Spinal muscular atrophy (SMA) is a common neuromuscular disorder of childhood, associated with a high mortality rate during the first 2 years of life. Most practitioners expect patients with SMA to follow a progressive course with loss of muscle strength and function over 2-10 years. Counselling sessions with parents frequently emphasize the high mortality rate and risk for respiratory failure. The progressive nature of SMA has been attributed to the loss of motor neurons. Fifty-eight children, ages 6 years and younger, were examined between January, 1987, and April, 1992, as part of a large, multicenter collaborative study of SMA. Muscle function was evaluated at regular intervals using a standardized protocol that was demonstrated to be reliable. We determined a prevalence of 56% for tongue fasciculations, a prevalence of 22% for facial weakness, and persistent deep tendon reflexes in one patient. Improved motor function and acquired milestones during the study were documented. This work should contribute toward a better understanding of the natural history of SMA.

Child↗

PubMedDate not supplied

Radiation-associated carcinoma of the salivary glands. A controlled study.

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Head and Neck Neoplasms↗

PubMedDate not supplied

The medical aspects of soccer injury epidemiology.

In this article, the six major studies of soccer injury epidemiology are reviewed. Strengths and weaknesses of each epidemiologic design are critiqued and the crucial importance of the definition of injury is emphasized. The effect of age, sex, and intensity of play on injury rates is discussed. Our present knowledge of injury rate by anatomical site, player position, and the type of playing surface are reviewed. We examined the importance of player factors such as flexibility, joint laxity, weakness, and incomplete rehabilitation from other injuries. In addition, we reviewed the role played by inadequate equipment, field conditions, and rule violations. A successful program for soccer injury prevention is described, and guidelines for future soccer injury epidemiology research are proposed.

Adolescent↗

PubMedDate not supplied

Atlantooccipital junction: standards for measurement in normal children.

This study describes a simple method for measuring the distance between the occiput and atlas when a distraction-dislocation injury is suspected in a child. Measurements were made at five evenly spaced locations along the atlantooccipital joint on cross-table lateral skull radiographs in 100 normal children. These data were compared with similar measurements in eight patients with proved atlantooccipital dislocation. The mean normal measurement fell between 1.96-2.63 mm for all five points. For boys or girls aged 1-15 years, the normal distance should not exceed 5 mm at any point in the joint. The likelihood that any normal child will have a measurement greater than or equal to 4.5 mm at any point is between 0.4-5.85% (expected false-positive rate).

Adolescent↗