Physiological evaluation of gait disturbances post stroke.

A large proportion of stroke survivors have to deal with problems in mobility. Proper evaluations must be undertaken to understand the sensorimotor impairments underlying locomotor disorders post stroke, so that evidence-based interventions can be developed. The current electrophysiological, biomechanical, and imagery evaluations that provide insight into locomotor dysfunction post stroke, as well as their advantages and limitations, are reviewed in this paper. In particular, electrophysiological evaluations focus on the contrast of electromyographic patterns and integrity of spinal reflex pathways during perturbed and unperturbed locomotion between persons with stroke and healthy individuals. At a behavioral level, biomechanical evaluations that include temporal distance factors, kinematic and kinetic analyses, as well as the mechanical energy and metabolic cost, are useful when combined with electrophysiological measures for the interpretation of gait disturbances that are related to the control of the central nervous system or secondary to biomechanical constraints. Finally, current methods in imaging and transcranial magnetic stimulation can provide further insight into cortical control of locomotion and the integrity of the corticospinal pathways.     

Lisch nodules after trabeculectomy.

The development of Lisch nodules in an eye that had undergone trabeculectomy with mitomycin C is described. Complete ophthalmologic examinations and genetic testing of a 12-year-old boy were performed. Lisch nodules can develop after trabeculectomy without the systemic manifestations of neurofibromatosis type 1.     

Mental health issues in the workplace: maintaining a productive work force.

Occupational health nurses must intervene early and validate the conditions and experiences of employees with psychiatric disabilities. Occupational health nurses must ensure employees are receiving appropriate treatment. They must be aware of and prepared to mitigate iatrogenic influences. Occupational health nurses can facilitate resolution of workplace conflicts and issues regarding changing supervisors or departments. They can also facilitate return to work by establishing clear restrictions and coordinating accommodations. compassionate and supportive, yet assertive, approach is key to managing mental health disability. It will, in most cases, facilitate successful return to full-time work.     

Long-term results of dietary fenbendazole to eradicate Syphacia muris from rat colonies.

The pinworm Syphacia muris was eradicated from rats after treatment with fenbendazole-medicated chow (150 ppm) and without environmental decontamination for > 54 months. However, this regimen was successful only when the treatment was delivered and efficacy monitoring was done by personnel of the institutional animal resources program. The same pinworm elimination program failed 7 to 24 months after the cessation of treatment in a satellite colony in which animal care, including provision of medicated diet and sample collection for efficacy monitoring, was provided by research personnel. A failure to uniformly deliver adequate therapeutic doses or reinoculation of rats with pinworm eggs from the contaminated environment could not be excluded as causes of the failure. However, there were risk factors, and animal care practices unique to the satellite colony that may have facilitated the re-emergence of pinworms. These risk factors included hand-washing of cages, storage of contact bedding in areas that were not vermin-proof, and animal care provided by personnel having contact with rodents of pet-store origin.     

Tics moderate treatment outcome with sertraline but not cognitive-behavior therapy in pediatric obsessive-compulsive disorder.

BACKGROUND: The presence of a comorbid tic disorder may predict a poorer outcome in the acute treatment of pediatric obsessive-compulsive disorder (OCD). METHODS: Using data from the National Institute of Mental Health (NIMH)-funded Pediatric OCD Treatment Study (POTS) that compared cognitive-behavior therapy (CBT), medical management with sertraline (SER), and the combination of CBT and SER (COMB), to pill placebo (PBO) in children and adolescents with OCD, we asked whether the presence of a comorbid tic disorder influenced symptom reduction on the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) after 12 weeks of treatment. RESULTS: Fifteen percent (17 of 112) of patients exhibited a comorbid tic disorder. In patients without tics, results replicated previously published intent-to-treat outcomes: COMB > CBT > SER > PBO. In patients with a comorbid tic disorder, SER did not differ from PBO, while COMB remained superior to CBT and CBT remained superior to PBO. CONCLUSIONS: In contrast to CBT outcomes, which are not differentially impacted, tic disorders appear to adversely impact the outcome of medication management of pediatric OCD. Children and adolescents with obsessive-compulsive disorder and a comorbid tic disorder should begin treatment with cognitive-behavior therapy alone or the combination of cognitive-behavior therapy plus a serotonin reuptake inhibitor.     

Gender differences in condom-related behaviors and attitudes among Mexican adolescents living on the U.S.-Mexico border.

Adolescents are at increasing risk for HIV infection in Mexico. Research on gender differences in risk behaviors and determinants is needed to develop effective HIV prevention interventions targeting Mexican adolescents. This study examined gender differences in the likelihood of unprotected sex and theoretical correlates among high school students in the border city of Tijuana. Three hundred seventy high-school students completed a face-to-face interview and a self-administered survey. Differences in sexual initiation, condom use, intentions to use condoms in the future, and attitudes towards condoms in this population were assessed. Although male students initiated sexual practices earlier than females, females were more likely to have unprotected sex. Females perceived themselves as more likely to avoid unprotected sex in the future and held more favorable attitudes about condoms. The results suggest that stereotypical gender roles and communication barriers place Tijuana female high school students at higher risk for HIV infection than their male peers.