Determinants of functioning of adolescents and young adults with cerebral palsy

Purpose. To describe the level of functioning of adolescents and young adults with cerebral palsy (CP) and study determinants of their level of functioning.

Method. In the CP Transition study, adolescents and young adults aged 16 - 20 years, diagnosed with CP without severe learning disabilities (n = 103) participated. In this group we assessed subject characteristics, i.e., age, type of CP, gross motor function (GMFCS), level of education as well as outcome measures on functioning in daily activities and social participation (Life Habits questionnaire, Vineland Adaptive Behavior Scale, Functional Independence Measure). Multivariate regression analyses were performed.

Results. About 20 - 30% of the participants encountered restrictions in daily activities (mobility, self-care, nutrition) and social participation (taking responsibility, community living, leisure activities and employment). The GMFCS level, level of education, and age proved to be important determinants of functioning in daily activities and social participation, explaining 70% and 66% of the variance in outcome respectively.

Conclusion. A significant number of adolescents and young adults with CP without severe learning disabilities are restricted in daily activities and social participation. These problems are mainly attributable to restricted gross motor functioning, a low level of education and younger age.     

Functional activities of the upper extremity of young adults with cerebral palsy: a limiting factor for participation?

Purpose. To assess functional activities of the upper extremity of young adults with cerebral palsy (CP) and to determine their relations with participant characteristics and participation.

Method. Assessment of functional activities of the upper extremity was performed on 103 participants (aged 16 - 20 years) with the Melbourne assessment and the Abilhand Questionnaire. Participation was measured with the Life Habits Questionnaire. Participant characteristics included age, gender, limb distribution of the spastic paresis, educational level and gross and fine motor function. Relations among these variables were studied by means of correlation coefficients and linear regression analysis.

Results. Limitations in functional activities of the upper extremity were related to the limb distribution of the spastic paresis and were especially present in quadriplegic participants. Significant correlations between participant characteristics and measures of functional activities were present. Limitations in functional activities of the upper extremity, measured with the Abilhand Questionnaire, were an important determinant for participation, in addition to the gross motor function and educational level.

Conclusion. Limitations in functional activities of the upper extremity are an important determinant for restrictions in participation in young adults with CP. It is recommended to include assessment of functional activities of the upper extremity in patients with CP.     

Personal and environmental factors contributing to participation in romantic relationships and sexual activity of young adults with cerebral palsy

Purpose: To study determinants of romantic relationships and sexual activity of young adults with cerebral palsy (CP), focusing on personal and environmental factors. Method: A cohort study was performed with 74 young adults (46 men; 28 women) aged 20–25 years (SD 1.4) with CP (49% unilateral CP, 76% GMFCS level I, 85% MACS level I). All participants were of normal intelligence. Romantic relationships, sexual activity (outcome measures), personal and environmental factors (associated factors) were assessed. Associations were analyzed using logistic regression analyses. Results: More females than males with CP were in a current romantic relationship. Self-esteem, sexual esteem and feelings of competence regarding self-efficacy contributed positively to having current romantic relationships. A negative parenting style contributed negatively. Age and gross motor functioning explained 20% of the variance in experience with intercourse. In addition, sexual esteem and taking initiative contributed significantly to intercourse experience. Conclusions: For young adults with CP personal factors (20–35% explained variances) seem to contribute more than environmental factors (9–12% explained variances) to current romantic relationships and sexual experiences. We advice parents and professionals to focus on self-efficacy, self-esteem and sexual self-esteem in development of young adults with CP.

Implications for Rehabilitation

• The severity of gross motor functioning contributed somewhat to sexual activities, but not to romantic relationships.

• High self-efficacy, self-esteem and sexual self-esteem can facilitate involvement in romantic and sexual relationships for young adults with CP.

     

Comparing the self concept of children with cerebral palsy to the perceptions of their parents

Purpose. To assess functional activities of the upper extremity of young adults with cerebral palsy (CP) and to determine their relations with participant characteristics and participation.

Method. Assessment of functional activities of the upper extremity was performed on 103 participants (aged 16 – 20 years) with the Melbourne assessment and the Abilhand Questionnaire. Participation was measured with the Life Habits Questionnaire. Participant characteristics included age, gender, limb distribution of the spastic paresis, educational level and gross and fine motor function. Relations among these variables were studied by means of correlation coefficients and linear regression analysis.

Results. Limitations in functional activities of the upper extremity were related to the limb distribution of the spastic paresis and were especially present in quadriplegic participants. Significant correlations between participant characteristics and measures of functional activities were present. Limitations in functional activities of the upper extremity, measured with the Abilhand Questionnaire, were an important determinant for participation, in addition to the gross motor function and educational level.

Conclusion. Limitations in functional activities of the upper extremity are an important determinant for restrictions in participation in young adults with CP. It is recommended to include assessment of functional activities of the upper extremity in patients with CP.     

SURAMIN ACTIVIY IN HUMAN HEAD AND NECK SQUAMOUS CELL CARCINOMA——Ⅱ.EFFECT OF SURAMIN ON HUMAN HEAD AND NECK CARCINOMA XENOGRAFTS AND RELATED TOXICITY AND PHARMACOKINETIC STUDIES IN NUDE MICE

In part Ⅰ of the study,we have demonstrated that suraminhas a marked antiproliferative effect on human head and neck squamous cellcarcinoma cell lines,In the present study,both toxicity and pharmacokineticstudies in nude mice were done.The treatment of nude mice bearing head andneck cancers with suramin showed that suramin had a minimal antitumor effect.The possible mechanism of suramin lacking antitumor effect is discussed.     

Hospitalization for respiratory syncytial virus infection in young children: development of a clinical prediction rule

BACKGROUND: Because passive immunization against respiratory syncytial virus (RSV) is costly, its use should be restricted to well-defined groups of high risk children. We aimed to develop a clinical prediction rule that estimates the individual monthly risk of hospitalization for RSV infection in young children. METHODS: A retrospective cohort study was conducted in the southwestern part of The Netherlands. We included children born between January 1, 1996 and December 31, 1998. Children hospitalized for proven RSV infection were compared with children not hospitalized for RSV infection. The monthly risk was estimated with a logistic regression model including 5 clinical predictors (gender, gestational age, birth weight, presence of bronchopulmonary dysplasia and age) and the mean seasonal monthly pattern of RSV infections. We compared the predictive performance of the prediction rule with the guidelines of the American Academy of Pediatrics (AAP). FINDINGS: Information was collected on 2469 hospitalized children and 140,661 children who were 1,181,790 months at risk. All predictors were statistically significant, with age and the seasonal monthly RSV pattern having the strongest effects. The clinical prediction rule that included these predictors could better discriminate between high and low risk children than the AAP guidelines and would potentially reduce the number of immunizations by 20%. INTERPRETATION: The prediction rule reliably estimates individual monthly risks of hospitalization for RSV infection in the population studied. It provides an improved index for passive immunization but further validation in other populations is required.     

银屑病和日光性角化病皮损应用氨基-γ-酮戊酸荧光染色后肉眼荧光强度与原卟啉Ⅸ含量的相互关系

应用5-氨基-γ-酮戊酸（ALA）诱导的卟啉荧光诊断（FDAP）中，肉眼可观察到原卟啉IX（PpIX）沉积。因操作重复性低，且涉及PpIX肿瘤选择的机制知之甚少，所以解释荧光数据仍有些困难。本研究中，作者要研究FDAP后银屑病和日光性角化病（AK）患者皮损的PpIX沉积情况。基于此目的，将患者脱屑区皮损和无皮损正常皮肤用20％ALA油孵育3h，进行FDAP，取强荧光区皮损和无皮损处皮肤活检。从活检标本中提取PpIX、蛋白质和双链DNA行荧光分光光度法定量，用图像分析软件分析由FDAP获得的数字图像。