What are specific performance weaknesses?

The term "specific developmental disorder" means localized deficits in very different functions contrasting fit in the general otherwise normal performance level of a child. These disorders are mostly looked upon in a developmental context and differentiated from acquired neuropsychological syndromes (e.g. aphasia, apraxia). The most important clinically relevant disorders are: the specific reading disability, the specific dyscalculia, other specific learning disabilities, the specific developmental language disorder, the specific retardation in the motor development, and multiple developmental retardations. In a population of all patients treated in institutions for children and adolescents, 30% show specific developmental disorders with a predominance of boys. There is no correlation between dyslexia and social class but it does exist for specific developmental language disorder and motor retardation. As to the etiology of specific developmental disorders, genetic factors, congenital or acquired cerebral dysfunctions, maturation or developmental retardation and cognitive variables are discussed. The multifactor-approach seems to be the best way of understanding specific developmental disorders, which are difficult to prove.     

Enzyme linked immunosorbent assay for detecting specific IgM antibody in congenital cytomegalovirus infection

ABSTRACT. An enzyme linked immunosorbent assay (ELISA) was used to determine whether cytomegalovirus (CMV) specific IgM antibody was present in the serum of 135 neonates suspected of having congenital CMV infection. The assay was compared with the fluorescent antibody (FA) technique for cytomegalovirus specific IgM using the IgM fraction separated from serum by chromatography, a technique which has been shown to be a sensitive and specific method of detecting CMV specific IgM antibody.
Elevated optical density reactions with the ELISA technique were only obtained with the seven sera that were shown to contain CMV specific IgM antibody by the fluorescent antibody technique. Sera from 128 neonates that were negative by the CMV-IgM-FA technique gave low optical density ELISA readings.
The ELISA appeared at least as sensitive and specific as the fluorescent antibody test for detecting cytomegalovirus specific IgM antibody in neonates.     

Verbal and nonverbal intelligence in children with language development disorders

Difficulties in language acquisition seem to be serious, if there are additional problems like intellectual and/or emotional/social impairment, which are often reported [10]. These additional problems and the definition of specific language impairment as a developmental disorder, restricted to language acquisition seem to be contradictory [17]. Aim of that study is to look for specific language impaired children with similar cognitive abilities and though to investigate, if there are children without additional cognitive problems considering the definition of specific language impairment. 93 children, between 4;0 and 6;6 years old, were diagnostized as specific language impaired (ICD-10) and were assessed by the "Hannover Wechsler Intelligenztest für das Vorschulalter (HAWIVA)" [6] (german version of WPPSI). Cluster analysis showed, that 1/3 of the specific language impaired children presented no additional cognitive problems and 2/3 of them showed cognitive problems regarding nonverbal and verbal intelligence indeed. These additional cognitive problems indicate that there may be a more basic cognitive defect underlying specific language impairment [15]--at least for a group of specific language impaired children. Furthermore the nonverbal and verbal intellectual difficulties emphasize to general developmental support of specific language impaired children for optimal improvement in language acquisition.     

New approaches to the diagnosis of tuberculosis in childhood with special reference to neurotuberculosis

Bacteriological diagnosis of tuberculosis in childhood is often unsuccessful owing to the difficulty in obtaining suitable specimens. Many attempts have been made to diagnose tuberculosis immunologically but with very limited success. Positive tuberculin reactions may be the result of nonspecific sensitization while negative reactions occur in undernourished children. Serodiagnostic tests suffer from problems of specificity, even when very specific antigens are used, and are often least helpful in diagnostically difficult cases. Detection of antigen has proved to be of more value, especially with clean specimens such as cerebrospinal and pleural fluids. Detection of specific components ofMycobacterium tuberculosis by linked gas chromatography and mass spectroscopy is very sensitive and specific but the equipment is very costly. Detection of specific DNA sequences ofM. tuberculosis in specimens by use of labelled ‘DNA probes’ is rather insensitive although the sensitivity may be increased greatly by use of the polymerase chain reaction to amplify small amounts of the specific DNA. Non specific indicators of tuberculosis are generally unhelpful although the bromide partition test and assay of the enzyme adenosine deaminase in cerebrospinal fluid appear to be of value in the diagnosis of tuberculous meningitis. More research is required to develop a simple, specific and automated test for tuberculosis in childhood.     

儿童变态反应性疾病过敏原3 504例调查分析

目的：了解儿童变态反应性疾病的过敏原状况,以便于有针对性的预防和治疗。方法：对3 504例各种变态反应性疾病患儿,采用UniCAP100系统检测血清fx5E（食物筛查试验）或Phadiatop（环境吸入性筛查试验）,及血清特异性IgE。结果：过敏性鼻炎、过敏性结膜炎、哮喘及丘疹性荨麻疹患儿的血清环境吸入性变应原阳性率明显高于食物性变应原,而过敏性紫癜及消化道疾病患儿的食物性变应原阳性率明显高于环境吸入性变应原。环境吸入性特异性IgE水平较高,屋尘、户尘螨、粉尘螨大部分达到6级,食物性特异性IgE水平较低,均在3级以下。结论：不同的儿童变态反应疾病的食物和环境吸入过敏原有显著差异,环境吸入性特异性IgE水平较食物性特异性IgE高。［中国当代儿科杂志,2010,12（9）：720-722］     

Allergic reactions in treatment with L-asparaginase. Significance of specific IgE antibodies

The formation of specific IgE antibodies to L-Asp was studied in 27 children with ALL. Increased titers of specific IgE antibodies were significantly more frequent (p less than 0.001) prior to L-Asp infusions followed by allergic reactions than in those without reactions. After passive sensitization of basophile granulocytes of a healthy volunteer using patient's serum with the highest titers of specific IgE antibodies to L-Asp a significant release of histamine was observed after exposure of cells to L-Asp. In 1 of 8 patients with allergic reactions titers of specific IgE antibodies were elevated, while there was not detectable activation of the complement system. In conclusion, elevated titers of specific IgE antibodies to L-Asp are frequently detectable prior to L-Asp infusions which are associated with allergic reactions. In addition to activation of the classical complement pathway specific IgE antibodies and mediator release from mast cells may contribute to clinical symptoms. In a small number of patients this mechanism alone may be responsible for the allergic reaction.     

Parental alcohol-specific rules and alcohol use from early adolescence to young adulthood

Background: Several studies stress the importance of alcohol‐specific rules during adolescence to prevent them from drinking early and heavily. However, most studies have short follow‐up periods and do not cover the relevant developmental period in which direct parental control diminishes and adolescent alcohol use increases. The current study aimed to provide a developmental perspective on the link between alcohol‐specific rules and alcohol use from early adolescence until early adulthood in the Netherlands. Methods: The sample consisted of 428 Dutch families including fathers, mothers and adolescents from 2 age groups (13 and 15 years old) at Time 1 (T1), who have been surveyed annually for 6 years. To address the effect of alcohol‐specific rules on adolescent alcohol use over time, a latent growth curve analytic approach with time‐varying covariates was employed. Results: Over time, adolescent alcohol use increased, whereas alcohol‐specific rules decreased. Most importantly, however, the lagged paths of alcohol‐specific rules consistently predicted subsequent alcohol use across the 6 assessments for both younger and older siblings. Thus, strict alcohol‐specific rules at a certain point in time were related to a lower intensity of adolescent alcohol use a year later. Conclusions: Although parents turn somewhat less strict in alcohol‐specific rules over time, and adolescent alcohol use increases over time, the specific rules parents set remain important in restraining the alcohol use of their adolescent offspring. Thus, parents should and can feel confident about their parenting capabilities, and they should maintain being strict to prevent their offspring from drinking.     

体内和体外变应原测定在过敏性哮喘诊断中的联合应用

目的分析变应原皮肤点刺试验(SPT)和血清吸入性变应原筛查(Phadiatop)及特异性IgE测定联合应用在过敏性哮喘变应原诊断中优势。方法对57例诊断哮喘患儿进行吸入性变应原SPT测定和Phadiatop测定。对其中33例进行血清户尘螨特异性IgE测定。分析本组哮喘患儿SPT结果分布,SPT与Phadiatop结果符合率,户尘螨SPT与其特异性IgE结果符合率。结果儿童哮喘吸入性致敏原分布最常见的为尘螨、真菌、宠物等室内变应原。本组SPT和Phadiatop阳性检出率分别为86%、79%,SPT与Phadiatop符合率86%。5例Phadiatop阴性患儿经SPT和真菌特异性IgE测定证实存在真菌过敏。户尘螨SPT和特异性IgE结果符合率为97%。结论在儿童哮喘相关吸入性变应原诊断中,联合应用体内和体外变应原测定方法可互为补充,有助于提高变应原诊断的敏感性和特异性。     

Geschlechtsentwicklung zwischen Genen und Hormonen

Sex differences in males and females develop through the action of sex specific genes and hormones. Specific sex different genes are responsible for the development of the unspecific gonad into testes or ovaries. They are responsible for the secretion of sex hormones which regulate the differentiation of internal and external genitalia, pubertal development and fertility. Sex specific differences are also present in the brain, particularly in the hypothalamus and preoptic area. These morphologic differences are most likely responsible for the development of a sexual identity and a sex specific orientation. They regulate the characteristic behavioral patterns during mating and influence maternal or paternal behavior. Most morphologic and biochemical differences between males and females are still unknown, only a minor part can be clearly associated with specific genes. However, it is certain that the major part of sex specific behavior is genetically determined. To identify these and to differentiate them from socially-determined behavior further investigations are needed.     

食物IgG抗体检测在慢性消化系统疾病中的临床意义

目的探讨血清中14种食物过敏原特异性IgG与小儿慢性消化系统疾病的关系。方法应用酶联免疫法检测40例慢性消化系统疾病患儿,血清中食物特异性IgG水平,然后按3∶1分别采用微粒子化学发光法和散射比浊法检测血清总IgE和血清IgG4水平。结果40例患儿食物过敏原特异性IgG升高有1到6种不等,总阳性率为100%,2种以上升高者为87.5%。食物特异性IgG升高以鸡蛋(92.5%)和牛奶(72.5%)最多见,其次为小麦、大豆(分别为40.0%、27.5%),鸡肉、猪肉和玉米均为0。根据试验结果调整所有患儿的饮食,病人症状在3周内明显改善者62.5%,症状有所改善者32.5%,无效5.0%,总有效率为95.0%。血清总IgE大于正常值者为17.5%,与食物特异性IgG无相关性(r=-1.132,P=0.268)。血清总IgG4水平变化与食物特异性IgG无相关性(r=0.863,P=0.396),与年龄呈正相关(r=3.317,P=0.003)。结论测定食物过敏原特异性IgG在小儿慢性消化系统疾病诊治中有重要意义。     

Longitudinal study of the number and choice of leisure time physical activities from mid to late adolescence: implications for school curricula and community recreation programs

BACKGROUND: Physical activity (PA) declines during adolescence. There has been little research describing this decline or examining participation and nonparticipation in specific activities. OBJECTIVE: To describe the pattern of change in the number of physical activities, the time spent on specific activities, and the stability of participation and nonparticipation in specific activities during adolescence. DESIGN AND SETTING: A population-based 4-year longitudinal study of adolescents recruited from a single suburban school district near Pittsburgh, Pa. PARTICIPANTS: A total of 782 adolescents, aged 12 to 15 years at baseline. MAIN OUTCOME MEASURES: Physical activity was measured annually via questionnaire. Outcome measures include hours per week of PA, number of reported activities, and participation (yes or no) in specific activities. RESULTS: Physical activity declined during the 4 years by 26%. The decline in PA was primarily due to a decrease in the number of reported activities. Adolescents who continued to report an activity during the 4 years of the study maintained or increased the time spent on that specific activity. Female adolescents were more likely to report individual activities, while male adolescents were more likely to report team activities. The probability of maintaining participation in a specific activity during the 4 years was low to moderate, 0.02 to 0.47 for female adolescents and 0.04 to 0.71 for male adolescents. The probability of not participating in a specific activity during the 4 years was extremely high and consistent for male and female adolescents, 0.70 to 1.00. CONCLUSIONS: The decline in PA during adolescence is primarily due to a decrease in the number of activities in which the adolescent is participating, and there is only a moderate probability that an adolescent will continue to participate in an activity during the 4-year period from junior to senior high. Future efforts should be directed at identifying factors associated with initiating and maintaining participation in specific activities.     

A specific IgM test for the diagnosis of Epstein-Barr virus infections (author's transl)]

IgM antibodies specific for Epstein-Barr virus (EBV) were measured in 302 patients with high IgG antibody titers to study whether EBV was the cause of disease in children having one or more symptoms of classical infectious mononucleosis. IgM antibodies specific for EBV were found in all patients with the defined clinical picture of infectious mononucleosis. In addition the majority of cases with clinical suspicion of the disease had also specific IgM titers. Besides infectious mononucleosis EBV can also be the cause of other diseases like hepatitis, and lymphadenitis: we found IgM antibodies specific for EBV in 48% of patients with nonbacterial lymphadenitis and in 64% of patients with hepatitis not due to hepatitis A or B virus. In contrast to observations by others we were able to show heterophile antibodies in cases with incomplete features of infectious mononucleosis. IgM antibodies to EBV were found in 4 out of 85 controls only. We conclude that untypical features of infectious mononucleosis can be caused by EBV also. Therefore the determination of specific IgM antibodies to EBV can be helpful in the diagnosis of uncharacteristic EBV infections.     

The use of specific immunoglobulin for the treatment of children with acute herpetic encephalitis

The use of specific immunoglobulin in combination with conventional agents of pathogenetic and symptomatic therapy was over two times more potent in reducing the lethality due to herpetic encephalitis. The residual phenomena in the survivors were also less pronounced in those given specific immunoglobulin. A relationship has been discovered between the outcomes of herpetic encephalitis and the time since the treatment with specific immunoglobulin was instituted, the rate of coma development and its intensity at the moment of the therapy onset.     

The prognostic significance of specific IgG antibodies in insect sting allergy

Specific IgG antibodies against bee venom and bee venom components were studied in the serum of 40 bee-sting allergic patients, 60 bee keepers, and 31 control subjects. The highest titres were observed in successfully hypothesized patients and in bee keepers. Subclass-typing in bee-sting allergic patients showed the highest antibody levels in subclass IgG 2, followed by IgG 3, IgG 4 and IgG 1. During hyposensitization, a rise in specific IgG antibodies in all subclasses and against bee venom and all its components was found. The allergic reaction to bee stings disappeared with the rise of specific IgG antibodies, as demonstrated by a bee-sting challenge. After 6 months of hyposensitization therapy, the specific IgG antibodies remained above, and the specific IgE antibodies fell below, the pretreatment levels.     

血清特异性IgE和IgG检测在儿童特应性皮炎过敏原诊断中的应用

目的探讨血清特异性IgE和IgG检测在儿童特应性皮炎过敏原诊断中的应用和意义。方法对64例患特应性皮炎的儿童,采用酶联免疫方法检测血清中食物过敏原的特异性IgG,同时采用免疫印迹方法检测血清中食物过敏原和吸入性过敏原的特异性IgE。结果食物过敏原特异性IgG和特异性IgE的检测结果不一致(P<0.01),食物过敏原特异性IgG的总阳性率为93.75%,主要食物过敏原是牛奶和鸡蛋。食物过敏原特异性IgE的总阳性率为46.88%,主要食物过敏原是鸡蛋和鱼虾蟹。吸入性过敏原特异性IgE的总阳性率为34.38%,主要过敏原是尘螨和霉菌。在0～1岁的特应性皮炎患儿中,以食物过敏原特异性IgE阳性多见;1岁以上的患儿吸入性过敏原特异IgE阳性多见,同时合并呼吸道过敏症状增多(P均<0.05)。结论食物过敏原和吸入性过敏原均是引起儿童特应性皮炎的重要原因。联合测定食物过敏原的特异性IgE和特异性IgG是变态反应性皮肤病患儿诊断食物过敏原的有效方法。尽早采取有效的环境控制,对治疗儿童特应性皮炎和预防呼吸道过敏性疾病的发生非常重要。     

Ontogeny of IgG2 antibodies against S. aureus teichoic acid in normal and immunodeficient children

Anti-teichoic acid antibodies of various subclasses were found to be effectively transported across the placenta during pregnancy. In adults these antibodies are mainly of the IgG2 subclass although substantial amounts of specific IgG1 antibodies may also be found. During ontogeny, specific IgG1 antibodies develop during the second year of life whereas specific IgG2 antibodies appear markedly later. In IgG2 deficient children, prolonged deficiency of specific anti-teichoic acid antibodies was observed, suggesting a lack of maturation of the appropriate idiotype(s). In children who received a bone marrow transplant from adult donors, engraftment of IgG2 producing cells could be seen, thus transferring the ability to produce specific antibodies.     

Correlation of allergen‐specific IgG subclass antibodies and T lymphocyte cytokine responses in children with multiple food allergies

Scott‐Taylor TH, Hourihane J, Strobel S. Correlation of allergen‐specific IgG subclass antibodies and T lymphocyte cytokine responses in children with multiple food allergies.
Pediatr Allergy Immunol 2010: 21: 935–944.
© 2010 John Wiley & Sons A/S Cytokines can affect the quantity and class of allergen‐specific immunoglobulins through the T cell polarization that accompanies atopy. Antigen‐specific IgG subclasses and IgE antibodies were compared with intracellular T cell cytokine changes to sensitizing antigens in 23 children with multiple food allergies and 20 healthy controls. Allergic children showed higher levels of total and food‐specific IgE, IgG1 and IgG4 to peanut, milk and egg than non‐atopic children or adults, coinciding with a TH2 cytokine response to sensitizing antigens. IgG1 and IgG4 antibodies specific to milk and egg and peanut protein were elevated relative to age‐matched healthy children (p ≤ 0.05) and, in milk‐ and egg‐sensitized children, correlated with cytokine responses (p < 0.05). Peanut‐sensitized children additionally had elevated levels of IgG2 and IgG3 also which correlated inversely (p < 0.003 and p < 0.04, respectively) with IFNγ production. Elevated allergen‐specific IgG subclass antibodies in sensitized children correlated with total IgE levels (p ≤ 0.05) in all three food allergen groups. The ratio of specific IgG1 to IgG4 was highest in those with high IgE, inverted with resolution of allergy, and correlated with total IgE levels (p ≤ 0.01) in milk‐ and egg‐sensitized children. The correlation of TH2 responses with allergen‐specific antibodies would implicate polarized T cells in food allergic children in IgE hypersensitivity and overproduction of particular IgG subclasses alike. IgG1:IgG4 ratio declines with allergy sensitization and may denote emerging tolerance.     

舌下含服粉尘螨滴剂治疗支气管哮喘伴变应性鼻炎的疗效

目的 探讨舌下含服粉尘螨滴剂特异性免疫治疗支气管哮喘(哮喘)伴变应性鼻炎的疗效及安全性.方法 选取516例年龄4～13岁哮喘伴变应性鼻炎患儿.其中291例完成1 a舌下免疫治疗(免疫治疗组),非免疫治疗对照组225例.患儿均完成10种常见变应原皮肤点刺试验,点刺试验结果呈阳性反应.免疫治疗组根据皮肤点刺试验结果分尘螨过敏组80例、尘螨及蟑螂过敏组71例、尘螨及花粉过敏组74例、尘螨及狗毛过敏组66例.应用粉尘螨滴剂进行临床免疫治疗,记录治疗前后哮喘控制问卷(ACQ)评分、鼻炎症状评分、用药情况和不良反应.结果 1.治疗12个月后,免疫治疗组和非免疫治疗对照组ACQ评分分别为(0.28±0.33)分和(1.07±0.68)分,与治疗前[(1.76±0.75)分和(1.55±0.62)分]比较,分别下降了(74.03±37.66)%和(29.32±44.53)%,2组ACQ评分比较差异有统计学意义(Z=-154.109,P<0.000 1).2.治疗12个月,免疫治疗组和非免疫治疗对照组鼻炎症状评分分别为(0.337±0.479)分和(0.560±0.634)分,较治疗前[(0.899±0.667)分和(0.892±0.688)分]分别有70.8%和39.1%的患儿评分级别降低,2组比较差异有统计学意义(χ2=51.949,P<0.000 1).3.治疗12个月,免疫治疗组和非免疫治疗对照组治疗哮喘月均用药评分分别为(20.91±18.03)分 和(85.22±47.84)分,与治疗初始月均用药评分[(113.41±35.02)分和(108.86±35.24)分]比较,分别下降了(75.10±28.80)%和(20.60±39.52)%.4.治疗12个月,免疫治疗组肺功能呼气峰流速(预计值百分比)[(91.38±8.82)%]较治疗前上升(8.84±9.64)%.5.免疫治疗结束,免疫治疗组粉尘螨试验阳性级别降低,与非免疫治疗对照组比较差异有统计学意义(χ2=70.850,P<0.000 1).6.各免疫治疗亚组ACQ评分、月均用药评分和粉尘螨皮试阳性级别降低的差异均无统计学意义.7.与用药相关的皮疹、鼻咽痒和哮喘发作不良反应发生率为24.7%,未出现过敏性休克等严重不良反应.结论 特应性舌下免疫治疗方法安全有效,是治疗儿童哮喘伴变应性鼻炎的重要措施之一.     

Cerebral magnetic resonance imaging in the neonatal period. Initial results

The place of neonatal cerebral MRI and its specific contribution compared with conventional imaging techniques were evaluated in 36 patients. The difficulties specific to the patient population studied met during this preliminary period are described, with their local solutions. A preliminary evaluation of the diagnostic and prognostic value of MRI according to the disease state and gestational age is presented. The specific contribution of MRI compared with transfontanellar ultrasonography and CT scan is discussed.     

The monocyte-macrophage-system (author's transl)]

The importance of the monocyte-macrophage-system in specific and non-specific immune reactions is described. Macrophages are involved during both the afferent phase, e.g. antigen trapping, antigen processing, and the efferent phase, e.g. allograft rejection, tumour cell destruction, of the specific immune system. The monocyte-macrophage system can be activated by non-specific and - more important in vivo - by specific mechanisms via soluble factors produced by sensitized T-lymphocytes. Finally, some clinically important disorders of macrophage function are described.