Person-to-person transmission of Giardia lamblia in day-care nurseries.

In an outbreak of giardiasis at two day-care nurseries in metropolitan Toranto Giardia lamblia appeared to be transmitted person to person. No common source of infection could be found. The proportions of children infected in the two nurseries were 39% and 17%; infection was spread to 7% and 23% of their household contacts. Of the infected children and household contacts 26% and 30% respectively of those for whom detailed information could be obtained were symptomatic. Canadian children were more likely to be infected and symptomatic than were immigrant children attending the nurseries. The most susceptible ages for infection were 1 to 3 years. The results of this study suggest that all children in day-care nurseries who are infected with G. lamblia should be treated, regardless of whether they are symptomatic.     

Course of dysentery and the specific alteration of the neutrophils in children in the use of monomycin and a diet with an increased protein content]

Acute dysentery mainly due to Shigella sonnei and dynamics of the neutrophil damage index (NDI) of the blood were studied in 80 children at the age of 1 to 14. 20 children (group 1) were treated with monomycin under conditions of a diet with an excessive content of protein (by 25% higher than the physiological norm). 60 children or 3 groups of 20 children each were not subject to such conditions and were considered as control groups. Reduction in the time of recovery (by 4 days) and bacteriological sanation (by 6 days) of the convalescents in the 1st group decreased as compared to that in the control groups. The test for the NDI of the blood was close in all the groups. It was concluded that an excessive protein content in the diet increased the efficacy of monomycin therapy in dysentery children. It is recommended that the diet with an excessive protein content be used in monomycin treatment of dysentery children.     

Behaviour of parents and children in two contrasting urban neighbourhoods: an observational study

Studies based on self-report questionnaires suggest that there are social gradients in parental investment within developed societies, with reduced investment occurring in families of lower socioeconomic position. However, these results have not been investigated by direct observation of behaviour in its natural setting. Here, I report the results of an observational study of behaviour of parents and children on the streets of two neighbourhoods of the same city, one affluent and one deprived. In the deprived neighbourhood relative to the affluent one, children were more likely to be on the streets in the evenings, were less likely to be accompanied by adults, infants were more likely to be crying, and babies were more likely to be in the care of children. Where mothers were present, though, they were less likely to be the sole adult with a brood. In particular, there was a greater prevalence of groups consisting of multiple females plus children. Although only two sites have been studied here, the method could be extended to other areas, and the initial results confirm that, under harsh environmental conditions, children receive less care by adults, alloparenting of infants by children becomes more important, and women mitigate the costs of caring for children by cooperating with other adults, particularly other women.     

Head injuries related to the use of baby walkers.

To determine what proportion of head injuries in children under 24 months of age who presented to an emergency department were related to the use of baby walkers, we reviewed the charts of 52 such children. Walkers were involved in 42% of the head injuries in the children under 12 months of age and in none of those in the children aged 12 to 24 months. All walker-related injuries, including skull fractures in three children, involved stairs (p less than 0.001). Questionnaires were also sent to all families with children aged 3 to 18 months attending a private pediatric practice to determine the prevalence of falls involving baby walkers among these children and the factors associated with such falls. Of the 152 responding families 82% reported using or having used a walker. Thirty-six percent of the families reported that their child had a fall while in a walker, with 8.8% of the falls resulting in contact with a doctor. Walker-related falls were directly associated with time spent in the walker (p less than 0.001) and with a previous fall from the walker by an older sibling (p less than 0.03). Since there is no demonstrated benefit of walkers, their use should not be encouraged, and parents should be advised of their potential danger.     

Clinical course of untreated tonic-clonic seizures in childhood: prospective,hospital based study.

OBJECTIVE: To assess decleration and acceleration in the disease process in the initial phase of epilepsy in children with new onset tonic-clonic seizures. STUDY DESIGN: Hospital based follow up study. SETTING: Two university hospitals, a general hospital, and a children''s hospital in the Netherlands. PATIENTS: 204 children aged 1 month to 16 years with idiopathic or remote symptomatic, newly diagnosed, tonic-clonic seizures, of whom 123 were enrolled at time of their first ever seizure; all children were followed until the start of drug treatment (78 children), the occurrence of the fourth untreated seizure (41 children), or the end of the follow up period of two years (85 untreated children). MAIN OUTCOME MEASURES: Analysis of disease pattern from first ever seizure. The pattern was categorised as decelerating if the child became free of seizures despite treatment being withheld. In cases with four seizures, the pattern was categorised as decelerating if successive intervals increased or as accelerating if intervals decreased. Patterns in the remaining children were classified as uncertain. RESULTS: A decelerating pattern was found in 83 of 85 children who became free of seizures without treatment. Three of the 41 children with four or more untreated seizures showed a decelerating pattern and eight an accelerating pattern. In 110 children the disease process could not be classified, mostly because drug treatment was started after the first, second, or third seizure. The proportion of children with a decelerating pattern (42%, 95% confidence interval 35% to 49%) may be a minimum estimate because of the large number of patients with an uncertain disease pattern. CONCLUSIONS: Though untreated epilepsy is commonly considered to be a progressive disorder with decreasing intervals between seizures, a large proportion of children with newly diagnosed, unprovoked tonic-clonic seizures have a decelerating disease process. The fear that tonic-clonic seizures commonly evolve into a progressive disease should not be used as an argument in favour of early drug treatment in children with epilepsy.     

Features of the associative function of the brains of children with high and low lability of nervous system processes

Characteristics of brain associative functions in children of 6 years old with different lability of nervous processes, were compared by methods of conditioning and informational analysis. In children with a low lability, these functions were 1.6 time slower than in other children. Enhanced demands to lability (limitation of time, acceleration of signals presentation) lead to their further slowing and successive inhibition. In children with a high lability, in such conditions an activation of brain associative functions was recorded followed by expressed successive excitation. These differences may be considered as typological. In cases of learned inertness of motor reactions, the characteristics of these functions corresponded to those in children with a high lability of nervous processes.     

Nutrition survey of schoolchildren in greater Winnipeg. II. Dietary intake and biochemical assessment.

The total dietary intake of energy and of individual nutrients of 99 grades 3 and 6 children from 10 greater Winnipeg shcools were generally comparable to those reported by Nutrition Canada for the Manitoba and national samples, although the percentile distributions of total caloric intake and dietary intake of vitamin A for the Winnipeg children tended to be lower. The median daily intake of protein was 212% of the Canadian Dietary Standard and most came from animal sources. Dietary fat was largely from animal sources as well. Hemoglobin concentrations were marginally low in four children, and urinary riboflavin:creatinine ratios were low in six children. There was no biochemical evidence of thiamin deficiency. The results suggest a need for change in dietary patterns and for education in nutrition, including relative nutrient/cost benefits. A well planned school snack program with an education component is a medium by which change could be introduced. This should preferable be part of a total school health program.     

Peer Victimization Experienced by Children and Adolescents Who Are Deaf or Hard of Hearing

Victimization is a relatively common, yet serious problem, with potentially severe consequences for children''s psychosocial and academic functioning. Children who are Deaf or Hard of Hearing (DHH) may be at a higher risk for victimization than hearing children. The aims of the present study were to compare DHH and hearing children on i) self-reported experiences of victimization and ii) associations between victimization, parental- and child variables. In total 188 children (mean age 11;11 years) from the Netherlands and Dutch-speaking part of Belgium participated in the study. No difference between DHH and hearing children were found on general experiences of victimization. However, differences between the groups were found on specific forms of experienced victimization and on the associations between victimization and parental variables. For DHH children, parental sensitivity and parents who challenge their DHH children to become competent in the practical, emotional, cognitive and social domain is associated with them being less victimized. For hearing children at this age these relations were reversed, absent or more complex. Finally, DHH children in special schools were more victimized than DHH children in regular schools. It can be concluded that parents can play an important role in reducing social problems experienced by DHH children and young adolescents.     

Child growth and the economic value of children in rural Bolivia

Previous investigations have yielded contradictory conclusions concerning the importance of the economic contribution of children to households in agricultural societies. The present study evaluates the significance of children 's economic input in rural Ancoraimes, Bolivia by using child growth as an indirect indicator of the economic value of children. Children whose households differed in size and age composition were compared on the basis of five anthropometric measurements. Children from households with many young, nonproducing children were found to be significantly smaller for their age than children from households with few nonproducing children. Absolute household size had no major effect on child growth. While young children have a negative effect on the growth of children in the household, the positive effect of children as they grow older appears to make up for this loss. In terms of child growth, children are neither a net liability nor a net asset to agricultural households in Ancoraimes.     

Dermatoglyphics of the relatives of children with congenital defects in development]

The localization of an axial triradius and the flexor creases were studied in 173 phenotypically normal mothers and 104 fathers of congenitally malformed children. The most pronounced changes ofdermatoglyphics were found in the parents of children with polygenic determined defects, less pronounced ones-- in the parents of children with multiple congenital non-chromosomal defects and with Down's syndrome. The frequency of the pathological features studied was similar both in children with polygenically determined isolated defects and with Down's syndrome. The frequency of the pathological determined isolated defects and in their parents. In multiple congenital defects and in Down's syndrome the abnormalities ofof the localization of an axial triradius and of the flexor creases were found in children more frequently than in the parents. It is suggested that the above mentioned peculiarities of parental dermatoglyphics may be useful for the genetic counsleling.     

DNA damage evaluated by alkaline single cell gel electrophoresis (SCGE) in children of Chernobyl, 10 years after the disaster

Using the alkaline single cell gel electrophoresis (Comet) assay, the extent of DNA damage was evaluated in leukocytes of 43 Belarussian children (16 healthy and 27 affected by thyroid cancer). Thirty-nine healthy children from Pisa (Italy) were enrolled in the study as controls. In addition to basal levels of DNA damage, leukocytes were treated in vitro with bleomycin (BLM), a radiomimetic drug, to evaluate a possible adaptive response in different groups of children. Results with the Comet assay indicated an increased level of DNA damage (P=0.037) in leukocytes of Belarussian children compared to the Italian control group. In addition, within the Belarus group, lower basal levels of DNA damage (P<0.001) were found in children with cancer compared to healthy children. Tumor affected children were living in less radiocontaminated areas (P<0.04) than the healthy children and there was a significant relationship (P=0.03) between the amount of environmental radiocontamination and DNA damage in leukocytes. There were no differences in the sensitivity of leukocytes from different groups of children to BLM, indicating the absence of an adaptive response. The lack of an adaptive response may have been due to the use of noncycling cells and/or the bleomycin dose chosen. Tests for the presence of clastogenic factors (CF) in the blood serum of children showed that 39% of the tumor affected children and 19% of the healthy children in the exposed group were positive as compared to the Italian control group (0%) (Chi-square test, P<0.04). The higher levels of genomic damage in children evaluated 10 years after the Chernobyl disaster could be related to the increased incidence of individuals with CF.     

A high frequency of apoptosis was found in cultures of lymphocytes isolated from the venous blood of children born with a low birth weight

Children born with a low birth weight (below 2500 g) exhibit a slower rate of development, and a greater tendency towards morbidity and mortality, together with a deficit of weight and height. One reason could be an increase in the level of cell elimination by apoptosis. The aim of this study was to evaluate and compare the incidence of apoptotic and necrotic (dead) cells in cultures of peripheral blood lymphocytes obtained from children born with a low birth weight and from children with a normal birth weight. Peripheral blood lymphocytes were obtained by venipuncture (10 ml) and isolated using the density gradient centrifugation method. The lymphocytes were cultured for 48 h in a culture medium containing low concentrations of fetal calf serum. A comparison study was performed between low birth weight children and normal birth weight children and the susceptibility of their lymphocytes to apoptosis and to necrosis in serum-deficient feeding culture conditions. The amount of apoptotic cells and the percentage of dead cells were significantly higher in cultures of lymphocytes obtained from low birth weight children than in cultures from normal birth weight children. The two estimated parameters inversely correlated with the concentration of fetal calf serum in the culture medium. Pulsed field gel electrophoresis showed increased DNA degradation patterns in the cultures of lymphocytes obtained from low birth weight children. Our results should be perceived as an indication that, under worse feeding conditions, the elimination of cells by apoptosis and by necrosis is significantly higher for lymphocytes of low birth weight children than for those of normal birth weight children. The enhanced elimination of lymphocytes is related to a greater susceptibility to infections, especially of the respiratory tract, as established in the retrospective analysis of the anamneses of the examined group of low birth weight children.     

Psychopathology in adolescent children of physicians.

The clinical records of 27 adolescent children of physicians who were treated in a psychiatric unit for adolescents were studied. Most of the children had been referred by their physician fathers for evaluation of conduct or mood disorders. These referrals were often the focus of family distress. There appeared to be no typical syndrome presented by physicians'' children. Those treating such patients should be especially sensitive to the possibility that parental denial will increase the patient''s resistance to therapy. Family therapy, an effective treatment for psychologic problems in adolescents, is often avoided by physicians.     

Application of a live attenuated varicella vaccine to hospitalized children and its protective effect on spread of varicella infection.

Twenty-three hospitalized children with no history of varicella or no detectable complement fixing (CF) antibody, were vaccinated with a live attenuated varicella vaccine (Oka strain) immediately after the occurrence of a case of varicella in a children's ward of hospital. These children suffered from the nephrotic syndrome, nephritis, purulent meningitis, hepatitis etc., and 12 of them were receiving steroid therapy. An antibody response was noticed in all the vaccinated children, with mild fever in 6 and a mild rash in 2 of 6. It was uncertain whether these reactions were due to vaccinatin or to naturally acquired infection modified by vaccination. No other clinical reactions or abnormalities of the blood or urine were detected. Thus the spread of varicella infection was prevented, with the exception of one severe case in an unvaccinated patient. In another trial, 16 children with renal diseases were also vaccinated. All the children showed an immune response with no clinical reactions and no abnormalities in blood and urine examinations. Thus live varicella vaccine (Oka strain) can be used safely and effectively for hospitalized children, and its effectiveness in preventing spread of varicella infection was confirmed.     

Cranial computertomography in children with acute lymphatic leukemia (ALL) and non Hodgkin-lymphoma (NHL) after different methods of CNS-treatment

42 children with acute lymphatic leukemia (ALL) or non-Hodgkin lymphoma (NHL) were subjected to cranial computer tomography (CT). 4 groups were formed according to CNS therapy. Group 1: 18 children in complete first remission after CNS prophylaxis with intrathecal 198 Au-colloid and methotrexate were examined between 3 1/2 and 7 1/3 years after beginning of therapy. 15 patients had normal computer tomograms, only 3 children had slight anomalies. The quantitative assessment of the computer tomograms yielded normal results for all 18 children. Group 2: 8 children were examined before CNS prophylaxis. 1 child had a connatal septum pellucidum cyst, 4 children had no anomalies and 3 children slight anomalies. The deviations from normal in groups 1 and 2 should be physiological variations. Group 3: 6 children were examined between 10 months and 8 1/4 years after termination of prophylactic CNS-irradiation (18-22.5 Gy) in combination with intrathecal methotrexate. Normal findings were obtained for 2 patients only. The other children had distinct cortical, subcortical or cerebellar atrophies and calcification of stem ganglia. Neurological complications had temporarily appeared in one child after skull irradiation. Group 4: A CT was made of 10 children during or after meningosis leukemia. The children who had received 198 Au-colloid for CNS prophylaxis yielded no pathological CT results. Distinct cortical, subcortical and cerebellar atrophies or calcification of stem ganglia were found in children after one or two CNS irradiations. These CT investigations confirm the results published by other authors, i.e. that owing to an irradiation--cytostatic therapy of the children's brains CNS lesions can be found in the CT. Their prognosis can only be determined by longterm observations. CNS prophylaxis by means of intrathecal 198 Au-colloid and methotrexate does not lead to any pathological CT anomalies.     

Status of selenium and antioxidant enzymes of goitrous children is lower than healthy controls and nongoitrous children with high iodine deficiency

In order to investigate the relations of iodine deficiency and/or goiter with selenium (Se) and antioxidant enzyme (AOE) status, we determined the relevant parameters of goitrous high school children living in an endemic goiter area of Turkey. Subjects were selected by a simple random sampling technique after screening the whole population of the high schools of two towns by neck palpation. The results of the goitrous group (n = 48, aged 15-18 yr) were compared with those of nongoitrous control children (n = 49) from the same populations, and with an outside control group (n = 24) from a lower-goiter-prevalence area. The overall prevalence of goiter was 39.6% in the high school population of the area. Activities of erythrocyte AOE (glutathion peroxidase, catalase, and superoxide dismutase) and concentrations of plasma and erythrocyte Se and urinary iodine were found to be significantly lower in goitrous children than both in-region and out-region of the control groups. When the whole study group was reclassified according to the severity of iodine deficiency, it was found that the AOE and Se status of those control children without goiter but with high iodine deficiency was significantly higher than goitrous children, although they did not differ from nondeficient control group. This might be the result of the possibility that goitrous children are exposed of oxidative stress, which may introduce alterations to the antioxidant defense system and/or the antioxidant status is relatively lower in goitrous children than those children who are highly iodine-deficient but did not develop goiter. The results of this study seem to support the view that the risk of goiter development may be higher in highly iodine-deficient children with lower enzymatic antioxidant and Se status.     

Malignant tumors during the first 2 decades of life in the offspring of atomic bomb survivors.

The risk of cancer (incidence) prior to age 20 years has been determined for children born to atomic bomb survivors and to a suitable comparison group. Tumor ascertainment was through death certificates and the tumor registries maintained in Hiroshima and Nagasaki. The rationale for the study stemmed from the evidence that a significant proportion of such childhood tumors as retinoblastoma and Wilms tumor arise on the basis of a mutant gene inherited from one parent plus a second somatic cell mutation involving the allele of this gene. Gonadal radiation doses were calculated by the recently established DS86 system, supplemented by an ad hoc system for those children for one or both of whose parents a DS86 dose could not be computed but for whom an ad hoc dose could be developed on the basis of the available information. The total data set consisted of (1) a cohort of 31,150 live-born children one or both of whose parents received greater than 0.01 Sv of radiation at the time of the atomic bombings (average conjoint gonad exposure 0.43 Sv) and (2) two suitable comparison groups totaling 41,066 children. Altogether, 43 malignant tumors were ascertained in the children of exposed parents, and 49 malignant tumors were ascertained in the two control groups. A multiple linear regression analysis revealed no increase in malignancy in the children of exposed parents. However, examination of the data suggested that only 3.0-5.0% of the tumors of childhood that were observed in the comparison groups are associated with an inherited genetic predisposition that would be expected to exhibit an altered frequency if the parental mutation rate were increased. There is thus far no confirmation of the positive findings that Nomura found in a mouse system.     

Population genetics in the province of Ferrara. II. Survival of children with Cooley's anemia.

The demographic data of children with Cooley's anemia seen at the thalassemia center in Ferrara were analyzed. Survival was studied as a function of several variables, the most interesting being the distance between birthplaces of the parents of affected children. This distance was considered an indicator of genetic distance, and therefore an indicator of residual hybridity of the children. The significant regression of survival on interparental distance might be interpreted as an indicator of increased survival due to residual hybridity. The significant correlation of survival with expected hybridity supports this interpretation.     

Usefulness of the passive hemagglutination micromethod in the diagnosis of whooping cough

Studies on modification of diagnostic test for pertussis have been continued, they were practically restricted to an application of passive haemagglutination micromethod. Six hundred and twenty eight sera from children suspected to be infected with Bordetella and 38 sera of control children suffering from non-infectious diseases were tested. Despite of the fact that higher titers were obtained with method using red blood cells preserved in Alsevier solution, the passive haemagglutination micromethod may be used in field studies especially during pertussis epidemics what was confirmed by statistical analysis.     

Infection status of intestinal parasites in children living in residential institutions in Metro Manila, the Philippines

A small scale survey was performed to know the infection status of intestinal parasite in children of the residential institutions and street communities in Metro Manila, Philippines. A total of 284 stool samples from 11 institutions and 3 street communities was examined by the formalin-ether concentration method. The scotch tape anal swab was adapted to 121 children to investigate the infection status of Enterovius vermicularis. It was found out that 62.0% of the children examined were positive for one or more intestinal parasites. Multiple infections were observed in 34.2% of the children. Among 172 children who gave detail information, the prevalence for Ascaris lumbricoides, Trichuris trichiura, and hookworm was 36.0%, 44.8%, and 7.0% respectively. Of the children examined, 47.7% were found to be harboring parasitic protozoans such as Entamoeba histolytica, Giardia lamblia, and Blastocystis hominis. The most prevalent of these protozoans was B. hominis with an infection rate of 40.7%. The prevalence of these infections among children living in institutions was relatively high. More efforts should be made to implement anthelminthic programs including bi-annual follow-up treatments.