Longevity Of Children Research Articles

Industrial Processing Induces Pericardial Patch Degeneration.

BackgroundAutologous pericardium is considered gold standard for various reconstructive surgical procedures in children. However, processed bovine, equine, and porcine pericardial tissue are also widely used. We investigated structural differences and analyzed alterations caused by industrial processing. Additionally human and equine pericardium explants, used during aortic valve reconstruction were analyzed.MethodsPericardial tissues (native, processed and explanted) were gathered and stained with HE and EvG to visualize collagen as well as elastic fibers. Fiber structures were visualized by light and polarization microscopy. Antibody staining against CD 3, CD 20, and CD 68 was performed to identify inflammation.ResultsNative pericardium of different species showed small differences in thickness, with bovine pericardium being the thickest [bovine: 390 μm (± 40.6 μm); porcine: 223 μm (± 30.1 μm); equine: 260 μm (± 28.4 μm)]. Juvenile pericardium was 277 μm (± 26.7 μm). Single collagen bundle diameter displayed variations (~3–20 μm). Parallel collagen fibers were densely packed with small inter-fibrillary space. After industrial tissue processing, loosening of collagen network with inter-fibrillary gapping was observed. Pericardium appeared thicker (mean values ranging from 257–670 μm). Processed tissue showed less birefringence under polarized light. All analyzed tissues showed a small number of elastic fibers. Fibrosis, calcification and inflammatory processes of autologous and equine pericardium were observed in patient explants.ConclusionNone of the analyzed tissues resembled the exact structure of the autologous pericardial explant. Degeneration of pericardium starts during industrial processing, suggesting a potential harm on graft longevity in children. A careful surgical approach prior to the implantation of xenografts is therefore needed.

Need for global core competencies in Child Health and the Environment: a Canadian perspective

Children are the planet’s most valuable resource. Mortality rates and longevity in children are improving; however, morbidity related to early-life exposures is increasing and with it health spending. A focus...

Reasons for direct restoration failure from childhood to adolescence: A birth cohort study

ObjectivesThe aim of this study was to assess the prevalence of direct restorations in posterior teeth in children aged 12, from a birth cohort, and to test the association between the quality of the restorations and individual variables experienced in the life cycle. MethodsAll live-born children in Pelotas, in 2004, were prospectively investigated and a representative sample was assessed for oral conditions at ages 5 and 12. The outcome was the quality of the restoration (satisfactory/unsatisfactory). Independent variables included socioeconomic, behavioral and oral health characteristics at the individual level and the size of cavity and material at the tooth level. Associations were tested using multilevel logistic regression models. ResultsA total of 1,000 participants and 249 restorations in the permanent dentition were examined. Most of the restorations were composites (73.5%), while only 6.8% were amalgam. After adjusted analyses, children whose parents received information on how to prevent their child from developing caries before reaching 5 years of age had 91.0% less chance of having an unsatisfactory restoration compared to children whose parents never received information (OR = 0.09; 95% CI 0.01–0.59). Also, the chances of presenting unsatisfactory restorations were 5.3 higher in children at high-risk for untreated dental caries in the permanent dentition, in comparison with children at low risk (OR = 5.32; 95% CI 1.07–26.6). ConclusionsLow-risk for untreated dental caries and having received information on preventing dental caries, reduced the chance of presenting failed restorations, showing that factors related to individuals play an important role in the quality of restorations. Clinical significanceOur findings highlight the role that individual-related factors play in restoration longevity in children, reinforcing the need for a patient-centered approach in restorative dentistry.

The Long-Run Impact of Cash Transfers to Poor Families.

We estimate the long-run impact of cash transfers to poor families on children's longevity, educational attainment, nutritional status, and income in adulthood. To do so, we collected individual-level administrative records of applicants to the Mothers' Pension program-the first government-sponsored welfare program in the United States (1911-1935)-and matched them to census, WWII, and death records. Male children of accepted applicants lived one year longer than those of rejected mothers. They also obtained one-third more years of schooling, were less likely to be underweight, and had higher income in adulthood than children of rejected mothers.

VEPTR: past experience and the future of VEPTR principles

This review summarizes the experience with the vertical expandable prosthetic titanium rib (VEPTR) device, which enables five new procedures to treat complex spine and chest wall abnormalities in pediatric patients, which cause thoracic insufficiency syndrome, the inability of the thorax to support normal respiration or lung growth. The literature on VEPTR was reviewed and discussed by the author, the inventor of the VEPTR. The central VEPTR treatment principle is to correct volume depletion deformity of the thorax, and maintain the correction until skeletal maturity, at which time procedures such as spinal fusion can be considered. For individual cases of complex deformity, VEPTR strategies can differ remarkably. The goal of VEPTR surgery is to pursue the surgical strategy that provides the largest, most symmetrical, most functional thorax that can grow as normally as possible. Assessment of these results is difficult, since natural history of VEPTR-treated diseases are not clearly known and no current imaging test can measure thoracic insufficiency syndrome, but dynamic lung MRI have promise for the future in better defining this potentially lethal condition. VEPTR and its principles of use have become an important first step toward improving the quality of life and longevity of children with thoracic insufficiency syndrome, but much work remains to advance both its design and its use.

Longitudinal stability of friendships in rhesus monkeys (Macaca mulatta): individual- and relationship-level effects.

The longevity of children's friendships is influenced by a multitude of individual- and relationship-level attributes, but little is known about the factors that impact friendship maintenance in nonhuman primate juveniles. We investigated whether the following predicted the longitudinal stability of friendships in juvenile rhesus monkeys (Macaca mulatta): (1) individual characteristics including sex, dominance rank, matriline size, and temperament; and (2) relationship characteristics including kinship, reciprocity, complexity, and similarity between friends in sex, rank, and temperament. We recorded affiliative interactions of 29 two-year-old rhesus monkeys, previously observed as yearlings, at the California National Primate Research Center. Friends were defined as peers with whom subjects spent more time affiliating than expected by chance. Temperament had been assessed at 3-4 months of age. Sex was the only individual characteristic predicting friendship stability: males maintained more friendships from age one to two than did females. Relationship characteristics predicting friendship stability included similarity between individuals in temperament, kinship, and sex. In addition, reciprocated friendships, rather than unidirectional friendships, were significantly more likely to persist over time. Our findings suggest that the factors influencing friendship maintenance in rhesus monkeys are similar to those impacting human friendship longevity.

Right Ventricle–to–Pulmonary Artery Conduit Longevity: Is it Related to Allograft Size?

Cryopreserved valved allografts are routinely oversized to account for somatic growth in children requiring right ventricle-to-pulmonary artery (RV-PA) continuity. The objective of this study is to determine the effect of oversizing on conduit longevity. We reviewed the records of all patients undergoing RV-PA cryopreserved valved allograft placement from 1988 to 2006 for diagnosis, age, allograft type, time to valved conduit explant, and indication for surgery. Conduit size at the time of insertion was compared with pulmonary valve size normalized for body surface area (z score). Multivariate Cox regression models with cluster analysis were constructed to assess risk of allograft oversizing for conduit failure. Kaplan-Meier analysis was used to obtain median freedom from explantation time. A total of 140 cryopreserved valved allografts (z score, 1.8 +/- 1.3; range, -1.5 to 4.9) were implanted in 99 patients (median age, 5.6 years). Reoperation was required in 66 (67%) of 99 patients during the study period. Modeling z scores as a dichotomous variable revealed that risk of allograft explantation increases 113% when allografts with z scores of 2.7 or higher are used compared with those with z scores of less than 2.7 (p < 0.01). Median adjusted freedom from explantation for this same grouping was 4.9 years versus 9.4 years. The presence of branch pulmonary artery stenosis shortens the conduit life (p < 0.001), whereas insertion of a pulmonary allograft may extend the conduit life (p = 0.13). Cryopreserved valved allograft oversizing (z score > or = 2.7) in the pulmonary position results in decreased longevity in children. Presence of branch pulmonary artery stenosis is also associated with earlier conduit explantation.

Exposing the Limitations of Disability Theory: The Case of Juvenile Batten Disease

Current estimates suggest that approximately 10% of the world's population, more than half a billion people, are disabled. It is predicted that this number will rise dramatically in the next quarter of a century and that increasing longevity of children with gene-linked disability means that this group will make up an ever more significant percentage of this number in the West. The area of disability studies has developed alongside an increasing awareness that ‘disability’ is about more than the care of functionally impaired people. This paper explores the nature of juvenile Batten disease; a rare, neurodegenerative, metabolic disease; as a means of exposing some of the limitations of current sociological theory around disability. The arguments for the social construction of disability and the removal or separation of the body or ‘impairment’ from disability are addressed along with the issue of the ‘new genetics’. It is suggested that, while disability theory has made huge advances in disability awareness, it has marginalized the embodied experiences of those with multiple or profound disability.

Geography of child mortality clustering within African families

After decades of sustained child mortality reductions, infant and early childhood mortality levels in Africa remain high. This can partly be ascribed to the concentration of child mortality within particular families, communities or geographic localities. Strong mortality clustering is indicative of marked social inequality and of an unequal distribution of health and health-related resources and infrastructures. It also signifies a concentration of nutritional and sanitary behaviors harmful to the good health and longevity of children. Finally, it likely points to the existence of particular genetic problems in certain families, or environmental problems within specific communities. Using nationally representative family level data from all sub-regions of Africa, two important findings emerge from this study. First, levels of mortality have generally declined in all countries over time, and as mortality decreases, mortality clustering tends to follow the same trend. Second, bio-demographic covariates have a more important effect on familial mortality clustering risks than socio-economic ones.

Endocardial pacing electrode longevity in children

Endocardial pacing electrode longevity in children

Evaluation of pacemaker pulse generator and patient longevity in patients aged 1 day to 20 years

The longevity of pediatric patients requiring pacemakers and the survival rates of the Implanted generators were evaluated. From January 1970 to December 1985, 96 patients aged 1 day to 20 years underwent 162 pulse generator implantation procedures. Indication for initial implantation was surgically induced heart block in 52 patients, sick sinus syndrome in 20, congenital complete heart block with symptoms of low cardiac output in 19 and tachydysrhythmia control in 5. Modal age at initial implantation was less than 1 year; median age was 5 years. During this period 90 generators were removed from service: 49 (54%) because of generator failure, 22 (24%) because the patient died, 12 (13%) because of elective upgrade at the time of lead failure or cardiac surgery, 5 (6%) because of generator pocket infection and 2 (2%) because of manufacturer's recall. Pulse generators were separated into 4 groups based upon generator technology. Group 1 (n = 16) were asynchronous units with mercury-zinc batteries; group II (n = 18) were single-chamber demand units with mercury-zinc batteries; group III (n = 14) were single-chamber demand units with rechargeable batteries; and group IV (n = 114) were single- or dual-chamber demand units with lithium batteries. Patient survival rate was 84% at 6 months and 70 % by 109 months. There was no further decrease to the end of the study period. Six-month generator survival rate was 82% for all groups, mostly a reflection of patient deaths. The next significant decrease in survival rates occurred at 14 months in group I, 19 months in group 11, 48 months in group III and 26 months in group IV. Fifty percent of generators were out of service by 17 months in group 1, 22 months In group 11, 52 months in group III and 63 months in group IV. By 108 months the group IV survival rate was only 28%. Despite improved battery and electronic technology, generator longevity in children is significantly less than the generator theoretical life expectancy and patient longevity. Patient survival rates indicate an excellent prognosis for children requiring pacemaker implantation, who would benefit from increased pulse generator longevity.