The aim of this population-based study was to describe function in cerebral palsy (CP) in relation to neuroimaging.
Motor function, accompanying impairments, and neuroimaging (86 by magnetic resonance imaging, 74 by computed tomography) were studied in 186 children born in western Sweden between 1999 and 2002 (96 males, 90 females; age range at data collection 4-8 y). results: Forty per cent of the children had unilateral spastic CP, 39% bilateral, 16% dyskinetic CP, and 5% ataxia. Fifty-one per cent were in level I of the Gross Motor Function Classification System (GMFCS), 14% in level II, 3% in level III, 11% in level IV, and 22% level V. Forty per cent of the children were in level I of the Manual Ability Classification System 19% were in II, 9% at III, 8% in IV, and 24% in level V. Seventy-six per cent of the children with white-matter lesions were in GMFCS levels I and II, whereas 67% with basal ganglia lesions were in levels IV and V. Learning disability* (45%), epilepsy (44%), and visual impairment (17%) were most common in children with brain maldevelopment, and cortical/subcortical or basal ganglia lesions. Speech was impaired in 49% of the children, absent in 30%, and 6% had a neuropsychiatric diagnosis. Compared with children born between 1991 and 1998, the numbers of those in GMFCS level I increased (p=0.007), as did those with epilepsy (p=0.015).
Neuroimaging improves the understanding of the neuroanatomical basis for function in CP. Type and severity of motor impairment and accompanying impairments are related to the timing of lesions.
Comment In: Dev Med Child Neurol. 2011 Jun;53(6):48221506996
Studies reporting the incidence of isolated cutaneous lupus erythematosus (CLE) are rare.
To examine in a population-based cohort study the incidence of CLE and its subsets in Sweden. The short-term probability of receiving an additional diagnosis of systemic lupus erythematosus (SLE) is also assessed.
A population-based open cohort study including all patients with CLE [International Classification of Diseases (ICD) code, ICD-10: L93] in Sweden, 2005-2007. Patients (n=1088) were identified in the Swedish National Patient Register.
The incidence of CLE was 4·0/100,000; the female/male ratio was 3:1. Mean age at disease onset was 54 years. The most common subset was discoid lupus erythematosus (DLE) (80%, n = 868). A quarter of the patients (24%, n=260) were already diagnosed with SLE at the time they were diagnosed with CLE. During the whole observation period (2005-2007), an additional 18% (n = 107) were diagnosed with SLE, the probability of receiving an additional SLE diagnosis being highest for the subacute CLE (SCLE) subset.
This is the first nationwide epidemiological study on CLE. We found the incidence of CLE to be about equal to that of SLE, and found a higher short-term probability for receiving an additional diagnosis with SLE than previously described for CLE. Subsets other than DLE and SCLE were rarely reported in our system; an update of the ICD codes for this diagnostic group could increase reporting of these more unusual cases. Our study clarifies that monitoring and follow-up are called for in this patient group due to the risk for SLE, and underscores the need for clear criteria for risk assessment in the large group of patients with CLE who also fulfil criteria for SLE.
Several factors associated with an unfavourable outcome after severe traumatic brain injury (TBI) have been described: prolonged pre-hospital time, secondary referral to a level 1 trauma centre, the occurrence of secondary insults such as hypoxia, hypotension or low end-tidal carbon dioxide (ETCO(2)). To determine whether adverse events were linked to outcome, patients with severe TBI were studied before arrival at a level 1 trauma centre.
Prospective, observational study design. Patients with severe TBI (n = 48), admitted to Umeå University Hospital between January 2002 to December 2005 were included. All medical records from the site of the accident to arrival at the level 1 trauma centre were collected and evaluated.
A pre-hospital time of >60 min, secondary referral to a level 1 trauma centre, documented hypoxia (oxygen saturation 100 beats/min) at any time before arrival at a level 1 trauma centre were not significantly related to an unfavourable outcome (Glasgow Outcome Scale 1-3).
Early adverse events before arrival at a level 1 trauma centre were without significance for outcome after severe TBI in the trauma system studied.
Cutaneous metastases may cause considerable discomfort as a consequence of ulceration, oozing, bleeding and pain. Electrochemotherapy has proven to be highly effective in the treatment of cutaneous metastases. Electrochemotherapy utilises pulses of electricity to increase the permeability of the cell membrane and thereby augment the effect of chemotherapy. For the drug bleomycin, the effect is enhanced several hundred-fold, enabling once-only treatment. The primary endpoint of this study is to evaluate the efficacy of electrochemotherapy as a palliative treatment.
This phase II study is a collaboration between two centres, one in Denmark and the other in the UK. Patients with cutaneous metastases of any histology were included. Bleomycin was administered intratumourally or intravenously followed by application of electric pulses to the tumour site.
Fifty-two patients were included. Complete and partial response rate was 68% and 18%, respectively, for cutaneous metastases 3 cm. Treatment was well-tolerated by patients, including the elderly, and no serious adverse events were observed.
ECT is an efficient and safe treatment and clinicians should not hesitate to use it even in the elderly.
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Agency and communion are fundamental human motives, often conceptualized as being in tension. This study examines the notion that moral exemplars overcome this tension and adaptively integrate these 2 motives within their personality. Participants were 25 moral exemplars-recipients of a national award for extraordinary volunteerism-and 25 demographically matched comparison participants. Each participant responded to a life review interview and provided a list of personal strivings, which were coded for themes of agency and communion; interviews were also coded for the relationship between agency and communion. Results consistently indicated that exemplars not only had both more agency and communion than did comparison participants but were also more likely to integrate these themes within their personality. Consistent with our claim that enlightened self-interest is driving this phenomenon, this effect was evident only when agency and communion were conceptualized in terms of promoting interests (of the self and others, respectively) and not in terms of psychological distance (from others) and only when the interaction was observed with a person approach and not with the traditional variable approach. After providing a conceptual replication of these results using different measures elicited in different contexts and relying on different coding procedures, we addressed and dismissed various alternative explanations, including chance co-occurrence and generalized complexity. These results provide the first reliable evidence of the integration of motives of agency and communion in moral personality.
An assessment of actual nutrition and physical fitness of athletes of the Russian national sleigh team are presented, and the need to develop for them the individual well-balanced diet that will reimburse the amount of consumed energy and nutrients and help athletes to obtain high results.