[CME:Heparin-Induced Thrombocytopenia]. / CME: Heparin-induzierte Thrombozytopenie.

CME:Heparin-Induced Thrombocytopenia Abstract. Heparin-induced thrombocytopenia (HIT) is a dangerous, potentially fatal, immunologically mediated side effect of heparin. Typically, five to ten days after heparin exposure there is a decrease in platelet count with a mean of 60 x 109/l. Due to an activation of thrombocytes by HIT antibodies, venous or more rarely arterial thromboses may occur. The diagnosis of HIT includes the calculation of the probability of a HIT using the 4T Score and the laboratory detection of HIT antibodies. The HIT therapy represents the immediate discontinuation of the heparin therapy as well as the beginning of an alternative therapeutic anticoagulation.

Behavioral and emotional problems in children and adults with cerebral palsy.

OBJECTIVE: In patients with cerebral palsy (CP), psychological problems influence their participation in society. Little is known about the persistence of behavioral and social problems into adulthood. MATERIALS AND METHODS: In a two-center cross-sectional study, caregivers of 121 adults and 88 children were ask to assess behavior of the patients through the parent/caregiver forms of the Child Behavior Checklist (CBCL), the Strengths and Difficulties Questionnaire (SDQ), and the Vineland Adaptive Behavior Scale II (VABS). Questionnaires were returned from 43 adults and 39 children. RESULTS: In both groups we found the same frequency of abnormalities in attention problems (32.4 vs. 36.1%, p = 0.826) and social interaction problems (32.3 vs. 33.3%; p = 0.926) in the CBCL, and peer problems (38.9 vs. 75.7%; p = 0.115) in the SDQ. Children show a lower percentage of abnormal prosocial behavior (41.7 vs. 16.2%, p = 0.016) and lower abnormal rates of communication (88.2 vs. 61.5; p = 0.01) and daily living skills (90.0 vs. 71.8; p = 0.041), whereas the level of abnormalities in both groups in these dimensions of VABS notably high. CONCLUSION: The persistence of psychological and social problems from childhood into adulthood underlines the importance of focusing on early intervention.