Aim To determine the association between gross motor function and nutritional status in children with cerebral palsy (CP) residing in an urban area in a developing country. Method We conducted a cross‐sectional study in 177 children (ages 2–12y, 59.3% male) with a diagnosis of CP who were attending rehabilitation centres in Bucaramanga, Colombia (2012–2013). A physiotherapist evaluated patients using the Gross Motor Function Classification System (GMFCS, levels I to V). Nutritional status was evaluated by nutritionists and classified according to the World Health Organization growth charts. We used linear and multinomial logistic regression methods to determine the associations. Results There were 39.5%, 6.8%, 5.6%, 16.4%, and 31.6% patients classified in levels I to V respectively. The mean adjusted differences for weight‐for‐age, height‐for‐age, BMI‐for‐age, and height‐for‐weight z‐scores were significantly larger for children classified in levels II to V compared with those in level I. The children classified in levels IV and V were more likely to have malnutrition (adjusted odds ratio [OR] 5.64; 95% confidence interval [CI] 2.27–14.0) and stunting (OR 8.42; 95% CI 2.90–24.4) than those classified in GMFCS levels I to III. Interpretation Stunting and malnutrition are prevalent conditions among paediatric patients with CP, and both are directly associated with higher levels of gross motor dysfunction.

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Background: We investigated whether surveillance imaging had an impact on post-relapse survival in patients with rhabdomyosarcoma (RMS). We hypothesized that relapse detected by imaging (group IM) would be associated with longer survival compared with relapse detected with a clinical sign or symptom (group SS). Materials and Methods: We performed an observational multi-institutional study in 127 patients with relapsed RMS comparing overall survival (OS) after relapse using Kaplan-Meier and Cox proportional hazards analyses. Results: Relapse was detected in 60 (47%) group IM and 67 (53%) SS patients. Median follow-up in survivors was 4 years (range 1.0 to 16.7 y). Four-year OS rates were similar between group IM (28%, 95% confidence interval [CI]: 14%-40%) and SS (21%, 95% CI: 11%-31%) (P=0.14). In multivariable analyses accounting for institution, age at diagnosis, time to relapse, risk group at diagnosis, and primary site, not receiving chemotherapy (hazard ratio [HR]: 6.8, 95% CI: 2.8-16.6), radiation (HR: 3, 95% CI: 1.7-5.3), or surgery (HR: 2.8, 95% CI: 1.6-4.8) after relapse were independently associated with poor OS. Conclusion: These results on whether surveillance imaging provides survival benefit in patients with relapsed RMS are inconclusive. Larger studies are needed to justify current surveillance recommendations. Chemotherapy, radiotherapy and surgery to treat recurrence prolong OS.

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ResumenIntroducción: La ausencia de instrumentos con adecuadas propiedades psicométricas adaptados para Colombia, que evalúen las barreras de acceso a los programas de rehabilitación cardiovascular justifica esta investigación. Objetivo: Determinar la validez de contenido de la Escala de Barreras para la Rehabilitación Cardiaca en población colombiana. Métodos y materiales: Se realizó un estudio de pruebas diagnósticas. En la primera fase se requiririeron dos traductores de lengua materna español y uno de lengua materna inglesa para la traducción y retrotraducción del cuestionario original. En la segunda fase se realizó la adaptación transcultural y se evaluó la validez de contenido mediante un panel de cuatro expertos con experiencia en investigación, medicina deportiva y rehabilitación cardiaca. Resultados: El instrumento fue traducido y adaptado al español colombiano. El panel de expertos decidió eliminar el ítem 18 de la escala original. El índice de validez de contenido fue aceptable para la mayoría de los ítems, excepto para los ítems 10, 15 y 18, por lo cual se realizaron modificaciones en palabras, frases o conjugaciones verbales según las recomendaciones del panel. Por otra parte, el Indice de Validez de Contenido en relevancia fue de 0,86 y en pertinencia de 0,88. Conclusión: Se cuenta con un instrumento que evalúa barreras de acceso a los programas de rehabilitación cardiovascular adaptada a población colombiana y con validez de contenido, por lo cual los resultados que se obtengan de la aplicación de la escala serán válidos. No obstante, se sugiere continuar con la evaluación de la reproducibilidad del instrumento. AbstractIntroduction: This research was based on the absence of instruments with appropriate psychometric properties, adapted for Colombia, which evaluate the barriers of access to cardiovascular rehabilitation programs. Objective: To determine the validity of content of the barriers scale for the cardiac rehabilitation in Colombian population. Methods and materials: A study of diagnostic tests was done. In the first phase, two native speakers of Spanish and one of English were required to translate and retro translate the original questionnaire. In the second phase, the transcultural adaptation was done and the validity of content was assessed by a panel of four experts with experience in research, sports medicine and cardiac rehabilitation. Results: The instrument was translated and adapted to the Colombian Spanish. The panel of experts decided to remove the item 18 from the original scale. The content validity index was acceptable for the majority of the items, except for items 10, 15 and 18, where modifications were made in terms of words, phrases or conjugations according to the

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Résumé Chez une malade dans le sérum de laquelle existait une puissante leuco‐agglutinine et qui présentait à chaque transfusion des chocs violents ont été entreprises des expériences de transfusion des diffé‐rents éléments du sang. Aucun choc n'a suivi I'injection du plasma, du plasma riche en plaquettes, du sang appauvri en leucocytes. Un choc a été observé chaque fois que les leucocytes en nombre suffisant ont été injectés. Ces résultats ont conduit à n'utiliser chez cette malade que du sang préalablement appauvri en leucocytes. Depuis lors aucun choc n'a plus été enregistré. Une technique de préparation du sang appauvri en leucocytes est présentée. Summary In a patient whose serum contained a potent leuko‐agglutinin and who suffered severe shock at every blood transfusion, experiments were undertaken with various elements of blood. The injection of plasma, of plasma rich in platelets, and of blood with a reduced leukocyte content did not cause any shock, but shock occurred whenever sufficient leukocytes were given. Following these results, the patient was treated only with blood from which most leukocytes had been removed, and from then on no shock was observed any more. The technique used for removing the leukocytes is described in detail. Zusammenfassung Bei einer Patientin, deren Serum ein hochtitriges Leukozytenagglutinin enthielt, und die Lei jeder Vollbluttransfusion mit einem schweren Schock reagierte, wurden versuchsweise die verschiedenen Zellelemente des Blutes getrennt transfundiert. Die Transfusion von Plasma, plättchenreichem Plasma und leukozytenarmem Blut wurde von der Patientin reaktionslos ertragen. Jedesmal, wenn eine genügende Anzahl Leukozyten transfundiert wurde, reagierte die Patientin mit einem mehr oder minder schweren Schock. Diese Beobachtung veranlaßte uns, dieser Patientin nurmehr leukozytenarme Erythrozytenaufschwemmungen zu transfundieren, welche von ihr bisher stets reaktionslos ertragen wurden. Eine Technik zur Herstellung von leukozytenarmen Erythrozytenaufschwemmungen wird beschrieben.

RESUMEN La medición de la calidad de vida (CV) permite establecer la percepción general del individuo a los procesos de saludenfermedad, el tratamiento instaurado y la percepción de la salud.