Impact of intensive upper limb rehabilitation on quality of life: a randomized trial in children with unilateral cerebral palsy

Aim The aim of this study was to determine whether constraint‐induced movement therapy is more effective than bimanual training in improving the quality of life of children with unilateral cerebral palsy (CP). Method Sixty‐three children (mean age 10y 2mo [SD 2y 6mo]; 33 males, 30 females) with CP of the spastic motor type (n=59) or with spasticity and dystonia (n=4) were randomly allocated to two groups. The children were assessed as Manual Ability Classification System level I (n=16), II (n=46), or III (n=1). Each group received 6 hours of daily intervention (either constraint‐induced movement therapy [CIMT] or bimanual training [BIM]) for 10 days over a 2‐week period (total intervention time 60h). Children aged 9 years and older completed the Cerebral Palsy Quality of Life Questionnaire for Children (CPQOL‐Child) and those aged 8 years and older completed the KIDSCREEN‐52. All parents completed proxy versions of each measure. Assessments were made at baseline and at 3, 26, and 52 weeks after the end of the intervention. Results Thirty‐five children completed the CPQOL‐Child and 41 completed the KIDSCREEN‐52. No changes in social or emotional well‐being were reported by children in either group. Children and parents from both groups reported a significant improvement in their or their child’s feelings about functioning as well as participation and physical health on the CPQOL‐Child. The parents of children receiving CIMT reported positive and sustained changes in their child’s social well‐being (CPQOL‐Child). The CIMT group showed significant improvements in physical well‐being, psychological well‐being, and moods and emotions (KIDSCREEN‐52) at 3 weeks post intervention, which were maintained over the study period. Interpretation Intensive goal‐directed upper limb training programmes using either CIMT or BIM achieved domain‐specific changes in quality of life relating to feelings about functioning and participation and physical health. A condition‐specific quality of life compared with a generic measure may be better able to detect changes in quality of life in children with unilateral CP.     

Genetic associations with performance on a behavioral measure of distress intolerance

Both theory and empirical evidence support possible associations between two candidate genetic polymorphisms (SLC6A4 5-HTTLPR l/s and COMT Val(158)Met--rs4680 variants) and emotion-regulation difficulties. One particular form of emotion-regulation difficulty, distress intolerance, has been measured using a behavioral assessment in youth; data indicate a relationship with poor psychological functioning. No prior study has investigated genetic influences on emotion-regulation difficulties in youth. As part of a larger longitudinal study on adolescent risk behaviors, 218 10-14 year-old youths from the metropolitan Washington, D.C., area completed a measure of distress intolerance, the Behavioral Indicator of Resilience to Distress (BIRD), and provided saliva samples for DNA extraction and genotyping. Results indicate that those with one or two copies of the s allele of the 5-HTTLPR polymorphism were more likely to perform poorly on the task (i.e., choose to quit) than were those homozygous for the l allele. Participants who were Val allele carriers of the COMT Val(158)Met polymorphism were also more likely to quit the task compared to Met homozygotes. A summative risk allele score was created to combine the two polymorphisms, and each risk allele was associated with a 1.75 fold increased likelihood of quitting the task. Exploratory analyses revealed that emotional abuse moderated the relationship between the 5-HTTLPR and BIRD performance, as well as the genetic risk allele and the BIRD. This is the first investigation of genetic predictors of a behavioral measure of tolerance to distress. Results suggest that distress tolerance is at least partially regulated by specific genetic variants. Implications are discussed.     

A new set of microsatellite loci for Leptonycteris yerbabuenae and cross species amplification with other glossophagines

A technique based on 454 sequencing of an enriched library was used to construct genomic libraries highly enriched for microsatellite loci for Leptonycteris yerbabuenae. Twenty-four polymorphic microsatellites were developed and tested as markers in the target species. We probed ascertainment bias in 5 different glossophagines (L. nivalis, Glossophaga leachii, G. soricina, Anoura geoffroyi, and Choeronycteris mexicana), indicating their potential utility for suitable studies of population genetics and other related analyses. Levels of expected heterozygosity were medium?Clow for all markers (mean H_E?=?0.147, range 0.008?C0.46).     

Omega-3 Fatty acids and pregnancy

Omega-3 fatty acids are essential fatty acids that must be consumed in the diet. Adequate consumption of omega-3 fatty acids is vitally important during pregnancy as they are critical building blocks of fetal brain and retina. Omega-3 fatty acids may also play a role in determining the length of gestation and in preventing perinatal depression. The most biologically active forms of omega-3 fatty acids are docosahexaenoic acid and eicosapentaenoic acid, which are primarily derived from marine sources such as seafood and algae. Recent surveys, however, indicate that pregnant women in the United States and in other countries eat little fish and therefore do not consume enough omega-3 fatty acids, primarily due to concern about the adverse effects of mercury and other contaminants on the developing fetus. This review discusses the benefits of omega-3 fatty acid consumption during pregnancy and provides guidelines for obstetricians advising patients.     

Primary left atrial fibrosarcoma

An elderly female with refractory cardiovascular symptoms due to functional mitral stenosis secondary to a primary left atrial fibrosarcoma is described. The symptoms are often nonspecific and most of the patients present first time with hemodynamic compromise. A high index of suspicion is essential for the early diagnosis of these highly malignant cardiac tumors because of their rarity, a wide spectrum of nonspecific symptoms and poor survival.