Diagnostic value of a psychological test in cases of suspected child abuse

The use of the Bene-Anthony Family Relations Test is described and illustrated by three examples of child abuse. This test should be considered in the investigation of definite or suspected cases of abuse and as part of the preparation of court evidence.     

The physics of FeldenkraisPart 3: stability

In the last article in this series, we briefly examined the Principle of Least Effort and the five forms of strain. Strain, you may recall, in physics, describes a change in the volume of a material when a force is applied. Our treatments are a blend of rotation and translation movements of our hands with a changing mix of strains being applied onto the client's tissues. Harnessing and interweaving the various forms of strain with dexterity may aid us in improving our treatment efficacy.In this tissue, we will consider the importance of anchorage and stability in treatment, We will consider a set of ‘House Rules' for improving treatment. In addition, we will explore Bernstein's concept of degrees of freedom.     

Cerebrospinal fluid rhinorrhea: depiction with MR cisternography in dogs

Canine cerebrospinal fluid rhinorrhea, which occurs frequently in purebred beagles, was demonstrated in two dogs on magnetic resonance images after cisternal introduction of gadolinium-DTPA dimeglumine.     

The distribution of infectivity in blood components and plasma derivatives in experimental models of transmissible spongiform encephalopathy

BACKGROUND: The administration of blood components from donors who subsequently develop Creutzfeldt-Jakob disease has raised the issue of blood as a possible vehicle for iatrogenic disease. STUDY DESIGN AND METHODS: We examined infectivity in blood components and Cohn plasma fractions in normal human blood that had been "spiked" with trypsinized cells from a scrapie-infected hamster brain, and in blood of clinically ill mice that had been inoculated with a mouse-adapted strain of human transmissible spongiform encephalopathy. Infectivity was assayed by intracerebral inoculation of the blood specimens into healthy animals. RESULTS: Most of the infectivity in spiked human blood was associated with cellular blood components; the smaller amount present in plasma, when fractionated, was found mainly in cryoprecipitate (the source of factor VIII) and fraction I+II+III (the source of fibrinogen and immunoglobulin); almost none was recovered in fraction IV (the source of vitamin-K-dependent proteins) and fraction V (the source of albumin). Mice infected with the human strain of spongiform encephalopathy had very low levels of endogenous infectivity in buffy coat, plasma, cryoprecipitate, and fraction I+II+III, and no detectable infectivity in fractions IV or V. CONCLUSION: Convergent results from exogenous spiking and endogenous infectivity experiments, in which decreasing levels of infectivity occurred in cellular blood components, plasma, and plasma fractions, suggest a potential but minimal risk of acquiring Creutzfeldt-Jakob disease from the administration of human plasma protein concentrates.     

肾移植术后卡氏肺囊虫肺炎5例回顾性分析

目的:观察肾移植术后卡氏肺囊虫肺炎的发生率及治疗效果。方法:选择2003-01/2005-12在中山市人民医院行肾移植的患者112例,患者均知情同意。按是否使用猪抗人淋巴细胞免疫球蛋白分为2组,基础免疫抑制组(n=68)给予环孢素A/他克莫司 吗替麦考酚酯 强的松;抗体诱导组(n=44)给予猪抗人淋巴细胞免疫球蛋白 环孢素A/他克莫司 吗替麦考酚酯 强的松。两组共发生卡氏肺囊虫肺炎5例,其中基础免疫抑制组2例,抗体诱导组3例。5例患者通过普通抗感染治疗,3～7d病情未见好转,遂行支气管镜活检 深部吸痰培养,尽早明确病原体,指导抗菌治疗。比较两组患者卡氏肺囊虫肺炎的发生率,并观察其治疗效果。结果:5例卡氏肺囊虫肺炎患者全部进入结果分析,无脱落。①5例患者经支气管纤维镜肺组织活检确诊为卡氏肺囊虫肺炎,发生率为4.46%,其中抗体诱导组6.82%(3/44)明显高于基础免疫抑制组2.94%(2/68)。②5例卡氏肺囊虫肺炎中2例合并金黄色葡萄球菌感染。以复方磺胺甲恶唑为基础药物进行综合治疗,3例患者临床治愈出院,随访3个月,移植肾及肺功能正常;死亡2例。③5例患者治疗期间均无排斥反应发生。④在发病初期5例患者的CD4/CD8平均值为1.02±0.15,3例治愈患者的CD4/CD8平均值为1.42±0.23,在恢复过程中逐渐升高。2例死亡患者的CD4/CD8平均值为1.10±0.21。结论:早期支气管纤维内镜活检对肾移植术后卡氏肺囊虫肺炎的诊断非常重要,早期诊断、早期治疗是治愈的关键。猪抗人淋巴细胞免疫球蛋白可增加肾移植术后卡氏肺囊虫肺炎的发生率。     

A review of Aston Patterning

Judith Aston is a somatic pioneer. She began as a dancer and physical education teacher. Severe accidents prompted her to seek out Ida Rolf who not only worked on her but also entrusted her with developing the Rolf movement curriculum. She next followed her instincts and refined her concepts for helping people problem solve. For the past 28 years she has continued to improve the Aston Paradigm^® combining bodywork, ergonomic supports, exercises and movement therapy.     

Facilitating the decrease in fibromyalgic pain during metabolic rehabilitation: an essential role for soft tissue therapies

Recent evidence indicates that fibromyalgia (FMS) is a manifestation of impaired metabolism. In most cases, the cause is primarily inadequate thyroid hormone regulation of cell function. The measurable features of FMS can be improved or relieved in most patients through therapy that is best termed ‘metabolic rehabilitation’. For many patients undergoing metabolic rehabilitation, however, FMS pain scores normalize only after soft tissue treatment controls or eliminates noxious neural input from the musculoskeletal system to the central nervous system. Our studies and clinical experiences convince us that effective soft tissue therapy can expedite the typical patient's improvement or recovery. Neglecting to use such therapy can hinder recovery, even when the patient undergoes expertly conducted metabolic rehabilitation. This paper describes the probable mechanisms by which musculoskeletal lesions can sustain FMS pain, and gives guidelines for treating the FMS patient's soft tissues to facilitate the reduction of pain during metabolic rehabilitation.     

Shoulder disorders—Part 2: Examination

Thorough evaluation of patients with shoulder problems should classify patients into discreet diagnostic groups—red flags, impingement syndrome, adhesive capsulitis, shoulder instability. Most rotator cuff tendonitis patients fall into the impingement category. The most important aspect of the initial evaluation is to rule out red flags suggestive of tumor, infection or fracture. If present such patients always require additional testing and often referral.A patient will be classified into the impingement category if there is (a) pain with active shoulder motions (i.e., painful arc), (b) pain with overpressure of passive shoulder elevation (i.e., a positive Neer's test) or horizontal shoulder adduction/internal rotation (Hawkins test), and (c) painfully weak resisted shoulder motions. Impingement syndrome patients should also be evaluated for partial or full-thickness rotator cuff tears, especially if the response to 4–6 weeks of rehabilitation is unsatisfactory.Patients with adhesive capsulitis have severe ROM loss. The most restricted ROMs are with shoulder abduction, external rotation, and flexion. In contrast, patients with shoulder instability are hypermobile. A history of recurrent dislocations is often present. An apprehension sign may be present. SLAP II-IV lesions are common in this patient group and the labrum can be seen to be stretched anterior during many of the functional tests.