Fiber intake and childhood appendicitis.

In order to investigate the possible role of fiber in the etiology of acute appendicitis, 203 consecutive appendectomized children with histologically proved appendicitis and 1922 controls were studied by the diet history method. Statistics were performed by multivariate analysis of variance, discriminant analysis and chi 2. Appendectomized children had statistically significant lower mean daily intake of fiber (17.4 g versus 20.4 g, P < 0.001) including all fiber fractions: cellulose, uronic acid, pentose, exose and lignin. No statistical difference was found for energy, protein, carbohydrate and fat intake. Discriminant analysis proved that only cellulose and exose are independently correlated to appendicitis and lower fiber intake is thought to be the cause in 70% of the cases. Recurrent abdominal pain, chronic constipation and positive family history of appendectomy were more frequent in appendectomized children (P < 0.001). This study gives evidence that low fiber intake could play an important role in the pathogenesis of appendicitis.

Children with alopecia areata: psychiatric symptomatology and life events.

OBJECTIVES: To examine the nature of psychopathology of children with alopecia areata (AA) and to investigate the frequency and quality of life events in the year before AA developed in comparison with a control group. METHOD: Thirty-three subjects with AA, mean age 10.5 +/- 0.3 years, were compared with 30 controls who visited a pediatrician for a mild condition. In addition, 16 preschool children with AA were compared with 17 preschool children who visited the pediatrician for a mild condition. The following measures were used: Child Psychiatric Interview, Children's Depression Inventory (CDI), Children's Manifest Anxiety Scale (CMAS), Life Events Scale for Children, and Child Behavior Checklist (CBCL). RESULTS: On the CBCL, children with AA had more psychological problems, in total, than controls, and in particular, they were more anxious or depressed, withdrawn, aggressive, and delinquent. They also had more somatic problems as well as problems in social relations and in attention. Girls with AA seem to have been affected more in dimensions of total problems, anxiety/depression, and internalizing/externalizing syndromes. In terms of anxiety (CMAS), more children with AA than controls seemed to worry and to have difficulties in concentration and physiological symptoms of anxiety. In the Child Psychiatric Interview, all children with AA exhibited symptomatology of anxiety or depression or both, usually of mild or moderate nature. Major depression was not detected through the CDI. Fewer children with AA had positive life events the year before AA than controls in a similar time period. CONCLUSIONS: Compared with controls, children with AA had more psychiatric symptoms in general and symptoms of anxiety or depression, or both, in particular. There is also evidence that lack of positive life events in the prealopecia period played a role in their lives. Psychiatric assessment, and if necessary treatment, is warranted for all children with this condition.