Development of language in 18-30-month-old HIV-1-infected but not ill children.

Thirty-six children (age range, 18-30 months) born to HIV-1-infected mothers were studied for speech development by matching 18 infected with 18 non-infected subjects for age, sex and socioeconomic status. All the children were in good health. Each child was given three comprehension and three production tasks. In addition, each child's mean length of utterance (MLU) was obtained by observation of natural child-parent interactions. The development quotients (DQ) were assessed by Brunet-Lézine's tests. Infection significantly affected children's MLU, the infected children being less advanced than those non-infected. Both infected and non-infected children progressed in language acquisition from the second to the third year of age, but infected children had significantly greater production difficulty than non-infected children in the second year of life. The matched subjects design adopted gives some strength to the conclusion that HIV-1 infection impairs the genesis rather than the later development of language in infected but not ill children.

How frequent and how early does the neurological involvement in HIV-positive children occur? Preliminary results of a prospective study.

To study the natural history of the neurological involvement in pediatric human immunodeficiency virus (HIV) infection, 77 children born to seropositive mothers have been followed up since birth. The median follow-up time has been 17.5 months. Fourteen children were classified as infected, 34 as not infected, and 21 as indeterminable. Only two children with full-blown acute immune deficiency syndrome had severe neurological manifestations. "Soft" neurological signs were found in six infected, and ten non-infected children (chi 2, P < 0.05). The mean development quotient and IQ scores in the infected and the non-infected children were 82.22, and 93.15, respectively (Mann-Whitney test, P > 0.05). These data suggest that neurological and developmental abnormalities do not occur early in the course of vertical HIV infection and that they are associated with severe immunodeficiency.

[Brain tumors: classification and clinical aspects]. / Tumori cerebrali: classificazione e clinica.

Brain tumors represent 40% to 50% of all solid tumors in children under 18 years of age, with an average incidence of 2 to 5 cases per 100,000/annum. These tumors are gliomas in 60% to 70% of cases. The most common location is infratentorial (60% of cases), with cerebellar astrocytomas, medulloblastomas and brain stem gliomas occurring in equal measure (20%). Astrocytomas are the predominant form (25%) in the supratentorial compartment. This review analyses clinical symptoms and instrumental procedures for the diagnosis of various types of brain tumor, together with recommendations for their management based on controlled clinical trials.

[Endometrial morphological changes in intrauterine device users]. / Modificazioni morfologiche endometriali nelle portatrici di dispositivi intrauterini.

PIP: The diminution of the number of births seems to stem from a widespread use of voluntary abortions and only partially from a correct use of contraceptive methods. The IUD is not without clinical complications, such as hemorrhage, pelvic or endometrial inflammation, possibly ectopic pregnancy, perforation of the uterus, and loss of the IUD itself. In several out-patient clinics in the province of Novara Italy the morphological and/or morpho-functional alterations of the endometrium were analyzed histologically and evaluated on a percentage basis after removal of the IUD and examination of adhering endocervical or endometrial tissue fragments. The total sample comprised 50 patients between the ages of 20 and 46. Removal of the IUD was performed between the 1st and 3rd theoretical date of the menstrual cycle. In 60% of the patients sufficient endometrial material revealed, under the morphological aspect, that 50% had superficial inflammation and pseudodeciduation, 46% superficial dysplasia of the epithelium, 8% papillary formation, 4% superficial microthrombosis and 26% granular tissue and/or exudative material. Under the functional aspect, the endometrium was in the regular menstrual phase, as expected, for 20% of these patients, 18% in the proliferative and 18% in the secretory phase. The anomalous or phase-altering function and morphological alteration of the endometrium reacting to the presence of an extraneous device is probably one of the reasons for the contraceptive efficacy of the IUD. These well-documented endometrial and endocervical alterations do not contraindicate the use of the IUD but regular clinical and cytologic checkups are advised.^ieng