Outcome at 4 to 5 years of age in children recovered from neonatal chronic lung disease.

Outcomes were compared for 31 very-low-birthweight children recovered from chronic lung disease and 31 very-low-birthweight controls. All children had been free of major abnormalities on neonatal cranial ultrasonography. At 4 to 5 years of age, children were examined by a pediatrician and tested by a psychologist who administered the Wechsler Preschool and Primary Scale of Intelligence-Revised. Despite similar medical outcomes, the children who had had neonatal chronic lung disease had lower Full-scale IQs (median 83 vs 87) and Performance IQs (79 vs 90). Median Verbal IQ was similar in the two groups (85 vs 87). A higher proportion of children who had had chronic lung disease had Full-scale IQ < 70 (8/31 [26%] vs 1/31 [3%]) and Performance IQ < 70 (8/31 [26%] vs 0/31). These effects persisted after adjustment for confounding factors.

Comparison of clarithromycin and penicillin VK suspensions in the treatment of children with streptococcal pharyngitis and review of currently available alternative antibiotic therapies.

In a randomized investigator-blinded study, 506 children ages 6 months to 12 years with positive rapid direct antigen tests for Group A beta-hemolytic Streptococcus (GABHS) received treatment with either clarithromycin suspension, 7.5 mg/kg twice daily, or penicillin VK suspension, 13.3 mg/kg three times per day for 10 days. Signs and symptoms of pharyngitis or tonsillitis were evaluated and throat cultures were obtained before treatment, once during treatment and 4 to 6 days and 19 to 25 days posttreatment. All GABHS isolates were susceptible in vitro to clarithromycin. Successful clinical responses at the end of treatment were demonstrated in 169 of 176 (96%) evaluable clarithromycin-treated patients and 179 of 191 (94%) evaluable penicillin-treated patients. GABHS was successfully eradicated at end of treatment in 168 of 183 (92%) evaluable clarithromycin-treated patients compared with 162 of 199 (81%) evaluable penicillin-treated patients (P = 0.004). There were no significant changes in hematologic or serum chemistry parameters in either group. Both drugs were well-tolerated. The incidence and nature of adverse events were similar in the clarithromycin and penicillin groups, except for gastrointestinal complaints reported in 35 of 250 (14%) clarithromycin recipients compared with 12 of 256 (5%) penicillin recipients (P < or = 0.001). The results indicate that twice daily clarithromycin was as safe and effective as three times daily penicillin VK in the treatment of children with streptococcal pharyngitis or tonsillitis. Clarithromycin was statistically superior to penicillin VK in the eradication of GABHS.

The relationship between MCMI personality scales and clinician-generated DSM-III-R personality disorder diagnoses.

This study examined the relationship between elevations on the personality scales of the Millon Clinical Multiaxial Inventory (MCMI) and clinician-generated Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-III-R]; American Psychiatric Association, 1987) diagnoses for 101 psychiatric patients at a VA medical center/psychiatric hospital in the Southeastern United States. Personality disorder diagnoses were made by employing a personality symptom checklist that consisted of all the verbatim criteria for personality disorders contained in the DSM-III-R. Clinicians who completed the checklists were required to have had at least 5 hr of direct contact with the patients who completed the MCMI. The results indicated that only the Schiozotypal scale of the MCMI was related to its respective DSM-III-R personality disorder in the simple correlation. An examination of the diagnostic efficiency statistics for each of the MCMI personality disorder scales revealed overall low sensitivity, poor specificity, poor positive predictive power, and low diagnostic power, which suggests that the MCMI may have only limited utility in identifying personality disorders.

Relationships between the MAPI and the MMPI in the assessment of adolescent psychopathology.

Although the Minnesota Multiphasic Personality Inventory (MMPI) and the Millon Adolescent Personality Inventory (MAPI) are both widely used in the clinical assessment of adolescents, no research has examined the interrelationship between these two instruments. We investigated MMPI and MAPI responses from 199 adolescents assessed at entrance to inpatient or outpatient psychiatric programs in Florida and Virginia. Univariate correlation analyses identified areas of significant associations between these measures, with coefficients ranging widely from -.70 to .72. Substantial diagnostic differences were found between these instruments. The MAPI, for example, yielded no depression-related diagnoses, but produced many more adjustment disorder and personality disorder diagnoses than the MMPI. The rates of diagnostic assignment agreements between diagnoses produced by clinical judgment, MMPI findings, and MAPI interpretive reports were typically quite low.

Concurrent validity of the Gardner Test of Visual-Motor Skills.

Scores on the Test of Visual-motor Skills, Developmental Test of Visual-motor Integration, and Bender-Gestalt test were compared for a sample of 44 elementary school children referred for evaluation of learning disorders. While the tests shared common variance, the mean standard score on the Test of Visual-motor Skills was significantly lower than the means of the other two tests, suggesting caution in the clinical use of the new scale.

Ratio developmental quotients from the Bayley are comparable to later IQs from the Stanford-Binet.

Ratio developmental quotients (DQs) from Bayley Scales administered after age 30 months were compared to Stanford-Binet IQs secured later. Means from two testings of 42 mentally retarded children were almost identical. The DQs and IQs correlated .81, p less than .001. These findings justify the use of Bayley ratio quotients to determine intellectual level of children who are too old for the Bayley norms but too retarded to earn a basal level on the Stanford-Binet.

The etiologic and epidemiologic spectrum of bronchiolitis in pediatric practice.

To develop a broad understanding of the causes and patterns of occurrence of wheezing associated respiratory infections, we analyzed data from an 11-year study of acute lower respiratory illness in a pediatric practice. Although half of the WARI occurred in children less than 2 years of age, wheezing continued to be observed in 19% of children greater than 9 years of age who had lower respiratory illness. Males experienced LRI 1.25 times more often than did females; the relative risk of males for WARI was 1.35. A nonbacterial pathogen was recovered from 21% of patients with WARI; respiratory syncytial virus, parainfluenza virus types 1 and 3, adenoviruses, and Mycoplasma pneumoniae accounted for 81% of the isolates. Patient age influenced the pattern of recovery of these agents. The most common cause of WARI in children under 5 years of age was RSV whereas Mycoplasma pneumoniae was the most frequent isolate from school age children with wheezing illness. The data expand our understanding of the causes of WARI and are useful to diagnosticians and to researchers interested in the control of lower respiratory disease.