Weekly changes in psychophysiological variables of 8- to 10-year-old school girls.

Three groups of schoolgirls 8, 9, and 10 years of age, respectively, self assessed sleep onset/offset and duration, as well as oral temperature and a set of cognitive measures, at school at 09:00, 11:00, 14:00, and 16:00 h on Mondays, Tuesdays, Thursdays, and Fridays (and/or Saturday) for 2 consecutive weeks (spring 1987 and 1989). The scores of a letter cancellation test exhibited neither daily nor weekly temporal variation at the age of 8 years [analysis of variance (ANOVA), p > 0.05]. In contrast, in the 10-year-olds, changes as a function of both time of day (peak time 14:00-16:00 h) and day of week (peak day Tuesday-Friday) were substantiated. Moreover, the time of best performance on the letter cancellation test varied systematically according to the day of the week (ANOVA, p = 0.000). Day of the week changes in the observed duration of sleep, self-rated fatigue, drowsiness, and attention changes were not detected in any of the age groups. It is hypothesized that temporal performance variations in the girls during the 7-day period was age related.

Diurnal changes in psychophysiological variables of school girls: comparison with regard to age and teacher's appreciation of learning.

Ninety-five nonresident girls of a private school volunteered for the study with the teachers' help as well as parental consent. Ages were approximately 8, 9, and 10 years. They were synchronized with diurnal activity from 0730 to 2100 h and nocturnal rest. Fatigue, drowsiness, and attention were self-rated using visual analogue scales; oral temperature was self-measured and a letter cancellation test was performed. Each of these variables was measured at school at 0900, 1100, 1400, and 1600 h on Mondays, Thursdays, Fridays, and Saturdays for two consecutive weeks in 1987 (March 30-April 11) and again in 1989 (March 13-25) when the youngest group had become 10 years old. According to conventional teacher evaluation of learning (learning performance) within each group, three subgroups were formed: top third, middle third, and bottom third. Time series (more than 50,000 data) were analyzed according to several statistical methods, but mainly chronograms with ANOVA. Similar diurnal changes in oral temperature were validated for each group and subgroups. The occurrence of a diurnal change in self-rated variables (fatigue and drowsiness) and score in letter cancellation was age related: no detection in the 8-year-old group (and subgroups) and validation (p less than 0.002) in 9- and 10-year-old groups (and respective subgroups). A good learning performance was associated with a reduced drowsiness in school girls of 9 and 10 years. Age-related, time-of-day differences in drowsiness (when detected) as well as learning performance effect were not associated with observed duration of sleep. Validated changes in self-rated fatigue were close to that of drowsiness. At 0900 h, girls of 9 and 10 years were more tired when belonging to the bottom third than top third subgroup. Whatever the time of day, self-rated attention was greater in the top than in the bottom third for these girls. Differences related to learning performance were validated in each grade. However, best scores were recorded for the bottom third in the 8-year-old group, while best scores were provided by top third subgroups in 10-year-old girls. It seems that in girls around 8 years of age, critical changes can be detected with regard to the (ontogenic?) occurrence of time-of-day differences in a set of psychophysiologic variables as well as influential effects of learning performance on the same variables. Reported finding are compatible with the hypothesis of circadian oscillators working at the level of the cortex of the human brain.

[Benigne multi-recurrent meningitis (Mollaret's disease). A case in a child of 2 years and 8 months]. / Méningite multi-récurrente bénigne (Maladie de Mollaret). Un cas chez un enfant de 2 ans et 8 mois.

The authors report a case of meningitis, presenting all characteristics of the disease described in 1944 by P. Mollaret, occurring in a child aged 2 years and 8 months. They stress the rarity of cases on childhood. The cells found in the cerebrospinal fluid, photographs of which are included, are fragile and may undergo early lysis. They are present in association with lymphocytes and polynuclears, giving the slide examined a highly characteristic mottled appearance. The authors raise the question of the morphological similarity of these large cells, with their polygonal contour and small central nucleus, with an epithelium.

[Deficiencies, disabilities and handicaps: taking responsibility for the young maladjusted child]. / Déficiences, incapacités et handicaps: prise en charge du jeune enfant inadapté.

A handicap should not be confused with deficiency or incapacity. It is the resulting difference between an individual's competencies and the situation which is proposed to, or imposed to, him. Whatever the type of deficiency a child may have, and the subsequent incapacity, it is important to discern for therapy, the positive aspects of his personality as soon as possible in order to develop his chances for success and avoid set backs. Structures such as the Medical and Social Early Action Center (CAMSP), which we created in 1976 at the Medical Center in Versailles, allow personalized care. More than progress in reference to an often illusory norm, it is the search for talents, aptitudes and, in function of this, the acquisition of knowledge, which should be the educator's concern. An excess of legislation may unfortunately lead to the standardization of the means and goals.

[The child and school: uneasy feelings]. / L'enfant et l'école: malaise.

For many children, the school system in France is maladjusted and is a source of repulsion instead of psychological and intellectual enrichment. The author analyses the causes of this maladjustment.

[Communication in the trisomy 21 patient: observation and therapeutic possibilities]. / La communication chez le trisomique 21: observation et possibilités thérapeutiques.

The behaviour of 4- to 6-year-old children with Down syndrome was studied by audio-visual means during individual or group stimulation sessions. From these observations, it is concluded that children with Down syndrome have a rich preverbal communication, but poor child-to-child interchanges. Thus, when taking care of children with Down syndrome, it is necessary to accentuate individual stimulation and take into account the affective drive of the child towards the adult.

[Child health in the school environment]. / La santé de l'enfant en milieu scolaire.

The authors studied the consequences of the present school system on children's health. They emphasize the causes of failures, mostly related to a misappreciation of children's individual differences and inequalities of the rate of physical and psychoaffective development. Overloaded school days, the lack of respect of sleep and extra-curricular needs, the overlooking of attention capacities were also studied.

[Intraspinal epidermoid cysts and lumbar punctures]. / Kystes épidermoïdes intrarachidiens et ponctions lombaires.

The authors describe a case of intra-spinal epidermoid cyst and recall the scarcity of the symptoms of such tumors and their slow evolution and emphasize the very likely part taken by spinal punctures in the genesis of a number of them.

[Anhidrosis. Presentation of an unusual case report]. / Anhidrose. Présentation d'une forme clinique particulière.

A one month old girl with sudden attacks of fever and dehydration was found to have anhydrosis. Histologically the sweat glands were normal but the electrical resistance of the skin showed there was an abnormality of sweating. The cause of the disorder is unknown but could be due to a defect in the secretion of acetyl choline by the post ganglionic sympathetic nerves or due to a receptor defect in the sweat gland. This new syndrome should be considered in all infants with a high fever of unknown origin.

[The pediatrician and school difficulties]. / Le pédiatre et les difficultés scolaires.

Difficulties at school are amongst the most frequent encountered in paediatric practice but paediatricians are infrequently consulted by those who are responsible for the children from day to day. As a result decisions are often contrary to the elementary principles of physiology. Unfortunately the chronological age is still the important criteria for determining school progress. Thus the age for learning to read is fixed arbitrarily at 6 years. Small children have specific difficulties even though they are normal intellectually. Overall the rhythm of life of the child is not considered by the exacting scholastic requirements. Finally the school forgets the need of the sick child too easily and demands a major effort of adaptation without making any allowances itself.

[Acute nalidixic acid poisoning in children]. / Intoxication aigue par l'acide nalidixique chez l'enfant.

A 31 month old child developed seizures 30 minutes after the accidental ingestion of toxic quantities of nalidixic acid. The case is unusual because of the age of the patient and the circumstances of the poisoning. It emphasises that this drug is contraindicated in children with previous neurological disease.

[Transcutaneous trinitrine. Calling into question the efficacy and innocousness of its use in facilitating venous approach]. / La trinitrine transcutanée. Mise en cause de son efficacité et de son innocuité dans son emploi pour faciliter l'abord veineux.

Seven infants aged 6 days to 9 months were tested for the use by rubbing of a pomade containing 1 mg trinitrine. The study was interrupted because of high blood passage of trinitrine. The authors emphasize the difficulty of any comparison with the use of this drug in adults. They indicate that there was no clinically appreciable side-effect but they advise to delay, until further studies, the use of this technique, with the only objective of improving the technique of intravenous injections or sampling.

[Septic arthritis due to a nontoxigenic diphtheria bacillus]. / Arthrite purulente à bacille diphtérique atoxinogene.

Septic arthritis of the hip in a 2 year old child is described. A nontoxigenic diphtheria bacillus was isolated in large numbers from the articular fluid. The same organism was isolated from excoriated skin lesions of the toes. The bacteriology, epidemiology and pathology of the infection are discussed.

[Pancreatico-peritoneal fistula in the newborn infant revealed by a hemorrhagic ascites]. / Fistule pancréatico-péritonéale du nourrisson revelee par une ascite hemorragique.

Chronic haemorrhagic ascites in an infant is reported. After much hesitation without a definite diagnosis the first laparotomy was carried out and the estimation of amylase, lipase and proteolytic enzyme activities in the ascitic fluid suggested a pancreatic origin for the ascites. This was conformed at a second laparotomy when the condition was correted. This emphasises the importance of the estimation of pancreatic enzymes in unexplained ascites in children.