ABSTRACT
Evaluated a 15-month social support intervention for mothers of children with JRA. Five mentors (mothers of young adults who have had JRA since childhood) were linked to mothers of children with JRA ages 2 to 11 for purposes of enhancing specific types of social support and overall mental health. The total number of reported mental health symptoms decreased in the experimental group and remained the same in the control group. The experimental group showed greater improvement on all indices of support relative to the control group. Trends in the data consistently favored the experimental group, but differences between the experimental and control group were statistically significant on few of the outcome measures. Results provide tentative evidence for positive effects of mentoring interventions for this population of parents.
Subject(s)
Adaptation, Psychological , Arthritis, Juvenile/psychology , Mothers/psychology , Sick Role , Social Support , Adolescent , Adult , Child , Child, Preschool , Family Therapy , Female , Humans , Male , Self-Help Groups , Treatment OutcomeABSTRACT
Examined direct and mediated relations between condition parameters and maternal mental health for 53 mothers of 2- to 11-year-old children with juvenile rheumatoid arthritis (JRA). Multivariate analyses revealed that when considered simultaneously, indices of both biological severity and functional severity were associated significantly with maternal mental health. Further, mother's appraisals of the impact of the child's illness on the family partially mediated the effects of medication type and child's functional status on mother's mental health. Results provide support for conceptual models that emphasize the cognitive mechanisms by which condition parameters such as biological and functional severity might affect maternal mental health. Explicating the processes by which a child's JRA might lead to psychological adjustment problems in the parent has implications for developing preventive and treatment interventions.
Subject(s)
Adaptation, Psychological , Arthritis, Juvenile/psychology , Mothers/psychology , Sick Role , Activities of Daily Living/psychology , Adjustment Disorders/diagnosis , Adjustment Disorders/psychology , Adult , Child , Child, Preschool , Family/psychology , Female , Humans , MaleABSTRACT
We determined the prevalence and incidence of juvenile rheumatoid arthritis (JRA) in an urban Black population in Baltimore, identifying three cases through review of computerized outpatient encounters and a fourth case by reviewing discharge records at area hospitals. The prevalence of JRA among Blacks, as of December 31, 1980, was estimated as 0.26 per 1,000 (95 per cent confidence interval: 0.07, 0.66), the average annual incidence 6.6 per 100,000 per year (0.8, 23.8) for the years 1979 and 1980. These data suggest that Black race is not associated with significantly increased risk of development of JRA.
Subject(s)
Arthritis, Juvenile/epidemiology , Black People , Adolescent , Age Factors , Child , Child, Preschool , Female , Humans , Infant , Male , Maryland , Sex Factors , Urban PopulationABSTRACT
Diffuse fasciitis with eosinophilia is a newly recognized connective tissue disease appearing initially to be either scleroderma or dermatomyositis. It has clinical and histologic features that allow it to be clearly separated from both disorders and has a more favorable prognosis. The majority of reported cases have been in adults. The disease involves the extremities, and at times the trunk, diffusely. One sees firm, often puckered or rivuleted skin, tightly bound to underlying structures; contractures result in several weeks. Early peripheral blood features are eosinophilia and elevated immunoglobulins. For diagnosis, full-thickness biopsies extending from skin through subcutaneous tissue, fascia, and muscle are taken together as one block. These tissues should not be separated from each other. The diagnostic lesion is in the fascia which is edematous, thickened, and infiltrated by mononuclear cells. The other tissues are completely normal. The clinical response to steroids is prompt and favorable.
Subject(s)
Eosinophilia/diagnosis , Fasciitis/diagnosis , Adolescent , Dermatomyositis/diagnosis , Diagnosis, Differential , Fasciitis/drug therapy , Fasciitis/pathology , Female , Humans , Immunoglobulins/analysis , Leg , Prednisone/therapeutic use , Scleroderma, Localized/diagnosisABSTRACT
Since both psoriasis and seronegative arthritis occur individually in childhood, they may be expected to occur together occasionally. Clinical features used to identify psoriatic arthritis as a disease sui generi have been assembled in groups of adult patients, establishing the justification for describing a distinct syndrome. A review of the experience in an active children's rheumatology service indicates that the syndrome of psoratic arthritis occurs in the pediatric-aged patient with sufficient frequency to qualify as a diagnostic term appropriate in the classification of childhood-onset arthritis.
Subject(s)
Arthritis, Juvenile/complications , Psoriasis/complications , Adolescent , Adult , Arthritis, Juvenile/etiology , Arthritis, Juvenile/therapy , Aspirin/therapeutic use , Child , Child, Preschool , Female , Humans , Infant , Male , Palliative Care , Physical Therapy Modalities , Psoriasis/etiology , Psoriasis/therapyABSTRACT
Brodie's abscess is a form of subacute osteomyelitis which is defined by a particular constellation of clinical, radiological and pathological features. Its occurrence in infants is extremely rare. This case documents just such an occurrence. To our knowledge, the pathogen Haemophilus influenzae has not been previously recognized as a cause of Brodie's abscess in particular or subacute osteomyelitis in general. The clinical presentation and diagnostic pitfalls which may be encountered in this age group are discussed.
