Prospective analysis of sinus symptoms and correlation with paranasal computed tomography scan.

OBJECTIVES: We designed a prospective study to determine whether there is a correlation between the severity of sinus symptoms and the severity of computed tomography (CT) scan evidence of rhinosinusitis. METHODS: Acute and chronic rhinosinusitis patients rated their symptoms and had a CT scan of the sinuses taken the same day. A Likert severity scale and standardized CT scoring system were used. Data were analyzed by nonparametric methods with Kendall's rank correlation coefficient. RESULTS: The severity of 5 symptoms correlated with severity of disease on CT scan. Headache and facial pain or pressure had no correlation. CONCLUSION: The certainty of a clinical diagnosis of rhinosinusitis requiring treatment is enhanced in patients with high symptom severity scores for fatigue, sleep disturbance, nasal discharge, nasal blockage, or decreased sense of smell. Isolated headache and facial pain or pressure are less reliable predictors of CT scan findings supporting the diagnosis rhinosinusitis.

Sarcoidosis of the pediatric larynx.

Sarcoidosis is a chronic granulomatous disease of unknown pathogenesis. Reports of sarcoidosis are much less common in the pediatric literature than in the adult literature. The disease is usually systemic; rarely, however, single organs are affected. Isolated laryngeal involvement is an unusual presentation. We report a well-documented case of isolated laryngeal sarcoidosis in a 14-year-old white boy who presented to our institution with a 6-month history of dysphonia, dyspnea on exertion, and extremely sonorous snoring at night owing to his supraglottic airway disease. To our knowledge, this is only the second case of isolated laryngeal sarcoidosis reported in the pediatric literature. We review the literature and discuss the differential diagnosis, diagnostic evaluation, and treatment with carbon dioxide laser epiglottectomy and intralesional glucocorticoid deposition, which resulted in marked resolution of our patient's symptoms.

The meaning of measures: pitfalls in behavioral and developmental research.

This article considers a number of issues encountered in the selection and use of measures in research in the area of behavioral and developmental pediatrics. In addition to considering basic psychometric principles, it is argued that problems inherent in the developmental process, the lack of correspondence between study and standardization samples, and methodological factors affecting measurement may threaten the validity of individual measures and bias research outcome. A number of recommendations are made to counter the effects of these common measurement problems that indirectly result from the absence of a "gold standard" for measuring behavior and development.

Developmental screening using parent report.

The need for comprehensive screening of pediatric populations to identify potential development problems is widely accepted. The lack of systematic screening in pediatric practice is due to several factors, including the need for an efficient, reliable instrument and the limited professional time available for screening. The present study compares the effectiveness of a screening instrument, the Minnesota Child Development Inventory, with an individually administered psychological test, the McCarthy Scales of Child Development. Because the former uses a parent report format, little professional time is involved in screening. The Minnesota and McCarthy were administered to 364 children who were within 1 month of their third birthday. Four of five Minnesota scores correlated significantly (p less than 0.0001) with each of the six McCarthy subscores. The Minnesota appears to be an efficient, valid test that would facilitate comprehensive screening in a pediatric population.

Parent-child life events: relation to treatment in asthma.

Children and adolescents with asthma were divided into groups of responders (N = 22) and nonresponders (N = 22) on the basis of their response to medical management. The mothers and children from both groups were given scales to measure life events and perceptions of behavior style. The effects of life event stresses and parent-child relations on the response to medical treatment were evaluated for each patient. Comparisons were made on the basis of response-nonresponse, sex, and age. Several patterns of relationship to treatment outcome were identified. The implications of these findings are discussed in terms of coping skills, psychological defenses, and the availability of social support systems. A conceptual scheme for treatment approaches is presented.

Visual-motor problems of adolescents who attempt suicide.

Using the Canter Background Interference Procedure with the Bender-Gestalt Test, a group of 18 adolescent suicide attempters earned test scores indicating they had significantly more problems with visual-motor coordination than did a control group of 21 adolescents. There were also a greater number of school failures and behavior problems among these suicide attempters. The findings suggest that learning disabilities may be an unrecognized factor which increases the risk of suicide attempts by adolescents.

Adolescents who attempt suicide.

A suicide prevention program for teen-agers was established and at the completion of the first two years a review of the data was undertaken. A group of 65 adolescents who attempted suicide were identified in that time period. The median age group was 16 years, and 75% were girls. Ingestion was the predominant method used in these suicidal attempts. The major characteristics of these youngsters included long-term family disruption, social isolation, and academic difficulties. A subgroup of 25 adolescents received psychologic tests. When compared to a matched control group there was a significantly higher rate of minimal brain dysfunction for those adolescents who attempted suicide.