Brief report: relationship between HIV infection and WPPSI-R performance in preschool-age children.

OBJECTIVE: To determine the neurodevelopmental effects of perinatally acquired HIV infection on children of preschool age. METHODS: Participants included 40 children infected with HIV between the ages of three and five and an equal number of noninfected controls individually matched according to ethnicity, age, sex, and prenatal drug exposure. Participants were administered the Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R), upon which an analysis of subtest distribution was conducted. RESULTS: Whereas both groups evidenced mean IQ and subtest scores significantly below published norms, an effect for HIV group status was not found when a factor combining Performance IQ (PIQ) and Verbal IQ (VIQ) was analyzed. However, the group infected with HIV scored significantly lower than controls on the Block Design subtest. CONCLUSIONS: Gross cognitive deficits are not evident among preschool children infected with HIV relative to matched controls. However, this study does provides some evidence for more focal deficits. Further investigation with older children should be conducted.

Empirically supported treatments in pediatric psychology: recurrent pediatric headache.

OBJECTIVE: To review the empirical research examining behavioral treatments for recurrent pediatric headache. METHODS: Thirty-one investigations published after 1980 were reviewed using predetermined criteria to evaluate the adequacy of research methodologies. A modification of criteria proposed for evaluating the efficacy of psychological interventions for adults (Task Force on Promotion and Dissemination of Psychological Procedures, 1995) was used to evaluate the adequacy of evidence available for individual intervention strategies. RESULTS: Sufficient evidence exists to conclude that relaxation/self-hypnosis is a well-established and efficacious treatment for recurrent headache. Furthermore, enough evidence exists to conclude that thermal biofeedback alone is a probably efficacious treatment. Other promising interventions have been tested that combine relaxation and biofeedback or integrate other cognitive-behavioral treatment approaches, but are limited by inadequate research methodologies. CONCLUSIONS: We discuss the importance of developmentally based conceptual models and the impact of diagnostic heterogeneity and offer specific recommendations for future intervention research in the area of recurrent pediatric headache.

The Miami pediatric quality of life questionnaire: parent scale.

Because there were limited measures available to assess health-related quality of life (HRQL) in children with chronic illnesses, this study was initiated to develop an empirically derived questionnaire for use in evaluating HRQL issues in children treated for cancer. Extensive interviews were conducted with 30 families of children with cancer, 10 of pre-school age, 10 of school age and 10 of adolescent age. Responses were videotaped and transcribed, then categorized to develop a pool of 56 items, which were administered to 132 children with cancer and to their parents. This report focuses on parental responses to objective items and ratings of importance of each of these items. Three primary categories, Self-Competence, Emotional Stability and Social Competence, were identified, each of which had solid internal consistency, sensitivity and reliability across 1-month intervals. The measure demonstrated the ability to discriminate between children with different types of cancer, offers an alternative to measures relying on expert judgment to assess HRQL and may lead to greater inclusion of psychological and social concerns as primary factors in determining HRQL in children participating in clinical trials.

[Lichen and hepatitis C]. / Lichen et hépatite C.

We report a case of lichen planus in a patient with hepatitis C infection and discuss the relationship between these two diseases.

Recurrent pediatric headaches: assessment and intervention.

Assessment and intervention issues in recurrent pediatric headache are discussed. A broad overview of diagnostic and etiological issues is presented, with consideration of the application of functional models to recurrent headache patterns. Behavioral treatment outcome research is reviewed, and pharmacotherapy approaches are briefly addressed. Recommendations are made for clinical practice, and future research priorities in the area of recurrent pediatric headache are underscored.

[Basocellular nevomatosis. Follow-up of 3 generations]. / Naevomatose baso-cellulaire. Suivi de trois générations.

We report on Gorlin-Goltz syndrome observed in 4 patients belonging to three generations of the same family. We present the clinical findings and emphasize recent genetic discoveries. We discuss the difficulty in following these patients and propose a series of simple explorations which can be helpful.

[Bilateral paralysis of the 6th cranial nerve pair and minor head injury. Apropos of a case. Review of the literature]. / Paralysie bilatérale de la sixième paire crânienne et traumatisme crânien bénin. A propos d'un cas. Revue de la littérature.

We report a case of bilateral switch nerve palsy following minor head trauma. We discuss available literature, frequency and pathophysiology of bilateral abducens nerve palsy after minor head trauma. We also present current knowledge of prognosis and treatment of oculomotor palsies after trauma.

Progressive multifocal leukoencephalopathy and magnetic resonance imaging.

Progressive multifocal leukoencephalopathy developed in a homosexual man with underlying Hodgkin's disease. Computed tomography and magnetic resonance imaging of the brain demonstrated multiple lesions, more in gray than white matter. Brain biopsy established the diagnosis of progressive multifocal leukoencephalopathy. Magnetic resonance imaging was found useful for detecting brain lesions and for localizing an accessible lesion for biopsy.

Utilization review altered to advantage.

PSRO adopted a methodology in which first five days of hospitalization were exempted from utilization review. Substantial savings and expanded concurrent review resulted.

Ultrastructural characteristics of the non-immune rosette-forming cell.

Non-immune rosette formation, where a non-sensitized lymphocyte is surrounded by three or more sheep red blood cells, is an in vitro technique which is thought to be specific in the identification of thymus-dependent (T) lymphocytes. Using the electron microscope and tissue culture techniques, we have studied the ultrastructure of the rosette-forming lymphocyte which has been stimulated by various cellular mitogens. Non-sensitized but stimulated lymphocytes, which form rosettes, have a morphology similar to that of previously identified T cells, adding further credence to the concept that non-sensitized rosette-forming cells represent a population of T cells. Changes in the binding pattern of the sheep red cell membrane to the lymphocyte have been identified which may represent an early phase of cell 'activation'. This marker of activation offers a potential method of studying membrane responses in attempts to localize cellular defects involving the T lymphocyte. In addition, preliminary studies using fluorescein-labelled sheep red blood cell fragments suggest specific attachment of labelled membrane to the T lymphocyte, allowing rapid identification of T cells in smears or tissue preparations.