Developmental science, systems of care, and prevention of emotional and behavioral problems in youth.

Developmental science, a metatheoretical framework for investigating individual development across the lifecourse, is discussed in terms of its application to prevention and treatment of emotional and behavioral problems. The multifaceted, dynamic, and bidirectional contribution of factors, both internal and external to the individual, is thus emphasized. Key aspects of developmental science, systems of care, and prevention are described, and the implications for delivery of mental health services to children and youth are discussed.

Heterogeneity of popular boys: antisocial and prosocial configurations.

This study examined subtypes of popular 4th-6th grade boys (N = 452). Popular-prosocial (model) and popular-antisocial (tough) configurations were identified by means of teacher ratings and compared with peer and self-assessments and social centrality measures. Peers perceived model boys as cool, athletic, leaders, cooperative, studious, not shy, and nonaggressive. Peers perceived tough boys as cool, athletic, and antisocial. Model boys saw themselves as nonaggressive and academically competent. Tough boys saw themselves as popular, aggressive, and physically competent. Tough boys were disproportionately African American, particularly when African Americans were a minority in their classrooms. Model and tough boys were overrepresented at nuclear social centrality levels. These findings suggest that highly aggressive boys can be among the most popular and socially connected children in elementary classrooms.

Ataxia, chorea, seizures, and dementia. Pathologic features of a newly defined familial disorder.

Five generations of a family exhibit a unique autosomal dominant neurologic disorder characterized by the development (usually between 15 and 30 years of age) of ataxia, seizures, choreiform movements, progressive dementia, and death after 15 to 25 years of illness. Neuropathologic findings in two deceased family members revealed remarkably similar findings, including marked neuronal loss of the dentate nucleus, microcalcification of the globus pallidus, neuroaxonal dystrophy of the nucleus gracilis, and demyelination of the centrum semiovale. The clinical and pathologic findings are closely correlated. Ataxia and chorea are related to severe neuronal loss in the dentate nucleus with calcification in the globus pallidus. Dementia occurs with progressive demyelination of the centrum semiovale, and loss of posterior column function occurs with neuroaxonal dystrophy of the nucleus gracilis and nucleus cuneatus.

Subdural empyema complicating meningitis in infants: improved prognosis.

No deaths occurred among six consecutive cases of subdural empyema complicating meningitis in infants treated between 1968 and 1978 at North Carolina Memorial Hospital, Chapel Hill. Five of the six infants had no neurologic sequelae in follow-up periods ranging from 6 months to 7 years. This contrasts with a mortality rate of 50% in a previously reported series of infants with subdural empyemas treated between 1955 and 1966 at the same hospital. The reasons for improved prognosis include early diagnosis (computed tomography and subdural paracentesis) and adequate surgical drainage during intensive antibiotic therapy.

The "hypernormal" CT scan in dementia: bilateral isodense subdural hematomas.

Enlarged ventricles and prominent sulci are common findings on computed tomography (CT) in elderly demented patients. Three such patients were found to have small, symmetric ventricles and minimal sulci on tomography; these CT scans were considered "hypernormal" for the patients' ages and clinical syndromes. Bilateral isodense subdural hematomas were subsequently diagnosed by isotope brain scans in two cases and by angiography in the third. A "hypernormal" CT scan in an elderly demented patient suggests the possibility of bilateral isodense subdural hematomas, and requires further evaluation with isotope brain scan and, if necessary, angiography.

Elimination of antipyrine from saliva as a measure of metabolism in man.

The salivary half-life of antipyrine was used as a convenient procedure for estimating the relative rates of drug metabolism in man. The concentration ratio of antipyrine in plasma and saliva was one over a 24-hr period following the oral or parenteral administration of the drug to man and rat. Phenobarbital, a known stimulator of drug metabolism in animals and man, increased markedly the elimination of antipyrine from saliva of rats, while SKF-525A, a potent inhibitor of drug metabolism, prolonged the elimination of antipyrine from rat saliva. In addition, the known sex difference in the metabolism of drugs in the rat was detected by measuring the elimination rate of antipyrine from saliva of male and female rats. The clinical application of the procedure indicated that a group of epileptic patients treated with anticonvulsants for more than 2 mo had a mean antipyrine salivary half-life of 4 hr, whereas a mean half-life of 13 hr was found in a group of normal volunteers. The results show that the elimination rate of antipyrine from saliva is a useful index of drug metabolism in animals and man.