Neck pain in children: a retrospective case series.

INTRODUCTION: Spinal pain in the paediatric population is a significant health issue, with an increasing prevalence as they age. Paediatric patients attend for chiropractor care for spinal pain, yet, there is a paucity of quality evidence to guide the practitioner with respect to appropriate care planning. METHODS: A retrospective chart review was used to describe chiropractic management of paediatric neck pain. Two researchers abstracted data from 50 clinical files that met inclusion criteria from a general practice chiropractic office in the Greater Toronto Area, Canada. Data were entered into SPSS 15 and descriptively analyzed. RESULTS: Fifty paediatric neck pain patient files were analysed. Patients' age ranged between 6 and 18 years (mean 13 years). Most (98%) were diagnosed with Grade I-II mechanical neck pain. Treatment frequency averaged 5 visits over 19 days; with spinal manipulative therapy used in 96% of patients. Significant improvement was recorded in 96% of the files. No adverse events were documented. CONCLUSION: Paediatric mechanical neck pain appears to be successfully managed by chiropractic care. Spinal manipulative therapy appears to benefit paediatric mechanical neck pain resulting from day-today activities with no reported serious adverse events. Results can be used to inform clinical trials assessing effectiveness of manual therapy in managing paediatric mechanical neck pain.

INTRODUCTION: La douleur vertébrale chez la population pédiatrique constitue un important problème desanté, avec une prévalence croissante à mesure qu'ils grandissent. Les patients pédiatriques consultent des chiropraticiens pour des douleurs vertébrales; toutefois, il y a toujours un manque de preuves de qualité pour guider le praticien à planifier des soins appropriés. MÉTHODOLOGIE: Un examen rétrospectif des dossiers a été utilisé pour décrire la gestion chiropratique dela douleur cervicale chez les patients pédiatriques. Deux chercheurs ont extrait des données d'une clinique de chiropratique de la région du Grand Toronto, au Canada, portant sur 50 dossiers cliniques qui répondaient aux critères d'inclusion. Les données ont été saisies dans SPSS 15 et soumises à une analyse descriptive. RÉSULTATS: Cinquante dossiers de patients pédiatriques souffrant de douleurs cervicales ont été analysés. La tranche d'âge des patients variait de 6 à 18 ans (moyenne de 13 ans). La plupart (98 %) ont reçu un diagnostic de cervicalgie mécanique de stade I­II. La fréquence de traitement était en moyenne 5 visites sur une période de 19 jours, la thérapie de manipulation vertébrale étant utilisée pour 96 % des patients. Une amélioration significative a été enregistrée dans 96 % des cas. Aucun incident indésirable n'a été documenté. CONCLUSION: Il semble que la cervicalgie mécanique chez les patients en pédiatrie soit gérée avec succès par des soins chiropratiques. La thérapie de manipulation vertébrale semble être bénéfique au traitement, chez les patients pédiatriques, de la cervicalgie mécanique survenue à la suite des activités quotidiennes sans signalement d'effets indésirables graves. Les résultats peuvent être utilisés pour informer les essais cliniques évaluant l'efficacité de la thérapie manuelle dans la gestion de la cervicalgie mécanique chez les patients en pédiatrie.

Quality of structured abstracts of original research articles in the British Medical Journal, the Canadian Medical Association Journal and the Journal of the American Medical Association: a 10-year follow-up study.

BACKGROUND: We compared the quality of structured abstracts of original research articles from the British Medical Journal (BMJ), Canadian Medical Association Journal (CMAJ), and the Journal of the American Medical Association (JAMA) from 1991 to 1992 and 2001 to 2002 between journals. METHODS: A random, stratified sample of 54 abstracts from 2001 to 2002 in BMJ, CMAJ, and JAMA was compiled and coded. Two blinded raters reviewed 27 abstracts each against 33 objective criteria, separated into eight categories (purpose, research design, setting, subjects, intervention, measurement of variables, results, and conclusion). The quality score was the proportion of criteria present (range = 0-1). RESULTS: The overall mean quality score (0.74) for 2001-2002 was significantly higher than the 1988-1989 unstructured abstracts (mean = 0.57; p<0.001) but not different from the 1991-1992 structured abstracts (mean = 0.74; p>0.05). In 2001-2002, abstracts of CMAJ and JAMA (both means = 0.76) improved significantly over 1991-1992 (p<0.05) and scored significantly higher than BMJ (mean = 0.71; d.f. = 16, p<0.05). Some individual criteria scores (intervention, statistical information) improved but information was found consistently under-represented in areas that imply shortcomings of the studies. INTERPRETATION: We found a consistency in abstract quality regardless of the precise format used by different journals. This indicates that the framework for research articles already in place should be maintained and further modification of the framework may not necessarily improve the abstract quality.

Molecular cloning of a new gene which is differentially expressed in breast and prostate cancers.

OBJECTIVE: The chromosomal region 19q13 is non-randomly rearranged in many solid tumors. METHODS: Using the positional candidate gene approach, we cloned a new gene, tentatively named cancer-associated gene (CAG), which is differentially expressed in breast and prostate cancers. RESULTS: The gene is formed of 3 exons and 2 intervening introns. Its coding region is 1,047 bp in length and is predicted to encode a 348-amino-acid polypeptide. The new gene maps to chromosome 19q13.4 and is located 14 kb telomeric to the kallikrein gene locus (KLK14 gene) and 17 kb centromeric from the Siglec family of genes (Siglec-9). The gene is expressed in a wide variety of tissues including the brain, colon, kidney and pancreas. The CAG protein shows a high degree of conservation among species and phylogenetically is most closely related to its mouse ortholog. In silico analysis indicates that this gene is differentially expressed in a variety of tumors including brain, colon, ovarian and prostate cancers. CONCLUSIONS: Our preliminary experimental data show that CAG is upregulated in prostate cancer tissues compared to normal prostatic tissues. CAG also appears to be downregulated in breast cancer tissues. The physiological function of the CAG protein is currently unknown.