OBJECTIVES: To find out the etiology and outcome in terms of clinical improvement among children having esophageal stricture (ES). METHODS: This prospective study was conducted from July 2019 to ...March 2020 at Children’s Hospital, Multan, Pakistan on diagnosed patients of ES, ageing <15 years. Demographic details, different etiologies, location of the ES and treatment outcome were recorded. After initial management, endoscopy and dilatation was done at 6 weeks. Patients were followed-up for at least 12 weeks. RESULTS: Out of 32 children with ES, 19 (59.4%) were males. Mean age of children was 36.58±19.6 months. Twenty-four (75%) patients had proximal and 8 (25%) had distal stricture. Chemical burn (n=23; 71.9%) and esophageal atresia (n=4: 12.5%) were commonest causes of ES. Dilatation and surgery were performed in 21 (65.6%) cases followed by dilatation only in 10 (31.3%) cases and surgery alone in one (3.1%) case. In patients with chemical burns, majority (n=16/23; 69.6%) required both dilatation and surgery. Overall outcome of treatment options was good in 62.5% (n=20/32) patients. Outcome was good in 61.9% (n=13/21) of patients requiring both dilatation and surgery and 70% (n=7/10) in patients having dilatation alone (p=0.385). Outcome was good in 69.6% (n=16/23) of patients with chemical burns and 70% (n=7/10) in patients with dilatation only (p=0.385). Mortality rate was 3.1% (n=1). CONCLUSION: Chemical burn and esophageal atresia were the commonest causes of ES. Outcome of all procedures was good in 62.5% cases and had no significant relationship with causes and site of ES or types of treatment.
The Bruce treadmill protocol is an often-used exercise test for children and adults. Few and mainly old normative data are available for young children. In this cross-sectional observational study we ...determined new reference values for the original Bruce protocol in children aged 4 and 5 years. Furthermore, we compared the original protocol with the so-called ‘half Bruce’ protocol. In the Netherlands this half-Bruce protocol is often used for young children because of the rather large increments in workload in the original protocol. Seventy-eight healthy Dutch children participated. The maximal endurance time was the criterion of exercise capacity. The new reference values for the original Bruce protocol are presented as reference centiles. The mean (SD) endurance time using the original protocol was 10.2 (SD 1.5) min.; this was 9.4 (1.3) min. for the half-Bruce protocol. The mean difference was 50 seconds (95% CI: 29–71 s,
P
< 0.001). So, for children aged 4 and 5 years the endurance times obtained with the original and half-Bruce protocol are different and should not be considered interchangeable. Our new reference values can be used as reference values for the original Bruce protocol.
Airway inflammation is an early feature of asthma. Early detection and anti-inflammatory treatment may have important therapeutic impact. Exhaled nitric oxide is a noninvasive marker of airway ...inflammation. The current study investigated the association between exhaled nitric oxide and asthma, wheezing phenotypes, atopy and blood eosinophilia in a large group of 4-yr-old children from the general population. All children participated in the Prevention and Incidence of Asthma and Mite Allergy study, a birth cohort study of high-risk (atopic mother) and low-risk children in the Netherlands. Nitric oxide levels were successfully determined in 429 children. Although there was overlap in the distribution of values of children with and without asthma or atopy, mean values were higher in children with atopy or doctor's diagnosed asthma (geometric mean (ppb) 9.4 and 10.0, respectively) as compared to those without (7.7 and 7.9). Values were highest in atopic symptomatic children. Values were not associated with wheezing phenotype or blood eosinophilia. This study is one of the few large-scale epidemiological studies among 4-yr-old children from the general population showing that children with symptoms of asthma and atopy have higher levels of exhaled nitric oxide than those without.
Malka Margalit, Ph.D., was the Head of the Jaime and Joan Constantiner School of Education, Tel-Aviv University. She received her Ph.D. from London University and was nominated full professor in ...1994. She has published her research in 4 books, 110 articles in international peer-reviewed journals, and several chapters in professional books. Professor Margalit is the Vice President for International Development of the IARLD (International Academy of Research in Learning Disabilities), is on the coordinating board of the International Society for Research in Early Intervention, and was Chairperson of the Israeli Council of Psychologists, Director of the Sneurson Psycho-Educational Center and representative of the Israeli Psychologists` organizations in the National Health Committee of the Israeli Ministry of Health. She was also the chairperson of the Shalem Foundation research Committee, Chairperson of the Committee on Disability and Rehabilitation in the International Council of Psychologists, and the Vice Chairperson of the International Association of Special Education. She received the Enoch Award for Scientific Contribution to Special Education and has frequently been invited as an international evaluator to present her research in international conferences around the world. Professor Margalit is a certificated senior educational and rehabilitational psychologist. She is a member of several international professional organizations, and on the editorial boards of several scientific journals, including the Journal of Learning Disabilities, European Journal of Special Needs Education, and Exceptional Children. Professor Margalit was nominated by the Minister of Science and the Minister of Education to chair the national committee that examined the needs of students with learning disabilities in Israel (Margalit Committee). The report`s conclusions were presented in 1997, and are currently being implemented throughout the Israeli educational system. She also chaired the national committee to evaluate the implementation of the Special Education Law (Margalit Committee II). In her research, through her books, chapters and research articles, Professor Margalit examines in depth children`s loneliness and the impact of emotions and motivation on learning and adaptive development. She is employing empowering models such as Hope Theory to promote growth and adjustment instead of the traditional focus on the causes for dysfunction. She is conducting research on the contributions of friends (including Internet support and virtual friends), schools and families to the adjustment of children with special needs versus typical development. Her studies examine methods for promoting effective coping, enhancing personal strength and reframing difficulties into challenges including the use of technology to enhance empowerment processes.
Aim: To report findings about the Motor Performance Checklist (MPC) for 5‐year‐olds, a simple 12‐item instrument for assessing gross and fine motor skills, in a research study of neurodevelopmental ...outcomes after neonatal events.
Methods: We trained 10 examiners to use the MPC in a study of the outcomes of neonatal jaundice and dehydration in 339 5‐year‐old children. We compared MPC scores with those on the Wechsler Preschool and Primary Scale of Intelligence‐Revised (WPPSI‐R), the Beery–Buktenica Developmental Test of Visual‐Motor Integration‐Fourth Edition (VMI‐4), and a standard neurological examination, and compared failure rates on each MPC item across examiners. Parent concerns about their child’s development were addressed using the Parent Evaluation of Developmental Status (PEDS).
Results: Children who ‘failed’ the MPC had 7–10 points lower mean scores on the WPPSI‐R subscales (P = 0.001), 9–10 points lower mean scores on the VMI‐4 subscales (P = 0.001), and were almost twice as likely to have a ‘questionable’ neurological examination score (adjusted OR 1.86, 95% CI 1.00–3.53, P = 0.005). On the PEDS, only the concern about the use of arms and hands was significantly associated with MPC failure. We found significant sex differences on four of the 12 MPC items. We also found differences in failure rates by different examiners.
Conclusions: MPC scores correlated with other measures of neurodevelopment. Because of different failure rates across examiners, examiner terms need to be included if it is used in research studies.
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