Aim: The aim of this study was to explore whether children born preterm have deficient executive functions (EF) in comparison with children born at full term, and, if so, whether this is dependent on inferior intelligence scores and can be correlated to specific neonatal risk factors and gender. Methods: In a population‐based study, the executive functions of 182 preterm children (birthweight less than 1500 g, VLBW) and 125 controls from the Stockholm Neonatal Project were assessed at 5± y with a neuropsychological test battery (Nepsy 1990). Results: The controls surpassed the VLBW children on tests of executive functions (EF), even after controlling for intelligence (IQ); a necessary correction since there were significant correlations between measures of EF and IQ. EF was associated with retinopathy of prematurity (ROP), and with visual impairment as a whole. In both groups, girls surpassed boys on tests of executive functions. Conclusion: We conclude that it is possible to analyse executive functions already at preschool age. Preterm children are at risk of having subnormal levels of executive functioning, even though their general IQ is normal.
Bone marrow transplantation (BMT) involves conditioning with cyclophosphamide and, for patients with malignant disease, total body irradiation (TBI). This study describes the neuropsychological development of 10 children treated for leukemia (n = 7), neuroblastoma (n = 1) or severe aplastic anemia (SAA; n = 2) at 3 years of age or younger. A moderate general developmental delay, with pronounced motor deficits and varying degrees of perceptual and cognitive problems, was observed in all children treated for malignant disease. Children treated for SAA had normal development. We conclude that BMT, including TBI, can be directly associated with long-term neuropsychological impairment in children treated at a very young age. Continued medical and psychological follow-up procedures are needed.
Bone marrow transplantation (BMT) involves conditioning with cyclophosphamide and, for leukemic patients, total body irradiation (TBI). Based on the concern that this may lead to later neuropsychologic impairment in children, a longitudinal study was conducted. Thirty pediatric bone marrow transplant recipients, treated for leukemia or severe aplastic anemia (SAA), and their sibling donors, were given a neuropsychological examination in 1986 and 1988. A third follow-up study of patients treated before 12 years of age was undertaken in 1990-91. We present longitudinal data on patients treated with BMT when 3-11 (n = 15) and 12-17 (n = 11) years old. No neuropsychological deficits were found in the older group, or among non-irradiated SAA patients. In the first follow-up, children treated with BMT, including TBI at 3-11 years of age, performed less well than donors on tasks involving perceptual and fine-motor speed. In the second follow-up, this group of patients also demonstrated a slight deficit in non-verbal problem solving. An additional relative decline in verbal reasoning was noted in the third follow-up, 5.5-10 years after treatment. Alertness to signs of developmental difficulties in children treated with BMT, including TBI, is recommended.
AbstractsResults Both cases presented with abdominal pain and hepatomegaly, combined with nausea and dyspeptic complaints. Laboratory investigation revealed marked elevation of serum transaminase levels. Synthetic function of the liver stayed intact. Abdominal ultrasound showed isolated, homogenous hepatomegaly, without other abdominal abnormalities. In one case liver biopsy was performed, showing hepatic glycogenosis. Other causes for hepatomegaly were excluded. With improved diabetic control all complaints improved within three weeks, with normalisation of serum transaminase levels. Review of literature that hepatic glycogenosis, not frequently described, is an important complication of type I diabetes mellitus. Hepatic glycogenosis as result of glycogen storage in hepatocytes, caused by periods of hyperglycaemia and frequent insulin boluses. This process is reversible with improved glycaemic control.
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