Growth hormone therapy, muscle thickness, and motor development in Prader-Willi syndrome: an RCT.

Objective: To investigate the effect of physical training combined with growth hormone (GH) on muscle thickness and its relationship with muscle strength and motor development in infants with Prader-Willi syndrome (PWS).

Methods: In a randomized controlled trial, 22 infants with PWS (12.9 ± 7.

Growth hormone combined with child-specific motor training improves motor development in infants with Prader-Willi syndrome: a randomized controlled trial.

Although severe motor problems in infants with Prader-Willi syndrome (PWS) are striking, motor development has never been studied longitudinally and the results of growth hormone (GH) treatment on motor development are contradictory. The authors studied whether GH treatment can enhance the effect of physical training on motor development in infants with PWS. Twenty-two infants were followed for two years during a randomized controlled trial.

Objective evaluation of muscle strength in infants with hypotonia and muscle weakness.

The clinical evaluation of an infant with motor delay, muscle weakness, and/or hypotonia would improve considerably if muscle strength could be measured objectively and normal reference values were available. The authors developed a method to measure muscle strength in infants and tested 81 typically developing infants, 6-36 months of age, and 17 infants with Prader-Willi Syndrome (PWS) aged 24 months. The inter-rater reliability of the measurement method was good (ICC=.

Advanced medical life support procedures in vitally compromised children by a helicopter emergency medical service.

Background: To determine the advanced life support procedures provided by an Emergency Medical Service (EMS) and a Helicopter Emergency Medical Service (HEMS) for vitally compromised children. Incidence and success rate of several procedures were studied, with a distinction made between procedures restricted to the HEMS-physician and procedures for which the HEMS is more experienced than the EMS.

Methods: Prospective study of a consecutive group of children examined and treated by the HEMS of the eastern region of the Netherlands.

Sample size calculations for 3-level cluster randomized trials.

Background: The first applications of cluster randomized trials with three instead of two levels are beginning to appear in health research, for instance, in trials where different strategies to implement best-practice guidelines are compared. In such trials, the strategy is implemented in health care units ('clusters') and aims at changing the behavior of health care professionals working in this unit ('subjects'), while the effects are measured at patient level ('evaluations').

Purpose: To guide the choice of number of clusters, number of subjects per cluster, and number of evaluations per subject.