Reconstructive neurosurgery for Parkinson's disease: a systematic review and preliminary meta-analysis.

This systematic review and meta-analysis aimed to identify the determinants for best practice and establish current benchmarks for recovery following reconstructive neurosurgery for people with Parkinson's disease. Eleven studies reporting results for 95 grafted patients were selected on the grounds of using optimal surgical techniques and the Core Assessment Program for Intracerebral Transplantation (CAPIT) protocol for data collection. Consistent trends demonstrating high levels of recovery were identified on most outcome measures. Determinants for best practice were identified as selecting younger patients; using low dose immunosuppression; bilateral grafting; and employing strategies to ensure the quantity and viability of the grafted cells. Secondary analysis of data demonstrated a correlation of rho=0.666 (P<0.05) between increases in striatal dopaminergic activity and UPDRS Motor (off) scores. Overall effect size 'd' was found to be 1.129 UPDRS Motor (off) condition and 0.719 for UPDRS Total (off) condition. The design of the studies and the variable standards for reporting the data precluded the use of more powerful and accurate meta-analyses. It was recommended that the creation of a collaborative database would improve the extraction of data and allow for more powerful statistical analyses for evaluating the overall harm and benefits associated with reconstructive neurosurgery.

Implications of neurological rehabilitation for advancing intracerebral transplantation.

Neurological rehabilitation involves the systematic presentation of environmental stimuli and challenges that enable the patient to learn strategies for minimizing their disabilities. Rehabilitation therapy of transplant recipients may be an important factor in enhancing the efficacy of the transplanted organ or tissue to promote functional recovery. Laboratory research and clinical trials on neural transplantation, as an experimental treatment for neurological disorders (e.g., Parkinson's disease, Huntington's disease, and cerebral ischemia), have focused primarily on devising effective surgical implantation strategies with little attention devoted to the interaction between environmental factors and restorative neurosurgery. Exercise training as part of neurological rehabilitation may be an important factor for neural transplantation therapy for Parkinson's disease. Rehabilitation providers are particularly well placed to provide the environment and the support to optimize the behavioral functioning of neural transplant patients in learning to use the new grafted tissue.

Caudate nucleus lesions impair the ability of rats to learn a simple straight-alley task.

Learning to run down a straight alley for a food reward was investigated in rats with lesions of the telencephalon. Over 84 trials the running latencies of rats with lesions of the caudate nucleus were significantly greater than those of subjects with lesions of the frontal cortex or sham-lesioned rats. The running latencies of the cortical- and the sham-lesioned groups were not significantly different. It was suggested that the performance of the caudotomized rats reflected a learning deficit.

Objective knowledge about Huntington's disease and attitudes towards predictive tests of persons at risk.

The task of genetic counselling of people at risk for Huntington's disease might be facilitated by increased knowledge of relevant population characteristics. The aim of the present study was to clarify select socioeconomic characteristics, knowledge concerning the disease, and attitudes towards predictive tests of people at 50% risk of inheriting Huntington's disease in the state of Victoria. A random sample of subjects was drawn from the Huntington's disease register and 50 questionnaires were analysed. Respondents completed three questionnaires which covered their socioeconomic characteristics, the extent and accuracy of their knowledge about the genetic, progress, and treatment of Huntington's disease, and their attitude and acceptance of predictive tests as well as their intentions about future reproduction. A very positive attitude was found to be held by the respondents towards a predictive test if it was safe, reliable, and non-invasive. Resultant problems which would arise, should a reliable test be found, are discussed. The respondent's knowledge concerning the disease was found to be adequate generally.

The bad old days: clandestine abortions among the poor in New York City before liberalization of the abortion law.

In surveys of poverty neighborhoods in New York City conducted in 1965 and 1967, it became apparent that clandestine abortions were more frequently reported as occurring when the woman was married and had one to three children than before marriage or after three children had already been born. Knowledge of persons who could induce an abortion was not very common among the women interviewed, and most of those who were known did not have any specialized medical training. Physicians were involved in only two percent of the respondents' own reported abortion attempts and in six percent of those among their friends, relatives and acquaintances. There was a fairly large variety of methods known and used that were supposed to provoke an abortion. The largest proportion of these were substances taken by mouth--some of which, like turpentine, Chlorox and massive doses of quinine, are quite dangerous. The next largest group involved uterine insertions. Other types of methods like massage and baths were quite rare. The popularity of the oral route of administration may be relevant to biomedical researchers who are developing new fertility regulating methods and are concerned about their acceptability.

The effect of an additional birth on low-income urban families.

Abstract The effects of the birth of an additional child to families living in poverty areas of New York City are studied in this paper. Surveys conducted by the National Opinion Research Center in 1965 and 1967 provided the data in a panel of parous or married women of childbearing age. Control ling for the number of children in the family in 1965, the non-occurrence of an additional birth in the following two years was found to have a significant effect on current income, savings, reliance on public assistance, general ability to plan and organize one's household, and wife's employment. No significant effects were found with respect to possession of consumer durables or attending a school or training course. While many claims have been made about the beneficial effects of family planning on family welfare, this study is among a very small number where such effects are empirically documented.

Introductory statement: the objectives and history of birth planning.

PIP: The major reasons given for population planning are health, human rights, ecological balance and political economy of population size. Contraception, however, is an old subject and has been used since classical times. France showed the earliest widespread use of contraception in Europe in the nineteenth century with the goal of improvement of family status. The extension of birth control in the U.S. was promoted by feminists such as Goldmann and Sanger as a necessary part in the emancipation of woman. The eugenics philosophy of population bloomed in the 1920s and 1930s and led in part to the policies of Hitler. In the 1960s the demographic factors of population growth were given more consideration. In the mid 1960s ecologists explained population growth as a damaging force to the environment through its depletion of resources and pollution, and thus felt it must be limited on ecological grounds. This mixture of reasons for population planning has led to a decrease in humanitarian concerns and thus the health and welfare of clients is often not the prime concern in population programs.^ieng