ABSTRACT. Objectives. Pain among children and adolescents has been identified as an important public health problem. Most studies evaluating recurrent or chronic pain conditions among children have been limited to descriptions of pain intensity and duration. The effects of pain states and their impact on daily living have rarely been studied. The objective of this study was to investigate the impact of perceived pain on the daily lives and activities of children and adolescents. In addition, we sought to delineate self-perceived triggers of pain among children and adolescents. In this study, we (1) document the 3-month prevalence of painful conditions among children and adolescents, (2) delineate their features (location, intensity, frequency, and duration), (3) describe their consequences (restrictions and health care utilization), and (4) elucidate factors that contribute to the occurrence of pain episodes among young subjects.Methods. The study was conducted in 1 elementary school and 2 secondary schools in the district of Ostholstein, Germany. Children and adolescents, as well as their parents/guardians, were contacted through their school administrators. The teachers distributed an information leaflet, explaining the conduct and aim of the study, to the parents a few days before the official enrollment of the youths in the study. Parents of children in grades 1 to 4 of elementary school were asked to complete the pain questionnaire for their children at home, whereas children from grade 5 upward completed the questionnaire on their own during class, under the supervision of their teachers. The response rate was 80.3%. As previously stated, chronic pain was defined as any prolonged pain that lasted a minimum of 3 months or any pain that recurred throughout a minimal period of 3 months. The children and adolescents were surveyed with the Luebeck Pain-Screening Questionnaire, which was specifically designed for an epidemiologic study of the characteristics and consequences of pain among children and adolescents. The questionnaire evaluates the prevalence of pain in the preceding 3 months. The body area, frequency, intensity, and duration of pain are addressed by the questionnaire. In addition, the questionnaire inquires about the private and public consequences of pain among young subjects. Specifically, the questionnaire aims to delineate the self-perceived factors for the development and maintenance of pain and the impact of these conditions on daily life.Results. Of the 749 children and adolescents, 622 (83%) had experienced pain during the preceding 3 months. A total of 30.8% of the children and adolescents stated that the pain had been present for >6 months. Headache (60.5%), abdominal pain (43.3%), limb pain (33.6%), and back pain (30.2) were the most prevalent pain types among the respondents. Children and adolescents with pain reported that their pain caused the following sequelae: sleep problems (53.6%), inability to pursue hobbies (53.3%), eating problems (51.1%), school absence (48.8%), and inabilit...

Functional MR imaging activation within the STG in response to passive speech stimulation helped differentiate autistic from control subjects, demonstrating the potential utility of functional MR imaging as an objective indicator of language impairment in autism. Future studies may lead to an early and objective indicator for autism with these methods.

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Remifentanil is commonly used during anesthesia in pediatric electrophysiologic studies (EPS). The purpose of this study is to determine the effects of remifentanil on the cardiac electrophysiologic properties of children undergoing ablation of supraventricular tachycardia (SVT). A prospective study was performed in patients undergoing EPS before ablation of SVT. Each patient received two different anesthetic protocols: protocol 1 = propofol (200 mcg/kg/min) and protocol 2 = propofol (120 mcg/kg/min) plus remifentanil (0.3 mcg/kg/min). EPS data were measured during the steady state of each protocol. Paired Student t test was performed for analysis of continuous data. All p values <0.05 were considered statistically significant. Fifteen patients were enrolled between April 2005 and January 2006. The mean age was 13.3 ± 2.9 years (range 6.7 to 17.7). Seven patients had atrioventricular (AV) nodal re-entry tachycardia; 5 patients had Wolff-Parkinson-White syndrome; 2 patients had a concealed accessory pathway; and 1 patient was not inducible. Of the 14 patients who underwent ablation, 13 (93%) achieved successful. The baseline sinus cycle length extended from 884 ± 141 ms during protocol 1 to 980 ± 165 ms during protocol 2 (p = 0.01), and the Wenckebach cycle length lengthened from 377 ± 96 ms to 406 ± 109 ms (p = 0.01). No other variables measured (atrial-His (AH) and His-ventricular (HV) interval, atrioventricular node (AVN), and atrial, ventricular, and accessory pathway effective refractory periods) changed significantly between the two different protocols. In pediatric patients undergoing EPS before ablation of SVT, remifentanil appears to slow both sinus and AV nodal function. These effects should be taken into consideration when performing EPS.

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