Associations between Manual Abilities, Gross Motor Function, Epilepsy, and Mental Capacity in Children with Cerebral Palsy

How to Cite This Article: Gajewska E, Sobieska M, Samborski W. Associations between Manual Abilities, Gross Motor Function, Epilepsy, and Mental Capacity in Children with Cerebral Palsy. Iran J Child Neurol. 2014 Spring 8(2):45-52.ObjectiveThis study aimed to evaluate gross motor function and hand function in children with cerebral palsy to explore their association with epilepsy and mental capacity. Material & MethodsThe research investigating the association between gross and fine motor function and the presence of epilepsy and/or mental impairment was conducted on a group of 83 children (45 girls, 38 boys). Among them, 41 were diagnosedwith quadriplegia, 14 hemiplegia, 18 diplegia, 7 mixed form, and 3 athetosis.A neurologist assessed each child in terms of possible epilepsy and confirmed diagnosis in 35 children. A psychologist assessed the mental level (according toWechsler) and found 13 children within intellectual norm, 3 children with mild mental impairment, 18 with moderate, 27 with severe, and 22 with profound.Children were then classified based on Gross Motor Function Classification System and Manual Ability Classification Scale.ResultsThe gross motor function and manual performance were analysed in relation to mental impairment and the presence of epilepsy. Epilepsy was found to disturb conscious motor functions, but also higher degree of mental impairment wasobserved in children with epilepsy.ConclusionThe occurrence of epilepsy in children with cerebral palsy is associated with worse manual function. The occurrence of epilepsy is associated with limitations in conscious motor functions. 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Qualitative assessment in the third month of life allows for a better prognosis of the achievement of motor milestones versus assessment of pathological reflexes- prospective studies on Polish children

IntroductionThe characteristic feature of primitive reflexes is that they occur early in development and must expire at a well-defined age. The study was conducted prospectively on a group of 107 children (74 boys). The study population included 83 infants born on time (weight 3,465 ± 395 g) and 24 born prematurely (weight 2,225 ± 793 g).MethodsAn analysis of motor development at 3 months of age consisting of a qualitative assessment (motor performance) and a check of reflexes was performed; at 9 months, the child was checked for crawling and sitting down, and at 16 months for walking.ResultsThe more abnormal reflexes, the less likely it was to achieve the assessed milestones in time. It is possible to notice that the qualitative assessment is, in each case, a better predictor of the milestones than any of the reflexes, except for walking, where the Babkin reflex was strongly predictive. However, the qualitative assessment sum still occupies the second and third positions in prone and supine positions.DiscussionThe occurrence of Babkin’s reflex at 3 months of age impacts the achievement of sitting down and walking functions. An abnormal Galant reflex was strongly associated with the lack of occurrence of crawling on time. At the same time, a high-quality score at 3 months of age guarantees the development of crawling on time, sitting down, and walking

Characterisation of the wheat phospholipid fraction in the presence of nickel and/or selenium

The influence of nickel (Ni) and/or selenium (Se) on phospholipid composition was studied in shoots and roots of wheat seedlings. Phospholipid differences between samples were analysed using liquid chromatography/electrospray ionization–MS coupled. A total of 39 lipid species were identified. Individual phospholipids were then quantified using a multiple reaction monitoring method. In the roots, Ni toxicity was associated with an elevated level of phosphatidic acid species. In the shoots, the phosphatidylcholine/phosphatidylethanolamine ratio was about fivefold higher than in roots and decreased in Ni-treated samples. Additionally, the concentrations of phospholipid species containing C 18:3 fatty acid were reduced. Lipidome data were then analyzed using principal component analysis, which confirmed the compositional changes in phospholipids in response to Ni and Ni ? Se. In contrast, the phospholipid profiles of wheat seedlings exposed to Se alone showed more similarities with the control. Together, our results suggested that the presence of Se, despite a considerable improvement of growth of Ni-treated wheat, did not counterbalance negative effect of Ni on the phospholipid composition in wheat roots and shoots

Comparison of endometrial biopsy and postoperative hysterectomy specimen findings in patients with atypical endometrial hyperplasia and endometrial cancer

Objectives: The aim of the study was to assess the concordance between the preoperative endometrial sampling and microscopic examination of the hysterectomy specimens in patients surgically treated for atypical endometrial hyperplasia and endometrial carcinoma. Material and methods: We analysed a group of 204 patients, of whom 160 (78.43%) underwent surgical treatment for cancer of the corpus uteri and 44 (21.57%) for atypical endometrial hyperplasia. The preoperative diagnosis was based on the histological examination of endocervical and endometrial samples obtained by fractional curettage and it was compared to the histological findings at hysterectomy. The comparison was made for the basic diagnosis, the histological type of the cancer and the grade of tumour differentiation. Results: When the histological types of cancer diagnosed in endometrial curettage and hysterectomy specimens were com­pared, the concordance was observed in 134/160 patients (83.75%). The highest concordance was found for endometrioid carcinoma (127/148 patients, 85.81%). The grade of tumour differentiation was accurate in 69.31% of patients. The highest concordance was for moderately differentiated carcinomas. Of 44 patients who underwent surgical treatment for atypical endometrial hyperplasia, the preoperative diagnosis was confirmed by the postoperative histopathological examination in 21 patients (47.73%). In 15 patients (34.09%) endometrial cancer was diagnosed at hysterectomy. Conclusions: In endometrial cancer our findings demonstrate a high level of concordance between the histological diagnosis on endometrial curettage and at hysterectomy. Own observations have confirmed that over 30% of patients undergoing surgical treatment for atypical endometrial hyperplasia have concurrent endometrial cancer which is determined by surgery

Subclinical target organ damage in patients with essential hypertension

W ostatnich dekadach dokonał się znaczący postęp w możliwościach oceny struktury i funkcji układu sercowo-naczyniowego, który u chorych z nadciśnieniem tętniczym pierwotnym umożliwił ocenę wczesnych zmian w obrębie serca i naczyń. Za najbardziej charakterystyczne zmiany w sercu w przebiegu nadciśnienia uważa się pogrubienie ścian, wzrost masy mięśnia lewej komory, przebudowę komory oraz dysfunkcję rozkurczową. Przyjmuje się, że u chorych z nadciśnieniem tętniczym pogrubienie błony wewnętrznej i środkowej oceniane najczęściej w obrębie tętnicy szyjnej poprzedza rozwój ogniskowych zmian miażdżycowych. Badania rozpoczęte na początku lat 90. ubiegłego wieku dostarczyły dowodów wskazujących na rozwój dysfunkcji śródbłonka w przebiegu nadciśnienia tętniczego. Mikroalbuminuria należy do najwcześniejszych objawów uszkodzenia nerek w przebiegu nadciśnienia i zaliczana jest do najważniejszych czynników ryzyka sercowo-naczyniowego. Wyniki dotychczasowych badań wskazują na związek mikroalbuminurii zarówno z klasycznymi, jak i nowo poznanymi czynnikami ryzyka.Assessment of subclinical target organ damage is a key element in the management of patients with hypertension. Impaired diastolic function and increased LV mass are common findings in hypertensive patients and may occur early in the natural history of hypertension. Ultrasonographic measurements of intima-media thickness (IMT) in carotid arteries are being applied extensively and have been regarded as a valid indicator of atherosclerosis. Several studies showed association between IMT and hypertensive target organ damage, cardiovascular events and risk factors. Microalbuminuria is a marker for generalized vascular dysfunction, is the earliest sign of nephropathy and predicts target organ damage, notably renal disease. Hypertensive patients with microalbuminuria had a significantly higher prevalence of CAD, LV hypertrophy, MI and stroke. The modern goal of the treatment of hypertension is to prevent progression, or even to reverse, subclinical target organ damage

The Polish Version of the Alberta Infant Motor Scale: Cultural Adaptation and Validation

The Alberta Infant Motor Scale (AIMS) is a diagnostic tool for the assessment of the motor performance of infants from the time of birth, to the period of independent walking (0–18 months). This study aims to derive a Polish version of the AIMS through its cultural adaptation and validation. The study included 145 infants aged 0–18 months, who were divided into four further age groups: 0–3 months, 4–7 months, 8–11 months, and older than 12 months. The validation was based on an analysis of intrarater and interrater reliability values, as well as concurrent validity, using the gross motor scale of Peabody Developmental Motor Scales-2 (PDMS-2). The total Intraclass Correlation Coefficient (ICC) for intrarater reliability was 0.99 (ICC range in positions was 0.87–0.99, in subgroups was 0.91–0.99), while in particular positions, the ICC ranges were as follows: prone 0.97–0.99, supine 0.94–0.99, sitting 0.95–0.99, and standing: 0.63–0.99. The total ICC for interrater reliability was 0.99 (ICC range in positions was 0.98–0.99, in subgroups was 0.91–0.99), while in particular positions, the ICC ranges were as follows: prone 0.95–0.99, supine 0.93–0.96, sitting 0.93–0.98, standing 0.91–0.98. Only the standing position was analyzed for the subgroup of participants over 12 months old. The Spearman correlation between the Polish version of the AIMS and the gross motor scale of PDMS-2 was significant in the total population (r = 0.97, p < 0.0001) and in subgroups (r = 0.79–0.85, p < 0.0001). The results of our study confirm that the Polish version of the AIMS is reliable for infants aged 0–18 months and can be applied to this population for clinical and scientific purposes.Trial RegistryClinicalTrials.gov ID NCT05264064, URL https://clinicaltrials.gov/ ct2/show/NCT05264064

Achieving Motor Development Milestones at the Age of Three Months May Determine, but Does Not Guarantee, Proper Further Development

Proper motor performance at 3rd month is necessary for further motor development. The paper aims to demonstrate the reliability, sensitivity, and predictive value of an original motor performance assessment tool in comparison with the neurological assessment at 3, 6, and 9 months. Children (n=123), born at term without pre- or perinatal complications, born at term with pre- or perinatal complications, or born preterm, were assessed at the age of 3, 6, and 9 months, by a neurologist and a physiotherapist. The physiotherapist evaluated 15 qualitative features typical for the age of 3 months in the prone and supine positions. The final neurological assessment determined the degree of developmental disorder. Neurological and global physiotherapeutic assessments showed a statistically significant correlation. Qualitative assessment results were very good in healthy children and decreased with worsening neurological diagnoses. Children diagnosed with cerebral palsy did not show proper qualitative features of 3 months when analyzed at 3, 6, and 9 months. Children with delayed motor development revealed minor qualitative performance impairments as early as 3 months but improved with age. Qualitative assessment at 3 months not only facilitates diagnosis of major developmental disorders but is also a good predictor of delayed motor development in children

Is there the gap in public health literature in Europe?

Introduction and objective: The growing expectations for the effectiveness of public health increase the demand for scientific literature, concerning research, reviews and other forms of information. The bibliographic databases are of crucial importance for researchers and policy makers. The objective of this study is to estimate the supply of scientific literature related to public health in selected European countries, which are available to a wide range of users. Material and Methods: Analysis of the number of bibliographic records on topics related to public health was based on searches in Ovid MEDLINE ( R) in May and June 2011. According to MeSH terms, 11 keywords and names of 13 European countries were used in the search. Publications from the years 2001–2010 were analyzed. A number of publications indexed under ‘public health’, and related to selected countries were compared with the size of the population of those countries, GDP, total expenditure on health and burden of disease (DALYS’s). Results: The most popular topic was ‘health policy’, whereas the topics ‘occupational health’ and ‘environmental health’ were less prevalent. There were no significant changes in the number of publications in 2001–2010. The number of articles indexed under ‘public health’ had significant positive correlation with national GDP, expenditure on health and population size, and negative with DALY’s. Conclusions: According to the criteria accepted in this study, the Nordic countries – Finland, Sweden and Norway – were very productive in this respect. Poland and other Central European Countries were less productive

Three pregnancies in a Marfan syndrome patient after a mitral and tricuspid valve surgery

Marfan syndrome is an autosomal dominant disorder of connective tissue with up to 25% of cases related to a spontaneous mutation. It has been associated with perinatal loss, preterm labor, and, potentially, a rupture of the maternal aortic arch. We present a case of a woman diagnosed with Marfan syndrome after a miscarriage of her first pregnancy. At the time of diagnosis she had mild aortic bulb dilation and insufficiency of the mitral and tricuspid valves. She underwent cardiosurgical correction, after which she had two uneventful pregnancies. This case suggests that preconceptional correction of valve defects in women with Marfan syndrome may decrease the risk of cardiac decompensation during future pregnancies. Additionally, close clinical follow up and the appropriate use of beta-adrenergic blockade may decrease the risk of aortic rupture, a significant risk factor for mortality in pregnant women

Tobacco Smoke Exposure During Pregnancy Increases Maternal Blood Lead Levels Affecting Neonate Birth Weight

To assess the effect of lead exposure from cigarette smoke on fetal growth, blood lead concentrations were measured using inductively coupled plasma mass spectrometry in 150 healthy pregnant women. Mean lead concentrations in plasma and whole blood were significantly higher in the smoking group compared with the nonsmoking group in each trimester of pregnancy (p < 0.001). Logistic regression analysis showed the highest impact of the number of cigarettes smoked per day for serum lead concentration (β = 0.238; p < 0.05), while in whole blood, it was duration of smoking before conception (β = 0.297; p < 0.001). Birth weight of the smoking mothers' infants was significantly lower (mean ± SEM, 3,192 ± 50.8 and 3,569 ± 49.6 g, respectively; p < 0.001) and negatively correlated with lead levels in plasma (r = −0.38; p < 0.001) and in whole blood (r = −0.27; p < 0.001). Therefore, it is suggested that smoking during pregnancy increases lead concentrations in maternal blood. Fetal exposure to low doses of lead in utero may be a serious risk factor causing lower birth weight