasta Salvatore , Comi Giacomo P. , Perini Maria P. , Lupi Assuero , Strazzer Sandra , Rognoni Felice , Rossoni Roberto
Published: March 2008

Three cases of Leigh disease are described. In all three, symptoms began in the first months of life, with muscle hypotonia, lactic acidosis, and psychomotor delay. The diagnosis was made on the basis of the clinical characteristics, biochemical abnormalities, and typical brain magnetic resonance imaging with symmetric lesions suggesting bilateral necrosis at the level of the basal ganglia and of the midbrain. Cytochrome c oxidase (complex IV of the mitochondrial respiratory chain) deficiency was demonstrated in muscle tissue in all patients and confirmed in skin fibroblasts in patient 3. A genetic heterogeneity was present in these patients since only one had a SURF-1 gene mutation. The clinical, biochemical, and neuroradiologic aspects are discussed. Finally, the finding of facial dysmorphisms in the cytochrome c oxidase deficiency observed in one of the described cases is of extreme interest; to our knowledge, this association has never been reported in the literature. (J Child Neurol 2001;16:608-613).
Prognostic Value of Auditory Brainstem Response for Neurologic Outcome in Patients With Neonatal Indirect Hyperbilirubinemia
Authors: Yilmaz Yüksel , Degirmenci Serpil , Akdas Ferda , Külekçi Sezer , Çiprut Ayça , Yüksel Şengül , Yildiz Feyza , Karadeniz Leyla , Say Aysu
Published: March 2008

To investigate the value of the auditory brainstem response as a reliable test for the neurologic prognosis of infants with neonatal indirect hyperbilirubinemia, auditory brainstem response studies were performed in 22 infants. The patients were followed up until 12 months of age. Two patients demonstrated pathologic auditory brainstem response consistent with auditory neuropathy but had no neurologic finding except a lack of speech at 12 months of age. Two other patients had neurologic sequelae, one showing severe dyskinetic cerebral palsy, the other mild hypotonia and motor retardation, but their auditory brainstem response results were normal. These results suggested that auditory brainstem response examination might not provide reliable information for the neurologic prognosis. Neurologic disturbances resulting from bilirubin neurotoxicity can be seen in patients with a normal auditory brainstem response, but patients with an abnormal auditory brainstem response may not have any neurologic dysfunction apart from speech retardation. (J Child NeuroL 2001;16:772-775).
Rett Syndrome: Clinical Manifestations in Males With MECP2 Mutations
Authors: Ben Zeev Bruria , Yaron Yuval , Schanen N. Carolyn , Wolf Haika , Brandt Nathan , Ginot Nathan , Shomrat Ruth , Orr-Urtreger Avi
Published: March 2008

Rett syndrome is a neurodevelopmental disorder characterized by cognitive and adaptive regression with autistic features, loss of acquired skills, and stereotypic hand movements that almost exclusively affects females. It is an X-linked dominant disorder, with presumed lethality in males. Nonetheless, there are a few descriptions of males suspected of having Rett syndrome. With the recent discovery that the MECP2 gene is responsible for most cases of Rett syndrome, it is possible to molecularly assess cases of affected males by direct sequencing analysis. We describe an Israeli family consisting of a female having classic Rett syndrome and a male sibling with severe neonatal encephalopathy. Molecular analysis revealed that both sister and brother have the same MECP2 gene mutation; however, their mother does not. This case, as well as other published studies of males with MECP2 mutations, reveals that the clinical manifestations in viable males vary from neonates with severe encephalopathy to adults with mental retardation and demonstrate genotype-phenotype correlations. (J Child Neurol 2002;17:20-24).
Mutation Analysis of MECP2 and Clinical Characterization in Korean Patients With Rett Syndrome
Authors: Jong Hee Chae  , Yong Seung Hwang  , Ki Joong Kim
Published: March 2008

Rett syndrome is a progressive neurodevelopmental disorder occurring predominantly in females. Recently, mutations in the MECP2 gene on Xq28, which encodes methyl-CpG binding protein 2, were identified as responsible for some cases of Rett syndrome. In the present study, we analyzed the entire coding sequence of the MECP2 gene in 20 sporadic cases of Rett syndrome in Korea. Of the 20 patients, 14 (70%) had pathogenic mutations, which included 10 different mutations. Altogether, there were five missense mutations (D97Y, L100V, R133C, T158M, R306C), four nonsense mutations (R168X, R255X, R270X, R294X), and one frameshift mutation (a 41-bp deletion at 1157-1197). Two of these were novel mutations (D97Y, L100V). Most of the nucleotide substitutions involved C to T transitions at CpG hotspots. We could find no clear phenotype-genotype correlation according to the type of mutation. However, there was a tendency for patients with no MECP2 mutation (30%) to show more severe symptoms and more rapid clinical progression than patients with mutations. Further studies are necessary to identify the other possible genetic causes of Rett syndrome. (J Child Neurol 2002;17:33-36).
Asymptomatic Idiopathic Intracranial Hypertension in Young Children
Authors: Weig Spencer G.
Published: March 2008

Presenting symptoms of idiopathic intracranial hypertension are known to vary with age. Older children may complain of headache, neck pain, diplopia, intracranial noises, or transient visual obscurations. Younger children may present with apathy or irritability. This report describes three young children with no obvious relevant symptoms in whom papilledema was newly found on routine follow-up eye examination for unrelated problems. At presentation, all had early papilledema with negative cranial neuroimaging studies. All remained apparently asymptomatic, but the papilledema progressed. Sedated lumbar puncture showed elevated cerebrospinal fluid pressure in all three. Two were felt to have truly idiopathic intracranial hypertension, whereas the third had jugular venous obstruction. The papilledema responded to treatment with either acetazolamide or furosemide in all three. An apparent lack of symptoms does not rule out chronic increased intracranial pressure in young children. (J Child Neurol 2002;17:239-241).
Dietary Intake and Blood Folate Levels in Honduran Women of Childbearing Age
Authors: Holden Kenton R. , Collins Julianne S. , Greene Jennifer F. , Hinkle Sara , Nave Amanda F. , Portillo J. Manuel , Page Grier P. , Stevenson Roger E.
Published: March 2008

Neural tube defects are common birth defects, the frequency of which appears to be reduced by maternal supplementation and/or fortification of folic acid. Latin Americans have a high incidence of neural tube defects. We surveyed the dietary intake of Honduran women of childbearing age using a 24-hour dietary recall questionnaire in inner-city, town, and country areas. We randomly checked blood folate in the surveyed population to compare to the normal range for the US population. Normal US recommended dietary allowance intake of folate was documented in association with a low intake of many other essential nutrients. There also were significant differences for nutrient intakes in city, town, and country areas. Blood folate levels in all locations were in the low normal range when compared to the presupplementation/ prefortification US population. Our data support using an established folic acid fortification public health initiative to decrease the prevalence of neural tube defects in Honduras. (J Child Neurol 2002;17:341-346).
Neuronal Density and Architecture (Gray Level Index) in the Brains of Autistic Patients
Authors: Casanova Manuel F. , Buxhoeveden Daniel P. , Switala Andrew E. , Roy Emil
Published: March 2008

Although neuropathologic studies have centered on small samples, it is accepted that brains of autistic individuals tend to be large, on average. Knowledge regarding the cause of this macrocephaly is limited. Postmortem studies reveal little in terms of cortical dysplasia. Some of these studies suggest increased cell-packing density in subcortical structures. These neuronomorphometric studies have been subjective or based their conclusions on measures of neuronal density. Our study sought the possible presence of increased cell-packing density by using the Gray Level Index. The Gray Level Index is defined as the ratio of the area covered by Nissl-stained elements to unstained area in postmortem samples. Analyzed images included Brodmann's cortical areas 9, 21, and 22 of 9 autistic patients (7 males, 2 females; mean age of 12 years, with a range of 5 to 28 years) and 11 normal controls (7 males, 4 females; mean age of 14 years, with a range of 3 to 25 years). The overall multivariate test revealed significant differences both between autistic patients and controls (P = .001) and between hemispheres (P = .025). Follow-up univariate tests showed significant diagnosis-dependent effects in feature distance (P = .005), the standard deviation in distance (P = .016), and feature amplitude (P = .001). The overall mean Gray Level Index was 19.4% in controls and 18.7% in autism (P = .724). In autism, an increased number of minicolumns, combined with fewer cells per column (or their greater dispersion), results in no global difference in neuronal density. (J Child Neurol 2002;17:515-521).
Combined Genetic Defects in a Child With Ischemic Stroke: Case Report
Authors: Deda Gillhis , Içağasioğlu Dilara , Qaksen Hüseyin , Akar Nejat
Published: March 2008

A 10-year-old Turkish boy was admitted with mild right spastic hemiplegia. First, he experienced sudden numbness and weakness in the right extremities at the age of 2 years and was diagnosed with right hemiparesis. His parents were generally healthy and nonconsanguineous. His mother suffered from deep vein thrombosis of the left lower extremity during pregnancy and had recurrent fetal loss. At the age of 10 years, a thrombophilia marker examination revealed that plasma-free protein S was 49.3% (normal range = 70-123%), and factor VIII level was found to be 470 IU/dL (normal = 150 IU/dL). The patient and his two siblings were found to be heterozygous for factor V Leiden mutation. His mother was also heterozygous for factor V Leiden mutation and had protein S deficiency A combination of protein S deficiency, factor V Leiden mutation, and a high level of factor VIII was detected in our patient. After his first attack at the age of 2 years, in spite of no prophylaxis, he did not experience any other ischemic insult. To our knowledge, this is the first patient with these combinations of genetic defects and ischemic stroke to be reported in the literature. (J Child Neurol 2002;17:533-534).
Severe Spinal Muscular Atrophy Variant Associated With Congenital Bone Fractures
Authors: Felderhoff-Mueser Ursula , Grohmann Katja , Harder Anja , Stadelmann Christine , Zerres Klaus , Bührer Christoph , Obladen Michael
Published: March 2008

Infantile autosomal recessive spinal muscular atrophy (type I) represents a lethal disorder leading to progressive symmetric muscular atrophy of limb and trunk muscles. Ninety-six percent cases of spinal muscular atrophy type I are caused by deletions or mutations in the survival motoneuron gene (SMN1) on chromosome 5q11.2-13.3. However, a number of chromosome 5q-negative patients with additional clinical features (respiratory distress, cerebellar hypoplasia) have been designated in the literature as infantile spinal muscular atrophy plus forms. In addition, the combination of severe spinal muscular atrophy and neurogenic arthrogryposis has been described. We present clinical, molecular, and autopsy findings of a newborn boy presenting with generalized muscular atrophy in combination with congenital bone fractures and extremely thin ribs but without contractures. (J Child Neurol 2002;17:718-721).
Mitochondrial DNA Deletion in a Child Mitochondrial DNA Deletion in a Child With Megaloblastic Anemia and Recurrent Encephalopathy
Authors: Akman Cigdem Inan , Sue Carolyn M. , Shanske Sara , Tanji Kurenai , Bonilla Eduardo , Ojaimi Joceline , Krishna Sindu , Schubert Romaine , DiMauro Salvatore
Published: March 2008

A 3½-year-old boy presented with megaloblastic anemia and recurrent episodes of severe lactic acidosis and coma. At age 4 years, he developed sepsis and died; postmortem examination failed to show any gross abnormality in any tissue. Biochemical analysis of muscle showed decreased activities for all respiratory chain enzymes except complex II. Muscle histochemistry revealed diffuse cytochrome c oxidase deficiency. Southern blot analysis of mitochondrial DNA from muscle, liver, and blood showed a heteroplasmic single mitochindrial DNA deletion of 2.4 kb, which removed the genes for cytochrome c oxidase I and II and the transfer ribonucleic acid genes for serine and aspartic acid. Single large-scale deletions in mitochondrial DNA have been associated with Pearson's syndrome, Kearns-Sayre syndrome, and progressive external ophthalmoplegia. This patient's presentation is unusual and suggests an overlap between Pearson's syndrome and Kearns-Sayre syndrome. (J Child Neurol 2004;19:258-261).
Factors Associated With Poor Control in Partial Complex Epilepsy
Authors: Verrotti Alberto , Latini Giuseppe , Giannuzzi Raffaella , Cutarella Rocco , Trotta Daniela , Morgese Guido , Chiarelli Francesco
Published: March 2008

To evaluate the predictive factors of response to anticonvulsant therapy in children with complex partial epilepsy, we studied prospectively 74 children and adolescents suffering from this type of epilepsy. All children were prospectively followed for at least 2 years after the beginning of anticonvulsant therapy. At the end of follow-up, the children were subdivided into two groups according to the frequency of seizures: group A, children who were seizure free in the last year, and group B, children with at least six seizures in the previous year. Children with a poor response to anticonvulsant therapy had a more frequent personal history of neonatal seizures, an interval of less than 6 months between the first and the second seizures, and persistent abnormal electroencephalograms than the seizure-free patients and were often treated with poly-therapy. (J Child Neurol 2004;19:262-264).
Prevalence of Epilepsy in Turkish Children Between the Ages of 0 and 16 Years
Authors: Serdaroglu Ayşe , Ozkan Seçil , Aydin Kürşad , Gücüyener Kivilcim , Tezcan Sabahat , Aycan Sefer
Published: March 2008

The aim of this cross-sectional study was to determine the prevalence of epilepsy in Turkey among children between the ages of 0 and 16 years. The study population consisted of 24,773,569 children living in Turkey. Because the prevalence of childhood epilepsy is reported to be 0.001 to 1% in the literature, the sample size was determined as 48,260, with 0.05 error type I and 0.10 error type 2 (power 0.90), and the effect size was 2. With the cluster sampling method, samples were selected from cities, towns, districts, and villages, and 46,813 (97%) children were reached. The study questionnaire contained sections with individual informational questions and questions for the selection of suspected epilepsy cases and physical examination results. The epilepsy classification was designed according to the classification of the International League Against Epilepsy (ILAE). The prevalence of epilepsy was determined as 0.8%; 55.2% of the subjects with epilepsy were grouped as generalized, 39% as partial, and 5.8% as unidentified. Age, place of residence, route of delivery, place of delivery, and social and economic status had no statistically significant effect on the development of epilepsy. Male gender, preterm, and post-term delivery increased the risk of developing epilepsy. Early diagnosis and treatment of epilepsy, as well as the education of health workers and families, are very important. (J Child Neurol 2004;19:271-274).
Feeling Lonely: A Parse Method Study With Children
Authors: Karnick Paula M.
Published: March 2008

Feeling lonely is a phenomenon experienced by all humans. The purposes of this research study were to discover the structure of the experience of feeling lonely, to contribute to nursing knowledge, and to expand the knowledge of feeling lonely. The Parse research method was used to guide this study and answer the research question: What is the structure of the lived experience of feeling lonely? Participants were 10 children ages 7 to 10 years. The central finding of this study was the following structure: The lived experience of feeling lonely is distressing isolation amid contentedness arising with cherished engagements. New knowledge extended the theory of humanbecoming and enhanced understanding of the experience of feeling lonely.
Urinary Incontinence and Self-Reported Health Among the U.S. Medicare Managed Care Beneficiaries
Authors: Chang Chih-Hung , Gonzalez Chris M. , Lau Denys T. , Sier Herbert C.
Published: March 2008

Objectives: To examine the prevalence and management of urinary incontinence (UI) and their impact on self-reported health in the U.S. Medicare managed care beneficiaries. Methods: Data were from the 2003 Medicare Health Outcomes Survey Cohort VI Baseline. Only beneficiaries aged 65 years or older and who self-completed the telephone interview were included. Results: About 37% of the study sample ( N = 82,196) reported having accidental urine leakage (the UI group). A total of 75% of the UI group indicated UI's being a problem and 41% of them had spoken with a doctor about it. Of these, 50% had received treatment. The findings indicate the UI group generally had significantly worse SF-36 Survey Scale scores than the non-UI group with and without adjusting other covariates. Discussion: UI is prevalent but undertreated as it adversely affects many health domains in this population. This study highlights the need for early detection, proper education, and access to effective treatment options for UI in the elderly.
Blood β-glucuronidase as a suitable biomarker at acute exposure of severe organophosphorus poisoning in human
Authors: Soltaninejad K , Shadnia S , Afkhami-Taghipour M , Saljooghi R , Mohammadirad A , Abdollahi M
Published: March 2008

Organophosphorus compounds are known to cause the selective release of liver microsomal β-glucuronidase into plasma. Organophophoruses may induce nitrosative stress leading to the generation of nitrogen free radicals and alterations in scavengers of free radicals in many biological systems. In this study, we investigate how acute human organophosphorus intoxication is associated with changes of blood nitric oxide, total thiol molecules, and activities of the acetylcholinesterase and β-glucuronidase. A total of 21 acute organophosphorus-poisoned patients were recruited into study and were divided into two groups of mildly (13) and severely affected (9); 26 age-matched healthy volunteers were recruited as control group. Results indicated that both mildly and severely affected patients had lower acetylcholinesterase activities as compared to controls. The extent of acetylcholinesterase reduction in the severely affected patients was higher than that of mildly affected patients. A significant increase in serum β-glucuronidase was observed only in severely affected patients as compared to controls. Both mildly and severely affected patients had lower plasma total thiol molecules as compared to controls. The extent of reduction of total thiol molecules in the severely affected patients was higher than that of mildly affected patients. No significant difference was observed in plasma total nitric oxide of controls and patients. It is concluded that nitrosative stress has a minor role in toxicity of organophosphorus, whereas blood β-glucuronidase is very sensitive biomarker at high exposure of severe organophosphorus poisoning.
Protective role of curcumin in myocardial oxidative damage induced by isoproterenol in rats
Authors: Nazam Ansari M , Bhandari U , Pillai KK
Published: March 2008

This study was designed to investigate the effect of oral curcumin pretreatment (200 mg/kg) on isoproterenol-induced myocardial injury in rats. Isoproterenol (85 mg/kg, s.c., in two divided doses at 24 h intervals) administration induced a statistically significant increase ( P < 0.01) in serum lactate dehydrogenase, creatine kinase, aspartate transaminase, and alanine transaminase activities and significant increase ( P < 0.01) in myocardial lipid peroxides levels as compared to vehicle control rats. Furthermore, significant depletion ( P < 0.01) of myocardial endogenous antioxidants viz. superoxide dismutase, catalase, and tissue glutathione levels were also found in the pathogenic control group, that is, isoproterenol only treated animals. Curcumin (200 mg/kg) pretreatment for 20 days in isoproterenol treated rats significantly lowered ( P < 0.01) the serum lactate dehydrogenase, creatine kinase, aspartate transaminase, alanine transaminase, and myocardial lipid peroxides levels and increased the levels of myocardial endogenous antioxidants (superoxide dismutase, catalase, and tissue glutathione) as compared to pathogenic control rats. Furthermore, histological examination of rat’s heart section confirmed myocardial injury with isoproterenol administration and near normal pattern with curcumin pretreatment. The results of our study provide clear evidence that the curcumin pretreatment enhances the antioxidant defense against isoproterenol-induced oxidative myocardial injury in rats and exhibit cardioprotective property.
Sublethal concentrations of gemcitabine (2′,2′-difluorodeoxycytidine) alter mitochondrial ultrastructure and function without reducing mitochondrial DNA content in BxPC-3 human pancreatic carcinoma cells
Authors: Yeo TK , Kintner J , Armand R , Perez R , Lewis LD
Published: March 2008

2′,2′-Difluorodeoxycytidine (gemcitabine), a pyrimidine nucleoside analog, is used therapeutically in the treatment of pancreatic, non-small cell lung, and breast cancer. The cytotoxic effect of gemcitabine is thought to be due to masked chain termination after the triphosphorylated anabolite of the drug is incorporated into nascent DNA strands. We tested the hypothesis that sublethal concentrations of gemcitabine inhibit DNA polymerase γ and reduce mitochondrial DNA content in BxPC-3 and MOLT-4 cell lines, and we used 2′,3′-dideoxycytidine, a known inhibitor of DNA polymerase γ as a positive control. The 6-day BxPC-3 cell growth IC50for gemcitabine and 2′,3′-dideoxycytidine was 0.003 μM (SD ± 0.0005) and 14.5 μM (SD ± 4.7), respectively, and in MOLT-4 cells was 0.002 μM (SD ± 0.001) and 0.86 μM (SD ± 0.23), respectively. These drug concentrations were anti-proliferative but non-cytotocidal. Electron photomicrographic studies showed deranged mitochondrial cristae patterns in BxPC-3 cells treated with either gemcitabine or 2′,3′-dideoxycytidine for 6 days. Mitochondrial oxidative phosphorylation dysfunction was observed as reflected by increased lactate concentration in the media of cells exposed to gemcitabine, but to a much greater extent in cells exposed to 2′,3′-dideoxycytidine. PCR analysis showed that gemcitabine did not reduce mitochondrial DNA content in either BxPC-3 or MOLT-4 cells, but 2′,3′-dideoxycytidine did. The effect of gemcitabine on mitochondrial ultrastructure and function did not concomitantly yield a reduction in mitochondrial DNA content. Therefore, the molecular target(s) by which gemcitabine and 2′,3′-dideoxycytidine produce mitochondrial abnormalities in these cells appear to be different.
Inhibitory role of Acorus calamus in ferric chloride–induced epileptogenesis in rat
Authors: Hazra R , Ray K , Guha D
Published: March 2008

The roots and rhizomes of Acorus calamus (Family: Araceae) have been used in the ancient systems of medicine for the treatment of various neurological disorders. Of the various methods used for inducing experimental epileptic models, the intracortical administration of ferric chloride (FeCl3) into sensorimotor cortex induces recurrent seizures and epileptic discharge similar to human post-traumatic epilepsy through the generation of free radicals. The present study focuses on the effect of Acorus calamus on the behavioral, electroencephalographic, and antioxidant changes in FeCl3-induced rat epileptogenesis. Topical administration of FeCl3 (5 μL; 100 mM) into the sensorimotor cortex of rats showed an increase in the wet dog shake behavior, spike wave discharges together with an significant increase in antioxidant enzyme activity, such as superoxide dismutase and catalase, resulting in an increase in the level of lipid peroxidation in cerebral cortex. Pretreatment with Acorus calamus (200 mg/kg b.w., p.o. for 14 days) and also diazepam (DZ, 20 mg/kg b.w., i.p.) decreased the WDS behavior, spike wave discharges with single isolated positive waves, and a significant decrease in activity of superoxide dismutase and level of lipid peroxidation was observed in cerebral cortex with respect to those observed in FeCl3-induced epileptic group. Data presented in this study clearly show that Acorus calamus possesses the ability for preventing the development of FeCl3-induced epileptogenesis by modulating antioxidant enzymes, which in turn exhibit the potentiality of Acorus calamus to be developed as an effective anti-epileptic drug.
Effect of sulphated polysaccharides on erythrocyte changes due to oxidative and nitrosative stress in experimental hyperoxaluria
Authors: Veena CK , Josephine A , Preetha SP , Varalakshmi P
Published: March 2008

Kidney stones are known to haunt humanity for centuries and increase in oxalate is a predominant risk factor for stone formation. The present study was initiated with a notion to study the oxidative and nitrosative stress on erythrocytes under oxalate stress and the putative role of sulphated polysaccharides. Hyperoxaluria was induced in two groups by the administration of 0.75% ethylene glycol in drinking water for 28 days and one of them was treated with sulphated polysaccharides from Fucus vesiculosus from the 8th day to the end of the experimental period of 28 days at a dose of 5 mg/kg body weight subcutaneously. Control and drug control (sulphated polysaccharides alone) were also included in the study. Glycolic and glyoxylic acid levels of urine were analyzed as an index of hyperoxaluria. The plasma enzymic markers of cellular integrity, redox status of red blood cells, osmotic fragility, and 14C-oxalate binding were investigated. Urine and plasma nitric oxide metabolites, expression of inducible nitric oxide synthase protein, and mRNA were assessed in kidney to evaluate the nitrosative stress. Increased levels of glycolic and glyoxylic acid in urine indicated the prevalence of hyperoxaluria in ethylene glycol–administered groups. Plasma aspartate and alanine transaminase were not altered, but alkaline phosphatase and lactate dehydrogenase of hyperoxaluric group were increased indicating tissue damage. Activities of antioxidant enzymes were decreased, whereas erythrocyte membrane lipid peroxidation was increased in hyperoxaluric rats. Moreover, an altered fragility with an increase in oxalate binding activity was observed in hyperoxaluric group. Increase in nitric oxide metabolites levels in urine and plasma along with an increase in expression of inducible nitric oxide synthase protein and mRNA in kidney were observed in hyperoxaluric rats. Administration of sulphated polysaccharides to hyperoxaluric rats averted the abnormal increase in urinary glycolic and glyoxylic acid levels and enzyme activities, decreased lipid peroxidation, and increased the activities of antioxidant enzymes. Furthermore, increased nitrosative stress accompanying hyperoxaluria was also normalized on sulphated polysaccharides treatment. To conclude, sulphated polysaccharide administration was able to maintain the integrity of erythrocyte membrane and decrease the damage to erythrocytes in hyperoxaluria.
Acute pancreatitis: a lesser-known complication of aluminum phosphide poisoning
Authors: Verma SK , Ahmad S , Shirazi N , Barthwal SP , Khurana D , Chugh M , Gambhir HS
Published: March 2008

There have been no case reports on aluminum phosphide–induced pancreatitis in the literature available. In this report, we present the case of a young man who developed acute pancreatitis and probably acute myocarditis following ingestion of aluminum phosphide pellets in the absence of the usual risk factors and after exclusion of other possible causes of pancreatitis. In the absence of re-challenge, we put forth the probable causative association of pancreatitis with aluminum phosphide or phosphine gas, its active pesticidal component.
Poisoning with 1-propanol and 2-propanol
Authors: Vujasinović M , Kočar M , Kramer K , Bunc M , Brvar M
Published: March 2008

1-Propanol and 2-propanol are isomers of an alcohol with three carbons. They are colorless liquids with a sweet odor. 1-Propanol is metabolized by alcohol dehydrogenase to propionic acid and presents with metabolic acidosis and elevated anion gap, whereas 2-propanol is metabolized by alcohol dehydrogenase to acetone and presents with rapidly developing (within 3–4 h after exposure) ketosis and ketonuria but without metabolic acidosis. We report a patient who simultaneously ingested a lethal dose of 1-propanol and 2-propanol as a hand disinfectant in hospital. The patient lost consciousness and stopped breathing within half an hour after ingestion. He was intubated and artificially ventilated. Initial laboratory results showed mixed acidosis with elevated anion gap, but ketonuria appeared only 12 h after admission and 6 h following the regaining of consciousness. Therefore, laboratory results in simultaneous poisoning with two isomers of alcohol are not just a sum of laboratory results obtained in isolated poisoning with each isomer because they influence each other’s metabolism: 1-propanol retards the metabolism of 2-propanol to acetone. In conclusion, 1-propanol and 2-propanol poisoning presents early with mixed acidosis and elevated anion gap and only later with ketonuria.
Bromism caused by mix-formulated analgesic injectables
Authors: Hsieh PF , Tsan YT , Hung DZ , Hsu CL , Lee YC , Chang MH
Published: March 2008

Bromism, chronic bromide intoxication, can be caused by a variety of medicines, but bromism due to pain-relieving injectable medications has not been reported. In this study, the methods used were internet searching on bromide-containing injectables available in Taiwan and the first case report of bromism due to mixed-formulated injectable medication. Many analgesic/antipyretic and antihistamine injections containing bromides are still being used in Taiwan. They contain sodium bromide up to 1000 mg/ampoule or calcium bromide up to 800 mg/amp. A 25-year-old female suffered from forgetfulness and unstable gait after long-term frequent injections of a preparation to relieve head and neck pain. Blood tests showed hyperchloremia (171 mEq/L) and a negative anion gap (−48.7 mEq/L). Serum bromide measured 2150 mg/L. She recovered completely in 3 days with saline treatment. Many bromide-containing injections are still being used in Taiwan. Clinicians should keep alert on this issue to avoid iatrogenic bromism or making misdiagnoses.
Two cases of valproic acid poisoning treated with l-carnitine
Authors: Chan YC , Tse ML , Lau FL
Published: March 2008

Two cases of acute valproic acid poisoning with central nervous system depression and raised ammonia level without hepatotoxicity were reported. They were treated successfully with the use of the antidotes: l-carnitine and other supportive measures. Clinical manifestation and progress was described, and discussion is focused on the use of l-carnitine in valproic acid–induced hyperammonemia, from its mechanism to the clinical experiences in the literature. Based on the favorable response of our two cases and the literature review, we recommend the administration of intravenous l-carnitine in patients of valproic acid overdose with hyperammonemia or valproic acid–induced hyperammonemic encephalopathy and hepatotoxicity at a dose of 50 mg/kg every 8 h for the first initial 24 h with further individual assessment.