Pubmed du 7/01/09

jeudi 8 janvier 2009

1. Boulet SL, Boyle CA, Schieve LA. Health Care Use and Health and Functional Impact of Developmental Disabilities Among US Children, 1997-2005. Arch Pediatr Adolesc Med ;2009 (Jan) ;163(1):19-26.

OBJECTIVE : To present nationally representative estimates of health-related limitations, needs, and service use among US children with and without developmental disabilities (DDs). DESIGN : Retrospective analysis of data from a sample of US households from the 1997-2005 National Health Interview Surveys. PARTICIPANTS : Children aged 3 to 17 years (n = 95 132). MAIN OUTCOME MEASURES : Parents or other knowledgeable adults reported on their children’s DDs, health needs, and use of health and education services. Developmental disabilities included attention-deficit/hyperactivity disorder, autism, blindness, cerebral palsy, deaf/a lot of trouble hearing, learning disability, mental retardation, seizures, stuttering/stammering, and other developmental delay. RESULTS : Among children with 1 or more DDs, prevalence estimates for limitations in movement (6.1%), needed help with personal care (3.2%), needed special equipment (3.5%), received home health care (1.4%), and regularly took prescription medication(s) (37.5%) were 4 to 32 times higher than for children without DDs. Children with DDs were 2 to 8 times as likely to have had more than 9 health care visits (14.9%), received special education (38.8%), had a surgical or medical procedure (7.5%), and recently visited a medical specialist (23.9%), mental health professional (26.6%), therapist/allied health professional (19.6%), and/or emergency department (10.3%). Effects were generally stable during the study interval and independent of age, race, sex, and family income. Cerebral palsy, autism, mental retardation, blindness, and deafness/a lot of trouble hearing were associated with the highest levels of health and functional impact indicators. CONCLUSIONS : Developmental disabilities profoundly affect children’s health and functioning. These data can inform evidence-based targeted prevention strategies for minimizing functional limitations and lifetime disability. Additional study of unmet needs and access to care is needed.

2. Hvidtjorn D, Schieve L, Schendel D, Jacobsson B, Svaerke C, Thorsen P. Cerebral Palsy, Autism Spectrum Disorders, and Developmental Delay in Children Born After Assisted Conception : A Systematic Review and Meta-analysis. Arch Pediatr Adolesc Med ;2009 (Jan) ;163(1):72-83.

OBJECTIVE : To assess the existing evidence of associations between assisted conception and cerebral palsy (CP), autism spectrum disorders (ASD), and developmental delay. DATA SOURCES : Forty-one studies identified in a systematical PubMed and Excerpta Medica Database (EMBASE) search for articles published from January 1, 1996, to April 1, 2008. STUDY SELECTION : Studies written in English comparing children born after assisted conception with children born after natural conception assessing CP, ASD, and developmental delay, based on original data with a follow-up of 1 year or more. Main Exposures In vitro fertilization (IVF) with or without intracytoplasmic sperm injection or ovulation induction with or without subsequent intrauterine insemination. MAIN OUTCOME MEASURES : Cerebral palsy, ASD, and developmental delay. RESULTS : Nine CP studies showed that children born after IVF had an increased risk of CP associated with preterm delivery. In our meta-analysis including 19 462 children exposed to IVF, we estimated a crude odds ratio of 2.18 (95% confidence interval, 1.71-2.77). Eight ASD studies and 30 studies on developmental delay showed inconsistent results. No studies assessed the risk of CP, ASD, or developmental delay in children born after ovulation induction exclusively. CONCLUSIONS : Methodological problems were revealed in the identified studies, and the gaps in our knowledge about the long-term outcomes of children born after assisted conception are considerable, including a lack of information on the long-term consequences of ovulation induction. Possible associations with ASD and developmental delay need assessment in larger studies. Studies on assisted conception and CP from countries outside of Scandinavia are needed, including detailed information on time to pregnancy, underlying cause of infertility, and type of IVF treatment.

3. Jia SW, Sun TT, Fan R. [Visualized study on acupuncture treatment of children autism using single photon emission computed tomography]. Zhongguo Zhong Xi Yi Jie He Za Zhi ;2008 (Oct) ;28(10):886-889.

OBJECTIVE : To provide the molecular iconographic evidence for acupuncture treatment of children autism (CA). METHODS : Electric acupuncture (EA) was applied on acupoints of bilateral Hegu (LI4), Quchi (LI11), Zusanli (ST36) and Sanyinjiao (SP6) in 34 CA patients’ with ABC scale > 57 scores. Using SIEMENS ECAM / ICON double head system, single photon emission computed tomography (SPECT) brain perfusion imaging were performed before and during EA with 99mTc-ECD. Then SPECT images were analyzed visually and quantitatively. RESULTS : Visual analysis showed that 114 foci of low cerebral perfusion and function were found in 34 CA patients before EA, 28 cases (82.35%) of them with abnormalities in left (or both) front lobes, left Broca area and left Wernicke area. During EA, the affected areas improved to different extent. Quantitative analysis showed that significant difference existed between pre-EA focal Ff and mirror-side Ff, pre-EA Ff and mid-EA Fe, focal BFCR% and mirror-side BFCR % (all P < 0.01). The improving analysis of cerebral perfusion and function showed that the efficacy of EA was 78.95%. CONCLUSION : Acupuncture was proved preliminarily effective in treating children autism.


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