Memory outcomes of temporal lobe surgery in adults aged over 45 years.

OBJECTIVE: It is assumed that temporal lobe resection in older people is associated with worse seizure outcomes and potential postsurgical memory decline. We studied postsurgical memory development and surgical efficacy in patients over 45 years of age compared with younger patients. METHODS: We studied 88 patients (51 male and 37 female) after temporal lobe surgery, which involved hippocampal resection. The patients were evaluated before surgery and in the first (72 patients) and/or third (57 patients) postsurgical year. The Wechsler Memory Scale III test was performed to evaluate the MQ postsurgical development. Engel's classification was used to evaluate the postsurgical seizure outcome. RESULTS: The presurgical MQ (median 88) in ≥45 years age group was significantly lower than in both younger groups (median MQ = 100 for ≤30 years age group, p = 0.002; median MQ = 107 for 31-44 years age group, p = 0.002). Three years after the surgery, the MQ decreased significantly in ≤30 years age group (p = 0.012), while only non-significant MQ decline was observed in both older groups. We found no significant impact of age on the surgical outcome. CONCLUSION: Higher age at the time of surgery does not significantly increase the risk for postsurgical memory decline; however, older patients are more likely to have lowered presurgical MQ. We did not find significant differences in the impact of surgery on seizure outcome among the age groups. Epilepsy surgery appears to be a safe and effective method in the age over 45 years even though an earlier surgery should be preferred.

Predictors of pregnancy-related emotions.

BACKGROUND: The study explores the pregnancy-related emotions of women. The investigated predictive factors include the woman's age, previous maternal experiences, especially miscarriage or birth defects, skills related to maternity, pregnancy planning, objective and subjective health status, social relationships and social support, especially the partner relationship, and housing status. METHODS: The Czech ELSPAC data obtained from 4,890 pregnant women was used. RESULTS: Age, partnership, previous pregnancy experience, pregnancy planning, and standard of housing all relate significantly to the emotions in the first month and in the sixth month of pregnancy. A change in the mother's emotional experience during pregnancy is significantly predicted by subjective health and social support. CONCLUSIONS: Health, social relationships, material conditions, and psychological preparedness affect the positive emotional experience of pregnancy. Women who planned to become pregnant are more content. However, the overall emotional experience also relates to the social and psychological preparedness for the upcoming changes.

Moderate alcohol consumption as a mediator of mother's behaviour towards her child.

AIM: The purpose of this study is to examine the effect of moderate drinking on mother's behaviour towards her child. METHOD: The European Longitudinal Study of Pregnancy and Childhood (ELSPAC) survey sample consisted of 3,569 Czech women, who were interviewed when their children were 18 months old. There were three areas related to mother child relationship investigated: hygiene, activities with the child, and the mother's emotional relationship with the child. Besides alcohol consumption, we also evaluated the mother's neuroticisms. RESULTS: Our results suggest that the behaviour of moderate drinking mothers differs from the behaviour of abstaining mothers. The abstinents express more emotions for the child, they handle better the demands of maternity and pay more attention to needs for child's educative activities. Significant differences were not noticed in the frequency of physical activities with the child (cuddling, physical playing, walks). CONCLUSION: Our data supports the assumption that moderate drinking of a mother is disadvantageous for the child as compared to abstinence. The abstinents display a higher level of concern about the child.

Maternal smoking during pregnancy, behavioral problems and school performances of their school-aged children.

BACKGROUND: Child behavior and school performance is influenced by many genetic and environmental factors including prenatal exposure to chemical neurotoxins contained in cigarette smoke. The European Longitudinal Study of Pregnancy and Childhood (ELSPAC) prospective study which in the Czech Republic incorporates a cohort of children born in the years 1991/2 in Brno city and the Znojmo district also allows to analyze the relationships between prenatal cigarette smoke exposure and the occurrence of behavior and learning disorders. METHODS: Using questionnaires repeatedly filled in by teachers and investigation protocols performed by research team workers data for the Brno sample of children was collected on the occurrence of signs indicating more serious problems with school assignment fulfilling and behavior disorders in the childrens' 8, 11 and 13 years of age. According to mothers' statements about their smoking behavior during pregnancy, the children were divided into two groups: prenatally exposed and non-exposed. The frequency differences of individual traits were evaluated in the SPSS statistical program (Pearson's chi2 test and linear associations, probability relations). RESULTS: In the ELSPAC study set the occurrence of inferior schoolwork performance evaluated based on term-report grades was more frequent in children prenatally exposed to mothers' smoking, along with more frequently diagnosed disorders which to significant extent implicate these inferior results and also special care needs occurred more frequently when compared to their peers born to non-smoking mothers. In the prenatally exposed subset also more frequent occurrence of various signs characterizing behavior disorders including attention disorders, hyperactivity, aggressiveness and signs of delinquency behavior were recorded. CONCLUSIONS: The Czech ELSPAC cohort confirmed the results of other studies; within it was documented that children born to smoking mothers have more frequent behavioral problems and problems with fulfilling their school assignments in the school age period.

Trends in respiratory morbidity of children in relation to their passive smoking exposure.

AIMS: Exposure of children to passive smoking is significantly associated with respiratory morbidity. Youngest children between 0-2 years are harmed in the most significant way, while, together with the growing age a decrease is observed of prevalence of respiratory diseases and influence of passive smoking. METHODS: During repeated investigations of children from European Longitudinal Study of Pregnancy and Childhood (ELSPAC) it was assessed, whether and how in the period from the birth to five years of age varied the rate of children exposed to environment filled with smoke and what were the differences in the frequency of diseases among the groups of children with different exposure level. Some selected characteristics of health were chosen from documentation provided in the 6th, 18th month and 5 years of children's age and processed in four children groups that differ in smoking behaviour of their mothers. The differences were statistically assessed in SPSS programme. RESULTS: In all compared age categories were children of smoking mothers more often exposed to stay in environment filled with smoke: children of middle and heavy smokers more, children of light smokers less. In all groups of smoking mothers, children were more often protected from exposure to passive smoking in the age of six months than after they reached 18 months and 5 years of age: differences were mostly statistically significant on the level of 1% of significance. Attending the kindergarten presents significant protecting factor for five years old children: they are more exposed during weekends than on week days (p < 0.001, resp. p < 0.01). Both respiratory symptomatology and morbidity were highly significantly increased in previous life periods of those children, whose mothers smoked. At the age of five, life in smoking household causes more frequent incidence of asthmatic symptomatology: wheezing and apnoe, and higher prevalence of allergies against home and pollen dust with breathlessness and wheezing as well (p < 0.05). CONCLUSIONS: ELSPAC study ascertained significant influence of maternal smoking on children's health in relation to passive smoking. Consequences of exposure clinically manifest themselves especially in increased incidence of respiratory and allergic morbidity.