Assessment of an abbreviated odorant identification task for children: a rapid screening device for schools and clinics

To validate the level of olfactory performance of children, we tested 825 volunteers, aged 4–17 years, with an abbreviated form of our pediatric odorant identification task. The test consisted of sniffing and identifying five odorants (baby powder, bubble gum, candy cane, licorice and peach). Mean olfactory scores increased as a function of age, reaching a plateau of about 94–95% correct at 8 years of age. In general, girls out–performed boys. Physicians require a test instrument such as the one we have devised to allow them to diagnose olfactory dysfunction in children. The present task is particularly applicable in screening large numbers of children in clinics or schools because it can be administered easily and rapidly. Adult subjects with olfactory dysfunction also performed poorly on this odorant identification task designed for children. Therefore, we expect that our odorant identification task will also detect children with severe olfactory dysfunction.     

Timing of sentinel lymphadenectomy in cutaneous melanoma

PURPOSE: The conduct of sentinel lymphadenectomy for cutaneous melanoma varies substantially among the medical disciplines. The authors sought to characterize the number of hot spots identified during preoperative lymphoscintigraphy for cutaneous melanoma and to determine its relation to the harvesting of sentinel lymph nodes. METHODS: Sixty-nine patients with cutaneous melanoma underwent lymphoscintigraphy with filtered Tc-99m sulfur colloid before sentinel lymphadenectomy. The lymphoscintigrams were reviewed and the number of hot spots visualized over time and the number of sentinel nodes harvested were determined. RESULTS: Lymphoscintigraphy identified 79 patients with 87 lymphatic basins at risk for metastatic disease. Lymphoscintigraphy was performed in a mean time of 30 minutes (range, 15 to 40 minutes). The mean number of hot spots increased from 0.2 to 2.0 hot spots 40 minutes after the initial static image, but the number of hot spots stabilized between 20 and 40 minutes. The same number of sentinel nodes as hot spots visualized were harvested in 58% of patients. Fewer sentinel nodes were identified at the time of surgery than were visualized by lymphoscintigrams in 39% of patients. CONCLUSIONS: More hot spots were identified up to 40 minutes after the initiation of lymphoscintigraphy. Sentinel lymphadenectomy can be performed as near to 40 minutes after the initiation of lymphoscintigraphy as is logistically reasonable. However, there may be substantial latitude in delayed performance of sentinel lymphadenectomy.     

Seizures in children with low-grade tumors： outcome after tumor resection and risk factors for uncontrolled seizures

OBJECT： The goals of this study were to define the incidence of seizures in children with low-grade tumors, study seizure outcome after lesionectomy in these children, and identify risk factors for poor seizure outcome, METHODS： The authors performed a retrospective chart review of children who harbored low-grade brain tumors, experienced seizures, and were treated in a single institution, Statistical analyses included step-wise as well as single-variable binary logistic regression analyses.     

Perinatal stimulation and adaptation of the neonate

The present report describes psychobiological studies of behavior around the time of birth. An adaptive, ecological perspective is presented in which stimulation of the fetus and newborn is purported to instigate adaptive postpartum behavior. Studies describing the perinatal sensory environment are reviewed, with a consideration of emergent sensory function of the fetus. It is asserted that afferent input associated with parturition perturbs the fetus and neonate, producing a general arousal state that facilitates breathing, suckling, and early learning. The view developed herein is that perinatal sensory input induces and canalizes the newborn's behavior, thereby regulating adaptive postpartum function. Deviations in afferent input may alter ontogenetic trajectories and compromise developmental outcome by reducing availability of conditions necessary for adequate postpartum adaptation.