Treatments for alopecia areata: A systematic review and network meta-analysis.

Existing guidelines form no consensus for alopecia areata (AA) treatment due to the absence of a universal standard treatment and arbitrary selection of reference arms in randomized control trials (RCTs). The aim is to identify the best treatment and to rank treatments using systematic review and network meta-analysis. Data were extracted by the two investigators independently. Odds ratio (OR) of treatment success rate was pooled using the frequentist weighted least squares approach to random-model network meta-analysis. RCTs providing data of treatment success rate from PubMed, EMBASE, Web of Science, and manual search were included. About 54 RCTs consisting of 49 treatments and 3149 patients were included. Pentoxifylline plus topical corticosteroids had the highest treatment success rate compared with "no treatment," followed by pentoxifylline alone, topical calcipotriol plus narrowband ultraviolet radiation B phototherapy, topical calcipotriol, intralesional corticosteroids, systemic corticosteroids, minoxidil plus topical corticosteroids, topical bimatoprost, psoralen ultraviolet radiation A phototherapy, and tofacitinib. Even with the network meta-analysis, the best treatment because of independent loops and wide confidence intervals could not be identified. Treatment options above may be reasonable strategies, but further comparison is required.

Psychometric properties of the parent and teacher forms of the Japanese version of the Strengths and Difficulties Questionnaire.

OBJECTIVE: This study examined the psychometric properties of the parent and teacher forms of the Japanese version of the Strengths and Difficulties Questionnaire (SDQ). METHOD: Parents and teachers of 1487 elementary school children (759 boys and 728 girls aged 6-12 years) participated in this study. RESULTS: The results of confirmatory factor analyses of the parent and teacher versions of the SDQ supported the five-factor structure reported in previous studies. However, factor invariance across sex was not observed. The alpha coefficients for the subscales of the SDQs varied between 0.55 and 0.86, the same reliability measures that were also reported in previous studies. Moreover, analyses of variance showed significant differences on all of the subscales according to sex and teacher-parent ratings. CONCLUSION: The factor structure of the SDQ was generally supported, but more gender-segregated investigations of the factor structures are needed. Parents tended to give higher ratings on the difficulties and strengths of children compared to the teachers. Boys were rated higher than girls were on difficulties, while girls were rated higher than boys were on strengths.

A clinical study of attention-deficit/hyperactivity disorder in preschool children--prevalence and differential diagnoses.

OBJECTIVE: We aimed to examine (1) the prevalence and characteristics of ADHD in preschool children, and (2) differential diagnoses among children who display symptoms of inattention and hyperactivity-impulsivity in early childhood. METHODS: The participants were children living in Kanie-cho, in Japan's Aichi Prefecture, who underwent their age 5 exams at the municipal health center between April 2009 and March 2011. We first extracted children who were observed to be inattentive or hyperactive-impulsive during their age 5 exams and considered as possibly having ADHD. We conducted follow-ups with these children using post-examination consultations, visits to preschools, and group rehabilitation. The results of the age 5 exams were combined with behavior observations and interview content obtained during subsequent follow-ups. A child psychiatrist and several clinical psychologists discussed these cases and made a diagnosis in accordance with the DSM-IV-TR. RESULTS: 91 (15.6%) of the 583 children selected were considered as possibly having ADHD; we were able to conduct follow-ups with 83 of the 91 children. Follow-up results showed that 34 children (5.8% of all participants) remained eligible for a diagnosis of ADHD. Diagnoses for the remaining children included: pervasive developmental disorders (six children, or 6.6% of suspected ADHD children), intellectual comprehension problems (four children, or 4.4%), anxiety disorders (seven children, or 7.7%), problems related to abuse or neglect (four children, or 4.4%), a suspended diagnosis for one child (1.1%), and unclear diagnoses for 29 children (31.9%). CONCLUSIONS: ADHD tendencies in preschool children vary with changing situations and development, and the present study provides prevalence estimates that should prove useful in establishing a diagnostic baseline.

The function of the frontal lobe in neonates for response to a prosodic voice.

We examined how neonates responded at the brain level to an element of acoustic stimulation using near-infrared spectroscopy (NIRS). Twenty full-term, healthy neonates were included in the study. The neonates were tested in their cribs while they slept in a silent room. First, two probe holders were placed on the left and right sides of the forehead over the eyebrows using double-sided adhesive tape. Then the neonates were exposed to the auditory stimuli from an external auditory speaker. The stimuli, readings of the first scene of "Little Red Riding Hood," were made with a digital voice. The stimuli consisted of two conditions: variably pitched speech (variable speech: VS) and monotonous flat-pitched speech (monotonous speech: MS). The analyses focused on changes in O(2)Hb because O(2)Hb is the most sensitive indicator of changes in cerebral blood flow in NIRS measurement. The O(2)Hb level promptly increased at the beginning of the VS condition, and then returned to baseline again, while O(2)Hb did not show any changes during the MS condition. Differences between baseline-stimulation relative values were used to perform a 2 (condition)x2 (recording site)x2 (gender) analysis of variance. The results show that VS (M=0.45, S.D.=1.33) produced a greater increase of oxygenated blood to the frontal area of the brain area than MS (M=-0.19, S.D.=1.28). Neonates' brain activation patterns suggest that they can discriminate differences in the prosodic patterns of utterances.