COMPARATIVE ANALYSIS OF THE KINEMATICS AND KINETICS OF FORWARD AND BACKWARD HUMAN LOCOMOTION

Although common in occurrence one of the least studied modes of human motion is backward locomotion. Backward walking and jogging are currently being used as components of physical therapy for persons who have suffered trauma or submitted to surgery on the lower extremity or back as well as stroke patients. (Gray, 1985, Bates and McCaw, 1986; Kramer and Reid, 1981; Bates, Morrison, Hamill, 1984). Anecdotal reports of reduced noxious stress and beneficial proprioceptive stimulation have perpetuated the use of this form of physical therapy. Position specific sport training necessitates backward locomotion to engender efficient game performances. In numerous sport activities the defensive techniques employed entail retreating or "jockeying" maneuvers. Evasive offensive techniques likewise include backward travel. Some coaches and athletes are supplementing their conventional fitness training regimens with backwards running claiming enhanced hip extensor overloading with the resulting strength adaptation (Morton, 1985)

Celiac Disease: Clinical-Pathological Correlation in 100 Consecutive Patients

Introduction: Celiac Disease (CD) is an autoimmune disease that manifests as inflammation in the small intestine that can be measured by both serology (tTG-IgA) and pathology (Marsh scores). Despite having two clear etiologies defining the disease, the relationship between these markers and the clinical presentation is unclear but the age at presentation has thought to be correlated with a worsened pathology. Methods: This was a retrospective chart review at Thomas Jefferson University Hospital (TJUH). The study consisted of patients diagnosed with Celiac Disease at TJUH with both a Marsh score and a tTG-IgA antibody result. Analysis via correlation statistics looked at the relationship between age at diagnosis, body-mass index (BMI), presenting symptoms/complications, adherence to diet, and appropriate clinical values. Results: There was no correlation between serological and pathological markers. There was no correlation between presenting age and Marsh score. Patients who fit the clear-cut definition for Celiac Disease presented with a wide variety of symptoms. The three major presenting symptoms were abdominal pain, bloating, and diarrhea. Discussion: This study confirmed the nonspecific findings associated with the clinical presentation of Celiac Disease. Further investigation is warranted to determine the efficacy of implementing a screening protocol for Celiac Disease

The usefulness of growth hormone treatment for psychological status in young adult survivors of childhood leukaemia: an open-label study

-1 SD) were included in the study. A final group of 13 patients (9 males and 4 females), mean age 23.7 ± 2.9 years (range 20 – 29.7) completed a 2-year treatment with GH. IQ and neuropsychological performance were assessed at pre-treatment (T1) and after one (T2) and two (T3) years. ANOVA was performed with assessment at T1, T2 and T3 as repeated measurements factor. Relations between test score changes and changes of IGF-I levels were determined by calculating the Pearson correlation coefficient. Results Scores on the cognitive tests were in the normal range. Verbal short- and long-term memory performance decreased between T1 and T2, and increased between T2 and T3. Performance at T3 was not significantly different from that at T1. Performance for sustained attention improved from T1 to T2 and from T1 to T3. Visual-spatial memory was improved after one year of GH treatment. A significant positive correlation was found for Δ IGF-I (T2-T1) with difference scores of visual-spatial memory (T2-T1 and T3-T1), indicating that IGF-I increase after one year of GH treatment is associated with increase in cognitive-perceptual performance at month 12 and 24. Conclusion Since the level of intellectual functioning of our patient cohort was in the normal range the present finding that GH treatment has negative effects on verbal memory and positive on attention and visual-spatial memory warrants similar studies in other groups of ALL survivors. Also, a lower dose of GH should be determined inducing as much IGF as needed to improve verbal as well as visual cognitive functions. The present findings indicate that more knowledge is needed before GH treatment may be recommended to enhance cognitive functions in ALL survivors

The Use of Infliximab in Older Inflammatory Bowel Disease Patients

Limited data suggest anti-tumor necrosis factor (TNF) antibodies have equal efficacy but higher morbidity and mortality in older compared to younger inflammatory bowel disease (IBD) patients(1)

The “Great Imitator” Presents with Abnormal Liver Enzymes

Case Report A 28 year-old male was referred to the gastroenterology clinic for evaluation of abnormal liver enzymes. Three months prior to presentation he was evaluated at a local emergency department for vomiting and upper abdominal pain. He described pain as epigastric and worse after eating. He denied fever, chills orchanges in his urine. At that time, the patient was not jaundiced but reported having a rash. Laboratory testing was remarkablefor elevated liver enzymes (Table 1). The patient was advised to follow up with his primary care physician. Though his symptoms resolved without medical therapy, liver enzymes obtained a few weeks later by his primary physician demonstrated progressive elevation and he was referred to the gastroenterology (GI) clinic for further evaluation