The shoulder endurance test (SET): A reliability and validity and comparison study on healthy overhead athletes and sedentary adults.

OBJECTIVES: The primary purpose was to examine the reliability of a new shoulder physical performance test -the Shoulder Endurance Test (SET)- in young healthy overhead athletes and sedentary adults and to provide preliminary reference values. The secondary objective was to determine whether there are differences on SET scores based on groups, sides and days. The third objective was to evaluate the relationship between the SET and shoulder rotational isometric strength in both groups. DESIGN: Reliability and validity study. SETTING: Laboratory setting. PARTICIPANTS: A total sample of 92 participants volunteered to participate in this study (30 healthy overhead athletes - 62 sedentary adults). MAIN OUTCOME MEASURES: We used a two-session measurement design separated by seven days to evaluate the reliability. We calculated intraclass correlation coefficients to determine relative reliability and used standard error of measurement and minimal detectable change to quantify absolute reliability. Systematic differences in SET scores between groups, days and sides were analysed with a two-way analysis of variance (ANOVA) for repeated measures. To check for systematic differences within groups between day 1 and day 2, a Wilcoxon Signed Rank Test was performed. Relationship between shoulder rotational isometric strength and the SET was determined using the Spearman Rank test (rs). RESULTS: Relative reliability was high to very high in both groups (intraclass correlation coefficient [2,1] range = 0.78-0.93) and absolute reliability was clinically acceptable. The standard error of measurement varied from 10.7 s to 16.45 s. The minimal detectable change ranged from 29.6 s to 45.6 s. Weak correlations were found between the SET and isometric shoulder rotational strength (rs range = 0.309-0.431). RESULTS: of the ANOVA for repeated measures showed a significant two-way interaction effect for day x groups (p = 0.020) and a significant main effect for side (p= < 0.001). Results of the Wilcoxon Signed Rank Test showed no systematic differences in group 1 between day 1 and day 2 for both sides (p = 0.79 dominant side; p = 0.66 non-dominant side). CONCLUSIONS: The SET is a reliable clinically applicable shoulder physical performance test in young adult overhead athletes and sedentary adult.

Efficacy and safety of levetiracetam in clinical practice: results of the SKATE trial from Belgium and The Netherlands.

OBJECTIVE: Aim of the study was to assess the efficacy and safety of levetiracetam as add-on treatment in patients with partial-onset epilepsy in clinical practice. METHODS: In this observational, multi-centre study patients were treated with levetiracetam for 16 weeks. From a starting dose of 1000 mg/day, dose levels were adjusted at 2-weekly intervals in 1000-mg steps, to a maximum of 3000 mg/day, based on seizure control and tolerance. Analysis of efficacy was based on reduction in seizure frequency relative to baseline, 50% and 100% responder rates (for partial seizures and all seizure types combined) and percentage of patients using levetiracetam at the end of the study. Analysis of safety was based on occurrence of adverse events. RESULTS: The present analysis concerns the results of patients recruited in Belgium and The Netherlands. Of the 251 patients included in the study, 86.9% completed 16 weeks of treatment. Reduction in frequency of partial-onset seizures was 62.2%, with 19.3% of the patients becoming seizure free and 56.6% having a reduction in seizure frequency of > or = 50%. These percentages were more or less the same when calculated for all seizure types combined. Tolerance of levetiracetam treatment was good, with most adverse events being only mild to moderate in severity, and only 10.0% of the adverse events leading to discontinuation from the study. Asthenia, somnolence, dizziness and headache were the most frequently reported adverse events. CONCLUSION: Levetiracetam is effective and safe as add-on treatment for partial-onset seizures in clinical practice.

Diagnosis and endovascular treatment of midbasilar dissecting aneurysm.

The authors present the case of a patient with a midbasilar dissecting aneurysm successfully treated by staged bilateral endovascular occlusion of the vertebral artery. The clinical and the radiological features are presented with references to the literature, and the choice of endovascular rather than neurosurgical treatment is discussed in light to our previously reported experience about the treatment of unclippable vertebrobasilar aneurysms.

An evaluation of interpersonal cognitive problem solving training with children.

A number of social skill training approaches have been devised for remediating peer relationship difficulties in children and adolescents. One recently developed approach, focusing on interpersonal cognitive problem solving (ICPS) skills, is described. ICPS training studies are also reviewed. Despite the pervasive methodological problems that characterize this literature, ICPS training appears to be effective as a remediation strategy with maladjusted youngsters, and as a secondary prevention strategy with children 'at risk'. While initial findings with nonclinical groups have been less encouraging, available follow-up data suggest that ICPS training may be efficacious as a primary prevention strategy, as well. Several suggestions are offered for improving the methodology of future training studies, while important issues and problems are highlighted for future investigation.

A multistudy analysis of socioeconomic status (SES) and the measures and outcomes of cognitive-behavioral treatment with children.

The relationship of the child's socioeconomic status (SES) to improvement and generalization from cognitive-behavioral treatment was investigated by comparing high and low SES groups on teacher ratings, performance measures, and judges' ratings of improvement and maintenance of positive change. Fifty-eight teacher-referred classroom problem children (grades 2-6) who had served as treated subjects in one of three treatment outcome studies were examined. SES data were collected by administration of a questionnaire to the head of each household. The judges' ratings were performed on clusters of teacher ratings and clusters of performance measures that were present in each study. Results indicated that, despite SES group variation in level of performance, improvement, when it occurred, was evident for both high and low SES groups. In addition, there were significant differences on a number of the performance measures at pretreatment, posttreatment, and follow-up. Initial SES group differences in verbal ability as measured by the Peabody Picture Vocabulary Test (PPVT) appear to have been an important factor in these performance differences.

[Progressive multifocal leukoencephalopathy after renal transplantation. Report of two cases]. / Leucoencéphalopathie multifocale progressive après transplantation rénale. A propos de deux observations.

Progressive multifocal leukoencephalopathy (PML) occurred in two patients after kidney transplantation. Two years after such a transplantation associated with immunosuppressive chemotherapy, a 54-year-old male developed polyneuropathy, diffuse alterations of the central nervous system and he died with the suspicion of hypertensive encephalopathy due to progressive renal failure. A 45-year-old female had kidney transplantation first complicated by Listeria monocytogenes meningoencephalitis. She was cured from this disease and had a satisfactory social rehabilitation for two years. Afterwards, she suffered from various neurological ailments, including epilepsy, that were attributed to combined renal failure and developing hydrocephalus. One year after the onset of these neurological symptoms, the grafted kidney was removed and chemotherapy was discontinued but she died a few weeks later. Both patients had typical PML. By electron microscopy, performed on formalin fixed brain tissue, intranuclear round particles (40-50 nm) could be recognized in the first case only. These two cases are confronted with the six published observations of PML following organ transplantation. The frequency of PML has been estimated at 1 for 5000 kidney transplantation, 1 for 2000 chronic lymphoid leukemia and 1 for 10,000 Hodgkin's disease.

Two cases of progressive multifocal leukoencephalopathy after renal transplantation.

Progressive multifocal leukoencephalopathy (PML) occurred in two patients after kidney transplantation. Less than 2 years after such a transplantation associated with immunosuppressive chemotherapy a 54-year-old male developed polyneuropathy then clinical diffuse alteration of the central nervous system. He died three months later with the suspicion of hypertensive encephalopathy due to progressive renal failure. A 45-year-old female had a kidney transplantation first rapidly complicated by Listeria monocytogenes meningoencephalitis. She was cured from this disease and had a satisfactory social rehabilitation during two years. Afterwards, she suffered various neurological troubles, including epilepsy, that were attributed to combined renal failure and developing hydrocephalus. One year after the onset of these neurological symptoms, the grafted kidney was removed and chemotherapy was discontinued. She died three months later. Both patients had typical PML with eosinophilic intranuclear inclusions in presumptive oligodendroglial cells. By electron microscopy, performed on formalin fixed brain tissue, round particles (40-50 nm) could be recognized in some glial cell nuclei. These two cases are confronted with the four published observations of PML following organ transplantation.

[Crossed aphasia in a right-handed patient: a report on one case (author's transl)]. / Aphasie croisée chez une droitière. A propos d'une observation.

The authors report on a 37 year old right-handed patient with a right rolando-parietal infarct which was manifest clinically by not only sensory-motor disorders of the left side of the body, but more especially by an expression aphasia. This observation fulfills the criteria for defining the exceptional case of crossed aphasia in a right-handed patient: aphasic destruction of language engendered by a right unilateral lesion in such a patient, without a previous history of a cerebral lesion or family history of left-handedness. Comparing the aphasic signs in this patient with the rare cases reported in the published literature shows that there is a particular pathognomonic profile, close to the type of aphasic disorganization seen in children and left-handed adults. The authors review the neuropsychopathogenic explanations for this crossed aphasia of right-handed patients.

[Disorders of heat and water regulation. Proliferative reticulo granulomatous process of hypothalamic origin (author's transl)]. / Troubles de la régulation thermique et de la régulation hydrique. Processus prolifératif réticulo-granulomateux à détermination hypothalamique.

The authors report the anatomical and clinical findings in a 65 year old patient with a lesion in the hypothalamus presenting mainly as disorders in heat and water regulation. Disorders in heat regulation dominated the clinical picture, in relation to a poikilothermia. Conservation of reactivity to pyrogenic bacteria is debatable. Inappropriate secretion of antidiuretic hormone (ISADH) by a direct effect on the supraoptico-hypophyseal aixs can account for the water and electrolyte disturbances. The anatomical lesions, due to hypothalamic changes, can be included in the circumscribed proliferative reticuloses of the CNS having a pseudo-inflammatory histological appearance.

[Statistical approach to psychosomatic headaches]. / Approccio statistico alle cefalee psicosomatiche

Three groups of patients were compared statistically: 79 with the diagnosis psychosomatic headache' (in the strict sense of the term), 450 others whose headache was part of another disorder (termed symptomatic headache'), and 850 patients free from headache symptoms. The following characteristics were found for the group with psychosomatic headache: More psychosomatic diseases in the family, usually the eldest in birth rank, usually living in towns, married, two children, intellectual level above average, overweight, ego-strength with compulsive features, tendency towards oral abuse of different kinds, few other psychosomatic complaints (contrary to the group with symptomatic headache). In the discussion the Authors try to demonstrate the defensive function of this selective somatisation.

[Statistical study in psychosomatic headache (author's transl)]. / Statistische Untersuchung der psychosomatischen Kopfschmerzen

Three groups of patients were compared statistically: 79 with the diagnosis "psychosomatic headache" (in the strict sense of the term), 450 others whose headache was part of another disorder (termed "symptomatic headache"), and 850 patients free from headache symptoms. The following characteristics were found for the group with psychosomatic headache: More psychosomatic diseases in the family, usually the eldest in birth rank, usually living in towns, married, two children, intellectual level about average, overweight, ego-strength with compulsive features, tendency towards oral abuse of different kinds, few other psychosomatic complaints (contrary to the group with symptomatic headache). In the discussion the authors try to demonstrate the defensive function of this selective somatisation.