Retinoblastoma: Inventory in Mali and Program to Develop Early Diagnosis, Treatments and Rehabilitation.

Published February 9, 2013

Retinoblastoma: inventory in Mali and program to develop early diagnosis, treatments and rehabilitation.

Bull Cancer. 2013 Feb 8;
Traore F, Togo B, Sylla F, Cheick TB, Diakité AA, Dicko-Traore F, Sylla M, Sidibé T, Doz F, Harif M, Bey P, Desjardins L

Retinoblastoma (RB) is a rare embryonic tumour that represents 1/16,000 births in France. In Mali, a study showed the characteristics of a hospital series of cases seen in Bamako in the Pediatric Oncology Unit of Gabriel Touré Teaching Hospital and in the Tropical Ophthalmology Institute of Africa (IOTA) between January 2005 and June 2007. Median age was 4 years versus 2 years in France for unilateral disease. Near two third of children with RB had extra-ocular extension at diagnosis, which is now exceptional in France. Only 11% were bilateral versus 35% in France. Cure rate was around 50%, but it is estimated only on the cases arriving in Bamako and with at least 20% lost of follow-up. Cure rate is over 95% in France within an exhaustive register. RB appears as an exemplary tumor and rapid improvements could be obtained in low-income countries with relatively limited means. This is why, the Alliance mondiale contre le cancer (AMCC), the Institut Curie in Paris, which is the reference center in France for RB, and teams in Bamako were proposing a program to help the development of early diagnosis, treatments, including eye preservation, and rehabilitation of children with RB in sub-Saharan Africa in collaboration with the Groupe franco-africain d’oncologie pédiatrique (GFAOP). The official launching of this program was held in Bamako November 4(th), 2011 for Mali and the surrounding regions. After this first experience, this program is now implemented in other countries.
HubMed – rehab

Hematological abnormalities in severe anorexia nervosa.

Filed under: Rehab Centers

Ann Hematol. 2013 Feb 8;
Sabel AL, Gaudiani JL, Statland B, Mehler PS

Little is known about the prevalence of hematologic abnormalities in adults with severe anorexia nervosa. We report the first major analysis of hematologic dysfunction in such patients. We retrospectively analyzed the charts of 53 men and women with severe anorexia nervosa, admitted between October 2008 and December 2010 for medical stabilization to our center, which has a national referral base. Patients were predominantly female (89 %), with a median age of 28 years (range 17-65), and were hospitalized for a median duration of 15 days (I.Q.R. 9-29). Nadir body mass index during hospitalization was markedly low at 12.4 kg/m(2) (range 8.4-15.7), and the mean discharge BMI was 13.8 kg/m(2) (range 10.2-16.8). 83 % of patients were anemic (hematocrit <37 %), with only 3 (6 %) having iron deficiency. 79 % were leukopenic (WBC??400 k/?L) during their hospitalization. Eighty-nine percent of patients had resolved their neutropenia by discharge. Marked hematologic deficiencies are often present in patients with severe anorexia nervosa, generally attributed to starvation-mediated gelatinous marrow transformation which resolves with proper nutritional rehabilitation. Improved provider awareness of this association may reduce unnecessary testing and costly treatment interventions.
HubMed – rehab

The Cardiac Health and Assessment of Relationship Management and Sexuality Study: A Qualitative Inquiry of Patient, General Practitioner, and Cardiac Rehabilitation Staff Views on Sexual Assessment and Counseling for Cardiac Patients.

Filed under: Rehab Centers

J Cardiovasc Nurs. 2013 Mar; 28(2): E1-E13
D’Eath M, Byrne M, Doherty S, McGee H, Murphy AW

BACKGROUND:: Sexual dysfunction is a problem for some patients with cardiovascular disease. This study was the final phase of the Cardiac Health and Assessment of Relationship Management and Sexuality (CHARMS) study of sexual function, assessment, and counseling for people with coronary heart disease in Ireland. OBJECTIVES:: The aim of this study was to explore the perspectives of patients, cardiac rehabilitation staff, and general practitioners on the provision of sexual assessment and counseling within Irish health services and how it can be optimized. METHODS:: Group interviews with cardiac rehabilitation staff (n = 14) and patients (n = 13) and telephone interviews with general practitioners (n = 9) were conducted. The interviews were semistructured, digitally recorded, transcribed verbatim, and analyzed using qualitative, descriptive analysis. RESULTS:: All 3 stakeholder groups reported that the problem of sexual dysfunction among cardiac patients was an important issue that was underaddressed in practice. Patients want the issue to be addressed in an explicit way throughout and after the rehabilitation process by confident and knowledgeable professionals. Cardiac rehabilitators widely acknowledged the role that they could play in the provision of sexual assessment and counseling, but many were constrained by a perceived lack of knowledge and confidence. Most cardiac rehabilitation staff would welcome relevant guidelines and training. General practitioners were unlikely to initiate a discussion about sexual dysfunction; however, most were confident that patients would be comfortable in raising it. General practitioners would welcome more awareness raising but did not identify a need for specific training or resources. CONCLUSIONS:: Perspectives differed both across and within stakeholder groups about current services and the development of future services. A disconnect exists between the service that the professionals perceive they give and that experienced by patients. Sexual assessment and counseling should be addressed more explicitly, and patients should be empowered to seek individual assessment and counseling at a time that is appropriate for them.
HubMed – rehab

The effects of task demands on bimanual skill acquisition.

Filed under: Rehab Centers

Exp Brain Res. 2013 Feb 8;
Hoyer EH, Bastian AJ

Bimanual coordination is essential for everyday activities. It is thought that different degrees of demands may affect learning of new bimanual patterns. One demand is at the level of performance and involves breaking the tendency to produce mirror-symmetric movements. A second is at a perceptual level and involves controlling each hand to separate (i.e., split) goals. A third demand involves switching between different task contexts (e.g., a different uni- or bimanual task), instead of continuously practicing one task repeatedly. Here, we studied the effect of these task demands on motor planning (reaction time) and execution (error) while subjects learned a novel bimanual isometric pinch force task. In Experiment 1, subjects continuously practiced in one of the two extremes of the following bimanual conditions: (1) symmetric force demands and a perceptually unified target for each hand or (2) asymmetric force demands and perceptually split targets. Subjects performing in the asymmetric condition showed some interference between hands, but all subjects, regardless of group, could learn the isometric pinch force task similarly. In Experiment 2, subjects practiced these and two other conditions, but in a paradigm where practice was briefly interrupted by the performance of either a unimanual or a different bimanual condition. Reaction times were longer and errors were larger well after the interruption when the main movement to be learned required asymmetric forces. There was no effect when the main movement required symmetric forces. These findings demonstrate two main points. First, people can learn bimanual tasks with very different demands on the same timescale if they are not interrupted. Second, interruption during learning can negatively impact both planning and execution and this depends on the demands of the bimanual task to be learned. This information will be important for training patient populations, who may be more susceptible to increased task demands.
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