Applicability of a new robotic walking aid in a patient with cerebral palsy. Case report.

BACKGROUND: Gait training with the help of assistive technological devices is an innovative field of research in neurological rehabilitation. Most of the available gait training devices do not allow free movement in the environment, which would be the most suitable natural and motivating condition for training children with neurological gait impairment. AIM: To evaluate the potential applicability of a new robotic walking aid as a tool for gait training in non-ambulatory children with Cerebral Palsy. DESIGN: Single case study SETTING: Outpatient regimen POPULATION: A 11-years-old child unable to stand and walk independently as a result of spastic tetraplegic cerebral palsy (CP). METHODS: The experimental device was a newly actuated version of a dynamic combined walking and standing aid (NF-Walker®) available in the market which was modified by means of two pneumatic artificial muscles driven by a foot-switch inserted in the shoes. The child was tested at baseline (while maintaining the standing position aided by the non-actuated NF-Walker®) and in the experimental condition (while using the actuated robotic aid). The outcome measures were: 2-minute walking test, 10-metre walking test, respiratory and heart parameters, energy cost of locomotion. RESULTS: At baseline, the child was unable to perform any autonomous form of locomotion. When assisted by the actuated aid (i.e. during the experimental condition), the child was successful in moving around in his environment. His performance was 19.63 m in the 2-minute walking test and 64 s in the 10-metre walking test. Respiratory and heart parameters were higher than healthy age-matched children both at baseline and in the experimental condition. The energy cost of gait, which was not valuable in the baseline condition, was significantly higher than normality during the experimental condition. CONCLUSION: The new robotic walking aid may help children suffering from CP with severe impairment of gait to move around in their environment. CLINICAL REHABILITATION IMPACT: This new robotic walking device may have a potential impact in stimulating the development and in training of gait in children with neurological gait impairment. Future studies are warranted in order to test this hypothesis.

[Detection of lysergic acid diethylamide in human urine: elimination, screening and analytical confirmation]. / Détection de l'acide lysergique diéthylamide (LSD) dans l'urine humaine: élimination, dépistage et confirmation analytique.

The Coat-A-Count DPC and Roche Abuscreen RIA for LSD were used to search for LSD in urines containing various drugs commonly found in specimens from addicted groups. Elimination of LSD in urine of a volunteer after ingestion of 50 micrograms confirmed that LSD can be detected after 3 days at 0.1 ng/ml cut-off level. Chromatographic conditions were restudied and the full spectrum of trimethylsilyl LSD at 0.125 ng with ion trap GC-MS (ITS40) was shown.

[The transsexual after sex change. Evolution and prognosis]. / Le transsexuel après le changement. Evolution et pronostic.

Sex reassignment surgery is at the present time the most acceptable solution which can be offered to the transsexuals. Diagnosis, postoperative status, prognostic factors and outcome are taken into account, with the purpose of having a better assessment for these patients.

[Catamnestic study of 76 cases of heroin addiction among young adults (5 to 12 year follow-up)]. / Etude catamnestique de 76 cas de toxicomanie à l'héroïne chez de jeunes adultes (5 à 12 ans de recul).

A group of 76 narcotic addicts (53 male, 23 female) first admitted to the "Clinique Psychiatrique Universitaire", Lausanne, between January 1970 and December 1977 were followed up 5 to 12 years later. The average age of first admission was 21,82; the average age of narcotic addition, 19. Over the period, 5.3% died - half directly from their addiction, half by suicide. In 1982 the status of 14,5% was uncertain. Only 13,2% were still known to be using drugs whereas 21% were under treatment (methadone maintenance program: 17,1%) and 2,6% in prison. Thirty-three subjects (43,4%) have achieved stable abstinence, i.e. haven't been using any opioid drug for 5 months before follow-up. Findings on employment and marital status indicated a satisfactory social adjustment for a majority of subjects.

[Drug addiction and culture]. / Toxicomanie et culture.

In the course of ages drug always existed. It accompanied man in migrations, conquests and defeats. Formerly bordered upon some countries, and witness of a determined culture, drug has now a planetary dimension. In a way, it is the price of our material progress. Medicine has a limited understanding of the fact. It is worth while when approaching the therapeutic problem of drug addict to study new ways in approaching the problem.

[Ophthalmological side effects of lithium (author's transl)]. / Les effets secondaires du lithium en ophtalmologie.

Among the side-effects due to the psychotropic drugs, one knows the ocular lesions, especially those due to major tranquillizers (f.e. opacities in the cornea and the lens). Ocular examination of 73 patients suffering of affective disorders, and receiving lithium salts during several years showed no significant ocular lesions due to the medication.

[Alcoholism in the young]. / Alcoolisme des jeunes.

The ideas on alcoholism have somehow changed during these last years. In the past, ideas were axed mainly on the individual causes of alcoholism; today we are more interested on the sociocultural factors. Statistics prove, on the other hand, that there is a considerable increase of alcoholism by the youth. Young people begin earlier ordinary consumption of alcohol, or take alcohol with drugs, or replace hard drugs by alcohol. It is very urgent to study this new phenomenon, and to think about new structures, in order to take care of the victims of this new pathology.