Use of a dynamic foot pressure index to monitor the effects of treatment for equinus gait in children with cerebral palsy.

The purpose of this study is to introduce and describe a newly developed index using foot pressure analysis to quantify the degree of equinus gait in children with cerebral palsy before and after injection with botulinum toxin. Data were captured preinjection and 12 weeks postinjection. Ten children aged 2(1/2) to 6(1/2) years took part (5 boys and 5 girls). Three of them had a diagnosis of spastic diplegia and 7 of congenital hemiplegia. In total, 13 limbs were analyzed. After orientation and segmentation of raw pedobarographic data, we determined a dynamic foot pressure index graded 0 to 100 that quantified the relative degree of heel and forefoot contact during stance. These data were correlated (Pearson correlation) with clinical measurements of dorsiflexion at the ankle (on a slow and fast stretch) and video observation (using the Observational Gait Scale). Pedobarograph data were strongly correlated with both the Observational Gait Scale scores (R = 0.79, P < 0.005) and clinical measurements of dorsiflexion on a fast stretch, which is reflective of spasticity (R = 0.70, P < 0.005). We demonstrated the index's sensitivity in detecting changes in spasticity and good correlation with video observations seems to indicate this technique's potential validity. When manipulated and segmented appropriately, and with the development of a simple ordinal index, we found that foot pressure data provided a useful tool in tracking changes in patients with spastic equinus.

Pédiatrie. 3. Traitement du membre supérieur dans les hémiparésies congénitales: progrès et perspectives [Pediatrics. Upper limb treatment in congenital hemiparesis: progress and perspectives].

Congenital hemiparesis is one of the most frequent pediatric motor disorders. Upper limb rehabilitation of the hemiparetic child has considerably evolved during the last decade by the use of focal chemical denervation (intramuscular botulinum toxin) and the introduction of novel rehabilitation techniques such as constraint induced movement therapy or robotic reeducation.

La démarche diagnostique des troubles cognitifs chez l'âgé

Cet article retrace une recherche qualitative pluridisciplinaire. Les cinq auteurs - anthropologues, médecin psychiatre, psychologue et sociologue - ont développé une collaboration autour d'une problématique récurrente chez les personnes âgées: les troubles cognitifs associés à l'âge, les difficultés à les diagnostiquer et à communiquer le diagnostic aux patients et à leurs proches. Huit patients et leurs proches se sont rencontrés séparément lors de deux séries d'entretiens sur l'annonce du diagnostic Mild Cognitive Impairment (MCI). Les résultats montrent que la communication du diagnostic MCI n'insuffle pas un tournant dans la trajectoire des patients. Les propos des experts semblent n'avoir qu'un faible impact sur la compréhension qu'ont les patients et leurs accompagnants de la santé mentale des sujets diagnostiqués.

Recent skin injuries in children with motor disabilities.

OBJECTIVE: To determine the frequency of recent skin injuries in children with neuromotor disabilities and its association with disability. DESIGN: Cross-sectional study of 168 children with neuromotor disabilities aged 2-16 years. SETTING: Two outpatient child rehabilitation centres. MAIN OUTCOME MEASURES: Children were classified as unrestricted walkers, restricted walkers or wheelchair dependent. Each participant's body surface was systematically examined for recent skin injuries with the exception of the anal-genital area. RESULTS: The mean age of our sample was 7.8 (SD 3.7) years with a 3:2 male/female ratio. Overall, 64% had cerebral palsy, 17% a neuromuscular disease and 19% other motor disabilities. Participants had on average 5.3 (SD 4.5) recent skin injuries (max 19), of which 2.5 were bruises (SD 3.3, max 16), 2.4 were abrasions, scratches or cuts (SD 3.0, max 16) and 0.4 were pressure lesions (SD 0.8, max 4). There was a significant decrease in the frequency of recent skin injuries and of bruises with increasing severity of motor disability. Most of this variation was accounted for by injuries to the lower limbs. There were no significant effects of gender, learning disabilities or other comorbidities. CONCLUSIONS: Children with neuromotor disabilities present a progressive reduction in the number of skin injuries with decreasing mobility. Therefore, recent skin injuries in this population which are unusual by their number, appearance or distribution, should raise at least the same level of suspicion for physical abuse as in children without disabilities.

Morphing Romania and Moldova Province

"Morphing Romania and the Moldova Province" gives a short insight of cartograms. Digital cartograms provide potential to move away from classical visualization of geographical data and benefit of new understanding of our world. They introduce a human vision instead of a planimetric one. By applying the Gastner-Newman algorithm for generating density-equalising cartograms to Romania and its Moldova province we can discuss the making of cartograms in general.

A comparison of pain scales in Thai children.

Three commonly used pain scales, the visual analogue scale, the Wong-Baker Faces Pain Scale, and the Faces Pain Scale Revised were administered to 122 Thai children, of whom half were HIV infected, in order to assess their validity. These scales presented moderate to good correlation and moderate agreement, sufficient for valid use in Thai children.

Identificação de resistência genética do cacaueiro à podridão-parda

O objetivo deste trabalho foi comparar métodos de caracterização da resistência do cacaueiro (Theobroma cacao) à podridão-parda (Phytophthora palmivora). Foram estudados os métodos escala de notas, índice de intensidade de infecção e índice de doença. Discos foliares de 103 genótipos receberam 0,2 mL de uma suspensão com 3x10(5) zoósporos de P. palmivora por mililitro, e os sintomas foram avaliados pelos três métodos. Foram realizadas três avaliações (repetições) por genótipo, cada uma composta por 20 discos. O método do índice de doença foi o mais eficiente em caracterizar a resistência de genótipos de cacaueiro a P. palmivora.

Metabolic syndrome and the risk of cardiovascular disease in older adults.

OBJECTIVES: The purpose of this study was to assess whether metabolic syndrome (MetSyn) predicts a higher risk for cardiovascular events in older adults. BACKGROUND: The importance of MetSyn as a risk factor has not previously focused on older adults and deserves further study. METHODS: We studied the impact of MetSyn (38% prevalence) on outcomes in 3,035 participants in the Health, Aging, and Body Composition (Health ABC) study (51% women, 42% black, ages 70 to 79 years). RESULTS: During a 6-year follow-up, there were 434 deaths overall, 472 coronary events (CE), 213 myocardial infarctions (MI), and 231 heart failure (HF) hospital stays; 59% of the subjects had at least one hospital stay. Coronary events, MI, HF, and overall hospital stays occurred significantly more in subjects with MetSyn (19.9% vs. 12.9% for CE, 9.1% vs. 5.7% for MI, 10.0% vs. 6.1% for HF, and 63.1% vs. 56.1% for overall hospital stay; all p < 0.001). No significant differences in overall mortality was seen; however, there was a trend toward higher cardiovascular mortality (5.1% vs. 3.8%, p = 0.067) and coronary mortality (4.5% vs. 3.2%, p = 0.051) in patients with MetSyn. After adjusting for baseline characteristics, patients with MetSyn were at a significantly higher risk for CE (hazard ratio [HR] 1.56, 95% confidence interval [CI] 1.28 to 1.91), MI (HR 1.51, 95% CI 1.12 to 2.05), and HF hospital stay (HR 1.49, 95% CI 1.10 to 2.00). Women and whites with MetSyn had a higher coronary mortality rate. The CE rate was higher among subjects with diabetes and with MetSyn; those with both had the highest risk. CONCLUSIONS: Overall, subjects over 70 years are at high risk for cardiovascular events; MetSyn in this group is associated with a significantly greater risk.

Indução de resistência do mamoeiro à podridão radicular por indutores bióticos e abióticos

O objetivo deste trabalho foi avaliar o potencial do uso de indutores de resistência bióticos e abióticos na redução da podridão radicular em mamoeiro. Mudas de mamoeiro foram pulverizadas com os fungicidas fosetil-Al, metalaxil e Mancozeb (2 g L-1), com os indutores abióticos fosfito de potássio (2,5 e 5 mL L-1), ácido salicílico 0,15 e 0,30%, Reforce (indutor comercial) + ácido salicílico a 5%, acibenzolar-S-metil (ASM) (0,15 e 0,30 g L-1), e com o indutor biótico Saccharomyces cerevisiae (3 e 6 mL L-1), três e seis dias antes da pulverização de 1 mL de suspensão de 10(5) zoósporos mL-1 de Phytophthora palmivora. Todos os tratamentos tiveram efeito no controle da podridão de raízes em relação à testemunha, com exceção do Reforce + ácido salicílico a 5% (3 mL L-1), seis dias antes da inoculação. Os tratamentos com ASM, com exceção da dosagem 0,15 g L-1 seis dias antes da inoculação, apresentaram resultados similares aos dos fungicidas metalaxil e Mancozeb. Plantas pulverizadas com ASM apresentaram aumento de atividade da peroxidase e beta-1,3-glucanase e maior concentração de lignina que a testemunha. No entanto, esses tratamentos não tiverem efeito sobre a atividade da quitinase. O ASM é um potencial indutor de resistência a P. palmivora em mamoeiro.