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Biomedical subjects

J Coplan

Publications and source records attributed to J Coplan.

At least 19 recordsLinked to original sources
PubMed2000

Counseling parents regarding prognosis in autistic spectrum disorder.

A triaxial model for autistic spectrum disorder (ASD) is presented, incorporating age, degree of intelligence, and severity of autistic features. As the name implies, ASD can vary in degree of expression from minimal to profound. Furthermore, the symptoms of ASD change in predictable ways with the passage of time. For example, echolalia during early childhood may be replaced by verbal literalism and difficulty with verbal humor during later childhood or adolescence. The prognosis for children with ASD is governed by the joint impact of the degree of expression of ASD and the degree of developmental delay, if any. All combinations of ASD and intellect are possible (ie, severe ASD plus severe mental retardation, severe ASD plus normal general intelligence, and so forth). The relationship among these 3 parameters-severity of ASD, level of general intelligence, and change in symptom expression over time, is represented schematically as a 3-dimensional graph. The utility of this graph as a counseling tool, and as the basis for future research on the prognosis of ASD are discussed.

Age Factors↗
PubMed1998

Early language development in children exposed to or infected with human immunodeficiency virus.

OBJECTIVES: To compare language development in infants and young children with human immunodeficiency virus (HIV) infection to language development in children who had been exposed to HIV but were uninfected, and (among subjects with HIV infection) to compare language development with cognitive and neurologic status. DESIGN: Prospective evaluation of language development in infected and in exposed but uninfected infants and young children. SETTING: Pediatric Infectious Disease Clinic, State University of New York-Health Science Center at Syracuse. SUBJECTS: Nine infants and young children infected with HIV and 69 seropositive but uninfected infants and children, age 6 weeks to 45 months. RESULTS: Mean Early Language Milestone Scale, 2nd edition (ELM-2) Global Language scores were significantly lower for subjects with HIV infection, compared with uninfected subjects (89.3 vs 96.2, Mann-Whitney U test). The proportion of subjects scoring >2 SD below the mean on the ELM-2 on at least one occasion also was significantly greater for subjects with HIV infection, compared with uninfected subjects (4 of 9 infected subjects, but only 5 of 69 uninfected subjects; Fisher's exact test). Seven of the 9 subjects with HIV infection manifested deterioration of language function. Four manifested unremitting deterioration; only 1 of these 4 demonstrated unequivocal abnormality on neurologic examination. Three subjects with HIV infection and language deterioration showed improvement in language almost immediately after the initiation of antiretroviral drug treatment. Magnetic resonance imaging or computed tomography of the brain were performed in 6 of 7 infected subjects with language deterioration, and findings were normal in all 6. ELM-2 Global Language scaled scores showed good agreement with the Bayley Mental Developmental Index or the McCarthy Global Cognitive Index (r = 0. 70). Language deterioration, or improvement in language after initiation of drug therapy, coincided with or preceded changes in global cognitive function, at times by intervals of up to 12 months. CONCLUSIONS: Language deterioration occurs commonly in infants and young children with HIV infection, is seen frequently in the absence of abnormalities on neurologic examination or central nervous system imaging, and may precede evidence of deterioration in global cognitive ability. Periodic assessment of language development should be added to the developmental monitoring of infants and young children with HIV infection as a means of monitoring disease progression and the efficacy of drug treatment.

Child, Preschool↗
PubMed1996

Platelet serotonin 2A (5-HT2A) receptor characteristics and parenting factors for boys at risk for delinquency: a preliminary report.

OBJECTIVE: This study examined the cross-sectional association between platelet membrane serotonin 2A (5-HT2A) receptor variables in children and characteristics of their parents that place these children at risk for antisocial behavior. METHOD: As part of a larger prospective study investigating predictors of antisocial behavior, 38 younger brothers of convicted delinquents provided platelet samples; samples from 34 boys (mean age=8.3 years) were usable. The authors determined the density (Bmax) and affinity (Kd) of platelet membrane 5-HT2A receptors by using [3H]lysergic acid diethylamide. They also measured parental characteristics related to serotonergic dysfunction in prior studies, the quality of parent-child interactions, and psychiatric profiles of the boys who provided platelets. RESULTS: Bmax was significantly lower in boys whose parents had histories of substance abuse or incarceration. Bmax was also inversely related to harsh parenting; boys raised in environments characterized by frequent parental physical punishment and anger had a significantly lower Bmax. Bmax was not related to boys' disruptive behavior. CONCLUSIONS: In boys at risk for antisocial behavior, the density of 5-HT2A receptors on platelets is inversely related to parental factors known to place youth at risk for antisocial behavior.

Antisocial Personality Disorder↗
PubMed1995

Olfactory performance during childhood. II. Developing a discrimination task for children.

OBJECTIVES: (1) To create a match-to-sample odorant discrimination task (MODT) for children and adolescents; (2) to assess whether nonolfactory factors affect olfactory performance more on an identification task than on the MODT; (3) to evaluate subjects with olfactory dysfunction; and (4) to create age-appropriate sets of odorants for use in the MODT format to test children of different ages. STUDY DESIGN: We tested 75 normal children, aged 2 to 18 years, and 17 other subjects, aged 7 to 53 years, with known or suspected olfactory dysfunction, with the MODT. We compared the age trends in variability of scores on the MODT with those on an odorant identification task, using a weighted linear regression analysis. RESULTS: The MODT was useful in children aged 5 years and older, but not generally in the 2- to 4-year-old children. There was an appreciable age trend in the variability of the scores on the identification task but not on the MODT. Mean MODT scores for subjects with suspected or known olfactory dysfunction were far below average. Finally, we created four sets of odorants that will likely be sensitive to age-specific changes in olfactory performance. CONCLUSIONS: The MODT appears to be a suitable test instrument to assess olfaction in children aged 5 and older and is less likely to be influenced by nonolfactory factors than an identification task. According to our preliminary results, it is likely that the MODT will allow us to detect olfactory deficits in children of many ages.

Adolescent↗
PubMed1995

Failure to identify human immunodeficiency virus-seropositive newborns: epidemiology and enrollment patterns in a predominantly white, nonurban setting.

OBJECTIVE: To describe the epidemiology of newborn seroprevalence for human immunodeficiency virus (HIV) in a predominantly white, nonurban population, and to determine the factors associated with enrollment at a regional pediatric acquired immunodeficiency syndrome (AIDS) center serving that population. DESIGN: Retrospective case series of children enrolled at a regional pediatric AIDS center during a 6-year period and comparison with universal blind newborn screening data collected by the state of New York during the same time interval. SETTING: The Pediatric AIDS Center at State University of New York-Health Science Center at Syracuse, which serves as the only source of HIV-related pediatric care for children in a 16-country region of upstate New York totaling 1.8 million population. RESULTS: One hundred thirty-nine HIV-seropositive infants were born in the region during the 6-year study period; complete blind screening data were available for 138. Sixty-five (47%) of these infants were white. Thirty-nine (28%) of 138 had been enrolled at the Pediatric AIDS Center within the first 90 days of life. An additional 22 (16%) were enrolled at older than 90 days of life. The remaining 77 (56%) have never been seen at the center and are presumed to be unidentified. County enrollment rates varied from 0% to 100% and correlated with percent nonwhite births (r = .58; 95% confidence interval, 0.04-0.86). Children in outlying counties were at greater risk for nonenrollment than children from Onondaga County (site of the Pediatric AIDS Center) (adjusted relative risk, 1.38; 95% confidence interval, 1.05-1.85). White infants residing outside of Onondaga County were at the greatest risk of nonenrollment; of 50 seropositive white infants residing outside of Onondaga County, only 7 (14%) were enrolled at the center within the first 90 days of life. CONCLUSIONS: Local demographic factors can skew the racial distribution of HIV-seropositive infants dramatically compared with the national experience. White race and residence in counties away from the medical center each constituted risk factors for nonenrollment at the Pediatric AIDS Center. The epidemiology of HIV in this predominantly white, rural population, coupled with physician practices, probably contributed to low identification and enrollment rates. As the AIDS epidemic spreads into similar populations elsewhere, HIV infection in pregnant women or newborn infants is likely to become progressively harder to detect, unless universal screening is adopted.

Black or African American↗
PubMed1993

Child development.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMed1993

The effect of acetazolamide on ventilation in panic disorder patients.

OBJECTIVE: Patients with panic disorder are behaviorally hypersensitive to CO2 inhalation and may also be biologically hypersensitive. A report by Mathew et al. showed, however, that administration of the carbonic anhydrase inhibitor acetazolamide, which is believed to increase brain CO2 level, did not cause panic in panic disorder patients. The authors of the present study noted that respiratory frequency did not increase in the earlier experiment and wondered whether respiratory stimulation occurred during acetazolamide administration, as would be expected if CO2 level increases significantly. METHOD: Ten patients with panic disorder and six normal control subjects received injections of acetazolamide, 1 g i.v., as per the Mathew et al. protocol, during breath by breath measurement of both tidal volume and frequency of respiration. RESULTS: Three patients had panic attacks, one before receiving acetazolamide, one during the injection, and one 2 minutes after injection. Only the last of these attacks appeared possibly attributable to acetazolamide. None of the control subjects panicked. Neither patients nor control subjects exhibited meaningful change in tidal volume, respiratory frequency, or minute ventilation, and both groups experienced a trend toward significant decrease in overall levels of anxiety and dyspnea after acetazolamide injection. CONCLUSIONS: The authors replicated the earlier finding that acetazolamide is not panicogenic in patients with panic disorder but also showed that at the dose given, there is no meaningful effect on ventilation. If acetazolamide does affect CO2 levels it does so in a way that does not stimulate ventilation. Therefore, the acetazolamide injection results of Mathew et al. and of the present study do not challenge hypotheses linking panic attacks to hypersensitive respiratory control mechanisms.

Acetazolamide↗
PubMed1993

Buspirone in social phobia.

The novel anxiolytic agent buspirone has been shown to be effective in generalized anxiety disorder, but its utility in phobic disorders is less clear. We examined its efficacy in social phobia in a 12-week open trial. Twenty-one patients who met DSM-III-R criteria for social phobia and who did not respond to 1 week of single-blind placebo were treated with buspirone, and 17 completed a minimum of 2 weeks of treatment. Twelve of these 17 patients met criteria for the generalized subtype of social phobia. At week 12, 8 (47%) of the 17 patients were rated much to very much improved in social phobia symptoms on the Clinical Global Impression Scale. Of the 12 patients who were able to tolerate a dose of 45 mg/day or more, 9 (67%) were at least much improved. Significant improvement was noted on measures of social anxiety and avoidance of social situations. Ratings of generalized anxiety and depression, which were low at baseline, did not change significantly during treatment. The results suggest that buspirone may have modest efficacy in the treatment of social phobia, but confirmation in a placebo-controlled trial is required.

Adult↗
PubMed1990

The role of personality in anxiety disorders.

It is widely believed that personality disorders and/or traits (PDT) have significant impact on the phenomenology, severity and consequently the treatment of anxiety disorders (AD). Specific PDT's are thought to be characteristic of certain types of AD's. However, little experimental data support these assumptions. The interpretation of the few comorbidity and outcome studies investigating the role of PDT's in anxiety is problematic from both theoretical and methodological points of view. The authors review what is known about the co-occurrence of PDT's and some of the AD's. Particular attention is paid to studies that demonstrate the alteration of PDT's as a result of successful treatment of an AD and to those assessing the difficulties encountered in the treatment of AD's in the presence of certain PDT's. Specific recommendations for much needed research are given.

Agoraphobia↗
PubMed1990

Quantifying language development from birth to 3 years using the Early Language Milestone Scale.

A point-scoring technique for the Early Language Milestone Scale is described. Normative data based on the original 1982 cross-sectional sample and validation data based on a separate longitudinal sample are presented. Mean Early Language Milestone Scale point scores, standard deviations, and percentile equivalents for raw point scores are presented for all ages from birth to 36 months. Correlations between point scores on the Early Language Milestone Scale and scores on other standardized developmental tests such as the Stanford-Binet Intelligence Scale, the Peabody Picture Vocabulary Test, and the Illinois Test of Psycholinguistic Abilities are presented. The clinical and research advantages of this point-scoring technique are presented and compared with the original pass/fail scoring method.

Child, Preschool↗
PubMed1988

Unclear speech: recognition and significance of unintelligible speech in preschool children.

Clarity of speech normally improves throughout the first few years of life, with acquisition of complete intelligibility by 4 years of age. Delayed emergence of intelligibility, or frankly unintelligible speech, often signify the presence of a major disturbance of language, overall cognitive development, or hearing. Norms are provided for the ages by which a child should be 50%, 75%, and 100% intelligible to strangers, and a new technique for screening intelligibility of speech is described. Data validating this technique are presented, and the developmental implications of unintelligible speech are reported. The importance of screening for intelligibility of speech is emphasized, in light of the findings presented.

Articulation Disorders↗
PubMed1987

Neurodevelopmental outcome of preschool children born preterm with and without intracranial hemorrhage.

Thirty-five children who had been born preterm with and without intracranial hemorrhage and weighing less than or equal to 1500 g were followed prospectively to assess neurodevelopmental outcome. The 13 children with hemorrhage were inferior to the 22 without hemorrhage in terms of birthweight, Apgar scores, health complications at and after birth, neurological integrity at age five and several scales of the McCarthy Scales of Children's Abilities. The hemorrhage group performed significantly below the standardized mean on each of the McCarthy scales, whereas the group without hemorrhage performed below the mean only in Quantitative and Memory scores. The Bayley scales at one year were not clinically sensitive to hemorrhage, but were predictive of McCarthy General Cognitive Index scores at age five. A greater proportion of children with hemorrhage have had educational difficulties and have been included in alternative school programs. Preterm, very low-birthweight children, and particularly those with intracranial hemorrhage, are at high risk for motor, perceptual and cognitive defects which underlie learning difficulties.

Brain Damage, Chronic↗
PubMed1987

Deafness: ever heard of it? Delayed recognition of permanent hearing loss.

Records of approximately 1,000 children seen for evaluation of developmental delay during the period July 1979 to December 1985 were reviewed; 46 children with permanent hearing loss were identified. Age at diagnosis of deafness and factors contributing to delay in diagnosis were sought. Mean age at diagnosis of profound congenital deafness was 24 months. Lesser degrees of congenital hearing loss were not diagnosed until 48 months of age. High-risk medical history or physical anomalies associated with embryologic abnormalities of the auditory system that should have triggered a prompt search for deafness went unheeded in most instances. In 40% of subjects, the author was the first to diagnose hearing loss. For two thirds of this subgroup, audiologic referral was prompted by medical, physical, or developmental findings rather than clinically evident hearing loss during physical examination. Adherence to specific historical, physical, or developmental risk criteria, regardless of the examiner's subjective impression of how well the child seems to hear, would have permitted the timely diagnosis of hearing impairment in all children in this series.

Child, Preschool↗