Background: Non-Hodgkin’s lymphoma is an aggressive malignant disease in children and adolescents. Although it is the fourth most common malignancy in Saudi children as reported in Saudi cancer registry, less informa...Background: Non-Hodgkin’s lymphoma is an aggressive malignant disease in children and adolescents. Although it is the fourth most common malignancy in Saudi children as reported in Saudi cancer registry, less information is available about pediatric Non-Hodgkin lymphoma and its outcome in Saudi Arabia. Study Objectives: To provide demographic data, disease characteristics, treatment protocol, toxicity and outcome of treatment in children & adolescents with Non-Hodgkin’s lymphoma treated at KFMC. This study will form base line for future studies about pediatric Non-Hodgkin’s lymphoma in KFMC, which may help to improve outcome for children with cancer in Saudi Arabia. Study Patients and Method: We retrospectively analyzed 28 children and adolescents diagnosed to have Non-Hodgkin’s lymphoma at KFMC between December 2006 and December 2013, followed-up through June 2014. Results: Of the 28 patients, 10 (35.7%) girls and 18 (64.3%) boys, the male-to-female ratio was 1.8;1. The median age at time of diagnosis was 6.4 years old (range 2.0 to 13.0 years old). The majority of patients (64.3%) were aged between 5 and 12 years old. Burkitt’s lymphoma BL/BLL was the most common pathological subtype (60.7%), and DLBCL was the second most common subtype (21.4%). Abdominal and Retroperitoneal involvement was the most common primary site (78.6%) including the ileocaecal region. Most of the children presented with advanced Stage III and IV (75%), Cytogenetic study which screens specifically for the t (8;14) (q24;q32) a characteristic genetic feature of Burkitt’s Lymphoma was obtained from 21 patients, variant rearrangement was observed in 3/21 samples and complex chromosomes karyotype in addition to IGH/MYC rearrangement was observed in 2/21 samples. Those patients presented with very aggressive lymphoma and combined BM and CNS involvement. We use the French-American-British Mature B-Cell Lymphoma 96 Protocol (FAB LMB 96) for treatment fornewly diagnosed Mature B-Cell type NHL and high risk ALL CCG 1961 Protocol for lymphoblastic lymphoma and international Anaplastic Large Cell Lymphoma 99 Study Protocol for ALCL. The median follow-up in patients not experiencing an adverse event was 53.1 months. The estimated 3-year EFE and OS rates in the entire cohort of patients with newly diagnosed NHL treated in the KFMC were 85.2% and 89.2% respectively;Overall survival (OS) rate of patients with mature B-cell-NHL was 88.9%. Conclusion: The outcomes and survival in our small series appeared to be excellent compared with those reported in other international trials even though most of our patients presented in advanced stage of the disease. We feel that the importance of the current study is to document the relative distribution of various types of pediatric non-Hodgkin’s lymphomas and age-specific distribution in different Histological subtypes.展开更多
Objective:To explore the time management tendency of left-behind adolescents,compare the differences of time management of left-behind.Methods:The questionnaire studies the adolescents students of major labor.Results:...Objective:To explore the time management tendency of left-behind adolescents,compare the differences of time management of left-behind.Methods:The questionnaire studies the adolescents students of major labor.Results:Left-behind adolescents are tend to form bad time management tendency(t<2.55,p<0.01)and among these left-behind adolescents there are great individual differences(F>4.24,p>0.05);16-year-old time is a critical period of forming social value of time management(F>4.24,p>0.05),the grade(F_((2,331))=3.74,p=0.03),and whether the only child(t=2.26,p=0.03)has priority to the impact of time management;the children’s age when their parents left.The left period of their parents,the parents who go out,and the visit interval all these factors affect the adolescents’time management tendency(R^(2)>0.21,p<0.001).展开更多
Nonalcoholic fatty liver disease(NAFLD) has become the dominant form of chronic liver disease in children and adolescents with the increasing prevalence of obesity worldwide. NAFLD represents a wide spectrum of condit...Nonalcoholic fatty liver disease(NAFLD) has become the dominant form of chronic liver disease in children and adolescents with the increasing prevalence of obesity worldwide. NAFLD represents a wide spectrum of conditions, ranging from fatty liver-which generally follows a benign, non-progressive clinical course-to non-alcoholic steatohepatitis, a subset of NAFLD that may progress to cirrhosis and end-stage liver disease or liver carcinoma. The underlying pathophysiological mechanism of "pediatric" NAFLD remains unclear, although it is strongly associated with obesity and insulin resistance. In this review we provide a general overview on the current understanding of NAFLD in children and adolescents, which underpins practice, enabling early diagnosis and appropriate therapeutic intervention for this life-threatening liver disease.展开更多
Background: Adolescent obesity is associated with high cardiovascular and metabolic risk. Western diet and reduced physical activity are strong environmental determinants. The “Health Production” model posits that i...Background: Adolescent obesity is associated with high cardiovascular and metabolic risk. Western diet and reduced physical activity are strong environmental determinants. The “Health Production” model posits that individuals born with a certain amount of health stock, which depreciates over life, but can be augmented by individual behaviors, including exercise and dieting. Objective: To study the association between health production and obesity in a random sample of 1692 Chilean adolescents (14.8 ± 0.7 years old), and to study the effect of gender and socioeconomic characteristics on health production. Method: We used an indicator that considered the quality of food intake and physical activity, establishing three categories: good (GHP), intermediate (IHP) and poor health producers (PHP). Multivariate analysis was used to study the odds of obesity and good health production. Results: There was 31% of GHP, 32% of IHP and 38% of PHP. Obesity (Adj. OR: 1.59;95%CI: 1.04 - 2.42) and abdominal obesity (Adj. OR: 2.24;95%CI: 1.35 - 3.40) were significantly higher in the PHP group, compared to the GHP and IHP group. Health production was significantly associated with socioeconomic factors and gender. Female sex and coming from a less wealthy household significantly reduced the odds of good health production. Conclusions: Poor health production in adolescence, as defined by food intake and physical activity, depreciates individuals’ “health stock”, increasing the risk of obesity. In our sample, health production was strongly associated with socio-economic factors and gender.展开更多
Background: Bright light therapy, an effective therapeutic option for depressive adults, could provide safe, economic, and effective rapid recovery also in adolescents. Method: This was a randomized cross-over trial, ...Background: Bright light therapy, an effective therapeutic option for depressive adults, could provide safe, economic, and effective rapid recovery also in adolescents. Method: This was a randomized cross-over trial, i.e. that 14 patients received first dim white light (50 lux) one hour a day for one week and then Bright light therapy (2500 Lux) for one week. 14 patients received first Bright light therapy and then dim white light. For assessment of depressive symptoms, Beck depression inventory scales were administered 1 week before and one day before dim white light treatment, on the day between dim white light and bright white light treatment, on the day after bright white light treatment and one week after bright white light treatment. Saliva melatonin and cortisol samples were collected at 08:00 a.m. and 08:00 p.m., 1 week before and one day before dim white light treatment, on the day between dim white light and bright white light treatment, on the day after bright white light treatment and one week after bright white light treatment and assayed for melatonin and cortisol to observe any change in circadian timing. Results: 28 volunteers, between 14 and 17 years old, completed the study. Beck depression inventory scores improved significantly. The assays of morning saliva melatonin showed significant differences between Bright white light and dim white light (p = 0.005), those of evening saliva melatonin and saliva cortisol did not show significant differences. No significant adverse reactions were observed. Conclusion: Antidepressant response to bright light treatment in this age group was statistically superior to dim white展开更多
Cutting or self inflicted epidermal damage (derma-abuse) describes a number of blood- letting behaviours among adolescents. Unlike suicidal behaviour, it is associated with low lethality and the absence of suicidal at...Cutting or self inflicted epidermal damage (derma-abuse) describes a number of blood- letting behaviours among adolescents. Unlike suicidal behaviour, it is associated with low lethality and the absence of suicidal attempts. The purpose of this study is two-fold: Firstly, to present and discuss vignettes of four young adolescents and secondly, to study the dynamics and characteristics of six derma-abusers who have attended Dual Group Therapy (DGT) concurrently with their parents for a six month period. Our findings suggest that patients involved in derma-abuse are generally non-suicidal but engage in comfort cutting for the psychological release of pain, tension reduction and anger management. There is a preponderance of females (80%) with an over-representation of mixed origin and borderline cultural states. In this small group, males amounted to 20% and were more bizarre, gruesome and brutal in their self-abuse. Of the total sample, 10% were of African origin, 60% were of Indian descent and 30% were of mixed ancestry. Psy- chodynamic factors explored in Dual Group Therapy (DGT) are the emphasis on non-suicidal intent, association with tension reduction, reclaiming power and mastery over self and others, life and death instincts, the significance of bloodletting in a socio-cultural context, trans- generational conflicts, dysfunctional family dynamics frequently with parental separation and sexual abuse and early sexual induction.展开更多
Background: The sexual health indices of the adolescents are very poor. This study ascertained the factors influencing the sexual behaviour among female adolescents in Onitsha, Anambra state, Nigeria. Method: This was...Background: The sexual health indices of the adolescents are very poor. This study ascertained the factors influencing the sexual behaviour among female adolescents in Onitsha, Anambra state, Nigeria. Method: This was a cross sectional design in which a total of 800 female adolescents were selected from secondary schools in the area using multistage sampling method;and also selected from a major market (for those who were not at school) in the same geographical area using cluster sampling technique. Data were collected from the respondents about socio-demographic profile, reproductive and sexual health knowledge, attitude, behavior, sources of sexual health information. Result: The highest proportion of students who had ever had sex was found among the 16 - 17 years age group while the modal age group was 18 - 19 years for non students. Also “not living with both parents” and poor family background, were markedly associated with increased likelihood to engage in sexual activity. Poverty level was particularly high among the non-student adolescents. Furthermore, wrong knowledge of fertile period, low risk perception of HIV and premarital, and use of condoms among the respondents were all significantly associated with increased chance to engage in sex. The student adolescents got sexuality information mainly from the teachers;as opposed to their non-student counterparts who had youth organization and friends as main sources. Conclusion: Family values, poverty alleviation, change of attitude through appropriate health and sexuality education especially targeting the non-student adolescents are highly recommended. Sexual negotiation skill, accessible formal education for all should be encouraged to create the right sexual behavior among the adolescent girls.展开更多
文摘Background: Non-Hodgkin’s lymphoma is an aggressive malignant disease in children and adolescents. Although it is the fourth most common malignancy in Saudi children as reported in Saudi cancer registry, less information is available about pediatric Non-Hodgkin lymphoma and its outcome in Saudi Arabia. Study Objectives: To provide demographic data, disease characteristics, treatment protocol, toxicity and outcome of treatment in children & adolescents with Non-Hodgkin’s lymphoma treated at KFMC. This study will form base line for future studies about pediatric Non-Hodgkin’s lymphoma in KFMC, which may help to improve outcome for children with cancer in Saudi Arabia. Study Patients and Method: We retrospectively analyzed 28 children and adolescents diagnosed to have Non-Hodgkin’s lymphoma at KFMC between December 2006 and December 2013, followed-up through June 2014. Results: Of the 28 patients, 10 (35.7%) girls and 18 (64.3%) boys, the male-to-female ratio was 1.8;1. The median age at time of diagnosis was 6.4 years old (range 2.0 to 13.0 years old). The majority of patients (64.3%) were aged between 5 and 12 years old. Burkitt’s lymphoma BL/BLL was the most common pathological subtype (60.7%), and DLBCL was the second most common subtype (21.4%). Abdominal and Retroperitoneal involvement was the most common primary site (78.6%) including the ileocaecal region. Most of the children presented with advanced Stage III and IV (75%), Cytogenetic study which screens specifically for the t (8;14) (q24;q32) a characteristic genetic feature of Burkitt’s Lymphoma was obtained from 21 patients, variant rearrangement was observed in 3/21 samples and complex chromosomes karyotype in addition to IGH/MYC rearrangement was observed in 2/21 samples. Those patients presented with very aggressive lymphoma and combined BM and CNS involvement. We use the French-American-British Mature B-Cell Lymphoma 96 Protocol (FAB LMB 96) for treatment fornewly diagnosed Mature B-Cell type NHL and high risk ALL CCG 1961 Protocol for lymphoblastic lymphoma and international Anaplastic Large Cell Lymphoma 99 Study Protocol for ALCL. The median follow-up in patients not experiencing an adverse event was 53.1 months. The estimated 3-year EFE and OS rates in the entire cohort of patients with newly diagnosed NHL treated in the KFMC were 85.2% and 89.2% respectively;Overall survival (OS) rate of patients with mature B-cell-NHL was 88.9%. Conclusion: The outcomes and survival in our small series appeared to be excellent compared with those reported in other international trials even though most of our patients presented in advanced stage of the disease. We feel that the importance of the current study is to document the relative distribution of various types of pediatric non-Hodgkin’s lymphomas and age-specific distribution in different Histological subtypes.
文摘Objective:To explore the time management tendency of left-behind adolescents,compare the differences of time management of left-behind.Methods:The questionnaire studies the adolescents students of major labor.Results:Left-behind adolescents are tend to form bad time management tendency(t<2.55,p<0.01)and among these left-behind adolescents there are great individual differences(F>4.24,p>0.05);16-year-old time is a critical period of forming social value of time management(F>4.24,p>0.05),the grade(F_((2,331))=3.74,p=0.03),and whether the only child(t=2.26,p=0.03)has priority to the impact of time management;the children’s age when their parents left.The left period of their parents,the parents who go out,and the visit interval all these factors affect the adolescents’time management tendency(R^(2)>0.21,p<0.001).
基金Supported by The National Key Research and Development Program of China,No.2016YFC1305301
文摘Nonalcoholic fatty liver disease(NAFLD) has become the dominant form of chronic liver disease in children and adolescents with the increasing prevalence of obesity worldwide. NAFLD represents a wide spectrum of conditions, ranging from fatty liver-which generally follows a benign, non-progressive clinical course-to non-alcoholic steatohepatitis, a subset of NAFLD that may progress to cirrhosis and end-stage liver disease or liver carcinoma. The underlying pathophysiological mechanism of "pediatric" NAFLD remains unclear, although it is strongly associated with obesity and insulin resistance. In this review we provide a general overview on the current understanding of NAFLD in children and adolescents, which underpins practice, enabling early diagnosis and appropriate therapeutic intervention for this life-threatening liver disease.
文摘Background: Adolescent obesity is associated with high cardiovascular and metabolic risk. Western diet and reduced physical activity are strong environmental determinants. The “Health Production” model posits that individuals born with a certain amount of health stock, which depreciates over life, but can be augmented by individual behaviors, including exercise and dieting. Objective: To study the association between health production and obesity in a random sample of 1692 Chilean adolescents (14.8 ± 0.7 years old), and to study the effect of gender and socioeconomic characteristics on health production. Method: We used an indicator that considered the quality of food intake and physical activity, establishing three categories: good (GHP), intermediate (IHP) and poor health producers (PHP). Multivariate analysis was used to study the odds of obesity and good health production. Results: There was 31% of GHP, 32% of IHP and 38% of PHP. Obesity (Adj. OR: 1.59;95%CI: 1.04 - 2.42) and abdominal obesity (Adj. OR: 2.24;95%CI: 1.35 - 3.40) were significantly higher in the PHP group, compared to the GHP and IHP group. Health production was significantly associated with socioeconomic factors and gender. Female sex and coming from a less wealthy household significantly reduced the odds of good health production. Conclusions: Poor health production in adolescence, as defined by food intake and physical activity, depreciates individuals’ “health stock”, increasing the risk of obesity. In our sample, health production was strongly associated with socio-economic factors and gender.
文摘Background: Bright light therapy, an effective therapeutic option for depressive adults, could provide safe, economic, and effective rapid recovery also in adolescents. Method: This was a randomized cross-over trial, i.e. that 14 patients received first dim white light (50 lux) one hour a day for one week and then Bright light therapy (2500 Lux) for one week. 14 patients received first Bright light therapy and then dim white light. For assessment of depressive symptoms, Beck depression inventory scales were administered 1 week before and one day before dim white light treatment, on the day between dim white light and bright white light treatment, on the day after bright white light treatment and one week after bright white light treatment. Saliva melatonin and cortisol samples were collected at 08:00 a.m. and 08:00 p.m., 1 week before and one day before dim white light treatment, on the day between dim white light and bright white light treatment, on the day after bright white light treatment and one week after bright white light treatment and assayed for melatonin and cortisol to observe any change in circadian timing. Results: 28 volunteers, between 14 and 17 years old, completed the study. Beck depression inventory scores improved significantly. The assays of morning saliva melatonin showed significant differences between Bright white light and dim white light (p = 0.005), those of evening saliva melatonin and saliva cortisol did not show significant differences. No significant adverse reactions were observed. Conclusion: Antidepressant response to bright light treatment in this age group was statistically superior to dim white
文摘Cutting or self inflicted epidermal damage (derma-abuse) describes a number of blood- letting behaviours among adolescents. Unlike suicidal behaviour, it is associated with low lethality and the absence of suicidal attempts. The purpose of this study is two-fold: Firstly, to present and discuss vignettes of four young adolescents and secondly, to study the dynamics and characteristics of six derma-abusers who have attended Dual Group Therapy (DGT) concurrently with their parents for a six month period. Our findings suggest that patients involved in derma-abuse are generally non-suicidal but engage in comfort cutting for the psychological release of pain, tension reduction and anger management. There is a preponderance of females (80%) with an over-representation of mixed origin and borderline cultural states. In this small group, males amounted to 20% and were more bizarre, gruesome and brutal in their self-abuse. Of the total sample, 10% were of African origin, 60% were of Indian descent and 30% were of mixed ancestry. Psy- chodynamic factors explored in Dual Group Therapy (DGT) are the emphasis on non-suicidal intent, association with tension reduction, reclaiming power and mastery over self and others, life and death instincts, the significance of bloodletting in a socio-cultural context, trans- generational conflicts, dysfunctional family dynamics frequently with parental separation and sexual abuse and early sexual induction.
文摘Background: The sexual health indices of the adolescents are very poor. This study ascertained the factors influencing the sexual behaviour among female adolescents in Onitsha, Anambra state, Nigeria. Method: This was a cross sectional design in which a total of 800 female adolescents were selected from secondary schools in the area using multistage sampling method;and also selected from a major market (for those who were not at school) in the same geographical area using cluster sampling technique. Data were collected from the respondents about socio-demographic profile, reproductive and sexual health knowledge, attitude, behavior, sources of sexual health information. Result: The highest proportion of students who had ever had sex was found among the 16 - 17 years age group while the modal age group was 18 - 19 years for non students. Also “not living with both parents” and poor family background, were markedly associated with increased likelihood to engage in sexual activity. Poverty level was particularly high among the non-student adolescents. Furthermore, wrong knowledge of fertile period, low risk perception of HIV and premarital, and use of condoms among the respondents were all significantly associated with increased chance to engage in sex. The student adolescents got sexuality information mainly from the teachers;as opposed to their non-student counterparts who had youth organization and friends as main sources. Conclusion: Family values, poverty alleviation, change of attitude through appropriate health and sexuality education especially targeting the non-student adolescents are highly recommended. Sexual negotiation skill, accessible formal education for all should be encouraged to create the right sexual behavior among the adolescent girls.
