Relationship between cytokine concentration in serum and preovulatory follicular fluid and in vitro fertilization/intracytoplasmic sperm injection outcome.

Differences in follicle cell function and follicular fluid biochemistry have been suggested to influence the developmental potential of human oocytes at both cellular and chromosomal levels. Follicular fluids provide the environment in which oocyte maturation occurs. Therefore, follicular fluids may affect fertilization and early embryonic development.

Proposed definition and classification of cerebral palsy, April 2005.

Because of the availability of new knowledge about the neurobiology of developmental brain injury, information that epidemiology and modern brain imaging is providing, the availability of more precise measuring instruments of patient performance, and the increase in studies evaluating the efficacy of therapy for the consequences of injury, the need for reconsideration of the definition and classification of cerebral palsy (CP) has become evident. Pertinent material was reviewed at an international symposium participated in by selected leaders in the preclinical and clinical sciences. Suggestions were made about the content of a revised definition and classification of CP that would meet the needs of clinicians, investigators, and health officials, and provide a common language for improved communication.

From research to clinical practice: considerations in moving research into people's hands. Personal reflections that may be useful to others.

It may take many years for published clinical research findings to be found, understood, adopted and applied in practice. In recognition of this delay, many jurisdictions and agencies are now promoting a stronger link between research and its dissemination in useable forms that will enable practitioners to access, understand and use new ideas. The purpose of this paper, first presented as a keynote address at the 15th Annual Meeting of the European Academy of Childhood Disability in Oslo in October 2003, is to share experiences of the author and his colleagues at a childhood disability system-linked research centre in Ontario, Canada.

Preoperative antibiotics and mortality in the elderly.

Objective And Background: It is generally thought that the use of preoperative antibiotics reduces the risk of postoperative infection, yet few studies have described the association between preoperative antibiotics and the risk of dying. The objective of this study was to determine whether preoperative antibiotics are associated with a reduced risk of death.

Methods: We performed a multivariate matched, population-based, case-control study of death following surgery on 1362 Pennsylvania Medicare patients between 65 and 85 years of age undergoing general and orthopedic surgery.

Analysis of criteria for metabolic syndrome in a population-based study of Japanese-Brazilians.

Objective: Criteria for metabolic syndrome (MS) differ particularly regarding the definition of central obesity and consequently, there could be differences in the assessment of cardiovascular risk. We estimated the prevalence of metabolic syndrome, compared the agreement of the World Health Organization (WHO) criteria with the standard and a modified National Cholesterol Education Program (NCEP) criterion and investigated whether additional factors were associated with the diagnosis of the syndrome in a Japanese descendant population.

Methods: In this cross-sectional, population-based survey, 1166 Japanese-Brazilians (533 men, 633 women) aged 57.

The health and well-being of caregivers of children with cerebral palsy.

Objective: Most children enjoy healthy childhoods with little need for specialized health care services. However, some children experience difficulties in early childhood and require access to and utilization of considerable health care resources over time. Although impaired motor function is the hallmark of the cerebral palsy (CP) syndromes, many children with this development disorder also experience sensory, communicative, and intellectual impairments and may have complex limitations in self-care functions.

Improving guideline adherence for the diagnosis of ADHD in an ambulatory pediatric setting.

Background: The American Academy of Pediatrics (AAP) has published clinical practice guidelines for the diagnosis of Attention Deficit Hyperactivity Disorder (ADHD). However, implementation of guidelines has been notoriously difficult to achieve in the wider context of changing individual physicians' clinical practice.

Objective: Implement a formalized diagnostic protocol for ADHD and study whether this protocol improved adherence of pediatric residents and faculty to published guidelines for the diagnosis of ADHD.

Effective rehabilitation for children and adolescents with brain injury: evaluating and disseminating the evidence.

Objective: To develop and evaluate literature reviews of the effectiveness of rehabilitation interventions for children with brain injury.

Design: We wrote 6 research summaries, which were evaluated by study participants.

Setting: Community.

Development, reliability and validity of a new measure of overall health for pre-school children.

Background: Few comprehensive systems are available for assessing and reporting the overall health of preschool children.

Objectives: (i) To develop a multi-dimension health status classification system (HSCS) to describe pre-school (PS) children 2.5-5 years of age; (ii) to report reliability and validity of the newly developed measure.

Allergy and infectious disease histories and the risk of childhood acute lymphoblastic leukaemia.

Infectious disease histories were evaluated in a population-based case-control study of childhood acute lymphoblastic leukaemia (ALL) as it has been hypothesised that delays in early infections are associated with an increased risk of disease. Allergy histories were also assessed as part of a broader evaluation of the role of immune factors in ALL. Cases (n = 255) were diagnosed between 1980 and 1991 at one of four referral centres in a 31-county area of New York State; controls (n = 760) were a random sample of live births from the same region, frequency matched to cases by sex, race and birth year.

Attributable effects in case2-studies.

In an effort to determine whether a particular treatment causes a particular outcome event, data are obtained from a database system that records events when they occur, and for such events, the system records exposure to the treatment. That is, the system records information about cases. The system provides no information about events that might have occurred but did not, that is, about units which are not cases.

[Body mass index, protein metabolism profiles and impact on IVF/ICSI procedure and outcome].

Objective: Higher risks of infertility have been found in overweight women. The purpose of the present study was to explore whether protein metabolism profiles related to body mass index (BMI) and to find out whether these parameters should affect IVF/ICSI outcome.

Patients And Methods: 52 patients were enrolled in this study.

Changes in prognosis after the first postoperative complication.

Background: Postoperative complications are common in the Medicare population, yet no study has formally quantified the change in prognosis that occurs after a broad range of first complications.

Objective: We sought to estimate the relative severity of 24 first postoperative complications.

Research Design: We undertook a multivariate matched, population-based, case-control study of death after surgery in a sample of 1362 Pennsylvania Medicare patients.

Malignant parotid tumors: presentation, clinical/pathologic prognostic factors, and treatment outcomes.

Purpose: To determine the important clinical/pathologic prognostic factors and optimal treatment of malignant parotid tumors.

Methods And Materials: This study was a retrospective chart review of 163 patients treated for malignant parotid tumors at two institutions. Of the 163 patients, 91 were treated with surgical resection and radiotherapy (RT), 56 were treated with surgery alone, and 13 were treated with RT alone.

An outbreak of multidrug-resistant Acinetobacter baumannii associated with pulsatile lavage wound treatment.

Context: Pulsatile lavage is a high-pressure irrigation treatment used increasingly in a variety of health care settings to debride wounds. Infection control precautions are not routinely used during the procedure and are not included in pulsatile lavage equipment package labeling.

Objectives: To investigate an outbreak of multidrug-resistant Acinetobacter baumannii and to test the hypothesis that pulsatile lavage wound treatment was the mode of transmission for the organism.

Plasma concentrations of endogenous hormones during one regular treatment cycle with a low-dose oral contraceptive and during two cycles with deliberate omission of two tablets.

In this open, prospective, phase-I study we closely monitored levels of endogenous progesterone, 17beta-estradiol, luteinizing hormone (LH) and follicle stimulating hormone in six healthy women. We determined plasma concentrations every 1-3 days during one untreated baseline cycle and during the first treatment cycle with regular pill intake of an oral contraceptive containing 30 microg ethinylestradiol plus 75 microg gestodene. During the following two treatment cycles, two tablets were deliberately omitted (in cycle 2 on days 6/7 and in cycle 3 on days 11/12).

Equivalent lengths of stay of pediatric patients hospitalized in rural and nonrural hospitals.

Background: Many children receive their care at local hospitals outside of a large urban area. There may be differences in the length of stay (LOS) between children hospitalized in rural versus urban hospitals. This study compared the differences in LOS, conditional LOS (CLOS), odds of prolonged stay, and 21-day readmission rates for children with 19 medical conditions and 9 surgical procedures admitted to rural, community, and large urban hospitals.

The health of primary caregivers of children with cerebral palsy: how does it compare with that of other Canadian caregivers?

Background: Caring for any child involves considerable resources, but the demands for these resources are often increased when caring for a child with a disability. These demands have implications for the psychologic and physical health of the caregiver (CG). Although a number of recent trends in health care stress the importance of studying and promoting the health of CGs of children with disabilities, the literature in this area exhibits 2 major weaknesses, ie, most studies draw conclusions from relatively small, potentially biased, clinic-based samples and the majority of work has focused on the psychologic health of CGs, whereas little research has been undertaken to study their physical well-being.

Changes in mobility of children with cerebral palsy over time and across environmental settings.

This study examined changes in mobility methods of children with cerebral palsy (CP) over time and across environmental settings. Sixty-two children with CP, ages 6-14 years and classified as levels II-IV on the Gross Motor Function Classification System, were randomly selected from a larger data base and followed for three to four years. On each of several assessments, parents completed a questionnaire on their child's usual mobility methods in the home, school, and outdoors/community settings.

Limb distribution, motor impairment, and functional classification of cerebral palsy.

This study explored the relationships between the Gross Motor Function Classification System (GMFCS), limb distribution, and type of motor impairment. Data used were collected in the Ontario Motor Growth study, a longitudinal cohort study with a population-based sample of children with cerebral palsy (CP) in Canada (n=657; age 1 to 13 years at study onset). The majority (87.

Reliability of family report for the Gross Motor Function Classification System.

The aim of this study was to determine the reliability of family reports for the Gross Motor Function Classification System (GMFCS), a condition-specific discriminative measure of severity of movement disability for children with cerebral palsy (CP). We conducted a cross-sectional survey using a short questionnaire with families of children with CP for whom we already had ratings of GMFCS level made by a health professional. We assessed the potentially confounding effect of whether the family had discussed the GMFCS with a professional.