SUMMARY Fifty‐seven boys with Duchenne muscular dystrophy aged between 6 years 3 months and 13 years 6 months, who were at the point of losing the ability to walk or had recently done so, were fitted with lightweight knee‐ankle‐foot orthoses to re‐establish walking. 47 walked well and independently in their orthoses, achieving good stability and confidence. 20 are still ambulant; the other 27 stopped walking at intervals ranging from eight to 48 months. Prolongatión of walking prevented the development of scoliosis, joint contractures and deformities and also benefited the boys psychologically. RÉSUMÉ Prolongatión de la marche dans la myopathie de Duchenne par orthése de faible poids: étude de 57 cas Cinquante sept garçons atteints de myopathie de Duchenne, âgés de six ans trois mois à 13 ans six mois, qui étaient sur le point de perdre la capacité de marche ou l'avaient récemment perdue ont été appareillés avec des orthéses légères genoucheville‐pied pour réétablir la marche. 47 garçons marchèrent bien et de facon indépendante dans leur orthése, présentant une bonne stabilité et confiance. 20 marchent encore; les 27 autrés s'arrétérent de marcher après des intervalles allant de huit à 48 mois. La prolongatión de la marche à empêché le développement de scoliose, de contractures articulaires et de déformations et fut psychologiquement bénéfique pour ces garçons. ZUSAMMENFASSUNG 57 Jungen mit einer Muskeldystrophie vom Typ Duchenne im Alter von sechs Jahren und drei Monaten bis 13 Jahren und sechs Monaten, die im Begriff waren, ihre Gehfähigkeit zu verlieren, oder diese gerade schon verloren hatten, wurden mit leichten Unterschenkelgehhilfen ausgestattet, die ihnen das Gehen wieder ermöglichten. 47 konnten mit ihren Gehhilfen gut und ohne Hilfe laufen und erreichten gute Stabilität und Selbstvertrauen. 20 laufen immer noch, die anderen 27 haben in Intervallen, die von acht bis 48 Monate reichen, aufgehört zu laufen. Die Verlängerung der Gehfähigkeit hat die Entwicklung einer Skoliose, sowie Gelenkkontrakturen und Deformierungen verhindert und auch den Jungen psychologisch geholfen. Verlängerung der Gehfähigkeit durch leichte Gehhilfen bei Patienten mil einer Muskeldystrophie vom Typ Duchenne: ein Überblick über 57 Fälle RÉSUMÉN Prolongacidn de la deambulaciín en la distrofia muscular de Duchenne con ortosis ligeras. Revisidn de 57 casos à cincuenta y siété niños con distrofia muscular de Duchenne de edades conprendidas entre seis años y 3 meses y 13 años y seis meses, que se hallaban próximos à perder su capacidad para andar o que la habian perdido hacia poco, se les aplicó unas ortosis ligeras de rodilla, tobillo y pie con el objeto de restablecerles la marcha. 47 anduvieron bien y con independencia con las ortesis, consiguiendo una buena estabilidad y confianza. 20 pueden todavia andar. Los otros 28 cesaron de andar à intervalos que iban de ocho à 48 meses. La prolongatión de la deambulaciín previno el desarrollo de escoliosis, contracturas y deformidades articulares, ademas de beneficiar à los nifios psicológica...

BackgroundDespite progress in reducing cigarette smoking in the general U.S. population, smoking rates, cancer morbidity and related heart disease remain strikingly high among the poor and underserved. Homeless individuals’ cigarette smoking rate remains an alarming 70 % or greater, and this population is generally untreated with smoking cessation interventions. Furthermore, the majority of homeless smokers also abuse alcohol and other drugs, which makes quitting more difficult and magnifies the health consequences of tobacco use.Methods/DesignParticipants will be randomized to one of three groups, including (1) an integrated intensive smoking plus alcohol intervention using cognitive behavioral therapy (CBT), (2) intensive smoking intervention using CBT or (3) usual care (i.e., brief smoking cessation and brief alcohol counseling). All participants will receive 12-week treatment with a nicotine patch plus nicotine gum or lozenge. Counseling will include weekly individual sessions for 3 months, followed by monthly booster group sessions for 3 months. The primary smoking outcome is cotinine-verified 7-day smoking abstinence at follow-up week 52, and the primary alcohol outcome will be breathalyzer-verified 90-day alcohol abstinence at week 52.DiscussionThis study protocol describes the design of the first community-based controlled trial (n = 645) designed to examine the efficacy of integrating alcohol abuse treatment with smoking cessation among homeless smokers. To further address the gap in effectiveness of evidence-based smoking cessation interventions in the homeless population, we are conducting a renewed smoking cessation clinical trial called Power to Quit among smokers experiencing homelessness.Trial registrationClinicalTrials.gov Identifier: NCT01932996. Date of registration: 20 November 2014.

An inpatient rehabilitation program appears to positively impact optimal outcomes (functional recovery and discharge to home) for selected patients with HT and is comparable with regional and national FIM gain and efficiency for patients admitted to IRFs with other cardiac conditions.

Here, we characterize the cool weather insect fauna found associated with partially skeletonized and desiccated human remains recovered from an abandoned house in an urban area of subtropical, coastal Galveston County, Texas, and use the information to conclude an approximate postmortem interval of 7-10 months. The predominant factors that allow for a confident assessment of the postmortem interval include climatological data, entomological data, and anthropological data. The documented insect fauna represents a unique assemblage present in a particular environment (an urban abandoned house in coastal Texas) at a particular time of year (winter) and includes expected forensically significant insects such as calliphorid flies, muscid flies, and dermestid beetles but also includes less commonly encountered insects such as an unusually dense population of live case-making clothes moths.

not discharged after LVAD to either home or rehab (in hospital death = 27, other facility = 8, unknown = 5) were excluded from the analysis. Results: Of the 263 patients included in the analysis, the mean age was 57 years (+/-14) and 200 (81.6%) were male. The discharge locations after LVAD implant were the following: home-116 (44.1%), IRF-79 (30.0%), SNF-68 (25.9%). Risk factors for requiring a rehabilitation facility after LVAD included older age, destination therapy status, lower INTERMACS score and a lower albumin at the time of implantation (Table ). Despite markers of severe illness at the time of implant, discharge to a rehabilitation unit was not statistically associated with increased mortality in the final adjusted model (HR 0.89, 95 % 0.48-1.67). Conclusion:In this analysis, > 50% of patients required admission to a rehabilitation facility, either IRF or SNF, following LVAD implantation. Although patients who required a rehabilitation facility generally had higher medical acuity at implant, survival was comparable to those who were discharged home, emphasizing the need for quality rehabilitation services in this subset of LVAD patients.