Does preterm birth affect global and configural processing differently?

Aim We investigated whether preterm birth affects later visuocognitive function and, in particular, whether it affects global and configural perceptual processing differently. Method We compared the performance of 21 healthy preterm children (8 females, 13 males; mean age 7y 8mo, SD 8mo; mean gestational age 29.3wks, SD 1.9; mean birthweight 1186.5g, SD 377.2) with that of a matched term comparison group (8 females, 13 males; mean age 7y 11mo, SD 1y 1mo; mean gestational age >37wks; mean birthweight >2500g) in two perceptual tasks pinpointing differences between local and global and between local and configural processing. Results There was no difference between preterm and term children’s global processing, as both groups showed a bias towards global information (preterm: t[1,20]=2.6, p=0.01; comparison group: t[1,20]=3.0, p=0.01). By contrast, no such typical pattern of performance was found for configural processing as, unlike the comparison group (t[1,20]=7.1, p<0.001), preterm children preferentially relied on local rather than on configural information (t[1,20]=?15.4, p<0.001). Interpretation These findings suggest that preterm birth may have a greater influence on the development of later perceptual skills than originally envisaged. We discuss the results according to the current and dominant view of the visual system.     

The Predilection of Chickenpox Exanthema to Influenza Vaccine Injection Site

Abstract:   Annual influenza immunization of children is highly recommended and is usually well tolerated. We report the first case of chickenpox exanthema localized to the influenza vaccination site in a boy with known egg allergy.     

Repeat botulinum toxin-A injections in the upper limb of children with hemiplegia: a randomized controlled trial

Aim  To test the effectiveness of repeat botulinum toxin A (BoNT‐A) injections in the affected arm of 22 children with hemiplegic cerebral palsy (19 males, three females), aged 1 year 10 months to 4 years 10 months (mean 3y 8mo, SD 9mo) in a randomized controlled trial. Method  Children received either three series of BoNT‐A injections plus twice‐weekly occupational therapy (OT) or OT alone in 16‐week cycles. Muscles targeted at each injection cycle in the 11 children receiving BoNT‐A+OT were the adductor pollicis (n=9), flexor pollicis longus (n=5), flexor digitorum superficialis (n=8), flexor digitorum profundus (n=8), flexor carpi radialis (n=2), flexor carpi ulnaris (n=6), pronator teres (n=10), and biceps brachii (n=11). Parental perception of treatment efficacy was assessed using the Canadian Occupational Performance Measure (COPM) and the Goal Attainment Scale (GAS), quality of movement using the Quality of Upper Extremity Skills Test (QUEST), fine motor skills using the Peabody Developmental Motor Scale – Fine Motor (PDMS‐FM), and spasticity using the Modified Tardieu Scale (MTS). Between‐group differences at 12 months were analysed using independent‐sample t‐tests. Results  All children were at Gross Motor Function Classification System levels I (BoNT‐A+OT n=6; OT n=8) or II (n=5 and n=3 respectively) and were too young to be classified using the Manual Ability Classification System. The BoNT‐A+OT group had higher COPM performance scores (mean difference ?0.8, 95% confidence interval [CI] ?1.5–0.0) and higher GAS T scores (mean difference ?6.9, 95% CI ?13.8 to ?0.1]). No significant difference was found for the COPM satisfaction, PDMS‐FM, or QUEST scores. The BoNT‐A+OT group showed progressive reduction in spasticity compared with the OT group. At study completion MTS mean difference was 50.0° (95% CI 22.4–77.6) for pronators and 20.9° (95% CI 2.4–39.4) for wrist flexors. Interpretation  Repeat BoNT‐A injections in the upper limb combined with OT resulted in progressively reduced spasticity and improved parental perception of performance.     

Long-Term Efficacy of Anchored Barbed Sutures in the Face and Neck

BACKGROUND The thread lift is a minimally invasive procedure that uses barbed sutures, inserted subcutaneously, to produce lifting of ptotic tissue of the face and neck. There are currently very limited data on longevity and patient satisfaction following barbed suture lifting procedures.
OBJECTIVE The purpose of this study was to assess long-term efficacy following the use of barbed sutures.
MATERIALS AND METHODS A satisfaction survey was mailed to 20 patients who were a minimum of 6 months (range, 6 to 16 months) postprocedure. Physician assessment of pre- and postprocedure photographs was also performed.
RESULTS At an average of 11.5 months postprocedure, patients felt that the barbed suture lift met their expectations, rating their satisfaction a 6.9 on a scale of 1 to 10. Independent physicians rated the overall improvement an average of 4.6 of 10. Higher scores were noted in Zone 1 (tear trough/malar fat pad and nasolabial folds) compared to Zone 2 (marionette lines, jowls, and jawline definition) and Zone 3 (platysmal bands and neck contour).
CONCLUSION The barbed suture lift procedure provides moderate long-term and sustained improvement for facial laxity, with most improvement seen in the tear trough/malar fat pads and nasolabial folds. In this study, clinical efficacy was seen up to 16 months postprocedure.     

Muscle Strength in Girls with Congenital Adrenal Hyperplasia

ABSTRACT. To assess whether exposure to excessive adrenal androgens increases muscle strength in girls with congenital adrenal hyperplasia, eighteen girls with 21 hydroxylase type congenital adrenal hyperplasia (CAH), aged 4.3–12.1 years were studied and compared with 78 healthy control girls aged 4–16 years. Maximum voluntary isometric strength was measured using a muscle testing chair, and the highest value from at least three attempts with each leg was recorded. Height and weight were also measured in the patients and controls. When compared with normal girls of similar age, some of the girls with CAH seemed unusually strong, but this difference was less marked when the CAH girls were compared with controls of similar weights. However, our data suggest that girls diagnosed later in childhood may have unusual muscle strength.     

NON-MALICIOUS ABSCONDING IN A MENTALLY HANDICAPPED WOMAN: SHORT-TERM SUCCESS BUT LONG-TERM PROBLEMS

Sometimes, the environment in which mentally handicapped people live is primarily responsible for some particular problem behaviour. We would like to present a situation where this seemed to be the case and to describe a procedure which helped initially to alleviate the problem but which, in the long-term, proved to be of limited usefulness. This was due, we believe, to difficulties inherent in many of our hospitals for the mentally handicapped, which are discussed below.