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Biomedical subjects

H Wallis

Publications and source records attributed to H Wallis.

At least 19 recordsLinked to original sources
PubMed2003

[Measurement of the deposition of salbutamol in the bronchial lavage fluid of infants and young children].

BACKGROUND: Inhaled salbutamol is well known to be effective in obstructive lung disease in the paediatric age group. However, the individually necessary dose cannot be predicted in a single patient. Two inhalation techniques were compared measuring the concentrations of salbutamol in the bronchial lavage fluid. PATIENTS AND METHODS: Forty nine children, age 2 to 73 months, inhaled salbutamol immediately before bronchoscopy, either 200 microg using a metered dose inhaler (MDI) or 2000 microg using a nebulizer (NEB). The concentrations of salbutamol were measured in the bronchial lavage fluid. RESULTS: In spite of different inhaled doses the concentrations of salbutamol were similar in the nebulizer group (n = 29) and the metered dose inhaler group (n = 20) (medians 160 vs. 163 ng/ml; p = 0.27) with a wide range in both groups (12 to 1139 and 5.2 to 641 ng/ml, respectively). In a single patient the concentrations differed by the factor 159 between the right and the left lung. The concentrations of salbutamol were not age dependent (p = 0.06 for NEB, p = 0.28 for MDI). CONCLUSIONS: In infants and young children the concentrations of salbutamol in the bronchial lavage fluid vary widely after a single inhalation using either a metered dose inhaler or a nebulizer.

Administration, Inhalation↗
PubMed1990

Congenital adrenal hyperplasia. I: Gender-related behavior and attitudes in female patients and sisters.

Thirty-five female patients with congenital adrenal hyperplasia (CAH) were compared to a group of 16 healthy sisters in regard to gender-related behavioral patterns, present attitudes, and plans for the future. A semi-structured interview with the subjects, ages 11 to 41 yr, and their mothers concentrated on four to five age stages. Results of retrospective data from single items as well as from several related composite scales ("interests and behavior," "appearance," "overall scores") revealed significant group differences: Both in mother-assessment and self-assessment, CAH patients showed a "more masculine" orientation than their sisters, but this was far from consistent across all age stages, especially for single items. Unexpectedly, the gender-behavior differences between CAH patients and sisters did not hold for certain items and scales of "social behavior" (e.g., assertiveness, dominance, acceptance in peer groups) and, in contrast to some of the existing literature, also not for "high-energy expenditure." With regard to expectations for the future, CAH patients had less of a "wish to have their own children" and a higher preference for "having a career versus staying at home." Age, socioeconomic status, intelligence, and presence or absence of a sister as possibly intervening psychosocial/demographic factors could not explain the group differences in behavior. Degree of genital masculinization (Prader stages) or "onset and quality" of therapy as measures of pre- and postnatal androgenization, respectively, could also not account for the degree of the "more masculine" orientation in the CAH group. Nevertheless, the overall results are compatible with earlier findings on the masculinizing effects of prenatal androgens on behavior in humans and point to a time period after sexual differentiation of the genitalia and before birth as the most likely one for the effects of prenatal hormones on behavioral masculinization in humans.

Adaptation, Psychological↗
PubMed1990

Congenital adrenal hyperplasia. II: Gender-related behavior and attitudes in female salt-wasting and simple-virilizing patients.

The salt-wasting (SW) and simple-virilizing (SV) forms of congenital adrenal hyperplasia (CAH) are characterized by distinct prenatal hormonal milieus. To test whether these hormonal milieus differentially influence the development of a "more masculine" behavioral pattern in female CAH patients (Dittmann et al., 1990), SW patients (N = 13) were compared both to SV patients (N = 20) and healthy sisters of both groups (N = 16). The data are based on semi-structured interviews in which subjects (11-41 yr) and mothers were asked about aspects of "Gender-related interests and behavior," "Level of activity," "Social behavior," (reflecting e.g., assertiveness, dominance, and acceptance by peer groups) and "Appearance"; these areas of interest were represented by composite scales. On most scales, and by both mother-assessment and self-assessment, SW patients differed significantly from both SV patients and sisters in having a "more masculine" orientation. SW patients also showed a higher "Level of activity." These SW group results probably account for much of the CAH/sister differences reported in the companion article (Dittmann et al., 1990). In contrast, SV patients differed from the sister sample on only a few scales. There were no significant differences between SV and SW subjects in the degree of virilization of the external genitalia (indicating no group difference in prenatal androgenization). SW patients were treated "earlier" and "better" after birth (indicating less postnatal androgenization). However, these medical conditions, as well as several psychosocial/demographic variables, could not explain the group behavioral differences. These results do not support a primarily psychosocial explanation of behavioral development in CAH patients, especially those with the SW condition; they rather suggest differential organizational effects of two different hormonal environments (SV vs. SW) during critical periods of prenatal CNS development.

Adolescent↗
PubMed1985

[Development, structure and initial evaluation of a comprehensive psychosocial care program for children with cancer and their families].

The development and trial of a model care program carried out by psychologists in close collaboration with oncologists aimed at the comprehensive in- and off-ward care of children with cancer and their families is reported. A structured psychosocial anamnesis in interview-form ("Aufnahmebogen") and an information list ("Checkliste") are used shortly after diagnosis to identify problems and to systematically inform on psychosocial support schemes. The procedure allows a comprehensive, early and preventative psychosocial care. An evaluation of 646 carefully documented contacts was carried out according to the criteria: number of contacts, initiator, person contacted, reason for contact and function of the psychologist. Various prerequisites important for the integration of psychologists into the oncological team are specified and discussed.

Adult↗
PubMed1984

[Psychosocial care of children and adolescents with chronic kidney disease (in a 2-year period)--problems, tasks, services].

The psychosocial services provided over a period of two years to 24 children and young people with chronic renal insufficiency in various disease stages were analyzed on the basis of patient files. A total of 1475 contacts (units) were classified according to the four dimensions: (1) type of care provided, (2) problems dealt with, (3) contact persons, (4) disease stage. Variety and multitude of the individual psychosocial problems present demonstrate the scope for psychosocial activity. Supportive services (1) pertaining to the so-called disease-context (2) and, more specifically, personal contacts with the patients (3) in the dialysis stage (4) were found to prevail among the functions of the attending psychologist. Psychosocial services focussing on specific individual and/or practical issues had plainly been far more important in the care of the chronically ill children and their families, than approaches based on classical clinical psychology and psychotherapy. These findings have resulted in increased staffing for supportive services "on site" (i.e. during dialysis time), which has entailed greater latitude in the time available for dealing with relevant preventive aspects in preparing patients for dialysis and transplantation.

Adaptation, Psychological↗
PubMed1983

[3 osteosarcoma therapy dropouts. Clinical cases].

We report on 3 cases of male late-adolescent/young-adult osteogenic sarcoma patients who refused complete chemical therapy according to the treatment plan "COSS 80". They all originated from disturbed family situations. Characteristic was their early independence and autonomy, dominance tendency, low level of self control, and high level of sociability. Primary motivation for refusal was the experienced intolerability of the chemotherapeutical side-effects and extreme fear of medical procedures (e.g. injections).

Adolescent↗
PubMed1981

[The use of psychopharmaca in infancy and preschool age results of questioning parents of school beginners (author's transl)].

Clinical observations show an increasing rate of psycho-drug prescriptions for preschool children. This is in contrast to only sparse information in the literature. In two Hamburg quarters parents of 790 children (aged 4 10/12 -7 10/12 years) were asked for this topic on the occasion of the school beginners medical examination. 17.3% of the children had taken a psycho-drug once or more up to the day of the examination. Psycho-drugs had been given in all ages from 1-6 years. Pediatricians had prescribed 90% of these psychopharmaca. 18% of the prescriptions served as accompanying medication in somatic diseases. 50% of the patients got neuroleptics, 20% the antidepressant imipramine. 20% of these children were treated with a psycho-drug for more than four weeks. The wanted effect of the medication was noted by 70% of the parents. It was concluded, that an intensive instruction in psychopharmacology is necessary not only for child psychiatrists but especially for pediatricians.

Age Factors↗
PubMed1981

[The situation of leukaemic children and their parents. First results of a pilot study on psycho-social care children with oncological disorders (author's transl)].

We report on a pilot-study on the psycho-social care for leukemic patients and their families by means of standardized psychological tests and questionnaires developed for this purpose. We pointed out the families' psychological symptoms of stress on order to obtain material for their psychosocial support. The psychologists part in a team of oncologists and haematologists has been described as well as tasks of social care of the children and their families. On the whole the tasks of psychological members of team ranged from intervention, counseling and supportive work to psychotherapy.

Anxiety↗
PubMed1976

[Methods of approach used by physicials untrained in behaviour therapy to reduce anxiety in children undergoing routine examination (author's transl)].

Samples of pediatricians (N = 50), general practitioners (N = 50) and doctors of a children's hospital (N = 30) were asked to rate the intensity of children's anxiety for 15 items of routine medical performances. In addition the first two groups were asked about the technique used to reduce children's anxiety or to hold it on a low level. The questionnaires were analysed under the following aspects: 1) Are there systematic differences between the three groups concerning the estimation of infantile fear-intensity?--2) Is it possible to express the described behaviour doctors regard as effective for anxiety-reduction in terms of learning theory or behaviour-therapy respectively?--3) Is there a statistical interaction between the estimation of fear-intensity and ways of approaching?--Concerning the estimation of children's fear-intensity the three groups turned out to be highly concordant. Nearly 60% of pediatricians and general practitioners at least once during a session use approaching-techniques in the sense of learning theory. There is no interaction between the two variables "fear-intensity-estimation" and "mode of approach".

Anxiety↗