[Granulocyte transfusion]. / Granulocyttransfusjon.

BACKGROUND: Granulocyte transfusion is used in the treatment of severe, sustained or complicated infection and neutropenia. In recent years, the method's efficacy has improved and its availability increased. After the introduction of granulocyte colony-stimulating factor (G-CSF) there has been a growing interest for granulocyte transfusion, and effective methods for collection and transfusion of granulocytes are now in clinical use. This paper presents clinical, immunological and ethical challenges, our own experience with granulocyte harvesting and documentation of efficacy. MATERIAL AND METHODS: The paper is based on our own experience with granulocyte transfusion and literature retrieved though a non-systemic search. RESULTS: The efficacy of granulocyte transfusion with respect to morbidity and mortality is still debated, and the method currently has no place in routine treatment of documented infection and neutropenia. However, the treatment could be an alternative for patients with inadequate response to conventional treatment and for whom sustained neutropenia is expected. The combined use of G-CSF, hydroxyethyl starch and corticosteroids considerably increases the yield of granulocytes collected for transfusion. INTERPRETATION: Granulocyte transfusion is clinically feasible, but more research is needed to define clinical indications and to document the procedure's efficacy. Larger randomized controlled efficacy trials are needed.

[Children with cerebral palsy referred to a multidisciplinary habilitation unit]. / Barn med cerebral parese henvist til en tverrfaglig habiliteringsenhet.

BACKGROUND: At Akershus University Hospital a new multidisciplinary team was set up to serve neurologically impaired children. We investigated how many children with cerebral palsy were referred to the team and whether referral resulted in an associated diagnosis. MATERIAL AND METHODS: All children with a diagnosis of cerebral palsy referred up until the end of the team's first year of full service were included. Data on birth weight and mobility were retrieved from patient files. Additional diagnoses were registered at inclusion date and two years later and compared to prevalence studies. RESULTS: 182 children had a diagnosis of cerebral palsy. 41 out of 114 children (36%) in the age bracket 6-14 were described as walking without using aids. After a minimum of two years' follow-up, 80 children had no neurological or psychiatric diagnosis (except cerebral palsy). INTERPRETATION: Children with mild motor impairment were underrepresented, and associated impairments, except epilepsy, were diagnosed less often than expected.