Children Age Range Research Articles

The role of alkaline phosphatase (alp) and γ-glutamyltransferase (ggt) enzymes activities in monitoring the effect of enzyme replacement therapy in children with gaucher disease

To assess the role of γ-Glutamyltransferase (GGT) and alkaline phosphatase (ALP) in the diagnosis of Gaucher disease (GD) and monitoring the response of liver and bone to the treatment with enzyme replacement therapy (ERT).A case-control study was done on 67 children age range from 3-10 years who had Gaucher disease recruited from the Pediatric Department and Unit of rare disease at Al Imamain Al-Kathemeaain medical city,Gastroenterology and Hepatology Teaching Hospital, Children Welfare Hospital Consultation Clinic and Central Child’s Teaching Hospital. The activity of Alkaline Phosphatase (ALP) and γ- GlutamylTransferase (GGT) enzymes were measured in the samples of 67 Gaucher patients who were categorized as newly diagnosed untreated patients (n=9), patients receiving ERT for 3-5 months (n=18) 6-12 months (n=20) and patients receiving ERT for more than one year (n=20) and compared with twenty age-matched control subjects. The data indicated that the levels of both ALP and GGT in GD patients (216.82 ± 64.51, 35.94 ± 7.11; respectively) were significantly higher than those of controls (163.17 ± 49.34, 28.33 ± 3.36; respectively). Levels of ALP showed to return to levels comparable to those of controls after more than one year of treatment, while GGT levels become comparable to controls’ levels within 6-12 months. Negative significant (p<0.05) correlations were obtained between the levels of ALP and GGT activities with the duration of receiving ERT. Receiver Operating Characteristic (ROC) curve results revealed that GGTshowed a higher area under the curve (AUC), sensitivity, and specificity than ALP activities in all studied groups and subgroups.The possibility of using ALP and GGT as supportive diagnostic markers and as powerful markers for the monitoring of the liver and bone improvement with the administration of ERT.

Hair cortisol concentrations are associated with hippocampal subregional volumes in children

The human hippocampus, a brain structure crucial for memory across the lifespan, is highly sensitive to adverse life events. Stress exposures during childhood have been linked to altered hippocampal structure and memory performance in adulthood. Animal studies suggest that these differences are in part driven by aberrant glucocorticoid secretion during development, with strongest effects on the CA3 region and the dentate gyrus (CA3-DG) of the hippocampus, alongside associated memory impairments. However, only few pediatric studies have examined glucocorticoid associations with hippocampal subfield volumes and their functional relevance. In 84 children (age range: 6–7 years), we assessed whether volumes of hippocampal subregions were related to cumulative glucocorticoid levels (hair cortisol), parenting stress, and performance on memory tasks known to engage the hippocampus. We found that higher hair cortisol levels were specifically related to lower CA3-DG volume. Parenting stress did not significantly correlate with hair cortisol, and there was no evidence to suggest that individual differences in hippocampal subregional volumes manifest in memory performance. Our results suggest that the CA3-DG may be the hippocampal region most closely associated with hair cortisol levels in childhood. Establishing causal pathways underlying this association and its relation to environmental stress and memory development necessitates longitudinal studies.

Dishabituation of Operant Responding in Preschool-Aged Children

In applied settings, reinforcer satiation and the resulting response decrements may negatively affect otherwise effective treatments and can be difficult to avoid for some learners; previous research has suggested that a more precise explanation for these decrements may involve habituation to the sensory properties of repeatedly presented reinforcers, a process that carries with it different implications that may be useful in practice. One such implication is that habituated responding can undergo dishabituation, a recovery of habituated responding, following a brief stimulus change. The current study examined the effects of a dishabituation procedure on the operant responding of three children, all within the age range of children who typically receive early intensive behavioral intervention services. The participants engaged in an operant task in which they placed various task stimuli (e.g., pieces of foam, blocks, or poker chips) into a container in exchange for a small edible item or access to a toy. In each condition, once responding decreased to a predetermined level, the reinforcer (i.e., an edible) or an antecedent variable (i.e., the research assistant facilitating the task or the task stimulus) was changed for 2 min and then returned for an additional 2 min, whereas all other stimuli remained the same. Results indicated dishabituation patterns were observed in eight out of nine experimental conditions compared to control (no change) conditions in which responding did not recover, suggesting dishabituation procedures may provide options for at least temporarily reinstating the effectiveness of reinforcers.

Short Term Neurodevelopmental Outcome in Infants and Children Presenting with a Clinical Picture of Central Nervous System Infection

Abstract Background Morbidity evaluation of patients with acute encephalitis/encephalopathy (AEE) is an important aspect of pediatric outcomes research. Aim of the Study Assessment of the neurodevelopmental outcome of infants and children presenting with acute CNS infection 1 month after hospital discharge. Patients and Methods Twenty previously healthy infants and children of age range 6-36 months presenting clinically to the Children’s Hospital, Faculty of Medicine, Ain Shams University ER with acute CNS infection. Upon presentation; patients were clinically and functionally assessed. Also, Laboratory investigations including blood tests and lumbar puncture assessment were done. According to the bacterial meningitic score (BMS); patients were classified as having ‘very low risk’ of meningitis or ‘not low risk’. One month after discharge; patients were neurodevelopmentally assessed using the third edition of the Bayley scales of infant and toddler assessment. Results Nine patients had ‘very low risk of meningitis’ and 11 had ‘not low risk’ according the BMS. The functional assessment tools used upon admission were comparatively insignificant in the two classified groups p = <0.05. However, all Bayley scales composite scores were lower in the ‘very low risk’ group compared to the ‘not low risk’ group with significant difference regarding the language composite score; 78+/-14 and 94+/-13 for the ‘very low risk’ and the ‘not low risk’ groups respectively p = 0.02. Also, significant negative correlations were found between the functional tests used and all Bayely scales composite scores. Conclusion and recommendations Neurodevelopmental evaluation of patients with CNS infection is important to highlight the adverse consequences of the disease.

Adherence to Azathioprine/6-Mercaptopurine in Children and Adolescents with Inflammatory Bowel Diseases: A Multimethod Study

Background Measurement of the degree of adherence is a key element for the evaluation of treatment efficacy and safety; thus, adherence plays an important role in clinical research and practice. The aim of this study was to investigate medication adherence in children with inflammatory bowel disease (IBD) utilizing a multimethod assessment approach. A further aim was to examine factors that can influence adherence within this population. Methods Medication adherence in 47 children (age range 3 to 17 years) with IBD in three centers in Northern Ireland and Jordan was assessed via subjective (parent and child versions of the Medication Adherence Report Scale (MARS) specific questionnaire) and objective methods, that is, high-performance liquid chromatography (HPLC) determination of the 6-mercaptopurine (6-MP) and azathioprine (AZA) metabolites in packed red blood cell samples taken during a clinic visit. Beliefs about prescribed medicines were also assessed in parents/guardians using the Beliefs about Medicines Questionnaire (BMQ). Results An overall nonadherence to AZA/6-MP therapy in children with IBD was found to be 36.17% (17 out of 47 patients were classified as nonadherent using at least one of the assessment methods). A total of 41 patients (91.1%) were classified as adherent to AZA or 6-MP using the blood sampling, while adherence rates using the MARS questionnaire completed by children and parents/guardians were 60.6% and 72.7%, respectively. The latter provides a more longitudinal measure of adherence. Child self-reported nonadherence rates were significantly higher than parent/guardian reported rates (p=0.013). Binary logistic regression analysis identified age to be independently predictive of adherence, with adolescents (children aged ≥ 13 years old) more likely to be classified as nonadherent. Regarding the BMQ, when parental/guardian necessity beliefs outweighed concerns, that is, higher scores in the necessity-concern differential (NCD), adolescents were more likely to be classified as adherent. Conclusion Results provide evidence for ongoing adherence challenges in the paediatric population with IBD. It is recommended that parents/guardians (particularly of older children) and older children themselves, should receive enhanced counselling and education about their prescribed medicines.

Behavioral and Neuropsychological Evaluation of Executive Functions in Children with Autism Spectrum Disorder in the Gulf Region.

This study examined the executive functioning abilities and development profiles of children with autism spectrum disorder (ASD). The participants were 119 children with ASD and 30 typically developing children (age range: 6–12 years) who were recruited from three Gulf states. The findings revealed executive functioning deficits in the ASD population when compared to the normative data or to those children without ASD. However, not all the forms of executive functioning were found to be impaired. Age-related differences in the patterns of performance on the utilized measures of executive functioning were also identified. The overall findings provide valuable information regarding the different components of the executive functions, which may prove useful in relation to the development of assessment protocols for ASD.

Towards person-centred quality care for children with life-limiting and life-threatening illness: Self-reported symptoms, concerns and priority outcomes from a multi-country qualitative study

Background: Paediatric life-limiting and life-threatening conditions (life-limiting conditions) place significant strain on children, families and health systems. Given high service use among this population, it is essential that care addresses their main symptoms and concerns. Aim: This study aimed to identify the symptoms, concerns and other outcomes that matter to children with life-limiting conditions and their families in sub-Saharan Africa. Setting and participants: Cross-sectional qualitative study in Kenya, Namibia, South Africa and Uganda. Children/caregivers of children aged 0–17 years with life-limiting conditions were purposively sampled by age, sex and diagnosis. Children aged 7 and above self-reported; caregiver proxies reported for children below 7 and those aged 7 and above unable to self-report. Results: A total of 120 interviews were conducted with children with life-limiting conditions (n = 61; age range: 7–17 years), and where self-report was not possible, caregivers (n = 59) of children (age range: 0–17) were included. Conditions included advanced HIV (22%), cancer (19%), heart disease (16%) endocrine, blood and immune disorders (13%), neurological conditions (12%), sickle cell anaemia (10%) and renal disease (8%). Outcomes identified included physical concerns – pain and symptom distress; psycho-social concerns – family and social relationships, ability to engage with age-appropriate activities (e.g. play, school attendance); existential concerns – worry about death, and loss of ambitions; health care quality – child- and adolescent-friendly services. Priority psycho-social concerns and health service factors varied by age. Conclusion: This study bridges an important knowledge gap regarding symptoms, concerns and outcomes that matter to children living with life-limiting conditions and their families and informs service development and evaluation.

How Do Childhood and Parental Anxiety Features Affect the Consequences of Child Sexual Abuse?

ABSTRACTThe purpose of the study was to investigate the anxiety features of children who experience child sexual abuse (CSA) and their parents, along with the features and consequences of sexual abuse in the environment of Child Advocacy Centers (CAC). The sample of this study comprised 150 children affected by CSA and one of their parents who were admitted to İzmir CAC between June 2016 and November 2016.The children-age range 9 to 13 years-and one of their parents were asked to complete the State-Trait Anxiety Inventory separately. The children also completed the Childhood Anxiety Sensitivity Index (CASI). During psychiatric evaluations of the children, sociodemographic characteristics and features of sexual abuse were noted and all psychiatric conditions were examined. The statistical analyses yielded significant correlations between the STAI scores of the parents and STAI-C and CASI scores of the children. There were statistically significant differences between the CASI scores, STAI-C subscale scores, and STAI subscale scores according to some variables of CSA along with their psychiatric diagnosis. Our findings showed that having higher anxiety sensitivity and trait anxiety levels and having parents with higher trait anxiety might be considered as risk factors for being diagnosed as having a psychiatric disorder due to CSA.

Dynamics of the age structure of international tourism in Chernivtsi oblast during 2005-2018

The article reveals the main theoretical and methodological approaches to the study of international tourism by different age groups. To assess the development of international tourist flows by different age groups, it is proposed to use the coefficient of tourist activity of the age group. The dynamics of formation and development of international tourist flows by different age groups within Chernivtsi oblast is analyzed. Introduction. Tourism and recreation are currently one of the key sectors of the world economy. Their development depends on many factors, one of the key of which is the age structure. It is known that people of different ages have different tendencies to travel. One of the most mobile groups is the youth and older age groups. Presenting main material. One of the most important factors that significantly affect the development of international tourism is the age structure. The age structure of tourists has a significant impact on: 1) determining the types of tourist services provided to international tourists; 2) the potential cost of consumption of tourist services (the price of the tourist product). Currently, in the statistical study of the age structure of tourists in Ukraine, it is customary to distinguish 4 age groups: children (age range from birth to 14 years), adolescents (15-17 years), youth (18-28 years) and tourists over 29 years. This classification is based on a number of factors: physiological, psycho-emotional, socio-economic. However, a significant variance in the number of years during which the tourist belongs to a particular age group significantly affects the formation of the number of tourists. In order to determine the influence of age group on the development of tourism and taking into account the above aspects of such assessment, it is proposed to calculate the coefficient of age activity of tourists (σі). It is calculated as the ratio between the number of tourists per year of the age interval of the i-th age group (kі) to the average values of the number of tourists per 1 year of the age interval (kс). It is assumed that the population makes tourist trips throughout life, so it corresponds to the average life expectancy in the region. In tourism of Chernivtsi oblast, the highest indicators of age activity of tourists and their number per one year of the age interval are typical for adolescents (15-17 years) and older age groups (over 29 years). The average tourist activity of adolescents is 1.24 and for adults 1.23. This means that adolescents and older tourists are 24% more likely to travel than other age groups. Each of these groups is characterized by high rates of tourists for one year of the age interval – on average for adolescents, this figure is 1178.9 tourists, for the older age group – 1153.7 tourists. The leading positions of adolescents (despite the lowest absolute values) are explained primarily by the shortest duration of the age interval of this age group – 3 years, as well as a number of socio-economic factors. In particular, with reaching adolescence, the process of creating comfortable living conditions in families is mostly completed, parents succeed and income increases while reducing current expenses, so more money is allocated for adolescents for tourism and recreation. The latter factor is also crucial to explain the dominance of older tourists in the number of tourists.

Hljóðþróun íslenskra barna á aldrinum tveggja til átta ára

Rannsóknir á hljóðþróun íslenskumælandi barna eru á fremur þröngu aldursbili eða komnar til ára sinna. Nauðsynlegt er að afla viðmiða m.a. til að skera úr um hvort börn fylgi aldursbundnum framburðarþroska eða hvort þau séu með frávik í framburði málhljóða. Upplýsingar um hljóðþróun geta auk þess gagnast í rannsóknum og vinnu í tengslum við hljóðvitund, hljóðkerfisvitund og lestrartileinkun. Markmið þessarar rannsóknar var að skoða hljóðþróun á breiðu aldursbili og kanna á hvaða aldri börn tileinka sér samhljóð og samhljóðaklasa, m.a. til að afla viðmiða um dæmigerðan framburðarþroska. Þátttakendur voru 437 börn á aldrinum 2;6-7;11 ára. Gögnum var safnað með því að leggja fyrir Málhljóðapróf ÞM. Helstu niðurstöður voru þær að stígandi er í málhljóðatileinkun barna en þó gætir rjáfuráhrifa fyrir fjögurra ára aldurinn, þ.e. börn hafa náð 90% allra stakra samhljóða strax á aldursbilinu 3;6-3;11 ára. Samhljóðaklasar eru seinna á ferðinni og var 90% markinu ekki náð fyrr en börnin voru á sjöunda ári. Börn tileinka sér fyrst /m/, /n/, /b/, /d/, /l/ og /h/ en þau hljóð sem birtast einna síðast í máli barna eru /r/, /s/, /þ/, [?] og [n?]. Þegar samhljóðin eru flokkuð eftir myndunarhætti ná börn fyrst tökum á nefhljóðum (ef frá er talið [n?] í framstöðu orða) en lokhljóð og hliðarhljóð fylgja fast á eftir. Börn eru lengur að tileinka sér önghljóð og sveifluhljóð. Niðurstöður rannsóknarinnar sýna glögglega hvernig greina má milli barna með dæmigerða hljóðþróun og jafnaldra sem þurfa á talþjálfun að halda. Jafnframt leggja þær grunn að frekari athugunum á tengslum málhljóðamyndunar og lestrartengdra þátta eins og að tengja málhljóð við bókstaf.

Product of Investigator Global Assessment and Body Surface Area (IGAxBSA): A practice-friendly alternative to the Eczema Area and Severity Index to assess atopic dermatitis severity in children

Accuratelydocumenting pediatric atopic dermatitis (AD) severity is important, but research tools, such as Eczema Area and Severity Index (EASI), are too time consuming for clinical settings. Product of the Physician Global Assessment and affected percentage of body surface area (PGA×BSA) is a new, rapid measure of psoriasis severity. To evaluate an Investigator Global Assessment and body surface area product (IGA×BSA) as an easy-to-use severity measure for pediatric AD. Patient-reported and objective disease severity measures were collected from 195 caretaker/child dyads (childage range, 5-17years) with almost clear (Validated Investigator Global Assessment for AD [vIGA] of 1) to severe (vIGA of 4) AD. Data were assessed with Spearman coefficients and plots. Severity strata were proposed by using an anchoring approach based on the EASI. IGA×BSA correlates better with the EASI than IGA alone (r=0.924 vs r=0.757, P<.001). Bland-Altman plot indicates high and consistent agreement between IGA×BSA and the EASI. Suggested severity strata for IGA×BSA are 0-30, mild; 30.1-130, moderate; and 130.1-400, severe (κ=0.760). The patient cohort was predominantly from the midwestern United States. IGA×BSA (using the vIGA) is a simple measure that correlates well with the EASI in patients with mild to severe pediatric AD. Future work is needed to affirm reliability across IGA scales and responsiveness to change.

Is Cognitive Training Effective for Improving Executive Functions in Preschoolers? A Systematic Review and Meta-Analysis.

In the present meta-analysis, we examined the effect of cognitive training on the Executive Functions (EFs) of preschool children (age range: 3–6 years). We selected a final set of 32 studies from 27 papers with a total sample of 123 effect sizes. We found an overall effect of cognitive training for improving EF (g = 0.352; k = 123; p < 0.001), without significant difference between near and far transfer effects on executive domains. No significant additional outcome effects were found for behavioral- and learning-related outcomes. Cognitive training programs for preschoolers are significantly more effective for developmentally at-risk children (ADHD or low socio-economic status) than for children with typical development and without risks. Other significant moderators were: individual vs. group sessions and length of training. The number of sessions and computerized vs. non-computerized training were not significant moderators. This is the first demonstration of cognitive training for transfer effects among different executive processes. We discuss this result in relationship to the lower level of modularization of EFs in younger children.Protocol Registration: PROSPERO (CRD42019124127). Available online at: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019124127.

Development of the Behavioral Inflexibility Scale for Children with Autism Spectrum Disorder and Other Developmental Disabilities.

Behavior inflexibility (BI) refers to rigid patterns of behavior that contrast with the need to be adaptable to changing environmental demands. We developed a parent‐reported outcome measure of BI for children with autism spectrum disorder (ASD) and other developmental disabilities with a multi‐step iterative process. A pool of 62 candidate items was generated through expert panel feedback, review of existing scales and focus groups. A consensus process was used to generate the final 38 items. Parents of 943 children (age range, 3–18 years; average, 11.4 years; 79% boys) with ASD completed an online survey. One hundred thirty‐three parents rated their child twice within 3 weeks (average = 16.5 days). A series of factor analyses suggested that the 38 items measured a single construct. Scores had a weak correlation with level of functioning (−0.12) and did not differ based on sex. Scores had a negligible correlation with age (−0.07), although measurement invariance was not supported. The mean total score for the Behavioral Inflexibility Scale (BIS) was normally distributed. Internal consistency was α = 0.97 and temporal stability was r = 0.92. Correlations with parent ratings on the subscales of the Repetitive Behavior Scale—Revised varied from 0.48 to 0.89. The correlation with parent ratings on the Social Communication Questionnaire total score was 0.52. Our data show that BI in children with ASD ranges significantly from mild to severe and that the 38‐item BIS is valid and reliable. Autism Res 2020, 13: 489–499. © 2020 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc.Lay SummaryWe developed a parent‐completed rating scale of behavior inflexibility (BI) for children with developmental disabilities using a multistep process. The Behavioral Inflexibility Scale (BIS) contains 38 questions rated on a 6‐point scale. Parents of 943 children with autism spectrum disorder (ASD) completed an online survey. We examined associations between the BIS and other scales and demographic variables. The BIS is valid and reliable. BI in children with ASD ranges from mild to severe.

Psychological distress and life satisfaction in mothers of attention-deficit/hyperactivity disorder children

Background: Attention-deficit/hyperactivity disorder (ADHD) is most commonly diagnosed psychiatric disorder of childhood ADHD which is often comorbid with other psychiatric disorders. This disorder is a major public health problem with enormous negative impact on the child, the family schools, and society. Objective: This study objective is to look into the relationship of attention-deficit hyperactivity symptom of children with psychological distress (i.e., depression, anxiety, and stress) and life satisfaction in their mothers. Materials and Methods: The sample of the present study consisted of 27 mothers with ADHD children who were selected with children age range from 6 to 17, both male and female. These children diagnosed as having ADHD attending the Psychiatry Child and Adolescent Unit. The study design is a case–control research. The measures used were depression, anxiety, and stress scale-21 translated version, along with the Satisfaction with Life Scale (SWLS), the Conners Parent and Teacher Rating Scale of attention-deficit hyperactivity disorder, and the Strengths and Difficulties Questionnaire (SDQ; parent version). Results: A total of 27 mothers with ADHD children compared to 25 mothers with no ADHD children. The results show that there was more maternal depression (P = 0.001), anxiety (P = 0.001), and stress (P = 0.002), also less satisfaction with life (P = 0.002) compared to mothers with no ADHD children. Conclusion: The results indicate that characteristics in children influence family distress and satisfaction with life. It means that mothers with ADHD children are at higher risk to develop psychological distress.

Problem behavior in young children referred with language difficulties: Relations to language and intentional communication.

This exploratory study aims to examine the relative contribution of language and intentional communication to internalizing and externalizing problem behavior. Twenty-nine Dutch-speaking children (age range 24-46 months) referred with language difficulties participated in this study. For the majority of children, these early language difficulties appeared to be part of a broader neurodevelopmental disorder, mainly autism spectrum disorder. Parent ratings on the Achenbach Child Behavior Checklist 1½-5 were predicted from children's language level and intentional communicative abilities, the latter being assessed by both parent report and direct observation. In all series of hierarchical regression analyses, chronological age and nonverbal mental age were included as covariates. Parents commonly reported withdrawal, emotionally reactive behavior, attention problems, and aggressive behavior. Parent-rated intentional communication was the most important predictor of internalizing problem behavior and played an important role in the prediction of aggressive behavior as well. However, chronological age and/or nonverbal mental age also predicted parent-rated levels of externalizing problem behavior, especially attention problems. The relation between language difficulties and problem behavior may be influenced by maturation and children's ability to communicate intentionally.Implications: Language proficiency should, therefore, be independently assessed from children's intentional communicative abilities which, in turn, may differ across contexts.

Efficacy and Safety of Intranasal Medical Management in Pediatric Patients with Idiopathic Recurrent Epistaxis.

Objective:The goal of the study was to verify the efficacy and safety of topical medical treatment in idiopathic recurrent pediatric epistaxis patients by intranasal usage of both an antimicrobial and a moisturizing agent as a first-step management modality.Method:Sixty-seven out of 326 pediatric patients with idiopathic recurrent epistaxis selected on a chart review of follow-up were enrolled in the study. The study was designed as an analysis of two groups: one group included 35 individuals (52.2% of the total cohort) having a hyperemic nasal mucosa and the second group included 32 individuals (47.8% of the total cohort) having a hypervascular nasal mucosa on physical examination before treatment.Results:The study was performed with a total of 67 children (age range 3-17 years) including 36 males (53.7% of total cohort) and 31 females (46.3% of total cohort). The mean age was 9.78±4.09 years. There was not any statistically significant difference between the groups in terms of age, duration of follow-up and recurrence time of epistaxis (p>0.05). Recurrence of epistaxis was seen in 22.9% (8/35) of hyperemic nasal mucosa group and in 34.4% (11/32) of hypervascular nasal mucosa group (p>0.05).Conclusion:We advise the use of both an intranasal antimicrobial ointment and a mucosal moisturizing gel as an effective, noninvasive and easily applicable medical treatment option for pediatric patients with idiopathic recurrent epistaxis before more invasive methods of epistaxis control.

Evaluation of Posterior Ocular Structures in Patients with Isolated Iris Coloboma.

Objectives:To measure lamina cribrosa thickness (LCT), lamina cribrosa depth (LCD) and subfoveal choroidal thickness (SFCT) by imaging posterior ocular structures in pediatric cases with isolated unilateral iris coloboma and to investigate the differences as compared with healthy contralateral eyes of these cases (fellow eyes) and healthy control eyes.Methods:This cross-sectional, comparative prospective study included seven children (age range, 9-17 years) with unilateral isolated iris coloboma. The healthy contralateral eyes of these cases formed the fellow group. An age-matched (age range 8-17 years) control group (n=9), including children with both eyes having either normal or corrected-to-normal visual acuity, was formed. A detailed ophthalmic examination was performed. The posterior ocular segments were evaluated using spectral domain-optical coherence tomography (SD-OCT) with enhanced depth imaging (EDI) technique.Results:The SFCT was 372.0±48.8 µm, 375.3±44.0 µm, and 386.5±71.8 µm, respectively, and the LCD was 362.4±68.3 µm, 354.4±47.1 µm, and 350.7±38.1 µm, respectively, in the coloboma, fellow, and control eyes. There was no difference between the groups regarding SFCT and LCD. The mean LCT was significantly thinner in the coloboma eyes (200.2±9.5 µm) than in the fellow (238.8±26.7 µm; p=0.023) and control eyes (240.0±12.9 µm; p<0.001). The LCT showed no significant correlation with age, axial length or spherical equivalent.Conclusion:Better visual prognosis is expected in isolated iris coloboma. However, detailed examinations using new technologies, such as SD-OCT, may reveal some structural changes. Longitudinal studies are required to understand if a thinner LCT in coloboma eyes is associated with any future problems.

Nasal Chamber Changes Following Rapid Maxillary Expansion in Children with Bilateral Cleft Lip and Palate

Purpose: The aim was to study the skeletal effect of rapid palatal expansion (RPE) on the anterior and posterior nasal width in a sample of Egyptian children (age range 9.4-14.3 years, mean 11.16 years) with bilateral cleft lip and palate (BCLP). Methods: Twenty Egyptian children with complete BCLP exhibiting maxillary transverse deficiency were divided randomly into; Group 1 received a fixed fan expander and Group 2 a hyrax expander. Cone-beam computed tomography (CBCT) images were taken before T1 and 3 months after expansion T2, just before the alveolar cleft grafting (ACG) surgical procedure. Linear and angular measurements were assessed to measure the degree of change on the anterior and posterior nasal chamber widths, dentition, and dental arch. Results: Repeated measure ANOVA with a between variable analysis was used to examine the effect of the two expanders on the dental arch and anterior nasal width as well as posterior nasal width. Statistically significant increase in dentoalveolar measurements were found in each group, nasal widths showed no statistically significant differences before and after expansion. Conclusion: increase in nasal width were found to be statistically insignificant following RME.

Impact of Childhood Psoriasis on Caregivers' Quality of Life, Measured with Family Dermatology Life Quality Index.

Psoriasis is a chronic skin disease, that often develops below the age of 18. In an integrated approach to childhood psoriasis, the impact of psoriasis on family members merits consideration. In this study, the impact of childhood psoriasis on caregivers (61 mothers and 4 fathers) of 65 children (age range 5-17.5 years) was measured using Family Dermatology Life Quality Index (FDLQI). Childhood psoriasis exerted a substantial impact on the QoL of caregivers (mean FDLQI 13.62 ± 6.15 points). Caregivers rated routine household expenditure, time spent caring for the skin of the child, and emotional distress as the areas most impacted by psoriasis. The areas least affected were parent-child relationships, and caregivers’ social lives. The impact of other people’s reactions to the child’s disease was rated as more severe by caregivers of girls compared with those of boys (p = 0.004).

Increased grey matter volume of the right superior temporal gyrus in healthy children with autistic cognitive style: A VBM study

The empathizing–systemizing model describes human cognitive style using empathizing (the drive to identify another’s mental state and respond appropriately) and systemizing (the drive to assess or construct rule-based systems). ‘Brain type’ was envisioned to explain individual differences in cognitive style based on the discrepancy of the two drives. In this model, individuals with autism spectrum disorder (ASD), a neurodevelopmental disorder, have extremely stronger systemizing. Revealing the underlying mechanisms of individual differences in cognitive style might contribute to elucidation of the pathology of ASD. We used voxel-based morphometry to compare the brain structures among the brain types (those who have stronger empathizing, those who have equally stronger drive to both, and those who have stronger systemizing) in 207 healthy children (age range: 5–15). Results showed that children with stronger systemizing had significantly greater grey matter volume of the right superior temporal gyrus (rSTG) than the others. The brain region, a distinctive brain structure of those with stronger systemizing, was overlapped with that of children with ASD. The rSTG is involved in detailed perceptual processing in social cognition, which is partially related to stronger systemizing. Our results contribute to elucidation of the underlying mechanisms of individual differences in cognitive style.