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Normative Data (normative + data)
Selected AbstractsNormative data of bone mineral density in an unselected adult Austrian populationEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 4 2003S. Kudlacek Abstract Background There is increasing evidence that correct interpretation of bone mineral density (BMD) measurements by dual energy X-ray absorptiometry (DEXA) requires a population-specific reference range. We therefore collected data on age-related BMD in a random sample of the normal adult Austrian population to establish an appropriate normative database. Methods We measured BMD by DEXA at five different skeletal sites in 1089 subjects, i.e. 654 females and 435 males, aged between 21,76 years, who had been recruited by 17 centres across Austria. Results Age-related bone loss was observed until age 65 years with significant changes at the lumbar spine (r = ,0·23), total hip (r = ,0·07), trochanter (r = ,0·10), femoral neck (r = ,0·30) and Ward's triangle (r = ,0·40) in the women but only at the femoral neck (r = ,0·23) and at Ward's triangle (r = ,0·40) in the men. When we calculated T scores from the BMD data of the young normal adult study population and used the T score set points according to the WHO classification of osteopenia and osteoporosis, we found that, depending on the skeletal site measured, 7·6,27·4% of the women and 16,41% of the men in our study group had low bone mass, whereas 0·6,2·7% of the female and 0·2,1·0% of the male study population were osteoporotic. However, osteoporosis was indicated in 4,9-fold more females and 5,15-fold more males when we based our estimates on the normative data provided by the manufacturers of the DEXA systems. Conclusion Our data underscore the importance of using a population-specific reference range for DEXA measurements to avoid overdiagnosis of osteoporosis. [source] Cognitive impairment in Parkinson's disease: Tools for diagnosis and assessment,,MOVEMENT DISORDERS, Issue 8 2009Jaime Kulisevsky MD Abstract Cognitive impairment (CI) and dementia are frequent and debilitating features associated with Parkinson's disease (PD). Formal neuropsychological examination is required to ascertain the degree and pattern of CI over the course of the disease. The use of different tools may explain heterogeneous data obtained from studies to date. Normative data for extensively used scales [Mattis Dementia Rating Scale (MDRS), Mini-Mental State Examination (MMSE)] is incomplete in PD populations. According to sample characteristics, statistical analyses, and methodological quality, 33 studies using scales not specific to PD (MDRS, MMSE, Cambridge Cognitive Assessment, FAB) or PD-specific scales (Mini-Mental Parkinson, Scales for Outcomes of Parkinson's disease,Cognition, Parkinson's Disease,Cognitive Rating Scale, and Parkinson Neuropsychometric Dementia Assessment) were eligible for the critical analysis of their appropriateness to assess cognition in PD. Of the four scales specifically designed for PD, the SCOPA-COG and the PD-CRS have undergone extensive and rigorous validation processes. While the SCOPA-COG mainly assesses "frontal-subcortical" cognitive defects, the PD-CRS also assesses "instrumental-cortical" functions, allowing better characterization of the different patterns of CI that may be present in PD from the earliest stages. The MMP and PANDA scales were designed as brief screening tests for CI and have not yet been subjected to extensive clinimetric evaluations. Further research on PD-specific tools seems mandatory to help establish accurate cut-off scores for the diagnosis of mild PDD, detect cognitive profiles more prone to the future development of dementia, and allow comparisons between different descriptive or interventional studies. © 2009 Movement Disorder Society [source] Millon Behavioral Health Inventory Scores of Patients With Chronic Pain Associated with Myofascial Pain SyndromePAIN MEDICINE, Issue 4 2001David A. Fishbain MSc, FAPA Objectives., Normative data for the coping styles and psychogenic attitudes of the Millon Behavioral Health Inventory (MBHI) for male and female chronic pain patients (CPPs) with mixed pain diagnoses have previously been reported and compared with normative MBHI manual data. However, results from other studies have suggested that CPPs with myofascial pain syndrome (MPS) may need to be considered as a distinct group in psychiatric/psychological studies. The purpose of the present study was then to provide normative data for each MBHI scale for male and female CPPs with MPS and to compare these data with MBHI manual norms for similarities and differences. Setting.,Multidisciplinary pain facility. Patients.,CPPs with an associated diagnosis of MPS. Outcome Measure.,MBHI base rate scores. Methods. CPPs with an associated diagnosis of MPS were first broken down into two groups: males and females. Analyses were then performed using the MBHI base rate scores of these two groups. For each group, the percentages of CPPs who had a base rate of 75 or above were calculated for each individual coping style and psychogenic attitude. These percentages were then compared by chi square with percentages of patients with base rate scores of 75 or above for each coping style and psychogenic attitude to the MBHI Manual normative sample. Results., Female CPPs with MPS differed from MBHI Manual normative counterparts on two of the six psychogenic attitude scales (future despair and somatic anxiety); no differences were found in any of the eight coping style scales. Male CPPs with MPS differed from MBHI Manual normative counterparts on one coping style scale (sociable) and three psychogenic attitude scales (premorbid pessimism, future despair, and somatic anxiety). Conclusions., The pattern of the results indicated that CPPs with MPS, especially males, differ from the MBHI Manual normative data counterparts. These differences appear to be greater than those for CPPs with mixed pain diagnoses. Differences in MBHI scale scores between CPPs with MPS and MBHI Manual normative data counterparts may be related to a number of issues, such as whether differences in state factors reflecting depression and anxiety might affect trait factors purportedly measured by the MBHI. [source] Normative data on Benton Visual Form Discrimination Test for older adults and impaired scores in Clinical Dementia Rating 0.5 participants: Community-based study.PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 1 2009Tajiri Project, The Osaki Aims:, The Benton Visual Form Discrimination test (VFD) is one of the non-verbal tests to assess the capacity for complex visual form discrimination. The purposes of the present study were to investigate the effects of age and education level of the VFD in healthy elderly subjects, rigorously excluding participants with Clinical Dementia Rating (CDR) 0.5, and the characteristics of VFD patterns in CDR 0.5 participants. Methods:, The 597 participants included CDR 0 (healthy elderly, n = 405), CDR 0.5 (mild cognitive impairment, n = 161), and CDR 1 and 2 (dementia, n = 31). The VFD, Digit Forwards, Digit Backwards and Rey,Osterrieth Complex Figure Test (RCFT) copying were used for neuropsychological assessment. Results:, There were significant effects of age and education level on the VFD in healthy participants, and the CDR 0.5 group had a lower score on the VFD than the healthy group. Low performance on the VFD was associated with Digit Backward and RCFT copying in both healthy and CDR 0.5 participants. Conclusions:, CDR 0.5 participants exhibit deficits of visual form discrimination related to attention, visual construction and organization. [source] Can personality traits help us explain disability in chronic schizophrenia?PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 5 2006ANDRÉS HERRÁN md Abstract, Psychotic features have been considered the main determinant of psychosocial function in schizophrenia. However, other variables are likely to affect dysfunction in these patients. The authors' hypothesis is that personality traits in outpatients with chronic schizophrenia differ from traits found in the healthy population and may be associated with disability in this disorder. A total of 62 patients with schizophrenia were evaluated with the Eysenck Personality Questionnaire (EPQ) and the Tridimensional Personality Questionnaire (TPQ). Psychotic features were measured with the help of the Positive and Negative Syndrome Scale (PANSS). Disability was assessed with the Disability Assessment Schedule (DAS). A total of 43 healthy subjects were used as controls for personality measurements. Normative data for the study population was also used to evaluate results in patients. Patients with schizophrenia had higher levels of neuroticism (median in percentile 65) and lower levels of extraversion (median in percentile 25) than the healthy population. Results of the TPQ showed higher harm avoidance and lower reward dependence levels compared to the healthy population. After multiple regression tests, negative symptoms were the strongest predictor of disability in patients with schizophrenia. Neuroticism contributed independently to the DAS overall behavior and global judgement subscales scores (more negative symptoms and higher neuroticism resulted in worse functioning), but not to the social role subscale. Outpatients with chronic schizophrenia showed high levels of neuroticism, harm avoidance, and introversion. Neuroticism significantly contributes to the long-term deficits found in patients with schizophrenia. [source] Social functioning and communication in children with cerebral palsy: association with disease characteristics and personal and environmental factorsDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 5 2010JEANINE M VOORMAN Aim, The objective of this longitudinal study was to describe the course of social functioning and communication in children with cerebral palsy (CP) over a 3-year period, its difference with the normative course, and its relationship with disease characteristics and personal and environmental factors. Method, Participants in this study were 110 children with CP (70 males, 40 females) with a mean age of 11 years and 3 months (SD 1y 8mo). Social functioning and communication were measured with the Vineland Adaptive Behavior Scales. Comparisons were made with normative data; data were analysed with generalized estimating equations. According to the Gross Motor Function Classification System (GMFCS), 50 of the 110 children were categorized as GMFCS level I, 16 as level II, 13 as level III, 13 as level IV, and 18 as level V. Results, The course of social functioning over a 3-year period showed an increase in restrictions in children with CP (p<0.001). Restrictions in communication increased more in children with the most severe forms of CP (p<0.001). In addition to disease characteristics (GMFCS category, presence of epilepsy, and speech problems), personal factors (externalizing behaviour problems) and environmental factors (having no siblings, low parental level of education, and parental stress) were associated with greater restrictions in social functioning and communication. Interpretation, The results indicate that it is important to focus not only on the medical treatment of children with CP, but also on their behavioural problems and social circumstances, and to support the parents so that social functioning and communication in these children may be improved. [source] Depressive symptoms in the first year from diagnosis of Type 2 diabetes: results from the DESMOND trialDIABETIC MEDICINE, Issue 8 2010T. C. Skinner Diabet. Med. 27, 965,967 (2010) Abstract Aims, To describe the course of depressive symptoms during the first year after diagnosis of Type 2 diabetes. Methods,Post hoc analysis of data from a randomized controlled trial of self-management education for 824 individuals newly diagnosed with Type 2 diabetes. Participants completed the Depression scale of the Hospital Anxiety and Depression Scale after diagnosis and at 4, 8 and 12 months follow-up. Participants also completed the Problem Areas in Diabetes scale at 8 and 12 months follow-up. We present descriptive statistics on prevalence and persistence of depressive symptoms. Logistic regression is used to predict possible depression cases, and multiple regression to predict depressive symptomatology. Results, The prevalence of depressive symptoms in individuals recently diagnosed with diabetes (18,22% over the year) was not significantly different from normative data for the general population (12%) in the UK. Over 20% of participants indicated some degrees of depressive symptoms over the first year of living with Type 2 diabetes; these were mostly transient episodes, with 5% (1% severe) reporting having depressive symptoms throughout the year. At 12 months post diagnosis, after controlling for baseline depressive symptoms, diabetes-specific emotional distress was predictive of depressive symptomatology. Conclusions, The increased prevalence of depressive symptoms in diabetes is not manifest until at least 1 year post diagnosis in this cohort. However, there are a significant number of people with persistent depressive symptoms in the early stages of diabetes, and diabetes-specific distress may be contributing to subsequent development of depressive symptoms in people with Type 2 diabetes. [source] A clinical profile of participants in an online support groupEUROPEAN EATING DISORDERS REVIEW, Issue 3 2007Alison M. Darcy Abstract Objective To explore the clinical characteristics of users of an online support group for people with eating disorders (EDs). Method One hundred and thirty-eight support group participants were recruited online and completed measures that were specifically adapted for internet administration. These included two subscales of the Eating Disorder Inventory-2 (EDI-2); the 26-item version of the Eating Attitudes Test (EAT-26); the Hospital Anxiety and Depression Scale (HADS); and the Rosenberg Self-Esteem Scale (RSE). Results Participants scored significantly higher than published normative data on all measures. In addition, while the group scored in line with traditional clinical samples, some self-reported diagnostic groups scored significantly higher on all of the factors. Discussion Participants demonstrated a clinical profile, in terms of reported distress, comparable to, and on some measures in excess of, samples diagnosed with an ED. Online support groups may be ideally placed to offer support and information to some people with EDs. Copyright © 2007 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Normative data of bone mineral density in an unselected adult Austrian populationEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 4 2003S. Kudlacek Abstract Background There is increasing evidence that correct interpretation of bone mineral density (BMD) measurements by dual energy X-ray absorptiometry (DEXA) requires a population-specific reference range. We therefore collected data on age-related BMD in a random sample of the normal adult Austrian population to establish an appropriate normative database. Methods We measured BMD by DEXA at five different skeletal sites in 1089 subjects, i.e. 654 females and 435 males, aged between 21,76 years, who had been recruited by 17 centres across Austria. Results Age-related bone loss was observed until age 65 years with significant changes at the lumbar spine (r = ,0·23), total hip (r = ,0·07), trochanter (r = ,0·10), femoral neck (r = ,0·30) and Ward's triangle (r = ,0·40) in the women but only at the femoral neck (r = ,0·23) and at Ward's triangle (r = ,0·40) in the men. When we calculated T scores from the BMD data of the young normal adult study population and used the T score set points according to the WHO classification of osteopenia and osteoporosis, we found that, depending on the skeletal site measured, 7·6,27·4% of the women and 16,41% of the men in our study group had low bone mass, whereas 0·6,2·7% of the female and 0·2,1·0% of the male study population were osteoporotic. However, osteoporosis was indicated in 4,9-fold more females and 5,15-fold more males when we based our estimates on the normative data provided by the manufacturers of the DEXA systems. Conclusion Our data underscore the importance of using a population-specific reference range for DEXA measurements to avoid overdiagnosis of osteoporosis. [source] Health-related quality of life in patients with Primary Sjögren's Syndrome and Xerostomia: a comparative studyGERODONTOLOGY, Issue 1 2002Jocelyne Rostron Abstract Objective: To compare the health status of groups of Primary Sjögren's and Xerostomia patients, using the Medical Outcomes Short Form 36 (SF-36). The SF-36 is a generic measure, divided into eight domains, used in the assessment of health-related quality of life. Patients and methods: The SF-36 was given to 2 groups: Group 1 comprised 43 patients diagnosed with Primary Sjögren's Syndrome (1SS) and an unstimulated whole salivary flow rate (UFR) of <0.1 ml/min). Group 2 (n = 40) reported Xerosiomia but had an UFR >0.2 ml/min. Sub groups of patients in Groups 1 and 2 were compared with community normative data, for the SF-36 Results: There were trends to suggest lower SF36 scores for 1SS patients but there were no significant differences between the mean domain scores of Groups 1 and 2. 1SS and Xerostomia patients registered lower mean scores across all 8 domains, compared with normative community data. Conclusion: The SF-36 was unable to detect significant differences between subjects with 1SS and Xerostomia but a larger sample size is required to confirm these findings. The results of this limited study suggest that a disease-specific measure is required to assess the impact 1SS on health-related Quality of life (QOL). [source] Gastric Stasis in Migraine: More Than Just a Paroxysmal Abnormality During a Migraine AttackHEADACHE, Issue 1 2006Objective.,The aim of this article is to evaluate gastric motility and emptying in the ictal and interictal period in migraine. Background.,Nausea is a predominant symptom of migraine and the basis of it is thought to be gastric stasis. Objective methods to establish this are however lacking. We utilized gastric scintigraphy studies to determine gastric motility in the ictal and interictal period of migraine. Methods.,Ten migraine subjects were compared to equal number of age and sex matched controls. Gastric scintigraphy using a standard meal was performed in all control subjects once and in all 10 migraine subjects in the interictal period and nine studies were performed in the ictal period migraine. Results.,The time to half emptying was delayed in migraine ictally (78%) and interictal period (80%) using normative data at this institution. Gastric stasis was less pronounced ictally (149.9 minutes) compared to interictal period (188.8 minutes). There was a significant delay compared to nonmigrainous controls (migraine 188.8 minutes vs normal controls 111.8 minutes; P < .05). These data were replicated in percentage of radioactive material remaining in the stomach at 2 hours. Conclusions.,Contrary to previous belief, this study has demonstrated that migraineurs suffer from gastric stasis both during and outside an acute migraine attack. This may suggest that migraineurs may have an abnormal autonomic function compared to nonmigrainous controls. The potential role of this in pathophysiology of migraine is discussed and avenues for further investigations are explored. [source] Motor acquisition rate in Brazilian infantsINFANT AND CHILD DEVELOPMENT, Issue 2 2009Virlaine Bardella Lopes Abstract This study used the Alberta Infant Motor Scale (AIMS) with the aim of characterizing motor acquisition rate in 70 healthy 0,6-month-old Brazilian infants, as well as comparing both emergence (initial age) and establishment (final age) of each skill between the study sample and the AIMS normative data. New motor skills were continuously acquired from 0 to 6 months of age by the Brazilian infants, but their acquisition rate was non-linear. When compared to the AIMS sample, Brazilian infants achieved lower percentiles, and their initial age to acquire skills requiring greater antigravity demand was higher. In contrast, Brazilian infants stopped exhibiting primitive patterns earlier, and their final age to acquire antigravity skills was lower. These differences in motor development are suggested to be a consequence of different parental practices and not necessarily indicate motor delay. Thus, the AIMS normative values should be adapted to cultural particularities so as to avoid that infants are misclassified as at risk for motor delay. Furthermore, an adequate assessment of motor development should consider not only the age at which a skill is emerged, but also the age at which such a skill is established in the infant's motor repertoire. Copyright © 2009 John Wiley & Sons, Ltd. [source] The Revised Kingston Standardized Cognitive AssessmentINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 4 2004Robert W. Hopkins Abstract The original Kingston Standardized Cognitive Assessment (KSCA) was designed to assess cognitive functioning in the elderly with suspected organic brain damage (i.e. dementia). It was specifically designed to be a relatively quickly administered assessment tool available to mental health professionals who were not trained in specialized cognitive assessment techniques. It was introduced over a decade ago to bridge a gap between brief, narrowly focused rating scales, and intensive, expensive, full neuropsychological assessments. Recently, a revision of the KSCA was completed. This revision includes the addition of a word-list memory task with immediate recall, delayed recall and recognition formats, as well as new norms for patients with Alzheimer's disease (AD). The updated norms reflect the abilities of higher-functioning (community-dwelling) patients. In order to facilitate the Revised KSCAs use we have developed a new scoring and analysis form as well as a more comprehensive scoring and administration manual. These changes have resulted in better detection of earlier Alzheimer's disease and use of comparison groups that reflect the changing referral base. The structure of the revised scale and updated normative data are described. An illustrative clinical case example is also provided. Copyright © 2004 John Wiley & Sons, Ltd. [source] Persistent sensory dysfunction in pain-free herniotomyACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 3 2010E. K. AASVANG Background: Persistent post-herniotomy pain may be a neuropathic pain state based on the finding of a persistent sensory dysfunction. However, detailed information on the normal distribution of sensory function in pain-free post-herniotomy patients hinders identification of exact pathogenic mechanisms. Therefore, we aimed to establish normative data on sensory function in pain-free patients >1 year after a groin herniotomy. Methods: Sensory thresholds were assessed in 40 pain-free patients by a standardized quantitative sensory testing (QST). Secondary endpoints included comparison of sensory function between the operated and the naïve side, and correlation between sensory function modalities. Results: QST showed that on the operated side, thermal data were normally distributed, but mechanical pressure and pinch thresholds were normalized only after log-transformation, and cold pain and pressure tolerance could not be normalized. Comparison of QST results revealed significant (P<0.01) cutaneous hypoesthesia/hyperalgesia, but also significant pressure hyperalgesia (P<0.01) and decreased pressure tolerance (P=0.02) on the operated vs. the naïve side. Wind-up was seen in 6 (15%) but with a low pain intensity. Conclusion: Persistent sensory dysfunction is common in pain-free post-herniotomy patients. Future studies of sensory function in persistent post-herniotomy pain should compare the findings to the present data in order to characterize individual patients and potentially identify subgroups, which may aid in allocation of patients to pharmacological or surgical treatment. [source] Review of Research Studies That Evaluated the Impact of Treatment for Childhood Cancers on Neurocognition and Behavioral and Social Competence: Nursing ImplicationsJOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING, Issue 2 2000Julia Challinor ISSUES AND PURPOSE. Given the increasing incidence of childhood cancer, increasing survivor rates, and documented incidence of sequelae, nurses need evidence on which to base interventions for families at risk. The authors review and critique research studies that evaluated the impact of treatment for childhood cancers. Implications for nursing practice are discussed. CONCLUSIONS. Research to evaluate the effects of treatment on neurocognition and behavioral and social competency of children with cancer has produced conflicting results. Most studies found deleterious effects on all three areas associated with childhood cancer treatment. Some studies, however, found no differences between childhood cancer survivors and children on therapy compared to normative data or healthy controls. PRACTICE IMPLICATIONS. Knowledge of the short-and long-term impact of treatment for childhood cancer on neurocognition and behavioral and social competence allows nurses to design interventions that mitigate neurocognitive effects, decrease behavioral problems, and improve social competence. [source] Normal Values of Balance Tests in Women Aged 20,80JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2004Rosemary C. Isles B Phty Objectives: To determine normal values for four commonly used clinical functional balance tests from community-dwelling women aged 20 to 80 and to identify any significant decline due to aging. Design: A cross-sectional study was undertaken to provide normative values for four clinical balance tests across 6 decade cohorts. Setting: The Betty Byrne-Henderson Center for Women and Aging, Royal Womens' Hospital, Brisbane, Australia. Participants: Four hundred fifty-six community-dwelling, independently ambulant women with no obvious neurological or musculoskeletal-related disability, aged 20 to 80, were randomly recruited from a large metropolitan region. Measurements: The clinical balance measures/tests were the Timed Up and Go test, step test, Functional Reach test, and lateral reach test. Multivariate analysis was used to test the effect for age, height, and activity level. Results: Normal data were produced for each test across each decade cohort. Gradual decline in balance performance was confirmed, with significant effect for age demonstrated. Conclusion: New normative data across the adult age decades are available for these clinical tests. Use of clinical balance tests could complement other balance tests and be used to screen women aged 40 to 60 whose performance is outside the normal values for age and to decrease later falls risk. [source] Development and validation of brief content scales for the psychological screening inventory-2,JOURNAL OF CLINICAL PSYCHOLOGY, Issue 7 2010Richard I. Lanyon Abstract This article describes the development of 21 brief content (BC) scales to supplement the existing scales of the Psychological Screening Inventory-2 (PSI-2), and three validity studies to support their use for both the PSI-2 and the original PSI. The BC scales comprise groups of four or more items that are statistically homogeneous in content and are replicated across three data sets: PSI and PSI-2 normative data and a PSI-based group of forensic respondents. Concurrent validity was shown in correlations with the following: (a) the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) basic clinical scales, Content scales, PSY-5 scales, and Restructured Clinical (RC) scales; (b) family/friend observer ratings; and (c) therapist ratings in an outpatient substance abuse treatment program. Consistent with the purpose of the PSI/PSI-2, the BC scales are intended to provide additional screening information and not a comprehensive representation of psychopathology. © 2010 Wiley Periodicals, Inc. J Clin Psychol: 66:1,13, 2010. [source] The health-related quality of life of childhood epilepsy syndromesJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 9 2003M Sabaz Objective: There is increasing awareness of the importance of assessing physical, psychological, social and behavioural well-being in chronic disease. The aim of this study was to examine the health-related quality of life (HRQoL) of children with common epilepsy syndromes and to explore if there are HRQoL differences between those syndromes. Methods: Each child had their epilepsy syndrome defined according to the International League Against Epilepsy classification. Epilepsy syndromes included symptomatic frontal, temporal, parietal/occipital lobe and partial unlocalized epilepsy, and two idiopathic epilepsies, childhood absence epilepsy (CAE) and benign rolandic epilepsy (BRE). Seizure semiology and ictal/interictal electroencephalogram (EEG) were determined for symptomatic partial epilepsy syndromes by video-EEG monitoring. HRQoL was evaluated with an epilepsy-specific instrument, the Quality of Life in Childhood Epilepsy Questionnaire, and two generic instruments, the Child Health Questionnaire and Child Behavior Checklist. Results: Children with symptomatic partial epilepsy syndromes were affected by epilepsy in a similar way and did not have unique HRQoL profiles. However, these children had significantly lower HRQoL scores compared to those with CAE or BRE. All children with epilepsy regardless of syndrome had a higher frequency of behavioural problems compared to normative data. Conclusion: These results indicate that children with epilepsy regardless of syndrome require evaluation of the psychosocial implications. There is a greater impact on HRQoL in symptomatic epilepsy compared to idiopathic epilepsy. Specific symptomatic partial syndromes did not differ in the degree they affect HRQoL. These findings have important implications for clinicians caring for children with epilepsy. [source] Evaluation of Jitter by Stimulated Single-Fiber Electromyography in Normal DogsJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 4 2003Sonia Añor Single-fiber electromyography (SFEMG), a technique used to investigate neuromuscular transmission, has been described previously in the pelvic limb of dogs. Because preferential involvement of isolated muscle groups can occur in disorders of neuromuscular transmission, SFEMG waabone in the peroneus longus (PL), extensor carpi radialis (ECR), and orbicularis oculi (OO) muscles of 10 adult, clinically normal dogs. Jitter was calculated as the mean absolute value of the consecutive differences in latency of 50 single muscle fiber action potentials after stimulation of intramuscular nerve bundles at the level of the motor point in at least 20 muscle fibers per muscle. Bilateral recordings were performed in 3 dogs. Mean jitter values were determined for each muscle, and differences among muscle groups and among dogs were compared. The upper limits of mean consecutive difference (mean plus 3 standard deviations) for the PL, ECR, and OO muscles were 21.94, 22.53, and 23.39 ,s, respectively, and the upper limit of mean consecutive difference for individual muscle fibers in the respective fiber pools was 28.62, 36.39, and 35.68 (JLs. Jitter values for the ECR and OO were significantly higher than the jitter value for the PL muscle (P < .05). Significant differences among muscles or dogs or between sides were not observed for the ECR. Significant differences among dogs were observed for OO jitter values and were attributed to extremely low jitter values in 1 dog. Significant differences were demonstrated between sides for the PL and were attributed to small sample size. Results of this study provide normative data that can be used in the application of the stimulated SFEMG technique to dogs with suspected disorders of neuromuscular transmission. [source] Impact of preoperative overt hepatic encephalopathy on neurocognitive function after liver transplantation,,LIVER TRANSPLANTATION, Issue 2 2009Eva U. Sotil In the current Model for End-Stage Liver Disease allocation system, patients are at risk of suffering repeated episodes of hepatic encephalopathy (HE) while waiting for an orthotopic liver transplantation (OLT); the posttransplantation impact of these episodes has not been well explored. We evaluated the cognitive function and quality of life in a group of OLT recipients (n = 25) who had suffered from overt HE prior to their procedure (HE-PreLT group) and compared their performance to that of a similar group of patients (n = 14) without overt HE (No HE-PreLT group) as well as to controls. Patients were selected from a cohort of 280 patients who underwent OLT during this period; the presence of clinical confounders excluded many of the remaining subjects. Demographic and clinical characteristics were balanced among groups. At an average of 18 months after OLT, we administered 2 neuropsychological batteries [Psychometric Hepatic Encephalopathy Score (PHES) test battery and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)]; a pyschophysiological test (critical flicker frequency); and the SF-36 quality of life score. The HE-PreLT group scored below controls in 5 of 6 cognitive domains tested by RBANS, 3 of 6 PHES subtests, as well as the critical flicker frequency test. The No HE-PreLT group scored below the controls in 1 of the 6 cognitive domains tested by RBANS. The more severe neurocognitive abnormalities seen in the HE-PreLT group did not appear to affect quality of life, as lower values than normative data were only found in 1 of the 8 SF-36 scales. In conclusion, neurocognitive abnormalities were more severe in liver transplant recipients that had suffered from overt HE prior to OLT. Prospective studies of neurocognitive function pre-OLT and post-OLT are needed to fully determine the impact of such abnormalities. Liver Transpl 15:184,192, 2009. © 2009 AASLD. [source] Transplantation of a vascularized rabbit femoral diaphyseal segment: Mechanical and histologic properties of a new living bone transplantation modelMICROSURGERY, Issue 4 2008Goetz A. Giessler M.D. A new vascularized bone transplantation model is described, including the anatomy and surgical technique of isolating a rabbit femoral diaphyseal segment on its nutrient vascular pedicle. The histologic and biomechanical parameters of pedicled vascularized femoral autotransplants were studied following orthotopic reimplantation in the resulting mid-diaphyseal defect. Vascularized femur segments were isolated in 10 rabbits on their nutrient pedicle, and then replaced orthotopically with appropriate internal fixation. Postoperative weightbearing and mobility were unrestricted, and the contralateral femora served as no-treatment controls. After 16 weeks, the bone flaps were evaluated by x-ray (bone healing), mechanical testing (material properties), microangiography (quantification of intraosseous vasculature), histology (bone viability), and histomorphometry (bone remodeling). Bone healing occurred by 2 weeks, with further callus remodeling throughout the survival period. Eight transplants healed completely, while two had a distal pseudarthrosis. Microangiography demonstrated patent pedicles in all transplants. Intraosseous vessel densities were comparable to nonoperated (control) femora. We found ultimate strength and elastic modulus to be significantly reduced when compared to normal controls. Viable bone, increased mineral apposition rate, and bone turnover were demonstrated in all transplants. The method described, and the data provided will be of value for the further study of isolated segments of living bone, and in particular, for investigations of reconstruction of segmental bone loss in weight-bearing animal models. This study also provides important normative data on living autologous bone flap material properties, vascularity, and bone remodeling. We intend to use this method and data for comparison in subsequent studies of large bone vascularized allotransplantation. © 2008 Wiley-Liss, Inc. Microsurgery, 2008. [source] Axonal excitability properties in hemifacial spasmMOVEMENT DISORDERS, Issue 9 2007Arun V. Krishnan PhD, FRACP Abstract Hemifacial spasm (HFS) is characterized by involuntary, irregular contractions of muscles innervated by the facial nerve. Whether the facial nerve has a relative predisposition for ectopic activity has not been clarified. Nerve excitability techniques, which provide information about membrane potential and axonal ion channel function, were initially measured in 12 control subjects looking for biophysical differences that may predispose the facial nerve to generate ectopic activity. In a second series of studies, facial nerve excitability was assessed in nine HFS patients. In both series, stimulus,response behavior, threshold electrotonus, a current threshold relationship, and the recovery of excitability following supramaximal stimulation were recorded following stimulation of the facial nerve. When compared to normative data from nerves in the upper and lower limbs, there was a relative "fanning-in" of threshold electrotonus, reduced superexcitability, and increased subexcitability in facial nerve studies from control subjects (P < 0.05), consistent with relative axonal depolarization. These findings may underlie the propensity for the facial nerve to develop ectopic impulse activity in motor axons. In the HFS patient study, there were no significant differences in distal facial nerve excitability properties from the affected side in HFS patients when compared either to the unaffected side or to normative facial nerve data. It is concluded that the impulse generator underlying HFS must consequently be sited more proximally and does not cause a generalized disturbance of motor axon excitability. © 2007 Movement Disorder Society [source] Dorsal caudal tail and sciatic motor nerve conduction studies in adult mice: Technical aspects and normative dataMUSCLE AND NERVE, Issue 6 2010Robin H. Xia MD Abstract Mice provide an important tool to investigate human neuromuscular disorders. The variability of electrophysiological techniques limits direct comparison between studies. The purpose of this study was to establish normative motor nerve conduction data in adult mice. The dorsal caudal tail nerve and sciatic nerve motor conduction studies were performed bilaterally on restrained anesthetized adult mice. The means and standard deviations for each electrophysiological parameter were determined in normal mice. Data were compared with inflammatory demyelinating polyneuropathy mice to determine whether these parameters discriminate between normal and abnormal peripheral nerves. Normal adult mice had a distal latency of 0.89 (±0.17) ms and 0.75 (±0.09) ms, distal compound motor unit action potential amplitude of 13.2 (±5.9) mV and 28.1 (±8.3) mV, and conduction velocity of 74.6 (±9.0) m/s and 76.5 (±8.3) m/s, respectively. These data were validated by the finding of statistically significant differences in several electrophysiological parameters that compared normal and polyneuropathy-affected mice. A standardized method for motor nerve conduction studies and associated normative data in mice should facilitate comparisons of disease severity and response to treatment between studies that use similar models. This would assist in the process of translational therapeutic drug design in neuromuscular disorders. Muscle Nerve, 2010 [source] Contractile properties of human motor units in health, aging, and diseaseMUSCLE AND NERVE, Issue 9 2001FRCPC, K. Ming Chan MD Abstract The primary function of skeletal muscle is to produce force for postural control and movement. Although the contractile properties of the whole muscle are useful functional indicators, they do not accurately reflect the heterogeneity of the constituent motor units (MUs) and their changes in health and disease. However, data on the contractile properties of human MUs, in comparison to other animal species, are relatively sparse. This, in part, is due to greater methodological challenges of in vivo studies of MUs in the human. The purpose of this review is to critically appraise the methods used in humans; to describe the normative data from different muscle groups; to discuss differences between data from healthy humans and other animal species; and, last, to characterize changes of the MU contractile properties in aging, disease, and in response to intervention. Because the spike-triggered averaging technique can only be used to study the twitch properties, other methods were subsequently developed to measure a wider range of contractile properties. Although there is general agreement between human data and those from other animal species, major differences do exist. Potential reasons for these discrepancies include true biological differences, but differences in the techniques used may also be responsible. Although limited, measurement of MU contractile properties in humans has provided insight into the changes associated with aging and motoneuronal diseases and provides a means of gauging their adaptive capacity for training and immobilization. © 2001 John Wiley & Sons, Inc. Muscle Nerve 24: 1113,1133 [source] Stimulated single fiber electromyography in the mouse: Techniques and normative dataMUSCLE AND NERVE, Issue 7 2001Clifton L. Gooch MD Abstract As the number of new transgenic mouse models of human neuromuscular disease continues to increase, the development of sophisticated electrophysiologic techniques for assessing the peripheral nervous system in these models has become important. Neuromuscular junction (NMJ) dysfunction, in particular, is often not detectable by morphologic or other techniques. To enable sensitive testing of murine NMJ function, we developed and tested a method for stimulated single fiber electromyography (S-SFEMG) in the gastrocnemius muscles of anesthetized mice. Jitter was assessed by measuring the mean consecutive latency difference (MCD) of single fiber responses to sciatic nerve stimulation at 2 HZ. Mean MCD values in normothermic mice were in the range of 6,8 ,s for different strains, with no MCD values exceeding 25 ,s. Reduced core temperature (to 29°,30°C) resulted in increased jitter, whereas intubation and mechanical ventilation of mice did not alter these values. Intraperitoneal and intravenous injection of vecuronium, however, resulted in progressively increased jitter followed by blocking in continuously monitored fibers. These observations validate the utility of S-SFEMG in mice as an index of NMJ function under a variety of physiologic conditions, and suggest that a high safety factor for neuromuscular transmission exists at mouse NMJs. © 2001 John Wiley & Sons, Inc. Muscle Nerve 24: 941,945, 2001 [source] Standardization of anal sphincter electromyography: Utility of motor unit potential parametersMUSCLE AND NERVE, Issue 7 2001Simon Podnar MD Abstract Advanced electromyography systems offer quantitative analysis of a number of motor unit potential (MUP) parameters. However, only limited data are available on the diagnostic usefulness of these parameters. In the present study, we compared the sensitivities of MUP parameters in revealing "neuropathic" changes in the external anal sphincter (EAS) muscles in 56 patients examined 5,240 months after damage to the cauda equina or conus medullaris. Using multi-MUP analysis, 20 MUPs were obtained from patients' EAS muscles. Their MUP parameters were compared with normative data from 64 controls. The diagnostic sensitivities of mean values/"outliers" of MUP parameters for detecting neuropathic EAS muscles were calculated (area 25%/30%; number of turns 18%/29%; size index 13%/24%; thickness 18%/18%; amplitude 17%/17%; spike duration 20%/9%; duration 15%/12%; number of phases 15%/11%; and their combination 51%/52%). Altogether, the cumulative sensitivity of multi-MUP analysis using both mean values and "outliers" was 62%. The combination of MUP parameters improves the diagnostic yield of MUP analysis, but the influence on specificity remains unknown. © 2001 John Wiley & Sons, Inc. Muscle Nerve 24: 946,951, 2001 [source] A review of clinical upper limb assessments within the framework of the WHO ICFMUSCULOSKELETAL CARE, Issue 3 2007Cheryl Metcalf BA (Hons) MSc Abstract This paper is intended to provide a practical overview for clinicians and researchers involved in assessing upper limb function. It considers 25 upper limb assessments used in musculoskeletal care and presents a simple, straightforward comparative review of each. The World Health Organization International Classification on Functioning, Disability and Health (WHO ICF) is used to provide a relative summary of purpose between each assessment. Measurement properties of each assessment are provided, considering the type of data generated, availability of reliability estimates and normative data for the assessment. Copyright © 2007 John Wiley & Sons, Ltd. [source] External anal sphincter responses after S3 spinal root surface electrical stimulationNEUROUROLOGY AND URODYNAMICS, Issue 7 2006Giuseppe Pelliccioni Abstract Aims The aim of this study is to present the normative data of direct and reflex motor anal sphincter responses, simultaneously evoked by S3 surface electrical stimulation. By this method, it is possible to test the functional integrity of the nervous pathways activated during sacral neuromodulation (SNM). Methods Twenty healthy subjects were studied. Motor-evoked potentials (MEPs) were recorded by concentric needle electrode from external anal sphincter (EAS). Electrical stimulation was applied by means of a bipolar surface electrode over the S3 right or left sacral foramina. Results Direct (R1) and reflex responses (R2 and R3) were found at latencies of 6.98, 25.12, and 50.31 msec, respectively. The two first responses were recorded in all the cases; the last response is steadily recorded in 17 out of 20 subjects. Conclusions Our data can serve as reference values for future study in patients with pelvic floor dysfunction. EAS responses following S3 percutaneous electrical stimulation can represent a useful aid in the selection of candidates to SNM. Neurourol. Urodynam. 25:788,791, 2006. © 2006 Wiley-Liss, Inc. [source] Protocol for clinical neurophysiologic examination of the pelvic floorNEUROUROLOGY AND URODYNAMICS, Issue 6 2001Simon Podnar Abstract Clinical neurophysiologic examination of the pelvic floor is performed worldwide, but there is no consensus on the choice of tests, nor on technical details of individual methods. Standardized methods are, however, necessary to obtain their valid application in different laboratories for the purpose of collection of normative data, comparison of patient data and organization of multi-center studies. It is proposed that in patients with suspected "lower motor neuron" type lesions concentric needle electromyography (CNEMG) is the most informative test to detect pelvic floor denervation/reinnervation, and the external anal sphincter (EAS) muscle is the most appropriate muscle to be examined (either in isolation,when a selective lesion is suspected,or in addition to examination of other muscles). An algorithm consisting of standardized tests including a standardized approach to CNEMG examination of the EAS is presented. The proposed electrophysiologic assessment consists of a computer-assisted analysis of denervation and reinnervation features of the CNEMG signal, a qualitative assessment of reflex and voluntary activation of EAS motor units, and of electrical (or mechanical) elicitation of the bulbocavernosus reflex in those patients in whom manual anogenital stimulation failed to elicit a robust response in the EAS. The proposed protocol could serve as a basis for further studies on validity, sensitivity and specificity of electrophysiologic assessment in patients with different types of "lower motor neuron" involvement of pelvic floor muscles and sacral dysfunction. Neurourol. Urodynam. 20:669,682, 2001. © 2001 Wiley-Liss, Inc. [source] Comparison of Rolyan and Jamar dynamometers for measuring grip strengthOCCUPATIONAL THERAPY INTERNATIONAL, Issue 3 2002FAOTA Associate Professor, Virgil Mathiowetz PhD Abstract This study compared the Jamar and Rolyan hydraulic dynamometers to determine their concurrent validity with known weights as well as their inter-instrument reliability and concurrent validity for measuring grip strength in a clinical setting. Thirty females and 30 males were tested on these two grip strength measurement devices using a repeated measure design. Results showed that the Jamar and Rolyan dynamometers have acceptable concurrent validity with known weights (that is, correlation coefficients were r , 0.9994), excellent inter-instrument reliability (that is, intraclass correlation coefficients ranged from 0.90 to 0.97) and strong concurrent validity (that is, no significant differences between dynamometers' scores). Data indicate that Jamar and Rolyan dynamometers measure grip strength equivalently and can be used interchangeably. Thus, therapists using the Rolyan dynamometer are justified in using published normative data, which were collected with the Jamar dynamometer. Copyright © 2002 Whurr Publishers Ltd. [source] | |||||||||||||||||||||||||||||||||||||