Significant Intergroup Differences In Terms Research Articles

Obstetrical and neonatal outcomes after successful external cephalic version relative to those after spontaneous cephalic presentations

ObjectiveExternal cephalic version (ECV) is a procedure during which the fetus is rotated from breech or transversal to cephalic presentation. Our aim was to assess the outcomes of successful ECV in terms of obstetrical and immediate neonatal outcomes relative spontaneous cephalic presentation. MethodsWe performed a retrospective single-center observational study from January 2007 to December 2017. All included participants benefited from trial of labor with delivery of the fetus in cephalic presentation. They were divided into two groups depending on whether an ECV had been successfully performed or cephalic presentation was spontaneous. ResultsThe cephalic presentation after ECV and spontaneous cephalic groups comprised 55 and 244 patients, respectively. The two groups differed significantly in terms of the proportion of induced labor (20 [36.4 %] and 56 [22.9 %], p = 0.04), use of oxytocin during labor (31 [56.4 %] and 100 [49.9 %], p = 0.04), duration of labor (342 ± 183 min and 279 ± 140 min, p = 0.008), spontaneous delivery (38 [69.1 %] and 199 [81.5 %], p = 0.04), intrapartum cesarean section (9 [16.4 %] and 16 [6.6 %], p = 0.02), occiput-posterior variety at birth (20 [36.4 %] and 56 [22.9 %], p = 0.04), and brace umbilical positioning at birth (3 [5.4 %] and 2 [0.8 %], p = 0.04), respectively. There were no significant intergroup differences in terms of APGAR score, cord arterial pH/lactates, or reanimation/intensive care admission. ConclusionA successful ECV does not seem to guaranty an identical labor progress and obstetrical outcome as spontaneous cephalic presentations. Immediate neonatal state, on the other hand, seems unaffected by a history of ECV.

Management of recurrent ureteral stricture: a retrospectively comparative study with robot-assisted laparoscopic surgery versus open approach.

BackgroundManagement of recurrent ureteral stricture is challenging. Consensus on the best surgical choice has not been demonstrated. In this study, we aim to report our experience in treating recurrent ureteral stricture and demonstrate whether robot-assisted procedure for redo ureteral surgery is as effective as open procedure while remaining less invasive.MethodsWe retrospectively assessed 41 patients (22 robot-assisted surgeries and 19 open surgeries) who underwent consecutive robot-assisted and open procedures for redo ureteral surgery from January 2014 to 2018 in our institution. Perioperative outcomes, including demographics, operative time, estimated blood loss, complications, pain scores, success rate and cost, were compared between two groups.ResultsThere was no significant intergroup difference in terms of age, body mass index, gender composition and American Society of Anesthesiologists scores. A total of 31 patients underwent redo pyeloplasty and ten underwent redo uretero-ureterostomy. Compared with open group, robot-assisted group showed shorter operative time (124.55 min vs. 185.11 min, p < 0.0001), less estimated blood loss (100.00 mL vs. 182.60 mL, p = 0.008) and higher cost (61161.77¥ vs. 39470.79¥, p < 0.0001). Complication rate and pain scores were similar between two groups. Median follow-up periods were 30 and 48 months for robot-assisted and open group respectively. Success rate in the robot-assisted (85.71%) and the open group (82.35%) was not significantly different.ConclusionsRobot-assisted surgery for recurrent stricture after previous ureteral reconstruction is as effective as open procedure and is associated with shorter operative time and less estimated blood loss.

Comparison Between Diclofenac and Ketorolac Ophthalmic Drops for Pain Management After Photorefractive Keratectomy: A Randomized Clinical Study.

To assess and compare the efficacy of two nonsteroidal anti-inflammatory drugs (NSAIDs), namely diclofenac and ketorolac, for pain control after photorefractive keratectomy (PRK). In this double-masked clinical study, 60 patients treated bilaterally with PRK were randomly allocated into two groups. Postoperatively, one group of patients received diclofenac 0.1% drops and the other group was prescribed ketorolac 0.5% ophthalmic drops in both eyes every 6 hr on the first day and then, no NSAID was applied until the third day. No oral analgesic drug was used after surgery. Patients completed the Visual Analog Scale questionnaire to determine the degree of pain and ocular discomfort (tearing, foreign body sensation, blurred vision, and photophobia) on the first and the third day after surgery. Pain relief was achieved with both medications after surgery, and there was no significant intergroup difference in the level of pain reduction at 24 and 72 hr postoperatively (P>0.05). The ketorolac group experienced less tearing and photophobia only at 24 hr postoperatively (P=0.01), and by 72 hr after surgery, the results were similar in two groups (P>0.05). There was no significant intergroup difference in terms of foreign body sensation or blurred vision on the first or third postoperative days (P>0.05). Both diclofenac and ketorolac are effective in reducing pain and ocular discomfort after PRK, and ketorolac may have greater control on tearing and photophobia during the first 24 postoperative hours.

Dental Implant Rehabilitation After Jaw Reconstruction Assisted by Virtual Surgical Planning.

To evaluate effects of preoperative virtual planning and jaw reconstruction guided by dental implant rehabilitation on dental prosthesis rehabilitation after jaw reconstruction. Patients indicated for segmental jaw resection and who agreed to receive jaw reconstruction procedures were enrolled in the study. Appropriate surgical procedures were determined by a maxillofacial surgeon and a prosthodontist before surgery. The virtual design was created according to preoperative computed tomography. Patients were divided into navigation and non-navigation groups. Implant surgery was performed 6 months after reconstruction surgery. After treatment completion, factors such as survival rate of implants, site of reconstruction, type of graft, and type of prosthesis were compared. In total, 29 patients were included in the study, with 16 patients in the non-navigation group and 13 in the navigation group. A total of 101 implants were inserted, and the implant success rate was 98.02% (2 implants extracted due to peri-implantitis). All patients received prosthetic treatment. Of the 13 navigation group patients, 9 received fixed implant-supported prostheses, whereas the other 4 received removable dentures. Of the 16 non-navigation group patients, 9 eventually received fixed implant-supported prostheses and 7 received removable dentures. There were no significant intergroup differences in terms of prosthesis type (P = .702). However, the proportion of fixed implant-supported prostheses in the navigation group was higher compared with the non-navigation group. Preoperative virtual planning and dental implant rehabilitation-guided jaw reconstruction through preoperative designing can provide a good opportunity to achieve high rates of implant success and dental rehabilitation. This method can also benefit fixed implant-supported prosthetic restorations. Moreover, the use of navigation after virtual planning has no effect on the type of prosthetic reconstruction.

Decreased Aquaporin 4 and 6 mRNAs in Patients With Chronic Otitis Media With Otorrhea.

ObjectivesAquaporins (AQPs) are integral membrane proteins engaged in the modulation of water homeostasis, but the roles they play in chronic otitis media (COM) have not been well investigated. Accordingly, we undertook document relations between the mRNA expressions of AQPs and COM, and explored the relation between these expressions and otorrhea, which is one of the most common symptoms of COM.MethodsLevels of the mRNAs of AQP 1, 2, 3, 4, 5, 6, 8, and 10 were assayed by real-time polymerase chain reaction in inflammatory tissue samples from 81 patients with COM with or without otorrhea. Relationships between AQP mRNA levels and the presence or absence of otorrhea, the presence or absence of bacteria, hearing threshold levels, types of hearing loss, and clinical manifestations were also evaluated.ResultsAQP 1, 2, 3, 4, 5, 6, 8, and 10 mRNAs were expressed in inflammatory tissues obtained from all 81 patients with COM with or without otorrhea. AQP 5 mRNA was most expressed in, followed in descending order by AQP 3, 1, 10, 6, 8, 2, and 4. There were no significant intergroup differences in terms of age, sex, duration of illness, levels of hearing loss in both ears, or incidences of conductive or sensorineural hearing loss. However, AQP 4 (P=0.035) and 6 (P=0.085) mRNA levels were significantly lower in the otorrhea group. In addition, bacteria culture positivity (P=0.014) and the incidence of sensorineural hearing loss (P=0.020) were higher in the otorrhea group.ConclusionAQP 1, 2, 3, 4, 5, 6, 8, and 10 are involved in the development of COM. Specifically, it shows reductions in AQP 4 and 6 mRNA levels, as observed in the otorrhea group, have an effect on the clinical manifestations of COM.

Influence of the Revised Nellix Instructions for Use on Outcomes After Endovascular Aneurysm Sealing

Purpose: To evaluate the impact of the revised Nellix instructions for use (IFU) from 2016 on clinical outcomes and anatomic applicability by retrospectively applying them to a cohort treated with endovascular aneurysm sealing according to the original IFU 2013. Methods: A single-center study was conducted of 100 consecutive patients (mean age 72±8 years, range 46–91; 89 men) treated electively with standard bilateral EVAS from July 2013 to August 2015 and followed through December 2017. Procedures previously classified within and outside the original IFU from 2013 (75 and 25, respectively) were reclassified according to the revised IFU 2016 (34 and 66, respectively). Stepwise backward logistic regression analysis was performed to evaluate the prognostic value of specific anatomic features for the development of endoleak and/or migration. Results: The single most important morphologic feature disqualifying patients from being within IFU 2016 was a thrombus ratio >1.4 (36 of 41 reclassified patients). Overall technical success was 98% (100% within vs 97% outside IFU 2016, p=0.323) and 30-day mortality was 3% (0% within vs 5% outside IFU 2016, p=0.251). During a median follow-up of 31 months (range 0–53), overall mortality was 21% (15% within vs 24% outside IFU 2016, p=0.469); aneurysm-related mortality was 8% (3% within vs 11% outside IFU 2016, p=0.533). Twenty-six patients developed an endoleak (6 within vs 20 outside IFU 2016, p=0.172) and 23 had migration (4 within vs 19 outside IFU 2016, p=0.088). Both proximal neck length <10 mm and neck angulation >60° were positive predictors for the development of endoleak and/or migration. A reintervention was performed in 26 patients (7 within vs 19 outside IFU 2016, p=0.376). While a significant difference was found between the within vs outside IFU 2016 groups with regard to freedom from migration (p=0.026) and the composite freedom from endoleak and/or migration (p=0.021), there were no significant differences in survival (p=0.201) or freedom from reintervention (p=0.505), suggesting a limited effectiveness of the new IFU 2016. Conclusion: The IFU 2016 reduced the anatomic applicability to 34% from 75% for the original IFU 2013. The lack of significant intergroup differences in terms of survival and reinterventions suggests a limited effectiveness of the new IFU 2016.

A comparison of the frequency, risk factors, and type of self-medication in pregnant and nonpregnant women presenting to Shahid Akbar Abadi Teaching Hospital in Tehran.

Background:Self-medication is a serious health problem that leads to an increased per capita consumption of medications, drug resistance, lack of optimal treatment, drug poisoning, and other unwanted complications. This study was conducted to compare self-medication in pregnant and nonpregnant women presenting to Shahid Akbar Abadi Teaching Hospital in Tehran, Iran.Materials and Methods:To conduct this cross-sectional study, 210 pregnant women and 210 nonpregnant women aged 15–45 years presenting to Shahid Akbar Abadi Teaching Hospital, Tehran, Iran, were selected through random sampling. Data were collected through interviews using a semi-structured questionnaire. The Chi-square test, t-test, and logistic regression model were used to analyze the data.Results:The prevalence of self-medication was 34.8% in the pregnant and 77.1% in the nonpregnant women. The age group in which the most frequent instances of self-medication were observed (53.4%) was the 21–30 age group in the pregnant women and the 31–40 age group (44.4%) in the nonpregnant women, suggesting a statistically significant intergroup difference in terms of age (P = 0.0001). Medicinal plants were the most common medications used by the pregnant women (19.6%) and synthetic medications were the most common used by the nonpregnant women (38.1%). The reasons for using medications without a prescription included believing in the illness being mild (22.8%), not having health insurance (9%), easy access in the pregnant women, a previous history of the illness, and easy access in the nonpregnant women.Conclusions:As medicinal plants are the most common medications used by pregnant women and since assessing the risk of herbal substances is difficult, pregnant women should be advised against the arbitrary use of these substances.

Effect of a Self-Management Empowerment Program on Anger and Social Isolation of Mothers of Children with Cerebral Palsy: A Randomized Controlled Clinical Trial

Background: Cerebral palsy (CP) is the most common chronic motor disability, which can have negative impacts on social behavior of mothers as the primary caregivers. Aim: To investigate the effect of an intervention program based on the self-management empowerment model on the anger and social isolation of mothers with CP children. Method: This randomized controlled clinical trial was performed on 72 mothers of CP in Bushehr and Shiraz, Iran, 2015. We employed Buss-Perry Aggression Questionnaire and the UCLA Loneliness Scale for data collection. The intervention group received self-management empowerment in five steps and two face-to-face sessions and was followed up regularly for 1.5 months. Thereafter, anger and social isolation of both groups were reexamined. Data analysis was performed using the Chi-square test, independent t-test, paired t-test, and Mann-Whitney test in SPSS, version 18. Results: The mean ages of the intervention and control groups were respectively 28.1±6.09 and 28.1±5.8 years, which independent t-test showed to be homogenous (P=0.31). Before the intervention, there was no significant difference between the two groups in terms of aggression (P=0.58) and loneliness scores (P=0.93); however, after the intervention, independent t-test reflected significant inter-group differences in terms of both scores (P<0.001). Implications for Practice: The designed empowerment program could reduce the anger of mothers of CP children and serve as a framework for empowering these mothers in healthcare and rehabilitation centers. The efficacy of the program in alleviating the social isolation of these mothers requires further research.

Incidence of Maternal Desaturation among Patients Undergoing Elective Caesaraen Section under Regional Anaesthesia

This was a prospective observational study to identify the incidence and possible risk factors for maternal desaturation following neuraxial blockade for elective caesarean section (CS). Patients with body mass index (BMI) ≥ 30 kg/m2 at the first antenatal consultation were identified and classified into the obese group. Neuraxial blockade in the form of subarachnoid block (SAB) or combined spinal-epidural (CSE) was performed. Mean arterial pressure (MAP) and oxygen saturation (SpO2) were recorded at baseline and at 5-minute intervals following neuraxial blockade. Desaturation, defined as SpO2 < 94% for more than 30 seconds without artifacts, was managed with oxygen therapy and other appropriate measures. Newborn Apgar score and umbilical cord blood gases were analysed. Among a total of 254 recruited patients, 69 (27.2%) were obese and were associated with significantly higher age, parity, previous CS and pre-existing diabetes mellitus. The incidence of oxygen desaturation was 1.2%, involving three patients in the non obese group. These desaturation episodes were short-lived and associated with intraoperative hypotension. Six patients, two of whom in the obese group, received rescue oxygen therapy following intraoperative events such as deteriorating SpO2 or hypotension. The mean MAP was significantly lower at baseline and at 5 minutes post neuraxial blockade in the non obese group, which could account for the occurrence of desaturation in this group only. There were no significant inter-group differences in terms of neonatal outcome, umbilical cord blood gases and changes in mean SpO2 post neuraxial blockade. In conclusion, the current practice of not routinely giving supplementary oxygen to patient during elective CS at our institution is deemed to be safe, provided continuous SpO2 monitoring is available throughout the surgery. Further randomised clinical trials are indicated to investigate the impact of maternal obesity and of labouring patients presenting for urgent or emergency CS on intraoperative oxygen desaturation.

8-mm versus 10-mm diameter self-expandable metallic stent in bilateral endoscopic stent-in-stent deployment for malignant hilar biliary obstruction.

We aimed to clarify the clinical benefits of using 8-mm versus 10-mm diameter self-expandable metallic stent (SEMS) in bilateral endoscopic stent-in-stent (SIS) deployment for malignant hilar biliary obstruction (MHBO). A total of 72 consecutive patients with MHBO treated by endoscopic bilateral SIS deployment were enrolled. The 8-mm and 10-mm diameter SEMSs were used in 37 patients (8-mm group) and 35 patients (10-mm group), respectively. We retrospectively compared technical success, functional success, complications, successful re-intervention, time to recurrent biliary obstruction (RBO) and survival time between two groups. There were no significant inter-group differences in terms of technical success (8-mm vs. 10-mm group, both 100%), functional success (96% vs. 100%), early (5% vs. 9%) and late (19% vs. 14%) complications other than RBO, and successful endoscopic re-intervention (94% vs. 100%), respectively. Time to RBO (median: 198 days vs. 222 days; log-rank, P = 0.440) and survival time (median: 186 days vs. 235 days; log-rank, P = 0.883) did not differ significantly between the two groups. However, the success rate of endoscopic bilateral revisionary stent insertion for RBO was significantly higher in the 10-mm compared to the 8-mm group (68% vs. 31%; P = 0.044). The 10-mm diameter SEMS is more suitable with regard to endoscopic re-intervention.

The effect of obesity on asthma in children

Introduction: The prevalence of obesity and asthma is increasing in recent years. Obesity is a risk factor for asthma. The presence of obesity may affect the clinical course of the disease in patients with asthma. This study was conducted to determine the effect of obesity on clinical course of asthma and pulmonary function tests in children with asthma. Material and Method: One hundred and sixty children with asthma who were followed in Pediatric ImmunologyAllergy Clinic were included in this study. Patients were evaluated prospectively between January 2011-June 2011. The patients were interrogated with detailed history of allergic disease, age, kin marriage, familial atopy, exposure to tobacco smoke, number of asthma attacks within the previous year, and systemic steroid use. Asthma control test, pulmonary function tests, skin prick tests, eosinophilia and total immunoglobulin E measurements were performed. Patients with waist circumferences above the 90th percentile were considered obese. Results: Ninety-six (60%) patients were of normal weight and 64 (40%) of them were obese. There were no statistically significant difference between both groups in terms of age, gender, consanguinity, family history of atopy, smoking, and atopy. The number of attacks and need of systemic steroid within the previous one year were significantly higher in obese asthmatics compared to normalweight individuals (p&lt;0.05). Asthma control in obese asthmatics was significantly worse (p&lt;0.05). There were no statistically significant intergroup difference in terms of serum total IgE, eosinophilia and respiratory function parameters (p&gt;0.05). Binary logistic regression analysis was used to investigate the variables that were effective on asthma control (age, family history of asthma, BMI, WC, number of attacks, systemic steroid use, FEV1, FVC, FEV1/FVC, PEF, and MEF 25-75). The effect of BMI was found to be greater (OR: 39 Cl: (0.36, 4435)). Discussion and Conclusion: Obesity worsens asthma control, increases systemic steroid use and the number of attacks in our patients with asthma. Weight loss together with appropriate treatment and avoidance from allergens may improve asthma control in these patients.&nbsp;

Framingham Risk Score for the prediction of coronary artery disease in patients with chronic rheumatic heart disease.

Patients with chronic rheumatic heart disease (CRHD) have concomitant coronary artery disease (CAD), but the model to detect coexistent coronary artery stenosis prior to surgery has not been validated. Our study investigated whether the Framingham Risk Score (FRS) is a valid predictor of CAD in patients undergoing surgery for CRHD. A total of 989 rheumatic patients were enrolled between 2005 and 2010. They were subdivided into two groups according to coronary angiography (CAG) results to identify potential factors in the development of CAD. Finally, all patients were assessed using the FRS to examine the association between the 10-year cardiovascular disease (CVD) risk and CAD. There were statistically significant inter-group differences in terms of age, sex, smoking, hypertension, bypass surgery and cardiac function in the New York Heart Association (NYHA) classification status (p<0.05). We showed that the FRS had high accuracy in predicting CAD in female and male patients with CRHD. In the male group, the area under the curve (AUC) for predicting CAD was 0.904, with a specificity of 90.3% and sensitivity of 76.1%. In the female group, the AUC for predicting CAD was 0.924, with a specificity of 77.5% and sensitivity of 90.9%, respectively. With a cut-off point of a 10-year CVD risk of 12.5 (%) in the male group and a 10-year CVD risk of 2.5 (%) in the female group, the FRS identified 746 low-risk patients, including 11 (4.3%) with CAD in the male group and 4 (0.8%) with CAD in the female group. None of the patients needed an indication for coronary artery bypass grafting (CABG). The FRS model can accurately predict the prevalence of significant CAD and can reliably identify low-risk patients in whom routine pre-surgical angiography could be avoided.

Magnification-assisted subinguinal varicocelectomy with testicular delivery in children: a preliminary report.

PurposeTo evaluate the effectiveness of magnification-assisted subinguinal varicocelectomy (MASV) with testicular delivery in children with severe varicocele.Materials and MethodsWe retrospectively analyzed the clinical data of 23 children 15 years or younger (mean age, 12.3±1.8 years) who underwent MASV with testicular delivery and ligation of all collateral veins except arteries and deferential veins between January 2010 and January 2014. All patients had grade 3 varicocele on the left side. Varicocelectomy was decided upon due to scrotal hypotrophy (n=14, 60.9%), the existence of mass (n=6, 26.1%, including 1 recurrent case), and discomfort (n=3, 13.0%). The preservation of internal spermatic artery (ISA) was successful in 8 patients (34.8%). The mean follow-up time was 10.8±6.6 months.ResultsThe surgical success rate of varicocelectomy was 100%. The overall symptom resolution rate was 91.3%. The scrotal mass and discomfort disappeared, but testicular catch-up growth did not occur in 2 among 14 patients with scrotal hypotrophy. The left testis volume increased from 6.5±4.3 mL to 10.6±7.5 mL (p=0.003). There were no significant inter-group differences in terms of the surgical success rate, symptom resolution, and catch-up growth between the ISA preservation group and the ligation group. None of the subjects demonstrated testicular atrophy or hydrocele after surgery.ConclusionsMASV with testicular delivery is an effective and safe method for children with severe varicocele.

Impact of internal spermatic artery preservation during laparoscopic varicocelectomy on recurrence and the catch-up growth rate in adolescents

ObjectiveTo investigate the effectiveness of laparoscopic varicocelectomy (LV) in adolescents with varicocele and analyze the impact of internal spermatic artery (ISA) preservation on surgical outcomes. Materials and methodsData on 92 adolescents with left varicocele who underwent LV between December 1998 and January 2011 were retrospectively analyzed. The mean age of the patients was 13.2 ± 2.1 years. Age, grade of disease, number of ligation veins, recurrence rates, and catch-up growth were analyzed in patients who underwent ISA preservation and ligation. The median duration of the follow-up was 21 months. ResultsISA preservation was performed on 50 patients (54%). There were no significant inter-group differences in terms of age, varicocele grade, number of ligation veins, and catch-up growth (93% vs. 90%). The patients who received artery preservation demonstrated a higher recurrence rate (22%) than those who received artery ligation (5%; p = 0.032). Among 13 patients who had persistent or recurrent varicocele, nine were treated with embolization and one was treated with magnification-assisted subinguinal varicocelectomy. None of these 10 patients demonstrated recurrence or testicular atrophy. ConclusionsLV with ISA ligation can reduce the recurrence rate and results in the same catch-up growth rate in comparison with LV with ISA preservation.

Microbiological Characteristics of Acute Prostatitis After Transrectal Prostate Biopsy

PurposeWe aimed to identify microbiological characteristics in patients with acute prostatitis after transrectal prostate biopsy to provide guidance in the review of prevention and treatment protocols.Materials and MethodsA retrospective analysis of medical records was performed in 1,814 cases who underwent prostate biopsy at Seoul St. Mary's Hospital and St. Vincent's Hospital over a 5 year period from 2006 to 2011. Cases in which acute prostatitis occurred within 7 days after the biopsy were investigated. Before starting treatment with antibiotics, sample collections were done for culture of urine and blood. Culture and drug susceptibility was identified by use of a method established by the Clinical and Laboratory Standards Institute.ResultsA total of 1,814 biopsy procedures were performed in 1,541 patients. For 1,246 patients, the procedure was the first biopsy, whereas for 295 patients it was a repeat biopsy. Twenty-one patients (1.36%) were identified as having acute bacterial prostatitis after the biopsy. Fifteen patients (1.2%) had acute prostatitis after the first biopsy, and 6 patients (2.03%) experienced acute prostatitis after a repeat biopsy. Even though the incidence of acute bacterial prostatitis was higher after repeat biopsy than that after the first biopsy, there was no statistically significant intergroup difference in terms of incidence (χ2=1.223, p=0.269). When the collected urine and blood samples were cultured, Escherichia coli was found in samples from 15 patients (71.4%), Klebsiella pneumoniae in 3 patients (14.3%), Enterobacter intermedius in 1 patient (4.8%), E. aerogenes in 1 patient (4.8%), and Pseudomonas aeruginosa in 1 patient (4.8%). A fluoroquinolone-resistant strain was confirmed in 5 cases (23.8%) in total. Three cases of E. coli and 1 case of Klebsiella had extended-spectrum β-lactamase activity.ConclusionsEmpirical treatment of acute prostatitis should be done with consideration of geographical prevalence and drug resistance. This study will provide meaningful information for the management of acute prostatitis after transrectal prostate biopsy.

The role of head stabilization in locomotion in children with cerebral palsy

The objective of the present study was to highlight the role of head stabilization and to analyze multisegment head-trunk coordination during gait in children with cerebral palsy (CP). Postural control was measured and compared in a group of 16 CP subjects and a control group of 16 healthy subjects. The subjects had to walk along an out-and-back course at their freely chosen gait speed. For each gait cycle, motion analysis techniques were used to calculate the amplitude of the head angle (relative to the trunk) in the sagittal and frontal planes. Kinematic analysis revealed a number of significant intergroup differences, with a more pronounced variation in the head angle (relative to the trunk) in the CP group than in the control group. There were no significant intergroup differences in terms of the angular amplitude of the head in the sagittal plane. The greater variability of the head angle in the frontal plane in the CP subjects might reflect the presence of greater head roll as a compensatory strategy. These finding suggest that the clinical evaluation of posture during gait in children with CP should be reconsidered.

The Gender Identity of Pedophiles: What Does the Outcome Data Tell Us?

ABSTRACT The aim of this study was to determine whether pedophiles have a different gender identity profile compared with non-sexual offenders. Participants were 87 male adult subjects, divided into three groups: (a) 27 pedophiles who abused male victims, (b) 30 pedophiles who abused female victims, and (c) 30 non-sexual offenders. The gender identity factor was measured with the Mf scale of the MMPI and the Bem Sex Role Inventory (BSRI). Results indicated no significant inter-group differences in terms of gender identity. However, the order of the three groups regarding scores on the Bem-Masculinity and the Mf scale was as predicted. Conceptual and empirical elements related to gender identity are addressed in order to shed light on potential disturbances in the gender identity of pedophiles.