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Delivery of mental health treatment in the home can close gaps in care. Telehealth also provides access to healthcare that has been disrupted due to the COVID-19 pandemic. In 2016, a home direct-to-consumer telehealth program was initiated. Mental health encounters made up a significant portion of all telehealth encounters and COVID-19 had a significant impact on accelerating the utilization of telehealth. Telemental health has been more successful at meeting targeted volumes than the overall health system. Of all the mental health diagnoses before and during COVID-19, attention deficit hyperactivity disorder, Autism Spectrum Disorder, and Anxiety Disorder were most common. The direct-to-consumer telehealth program saved patients a significant amount of travel miles and associated time, based on data from the period before COVID-19. Payment reimbursement for direct-to-consumer telehealth professional services was similar to reimbursement for in-person visits. This program demonstrates direct-to-consumer telehealth is a feasible and acceptable care modality for a variety of youth mental health disorders. [ABSTRACT FROM AUTHOR]

Purpose: Veliparib (V), an oral poly(ADP-ribose) polymerase (PARP) inhibitor, potentiates effects of alkylating agents and topoisomerase inhibitors in preclinical tumor models. We conducted a phase I trial of V with iv cyclophosphamide (C) and V plus iv doxorubicin (A) and C. Methods: Objectives were to establish the maximum tolerated dose (MTD) of the combinations, characterize V pharmacokinetics (PK) in the presence and absence of C, measure PAR in peripheral blood mononuclear cells (PBMCs) and γH2AX in circulating tumor cells (CTCs). In Group 1, dose escalations of V from 10 to 50 mg every 12 h Days 1–4 plus C 450 to 750 mg/m2 Day 3 in 21-day cycles were evaluated. In Group 2, V doses ranged from 50 to 150 mg every 12 h Days 1–4 with AC (60/600 mg/m2) Day 3 in 21-day cycles. In Group 3, patients received AC Day 1 plus V Days 1–7, and in Group 4, AC Day 1 plus V Days 1–14 was given in 21-day cycles to evaluate effects on γH2AX foci. Results: Eighty patients were enrolled. MTD was not reached for V and C. MTD for V and AC was V 100 mg every 12 h Days 1–4 with AC (60/600 mg/m2) Day 3 every 21 days. V PK appears to be dose-dependent and has no effect on the PK of C. Overall, neutropenia and anemia were the most common adverse events. Objective response in V and AC treated groups was 22% (11/49). Overall clinical benefit rate was 31% (25/80). PAR decreased in PBMCs. Percentage of γH2AX-positive CTCs increased after treatment with V and AC. Conclusion: V and AC can be safely combined. Activity was observed in patients with metastatic breast cancer. [ABSTRACT FROM AUTHOR]

Methylphenidate (Ritalin) given three times daily appears to be more effective than two times daily for children with a more severe attention deficit hyperactivity disorder (ADHD) without significantly more side effects. Four treatment strategies including twice daily, three times daily, gradual increase in concentration, or no treatment were compared for their effects on behavior among 25 boys with ADHD. Behavior was significantly improved with any treatment compared to no treatment. Parents and teachers rated the three times daily treatment better than the twice daily treatment., ABSTRACT. Objective. To evaluate the short-term efficacy and side effects associated with two methylphenidate hydrochloride (MPH) dosing patterns. Methods. Twenty-five boys with attention deficit hyperactivity disorder (ADHD) participated in a [...]

Adaptive functioning was below average for all three groups of children in a comparative study of attention deficit disorder (ADD), attention deficit hyperactivity disorder (ADHD), and pervasive developmental disorders or mild mental retardation (PDD/MR). The ADD and ADHD groups had significantly lower levels of adaptive functioning in relation to IQ for socialization, communication and daily living, although the PDD/MR group was lowest scoring. The Vineland Adaptive Behavior Scales were used in the study.

Six months to one-year of treatment appears to be effective in preventing serious complications in children with congenital toxoplasmosis. Toxoplasmosis is an infection that can cause mental retardation, blindness and neurological disability if transmitted by a pregnant woman to her fetus. Thirty-six children born with toxoplasmosis and treated for at least six months were evaluated near the time of their birth and again at 1, 3.5, 5 and 7 or more years of age. Thirty-two of the children were treated for one year. Forty-five percent of the children had normal neurologic examinations. Of these, 33% had abnormal findings during their first year. Sixty-seven percent had normal IQ scores. No children had hearing difficulties. Nine of the children were microcephalic and seven of these had neurologic impairment. Hydrocephalic children who received prompt treatment had few neurological difficulties. Fifty-eight percent of the children had visual impairment that interfered with their functioning. However it was not associated with abnormal development., Background. Earlier studies have shown that infants with untreated congenital toxoplasmosis and generalized or neurologic abnormalities at presentation almost uniformly develop mental retardation, seizures, and spasticity. Children with untreated subclinical disease at birth have developed seizures, significant cognitive and motor deficits, and diminution in cognitive function over time. Objective. To determine neurologic, cognitive, and motor outcomes for children with congenital toxoplasmosis who were treated for approximately 1 year with pyrimethamine and sulfadiazine. Design and methods. Systematic, prospective, and longitudinal neurologic, cognitive, and motor evaluations were performed for 36 individuals with congenital toxoplasmosis. These infants were born between December 1981 and january 1991 and were treated with pyrimethamine and sulfadiazine for approximately 1 year beginning in the first months of life. Compliance with medications was documented. These individuals were evaluated in a standardized manner in a single center in the first months of life and at approximately 1, 3.5, 5, 7.5, and 10 years of age. Their cognitive function was compared with the cognitive function of a nearest-age, samesex sibling when such siblings older than 3.5 years were available for study. Results. Signs of active central nervous system infection (eg, cerebrospinal fluid [CSF] pleiocytosis, hypoglycoffhachia, elevated CSF protein, and, in some instances, seizures and motor abnormalities) resolved during therapy. Six of the 36 children had perinatal seizures. Four had their anticonvulsant therapy discontinued successfully within the first months of life, and two additional children developed new seizures at 3 and 5 years of age. Tone and motor abnormalities resolved by 1 year of age in 12 of 20 infants who exhibited abnormalities of tone and motor function at their initial neonatal evaluation. By February 1992, 29 of the 36 children had been evaluated when they were 1 year old, and 23 (79%) had a mean [+ or -] standard deviation Mental Developmental Index (MDI) of 102 [+ or -] 22 (range, 59 to 140). Six (21%) had a measure of their cognitive function that was less than 50. Results of sequential IQ tests, performed at 1.5 year intervals or greater, did not differ significantly over time (P > .05). Seven children with MDIS greater than 50 were compared with sibling controls; they had scores of 87 [+ or -] 11 (range, 68 to 97) and their siblings had scores of 112 [+ or -] 15 (range, 85 to 132) (P = .008). Seventeen of 18 children without hydrocephalus and six of eight children with obstructive hydrocephalus responsive to shunting had normal or near-norinal neurologic and developmental outcomes. Children with hydrocephalus ex vacuo present at birth, with high CSF protein, and with lack of response to shunting have done less well. Conclusions. Neurologic and developmental outcomes were significantly better for most of these treated children than outcomes reported for untreated children or those treated for only 1 month (P