Cytomegalovirus (CMV) infection generally causes asymptomatic infection in the majority of immunocompetent individuals. However, the presentation may be complicated by life-threatening conditions in ...immunocompromised patients. We report a case of a 23-year-old healthy Caucasian female with acute CMV infection and splenic infarction. Serological studies confirmed acute CMV infection, and echocardiography did not show any evidence of endocarditis or mural thrombosis. We did not consider antiviral and anticoagulation therapies due to the immunocompetent nature of the patient and since the condition was suspected to be a minor vessel disease likely triggered by CMV infection.
Objective
Illness perceptions are key determinants of behavior directed at managing disease. Although suboptimal disease management has been reported in patients with gout, patients' perceptions of ...illness have not been systematically studied. The aim of this study was to examine illness perceptions in patients with gout.
Methods
A total of 142 patients with gout for <10 years were recruited from primary and secondary care settings. Participants completed a gout‐specific Brief Illness Perception Questionnaire, questionnaires about medication beliefs and adherence to urate‐lowering therapy (ULT), and had a comprehensive assessment of gout disease activity. Serum urate, flare frequency, and Health Assessment Questionnaire (HAQ‐II) scores were recorded at baseline and after 1 year.
Results
Patients viewed gout as a chronic condition that was responsive to treatment but not strongly influenced by personal actions. Overall, gout was seen as having a moderate impact on their life. Most patients believed that gout was caused by dietary factors. Adherence to ULT was positively associated with a greater perceived understanding of gout and inversely associated with perceived severity and consequences of disease. Of the clinical factors assessed, pain scores were most strongly associated with negative illness perception scores at baseline. Baseline illness perception scores (perceived severity of symptoms and consequences, lower personal and treatment control) predicted worsening musculoskeletal disability at 1 year as determined by the HAQ‐II. This relationship was independent of baseline disability scores.
Conclusion
Negative or pessimistic views about gout are associated with poorly controlled disease, lower adherence to ULT, and progression of musculoskeletal disability in patients with gout.
Aim
Lower limb surgery is often performed in ambulatory children with cerebral palsy (CP) to improve walking ability. This mapping review reports on outcome measures used in the published literature ...to assess surgical results, determine range and frequency of use, and map each measure to the International Classification of Functioning, Disability and Health.
Method
A mapped review of literature published between 1990 and 2011 was carried out to identify papers reporting the outcomes of lower limb orthopaedic surgery in ambulatory children with CP, aged 0 to 20 years.
Results
A total of 229 published papers met the inclusion criteria. Thirty‐two outcome measures with known psychometric properties were reported in the 229 papers. Twenty measures assess impairments in body structure and function and were used in 91% of studies. Ten measures assess restrictions in activity and participation and were used in 9% of papers. Two measures assessed quality of life. Since 1997, 29% of papers have used the Gross Motor Function Classification System to describe participants.
Interpretation
The body of literature evaluating outcomes of lower limb orthopaedic surgery in CP is small but increasing. There is a need to develop a suite of outcome measures that better reflect outcomes across the International Classification of Functioning, Disability and Health, including activity and participation.
What this paper adds
Less than half of recently published studies use the GMFCS to classify participants.
The activity and participation domain of the ICF is not well represented in current studies of orthopaedic surgical outcomes.
Further work is needed to define a minimum data set to adequately capture the outcomes of lower limb orthopaedic surgery in CP.
To investigate whether drawings of the self walking by children with cerebral palsy (CP) were associated with walking ability and illness perceptions.
This was an exploratory study in 52 children ...with CP (M:F = 28:24), mean age 11.1 years (range 5-18), who were attending tertiary level outpatient clinics. Children were asked to draw a picture of themselves walking. Drawing size and content was used to investigate associations with clinical walk tests and children's own perceptions of their CP assessed using a CP version of the Brief Illness Perception Questionnaire.
Larger drawings of the self were associated with less distance traveled, higher emotional responses to CP, and lower perceptions of pain or discomfort, independent of age. A larger self-to-overall drawing height ratio was related to walking less distance. Drawings of the self confined within buildings and the absence of other figures were also associated with reduced walking ability.
Drawing size and content can reflect walking ability, as well as symptom perceptions and distress. Drawings may be useful for clinicians to use with children with cerebral palsy to aid discussion about their condition.
Full text
Available for:
CEKLJ, FFLJ, NUK, ODKLJ, PEFLJ
Purpose: To assess an individual child's cognitive and emotional perceptions of their cerebral palsy (CP) and how these are associated with their reported life satisfaction and their functional ...walking ability.Method: Convenience sample of 48 children with cerebral palsy, GMFCS (Gross Motor Function Classification System) I-IV, mean age of 12.2 ± 2.5 years was recruited from tertiary level out-patient clinics. All children completed the Brief Illness Perception Questionnaire-Cerebral Palsy version (BIPQ-CP), Students' Life Satisfaction Scale (SLSS) and 1- and 6-min walk tests.Results: Children with CP reported levels of global life satisfaction (mean score 31.4/42) equivalent to previous studies of typically developing children. Higher total SLSS scores were associated with lower concern about CP (rho = −0.61, p < 0.001), lower emotional impact (rho = −0.58, p < 0.001), fewer perceived consequences (rho = −0.53, p < 0.001) and perceptions of higher levels of personal control (rho = 0.40, p = 0.01). Multiple regression models using BIPQ-CP constructs found that a combination of lower level of concern and fewer perceived consequences predicted 46% of the variance in SLSS score (p < 0.001). GMFCS levels, walk distance and age were not significant predictors of life satisfaction. Conclusions: Life satisfaction in this group of children was strongly associated with a child's perceptions of their CP but was not associated with functional walking ability. Although the cross-sectional nature of the study precludes assumptions of causality, understanding children's cognitive and emotional beliefs about their cerebral palsy would seem to be an important adjunct to clinical management.
Implications for Rehabilitation
Children with cerebral palsy as young as eight years can self-report cognitive and emotional beliefs about their condition.
The reported degree of concern about cerebral palsy is the strongest predictor of the child's reported level of life satisfaction.
Those children with cerebral palsy who do report high levels of concern about their condition also report that they have feelings of reduced personal control and are more affected emotionally, suggesting possible targets for intervention.
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