Syndrompatienten im Rahmen der kieferorthopädischen Frühbehandlung von Säuglingen mit Lippen-Kiefer-Gaumen-Spalten

Zusammenfassung Die kieferorthopädische Säuglingsbehandlung widmet sich schwerpunktmäßig Neugeborenen mit orofazialen Spaltbildungen und Kindern mit Syndromen, vornehmlichDown-Syndrom. Über 100 Dysmorphiesyndrome können mit Spaltbildungen einhergehen.An klinischen Beispielen (Robin-Syndrom,Stickler-Syndrom) wird die Problematik der Syndromdiagnostik umrissen und an einem Fall (orofaziodigitales Syndrom) der Beitrag des in der Spaltfrührehabilitation tätigen Kieferorthopäden zur Syndromidentifikation aufgezeigt.

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Summary The orthodontist's early orthopaedic treatment of the newborn focuses on cleft palate infants and children withDowns syndrome. In more than 100 malformation syndromes, orofacial clefting occurs. The problem of syndrome diagnosis is discussed by way of clinical examples (Robin-syndrome,Stickler-syndrome).A case of oro-facial digital syndrome serves to demonstrate the orthodontists contribution to syndromic diagnosis in early cleft rehabilitation.

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Résumé Le traitement orthodontique précoce de nourrissons se voue dans le plus grand nombre des cas aux nouveaunés atteints de malformations orofaciales et aux enfants souffrant de syndromes, surtout du syndrome deDown (mongolisme). La formation de fentes peut être accompagnée de plus de 100 syndromes de malformations.La problématique du diagnostic de syndromes (séquence deRobin et syndrome deStickler) est esquissée à titre d'exemples cliniques et l'apport que l'orthodontiste s'occupant de la rééducation précoce de fentes labiomaxillaires peut faire à l'indentification de syndromes est mis en évidence à propos d'un cas spécifique (syndrome oro-facio-digital).

     

The effect of out-of-home activity intervention delivered by volunteers on depressive symptoms among older people with severe mobility limitations: a randomized controlled trial

Objectives: To examine the effects of an individualized outdoor activity intervention carried out by volunteers on depressive symptoms among community-living older people with severe mobility limitations who have difficulties accessing the outdoors independently.

Methods: Secondary analyses of the ‘Volunteering, Access to Outdoor Activities and Wellbeing in Older People’ (VOW) data (ISRCTN56847832). VOW was a randomized single blinded two-arm controlled trial conducted in Jyväskylä, Finland, in 2009–2011. At baseline, 121 people aged 67–92 years with severe mobility limitations were interviewed at home and randomized into either an intervention or waiting list control group. Volunteers (n = 47) had retired from regular work and were trained for the study. A volunteer assisted the participant in attending recreational out-of-home activities once a week for three months. Depressive symptoms were assessed using the Center for the Epidemiological Studies Depression Scale (CES-D).

Results: In the intervention group the CES-D score did not change during the intervention (from 15.1 ± standard error 0.9 to 15.1 ± 0.9), while in the control group it increased from 17.0 ± 1.3 to 19.1 ± 1.4 (intervention effect p = .096). Among the subgroups with minor depressive symptoms at baseline (CES-D score 16–20), the CES-D score decreased in the intervention group and increased in the control group (p = .025).

Conclusion: A three-month outdoor activity intervention may improve mood among older people with severe mobility limitations. More randomized controlled trials of the topic are needed.     

The Helsinki approach to face transplantation

Aim

We herein describe the establishment of the Helsinki Vascularized Composite Allotransplantation (VCA) program and its execution in the first two face transplant cases.

A hierarchical cluster analysis to determine whether injured runners exhibit similar kinematic gait patterns

Previous studies have suggested that runners can be subgrouped based on homogeneous gait patterns; however, no previous study has assessed the presence of such subgroups in a population of individuals across a wide variety of injuries. Therefore, the purpose of this study was to assess whether distinct subgroups with homogeneous running patterns can be identified among a large group of injured and healthy runners and whether identified subgroups are associated with specific injury location. Three-dimensional kinematic data from 291 injured and healthy runners, representing both sexes and a wide range of ages (10-66 years), were clustered using hierarchical cluster analysis. Cluster analysis revealed five distinct subgroups from the data. Kinematic differences between the subgroups were compared using one-way analysis of variance (ANOVA). Against our hypothesis, runners with the same injury types did not cluster together, but the distribution of different injuries within subgroups was similar across the entire sample. These results suggest that homogeneous gait patterns exist independent of injury location and that it is important to consider these underlying patterns when planning injury prevention or rehabilitation strategies.     

The T Cell Receptor (TCR) in HLA-B27-Restricted T Cell Responses - an Introduction

Summary D-penicillamine, an agent still used in the treatment of rheumatoïd arthritis (RA) may produce inflammatory myopathy or myositis. Some reported cases are documented with muscle biopsy. We report a 34-year old female, receiving the drug for more than 4 years, who consulted us with recently developed proximal muscle pain and weakness. EMG-findings were typical for inflammatory muscle disease; muscle enzymes remained normal. D-penicillamine was stopped and she was started on prednisolone with rapid improvement. The EMG-findings, with follow-up within three months, proved to be a good diagnostic tool, in the absence of laboratory muscle enzymes abnormalities.Correspondence to: Algemeen Ziekenhuis Middelheim Dienst Fysische Geneeskunde en Reumatologie Lindendreef 1 2020 Antwerpen, BELGIUM