This study suggests that pulmonary function in SMA types II and III continues to decline after scoliosis surgery, though the rate of decline is less marked. Overall, the combined results from this study and all other previously published studies are conflicting in regard to the effect of scoliosis surgery on pulmonary function in SMA types II and III, though half of the studies (3 of 6) did demonstrate a continued decline in lung function postoperatively. This decline in pulmonary function despite spinal stabilization is likely secondary to the progressive neuromuscular weakness of the disease.

Level III—Retrospective study.

ABSTRACT. Objective. Allergic rhinitis is common and on the rise. Antihistamines are the mainstay of treatment and are the most commonly prescribed drugs in Singapore. Treatment-related sedation and its effect on cognition are a major concern. First-and second-generation antihistamines show varying degrees of sedation, but to date, objective studies in children are lacking. The objective of this study was to assess the sedating effect of cetirizine (second-generation antihistamine) and chlorpheniramine (first-generation antihistamine) compared with placebo using an objective neurophysiological test.Methods. This was a prospective, double-blind, placebo-controlled, randomized, single-dose, 3-way crossover study. Twenty-four children aged 7 to 14 years with allergic rhinitis completed the study. All children were randomly allocated to medication sequences and received 3 different drugs on 3 different days, at least 1 week apart. The P300 event-related potential was used as an objective test of sedation. Subjective assessment was by a visual analog scale.Results. Chlorpheniramine and cetirizine increased P300 latency when compared with baseline. No significant increase was obtained with placebo. The significant increase in P300 latency was not accompanied by significant change in subjective somnolence as measured by the visual analog scale.Conclusion. We have shown that cetirizine has sedative properties in children. The lack of correlation between P300 latency and the visual analog scale indicates that sedation induced by these drugs may not be subjectively noted. Pediatrics 2004;113:e116 -e121. URL: http: //www.pediatrics.org/cgi/content/full/113/2/e116; sedation, cetirizine, chlorpheniramine, P300 event-related potential.ABBREVIATIONS. CNS, central nervous system; ERP, event-related potential; VAS, visual analog scale; Fz , frontal location; Cz, central location; Pz, parietal location; T max , time to peak plasma drug concentration.A llergic rhinitis is on the increase worldwide as well as in Singapore. A 1994 survey showed the prevalence of rhinitis in Singapore children to be at a staggering 44%. 1 In children with allergic rhinitis, inadequate symptom control may contribute to learning impairment; school absences; poor quality of life; and emotional, social, or behavioral disturbances. 2 Oral antihistamines are the mainstay of therapy for allergic rhinitis in children 3 and have been used effectively for managing symptoms of allergic rhinitis for Ͼ50 years. They are the most commonly prescribed drugs among outpatient doctors in the public service in Singapore. 4 The major limitation of the use of first-generation antihistamines is sedation. 3 Being lipophilic molecules, they easily cross the blood-brain barrier and may exacerbate the decrease in cognitive function already experienced by the patient with allergic rhinitis. Sedating antihistamines have been shown to reduce learning performance in children. 5 In contrast, second-generation antihistamines are relatively lipophobic and therefore cross the blood-br...

Summary:Purpose: The purpose of this study was to assess the parent-and patient-validated content of quality-of-life measurement for use in children with epilepsy.Methods: We asked the parents of 80 consecutive children and adolescents with epilepsy to list in order of importance their concerns about living with or caring for their children with epilepsy. Patients were 3 months to 18 years of age (mean, 10 years) and identified at the outpatient clinic or during hospital stay. To minimize investigator bias, parents and children listed their concerns in a private setting without staff involvement.Results: Twenty-six distinct domains were generated by the parents and children. Concerns listed by more than 20 of parents included medication adverse effects (58), cognitive effects of epilepsy (46), prospects for the future (41), safety (35

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