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Nijmegen, Netherlands

Scheffer A.R.T.,Radboud University Nijmegen | Erasmus C.,Radboud University Nijmegen | Van Hulst K.,Radboud University Nijmegen | Van Limbeek J.,Institute of Research | And 3 more authors.
Developmental Medicine and Child Neurology

Aim Botulinum neurotoxin type A (BoNT-A) has been described as an effective intervention for drooling and is being increasingly adopted. However, its effectiveness compared with established treatments is still unknown. We undertook a within-participants observational study to examine this.Method An historic cohort was formed of 19 children and young adults (10 males, nine females) with severe drooling who underwent BoNT-A injections followed by surgical re-routing of the submandibular duct at least 6 months later. Mean age at time of admission was 11 years 5 months (range 5-17y) and mean age at the time of surgery was 14 years (range 6-23y). Fifteen children were diagnosed with bilateral cerebral palsy (CP), three with unilateral CP, and one with non-progressive developmental delay. Gross Motor Function Classification System levels were the following: level I, n=1; level II, n=2; level III, n=7; level IV, n=6; and level V, n=3). The primary outcome was the drooling quotient, which was assessed before each intervention and 8 and 32 weeks thereafter. A multivariate analysis of variance of repeated measures was performed, with the measurement points as the within-participant variables.Results The drooling quotient was reduced to a greater extent after surgery than after BoNT-A administration (p=0.001). Compared with a baseline value of 28, the mean drooling quotient 8 weeks after surgery was 10, and 32 weeks after surgery was 4 (p<0.001). Among the group treated with BoNT-A, the drooling quotient showed a significant reduction from a baseline value of 30 to 18 after 8 weeks (p=0.02), and a continued but diminished effect after 32 weeks (drooling quotient 22; p=0.05).Interpretation Both interventions are effective, but surgery provides a larger and longer-lasting effect. © The Authors. Journal compilation © Mac Keith Press 2010. Source

Huanca W.S.,University of Lleida | Casero T.,University of Lleida | Gatius F.,University of Lleida | Soria Y.,Institute of Research
Acta Horticulturae

Peaches and nectarines (Prunus persica (L.) Batsch) of 'Rich Lady' and 'Big Top' cultivars, respectively, grown according to the organic (OP) and integrated production (IP) systems, under similar soil and climate conditions in Lleida (Spain), were evaluated at harvest and after 7, 14 and 21 days of conventional cold storage at 0°C plus 3 days at 20°C, respectively. Ethylene production, total ascorbic acid (AA), weight, diameter, colour, firmness, titratable acidity (TA) and soluble solids content (SSC) were determined. Fruits mineral content was also determined at harvest. For both cultivars the ethylene production was lower in OP fruits. AA was always higher in IP than in OP nectarine fruits except for those measured after 7 days of storage. Regarding peaches, although there were no significant differences between the production systems, IP fruits presented a gradual reduction of AA with increasing days of storage whereas OP fruits maintained the AA content during the 21 days of storage. IP nectarines presented a higher weight and diameter but lower firmness, SSC and TA values than those reached by OP fruits. In peaches, no difference in weight, diameter and SSC were found between both production systems but firmness and TA were higher in IP than OP fruits, which presented a more coloured peel. Source

Keygnaert I.,Ghent University | Dialmy A.,Mohammed V University | Manco A.,Institute of Research | Keygnaert J.,Ghent University | And 3 more authors.
Globalization and Health

Background: The European Union contracted Morocco to regulate migration from so-called "transit migrants" from Morocco to Europe via the European Neighbourhood Policy. Yet, international organisations signal that human, asylum and refugee rights are not upheld in Morocco and that many sub-Saharan migrants suffer from ill-health and violence. Hence, our study aimed at 1) investigating the nature of violence that sub-Saharan migrants experience around and in Morocco, 2) assessing which determinants they perceive as decisive and 3) formulating prevention recommendations. Methods: Applying Community-Based Participatory Research, we trained twelve sub-Saharan migrants as Community Researchers to conduct in-depth interviews with peers, using Respondent Driven Sampling. We used Nvivo 8 to analyse the data. We interpreted results with Community Researchers and the Community Advisory Board and commonly formulated prevention recommendations. Results: Among the 154 (60 F-94 M) sub-Saharan migrants interviewed, 90% reported cases of multiple victimizations, 45% of which was sexual, predominantly gang rape. Seventy-nine respondents were personally victimized, 41 were forced to witness how relatives or co-migrants were victimized and 18 others knew of peer victimisation. Severe long lasting ill-health consequences were reported while sub-Saharan victims are not granted access to the official health care system. Perpetrators were mostly Moroccan or Algerian officials and sub-Saharan gang leaders who function as unofficial yet rigorous migration professionals at migration 'hubs'. They seem to proceed in impunity. Respondents link risk factors mainly to their undocumented and unprotected status and suggest that migrant communities set-up awareness raising campaigns on risks while legal and policy changes enforcing human rights, legal protection and human treatment of migrants along with severe punishment of perpetrators are politically lobbied for. Conclusion: Sub-Saharan migrants are at high risk of sexual victimization and subsequent ill-health in and around Morocco. Comprehensive cross-border and multi-level prevention actions are urgently called for. Given the European Neighbourhood Policy, we deem it paramount that the European Union politically cares for these migrants' lives and health, takes up its responsibility, drastically changes migration regulation into one that upholds human rights beyond survival and enforces all authorities involved to restore migrants' lives worthy to be lived again. © 2014 Keygnaert et al.; licensee BioMed Central Ltd. Source

Treatment of early Parkinson's disease (PD) should pursue objectives like possible disease-modifying effect, more physiological dopaminergic stimulation, and avoidance of motor fluctuations. The recent published ADAGIO trial showed that rasagiline (1 mg/day), used in early PD, has a disease-modifying effect. Dopaminergic drugs administered to provide more continuous dopaminergic stimulation prevent or minimize motor fluctuations in experimental animals. Dopamine (DA) agonists delay motor fluctuations in humans providing a more continuous dopaminergic stimulation. New formulations of DA agonists, such as once a day preparations and patch technology, have been developed to provide a more continuous delivery of drug and consequently a more physiological stimulation. According to patient characteristics, treatment of PD should be started with rasagiline and/or with long-acting DA agonists. Copyright © 2010 S. Karger AG, Basel. Source

Melchiorre D.,University of Florence | Linari S.,Regional Reference Center for Inherited Coagulopathies | Innocenti M.,University of Florence | Biscoglio I.,National Research Council Italy | And 3 more authors.

Haemarthrosis triggers haemophilic arthropathy (HA) because bleeding starts synovitis immediately, damages cartilage and leads to loss of function and disability. The aim of our study was to investigate the capacity of ultrasonography (US) in detecting bleeding and joint damage in HA. The joints of 62 patients (pts) with haemophilia A or haemophilia B were consecutively evaluated and scored (score ranging from 0 to 21) for effusion (E), bone remodelling (BR), cartilage damage (CD), synovial hypertrophy (SH), haemosiderin (H), osteophytes (O), haemarthrosis (Hae), erosion (Er) and fibrotic septa (FS) with US. X-rays [Pettersson Score (PXS)] were performed in 61 patients and clinical evaluation [World Federation Haemophiliac orthopaedic score (WFHO)] was performed in all patients. A total of 20 healthy subjects and 20 patients affected by Rheumatoid Arthritis (RA) were used as controls. Power Doppler US (PDUS) was performed in all patients on the knee, ankle and elbow joints. A total of 83 joints were studied (50 knees; 12 elbows and 21 ankles). US showed effusion in 57 joint, bone remodelling in 62, cartilage damage in 64, synovial hypertrophy in 45, haemosiderin in 39, osteophytes in 30, haemarthrosis in 24, erosion in 5 and fibrotic septa in 3. The X-rays score showed remodelling in 47 joints, narrowing joint space in 44, displacement/angulation in 39, osteoporosis in 42, subchondral irregularity in 44, subchondral cyst formation in 37, osteophytes in 36 and erosions in 25. The US score in healthy subjects was always ≤5 (range 0 to 4). In haemophiliacs, 34 of 83 joints showed US score ≤5, and 49 US score >5. Joints with US score ≤5 had a low PXS (SRCC=0.375, P<0.01) and joints with US score >5 showed a high PXS (SRCC=0.440, P<0.01). A significant correlation between US score and PXS for bone remodelling [Spearman's rho Correlation Coefficient (SRCC)=0.429, P<0.01] and for osteophytes (SRCC=0.308 P<0.05) was found. The correlation between the US score and number of bleedings in 83 joints was very significant (SRCC=0.375, P<0.01). A total of 24 bleeding joints were identified and verified with aspiration of haematic fluid. US may detect bone and cartilage alterations and synovitis. Indeed, PDUS identified bleeding also in asymptomatic joints and was able to show different entity of haemarthrosis. US may be a feasible and reliable tool to evaluate joint modifications in HA. © 2010 Blackwell Publishing Ltd. Source

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