Splint: the efficacy of orthotic management in rest to prevent equinus in children with cerebral palsy, a randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>Range of motion deficits of the lower extremity occur in about the half of the children with spastic cerebral palsy (CP). Over time, these impairments can cause joint deformities and deviations in the children's gait pattern, leading to limitations in moblity. Preventing a loss of range of motion is important in order to reduce secondary activity limitations and joint deformities. Sustained muscle stretch, imposed by orthotic management in rest, might be an effective method of preventing a decrease in range of motion. However, no controlled study has been performed.</p> <p>Methods</p> <p>A single blind randomised controlled trial will be performed in 66 children with spastic CP, divided over three groups with each 22 participants. Two groups will be treated for 1 year with orthoses to prevent a decrease in range of motion in the ankle (either with static or dynamic knee-ankle-foot-orthoses) and a third group will be included as a control group and will receive usual care (physical therapy, manual stretching). Measurements will be performed at baseline and at 3, 6, 9 and 12 months after treatment allocation. The primary outcome measure will be ankle dorsiflexion at full knee extension, measured with a custom designed hand held dynamometer. Secondary outcome measures will be i) ankle and knee flexion during gait and ii) gross motor function. Furthermore, to gain more insight in the working mechanism of the orthotic management in rest, morphological parameters like achilles tendon length, muscle belly length, muscle fascicle length, muscle physiological cross sectional area length and fascicle pennation angle will be measured in a subgroup of 18 participants using a 3D imaging technique.</p> <p>Discussion</p> <p>This randomised controlled trial will provide more insight into the efficacy of orthotic management in rest and the working mechanisms behind this treatment. The results of this study could lead to improved treatments.</p> <p>Trial Registration Number</p> <p>Nederlands Trial Register <a href="http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2091">NTR2091</a></p

CARRIER TRANSPORT IN MESOSCOPIC SILICON-COUPLED SUPERCONDUCTING JUNCTIONS

An overview is presented of experimental results on supercurrent flow and transport at finite voltages in a well-characterized, sandwich-type superconductor-semiconductor-superconductor junction. Carrier transport through the structure is found to be dominated by the interfaces. At low temperatures, inelastic scattering is negligible in the intermediate silicon layer and the system is mesoscopic. Application of a voltage results in a strongly nonthermal carrier distribution in the bulk of the semiconductor. The details of the distribution depend on elastic and Andreev scattering at the interfaces and are directly reflected by the measured current-voltage characteristics. The supercurrent is well described by a recent theory for the proximity effect that takes into account the reduction of the superconducting order parameter across the superconductor-semiconductor interface. Supercurrent measurements to identify a possible interplay between the superconductor phase and the single carrier phase in the semiconductor are discussed

The effects of golimumab treatment on systolic and diastolic left ventricular function in ankylosing spondylitis

SC Heslinga,1,2 TC Konings,3 IE van der Horst-Bruinsma,1,2 O Kamp,3 VP van Halm,3,4 HACM de Bruin-Bon,4 MJ Peters,5 MT Nurmohamed1,2 1Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Reade, Amsterdam, The Netherlands; 2Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, VU University Medical Center, Amsterdam, The Netherlands; 3Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands; 4Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands; 5Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands Background: Diastolic left ventricular (LV) dysfunction appears more prevalent in ankylosing spondylitis (AS). The effects of tumor necrosis factor alpha (TNF-&alpha;) blocking therapy, a strong and effective anti-inflammatory drug, on diastolic LV function in AS are unknown. The objective of the study was to find the effects of 1-year treatment with golimumab 50 mg subcutaneously once per month on systolic and diastolic LV dysfunction in AS patients.Methods: Forty consecutive AS patients were treated with TNF-&alpha; blocking therapy for 1 year. Transthoracic echocardiography was performed in all patients at baseline and after 1 year of treatment.Results: Diastolic LV function improved after treatment in four out of six (67%) AS patients who completed follow-up (P=0.125), and did not develop or worsen in any of the other patients. Treatment with TNF-&alpha; blocking therapy had no effect on systolic LV function.Conclusion: These findings give support to the hypothesis that diastolic LV dysfunction improves during treatment with TNF-&alpha; blocking therapy. Keywords: ankylosing spondylitis, cardiovascular disease, anti-TN

Can artificial substrates enriched with crustose coralline algae enhance larval settlement and recruitment in the fluted giant clam (Tridacna squamosa)?

10.1007/s10750-008-9698-0Hydrobiologia625183-90HYDR