Reactions of mothers and medical professionals to a film about Down Syndrome

Article Abstract:

Down syndrome is a genetic disorder that can be identified prior to birth. The syndrome is the result of a chromosome abnormality, and features of the syndrome include moderate to severe mental retardation with distinct physical characteristics, such as short stature. Although Down syndrome can be predicted, the condition is permanent and there is no treatment. To investigate the reaction of parents and medical professionals concerning Down syndrome, an 18-minute film entitled 'Down Syndrome - A Parental Perspective' was shown to 36 mothers, 29 genetic counselors, and 32 nurses. The three groups contained individuals of similar age, educational backgrounds, and socioeconomic levels. The film consisted of videotaped discussions of parents of Down syndrome children, and was designed to introduce pertinent issues and stimulate further discussion. An evaluation was completed by the subjects after viewing the film, and some statistically significant trends emerged. When questioned on the accuracy of the film in portraying the attitudes of parents, 89 percent of the mothers responded that the film was accurate, but only 14 percent of the genetic counselors and 40 percent of the nurses believed the film was accurate in this respect. Ninety-four percent of the mothers and 83 percent of the nurses believed that the benefits of having a Down syndrome child outweigh the problems; 48 percent of the genetic counselors felt similarly. Most of the genetic counselors (56 percent) believed that parents would choose to abort a Down syndrome fetus, but only 8 percent of the mothers and 10 percent of the nurses felt that most parents would choose abortion. These results indicate that there is a gap between what parental attitudes towards Down syndrome children actually are, and what genetic counselors perceive them to be. Because the medical professionals that counsel parents on the results of genetic tests often have little or no contact with Down syndrome children and their parents, their knowledge of how families are affected by this condition must be increased in order to provide effective counseling. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Social aspects, Evaluation, Surveys, Ethical aspects, Down syndrome, Genetic counseling

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Adult height achieved in children after kidney transplantation

Article Abstract:

One of the complications of chronic renal (kidney) failure in children is the inhibition of normal growth and development. Improvements in growth are often seen after kidney transplantation. In addition, the use of cyclosporine, an immunosuppressant agent administered after transplantation to prevent graft rejection, has allowed the reduction of corticosteroid dose (drugs used in the maintenance therapy for these patients), which has led to better growth rates. To further investigate these effects, 20 adolescents between the ages of 10 and 17 years who underwent a kidney transplantation were monitored from 1974 to 1986. The subjects were treated with either cyclosporine and low doses of prednisolone, a corticosteroid drug (nine children), or with azathioprine and high doses of prednisolone (11 children). Bone growth measurements were taken at the time of transplantation, and the normal adult height of each patient was estimated at this time. The bone ages in all the subjects were comparable at transplantation. However, after the transplant operation, the children treated with cyclosporine and low doses of corticosteroids achieved a yearly growth rate that was more than twice that observed in the group treated with azathioprine and high doses of corticosteroids. Also, the adult height (which was measured at 18 years for males and at 16 years for females) of the cyclosporine group was 1.3 centimeters (cm) more than predicted. In the azathioprine group, the adult heights were an average of 3.9 cm less than predicted. No significant renal insufficiency occurred in the patients given cyclosporine, but kidney function in these patients was lower compared with the azathioprine group. It is concluded that maintenance with cyclosporine and low doses of prednisolone in young kidney transplant recipients is related to a better growth outcome and normal bone maturation in these patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Physiological aspects, Corticosteroids, Adrenocortical hormones, Kidneys, Kidney transplantation, Dosage and administration, Child development deviations, Developmental disabilities, Chronic renal failure in children

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Insulinlike growth factors in patients with active nephrotic syndrome

Article Abstract:

Nephrotic syndrome is an abnormal kidney condition characterized by swelling, protein in the urine, and marked loss of albumin, a blood protein. Nephrotic syndrome can develop alone or in combination with another disease. Before steroid therapy became standard treatment for children, growth failure was common among those who were affected by nephrotic syndrome. However, growth failure continues to be a problem in children with nephrotic syndrome who are not responsive to standard steroid therapy. Insulin-like growth factor (IGF) is a hormone that helps to promote growth. To see if IGF-1 and IGF-2 are altered in children with nephrotic syndrome, blood levels of IGF were measured in 25 children. The protein essential for transporting IGF was also measured. Levels of IGF-1 and IGF-2 were significantly lower in patients with nephrotic syndrome, compared with similarly matched children without nephrotic syndrome. In addition, the protein needed to carry IGF was higher in the urine of patients with nephrotic syndrome. These findings were independent of the cause of nephrotic syndrome. The low levels of IGF in children with this disease may be explained by the excessive loss of the carrier protein in their urine. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Measurement, Growth factors, Insulin-like growth factors, Somatomedins, Nephrotic syndrome

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