Follow-up of adolescents treated in a psychiatric hospital. Predictors of outcome.

In the context of a long-term follow-up of 60 hospitalized adolescent psychiatric patients (26 months to four years after discharge), we examined correlates of outcome. The variables were as follows: (1) severity of psychopathology; (2) onset of symptomatology (process or reactive); (3) type of hospital treatment termination; (4) continuation of individual psychotherapy following discharge; (5) physically destructive behavior before hospitalization; and (6) energy level. Follow-up was by personal clinical interview exploring the expatient's current living conditions, peer relationships, current psychopathology and drug or alcohol use, legal difficulties, academic and work functioning, subjective contentment, and plans for the future. An evaluation was also obtained from parents and/or spouse. Statistical analyses of the interrelationships among the predictor variables and outcome demonstrated the importance of a multivariate approach.

Influence of gender and age on the behind-the-back reach test.

The behind-the-back reach test is a reproducible and reliable physical fitness test for musculoskeletal extensibility of the upper extremities, shoulder girdles, and upper back. Requiring only a rigid ruler and marking pen, administration of this test can be learned easily both by medical and nonmedical personnel. Normative data derived from a study of healthy subjects of different ages demonstrated that extensibility decreases with age. Moreover, musculoskeletal extensibility for women was significantly greater than that for men. The test results were not influenced significantly by anthropometric measurements.

Commotio cordis in a lacrosse goalie.

A case of commotio cordis has been documented in a male lacrosse goalie. The development of this injury is attributed to a defect in the design of the lacrosse chest protector. Insufficient foam padding over the sternum makes the goalie vulnerable to cardiac concussion. An improvement in the design of the chest protector is now being instituted by the manufacturers that should prevent this serious injury.

Talotibial exostoses with entrapment of the deep peroneal nerve.

An athlete with talotibial exostoses with entrapment of the deep peroneal nerve is presented. This diagnosis was made by history, physical and roentgenographic examinations, bone scan, and isokinetic exercising. Treatment of this condition involved surgical excision of the boney exostoses.

Follow-up of adolescents treated in a psychiatric hospital: operational solutions to some methodological problems of clinical research.

Procedural problems inhibiting follow-up research on psychiatric patients are discussed, and solutions offered, in the areas of ethical concerns, study design, selection of variables, collection of data, and researcher-clinician relationship. Early communication with patients about methods and goals, and maintenance of rapport and feedback between research and treatment staffs may overcome many difficulties of long-term research, and even aid treatment.

Influence of 5-aminoisoquinolin-1-one (5-AIQ) on neutrophil chemiluminescence in rats with transient and prolonged focal cerebral ischemia and after reperfusion.

Stimulation of neutrophils by different factors increases their oxidative activity and the free radicals produced can report on the degree of activation. Poly(adenosine 5'-diphosphate ribose)polymerase-1 (PARP-1), a nuclear enzyme activated by strand breaks in DNA, plays an important role in the tissue injury associated with ischaemia-reperfusion injury and inflammation. 5-aminoisoquinolin-1-one (5-AIQ) is a potent inhibitor of PARP-1 activity in vitro and in vivo in rats. Acute (80 min) and prolonged (24h) focal cerebral ischaemia was induced in rats by obstruction of the median cerebral artery, with or without reperfusion, with or without administration of 5-AIQ. The oxidative activity of neutrophils was measured by chemiluminescence. Administration of 5-AIQ.HCl (3.0 mg kg(-1) b.w. - i.v.) caused a significant decrease in the oxidative activity of neutrophils in the group which had experienced chronic ischaemia for 24h but had no significant effect in the group which had received 80 min ischaemia, when compared to the control group. Increase of the oxidative activity of neutrophils was confirmed in rats with prolonged cerebral ischaemia, followed by reperfusion. 5-AIQ probably may decrease this activity through inhibition of PARP-1 in focus of local ischaemia as well as hence lowering the expression of inflammatory mediators by activated neutrophils.

Follow-up of adolescents treated in a psychiatric hospital: measurement of outcome.

Treatment planning that is highly individualized and systematically improved must be based on careful assessments of the effectiveness of current technics. This report describes the long-term (three to eight years) outcome of psychiatric hospitalization for 120 severely disturbed adolescent patients as it is measured on three dimensions: peer and social functioning, relationship with parents, and educational and occupational functioning. The measurement scales and the follow-up procedures are practical and easily used.