PubMed Health⌕ Search

Biomedical subjects

G Worley

Publications and source records attributed to G Worley.

29 records · Page 2Linked to original sources

Anomalies associated with myelodysplasia.

The records of 181 patients with myelodysplasia were reviewed. The prevalence of associated genitourinary anomalies as well as cardiac, facial, anal, and tethered cord were determined. The prevalence of congenital malformations associated with myelodysplasia were less in this series than in previous reports.

Abnormalities, Multiple↗

Financial counseling for families of children with chronic disabilities.

A program to teach financial management skills to parents of children with chronic illnesses and disabilities was developed. To test the effectiveness of this program, a randomized, controlled prospective study was conducted of 115 families of children with spina bifida, 58 of whom received financial counseling while 57 served as controls. Significantly more frequent changes in behavior were found in the intervention group than in the control group at the end of the one-year study for 18 of the 68 variables, including such items as establishing records, using a budget, obtaining low-cost life insurance and taking appropriate tax deductions. Three-quarters of the families in the intervention group believe that the counseling program had had or would have a beneficial effect on the quality of their lives. Financial counseling may benefit families with chronically ill or disabled children.

Budgets↗

Hysterical conversion reactions mimicking neurological disease.

Seven children with illnesses diagnosed as hysterical conversion reactions (HCRs) were treated at our institution over a period of nine months. They all had neurological symptoms that included one or more of the following: paralysis, headache, seizures, and episodic blindness. All patients but one were misdiagnosed as having an organic disease prior to our final diagnosis. Five children were treated with medications for presumed organic illnesses. In all of these children a diagnosis of HCR was made on the basis of their history and neurological examination findings. They all recovered or began recovery within a few days of having HCR diagnosed, and none of them had had a relapse three to 11 months after the diagnosis of HCR was made. We believe, and there is ample evidence in the literature, that a positive diagnosis of HCR in childhood can be made when neurological manifestations cannot be explained on an anatomic and physiological basis. Although absence of an obvious organic cause is a helpful clue, exhaustive exclusion of all possible organic causes is not necessary for the diagnosis of HCR.

Adolescent↗

Toxocara canis infestation. Clinical and epidemiological associations with seropositivity in kindergarten children.

We studied a cohort of 333 children in kindergarten to determine the prevalence of seropositivity to Toxocara canis, and to detect and measure chronic health effects that might be attributable to past infection. We found that 23.1% of the children had serologic evidence of infection (antibody titer greater than or equal to 1:32), assayed by means of an enzyme-linked immunosorbent assay. Black children were more frequently infested than white children, as were children of parents who did not graduate from high school. In a subsample of seropositive and seronegative children, we found associations between seropositivity and both pica and puppy ownership; we did not find differences in the symptoms and signs that occur in toxocaral visceral larva migrans nor differences in measures of growth and nutrition. No child had ocular toxocariasis although 31.8% (106) of the children had antibody titers greater than or equal to 1:16. In a population in which approximately 20 to 30% of the children show serologic evidence of Toxocara infestation, care must be taken in differentiating toxocariasis-like ophthalmic lesions, due to the potential for the coincidental occurrence of retinoblastoma in a child who is seropositive for the Toxocara parasite.

Animals↗

Creatine kinase brain isoenzyme: relationship of cerebrospinal fluid concentration to the neurologic condition of newborns and cellular localization in the human brain.

Immunocytochemical study of human brain showed creatine kinase brain isoenzyme (CKBB) present in both neurons and astrocytes. Because creatine kinase brain isoenzyme is an intracellular enzyme that might be released with brain injury, its concentration in the CSF of newborns was measured using a radioimmunoassay. Infants who suffered a documented neurologic insult (a cerebroventricular hemorrhage or a CNS infection) were found to have a greater mean CSF creatine kinase brain isoenzyme concentration than those without a history of neurologic insult. Infants with a high concentration had a poor short-term outcome (death or neurologic abnormality when discharged) more frequently than did those with a lower concentration. Infants with a grade 3 or 4 cerebroventricular hemorrhage had a higher mean concentration than did those with a grade 1 or 2 hemorrhage. These data are consistent with the hypothesis that CSF creatine kinase brain isoenzyme is a metabolic indicator of brain damage in newborns.

Astrocytes↗

Toxocara canis infection: clinical and epidemiological associations with seropositivity in kindergarten children.

To determine epidemiological and clinical associations with Toxocara canis seropositivity, we studied 333 (87%) children of a cohort of 383 five- to seven-year-olds. The prevalence of seropositivity (antibody titer to T canis, greater than or equal to 1:32) was 23.1%. Black children were more frequently seropositive than were white children, as were children of parents who did not graduate from high school. In a sample of seropositive and seronegative children, seropositivity was associated with both a history of pica and puppy ownership, but not with a greater frequency of symptoms and signs that occur in visceral larva migrans or with poor growth. No child had evidence of ocular toxocariasis on retinal examination. For the whole sample, poor reading achievement, marked distractibility, and lower intelligence were associated with seropositivity, but by using multiple regression analysis, we found that these associations may be attributable to confounding variables.

Animals↗

Pediatric traumatic atlanto-occipital dislocation: five cases and a review.

Traumatic atlanto-occipital dislocation (AOD) has been thought to be a rare and fatal injury. Recently, more survivors, especially children, have been reported. During a 10-year period, the authors have encountered five children with traumatic AOD. A retrospective review of traumatic AOD in children from 1985 to 1995 was performed. Clinical presentation, initial radiologic findings, and final outcome were emphasized. Distance from the dens to the basion and the ratio of Powers were measured from initial lateral cervical spine radiographs. The average distance from the dens to the basion was 9.8 mm. The average ratio of Powers was 1.38. There were three survivors, two having a concomitant spinal cord injury. All survivors underwent a posterior occipitovertebral fusion. Three cases initially went undiagnosed. The diagnosis of AOD by lateral cervical spine radiographs can be difficult. The authors recommend detailed measurements of the initial cervical spine radiographs in pediatric patients at risk for traumatic AOD.

Atlanto-Occipital Joint↗