Joint Position Sense Testing in Young Children.

The standard physical examination evaluation for a proprioception abnormality depends upon the patient's ability to follow directions and respond to the examiner, a skill not yet developed in toddlers. This study demonstrates a new proprioception examination method that may allow for better localization of lesions and determines whether healthy toddlers would cooperate with this test. By placing stickers on children's hands, covering their eyes, and then moving their hands, the examiner can see whether the children reach for where their hands and stickers were previously located or to their new location, which serves as an indicator of proprioception ability. When tested on 12- to 36-month-old children without known neurologic issues, we found that older children were more cooperative during the test but that the ability to successfully find the sticker did not depend on age. We have optimized the test for efficient usage in a clinic setting and propose that this is a useful test that can be applied in children, with no change in confidence based on age. No children with known deficits in proprioception were tested, so sensitivity could not be assessed.

Variation in rod and cone density from the fovea to the mid-periphery in healthy human retinas using adaptive optics scanning laser ophthalmoscopy.

PurposeTo characterize the rod and cone photoreceptor mosaic at retinal locations spanning the central 60° in vivo using adaptive optics scanning laser ophthalmoscopy (AO-SLO) in healthy human eyes.MethodsAO-SLO images (0.7 × 0.9°) were acquired at 680 nm from 14 locations from 30° nasal retina (NR) to 30° temporal retina (TR) in 5 subjects. Registered averaged images were used to measure rod and cone density and spacing within 60 × 60 µm regions of interest. Voronoi analysis was performed to examine packing geometry at all locations.ResultsAverage peak cone density near the fovea was 164 000±24 000 cones/mm(2) and decreased to 6700±1500 and 5400±700 cones/mm(2) at 30° NR and 30° TR, respectively. Cone-to-cone spacing increased from 2.7±0.2 µm at the fovea to 14.6±1.4 µm at 30° NR and 16.3±0.7 µm at 30° TR. Rod density peaked at 25° NR (124 000±20 000 rods/mm(2)) and 20° TR (120 000±12 000 rods/mm(2)) and decreased at higher eccentricities. Center-to-center rod spacing was lowest nasally at 25° (2.1±0.1 µm). Temporally, rod spacing was lowest at 20° (2.2±0.1 µm) before increasing to 2.3±0.1 µm at 30° TR.ConclusionsBoth rod and cone densities showed good agreement with histology and prior AO-SLO studies. The results demonstrate the ability to image at higher retinal eccentricities than reported previously. This has clinical importance in diseases that initially affect the peripheral retina such as retinitis pigmentosa.

Malarial infection in Aedes aegypti : effects on feeding, fecundity and metabolic rate.

We have examined metabolic rate, lipid and carbohydrate of female Aedes aegypti during 10 days following a malaria-infected bloodmeal. In parallel, we determined bloodmeal size, portions retained and diuresed, and subsequent fecundity. We found that mosquitoes obtained identical masses of blood when feeding on an infected or control host. However, infected mosquitoes lost more mass during diuresis and retained a smaller mass. Infection led to a significant reduction in fecundity, the extent of which could not be explained by the difference in post-diuresis bloodmeal mass alone. We found no differences in lipid or carbohydrate content between infected and control mosquitoes during the 10 days post-infection, although infected mosquitoes had a lower body mass than controls. Metabolic rates were not different between groups, except during blood digestion, where the metabolic rate was lower in infected mosquitoes. These results suggest that infection by malaria does not lead to an increase in metabolic rate during the phases of midgut invasion and sporogony. However, infection does have a measurable effect on fecundity and subsequent body mass of the infected females.

Prospective study of factors predicting uptake of smoking in adolescents.

Risk factors for the uptake of cigarette smoking were examined prospectively in 2159 non-smoking secondary schoolchildren aged 11-13 who participated in a survey in 1983 and were followed up 30 months later, by which time 35 per cent had taken up smoking. In a multivariate logistic model, the strongest predictors to emerge were prior experimentation with cigarettes and sex, with more girls (41%) than boys (30%) starting to smoke. Other predictors of taking up smoking were being uncertain about smoking in the future, reporting having been drunk, having a boy or girl friend, believing teachers and friends would not mind if they took up smoking, and giving lower estimates of prevalence of smoking among teachers. Parental smoking behaviour and attitudes, beliefs about the effects of smoking on health, opinions about smoking and perceived strictness of parents did not predict take up of smoking when other variables were controlled for. The odds of taking up smoking varied from 0.24 (risk = 0.19) for a child with the most favourable combination of risk factors to 3.49 (risk = 0.78) for a child with the worst prognosis. These results differ from those of many cross sectional studies and hence indicate the importance of a prospective approach to this type of research.

Passive exposure to tobacco smoke: saliva cotinine concentrations in a representative population sample of non-smoking schoolchildren.

Saliva cotinine concentrations in 569 non-smoking schoolchildren were strongly related to the smoking habits of their parents. When neither parent smoked the mean concentration was 0.44 ng/ml, rising to 3.38 ng/ml when both parents were cigarette smokers. Mothers' smoking had a stronger influence than did fathers' (p less than 0.01). In addition, there was a small independent effect of number of siblings who smoked (p less than 0.01). The dose of nicotine received from fathers' smoking was estimated as equivalent to the active smoking of 30 cigarettes a year, that from mothers' smoking as equivalent to smoking 50 cigarettes a year, and that from both parents smoking as equivalent to smoking 80 cigarettes a year. This unsolicited burden may be prolonged throughout childhood and poses a definite risk to health.