Perception of effort at low and moderate intensity exercise in survivors of childhood acute lymphoblastic leukaemia.

OBJECTIVE: The study examined the degree to which male and female survivors of acute lymphoblastic leukaemia (ALL) perceive effort at low and moderate intensity exercise in association with related physiological variables. MATERIALS AND METHODS: Participants were 67 children. Thirty-five (14 boys and 21 girls) were long-time survivors of ALL and 32 (18 boys and 14 girls) were control subjects. The Children's Effort Rating Table (CERT) was used to measure whole-body perceived exertion at low and moderate intensity exercise. Peak oxygen uptake was measured using a motorized treadmill. CERT and physiological data were analysed using 2 x 2 mixed analyses of variance, appropriate t-tests and coefficients of correlation. RESULTS: In absolute terms, boys treated for ALL found perception of effort to be more strenuous at both low (3.9 vs. 3.5 units) and moderate (6.1 vs. 5.3 units) intensity exercise than control subjects, although differences were not significant (p > 0.05); girls treated for ALL found perception of effort to be the same as controls at low intensity exercise (3.1 vs. 3.1 units) but slightly higher than controls at moderate intensity exercise (5.6 vs. 5.2 units); neither of these differences were significant (p > 0.05). When CERT values were adjusted for (.-)VO(2) peak (%) and heart rate (HR) peak (%) differences remained non-significant. There were no significant interactions (Intensity x Group) in males, but the interaction for (.-)VO(2) peak (%) was significant in females (p < 0.05). The main effect for Intensity (low and moderate) was significant for all variables in boys and girls (p < 0.0001). The main effect for Group (ALL and controls) identified significantly greater absolute (b.p.m.) and relative (%) HR values in ALL boys at low and moderate intensity exercise. In female ALL and control subjects the interaction (Intensity x Group) distinguished between (.-)VO(2) peak (%) at moderate intensity exercise and HR peak (%) at low and moderate intensity exercise. Coefficients of correlation between perceived effort and (.-)VO(2) peak (%) in boys and girls were low to high (0.28-0.76), and between absolute and relative HR were also low to high (0.33-0.73). There were low correlations between time 'off therapy' and perceived effort, (.-)VO(2) peak (%) and HR peak (%) (-0.003 to -0.49). CONCLUSION: It was concluded that perception of effort in survivors of ALL at low and moderate intensity exercise was the same as that of control subjects. Correlations between perceived effort and physiological variables at moderate exercise were low to high, while those between perceived effort and time from treatment were generally weak.

Jessner's lymphocytic infiltrate in two girls.

Two girls demonstrated waxing and waning predominantly facial eruptions. Clinically as well as histologically, the lesions are consistent with lymphocytic infiltrate to Jessner and Kanof and constitute the first reported childhood cases. Although primarily a disease of male adults, this entity should be included in the differential diagnosis of facial plaques in children.

Use of recombinant interferon gamma administered intramuscularly for the treatment of psoriasis.

Twenty-three patients with chronic plaque-type psoriasis were treated with intramuscular administration of human recombinant interferon gamma. Patients were treated with doses of 0.01 to 0.25 mg/m2 daily (five out of seven days) for four weeks, or 0.25 mg/m2 three times weekly for one week with escalation to 0.5 mg/m2 for the subsequent seven weeks. Some patients treated with the 0.25-mg/m2 dose showed improvement coincident with their therapy. Although recombinant interferon gamma may have some therapeutic activity in certain patients' psoriasis, the magnitude of this effect is at best small. This result is in contrast to interferon alfa, which has been reported to cause an exacerbation of this disease. Staining of posttreatment biopsy specimens with a monoclonal antibody against HLA-DR antigen using an immunoperoxidase technique demonstrated HLA-DR expression by keratinocytes in some of the patients treated at the higher doses. No obvious correlation was seen between clinical improvement of the psoriasis and intensity or extent of HLA-DR antigen expression by keratinocytes in the skin biopsy specimens.

Infantile psoriasis: a follow-up study.

The appearance of psoriasis in infancy has been questioned by many dermatologists and pediatricians, although childhood psoriasis is a well-recognized entity. To elicit further information on this matter, a follow-up group of nine children who had been diagnosed initially as having infantile psoriasis was reexamined 6 to 13 years later to determine the course of the disease over time. Seven of the nine children had recurrent psoriatic lesions and two remained completely clear after the resolution of the initial eruption. The majority did not have a severe disease course; on the contrary, progression of the illness was mild for most of them. Familial aggregation was noted in almost all of the children. In fact, over the intervening years the number of relatives with psoriasis significantly increased. Most patients were not aware of the role of such factors as infections, injury, and stress in precipitating psoriasis. Participation in a self-help workshop is recommended as a way for both parents and children to learn to cope with the clinical and psychologic aspects of the illness.

Treatment of tinea pedis with econazole nitrate cream.

This study investigated the clinical effectiveness and the long-term relapse rate of the topical imidazole, econazole nitrate, in the treatment of tinea pedis. Econazole nitrate cream was applied by twenty-two patients with tinea pedis for twenty-eight consecutive days. Therapy was then discontinued and patients were evaluated to determine the long-term relapse rate. Nineteen (86 percent) of the twenty-two patients were considered cured at the end of twenty-eight days of treatment. At the follow-up examinations, 74 percent of the group considered to be clinically cured at the end of therapy remained clear for one month, 84 percent for two months, and 63 percent for three months after stopping active treatment. These data demonstrate that econazole nitrate is a highly effective topical agent in the treatment of tinea pedis and that clinical and mycologic cures in almost two thirds of the patients last for at least three months.