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Biomedical subjects

T F Anders

Publications and source records attributed to T F Anders.

18 recordsLinked to original sources
PubMed1979

Enuresis: the clinical application of an etiologically based classification system.

Enuresis is a common problem of childhood, but both a theoretical understanding and an etiologically based clinical approach to the symptom are lacking. The present descriptive study was undertaken to delineate subgroups within large, heterogeneous populations of enuretic children between the ages of four and 14. A number of variables were assessed through a detailed parental history for 116 enuretic children. Several relevant and significant correlations were identified, but overall no clinically useful patterns involving sleep stages, psychopathology, environmental events, or medical or family history were discovered. The results of this study confirm recent work in the field of enuresis and emphasize the need for new research directions.

Adolescent↗
PubMed1978

Sleep habits of children and the identification of pathologically sleepy children.

Sleep disorders and daytime sleepiness have been investigated only minimally in children. The sleep habits of 218 children, ages 10-13 years, were surveyed by a sleep habits questionnaire (SHQ). Our results demonstrate that total night time sleep on school nights begins to fall in early adolescence, whereas it remains relatively stable on non-school nights. Daytime sleepiness is not a common problem in this age group, in contrast to a college age population. We conclude that in adolescence chronic sleep deficits begin to occur which cumulatively affect later functioning. The potential use of the SHQ for depicting pathological sleepiness is also discussed.

Adolescent↗
PubMed1978

Further observations on the use of 5-hydroxytryptophan in a child with Lesch-Nyhan syndrome.

The effects of 5-hydroxytryptophan (5-HTP), a serotonin precursor, and carbidopa, a peripheral aromatic amino acid decarboxylase inhibitor, were studied in a boy with the Lesch-Nyhan syndrome. No effects on the self-mutilating behaviors of this disorder were noted. However, sleep patterns were normalized, with a reduction in the proportionate amounts of wakefulness and an augmentation of active sleep. A sharp reduction in waking behavioral dyskinesias was also correlated to increased drug dosage.

5-Hydroxytryptophan↗
PubMed1978

Respiration during sleep in children.

In 22 children (11 boys and 11 girls), aged 9 to 13 years, respiration was monitored during one night of sleep. No child had a significant history of breathing problems during sleep. Sleep was recorded using standard techniques (electroencephalography, electrooculography, electromyography), and respiration was measured with nasal thermistors and abdominal or thoracic strain gauges. Respiratory pauses (five seconds or longer) were determined for all sleep stages. Respiratory rate was scored only in the first and last sleep cycles and during ten waking minutes before sleep onset. Respiratory rate was significantly affected by wakefulness or stage of sleep: highest in wakefulness and stage 1, lowest in stage 2 of the last sleep cycle. Regularity of respiratory rate showed a similar effect. Variance of respiratory rate was significantly lower in girls than boys. Respiratory pauses during sleep were seen in every child, ranging from 3 to 40 pauses per night (average, 17.2 for boys and 18.0 for girls). Significantly greater numbers of pauses per minute were seen in stage 1 and rapid eye movement (REM) sleep than in stages 2, 3 and 4. The longest respiratory pause was 25 seconds. The conclusion is made that a small number of respiratory pauses during sleep are normal in children of this age.

Adolescent↗
PubMed1977

Child psychiatry and pediatrics: the state of the relationship.

A great deal of attention has been focused on the notion that child psychiatry and pediatrics should develop strong ties. Yet, a review of the literature suggests that, in spite of exhortations to the contrary, little true collaboration has developed between the two disciplines. This study surveys the major pediatric teaching and training centers throughout the country in an attempt to assess the current state of the relationship between child psychiatry and pediatrics. Of the 82 centers surveyed, 68% responded. Although enthusiasm and desire for closer collaboration were expressed repeatedly, actual successful efforts remain minimal. Psychiatric consultations on pediatric inpatient units continue to be the predominant child psychiatry service provided. A method for achieving closer relationships between the two disciplines is proposed.

Curriculum↗
PubMed1977

Relationships among the Brazelton Neonatal Scale, Bayley Infant Scales, and early temperament.

The present study investigated whether the Brazelton Neonatal Assessment Scale predicts 10-week performance on the Bayley Scales of Infant Development and examined whether early temperament relates to performance on both scales. 18 normal, term infants were studied. Conceptual, a priori scoring dimensions were applied to neonatal assessments at a mean of 8.6 days. Infant temperament data were available for 12 of the subjects at a mean of 13.3 days, and mental and motor development were assessed for all subjects at a mean of 68.8 days. The results indicate that the total of a priori Brazelton scoring dimensions and neonatal state control were predictive of Bayley mental quotients at 10 weeks. Caretakers' judgments of temperamental intensity and distractability at 2 weeks correlated with the Bayley scales and the Brazelton dimensions. Furthermore, dividing the infants into worrisome and optimal groups on the basis of the total produced significant differences in Bayley mental scores.

Attention↗
PubMed1976

The use of 5-hydroxytryptophan in a child with Lesch-Nyhan syndrome.

The effects of 5-hydroxytryptophan (5-HTP), a serotonin precursor, were studied in a boy with the Lesch-Nyhan syndrome. During the course of drug treatment, self-mutilation, crying, sleep state architecture, serum dopamine B-hydroxylase (DBH), and cerebrospinal fluid levels of 5-hydroxyindolylacetic acid and homovanillic acid were studied. Treatment with 5-HTP failed to affect this child's biting behavior. However, the drug significantly reduced irritability as measured by crying time. Moreover, 5-HTP may have affected sleep state architecture, making it more normal in character. Serum DBH levels were normal throughout the study. Neither the patient's mother nor his maternal grandmother showed a hypertensive response on the cold pressor test.

5-Hydroxytryptophan↗
PubMed1976

The pathophysiology of sleep disorders in pediatrics. Part I. Sleep in infancy.

In this part of the chapter we have described the characteristics of two alternating sleep states - REM and NREM sleep in preterm and full-term infants. We have indicated how individual physiologic measures, recorded during sleep, mature and become synchromized into patterns that define the sleep states. We have described abnormalities in this process and have related them to clinical populations of deviant infants. Throughout, we have emphasized the complexity of the process and the methodologic sophistication required to investigate adequately the multiple dimensions of sleep. Despite somewhat discrepant and confusing reports in the literature, we continue to believe that sleep studies will provide rewarding insights into the central nervous system functioning of the developing young infant.

Apnea↗
PubMed1976

The pathophysiology of sleep disorders in pediatrics. Part II. Sleep disorders in children.

In this part of the chapter we have used new terminology and developed a new system for classification of sleep disorders in children. We suggest that excessive daytime sleepiness should be investigated by clinicians before troubles at school necessitate referral. The narcolepsy-hypersomnia syndrome generally has not been recognized in the pediatric age group. Symptoms of excessive fear of falling asleep need to be viewed in this context. Sleep apnea-hypersomnia has received insufficient attention in the American literature. It is a syndrome that affects both adults and children with potentially disastrous cardiovascular and pulmonary complications. The relationship of the sleep apnea-hypersomnia syndrome to the sudded infant death syndrome remains speculative, although preliminary results from our longitudinal study have indicated a possible link. Both the narcolepsy-hypersomnia and the sleep apnea-hypersomnia syndromes are reviewed in detail. In contrast, we review briefly the NREM dyssomnias, including night terrors, sleepwalking, sleep talking and enuresis. All are well known to clinicians dealing with children, and we have related them to findings emanating from the sleep laboratory. We suggest that they are physiologically rather than psychogenically based and frequently represent immaturities of the central nervous system. Finally, the insomnias of childhood are presented. We emphasize that they are rare, and after ruling out organic conditions and drug-dependency syndromes, cultural styles or family stresses generally account for the majority of complaints.

Apnea↗
PubMed1975

Effects of varying laboratory conditions on behavioral-state organization in two- and eight-week-old infants.

Previous studies have found that laboratory conditions influence sleep-waking behavior in older infants, children, and adults. The present study employed videotape recordings to monitor continuous 24-hr sleep-waking activity in 2- and 8-week-old infants before, during, and after 12 hr of polygraphic recordings. Sleep- and waking-state organization were affected by laboratory conditions. At both age levels, increased fussy-crying and decreased alertness occurred during the first 4 hr in the laboratory when they were video recorded only and during the first 4 hr that the leads were in place. Decreased fussy-crying and increased alertness were noted in the following periods, indicating adaptation. Latency to sleep was shorter, and drowsiness increased and active sleep decreased while the leads were in place. At 8 weeks, quiet sleep increased and active sleep decreased while the leads were in place. These data suggest that the unfamiliar laboratory conditions inherent in both observational and polygraphic studies are stressful and that time for adaptation is needed.

Adaptation, Psychological↗
PubMedDate not supplied

Diuranal rhythms in 2- and 8-week-old infants: sleep-waking state organization as a function of age and stress.

Time of day differences in sleep-waking state organization were studied in 2- and 8-week-old infants by means of videotape recordings. Observations were made prior to and following adaptation to standard laboratory conditions previously found to be stressful. Diurnal rhythms occurred for a number of component sleep-waking states under the nonstressful conditions only, and increased with age.

Adaptation, Psychological↗