The prevalence of cerebral palsy in British Columbia, 1991-1995.

OBJECTIVE: To quantify the prevalence of cerebral palsy (CP) in British Columbia within a four-year birth cohort. METHODS: The study was a population-based record linkage study of a birth cohort of British Columbian children born between April 1, 1991 and March 31, 1995. Cases were identified by the presence of International Classification of Diseases, Version 9 (ICD-9) diagnostic code "343" recorded at three years of age or older or by having the ICD-9 diagnostic code "343" recorded prior to the third birthday with two confirmatory diagnoses within the first three years of life through a record search of the BC Medical Services Plan billing files for the fiscal years 1991 to 1995. RESULTS/CONCLUSION: This research has provided an estimate of the prevalence of CP in the four-year birth cohort 1991 to 1995 in British Columbia. An aggregate prevalence rate of CP was measured as 2.68 per 1000 live births, and a congenital rate was measured at 2.57 for the same population. Birth weight and gestational age demonstrated a significant relationship with the development of CP. This study should lend credence to the establishment of a CP register in British Columbia.

Reliability of S100B in predicting severity of central nervous system injury.

S100B is a protein biomarker that reflects CNS injury. It can be measured in the CSF or serum with readily available immunoassay kits. The excellent sensitivity of S100B has enabled it to confirm the existence of subtle brain injury in patients with mild head trauma, strokes, and after successful resuscitation from cardiopulmonary arrest. The extent of S100B elevation has been found to be useful in predicting clinical outcome after brain injury. Elevations of S100B above certain threshold levels might be able to reliably predict brain death or mortality. A normal S100B level reliably predicts the absence of significant CNS injury. The specificity of S100B levels as a reflection of CNS injury is compromised by the findings that extra-cranial injuries can lead to elevations in the absence of brain injury. This potential problem can most likely be avoided by measuring serial S100B levels along with other biomarkers and carefully noting peripheral injuries. Serum markers GFAP and NSE are both more specific for CNS injury and have little to no extra-cranial sources. Sustained elevations of S100B over 24 h along with elevations of GFAP and NSE can more reliably predict the extent of brain injury and clinical outcomes. In the future, S100B measurements might reliably predict secondary brain injury and enable physicians to initiate therapeutic interventions in a timelier manner. S100B levels have been shown to rise hours to days before changes in ICP, neurological examinations, and neuroimaging tests. S100B levels may also be used to monitor the efficacy of treatments.

Sampling and analysis of aircraft engine cold start particles and demonstration of an electrostatic personal particle sampler.

Aircraft engines emit an aerosol plume during startup in extremely cold weather that can drift into areas occupied by flightline ground crews. This study tested a personal sampler used to assess exposure to particles in the plume under challenging field conditions. Area and personal samples were taken at two U.S. Air Force (USAF) flightlines during the winter months. Small tube-and-wire electrostatic precipitators (ESPs) were mounted on a stationary stand positioned behind the engines to sample the exhaust. Other ESPs were worn by ground crews to sample breathing zone concentrations. In addition, an aerodynamic particle sizer 3320 (APS) was used to determine the size distribution of the particles. Samples collected with the ESP were solvent extracted and analyzed with gas chromatography-mass spectrometry. Results indicated that the plume consisted of up to 75 mg/m(3) of unburned jet fuel particles. The APS showed that nearly the entire particle mass was respirable, because the plumes had mass median diameters less than 2 micro m. These tests demonstrated that the ESP could be used at cold USAF flightlines to perform exposure assessments to the cold start particles.