Immigrant and ethnic neighbourhood concentration and reduced child developmental vulnerability: A Canadian cohort study.

INTRODUCTION: Studies have consistently demonstrated a gradient between median neighbourhood income and child developmental outcomes. By investigating statistical outliers-neighbourhoods with children exhibiting less or more developmental vulnerability than that predicted by median neighbourhood income-there is an opportunity to identify other neighbourhood characteristics that may be enhancing or impeding early childhood development. OBJECTIVE: Testing a variety of neighbourhood factors, including immigrant or ethnic concentration and characteristics of structural disadvantage (proportion of social assistance recipients, homes in need of major repair, residents with high school education only, lone parent families, and residents moving in the last year) we sought to identify factors associated with more or less developmental vulnerability than that predicted by median neighbourhood income, for young children. METHODS: For this cross-sectional study we used validated Early Development Instrument (EDI) data (2003-2013) linked to demographic and socioeconomic Census and Tax Filer data for 98.3% of Canadian neighbourhoods (n=2,023). The purpose of the instrument is to report, at a population-level, children's school readiness. Children's developmental vulnerability was assessed in five domains (physical health and well-being, emotional maturity, social competence, language and cognitive development, and communication and general knowledge) in relation to the 10th percentile from a national normative sample. Levels of children's neighbourhood vulnerability were determined per domain, as percent of children vulnerable at a given domain. Neighbourhoods were grouped into three cohorts, those having lower than predicted, as predicted, or higher than predicted children's vulnerability according to neighbourhood median income. Using multivariable binary logistic regression we modelled the association between select neighbourhood characteristics and neighbourhoods with lower or higher than predicted vulnerability per domain, compared to neighbourhoods with predicted vulnerability. This allowed us to determine neighbourhood characteristics associated with better or worse child developmental outcomes, at a neighbourhood-level, than that predicted by income. RESULTS: In neighbourhoods with less child developmental vulnerability than that predicted by income, high or low immigrant concentration and ethnic homogeneity was associated with less vulnerability in physical (adjusted odds ratio (aOR) 1.66, 95% CI: 1.43, 1.94), social (aOR 1.30, 95% CI: 1.11, 1.51), and communication domains (aOR 1.24, 95% CI: 1.03, 1.47) compared to neighbourhoods with vulnerability concordant with income. Neighbourhood ethnic homogeneity was consistently associated with less developmental vulnerability than predicted by income across all developmental domains. Neighbourhood-level structural disadvantage was strongly associated with child developmental vulnerability beyond that predicted by median neighbourhood income. CONCLUSION: Canadian neighbourhoods demonstrating less child developmental vulnerability than that predicted by income have greater ethnic and ethnic-immigrant homogeneity than neighbourhoods with child developmental vulnerability concordant with income. Neighbourhood social cohesion and cultural identity may be contributing factors. Neighbourhood structural disadvantage is associated with poorer early childhood development, over and above that predicted by neighbourhood income. Neighbourhood-level policy and programming should address income and non-income related barriers to healthy child development.

PET/CT Versus Standard Imaging for Prediction of Survival in Patients with Recurrent Head and Neck Squamous Cell Carcinoma.

The purpose of this study was to examine whether staging with 18F-FDG PET/CT better predicts survival in patients with recurrent head and neck squamous cell carcinoma (HNSCC) than chest x-ray (CXR) plus head and neck MRI or chest CT (CCT) plus head and neck MRI. Methods: This was a prospective cohort study based on paired data. Consecutive patients with histologically verified HNSCC recurrence were enrolled from September 2013 to March 2016. All patients underwent CXR/MRI, CCT/MRI, and PET/CT on the same day and before biopsy. All imaging studies underwent masked interpretation by separate teams of experienced nuclear physicians or radiologists. Recurrent carcinomas were categorized as localized (equivalent to primary stages I-II), locally advanced (equivalent to primary stages III-IVB), or metastatic (equivalent to primary stage IVC). Discriminative abilities for each imaging strategy with respect to cancer-specific and stage-based survival were compared using Kaplan-Meier analysis, Cox proportional-hazards regression with the Harrell concordance index (C-index), and net reclassification improvement. Results: In total, 110 patients (90 men and 20 women; median age, 66 y; range, 40-87 y) were included. PET/CT significantly changed the assigned tumor stage when compared with imaging strategies based on CXR/MRI or CCT/MRI (P < 0.001 for both). Kaplan-Meier analysis of PET/CT-based staging showed progressively worsened prognosis with localized, locally advanced, or metastatic disease (log-rank test, P < 0.001), whereas CXR/MRI and CCT/MRI were unable to distinguish between these groups in terms of survival (log-rank test, P = 0.18 and P = 0.58, respectively). Overall discriminative ability in predicting cancer-specific mortality was significantly greater for PET/CT (C-index, 0.72) than for CXR/MRI (C-index, 0.55) (P = 0.001) and CCT/MRI (C-index, 0.55)(P < 0.001). The addition of PET/CT to either CXR/MRI or CCT/MRI was associated with a significantly positive net reclassification improvement (P < 0.001 for both). Conclusion: Contrary to standard imaging strategies, PET/CT-based staging in recurrent HNSCC was able to significantly discriminate among the survival courses of patients with local, locally advanced, or metastatic disease and predict their respective survival probability.

[Innovative application of small molecules to influence -pathogenicity of dental plaque]. / Innovatieve toepassing van kleine moleculen voor beïnvloeding pathogeniciteit tandplaque.

Current preventive measures against infectious oral diseases are mainly focussed on plaque removal and promoting a healthy lifestyle. This in vitro study investigated a third preventive method: maintaining healthy dental plaque with the use of small molecules. As a model of dental plaque, in vitro biofilms were cultivated under conditions that induce pathogenic characteristics. The effect of erythritol and other small molecules on the pathogenic characteristics and bacterial composition of the biofilm was evaluated. The artificial sweetener erythritol and the molecule 3-Oxo-N-(2-oxycyclohexyl)dodecanamide (3-Oxo-N) had no clinically relevant effect on total biofilm formation. Erythritol did, however, lower the gingivitis related protease activity of the biofilm, while 3-Oxo-N blocked the caries related lactic acid accumulation. Furthermore, both substances ensured the biofilm maintained a young, non-pathogenic microbial composition. This shows it is possible to influence the dental plaque in a positive manner in vitro with the help of small molecules. Further research is necessary before this manipulation of dental plaque can be applied.

A PET/CT-Based Strategy Is a Stronger Predictor of Survival Than a Standard Imaging Strategy in Patients with Head and Neck Squamous Cell Carcinoma.

Our purpose was to examine whether staging of head and neck squamous cell carcinoma (HNSCC) by upfront 18F-FDG PET/CT (i.e., on the day of biopsy and before the biopsy) discriminates survival better than the traditional imaging strategies based on chest x-ray plus head and neck MRI (CXR/MRI) or chest CT plus head and neck MRI (CCT/MRI). Methods: We performed a masked prospective cohort study based on paired data. Consecutive patients with histologically verified primary HNSCC were recruited from Odense University Hospital from September 2013 to March 2016. All patients underwent CXR/MRI, CCT/MRI, and PET/CT on the same day. Tumors were categorized as localized (stages I and II), locally advanced (stages III and IVB), or metastatic (stage IVC). Discriminative ability for each imaging modality with respect to HNSCC staging were compared using Kaplan-Meier analysis, Cox proportional hazards regression with the Harrell C-index, and net reclassification improvement. Results: In total, 307 patients with histologically verified HNSCC were included. Use of PET/CT significantly altered the stratification of tumor stage when compared with either CXR/MRI or CCT/MRI (χ2, P < 0.001 for both). Cancer stages based on PET/CT, but not CXR/MRI or CCT/MRI, were associated with significant differences in mortality risk on Kaplan-Meier analyses (P ≤ 0.002 for all PET/CT-based comparisons). Furthermore, overall discriminative ability was significantly greater for PET/CT (C-index, 0.712) than for CXR/MRI (C-index, 0.675; P = 0.04) or CCT/MRI (C-index, 0.657; P = 0.02). Finally, PET/CT was significantly associated with a positive net reclassification improvement when compared with CXR/MRI (0.184, P = 0.03) but not CCT/MRI (0.094%, P = 0.31). Conclusion: Tumor stages determined by PET/CT were associated with more distinct prognostic properties in terms of survival than those determined by standard imaging strategies.

Saliva-Derived Commensal and Pathogenic Biofilms in a Human Gingiva Model.

In vitro models that closely mimic human host-microbiome interactions can be a powerful screening tool for antimicrobials and will hold great potential for drug validation and discovery. The aim of this study was to develop an organotypic oral mucosa model that could be exposed to in vitro cultured commensal and pathogenic biofilms in a standardized and scalable manner. The oral mucosa model consisted of a tissue-engineered human gingiva equivalent containing a multilayered differentiated gingiva epithelium (keratinocytes) grown on a collagen hydrogel, containing gingiva fibroblasts, which represented the lamina propria. Keratinocyte and fibroblast telomerase reverse transcriptase-immortalized cell lines were used to overcome the limitations of isolating cells from small biopsies when scalable culture experiments were required. The oral biofilms were grown under defined conditions from human saliva to represent 3 distinct phenotypes: commensal, gingivitis, and cariogenic. The in vitro grown biofilms contained physiologic numbers of bacterial species, averaging >70 operational taxonomic units, including 20 differentiating operational taxonomic units. When the biofilms were applied topically to the gingiva equivalents for 24 h, the gingiva epithelium increased its expression of elafin, a protease inhibitor and antimicrobial protein. This increased elafin expression was observed as a response to all 3 biofilm types, commensal as well as pathogenic (gingivitis and cariogenic). Biofilm exposure also increased secretion of the antimicrobial cytokine CCL20 and inflammatory cytokines IL-6, CXCL8, and CCL2 from gingiva equivalents. This inflammatory response was far greater after commensal biofilm exposure than after pathogenic biofilm exposure. These results show that pathogenic oral biofilms have early immune evasion properties as compared with commensal oral biofilms. The novel host-microbiome model provides an ideal tool for future investigations of gingiva responses to commensal and pathogenic biofilms and for testing novel therapeutics.

Head-to-Head Comparison of Chest X-Ray/Head and Neck MRI, Chest CT/Head and Neck MRI, and 18F-FDG PET/CT for Detection of Distant Metastases and Synchronous Cancer in Oral, Pharyngeal, and Laryngeal Cancer.

The purpose of this study was to determine the detection rate of distant metastasis and synchronous cancer, comparing clinically used imaging strategies based on chest x-ray + head and neck MRI (CXR/MRI) and chest CT + head and neck MRI (CHCT/MRI) with 18F-FDG PET/CT upfront in the diagnostic workup of patients with oral, pharyngeal, or laryngeal cancer. Methods: This was a prospective cohort study based on paired data. Consecutive patients with histologically verified primary head and squamous cell carcinoma at Odense University Hospital from September 2013 to March 2016 were considered for the study. Included patients underwent CXR/MRI and CHCT/MRI as well as PET/CT on the same day and before biopsy. Scans were read masked by separate teams of experienced nuclear physicians or radiologists. The true detection rate of distant metastasis and synchronous cancer was assessed for CXR/MRI, CHCT/MRI, and PET/CT. Results: A total of 307 patients were included. CXR/MRI correctly detected 3 (1%) patients with distant metastasis, CHCT/MRI detected 11 (4%) patients, and PET/CT detected 18 (6%) patients. The absolute differences of 5% and 2%, respectively, were statistically significant in favor of PET/CT. Also, PET/CT correctly detected 25 (8%) synchronous cancers, which was significantly more than CXR/MRI (3 patients, 1%) and CHCT/MRI (6 patients, 2%). The true detection rate of distant metastasis or synchronous cancer with PET/CT was 13% (40 patients), which was significantly higher than 2% (6 patients) for CXR/MRI and 6% (17 patients) for CHCT/MRI. Conclusion: A clinical imaging strategy based on PET/CT demonstrated a significantly higher detection rate of distant metastasis or synchronous cancer than strategies in current clinical imaging guidelines, of which European ones primarily recommend CXR/MRI, whereas U.S. guidelines preferably point to CHCT/MRI in patients with head and neck squamous cell carcinoma.

Candida albicans alters the bacterial microbiome of early in vitro oral biofilms.

The yeast Candida albicans is an oral commensal microorganism, occurring in the oral cavity of 50-70% of healthy individuals. Its effect on oral ecology has mostly been studied using dual-species models, which disregards the complex nature of oral biofilms. The aim of this study was to culture C. albicans in a complex model to study its effect on oral biofilms. Biofilms, inoculated using pooled stimulated saliva with or without addition of C. albicans, were grown under anaerobic, aerobic, or aerobic +5% CO2 conditions. Red autofluorescence was quantified using a spectrophotometer and visualized in fluorescence photographs. The microbiome of 5 h biofilms was determined using 16S rDNA sequencing. C. albicans was only able to proliferate in biofilms grown under aerobic conditions. After 48 h, C. albicans did not induce differences in total biofilm formation, lactic acid accumulation (cariogenic phenotype) or protease activity (periodontitis phenotype). In vitro, anaerobically grown biofilms developed red autofluorescence, irrespective of inoculum. However, under aerobic conditions, only C. albicans-containing biofilms showed red autofluorescence. Facultative or strict anaerobic Veillonella, Prevotella, Leptotrichia, and Fusobacterium genera were significantly more abundant in biofilms with C. albicans. Biofilms without C. albicans contained more of the aerobic and facultative anaerobic genera Neisseria, Rothia, and Streptococcus. The presence of C. albicans alters the bacterial microbiome in early in vitro oral biofilms, resulting in the presence of strictly anaerobic bacteria under oxygen-rich conditions. This in vitro study illustrates that C. albicans should not be disregarded in healthy oral ecosystems, as it has the potential to influence bacteria significantly.

Experiences of parents of children with special needs at school entry: a mixed method approach.

BACKGROUND: The transition from pre-school to kindergarten can be complex for children who need special assistance due to mental or physical disabilities (children with 'special needs'). We used a convergent mixed method approach to explore parents' experiences with service provision as their children transitioned to school. METHODS: Parents (including one grandparent) of 37 children aged 4 to 6 years completed measures assessing their perceptions of and satisfaction with services. Semi-structured interviews were also conducted with 10 parents to understand their experience with services. RESULTS: Post transition, parents reported lower perceptions of services and decreased satisfaction than pre-transition. The following themes emerged from the qualitative data: qualities of services and service providers, communication and information transfer, parent advocacy, uncertainty about services, and contrasts and contradictions in satisfaction. The qualitative findings indicate that parents were both satisfied and concerned with aspects of the post-transition service provision. CONCLUSIONS: While the quantitative results suggested that parents' experience with services became less positive after their children entered school, the qualitative findings illustrated the variability in parents' experiences and components of service provision that require improvements to facilitate a successful school entry.

Language impairment and early social competence in preschoolers with autism spectrum disorders: a comparison of DSM-5 profiles.

Children with autism spectrum disorder (ASD) and structural language impairment (LI) may be at risk of more adverse social-developmental outcomes. We examined trajectories of early social competence (using the Vineland-II) in 330 children aged 2-4 years recently diagnosed with ASD, and compared 3 subgroups classified by: language impairment (ASD/LI); intellectual disability (ASD/ID) and ASD without LI or ID (ASD/alone). Children with ASD/LI were significantly more socially impaired at baseline than the ASD/alone subgroup, and less impaired than those with ASD/ID. Growth in social competence was significantly slower for the ASD/ID group. Many preschool-aged children with ASD/LI at time of diagnosis resembled "late talkers" who appeared to catch up linguistically. Children with ASD/ID were more severely impaired and continued to lag further behind.

Correlative tomography.

Increasingly researchers are looking to bring together perspectives across multiple scales, or to combine insights from different techniques, for the same region of interest. To this end, correlative microscopy has already yielded substantial new insights in two dimensions (2D). Here we develop correlative tomography where the correlative task is somewhat more challenging because the volume of interest is typically hidden beneath the sample surface. We have threaded together x-ray computed tomography, serial section FIB-SEM tomography, electron backscatter diffraction and finally TEM elemental analysis all for the same 3D region. This has allowed observation of the competition between pitting corrosion and intergranular corrosion at multiple scales revealing the structural hierarchy, crystallography and chemistry of veiled corrosion pits in stainless steel. With automated correlative workflows and co-visualization of the multi-scale or multi-modal datasets the technique promises to provide insights across biological, geological and materials science that are impossible using either individual or multiple uncorrelated techniques.

Tuning the extent of chiral amplification by temperature in a dynamic supramolecular polymer.

Here, we report on the strong amplification of chirality observed in supramolecular polymers consisting of benzene-1,3,5-tricarboxamide monomers and study the chiral amplification phenomena as a function of temperature. To quantify the two chiral amplification phenomena, i.e., the sergeants-and-soldiers principle and the majority-rules principle, we adapted the previously reported sergeants-and-soldiers model, which allowed us to describe both amplification phenomena in terms of two energy penalties: the helix reversal penalty and the mismatch penalty. The former was ascribed to the formation of intermolecular hydrogen bonds and was the larger of the two. The latter was related to steric interactions in the alkyl side chains due to the stereogenic center. With increasing temperature, the helix reversal penalty was little affected and remained rather constant, showing that the intermolecular hydrogen bonds remain intact and are directing the helicity in the stack. The mismatch penalty, however, was found to decrease when the temperature was increased, which resulted in opposite effects on the degree of chiral amplification when comparing the sergeants-and-soldiers and the majority-rules phenomena. While for the former a reduction in mismatch penalty resulted in a decrease in degree of chiral amplification, for the latter it resulted in a stronger chiral amplification effect. By combining the sergeants-and-soldiers and majority-rules phenomena in a diluted majority-rules experiment, we could further determine the effect of temperature on the degree of chiral amplification. Extending the experiments to different concentrations revealed that the relative temperature, i.e., the temperature relative to the critical temperature of elongation, controls the degree of chiral amplification. On the basis of these results, it was possible to generate a general "master curve" independent of concentration to describe the temperature-dependent majority-rules principle. As a result, unprecedented expressions of amplification of chirality are recorded.

Azo dyes decomposition on new nitrogen-modified anatase TiO2 with high adsorptivity.

New vis active photocatalyst was obtained by the modification of commercial anatase TiO2 (Police, Poland) in pressure reactor in an ammonia water atmosphere at 100 degrees C for 4h. The photocatalytic activity of new material was tested during three azo dyes decomposition: monoazo (Reactive Read), diazo (Reactive Black) and poliazodye (Direct Green). Obtained photocatalyst had new bands at 1430-1440 cm(-1) attributed to the bending vibrations of NH(4)(+) and at 1535 cm(-1) associated with NH(2) groups or NO(2) and NO. UV-vis/DR spectra of photocatalyst had also insignificant decrease in visible region. Fluorescence technique was used for studying the amount of hydroxyl radicals produced on TiO2 surface during visible light irradiation. The hydroxyl radicals produced react with coumarin present in the solution to form 7-hydroxycoumarin which has fluorescent capacity. Photocatalytic activity of modified TiO2 was compared with commercial titanium dioxide P25 (Degussa, Germany). The photocatalytic activity of TiO2/N was higher than that of unmodified material and P25 under visible light irradiation. The ability for dye adsorption (Reactive Red) on photocatalyst surface was also tested. Unmodified TiO2 and P25 has isotherm of adsorption by Freundlich model, and nitrogen-modified TiO2 by Langmuir model. The presence of nitrogen at the surface of TiO2 significantly increased adsorption capacity of TiO2 as well as OH radicals formation under visible radiation.

New TiO2/C sol-gel electrodes for photoelectrocatalytic degradation of sodium oxalate.

This paper reports the preparation of carbon doped TiO2 electrodes by a modification of a sol-gel route. The electrodes have been characterized by measuring their photocurrent, as a function of applied potential. Their photoelectrocatalytic activity, relative to similar sol-gel electrodes without carbon, has been assessed by measuring the decomposition of a 10 mM sodium oxalate solution. Measurements have been made on electrodes prepared with 2%, 5% and 10% of active carbon. The highest photocurrents and the highest photoelectrocatalytic activity were both obtained with electrodes prepared by heating, at 600 degrees C, electrodes prepared with 5% of active carbon. All the electrodes showed evidence of enhanced photocatalytic activity at 1.2 V. Five percent addition of C double the measured rates of photodegradation, even though, in these preliminary studies, no attempt has been made to optimize the type of carbon or the details of the electrode preparation.

The significance of carboxy-terminal telopeptide of type I collagen (ICTP) and osteocalcin (OC) in assessment of bone disease in patients with multiple myeloma.

Bone disease occurring in multiple myeloma is usually evaluated using radiological methods. These methods, however, provide not much information about the dynamic process of bone resorption and formation. This study analysed levels of serum markers of bone turnover (ICTP and OC), reflecting function of osteoclasts and osteoblasts. It demonstrates increased level of ICTP in 75 patients with MM compared to control group (8 persons) and patients with Waldenström's macroglobulinemia (10 persons). The level of ICTP was also higher in patients with more advanced bone disease and probably in higher stage of disease according to Salmon and Durie classification. This tendency was not observed in relation to OC. Result of the research confirms that ICTP may incur sensitive and specific markers of bone lesions in multiple myeloma.

Dietary nitrites and nitrates, nitrosatable drugs, and neural tube defects.

BACKGROUND: Amine-containing (nitrosatable) drugs can react with nitrite to form N-nitroso compounds, some of which are teratogenic. Data are lacking on whether dietary intake of nitrates and nitrites modifies the association between maternal nitrosatable drug exposure and neural tube defects (NTDs) in offspring. METHODS: We examined nitrosatable drug exposure and NTD-affected pregnancies in relation to dietary nitrite and total nitrite intake in a case-control study of Mexican American women. We interviewed 184 women with NTD-affected pregnancies and 225 women with normal live births, including questions on periconceptional drug exposures and dietary intake. For 110 study participants, nitrate was also measured in the usual source of drinking water. RESULTS: Women who reported taking drugs classified as nitrosatable were 2.7 times more likely to have an NTD-affected pregnancy than women without this exposure (95% confidence interval [CI] = 1.4-5.3). The effect of nitrosatable drugs was observed only in women with higher intakes of dietary nitrite and total nitrite (dietary nitrite + 5% dietary nitrate). Women within the highest tertile (greater than 10.5 mg/day) of total nitrite were 7.5 times more likely to have an NTD-affected pregnancy if they took nitrosatable drugs (95% CI = 1.8-45.4). The association between nitrosatable drug exposure and NTDs was also stronger in women whose water nitrate levels were higher. CONCLUSIONS: Findings suggest that effects of nitrosatable drug exposure on risk for neural tube defects in offspring could depend on the amounts of dietary nitrite and total nitrite intake.

[Hematological disorder caused by a giant myoma of the uterus]. / Zaburzenia hematologiczne wywolane miesniakiem macicy.

OBJECTIVES: Polycythaemia means an increase in the number of red blood cells and usually a corresponding increase in the haematocrit and in the quantity of haemoglobin. Regarding etiology, primary and secondary forms of polycythaemia can be distinguished. The primary form--polycythaemia vera--is caused by autonomous erythroblastic hyperplasia. Secondary polycythaemia--erythrocythosis--may arise as a consequence of erythropoietin (EP) overproduction due to tissue hypoxia. These changes may stimulate the EP synthesis in the kidneys. EP may also be produced in metaplastic cells. STUDY DESIGN: A 59-year-old woman was admitted to the Clinic of Haematology of the Wroclaw Medical University with a 10-years' history of significant increase in HB, VPRC and RBC. Physical examination showed an obvious plethora and a large intra-abdominal painless tumour. Laboratory data revealed increases in Hb, VPRC, RBC and EP. A bone marrow aspiration was normal. During surgery, a large leiomyoma of the uterus was found and a total hysterectomy was performed. Pathological examination showed the tumour to be fibroleiomyoma. 4 weeks after surgery Hb, VPRC, RBC and EP, all returned to normal levels. RESULTS: Excluding the effect of the renal compression, it can be concluded that erythropoietin secreted by the the tumour caused the secondary haematological changes.

The MMPI-A and 13-year-old inpatients: how young is too young?

This study examined two questions in the use of the MMPI-A with 13-year-old inpatients: (a) are the profiles of 13-year-old inpatients markedly different from those produced by 14-year-old inpatients, and (b) what is the effect of scoring with standard MMPI-A norms versus Archer MMPI-A norms for 13-year-olds. Protocols from 56 13-year-old and 85 14-year-old psychiatric inpatients were analyzed. No significant differences were found for age in mean T scores, and no clear pattern of differences was found in percentage of elevations into the clinical range (T 65) for validity, clinical, content, or supplemental scales. A strong multivariate effect was found with the use of Archer MMPI-A norms resulting in lower T-score values than when standard MMPI-A norms are used. However, univariate differences based on norms were not routinely found with statistically significant differences in only 2 of the 38 scales for males and 7 of the 38 scales for females. The two major exceptions to this finding were that the use of Archer norms versus standard MMPI-A norms resulting in significantly higher mean T scores and a significantly higher percentage of cases falling within the clinical range for Scale 1 and the depression content scale.

[Diagnostic difficulties in Gaucher disease: report of two cases]. / Trudnosci w rozpoznawaniu choroby Gauchera: opis dwóch przypadków.

Diagnostic difficulties of Gaucher disease, a disorder resulted from a deficient activity of glucocerebrosidase is reported. Gaucher disease was described in the 16 year old male, 5 years after manifestation of the very first symptoms (fracture and osteomyelitis). At the age of 14, the cirrhosis due to viral hepatitis accompanied with splenomegaly was diagnosed. This findings was not associated with the earlier osseous disorders. Histopathologic examination of the removed spleen facilitate the diagnosis. The second case refers to 20 year old female. Clinical symptoms and additional test pointed to malignant neoplasm of thyroid, the reproductive organs or cancer of indistinguishable primary focus with metastases in the liver. Trepanobiopsy of bone marrow had made an accurate diagnosis possible, while determination of beta-glucosidase activity in peripheral white blood cells, chitotriosidase activity, and molecular investigations of gene specific to beta-glucocerebrosidase proved it.

Prediction of preschool behavioral problems in healthy and pediatric samples.

In a prospective study of 137 children (47 with cystic fibrosis, 48 with congenital heart disease, 42 with no chronic illness), four domains were examined as predictors of parent-reported behavioral problems, particularly internalizing problems, at 4 years of age: child health, child temperament, parent-child relationships, and family environment. Family environment, as measured by the Parenting Stress Index at 1,2, and 3 years, was the most powerful predictor. This suggests that this index is useful as an early screen for children at risk for behavioral problems and that a reduction of parenting stress is an appropriate target of preventive interventions.

Treatment characteristics of congenital heart disease and behaviour problems of patients and healthy siblings.

OBJECTIVE: To examine behaviour problems of children in families where one child was diagnosed with congenital heart disease (CHD), in relation to the intensity of treatment required for the CHD. METHODOLOGY: Treatment intensity was based on patients' hospitalizations, surgical operations, current treatment, frequency of check-ups and finality of surgical repair. Mothers of 29 patients and 43 healthy siblings (4-14 years old), and a sub-sample of fathers, reported on behaviour problems of their children and rated the frequency of considering patient's CHD while performing routine child care in nine areas of family life (accommodation of illness). RESULTS: High treatment intensity was associated with high accommodation of illness and elevated behaviour problems among patients. In contrast, siblings in families where treatment intensity was low, but accommodation of illness high were at most risk for behaviour problems. CONCLUSIONS: Treatment intensity has a markedly different impact on behaviour problems of patients and healthy siblings. It is important for parents and healthcare professionals to provide both patients and siblings with information about the patient's medical condition, regardless how much treatment that condition may need.