Eighteen SCA patients and 21 age-matched controls were tested. Upright standing was perturbed using rotations of the support surface. We recorded body motion and surface EMG. For lateral perturbations peaks in COM lateral velocity were larger in SCA patients than controls. These peaks were correlated with increased (“”hypermetric”") trunk roll downhill and reduced uphill knee flexion velocity. Subsequent arm abduction partially CB-5083 corrected the lateral instability. Early balance
correcting responses in knee and paraspinal muscles showed reduced amplitudes compared with normal responses. Later responses were consistent with compensation mechanisms for the lateral instability created by the stiffened knee and pelvis. We conclude that truncal hypermetria coupled with insufficient uphill knee flexion is the primary cause of lateral instability in SCA patients. Holding the knees and pelvis more rigid possibly permits a reduction in the controlled degrees of freedom and concentration on arm abduction to improve lateral instability. For backwards perturbations excessive posterior COM velocity
coincided with marked trunk hypermetric flexion forwards. We concluded that this flexion and the ensuing backwards shift of the pelvis result from rigidity which jeopardizes posterior stability. Timing considerations and the lack of confirmatory changes in amplitudes of EMG activity suggest that lateral and posterior instability in SCA is Selleck EPZ004777 primarily a biomechanical response to pelvis and knee rigidity resulting from Pitavastatin mw increased muscle background activity rather than changed evoked responses. (C) 2009 IBRO. Published by Elsevier Ltd. All rights reserved.”
“Purpose: We investigated ethnic differences in the risk of post-pyelonephritic renal scarring in infants and children for possible genetic determinants.
Materials and Methods: We searched all peer reviewed articles published from 1980 through 2006 in the PubMed (R), MEDLINE (R) (Ovid), Cochrane Central Register of
Controlled Trials and EMBASE (R) databases for the keywords, “”renal scarring and pyelonephritis,”" “”renal fibrosis”" and “”kidney scarring.”" References were included only when they specified acute pyelonephritis defined by a fever, positive urine culture and areas of photopenia in the renal cortex on 99mtechnetium dimercapto-succinic acid renal scans, repeat dimercapto-succinic acid scans obtained at least 3 months after acute pyelonephritis to assess for renal cortical scar formation and absence of recurrent urinary tract infection during followup. When possible data were analyzed according to patients and renal units.
Results: Among 23 references the overall rates of renal scarring in terms of patients and renal units were 41.6% and 37.0%, respectively. In terms of patients the incidence of renal scarring following acute pyelonephritis varied by region, from 26.5% (Australia) to 49.0% (Asia).