Predictors of intellectual outcome in a cohort of Brazilian children with congenital hypothyroidism

OBJECTIVE: To identify predictors of intellectual development in a cohort of children with permanent primary congenital hypothyroidism. DESIGN: Cohort study with intellectual development as the outcome. PATIENTS AND MEASUREMENTS: Thirty-one consecutive newborns with permanent primary congenital hypothyroidism diagnosed by a screening programme were recruited from the outpatient clinic of a district hospital and underwent psychometric evaluation with the Wechsler Intelligence Scales after a minimum follow-up of 4 years. RESULTS: Eight of the 31 patients (25.8%) presented impaired intellectual development (full-scale intellectual quotient < 85), and one of them presented mental deficiency (full-scale intellectual quotient 相似文献   

The “Cross-furrowed” forehead

Three middle-aged men were encountered whose foreheads showed a pattern of vertical lines as well as the standard transverse furrows. The etiology of these lines is obscure.     

Cognitive function at 10 years of age in children who have required neonatal intensive care

AIM: To study cognitive function at 10y of age in a cohort of children who required neonatal intensive care within the Uppsala Neonatal Follow-up Study. METHODS: 226 children, who were born in 1986-1989 and had required neonatal intensive care (NIC) and 72 full-term, healthy control children were enrolled in the study. NIC children were grouped according to gestational age (group I, 23-31 wk; subgroup IA, 23-27 wk; IB 28-31 wk; group II, 32-36 wk; group III, > 36 wk), with infants with congenital malformation (IWCM) included and excluded from the main groups. The Kaufman Assessment Battery for Children (K-ABC) was administered and results were analysed in relation to the K-ABC global scales: sequential, simultaneous, mental processing composite and achievement. RESULTS: The great majority of children had well-developed cognitive function, reaching scores at an average level or above. When groups were compared, full-term children that required NIC (group III) showed lower scores than controls on all scales measured by the K-ABC. Preterm children from all the studied groups (groups IA, IB, II) showed poorer performance than controls in the simultaneous processing scale, and group IA scored lower than controls in the achievement scale. The incidence of major cognitive impairment (IQ < 70) was low in NIC children (< 5%), but children from group IA showed significant higher frequency of impairment in the simultaneous, mental processing composite and achievement scales. Children from group IA presented a high frequency of discrepancy between the K-ABC scales, with lower simultaneous and higher sequential scores. Analysis with IWCM excluded from the main groups revealed identical results. CONCLUSION: Most children who needed neonatal intensive care had developed well their cognitive function at 10 y of age. The long-term effect of neonatal intensive care on cognitive function was more evident in extremely preterm infants (group IA), especially in tasks involving simultaneous ways of processing information.     

The Norplant experience in Zaria: a ten-year review

Norplant is an effective, long-acting, reversible, progestin-only contraceptive that provides protection for up to five years. The aim of this review is to ascertain the response of family planning clients in Zaria to Norplant. In Nigeria, Family Health International started pre-introductory clinical research on Norplant in 1985 at five sites including Zaria. Since the conclusion of the study, Norplant services have been maintained, but no attempt has been made to report the response of this largely Hausa and Muslim community where contraceptive use is generally low. It is important to determine whether the advantages of Norplant have had an impact on this setting. The study showed that most of the clients were satisfied with the method. There was a progressive increase in the number of women using Norplant by 1995, with a significant decrease in the number of women undergoing sterilisation. Acceptability of Norplant is on the increase, thus, it should be easily available, accessible and affordable.     

Lower corneal temperature in neuroleptic-treated vs. drug-free schizophrenia patients

Antipsychotic drugs (APDs) can decrease core body temperature in schizophrenia patients. Core temperature may correlate with corneal temperature and thus, we hypothesized that neuroleptic-treated schizophrenia patients would display lower corneal temperature compared with drug-free patients. Corneal temperature of 12 typical APD-treated and 9 drug-free male schizophrenia patients was assessed using a FLIR thermal imaging camera. The APD-treated patients exhibited substantially and significantly lower corneal temperature compared with the drug-free patients (31.57 +/- 0.98 degrees C vs. 34.55 +/- 1.65 degrees C; p < 0.0001). Our results suggest that APDs may decrease corneal/core temperature in schizophrenia patients. The relevance of this finding to the pathophysiology of schizophrenia or to the antipsychotic effect of neuroleptics merit further investigation.     

Cognitive behavior therapy (CBT) in anxiety disorders

This review examines CBT as a leading evidence-based psychotherapy. It describes briefly the major components of CBT: exposure, reduction of safety behaviors, attention focus modification and cognitive restructuring. Specific CBT strategies suited for the main anxiety disorders are reported (specific phobias, panic disorder and agoraphobia, social phobia, generalized anxiety disorder, obsessive compulsive disorder and post-traumatic stress disorder). The review emphasizes the efficiency of the use of CBT as a psychotherapeutic method in anxiety disorders. Finally, it points to the lack of the use of CBT in Israel and recommends its wide use in the mental health service here.