The development and validation of the impact of multiple sclerosis scale and the symptoms of multiple sclerosis scale

Objective

To develop and validate the Impact of Multiple Sclerosis Scale (IMSS) and the Symptoms of Multiple Sclerosis Scale (SMSS) using the Extended Disability Status Scale (EDSS) for construct validity.
Design

Panel design involving test-retest over 4 months.
Setting

A mailed survey.
Participants

Volunteers with a diagnosis of multiple sclerosis (MS) recruited from an MS support service in Australia: 193 people (mean age, 39y) and 150 people participated at time 1 and time 2, respectively.
Interventions

Not applicable.
Main Outcome Measures

Principal components analyses, the Cronbach α, and descriptive statistics for the 2 scales; correlations for construct validity with the EDSS and retest; and confirmatory factor analysis to test the stability of IMSS and SMSS components over time.
Results

The IMSS yielded 5 independent and reliable components; the SMSS yielded 3 components; both component structures were stable over time. These scales showed convergent validity with the EDSS.
Conclusions

The IMSS and SMSS are psychometrically sound scales suitable for clinical and research purposes to assess the symptoms and impact of MS.

Joint range of motion limitations in children and young adults with spinal muscular atrophy

Objectives
To elicit descriptive data about limited joint range of motion (ROM) in subjects with type II or III spinal muscular atrophy (SMA) and to examine the relation between the number of motions with limited range and both age and functional ability.
Design
Descriptive cross-sectional study.
Setting
Neurologic pediatric outpatient clinic at a hospital in Taiwan.
Participants
Twenty-seven subjects with SMA type II (mean age, 9.8±6.5y) and 17 with SMA type III (mean age, 12.2±8.7y).
Intervention
Measurement with transparent goniometers of joint ROM bilaterally of the shoulder, elbow, wrist, hip, knee, and ankle.
Main outcome measures
The proportion of participants with each ROM limitation compared with all participants with the same SMA type, age distribution of the participants with each ROM limitation, mean range loss of each motion limitation, and the contracture index (risk index of joint contracture).
Results
Eighty-nine percent of the participants with SMA type II experienced knee extension limitation. Approximately 50% of the participants with both types of SMA had ankle dorsiflexion limitation. The motions of knee and hip extension and ankle dorsiflexion also had a relatively high contracture index. The number of motions with limited range positively correlated (P<.001) with age and upper-extremity functional grade (the higher the functional grade, the poorer the functional ability) for SMA type II.
Conclusions
We found varying degrees of joint ROM limitation. Certain motions were noted to be high risks for the development of contractures. This risk was higher mostly in younger children.

Amoebic gill disease and natriuretic peptide receptors in the gills of Atlantic salmon

Amoebic gill disease (AGD) is a problem in the farming of Atlantic salmon, and may compromise osmoregulatory, cardiovascular and respiratory functions. We examined the effects of AGD on atrial and C-type natriuretic peptide (ANP and CNP) stimulated branchial cyclic GMP formation, since natriuretic peptides (NPs) are involved in cardiovascular function and osmoregulation. NPs act via guanylyl cyclase receptors (NPR), which stimulate cGMP formation. NPR activity was measured by ANP and CNP stimulation of branchial cGMP formation, and compared between diseased and healthy salmon over an 11 day AGD infection. We also measured plasma osmolality. Osmolality increased in AGD infected salmon from an initial 355 mmol.kg-1 to 411 mmol.kg-1 at 11 days. There was no evidence that branchial cGMP formation changed in response to AGD. In all groups, CNP stimulation of guanylyl cyclase was 190% of basal rate, whereas ANP was 150% of basal. After 11 days, all groups were given a 4 h freshwater bath, the usual treatment for AGD. Another group was given a seawater to seawater transfer, to control for handling. In this group, plasma osmolality at 11 days was the same as in AGD fish. This elevation may be due to these fish experiencing disturbance for the first time in 11 days. ANP and CNP branchial NPR activity at the conclusion of the 4 h transfers was elevated in all groups compared to that at 11 days. The increased cGMP formation in the handling control suggests a NPR response to the transfer/handling stress. AGD fish demonstrated the greatest elevation in ANP and CNP guanylyl cyclase activity immediately following the bath; these values were greater than in the control groups. The AGD infected salmon, therefore, responded more emphatically to the freshwater treatment, suggesting that the NP system is involved in some aspects of AGD.