Developmental medicine and child neurology
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Dev Med Child Neurol · Mar 2001
Fetal valproate syndrome and autism: additional evidence of an association.
Autism has been described in association with a variety of medical and genetic conditions. We previously reported on a patient whose clinical phenotype was compatible with both fetal valproate syndrome (FVS) and autism. ⋯ In all five of our patients, there was evidence of cognitive deficits, manifestations of autism, and typical phenotypic characteristics of FVS. The association between this known teratogen and autism has both clinical and research implications.
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Dev Med Child Neurol · Feb 2001
Impact of the therapist-child dyad on children's pain and coping during medical procedures.
This study examined the effects of physical therapists' behaviors on the levels of distress and coping of 32 children (19 males, 11 females; age range 2.6 to 9.1 years) during a painful medical procedure. This is the second study to assess children throughout rehabilitation following selective posterior rhizotomy and the first to assess the impact of physical therapists' behaviors. ⋯ Criticism, reassurance, checking child's status, praise, and empathic statements by therapists explained 65% of the variance in children's distress. Older children and children with higher IQ scores exhibited more coping behaviors.
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Dev Med Child Neurol · Jul 2000
Cerebral herniation in pyogenic meningitis: prevalence and related dilemmas in emergency room populations in developing countries.
This study aimed to determine the frequency and outcome of possible cerebral herniation in relation to lumbar puncture (LP) in postneonatal infants and children with pyogenic meningitis in the tropics. Children with meningitis aged between 6 weeks and 15 years (mean age 4.07 years; n=123) were recruited consecutively over 3 1/2 years at the University of Maiduguri Teaching Hospital, Nigeria. The frequency of possible herniation was determined by clinical evaluation in relation to the severity of illness (high versus low risk) on presentation and performance of LP. ⋯ In 99 patients with known outcomes who had LP on presentation, 21 of 81 without herniation pre- or post-LP, four of four with herniation pre- and post-LP, seven of eight with herniation post-LP only, and five of six with herniation pre-LP only died or recovered with sequelae (chi2 = 25.24, df = 3, p<0.0001). It is concluded that outcome depends on the severity of illness and the presence and timing of herniation. A policy of selective rather routine LPs may improve the outcome in meningitis in developing countries.