Alterations to locomotor navigation in a complex environment at 7 and 30 days following a concussion in an elite athlete.

PRIMARY OBJECTIVE: To compare the locomotor capacity during (1) unobstructed walking and (2) the circumvention of fixed obstacles with and without a simultaneous visual task in an elite athlete before and after a sports-related concussion. RESEARCH DESIGN: Case report. METHODS AND PROCEDURES: Gait analysis and clinical neuropsychological measures were taken pre- and at 7 and 30 days post-injury in an 18 year old male junior hockey player. The task consisted of walking along an unobstructed or obstructed path with or without a visual interference task. Measurements included dual tasks costs, response errors, maximal gait speed and minimal clearance with the obstacle. MAIN OUTCOME AND RESULTS: Although the athlete was symptom-free and neuropsychological test results returned to baseline relatively quickly, he showed continued errors in the interference task, abnormally small obstacle clearance distances and decreased maximal gait speed up to 30 days after the concussion. CONCLUSIONS: Concussion can result in persistent planning and attention deficits in ecologically valid, complex environments. This report suggests that functional assessment within an ecological context could be an innovative way to evaluate concussed athletes before sending them back to play, even in the absence of medically related symptoms or abnormal neuropsychological test results.

[Non-organic failure to thrive: retrospective study in hospitalized children]. / Scarsa crescita non organica: studio retrospettivo su bambini ricoverati.

To evaluate incidence, clinical and laboratoristic values of patients with non organic failure to thrive (NOFTT), a retrospective study (January 1987-January 1991) among inpatient children of Department of Pediatrics of University of Padova was made. Thirty-six children (23 females and 13 males) aged 10 days to 22 months were selected. The incidence of NOFTT was 1.15% of total admission for the same age; it was more frequent in females than in males (F:M = 1.8:1) and it was more represented in children 0-3 months and 10-12 months aged. The main data have been: breast-feeding very frequent but early stopped (45% within the first month of life); administration of special formulas (soy milk, hydrolisate, hypoallergenic formulas) in 25% of cases. Specific symptoms in different ages: regurgitation, sucking problems and dysphagia more present in children less than 3 months, and inappetence and/or food refusal more represented in children more than 3 months. Ematologic and other lab values were totally normal.

[Liver transplant in childhood: our experience]. / Il trapianto epatico in età pediatrica: la nostra esperienza.

From december 1984 to december of 1991, 12 children underwent on orthotopic liver transplantation (OLT): 6 had extrahepatic biliary atresia (EHBA), 2 had Byler disease, 2 hepatocellular carcinoma (HCC), 1 Alagille Syndrome and 1 had a hyperacute Wilson disease. The children, transplanted for the most part a broad, return for observation 3 months after OLT. A patient with hyperacute Wilson's Disease had 2 emergency OLTs and died of sepsis (due to Aspergillus); another with EHBA, operated for hepatoportoenterostomy, without result, died after OLT because of a ruptured aortic aneurysm. The other 10 are living with a variable follow-up between 8 months and 7 years. The post-operatory complications were present in 4 cases: in the same patient (15 months old) a hepatic artery thrombosis and then a portal vein thrombosis were observed; 3 patients had to have their biliary-digestive anastomosis redone. 7 of 10 patients had acute rejection. During the first month after OLT infection episodes were mostly due to bacteria (G-), Candida and Pneumocystis carinii (blood and intraabdominal sepsis). In the second period (1-3 months) there were viral infections, in particular CMV. An emergency transplanted patient, incompletely vaccinated, developed HBV infection. During long term follow-up (after the 3rd months from OLT) the children usually have mild infections of the respiratory and urinary tracts. After 1 year, they have a mean annual growth velocity that is between the 50th and 90th percentile. They showed a good rehabilitation. Their hospitalizations rate was reduced if compared with the period before OLT. Health, motor function and general behavior improved significantly.(ABSTRACT TRUNCATED AT 250 WORDS)