Amount and timing of group-based childcare from birth and cognitive development at 51 months: a UK study

This study investigated whether the amount and timing of group-based childcare between birth and 51 months were predictive of cognitive development at 51 months, taking into account: other non-parental childcare; demographic characteristics; cognitive development at 18 months, sensitive parenting and a stimulating home environment. Children’s (N=978) cognitive development was assessed at 51 months with four subscales of the British Ability Scales, two verbal and two non-verbal. Mothers were interviewed and observed at 3, 10, 18, and 36 months and the quality of group care was assessed at 10, 18 and 36 months (N=239) if it was used for ≥12 hours per week. Age of starting in group care and amount were highly associated (r=-.75). Multiple regressions indicated that, controlling for other factors, higher cognitive development and particularly non-verbal ability was associated with more hours per week in group care from 0 to 51 months, or an earlier start, or group care before age 2. Nevertheless, the majority of variance was explained by other predictors: sex (girl), higher cognitive development at 18 months, older mother, first language English, mother of white ethnic background, with more qualifications, higher family social class, more maternal responsivity at 10 months and a more stimulating home learning environment (HLE) at 36 months. Hours per week in relative care or home-based care were not significant predictors of cognitive scores. For the smaller relatively advantaged sample who had group care quality information (N=239), quality was a marginal predictor of better cognitive development but age of starting group care was not. Most variance was explained by 18 month cognitive development, maternal education and family social class

Clinical examination, MRI and arthroscopy in meniscal and ligamentous knee Injuries – a prospective study

Data from 565 knee arthroscopies performed by two experienced knee surgeons between 2002 and 2005 for degenerative joint disorders, ligament injuries, loose body removals, lateral release of the patellar retinaculum, plica division, and adhesiolysis was prospectively collected. A subset of 109 patients from the above group who sequentially had clinical examination, MRI and arthroscopy for suspected meniscal and ligament injuries were considered for the present study and the data was reviewed. Patients with previous menisectomies, knee ligament repairs or reconstructions and knee arthroscopies were excluded from the study. Patients were categorised into three groups on objective clinical assessment: Those who were positive for either meniscal or cruciate ligament injury [group 1]; both meniscal and cruciate ligament injury [group 2] and those with highly suggestive symptoms and with negative clinical signs [group 3]. MRI was requested for confirmation of diagnosis and for additional information in all these patients. Two experienced radiologists reported MRI films. Clinical and MRI findings were compared with Arthroscopy as the gold standard. A thorough clinical examination performed by a skilled examiner more accurately correlated at Arthroscopy. MRI added no information in group 1 patients, valuable information in group 2 and was equivocal in group 3 patients. A negative MRI did not prevent an arthroscopy. In this study, specificity, positive and negative predictive values were more favourable for clinical examination though MRI was more sensitive for meniscal injuries. The use of MRI as a supplemental tool in the management of meniscal and ligament injuries should be highly individualised by an experienced surgeon

The correlation between exaggerated fluid in lumbar facet joints and degenerative spondylolisthesis: prospective study of 52 patients

Magnetic resonance imaging (MRI) is often used to evaluate low back pain; however, MRI in the supine position does not always reveal degenerative spondylolisthesis. The existence of a linear correlation between increased fluid in the facet joints seen on the supine axial T2 MRI of the lumbosacral spine and lumbar instability seen on standing lateral flexion-extension lumbosacral radiographs has recently been reported. The objective of this prospective study was to determine the incidence of increased fluid in the lumbar facet joints seen on the supine axial T2 MRI, and to evaluate the correlation of this finding with radiographic evidence of lumbar instability

Radiculopathy as Delayed Presentations of Retained Spinal Bullet

Bullet injuries to the spine may cause injury to the anatomical structures with or without neurologic deterioration. Most bullet injuries are acute, resulting from direct injury. However, in rare cases, delayed injury may occur, resulting in claudication. We report a case of intradural bullet at the L3-4 level with radiculopathy in a 30-year-old male. After surgical removal, radicular and claudicating pain were improved significantly, and motor power of the right leg also improved. We report the case of intradural bullet, which resulted in delayed radiculopathy