Population pharmacokinetics of oral baclofen in pediatric patients with cerebral palsy.

Objective: To characterize the population pharmacokinetics (PK) of oral baclofen and assess impact of patient-specific covariates in children with cerebral palsy (CP) in order to support its clinical use.

Subjects Design: Children (2-17 years of age) with CP received a dose of titrated oral baclofen from 2.5 mg 3 times a day to a maximum tolerated dose of up to 20 mg 4 times a day.

Survey of the use of massage for children with cerebral palsy.

Background: Conventional medicine and complementary and alternative medicine (CAM) are merging into the broader field of "integrative medicine." Massage is no longer considered complementary or alternative in some conventional medical circles today.

Purpose: We aimed to determine the prevalence of massage use among children with cerebral palsy (CP) in the Pacific Northwest in the United States, the reasons that massage is being used, and the limits of recruitment for a future randomized controlled trial.

Sexual functioning in adolescents and young adults with spina bifida.

Objective: To assess sexual education and sexual functioning in adolescents and young adults with spina bifida.

Design: Survey, inception cohort.

Setting: The community.

Botulinum toxin for spasticity in children with cerebral palsy: a comprehensive evaluation.

Background: Spasticity is a prevalent disabling clinical symptom for children with cerebral palsy. Treatment of spasticity with botulinum toxin in children with cerebral palsy was first reported in 1993. Botulinum toxin provides a focal, controlled muscle weakness with reduction in spasticity.

Ambulatory physical activity performance in youth with cerebral palsy and youth who are developing typically.

Background And Purpose: Assessment of walking activity in youth with cerebral palsy (CP) has traditionally been "capacity-based." The purpose of this study was to describe the day-to-day ambulatory activity "performance" of youth with CP compared with youth who were developing typically.

Subjects: Eighty-one youth with CP, aged 10 to 13 years, who were categorized as being in Gross Motor Function Classification System (GMFCS) levels I to III and 30 age-matched youth who were developing typically were recruited.

GMFM 1 year after continuous intrathecal baclofen infusion.

The purpose of this study was to assess whether there is an improvement in motor function in persons with cerebral palsy (CP) who have had a reduction of muscle tone by continuous intrathecal baclofen infusion. This was a prospective, open label, non-blinded case series without a control group, conducted at multiple centres. There were 31 subjects, aged 4-29 years.

Lower extremity sensory function in children with cerebral palsy.

Objectives: (1) To determine the feasibility of qualitative sensory testing in the lower extremities (LE) of children with cerebral palsy (CP), especially spastic diplegia. (2) To determine if there is a detectable difference in qualitative LE sensory function in children with CP compared to typical children. (3) To determine if dorsal rhizotomy results in detectable changes in LE sensory function in children with spastic diplegia.

Hip status in cerebral palsy after one year of continuous intrathecal baclofen infusion.

The purpose of this study was to assess whether reduction of muscle tone by continuous intrathecal baclofen infusion affects the progression of hip subluxation in persons with cerebral palsy. This prospective, open-label, case series was conducted at multiple specialty referral centers. There were 33 subjects, ages 4 to 31 years.

Oral motor, communication, and nutritional status of children during intrathecal baclofen therapy: a descriptive pilot study.

Objective: To describe the oral motor, communication, and nutritional status of children receiving intrathecal baclofen (ITB) therapy for spasticity of cerebral origin.

Design: Observational cross-sectional design.

Setting: Tertiary-care regional children's hospital.

Long-term intrathecal baclofen therapy for severe spasticity of cerebral origin.

Object: The goal of this study was to ascertain the long-term effectiveness and safety of intrathecal baclofen (ITB) in the treatment of spasticity of cerebral origin in children and young adults.

Methods: A prospective, multicenter study was conducted in 68 patients who had been enrolled in the initial evaluation of ITB therapy and were willing to participate in long-term surveillance. Seventy-three percent of the patients were younger than 16 years of age at the time of study entry.

Long-term safety and efficacy of continuous intrathecal baclofen.

Long-term continuous intrathecal baclofen (CITB) infusion is a treatment option used to manage otherwise intractable spasticity and is delivered via an implantable pump. The purpose of this single-center multidisciplinary review was to report on the long-term safety and efficacy of CITB in the treatment of 21 children with intractable severe spasticity of cerebral origin. Nineteen recipients had spastic quadriplegia and two had spastic diplegia.

The route to extinction: population dynamics of a threatened butterfly.

We compare results of field study and model analysis of two butterfly populations to evaluate the importance of alternative mechanisms causing changes in abundance. Although understanding and predicting population fluctuations is a central goal of population ecology, it is not often achieved because long-term abundance data are available for few populations in which mechanisms causing fluctuations also are known. Both kinds of information exist for two populations of the checkerspot butterfly, Euphydryas editha bayensis, which are matched in most ways except for habitat area and topography.

Climate change hastens population extinctions.

Climate change is expected to alter the distribution and abundance of many species. Predictions of climate-induced population extinctions are supported by geographic range shifts that correspond to climatic warming, but few extinctions have been linked mechanistically to climate change. Here we show that extinctions of two populations of a checkerspot butterfly were hastened by increasing variability in precipitation, a phenomenon predicted by global climate models.