No description available.

Objectif : To determine the frequency and the nature of complications and sequelae of serogroup B and serogroup C meningococcal disease, during a recrudescence caused by a virulent clone of serogroup C, serotype 2a Neisseria meningitidis. To evaluate the quality of life of survivors. Methods. The study population included all cases of culture-proven serogroup B and C meningococcal disease reported in the province of Quebec, Canada, between 1 January 1990 and 31 December 1994. Complications and sequelae were assessed by review of medical files, postal questionnaires, and telephone interviews. Results. There were 167 cases of serogroup B and 304 cases of serogroup C infection. The largest number of cases was observed in the under 1 year age group for serogroup B and in the 10-19 year age group for serogroup C. Fatality rates were 7% for serogroup B and 14% for serogroup C. %). Only 3% of survivors of serogroup B cases had physical sequelae. 15% of survivors of serogroup C infection had one or more significant physical sequelae (skin scars 12%, amputations 5%, significant sensorineural hearing loss 2%, renal failure 1%, other sequelae 4%. Among cases without identified physical sequelae who completed the questionnaire, 19% reported a reduction in their quality of life attributable to the disease. Conclusions. These results confirm the gravity of disease caused by serogroup C, serotype 2a Neisseria meningitidis and support vaccination for control of outbreaks and epidemics of disease caused by this particular strain.

Technological advances in neonatal care have dramatically improved the survival and disability rates among low birthweight infants (LBW). One common factor associated with later problems among these babies is intraventricular hemorrhage (IVH). A meta-analysis was conducted among LBW infants with and without IVH to determine developmental outcome. More than 450 studies were located. Only 125 studies met inclusion criteria. Mean effect sizes were computed by comparing the LBW group to either a fullterm children, LBW children scored worse in all areas except gross motor skills. Cognitive assessment was done commonly up to 6 years of age. LBW infants scored about 1/2 standard deviation below their comparison group. A positive linear trend was found for severity of IVH: those children without an IVH scored comparably to fullterm children, while those with severe bleeds were about one standard deviation behind. Assessment of academic skills was done with the 8- to 11-year olds. There was no information given on presence/severity of IVH. Very few assessments were done. On general academic measures, the LBW children scored about 1/2 standard deviation behind the comparison group. Over 80% of the language assessments were done at 15- to 38-months of age. LBW children tended to score 1/2 to 3/4 of a standard deviation below the comparison group. The severity of hemorrhage did not mediate these results. Fine motor assessments were performed on children 9 months to 11 years old. LBW children were about 2/3 of a standard deviation behind the comparison group. These skills were not affected by severity of IVH. Gross motor abilities were typically measured before the children were 24 months old. LBW children showed more deficits in this area than in any other: almost 90% of a standard deviation behind. Gross motor skills appear to be strongly impacted both by being low birthweight and by the severity of IVH. Results indicate that IVH is a mediating factor in outcome among LBW infants. More research needs to be conducted on these children when they are school age, so long-term effects of low birthweight can be determined.

Bibliography: leaves 196-251 / ii, 251 leaves : ill ; 31 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, 1987

<p>Unga vuxna som överlevt barncancer i centrala nervsystemet (CNS) löper ökad risk för negativa neuropsykologiska, fysiska och psykologiska sena effekter. Låg självkänsla är en riskfaktor för psykisk ohälsa men tidigare forskning om hur barncancer i CNS och dess behandling påverkar självkänsla är begränsad. Med självrapporteringsformuäret Self Esteem Questionnaire (SEQ-42) undersöktes självkänsla hos en populationsbaserad rikstäckande kohort med 528 unga vuxna överlevare jämfört med 995 personer i en stratifierad kontrollgrupp. Patientgruppen hade signifikant lägre självkänsla än kontroller i fem av sex dimensioner i SEQ-42 (<em>p</em> <0,0001). Bland patienterna var den sammanfattande globala självkänslan positiv (skalvärde > 2,5) hos en majoritet, 78,2%, men risken för negativ självkänsla var i flera dimensioner dubbelt så stor för patientgruppen jämfört med kontrollgruppen. Kvinnor och personer med diagnoserna oligodendrogliom, medulloblastom/PNET, kraniala och spinala germinom eller kraniofaryngeom hade lägre självkänsla än andra undergrupper (<em>p</em> < 0,0001 – 0,037).</p><p> </p>

Unga vuxna som överlevt barncancer i centrala nervsystemet (CNS) löper ökad risk för negativa neuropsykologiska, fysiska och psykologiska sena effekter. Låg självkänsla är en riskfaktor för psykisk ohälsa men tidigare forskning om hur barncancer i CNS och dess behandling påverkar självkänsla är begränsad. Med självrapporteringsformuäret Self Esteem Questionnaire (SEQ-42) undersöktes självkänsla hos en populationsbaserad rikstäckande kohort med 528 unga vuxna överlevare jämfört med 995 personer i en stratifierad kontrollgrupp. Patientgruppen hade signifikant lägre självkänsla än kontroller i fem av sex dimensioner i SEQ-42 (p &lt;0,0001). Bland patienterna var den sammanfattande globala självkänslan positiv (skalvärde &gt; 2,5) hos en majoritet, 78,2%, men risken för negativ självkänsla var i flera dimensioner dubbelt så stor för patientgruppen jämfört med kontrollgruppen. Kvinnor och personer med diagnoserna oligodendrogliom, medulloblastom/PNET, kraniala och spinala germinom eller kraniofaryngeom hade lägre självkänsla än andra undergrupper (p &lt; 0,0001 – 0,037).

Kawasaki disease (KD) is the most common cause of paediatric acquired heart disease, which may be attributed to the combined effects of infection, immunological response, and genetic susceptibility. The most severe complication in KD is acute coronary artery lesions (CALs), including myocardial infarction and coronary artery aneurysms. Mounting evidence indicates that adhesion molecules and chemokines play an important role in inflammation and cardiovascular disease on basis of pathogenesis. Thus, this study aimed to investigate the association of seven single nucleotide polymorphisms (SNPs) of adhesion molecules and chemokines (P-selectin 290G>A, PSGL-1 62G>A, MCP-1 -2518A>G, SDF-1 -801G>A, PECAM-1 L125V, PECAM-1 S563N and PECAM-1 R670G) with the risk of KD, sequelae of CALs and initial intravenous immunoglobulin (IVIG) treatment failure. A total of 301 KD children (185 without acute and chronic CALs, 81 with acute but without chronic CALs, and 33 with acute and chronic CALs) and 246 sex-matched healthy controls were recruited in the case-control study. In addition, 166 cases from the above KD children and 332 parents were recruited to carry out case-parent trio study. We found that PECAM-1 3 SNPs polymorphisms were not associated with above several risks, except for CALs in chronic stage. As compared with non-Leu-Ser-Arg haplotype, Leu-Ser-Arg haplotype was associated with a significant increased risk for CALs in the chronic stage (AOR 2.50, 95% CI 1.05-6.00, P=0.039). Analyses based on the diplotypes of PECAM-1 also showed that Leu-Ser-Arg allele had a significant increased risk of CALs in chronic stage in dominant manner (AOR 2.98, 95% CI 1.15-7.72, P=0.024). In addition, carriers of Leu-Ser-Arg allele had significant increased counts of platelet (¡Ñ1000/Cumm) (672.6¡Ó207.6 versus 563.1¡Ó196.8; P=0.027) within 10 days of diagnosis of KD. Moreover, we also found a significant correlation between each SNP and polymorphonuclear neutrophil counts by genotype analysis. As for other genes, there were no markedly different outcomes regardless of the risk of KD, sequelae of CALs or initial IVIG treatment failure. In conclusion, the haplotype Leu-Ser-Arg of PECAM-1 is a genetic marker of susceptibility to sequelae of chronic CALs for KD patients. However, the role of PECAM-1 SNPs in CALs formation in the chronic stage in KD patients still needs further evaluation.

Hintergrund: Die Neuroborreliose ist eine bei etwa 10-15% der Patienten auftretende Folge der Infektion mit Borrelien. Die typische Klinik im Erwachsenenalter besteht zumeist aus einer polyradikulitischen Symptomatik, die als Bannwarth-Syndrom bezeichnet wird. Dagegen manifestiert sich die Neuroborreliose im Kindes- und Jugendalter meist mit einer monolateralen fazialen Parese oder einer Meningitis. Während im Erwachsenenalter neuropsychologische Langzeitfolgen nach stattgehabter Neuroborreliose anzunehmen sind, ist das mögliche Ausmaß von Langzeitfolgen im Kindes- und Jugendalter bislang noch unklar. Methoden: Das untersuchte Patientenkollektiv bestand aus 29 Patienten, die im Kindes- oder Jugendalter im Zentrum für Kinderheilkunde und Jugendmedizin der Universitätsmedizin Göttingen mit der Diagnose einer Neuroborreliose stationär behandelt wurden. Zum Zeitpunkt der Diagnose betrug das mittlere Alter der Patienten 9,0 ± 2,9 Jahre und es waren durchschnittlich 14,7 ± 3,4 Jahre zwischen Diagnosestellung und Testung vergangen. Das Patientenkollektiv wurde mit einer alters-, bildungs-, und geschlechtsgenormten, gesunden Kontrollgruppe (n=29) verglichen. Die Untersuchung setzte sich aus einer medizinischen Anamnese, einer neurologischen Untersuchung, Fragebögen zur psychiatrischen Beurteilung und einer neuropsychologischen Testbatterie zusammen. Den einzelnen neuropsychologischen Tests wurden Domänen zugeordnet. In der neuropsychologischen Testbatterie wurden die Domänen Aufmerksamkeit, Arbeitsgedächtnis, verbales Lernen und Gedächtnis, non-verbales Lernen und Gedächtnis, visuo-konstruktive Funktionen und frontale Exekutivfunktionen geprüft. Ergebnisse: Die Probanden zeigten signifikant häufiger milde neurologische Einschränkungen. Am Häufigsten fand sich eine residuelle faziale Parese. Hierbei korrelierten die Ergebnisse der neurologischen Untersuchung nicht mit den Ergebnissen der neuropsychologischen Testung. In der neuropsychologischen Testbatterie fanden sich keine signifikanten Unterschiede zur gesunden Kontrollgruppe. Fazit: Im Gegensatz zur durchgemachten Neuroborreliose im Erwachsenenalter, scheint die Erkrankung im Kindes- und Jugendalter nicht mit relevanten neuropsychologischen Langzeitfolgen einherzugehen.

The blind have generally been considered to be a homogeneous population whose deficits arise from an interaction of loss of vision, age of onset and socialization. Sequelae are posited to exist merely due to the limiting effects of blindness on experience. This is believed to affect all blind persons equally regardless of cause of blindness provided that independent secondary disabilities do not exist. This study investigated the possibility that different causes of blindness are related to specific neuropsychological deficits which cannot be explained by the mere presence of blindness. It was found that neuropsychological differences existed among specific sub-populations of blind persons. These results suggested that the cause of blindness may be a marker for specific Central Nervous System involvement.

Patients were selected for the study on the basis of 1: A diagnosis of systemic Lupus Erythematosus according to the 1982 revised American Rheumatology Association criteria47 and 2: An adequate biopsy defined as containing at least six glomeruli. Patients were biopsied at Groote Schuur Hospital during the period 1978 to 1988 and the indications for renal biopsy were clinical based on laboratory results of renal function. Patients were followed between 1 and 120 months with a mean observation period of 34 months. The clinical records were scrutinised and the following pa·rameters were noted at the time of biopsy: age, sex, race, time from diagnosis to biopsy, serum urea, creatinine, creatinine clearence and urinary 24 hour protein. Using the latest serum urea, creatinine, creatinine clearence and / or 24 hour urinary protein where available, outcome was graded as: 1: An improvement in renal function 2: A stable renal function 3: Deterioration in renal function 4: Patient on dialysis 5: Death due to disease.