BACKGROUND & AIMS: :This pilot study investigated adolescents with well-documented childhood lead burdens to determine the relationship between lead and unintentional injury. Adolescents completed a self-administered injury questionnaire. Results demonstrated that elevated childhood blood lead concentrations were significantly related to injury variables. Further study is necessary to understand adolescent health and safety implications.

背景与目标： : 这项初步研究调查了有充分记录的儿童铅负担的青少年，以确定铅与意外伤害之间的关系。青少年完成了一份自我管理的伤害问卷。结果表明，儿童血铅浓度升高与损伤变量显着相关。为了了解青少年健康和安全的影响，有必要进行进一步的研究。

BACKGROUND & AIMS: :Genetic factors are important for developing primary and subsequent malignancies in children. This study investigated the role of genetic factors involved in DNA-repair. Designed as a feasibility study, it addressed the possibility of obtaining samples for genetic analyses from former patients through the German Childhood Cancer Registry. Testing feasibility was as important as the biological question itself. We analyzed the expression of DNA-repair genes in untreated primary fibroblasts of 20 individuals with a second neoplasm compared to 20 matched single neoplasm cases using customized cDNA microarrays (1344 gene sequences, about 800 genes). Matching was by first neoplasm, age, and year of first diagnosis. Forty-six percent of the 52 contacted second neoplasm cases and 18% of the 132 single neoplasm patients participated in the study. The DNA-repair gene results show small differences in the basal gene expression of FTH1 and CDKN1A. To our knowledge, this is the first study using gene expression arrays in untreated primary fibroblasts regarding second neoplasms after a childhood neoplasm. We were able to recruit childhood cancer patients for genetic analyses long after diagnosis. The biological importance of the differences in the DNA-repair gene expression has to be elucidated yet.

背景与目标： : 遗传因素对于发展儿童原发性和继发恶性肿瘤很重要。这项研究调查了参与DNA修复的遗传因素的作用。作为一项可行性研究，它解决了通过德国儿童癌症登记处从以前的患者那里获得用于基因分析的样本的可能性。测试可行性与生物学问题本身一样重要。我们使用定制的cDNA微阵列 (1344个基因序列，约800个基因) 分析了20个具有第二个肿瘤的个体的未处理的原代成纤维细胞中DNA修复基因的表达，与20个匹配的单个肿瘤病例相比。根据首次肿瘤，年龄和首次诊断的年份进行匹配。52例接触第二肿瘤病例中的6% 例和132例单一肿瘤患者中的18% 例参加了研究。DNA修复基因结果显示FTH1和CDKN1A的基础基因表达差异很小。据我们所知，这是第一项使用基因表达阵列在未经治疗的原发性成纤维细胞中进行的关于儿童肿瘤后第二次肿瘤的研究。我们能够在诊断后很长时间招募儿童癌症患者进行基因分析。必须阐明DNA修复基因表达差异的生物学重要性。

BACKGROUND & AIMS: :DuPage County Health Department collected de-identified data from health forms submitted by participating schools for academic years 2011-2015 for kindergarten, sixth-, and ninth-grade students to determine the prevalence of obesity and elevated blood pressure among public school students. The prevalence of obesity in students for the 2014-2015 school year was 15.1%, and the prevalence of elevated blood pressure was 22.8%. Students in the "obese" body mass index percentile category had an elevated blood pressure prevalence of 44.2%, which was higher than students in the "nonobese" category (P < .001). Significant differences were also observed both by sex and by grade. The results identify the need to support implementation and evaluation of policies to reduce childhood obesity and improve health outcomes. By partnering with schools to obtain preexisting health data, state or local health departments with limited resources may replicate these methods to develop a childhood obesity surveillance system.

背景与目标： : 杜佩奇县卫生部门从参与学校提交的2011-2015学年幼儿园，六年级和九年级学生的健康表格中收集了不识别的数据，以确定公立学校学生中肥胖和血压升高的患病率。2014-2015学年学生的肥胖患病率为15.1%，血压升高的患病率为22.8%。“肥胖” 体重指数百分位类别的学生的血压患病率升高为44.2%，高于 “非肥胖” 类别的学生 (P <.001)。按性别和等级也观察到显着差异。结果表明需要支持实施和评估减少儿童肥胖和改善健康结果的政策。通过与学校合作以获取先前存在的健康数据，资源有限的州或地方卫生部门可以复制这些方法来开发儿童肥胖监测系统。

BACKGROUND & AIMS: OBJECTIVE:To examine the relative contribution of hyperactivity, conduct, and emotional problems in predicting criminal offending. METHOD:In all, 173 boys aged 6 to 8 years (assessed for hyperactivity, conduct, and emotional problems) were followed up 19 years later by examining criminal offense histories. RESULTS:Significant main effects for total and violent convictions were found, the strongest being for violent criminal offenses. Conduct problems predicted general offending (irrespective of the type of conviction), whereas emotional problems were the single best predictor of violent convictions. Hyperactivity was not a significant predictor in the models. CONCLUSION:The findings provide insight into the developmental mechanisms that mediate criminal behavior by showing that childhood emotional problems independently contribute to the risk of violent offending in later life.

背景与目标：

BACKGROUND & AIMS: :This study investigates the links between parents' perceptions of their social and built residential environment and obesity among Portuguese school boys and girls. A total of 1885 children, 952 girls and 933 boys, aged 3.0-10.0 years, were observed. The children's weight and height were measured, and their parents filled out the "Environmental Module" questionnaire of the International Physical Activity Prevalence Study. Age and sex-speci`fic BMI cut-off points were used to define being overweight/obese. Environmental characteristics were combined into 2 composite neighborhood indices that were used as predictors in logistic regression models. Girls living in neighborhoods perceived as having poorly built environmental conditions had increased odds of being obese (OR=1.47; p<0.005), and girls living in neighborhoods perceived as being unsafe and dangerous had also increased odds of being obese (OR=1.339; p<0.005). These relationships were not evident for boys. Improvements in the neighborhood environment could be a strategy for tackling the growing epidemic of childhood obesity and can simultaneously contribute to reduce health inequities across population subgroups.

背景与目标： : 这项研究调查了葡萄牙学校男孩和女孩中父母对其社交和建筑居住环境的看法与肥胖之间的联系。共观察到1885年名儿童，952名女孩和933名男孩，年龄在3.0-10.0岁之间。测量了儿童的体重和身高，他们的父母填写了国际体育活动患病率研究的 “环境模块” 问卷。年龄和性别特异性BMI临界点用于定义超重/肥胖。将环境特征合并为2个复合邻域指数，这些指数用作逻辑回归模型的预测因子。生活在被认为环境条件不佳的社区中的女孩肥胖的几率增加 (OR = 1.47; p<0.005)，生活在被认为不安全和危险的社区中的女孩肥胖的几率也增加 (OR = 1.339; p<0.005)。这些关系对男孩来说并不明显。改善邻里环境可能是解决日益严重的儿童肥胖症流行的一种策略，同时可以减少人口亚组之间的健康不平等。

BACKGROUND & AIMS: BACKGROUND:Frequent germ line cells mutations were previously demonstrated to be associated with aging. This suggests a higher incidence of childhood cancer among children of older parents. A population-based cohort study of parental ages and other prenatal risk factors for five main childhood cancers was performed with the use of a linkage between several national-based registries. METHODS:In total, about 4.3 million children with their parents, born between 1961 and 2000, were included in the study. Multivariate Poisson regression was used to obtain the incidence rate ratios (IRR) and 95% confidence interval (CI). Children <5 years of age and children 5-14 years of age were analysed independently. RESULTS:There was no significant result for children 5-14 years of age. For children <5 years of age, maternal age were associated with elevated risk of retinoblastoma (oldest age group's IRR = 2.39, 95%CI = 1.17-4.85) and leukaemia (oldest age group's IRR = 1.44, 95%CI = 1.01-2.05). Paternal age was significantly associated with leukaemia (oldest age group's IRR = 1.31, 95%CI = 1.04-1.66). For central nervous system cancer, the effect of paternal age was found to be significant (oldest age group's IRR = 1.69, 95%CI = 1.21-2.35) when maternal age was included in the analysis. CONCLUSION:Our findings indicate that advanced parental age might be associated with an increased risk of early childhood cancers.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Asthma is a common chronic inflammatory disease of the airways in which genetic factors play a major role in its pathogenesis. High serotonin serum levels in patients with asthma suggest that serotonin is involved in the pathophysiology of the disease. Serotonin clearance is mediated by the serotonin reuptake transporter, and functional polymorphisms in this gene lead to altered serotonin reuptake efficiency. OBJECTIVE:The aim of this study was to investigate the relationship between serotonin transporter gene polymorphisms and asthma. METHODS:Serotonin transporter gene polymorphisms (5-HTTLPR, rs35521 and STin2.VNTR) were assessed by PCR-based methods in 100 children with mild to moderate persistent asthma and compared with 100 healthy controls. RESULTS:There were no significant differences in allele, genotype or haplotype frequencies between patients and controls. No association was observed between SERT gene polymorphisms after stratification of patients for sex, age, spirometry indices, family history, passive smoking behavior and concomitant allergic rhinitis. Significant differences were observed in the distribution of 5-HTTLPR alleles (p = 0.025) and genotypes (p = 0.021) between patients with and without atopic dermatitis. CONCLUSIONS:Despite strong evidence suggesting the role of serotonin in the pathophysiology of asthma, we found no association between serotonin transporter gene polymorphisms and mild to moderate persistent asthma. Further serotonin transporter gene analyses in patients with severe asthma may open up new horizons in the utilization of common serotonin regulators to treat asthma, based on their pharmacogenetic effects. However, serotonin may also be indirectly influenced by emotional stress during asthma attacks.

背景与目标：

BACKGROUND & AIMS: CONTEXT:Improved survival of children with cancer has been accompanied by multiple treatment-related complications. However, most studies in survivors of childhood cancer focused on only 1 late effect. OBJECTIVE:To assess the total burden of adverse health outcomes (clinical or subclinical disorders ["adverse events"]) following childhood cancer in a large cohort of childhood cancer survivors with long-term and complete medical follow-up. DESIGN, SETTING, AND POPULATION:Retrospective cohort study of 1362 five-year survivors of childhood cancer treated in a single institution in the Netherlands between 1966 and 1996. All survivors were invited to a late-effects clinic for medical assessment of adverse events. Adverse events occurring before January 2004 were graded for severity in a standardized manner. MAIN OUTCOME MEASURES:Treatment-specific prevalence of adverse events (according to severity) at end of follow-up and relative risk of high or severe burden of disease (> or =2 severe or > or =1 life-threatening or disabling adverse events) associated with various treatments. RESULTS:Medical follow-up was complete for 94.3% of survivors (median follow-up, 17.0 years). The median attained age at end of follow-up was 24.4 years. Almost 75% of survivors had 1 or more adverse events, and 24.6% had 5 or more adverse events. Furthermore, 40% of survivors had at least 1 severe or life-threatening or disabling adverse event. A high or severe burden of adverse events was observed in 55% of survivors who received radiotherapy only and 15% of survivors treated with chemotherapy only, compared with 25% of survivors who had surgery only (adjusted relative risks, 2.18 [95% confidence interval, 1.62-2.95] and 0.65 [95% confidence interval, 0.46-0.90], respectively). A high or severe burden of adverse events was most often observed in survivors of bone tumors (64%) and least often in survivors of leukemia or Wilms tumor (12% each). CONCLUSIONS:In young adulthood, a substantial proportion of childhood cancer survivors already has a high or severe burden of disease, particularly after radiotherapy. This underscores the need for lifelong risk-stratified medical surveillance of childhood cancer survivors.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:This follow-up study aimed to assess the frequency of late effects on glucose and lipid metabolism after bone-marrow transplantation in childhood. METHODS:23 long-term survivors (median age 20 years) were studied 3-18 years after bone-marrow transplantation and compared with 23 healthy controls matched for age and sex and with 13 patients in remission from leukaemia. FINDINGS:12 (52%) of the 23 bone-marrow transplantation patients had insulin resistance, including impaired glucose tolerance in six and type 2 diabetes in four. The core signs of the metabolic syndrome (hyperinsulinaemia and hypertriglyceridaemia combined), were found in nine (39%) of the bone-marrow transplantation patients compared with one (8%) of the 13 leukaemia patients and none of the healthy controls (p=0.0015). The frequency of insulin resistance increased with the time since bone-marrow transplantation. Abdominal obesity, but not overweight, was common among the patients with insulin resistance. INTERPRETATION:Long-term survivors of bone-marrow transplantation are at substantial risk of insulin resistance, impaired glucose tolerance, and type 2 diabetes even at normal weight and young age. They also develop typical signs of the metabolic syndrome. We advocate measurement of serum lipids, fasting blood glucose, and serum insulin for the follow-up of all patients who undergo transplants in childhood, to be continued regularly and possibly life-long.

背景与目标：

BACKGROUND & AIMS: :Pulmonary complication is a rare manifestation of childhood malaria and isolated pleural effusion without pulmonary edema has never been reported in children. We report here an 11-year-old boy who suffered from cerebral malaria and massive right pleural effusion. The patient was treated with intravenous artesunate, albumin, and other supportive treatments. He recovered completely after eight days. The clinical and laboratory courses suggested that the plasma leakage played a role in the pathogenesis of pleural effusion.

背景与目标： : 肺部并发症是儿童疟疾的罕见表现，儿童中从未报道过无肺水肿的孤立胸腔积液。我们在这里报告了一个11岁的男孩，他患有脑疟疾和大量的右胸腔积液。患者接受静脉青蒿琥酯，白蛋白和其他支持治疗。八天后他完全康复了。临床和实验室课程表明，血浆渗漏在胸腔积液的发病机理中起作用。

BACKGROUND & AIMS: :The objective of this study was to examine the psychometric properties of the Invalidating Childhood Environment Scale (ICES; Mountford, Corstorphine, Tomlinson, & Waller, 2004), a measure designed to retrospectively assess exposure to parental invalidation. The ICES was administered to a sample of female college students along with measures of parental bonding and borderline personality disorder (BPD) symptomatology. In contrast with previous findings, the ICES demonstrated excellent internal consistency within a nonclinical sample. It also correlated in the predicted directions with measures of parental bonding and BPD symptomatology. Taken together, these findings suggest that the ICES is a promising retrospective measure of parental invalidation. They also provide some support for the hypothesized link between parental invalidation and BPD symptomatology and suggest that additional research with clinical samples is needed.

背景与目标： : 这项研究的目的是检查无效的儿童环境量表 (ICES; Mountford，Corstorphine，Tomlinson和Waller，2004) 的心理测量特性，该方法旨在回顾性评估父母无效的暴露。将ICES与父母联系和边缘性人格障碍 (BPD) 症状学的措施一起对女大学生样本进行了管理。与以前的发现相反，ICES在非临床样本中表现出极好的内部一致性。它还在预测的方向上与父母结合和BPD症状的测量相关。综合起来，这些发现表明ICES是父母无效的有希望的回顾性措施。他们还为父母无效和BPD症状之间的假设联系提供了一些支持，并建议需要对临床样本进行其他研究。

BACKGROUND & AIMS: :Low-level environmental lead exposure during childhood is associated with poorer emotional/behavioural functioning in later childhood and adolescence. Scarce research has examined whether these apparent effects persist into adulthood. This study is the first to examine prospective associations between lead exposure across early childhood and several common adult mental health problems. Childhood data (including blood lead concentrations) and adult data (from mental health questionnaires and psychiatric interviews) were available for 210 participants (44% males, mean age=26.3 years) from the Port Pirie cohort study (1979-1982 birth cohort). Participants had a mean childhood (to 7 years) average blood lead concentration of 17.2μg/dL. Among females, childhood blood lead showed small significant positive associations with lifetime diagnoses of drug and alcohol abuse and social phobia, and with anxiety, somatic and antisocial personality problems. For example: for a 10μg/dL blood lead increase, females were 2.84 times (95% CI 1.10, 7.30) more likely to have an alcohol abuse diagnosis. However, adjustment for childhood covariates - particularly stimulation within the home environment - rendered these associations non-significant. No significant or sizeable unadjusted or adjusted associations were seen for males. The associations between early lead exposure and emotional/behavioural functioning in children might persist into adulthood, at least for females. However, it is unclear whether such results arise from residual confounding, or other mechanisms. Interventions that focus on improving the childhood home environment may have a long-term positive impact on adult mental health outcomes. However, more prospective research using large and representative samples is needed to substantiate these results.

背景与目标： : 儿童时期低水平的环境铅暴露与儿童后期和青少年时期较差的情绪/行为功能有关。稀缺的研究已经检查了这些明显的影响是否会持续到成年。这项研究是第一个研究儿童早期铅暴露与几种常见成人精神卫生问题之间的前瞻性关联的研究。来自Port Pirie队列研究 (1979-1982出生队列) 的210名参与者 (44% 名男性，平均年龄 = 26.3岁) 可获得儿童数据 (包括血铅浓度) 和成人数据 (来自精神卫生问卷和精神病学访谈)。参与者的平均儿童期 (至7岁) 平均血铅浓度为17.2 μ g/dL。在女性中，儿童时期的血铅与终生对药物，酒精滥用和社交恐惧症的诊断以及焦虑，躯体和反社会人格问题的显着正相关。例如: 对于10 μ g/dL的血铅增加，女性更有可能被诊断为酒精滥用的2.84倍 (95% CI 1.10，7.30)。但是，对儿童期协变量的调整 (尤其是家庭环境中的刺激) 使这些关联不重要。男性没有发现明显或相当大的未经调整或调整的关联。儿童早期铅暴露与情绪/行为功能之间的关联可能会持续到成年，至少对于女性而言。但是，尚不清楚这些结果是由残留的混杂还是其他机制引起的。侧重于改善儿童家庭环境的干预措施可能会对成人精神卫生结果产生长期的积极影响。但是，需要使用大型且具有代表性的样本进行更多的前瞻性研究来证实这些结果。

BACKGROUND & AIMS: :Between October 1983 and May 1986, 17 cases of childhood acute lymphoblastic leukemia (ALL) were admitted to the General Hospital, Port of Spain, Trinidad. Fifteen of those cases were under 10 years of age, seven of whom presented with joint or bone pains. Boys outnumbered girls by almost 5:1 and the ethnic distribution showed a preponderance of patients of East Indian origin. At last follow-up (May 1989), the survival rate of the 15 under-10-year-old patients was 71%. Immunophenotype studies on nine of the 17 patients revealed six carrying T cell markers and three carrying markers suggestive of a pre-B phenotype. HLA tissue typing on 10 patients showed an enhanced frequency of the HLA-B40 antigen when compared with controls (p less than 0.05). This antigen was present in six of the patients typed and four carried the HLA-A2 and B40 antigens together, two of whom also carried the CW3 antigen and the other two carried untypable C antigens. Three of the four carrying HLA-A2 and B40 have died. Two of the three pre-B cases also carried the HLA-A2 and B40 antigens. HLA studies on three of the four families showed that HLA-A2 and B40 were on the same chromosome, i.e., a haplotype inherited from the mother in each case. None of the cases carried the HLA-B5 antigen although this antigen had a frequency of 37.8% in the control group (p less than 0.05). None of the controls with the HLA-B40 antigen carried the CW3 antigen. Further evidence of a disease association must await typing of the D locus antigens but current evidence would suggest an association between HLA-B40 and childhood ALL in Trinidad.

背景与目标： : 在1983年10月和1986年5月之间，特立尼达西班牙港综合医院收治了17例儿童急性淋巴细胞白血病 (ALL)。其中15例年龄在10岁以下，其中7例出现关节或骨痛。男孩的人数几乎超过女孩5:1，种族分布显示出东印度裔患者占多数。在最后一次随访 (1989年5月) 时，15名10岁以下患者的生存率为71%。对17例患者中的9例进行的免疫表型研究显示，有6例携带T细胞标记物和3例携带提示B前表型的标记物。与对照组相比，10例患者的HLA组织分型显示HLA-B40抗原的频率增加 (p小于0.05)。该抗原存在于六名分型的患者中，四名同时携带HLA-A2和B40抗原，其中两名还携带CW3抗原，另外两名携带不可分型的C抗原。四个携带HLA-A2和B40中的三个已经死亡。三个前B病例中有两个还携带HLA-A2和B40抗原。对四个家庭中的三个家庭的HLA研究表明，HLA-A2和B40在同一染色体上，即在每种情况下均从母亲继承的单倍型。尽管该抗原在对照组中有37.8% 频率 (p小于0.05)，但没有病例携带HLA-B5抗原。具有HLA-B40抗原的对照没有携带CW3抗原。疾病关联的进一步证据必须等待D基因座抗原的分型，但目前的证据表明特立尼达的HLA-B40与儿童之间存在关联。

BACKGROUND & AIMS: Femoral hernias rarely occur at any age, but are extremely rare in infancy. We present 38 cases of femoral hernia treated in our pediatric surgery department during the last 15 years. The number of patients who underwent surgery was high compared with other series reviewed. This might be due to the fact that these hernias were considered in the differential diagnosis of inguinal pathology in childhood. The preoperative diagnosis was correct in 22 cases (57. 8%). After surgical treatment no recurrence was reported.

背景与目标： 股疝很少发生在任何年龄，但在婴儿期极为罕见。在过去的15年中，我们在儿科外科治疗了38例股疝。与其他审查系列相比，接受手术的患者数量较高。这可能是由于这些疝气被认为是儿童腹股沟病理的鉴别诊断疾病。术前诊断正确22例 (57. 8%)。手术治疗后无复发报告。

BACKGROUND & AIMS: :Face processing in mothers is linked to mother-infant social communication, which is critical for parenting and in turn for child development. Neuroimaging studies of child maltreatment-exposed (CME) mothers are sparse compared to studies of mothers with postpartum depression, which have suggested blunted amygdala reactivity to infant stimuli. We expected to see a similar pattern in CME mothers. Based on broader studies in trauma-exposed populations, we anticipated increased amygdala reactivity to negative adult face stimuli in a comparison task in CME mothers given heightened evaluation of potential threat. We examined Neuroimaging studies of mothers with childhood maltreatment exposure (CME) (18-37 years old), who performed infant (N = 45) and/or adult (N = 46) face processing tasks. CME mothers exhibited blunted bilateral amygdala reactivity to infant faces. There was no between-group difference in amygdala reactivity to adult faces. In infant and adult face processing tasks regardless of CME, superior temporal gyrus activation was increased for negative-valence stimuli. Our preliminary findings suggest that childhood maltreatment alters maternal processing of infant social cues, a critical skill impacting infant socioemotional development.

背景与目标： : 母亲的面部加工与母婴社交交流有关，这对于育儿以及儿童发展至关重要。与产后抑郁症母亲的研究相比，暴露于儿童虐待 (CME) 母亲的神经影像学研究很少，后者表明杏仁核对婴儿刺激的反应性减弱。我们希望在CME母亲中看到类似的模式。基于对创伤暴露人群的更广泛研究，我们预计在CME母亲的一项比较任务中，杏仁核对成人面部负面刺激的反应性增加，并对潜在威胁进行了高度评估。我们检查了儿童虐待暴露 (CME) (18-37岁) 母亲的神经影像学研究，这些母亲执行婴儿 (N =   45) 和/或成人 (N =   46) 面部处理任务。CME母亲对婴儿面部的双侧杏仁核反应性减弱。杏仁核对成人面部的反应性没有组间差异。在婴儿和成人面部处理任务中，无论CME如何，对于负价刺激，上颞叶回的激活都会增加。我们的初步发现表明，儿童期虐待会改变母亲对婴儿社交线索的处理，这是影响婴儿社会情感发展的一项关键技能。