PubMed Health⌕ Search

Biomedical subjects

K N Olness

Publications and source records attributed to K N Olness.

15 recordsLinked to original sources
PubMed1999

Human immunodeficiency virus status and delayed-type hypersensitivity skin testing in Ugandan children.

BACKGROUND: In previous studies, delayed-type hypersensitivity (DTH) skin testing has been shown to be affected by several factors including nutritional status, intercurrent infection, host immune status, and previous exposure to the antigen being used. OBJECTIVE: To determine the effect of human immunodeficiency virus type 1 (HIV-1) status on DTH skin testing in a cohort of HIV-1-infected and noninfected Ugandan children followed prospectively from birth. DESIGN: Nested case-control study. SETTING: Primary care clinic serving study participants at Mulago Hospital, Makerere University, Kampala, Uganda. PARTICIPANTS: Thirty HIV-1-infected children and 30 age-matched, HIV-1-noninfected children. METHODS: After completion of history and physical, each child underwent Mantoux skin testing with both Candida and purified protein derivative (PPD). Results of skin testing were read in 48 to 72 hours. Complete chart reviews were performed on all children. CD4 lymphocyte counts were obtained on all HIV-1-infected children at the time the skin testing was read. RESULTS: The average age of participants was 67 months (range, 51-92 months). HIV-1-infected children (mean CD4 lymphocyte count, 1069 mL-1; range, 86-3378 mL-1), compared with noninfected, age-matched peers, developed significantly smaller PPD reaction size (mean, 1.18 mm +/- 4.3 vs 3.6 mm +/- 7.6, respectively). Candida responses were not different between the two groups of children. Among HIV-1-infected children, there was a larger Candida reaction size in children who had recently received chloroquine treatment. There was no significant correlation between Candida reactivity and PPD reactivity, progressive HIV-1 disease, or CD4 lymphocyte count. The six children diagnosed clinically with active tuberculosis had lower absolute CD4 lymphocyte counts than children without tuberculosis. Lack of reaction to PPD was associated with lower CD4 lymphocyte counts and progressive HIV-1 disease. CONCLUSIONS: In HIV-1-infected Ugandan children, DTH skin testing was influenced by the choice of antigen selected, HIV-1 infection, and recent treatment with chloroquine. Based on these findings, we believe that further prospective, longitudinal investigation into the role of chloroquine in HIV-1-infected children is needed. We emphasize the limitations of DTH skin testing in HIV-infected children as an adjunct in the diagnosis of active tuberculosis.

Antigens, Fungal↗
PubMed1998

Relaxation training and breast milk secretory IgA.

OBJECTIVE: To evaluate the hypothesis that breast-feeding women who participate in relaxation training will have increased secretory IgA (sIgA) levels in their breast milk compared with women not receiving training. DESIGN: Nonrandomized control trial of a convenience sample. SETTING: Women were recruited from the postpartum floor of a university teaching hospital. The intervention took place in the women's homes. PARTICIPANTS: Women in the first 48 hours after delivery who were planning to breast-feed their healthy newborn infants for at least 8 weeks were approached for enrollment. Women were excluded if they had previous experience with relaxation training. At 4 to 6 weeks postpartum, we enrolled 38 women still breast-feeding their infants. INTERVENTIONS: Women were allocated into 3 groups. Women in group 1 were taught relaxation and had breast milk samples collected before and after the teaching. Women in group 2 had conversation with similar breast milk sample collection, and women in group 3 had 1 breast milk sample collected. Women in group 1 were encouraged to practice the relaxation once or twice a day for 2 weeks, and a second visit was made to all mothers with repeated breast milk collections. Women who were still breast-feeding at 6 to 8 weeks after study end had a final breast milk sample collected. Breast milk was analyzed for secretory IgA levels. Stress was assayed using the Symptom Checklist-90-R and open-ended questions. RESULTS: There was no difference in sIgA levels among the 3 groups at any time. Women who reported stress present between visit 1 and visit 2 increased their sIgA levels at the final sample collection (+0.16 g/L) compared with women who reported no stress (-0.09 g/L; P= .03). The ratings of success in relaxation in women in group 1 were related to the following sIgA levels in sample 4: poor relaxation, 0.67 g/L; fair relaxation, 0.41 g/L; good relaxation, 0.35 g/L; and very good, 0.30 g/L (P= .006). CONCLUSIONS: Self-reported stress appears to increase breast milk sIgA levels. Success at relaxation was inversely related to sIgA levels in the group learning relaxation.

Adult↗
PubMed1997

Clinical and demographic characteristics of migraine in urban children.

OBJECTIVE: To establish the frequency, symptoms, duration, and treatment methods of childhood migraine in an urban area. DESIGN: Self-administered questionnaire survey. The questionnaire was designed according to criteria suggested by the International Headache Society (IHS). PARTICIPANTS: In 1994, with the help of school officials in 41 elementary and middle schools in the Greater Cleve-land Area, 18,000 questionnaires were distributed to the parents of schoolchildren who ranged in age from 5 to 13 years. RESULTS: Of the total 2572 respondents, 222 children (8.6%) met the IHS criteria for migraine. Male to female ratio was 1:1.2 (99:120), 65.8% had a positive family history of migraine, 30.6% had onset of migraine at 4 to 5 years of age, and 54.1% reported having an aura (71% of these were visual aura). The headaches were mostly pulsating, poorly localized, lasted about 2 to 12 hours, and were aggravated by motion, noise, and bright light. The associated symptoms were nausea, vomiting, photophobia, and phonophobia. During the attack, 43% of the migraineurs had to stay in bed, and 27% were unable to attend school. Only 19.8% of the migraineurs were diagnosed to have migraine by their physicians, and most of these had not received treatment. CONCLUSION: This study in an urban area indicates that childhood migraine is a common, often underdiagnosed disorder that causes significant suffering for children and their families.

Child↗
PubMed1996

Effects of self-induced mental imagery on autonomic reactivity in children.

The purposes of this research study were: (1) to determine whether changes in cardiac rate, skin temperature, and/or electrodermal activity occur as children change mental imagery and (2) to determine whether such changes are related to age, sex, or other variables. Children who were evaluated in this study had no previous experience with hypnosis or biofeedback training and were in good health with no learning disabilities. Thirty-eight boys and 38 girls ranging in age from 5 to 15 years were studied in a comfortable setting with a constant room temperature and biofeedback equipment. A Procomp 5DX computer software unit was used to measure autonomic reactivity during baseline and mental processing periods. After baseline monitoring indicated stabilization of autonomic measures, each child was asked to think about being in a quiet, pleasant place for 120 seconds. Pulse rate, skin temperature, and electrodermal activity were recorded. A resting period followed, and each child was then asked to think about an exciting activity, such as a preferred sports activity, for another 120 seconds. At the end of this monitoring, each child was asked to describe what had been his/her mental imagery during the two monitoring periods. Data analysis used paired t tests and repeated measures analysis of variance. For all children, the pulse rates showed significant decreases (p < .001) during quiet and relaxing imagery and significant increases (p < .001) during active imagery. Skin temperatures increased significantly (p < .001) during quiet imagery and active imagery, whereas electrodermal activity decreased (p < .001) during active imagery. Observed changes did not relate to age or sex. The results confirm our clinical observations that deliberate changing of mental imagery by children results in immediate autonomic changes. Questions evolving from this study and similar studies done in adults are: (1) Do average-thinking processes impact on autonomic changes over long periods of time and (2) do these changes ultimately impact on health, such as cardiovascular status?

Adolescent↗
PubMed1986

Hypnotherapy in children. New approach to solving common pediatric problems.

Physicians have long used the power of suggestion informally in their practice as a means of motivating patients and boosting compliance. Recent research shows that formal use of hypnosis can be a valuable primary or adjunctive therapy, especially in children. Children are more in touch with innate imagery processes than adults and consequently can learn and use self-hypnosis easily, particularly to control autonomic responses. Hypnotherapy has proven useful in habit and behavior disorders, psychophysiologic disorders, pain control, anxiety control, cellular growth, and chronic conditions. The cases reported here illustrate the effectiveness of this process in children. Before hypnotherapy can be used clinically, the physician should become certified by an association approved by the American Medical Association and know when hypnotherapy is indicated and how long it should be continued.

Adolescent↗
PubMed1985

Nutritional consequences of drugs used in pediatrics.

Pediatric drugs may have significant nutritional consequences via their effects on appetite, nutrient absorption, nutrient metabolism, and nutrient excretion. Examples of common drugs and effects on nutrition include the inhibition of vitamin C storage by aspirin; impairment of folic acid utilization by phenobarbital; phenylalanine accumulation by trimethoprim; and lipolysis caused by caffeine. Nutritional consequences of drugs are of greater clinical significance in children who are malnourished and in those on drugs for prolonged periods. It is important that physicians consider possible deleterious consequences of drugs in making therapeutic choices.

Appetite↗
PubMed1984

The use of relaxation-mental imagery (self-hypnosis) in the management of 505 pediatric behavioral encounters.

This report assessed outcomes of hypnotherapeutic interventions for 505 children and adolescents seen by four pediatricians over a period of one year and followed from four months to two years. Presenting problems included enuresis, acute pain, chronic pain, asthma, habit disorders, obesity, encopresis, and anxiety. Using strict criteria for determination of problem resolution (e.g., all beds dry) and recognizing that some conditions were intrinsically chronic, the authors found that 51% of these children and adolescents achieved complete resolution of the presenting problem; an additional 32% achieved significant improvement, 9% showed initial or some improvement; and 7% demonstrated no apparent change or improvement. Children as young as three years of age effectively applied self-hypnosis techniques. In general, facility in self-hypnosis increased with age. There was an inverse correlation (p less than 0.001) between clinical success and number of visits, suggesting that prediction of responsivity is possible after four visits or less.

Adolescent↗
PubMed1981

Parental perceptions of enuresis. A collaborative study.

Of 1,379 children 4 years of age and older who were patients in nine medical centers across the country, 346 (25.1%) were found to be enuretic. Their parents considered heavy sleeping and emotional problems as the main causes of enuresis in children; physical causes rarely were believed to be important. "Waking up the child" from sleep to urinate and "talking about the problem" were the main methods that parents used to treat enuresis. Very few used medication. Parents with a grade school level of education punish bed-wetting children at twice the rate of high school- and college-educated parents. Physicians need to be more aware that enuresis is an important problem for parents and that there are many widely held beliefs about cause and management.

Adolescent↗