Prediction of health behaviors in pediatric cancer survivors

BACKGROUND: It is important to understand the factors that motivate survivors of childhood cancer to engage in healthy behaviors. This is because of their susceptibility to adverse late effects from their malignancy and its treatment. We specifically examined sociodemographic and health perception variables as predictors of health-protective behaviors in pediatric cancer survivors. PROCEDURE: Forty-six patients, ages 10--18 years, who were previously treated for cancer and were 1--4 years off-therapy, were assessed using a battery of testing instruments. RESULTS: Preadolescent and adolescent cancer survivors reported moderately frequent practice of a variety of health-protective behaviors. The prevalence of risky health behaviors, as indicated by alcohol and tobacco use, was low. Regression analyses indicated that the practice of health-protective behaviors was best predicted by patient's age and socioeconomic status (SES); younger adolescents and patients from higher SES more frequently engaged in healthy behaviors. Health perception variables were not significantly related to health-protective behaviors. This was true despite findings that survivors perceived themselves to be vulnerable to health problems, identified a need to protect their health, and perceived their health outcomes to be largely determined by their own behaviors. CONCLUSIONS: Sociodemographic factors should be kept in mind when designing interventions to promote continuing good health for young cancer survivors. Also to be included is the assessment of specific health risks secondary to the cancer therapies given. Risk counseling that recognizes and builds on these variables will be most effective in helping this patient population observe sound health habits.     

Differences in age-related effects on brain volume in Down syndrome as compared to Williams syndrome and typical development

Background

Individuals with Down Syndrome (DS) are reported to experience early onset of brain aging. However, it is not well understood how pre-existing neurodevelopmental effects versus neurodegenerative processes might be contributing to the observed pattern of brain atrophy in younger adults with DS. The aims of the current study were to: (1) to confirm previous findings of age-related changes in DS compared to adults with typical development (TD), (2) to test for an effect of these age-related changes in a second neurodevelopmental disorder, Williams syndrome (WS), and (3) to identify a pattern of regional age-related effects that are unique to DS.

Methods

High-resolution T1-weighted MRI of the brains of subjects with DS, WS, and TD controls were segmented, and estimates of regional brain volume were derived using FreeSurfer. A general linear model was employed to test for age-related effects on volume between groups. Secondary analyses in the DS group explored the relationship between brain volume and neuropsychological tests and APOE.

Results

Consistent with previous findings, the DS group showed significantly greater age-related effects relative to TD controls in total gray matter and in regions of the orbitofrontal cortex and the parietal cortex. Individuals with DS also showed significantly greater age-related effects on volume of the left and right inferior lateral ventricles (LILV and RILV, respectively). There were no significant differences in age-related effects on volume when comparing the WS and TD groups. In the DS group, cognitive tests scores measuring signs of dementia and APOE ϵ4 carrier status were associated with LILV and RILV volume.

Conclusions

Individuals with DS demonstrated a unique pattern of age-related effects on gray matter and ventricular volume, the latter of which was associated with dementia rating scores in the DS group. Results may indicate that early onset of brain aging in DS is primarily due to DS-specific neurodegenerative processes, as opposed to general atypical neurodevelopment.     

Corticosteroid management of airway hemangiomas: Long-term follow-up

Nine children with airway obstructing hemangiomas were managed with corticosteroid therapy for durations of 6 weeks to 17 months. One patient required a tracheotomy. Steroid therapy improved the airways of the other 8 patients. Therapy was continued for 8 months or longer in 6 patients, none of whom developed life-threatening infections. Examinations 1½ to 7½ years after therapy revealed all of the patients to be within normal range for height and weight, but 3 of the 6 patients treated for 8 months or longer were in the lower range of normal. Steroid therapy is an effective method of protecting the airway in some patients with hemangiomas. Its disadvantage is that therapy may be necessary for several months. The risk of infections and growth suppression is minimized by using small maintenance dosage and alternate day therapy.     

Bronchial Reactivity in Western Red Cedar Induced Asthma

Summary: Bronchial reactivity in western red cedar induced asthma. R. D. Hamilton, A. J. Crockett, R. E. Ruffin and J. H. Alpers, Aust. N.Z. J. Med., 1979, 9, pp. 417–419.
A patient with Western red cedar induced asthma is described. The diagnosis was confirmed by a bronchial challenge with Western red cedar saw dust and the subsequent prolonged bronchial reactivity changes were measured using histamine inhalation tests.     

Pulmonary Function in Alpha,-Antitrypsin Deficiency

Summary: Five patients with chronic obstructive lung disease associated with homozygous deficiency of alpha,-antitrypsin were found in an 18-month period at the Repatriation General Hospital, Concord. The lung function of these patients was studied in detail and the alpha,-antitrypsin levels and lung function of relatives of two of the patients were measured.
The lung function results indicated the presence of severe emphysema in all patients and severe bronchitis in three of them. Abnormalities of lung function were found in all the asymptomatic relatives with homozygous and heterozygous deficiencies. These results, together with a review of the published results of lung function in people with homozygous deficiency indicate that in adults homozygous deficiency of alpha,-antitrypsin is always associated with abnormalities of lung function. Although some abnormality of lung function was found in all the relatives with heterozygous deficiency in the present study, it is not fully established if the hetero-zygous state is associated with an in-creased incidence of lung disease.     

Presence of chondroitin sulfate in the neuronal cytoplasm.

The distribution of glycosaminoglycans and glycoproteins has been studied in cytoplasmic and particulate fractions of neurons isolated in bulk from rat cerebrum. Lysis of the neurons in 25 mM sodium phosphate buffer at pH 7.5 released 20% of the protein and over 90% of the lactate dehydrogenase in a soluble form. Eighty-two percent of the chondroitin sulfate was also released, together with 55% of the heparan sulfate and 24-25% of the hyaluronic acid and glycoproteins. The chondroitin sulfate remaining in the membranes was completely depolymerized to disaccharides after treatment with chondroitinase ABC, and treatment of the neuronal membranes with 0.1% trypsin removed 55-63% of the chondroitin sulfate and heparan sulfate but only 25% of the sulfated glycoproteins. The results reported here support our previous conclusion that the soluble chondroitin sulfate proteoglycan of brain is largely a cytoplasmic constitutent of neurons (and astrocytes) and is not primarily present in nervous tissue as an extracellular ground substance.     

Vaginal colonization with mycoplasma hominis and ureaplasma urealyticum

Vaginal cultures obtained from unselected young women who consulted the gynecologist in a student health service were examined for Ureaplasma urealyticum and Mycoplasma hominis. Each participant completed a confidential questionnaire. Multiple logistic regression analysis was used to determine which variables, of a large number ascertained, were associated with mycoplasmal colonization. U. urealyticum was isolated from 273 (56.8%) of 481 participants. The following variables were significantly predictive of colonization with U. urealyticum: black race, absence of antibiotic use, cigarette smoking, and number of sexual partners during the last year. Lifetime number of sexual partners was significantly predictive only in women who used nonbarrier methods of contraception. M. hominis was isolated from 85 (17.7%) of the 481 participants. Independent variables that were significantly predictive of colonization with M. hominis included black race, young age, and, for users of nonbarrier methods of contraception, lifetime number of sexual partners.