Pyromania and enuresis. Multifactorial causes require multidimensional treatment concepts]

The abilities to control the voiding of the bladder and to act competently in dealing with fire are important factors of the normal development of children. Unfavourable conditional constellations in the socio-emotional, cognitive, or physical realm can cause developmental defects which manifest themselves in certain target symptoms, for instance Pyromania and Enuresis. The importance of multifactorial etiological models will be illustrated by a case report of a boy displaying symptoms of Pyromania and Enuresis nocturna. The analysis of the specific conditions of the case studied results in the appropriate multidimensional treatment concept.     

A clinical study of the lupus anticoagulant

Eighty-three patients with circulating anticoagulants were studied at The New York Hospital. The lupus-type anticoagulant, an inhibitor of the prothrombin activator complex, was demonstrated in 58 patients. The inhibitor was identified using the blood and tissue thromboplastin inhibition tests. Inhibition by the lupus anticoagulant was augmented in 67% of these patients by a cofactor present in normal plasma. The lupus inhibitor was detected primarily because of an unsuspected abnormal coagulation test. One-half of the patients with the lupus-type anticoagulant did not have systemic lupus erythematosus.     

Multi-institutional drug-use evaluation of intraocular irrigating solutions

A collaborative drug-use evaluation (DUE) of intraocular irrigating solutions (IOISs) at ophthalmic specialty hospitals nationwide is reported. Qualifying criteria for the use of an expensive fortified IOIS product were (1) the duration of surgery is more than 60 minutes, (2) the surgery is performed without a viscoelastic agent, (3) the patient's age is less than 50 years, (4) the patient has diabetes, and (5) the patient has evidence of compromised corneal endothelium. Surgical cases involving the use of IOISs were identified at each institution, and those cases involving fortified IOIS were reviewed for conformance with the criteria established. Of 23 institutions, 10 were able to perform the DUE. The review was concurrent at one institution and retrospective at the other nine. A case had to meet only one criterion to be considered in conformance. The cumulative mean rate of conformance with at least one criterion was 74%; the median conformance rate was 91%. The criteria that most frequently justified the use of fortified IOIS were surgical duration and nonuse of a viscoelastic material. Conformance with the DUE criteria varied with the institution, but valuable knowledge about the use of intraocular irrigating solutions was obtained by all.     

Family and Parent Predictors of Anxiety Disorder Onset in Offspring of Anxious Parents

Background

Offspring of anxious parents are at increased risk for developing anxiety disorders. There is a need to identify which youth are at greatest risk for disorder onset in this population.

Objective

This study prospectively examined several theory-based family and parent characteristics (e.g., family conflict, parental over-control, parental psychopathology) as predictors of anxiety disorder onset in children whose parents were clinically anxious.

Methods

Families were enrolled in a randomized controlled trial evaluating a family-based preventative intervention, relative to an information monitoring control condition, for offspring of anxious parents (N = 136; child mean age 8.69 years; 55% female; 85% Caucasian). Family and parent measures were collected using multiple informants and an observational task at baseline, post-intervention, and at a 6 and 12 month follow-up. Child anxiety disorder diagnosis was determined by independent evaluators using the Anxiety Disorders Interview Schedule for Children.

Results

Results indicated that none of the baseline family or parent variables examined predicted the onset of an anxiety disorder in children over the 1 year follow-up period.

Conclusions

Findings raise questions about the short-term risk associated with family and parent factors in anxiety disorder development in this high risk population.