Communication disorders and emotional/behavioral disorders in children and adolescents.

Recent research in child psychiatry has demonstrated a high prevalence of speech, language, and communication disorders in children referred to psychiatric and mental health settings for emotional and behavioral problems. Conversely, children referred to speech and language clinics for communication disorders have been found to have a high rate of diagnosable psychiatric disorders. Most of the emerging knowledge regarding relationships between communication disorders and psychiatric disorders has been presented in the child psychiatric literature. Speech-language pathologists and audiologists also need to be familiar with this information; an understanding of the complex interrelationship between communication disorders and emotional and behavioral disorders is important for diagnosis, assessment, and treatment. The purpose of this article is to review recent research and discuss clinical implications for professionals in speech-language pathology and audiology working with children and adolescents who have, or who are at risk for, developing emotional and behavioral disorders. Issues to be addressed include differential diagnosis, prevention, intervention, and the role of speech-language pathologists serving these children and adolescents.

Sensitivity and specificity of first screen mammography in the Canadian National Breast Screening Study: a preliminary report from five centers.

Sensitivity and specificity of first screen mammography in a randomized screening trial at five centers are reported. A total of 23,101 women underwent mammography; in 139, breast cancer was detected at first screening; in 20, less than 12 months after first screening; and in 47, at second screening. All 206 cancer cases were histologically confirmed, and 174 were defined as being detectable at first screening. Average length of follow-up for all women was 3.2 years. Interpretations of first screen mammograms by the center radiologists were matched to known outcomes. Simultaneous blind review was performed by a single reference radiologist with mammograms from all 206 cancer cases and those of a random sample of 739 women not known to have breast cancer at 15 months or more after initial screening. Overall, the five screening centers achieved a sensitivity of 69% (range, 60%-78%), a specificity of 94% (range, 93%-96%), a positive predictive value of 8.6% (range, 3%-16%), and a negative predictive value of 99.7% (range, 99.6%-99.9%).

Stimulus-secretion coupling in exocrine pancreas; possible role of calmodulin.

Many calcium-mediated effects in mammalian cells may be activated by calcium-calmodulin stimulated enzymes. These effects are inhibited by various antidepressant drugs which bind to and inactivate calmodulin. In the current study, calmodulin was identified by affinity chromatography and gel electrophoresis in the cytoplasm of dispersed rat pancreatic acinar cells. Its role in enzyme secretion was assessed by evaluating the effects of various antidepressants drugs on the enzyme secretory process. Chlorpromazine, trifluoperazine, thioridazine, chlorprothixene and amitriptyline inhibited amylase secretion stimulated by carbachol, A-23187, and cholecystokinin-pancreozymin but not that elicited by dibutyryl cyclic AMP secretin or vasoactive intestinal peptide (VIP). Haloperidol, sulpiride, phenobarbital, and ethanol were without effect on secretagogue-stimulated enzyme release. Only those agents which blocked secretion also inhibited 45Ca release stimulated by carbachol from isotope preloaded cells. The data suggest that calmodulin may have a functional role in pancreatic enzyme secretion.