Children's Memorial Hospital

About: Children's Memorial Hospital is a based out in . It is known for research contribution in the topics: Population & Transplantation. The organization has 5652 authors who have published 8967 publications receiving 283837 citations.

Age at Onset of Epilepsy, Pharmacoresistance, and Cognitive Outcomes: A Prospective Cohort Study.

Abstract: Objectives: Increasing evidence suggests that uncontrolled seizures have deleterious effects on cognition and behavior, particularly in the developing brain. Methods: In a community-based cohort, 198 children, aged Results: FSIQ was not correlated with age. PR was associated with an 11.4 point lower FSIQ ( p = 0.002) and similar decrements in each WISC-III domain. There were substantial age-PR interactions for FSIQ ( p = 0.003) and 3 domain scores, indicating a lessening impact of PR with increasing age. The dichotomous IQ indicator was strongly correlated with age at onset in the pharmacoresistant group ( p p = 0.61). Adjustment for adaptive behavior measured near onset did not alter the conclusions. Conclusions: Uncontrolled seizures impair cognitive function with effects being most severe in infancy and lessening with increasing age at onset. These findings further emphasize the need for early aggressive treatment and seizure control in infants and young children.

Asthma control, adiposity, and adipokines among inner-city adolescents.

Abstract: Background There is an association between adiposity and asthma prevalence, but the relationship to asthma control is unclear. Objectives We sought to understand the relationships among adiposity, sex, and asthma control in inner-city adolescents with asthma. Methods We prospectively followed 368 adolescents with moderate-to-severe asthma (ages 12-20 years) living in 10 urban areas for 1 year. Asthma symptoms and exacerbations were recorded, and pulmonary function and exhaled nitric oxide levels were measured every 6 weeks. Adiposity measures (body mass index [BMI] and dual-energy X-ray absorptiometric scans) were made, and blood was collected for measurement of allergy markers, adiponectin, leptin, TNF-α, IL-6, and C-reactive protein levels. Results More than 60% of female subjects and 50% of male subjects were above the 85th percentile of BMI for age. Higher BMI was associated with more symptom days ( R = 0.18, P = .02) and exacerbations ( R = 0.18, P = .06) among female subjects only. Adiponectin was inversely related to asthma symptoms ( R = −0.18, P R = −0.20, P 1 /forced vital capacity ratio ( R = 0.15, P Conclusion Adiposity is associated with poorer asthma control in female subjects. Adiponectin is associated with improved asthma control in male subjects.

Psychosocial characteristics of inner-city children with asthma: A description of the NCICAS psychosocial protocol

Abstract: Previous research has demonstrated a significant reciprocal relationship between psychosocial factors and asthma morbidity in children. The National Cooperative Inner-City Asthma Study investigated both asthma-specific and non-specific psychosocial variables, including asthma knowledge beliefs and management behavior, caregiver and child adjustment, life stress, and social support. This article presents these psychosocial characteristics in 1,528 4–9-year-old asthmatic urban children and their caretakers. Caretakers demonstrated considerable asthma knowledge, averaging 84% correct responses on the Asthma Information Quiz. However, respondents provided less than one helpful response for each hypothetical problem situation involving asthma care, and most respondents had more than one undesirable response, indicating a potentially dangerous or maladaptive action. Both adults and children reported multiple caretakers responsible for asthma management (adult report: average 3.4, including the child); in addition, children rated their responsibility for self-care significantly higher than did adults. Scores on the Child Behavior Checklist indicated increased problems compared to normative samples (57.3 vs. 50, respectively), and 35% of children met the criteria for problems of clinical severity. On the Brief Symptom Inventory, adults reported elevated levels of psychological distress (56.02 vs norm of 50); 50% of caretakers had symptoms of clinical severity. Caretakers also experienced an average of 8.13 undesirable life events in the 12 months preceding the baseline interview. These findings suggest that limited asthma problem-solving skills, multiple asthma managers, child and adult adjustment problems, and high levels of life stress are significant concerns for this group and may place the inner-city children in this study population at increased risk for problems related to adherence to asthma management regimens and for asthma morbidity. Pediatr. Pulmonol. 1997;24:263–276. © 1997 Wiley-Liss, Inc.