A new mechanism based on the seeding effect of the substrate is p

A new mechanism based on the seeding effect of the substrate is proposed to interpret the experimental results.”
“Guided tissue regeneration

(GTR) membranes with bioabsorbable characteristics have been employed, in recent years, for periodontal AZD2171 procedures to deflect the growth of gingival tissues away from root surface. They provide an isolated space over regions with defective tissues and allow the relatively slow growing periodontal ligament fibroblasts to be repopulated over the root surface. In this study, we have employed chitosan and tricalcium phosphate (beta-TCP) as viable membrane materials and evaluated their roles in GTR applications. Three types of beta-TCP/chitosan membranes, weight ratio of beta-TCP/chitosan 65 : 35, 33 : 67, and 10 : 90, were prepared for three categories: the mechanical strength to create an effective space; the rapid rate to reach hydrolytic equilibrium in phosphate buffer solution; and the ease of clinical manipulations. Consequently, standardized, transosseous, and critical-sized (cavity of 8 mm) skull defects were made in adult rabbits, and the defective regions were covered with the specifically prepared chitosan membranes. After 4 weeks of recovering, varying degrees of bone healing were observed beneath the beta-TCP/chitosan membranes in comparison to the control group. The beta-TCP/chitosan membranes covered

regions showed a clear boundary space between C646 cost connective tissues and bony tissues. Over all, good cell-occlusion and beneficial osteogensis effects by these bioabsorbable materials toward the wound recovery were indicated. (c) 2009 Wiley Periodicals, Inc. J Appl Polym Sci 112: 3127-3134, 2009″
“Objective This study explored associations between

the recently proposed three-factor structure of the 12-item Functional Assessment of Chronic Illness TherapySpiritual Well-being (FACIT-Sp) subscale (Peace, Meaning, and Faith), quality of life (QoL), and coping in an oncology population. Methods A total of 999 newly diagnosed, study eligible, consecutive cancer patients completed the FACIT-Sp and the Mental Adjustment to Cancer (MAC) scale. Results Hierarchical multiple regressions this website revealed that Peace alone added 3% to the prediction of QoL and accounted for 15.8% of the overlap in Total Functional Assessment of Cancer TherapyGeneral (FACT-G) scores (both p<0.001). Meaning alone added 1.3% to QoL prediction and accounted for 5.8% in overlap (both p<0.001). Faith did not significantly contribute to the unique prediction or overlap of QoL. Correlational analyses revealed that Peace was most prominently associated with the QoL subscales of Functional (r = 0.64) and Emotional Wellbeing (r = 0.61) and the coping styles of Helpless/Hopeless (r = -0.53), Fighting Spirit (r = 0.47), and Anxious Preoccupation (r = -0.34).

For the first time, the left and right anterior epidural volume b

For the first time, the left and right anterior epidural volume between the peridural

membrane and the posterior concavity of the lumbar vertebral bodies L3-S1 were determined for each segment. A CT scan and a polyester resin injection were used for the in vitro measurements.

The volumes determined in human cadavers using this method ranged from 0.23 ccm for L3 to 0.34 ccm for L5. The CT concavity volume determination showed this increase in volume from cranial to caudal, as well.

This volume is large enough to hold average-sized slipped discs without causing neurological deficits. A better understanding of the anterior epidural space may allow a better distinction of patient treatment options.”
“Objective.

To evaluate the utility of quantitative computerized pain drawings (CPDs) www.selleckchem.com/products/pu-h71.html in a sample of spine patients before and after surgery.

Design.

Analysis of changes in quantified CPDs, the Oswestry selleck compound Disability Index (ODI), the Short Form-36 Health Survey Questionnaire (SF-36), and numerical ratings

of pain intensity before and after surgery.

Setting.

Private clinic in large metropolitan area.

Patients.

Forty-six patients with spinal stenosis.

Interventions.

Surgery for the relief of pain due to spinal stenosis.

Outcome Measures.

A total points (TP) score was calculated from the CPD that reflected the total number LY333531 ic50 of pixels filled by the patient, and the percentage of total pain area indicated as aching, stabbing, numbness, pins and needles, burning, and other, were each calculated separately. CPD scores, ODI score, Physical Components Summary (PCS) and Mental Components Summary scores of the SF-36, and pain intensity ratings (0-10 scale) were all recorded before and after surgical intervention.

Results.

After surgery, patients showed significant improvements in the extent of shaded pain area of the CPD, pain intensity ratings, ODI, and SF-36 PCS scores (paired t-test,

P < 0.01). Changes in TP scores calculated from the CPDs were significantly correlated (P < 0.05) with changes in ODI scores (r = 0.34) and pain intensity ratings (r = 0.37). Changes in the percentage of total pain area covered by specific qualities of pain were not significant.

Conclusions.

Results from the present study provide initial support for the use of automated quantified data collected from CPDs to evaluate treatment interventions and to serve the clinician as a record of changes in spatial location, radiation or extent of pain, and the sensory quality of pain when evaluating individual patient needs.”
“Contents This study evaluated the effects of follicular phase administration of TAK-683, an investigational metastin/kisspeptin analog, on follicular growth, ovulation, luteal function and reproductive hormones in goats.

This survey analyzed

data from 81,799 adults (45,148 men

This survey analyzed

data from 81,799 adults (45,148 men and 36,651 women) who underwent health examinations at Chang Gung Memorial Hospital, in northern Taiwan, from 2000 through 2007. Hyperuricemia was defined as an SUA greater than 7.7 mg/dL in men or greater than 6.6 mg/dL in women. Patients were classified by uric acid-metabolic syndrome status as follows: A = no hyperuricemia and no metabolic syndrome, B Selleck BMN673 = presence of metabolic syndrome but not hyperuricemia, C = presence of hyperuricemia but no metabolic syndrome, and D = presence of both hyperuricemia and metabolic syndrome. Kidney function was assessed in terms of the estimated glomerular filtration rate (eGFR) by using the Modification of Diet in Renal Disease Study equation modified for Chinese. CKD was defined as an eGFR < 60 mL/min/1.73 m(2). The prevalences of hyperuricemia, metabolic syndrome, and CKD were 22.8% (26.3% in men and 18.6% in women), 13.5% (15.0% in men and 11.6% in women), and 2.2% (2.1% in men and 2.2% in women), respectively. In men, the age-adjusted odds ratios for CKD, with group A as reference,

were 1.95 for group B, 4.86 for group C, and 5.85 for group D. In women, the age-adjusted odds ratios were 1.96 for group B, 6.66 for group C, and 9.01 for group D. Hyperuricemia is strongly associated with CKD, independent of the presence of https://www.selleckchem.com/products/lonafarnib-sch66336.html metabolic syndrome.”
“Background: Ventricular rate control (VRC) is an important treatment strategy for patients with permanent atrial fibrillation (AF). We assessed the prevalence of poor VRC and the adequacy of various intermittent monitoring regimens to accurately characterize HER2 inhibitor VRC during permanent AF. Methods: We retrospectively analyzed data from dual chamber implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy defibrillator (CRT-D) patients in the Medtronic Discovery (TM) Link having permanent AF (AF burden >23 hours/day) and =365 consecutive days of device data. Poor VRC was defined as a day with the mean ventricular rate during AF >100 beats/minute (bpm) for ICD patients and >90 bpm for CRT-D patients. Intermittent monitoring regimens were simulated

from continuous device data by randomly selecting subsets of days in which data were available for analysis. Assessments of poor VRC were computed after replicating 1,000 simulations. Results: ICD (n = 1,902, age = 71 +/- 10) and CRT-D (n = 3,397, age = 72 +/- 9) patients were included and followed for 365 days. The prevalence of poor VRC was 24.8% among ICD patients and 28.6% among CRT-D patients. Significantly more patients were identified as having poor VRC with continuous monitoring compared to all intermittent monitoring regimens (sensitivity range = 8%31%). Furthermore, 11.6% of ICD patients and 17.9% of CRT-D patients experienced =7 days with poor VRC, to which the sensitivities of annual 7- and 21-day recordings were <7% and <20%, respectively.

Survival time was predicted to be 45 6 +/- A 0 9 months (mean +/-

Survival time was predicted to be 45.6 +/- A 0.9 months (mean +/- A standard deviation). Based on the log-rank test, the reoperation rate was higher at L5-6 (p = 0.002) and two-level (p = 0.01) NVP-AUY922 Cytoskeletal Signaling inhibitor DIAM (TM) implantation compared with L4-5 and one-level DIAM (TM) implantation. However, gender (p = 0.16), age (p = 0.41), and diagnosis (p = 0.67) did not significantly affect the

reoperation rate of DIAM (TM) implantation. Based on a Cox regression model, L5-6 [hazard ratio (HR), 10.3; 95% CI, 1.7-63.0; p = 0.01] and two-level (HR, 10.4; 95% CI, 1.2-90.2; p = 0.04) DIAM (TM) implantation were also significant variables associated with a higher reoperation rate. Survival time was significantly lower in L5-6 (47 vs. 22 months, p = 0.002) and two-level DIAM (TM) implantation (46 vs. 18 months, p = 0.01) compared with L4-5 and one-level DIAM (TM) implantation. The current results suggest that 8% of the patients who have a DIAM (TM) implantation for primary lumbar spinal stenosis or disc herniation are expected to undergo reoperation at the same level within 4 years after surgery. Based

on the limited data set, DIAM (TM) implantation at L5-6 and two-level in patients with LSTV are significant PF-6463922 risk factors for reoperation.”
“In the framework of large deformation diffeomorphic metric mapping (LDDMM), we present a practical methodology to integrate prior knowledge about the registered shapes in the regularizing metric. Our goal is to perform rich anatomical shape comparisons from volumetric images with the mathematical properties offered by the LDDMM framework. We first present the notion of characteristic scale at which image features are deformed. We then propose a methodology to compare anatomical shape variations in a multi-scale fashion, i.e., at several characteristic scales simultaneously. In this context, we propose a strategy to quantitatively measure the feature differences observed at each characteristic scale separately. After describing our methodology, we illustrate the performance of the method on selleck compound phantom data. We then compare the ability of our method to segregate a group

of subjects having Alzheimer’s disease and a group of controls with a classical coarse to fine approach, on standard 3D MR longitudinal brain images. We finally apply the approach to quantify the anatomical development of the human brain from 3D MR longitudinal images of pre-term babies. Results show that our method registers accurately volumetric images containing feature differences at several scales simultaneously with smooth deformations.”
“The objective of this study was to evaluate variations in podophyllotoxin concentrations in Juniperus species found in the Big Horn Mountains in Wyoming. It was found that Juniperus species in the Big Horn Mountains included three species; J. communis L (common juniper), J. horizontalis Moench. (creeping juniper) and J. scopulorum Sarg. (Rocky Mountain juniper).

Moreover, electron microscope observations indicate that slight m

Moreover, electron microscope observations indicate that slight miscut (similar to 0.5 degrees) of the R-plane sapphire substrate almost completely suppresses the formation of twinning defects in the (11 (2) over bar6) GaN films. (C) 2010 American Institute of Physics. [doi :10.1063/1.3475521]“
“The comparison of the degree of crystallinity and the micromechanical properties in the blends of recycled amorphous poly(ethylene terephthalate) (PET) with isotactic polypropylene (iPP) and high-density polyethylene (HDPE) with a compatibilizer

in different proportions is reported. The physical study of the composites of the compatibilized blends and clay is also discussed. The analysis, performed by means of wide-angle X-ray scattering and www.selleckchem.com/products/pd-1-pd-l1-inhibitor-2.html differential scanning calorimetry techniques, permits us to describe, at microscale level, the role of the compatibilizer on the structure and microhardness of the polymer blends that we studied. The results reveal that PET was incompatible with both iPP and HDPE. However, the presence of the compatibilizer, a styrene ethylene/butylene Ulixertinib ic50 styrene block copolymer grafted with maleic anhydride, allowed the compatibilization of these polymers. In the PET/iPP blends, the

clay seemed to have a nucleating effect on the iPP and also induced a hardness increase in the compatibilized blends. On the other hand, in case of PET/HDPE, the crystallinity of these samples (pure blends, blends with compatibilizer, and blends with compatibilizer plus clay) only depended on their composition. Similarly to the PET/iPP blends, the addition of clay induced an increase in the hardness of the compatibilized find more blends. (C) 2010 Wiley Periodicals, Inc. J Appl Polym Sci 118: 1278-1287, 2010″
“High-resolution

synchrotron radiation diffraction results indicate that the room temperature tetragonal (T) phase in (93-92)%Pb(Zn(1/3)Nb(2/3))O(3)-(7-8)%PbTiO(3) [PZN-(7-8)%PT] single crystals is a metastable phase stabilized by the transformation-cum-cooling stress in the crystal. This is manifested by the “”missing”" (001)(T) diffractions when the diffractions were taken from (001) fractured surfaces. The stress relaxation in this case has caused the metastable (001)(T) domains in the surface layer to transform to the equilibrium rhombohedral phase. Temperature and particle size effects on the metastable domains have been examined and discussed. Based on the present finding, a new PZN-PT phase diagram showing extended rhombohedral+tetragonal region is proposed. (C) 2010 American Institute of Physics. [doi:10.1063/1.3460804]“
“The effect of cellulases and beta-glucanases was evaluated for energy savings in the papermaking refining process. Two commercial enzyme preparations. Celluclast 1.

It was located between the omotransverse muscle and axillary arte

It was located between the omotransverse muscle and axillary artery and vein. The sensitive effect in the forelimb was seen mainly in the area supplied by the musculocutaneous nerve, indicating successful blockage in 17DMAG order the nerve plexus. Out of the eight forelimbs, the motor effect was observed in seven forelimbs. These results suggest the clinical feasibility of ultrasound-guided brachial plexus block in bovine medicine, although further studies are needed to examine various approaches, including

the sites of needle insertion and the appropriate volume and dosage of anaesthetic. (C) 2012 Elsevier Ltd. All rights reserved.”
“The aggregation of the microtubule-associated protein tau into paired-helical filaments is the defining characteristic of the tauopathies. It has become apparent that the hyperphosphorylation of tau likely plays a role in the aggregation process and thus strategies to reduce

www.selleckchem.com/products/cftrinh-172.html tau phosphorylation are generating wide interest. The O-GlcNAc posttranslational modification of tau has been shown to be reciprocal to its phosphorylation; increasing O-GlcNAc leads to reductions in tau phosphorylation. In this mini-review, we highlight the use of chemical compounds as a means of understanding the reciprocal nature of tau phosphorylation and tau O-GlcNAcylation and highlight some recent progress in this area.”
“Background: Malaria remains a major cause of morbidity and mortality among children under five years of age in Nigeria. Most of the early treatments for fever and malaria occur through self-medication with anti-malarials bought over-the-counter (OTC) from untrained drug vendors. Selfmedication through drug vendors can be ineffective, with increased risks of drug toxicity and development of drug resistance. Global malaria control initiatives highlights the potential role of drug vendors to improve access to early effective malaria treatment, which underscores the need for interventions to improve treatment obtained from these outlets. This

study aimed to determine the feasibility and impact of training rural drug vendors on community-based malaria treatment and advice with referral of severe cases to AZD5153 molecular weight a health facility.

Methods: A drug vendor-training programme was carried out between 2003 and 2005 in Ugwuogo-Nike, a rural community in south-east Nigeria. A total of 16 drug vendors were trained and monitored for eight months. The programme was evaluated to measure changes in drug vendor practice and knowledge using exit interviews. In addition, home visits were conducted to measure compliance with referral.

Results: The intervention achieved major improvements in drug selling and referral practices and knowledge. Exit interviews confirmed significant increases in appropriate anti-malarial drug dispensing, correct history questions asked and advice given.

1%, 13 9%, and 5 7%, respectively,

and did not differ sig

1%, 13.9%, and 5.7%, respectively,

and did not differ significantly by the baseline cytology interpretation (ASCUS or LSIL). Taking HPV genotypes into account, having a CIN 1 (compared with no CIN 1) was not a Selleckchem PU-H71 risk factor for developing CIN 3 (OR 0.99, 95% CI 0.54-1.8).

CONCLUSION: A CIN 1 diagnosis does not represent a significant risk factor for CIN 3 above the risk attributed to its molecular cause, genotype-specific HPV infection.”
“Purpose of review

Drug-refractory ventricular tachycardia in the setting of structural heart disease results in frequent implantable cardioverter defibrillator therapies and an increased risk of heart failure. Management requires catheter ablation procedures for effective suppression of the arrhythmia.

Recent Sapitinib clinical trial findings

Imaging and electroanatomic mapping technologies provide new insights into the myocardial structural

abnormalities responsible for ventricular tachycardia. Integration of imaging data with three-dimensional mapping systems coupled with improved targeting of abnormal electrical signals may improve the ablation outcomes. New ablation tools show promise for the effective ablation of previously unreachable myocardial ventricular tachycardia circuits.

Summary

Catheter ablation procedures have evolved over the last 2 decades. Improved technology may contribute to more widespread utilization of catheter ablation in the LY333531 cost future.”
“Leptadenia reticulata, a member of Asclepiadaceae, is a pharmaceutically important plant and has a number of medicinal properties. We describe here first time an efficient in vitro regeneration protocol using leaf of mature plant as explant. Callus was induced from cut ends of leaf inoculated on MS medium containing 1.0 mg l(-1) each of 2,4-D and BAP + additives. MS medium having a concentration of 2,4-D (0.5 mgl(-1)) and BAP (0.5 mgl(-1)) was found optimum for callus proliferation. Shoot differentiation from proliferated callus was observed on MS medium containing BAP alone or in combination with

IAA or NAA. The maximum number (30.70+/-1.70) of shoots with average length (8.62+/-0.32 cm) was produced on MS medium having a combination of BAP (0.5 mgl(-1)) and NAA (0.1 mgl(-1)). The shoots (81.6%) were rooted in vitro on one-fourth strength MS medium supplemented with IBA (1.5 mgl(-1)) and 100 mgl(-1) AC. For ex vitro rooting (85.0%), shoot bases were pretreated with auxin (IBA 200 mgl(-1)) for 3 min. Rooted plantlets by both methods were successfully acclimatized under the green house conditions with about 95% survival rate. The present protocol may be applicable for (i) large scale plant production (ii) germplasm conservation (iii) genetic transformation (iv) protoplast fusion and (v) superior somaclonal variants selection of this multipurpose medicinally important endangred plant. (C) 2013 Elsevier B.V. All rights reserved.

The purpose of this paper was to evaluate the results

of

The purpose of this paper was to evaluate the results

of cementless arthroplasty with a simultaneous subtrochanteric shortening osteotomy in a group of patients with Crowe type-IV developmental dysplasia of the hip.

Methods: In a retrospective study, we evaluated the results and complications of twenty-eight consecutive primary cementless total hip arthroplasties in twenty-four patients (twenty women and four men), all of whom had Crowe type-IV developmental dysplasia of the hip. The arthroplasty was performed in combination with a subtrochanteric shortening osteotomy and with placement of the acetabular component at the level of the anatomic hip center. The patients were evaluated at a mean of 4.8 years postoperatively.

Results: LXH254 mw The mean Harris hip score increased from 43 points preoperatively to 89 points at the time of final follow-up (p < 0.01). Twelve (43%) of the twenty-eight hips had an early or late complication or a reoperation. Two (7%) of the twenty-eight subtrochanteric osteotomies were followed by nonunion. There was one instance of isolated loosening of the femoral stem. One acetabular component loosened, and one acetabular

liner disengaged. Four hips dislocated postoperatively. All remaining components were well-fixed at the time of the last radiographic follow-up. No sciatic neurapraxic injuries were identified.

Conclusions: Cementless total hip arthroplasty combined selleck with a subtrochanteric femoral shortening osteotomy in patients with a high hip dislocation secondary buy PS-341 to developmental dysplasia was associated with high rates of successful fixation of the implants and healing of the osteotomy site and a mean postoperative Harris hip score of 89 points. The complication rate, however, was substantially higher than that associated with primary total hip arthroplasty in patients with degenerative arthritis.”
“The majority of studies of surgical outcome focus on measures of function and pain. Increasingly, however, the desire

to include domains such as patients’ satisfaction and expectations had led to the development of simple measures and their inclusion into clinical studies. The purpose of this study was to determine patients’ pre-operative expectations of and post-operative satisfaction with the outcome of their spinal surgery.

As part of the FASTER randomised controlled trial, patients were asked pre-operatively to quantify their expected improvement in pain and health status at 6 weeks, 6 and 12 months following surgery using 100 mm visual analogue scales (VAS), and to indicate their confidence in achieving this result and also the importance of this recovery to them. Patients were then asked to rate their satisfaction with the improvement achieved at each post-operative review using 100 mm VAS.

A variety of FePt nanocrystals, including nanowires, nanorods, na

A variety of FePt nanocrystals, including nanowires, nanorods, nanocubes, and nanosized DNA Damage inhibitor multipods, were successfully obtained. The shape control was realized by simply varying synthesis

parameters. The as-synthesized nanocrystals, having chemically disordered fcc structure, are found to be superparamagnetic at room temperature and their ferromagnetic-superparamagnetic transition temperature is size dependent that increases with particle size. The as-synthesized FePt nanocrystals were transformed to the chemically ordered L1(0) structure upon heat treatment, which exhibits hard magnetic properties with coercivity as high as 25 kOe. (C) 2009 American Institute of Physics. [DOI: 10.1063/1.3077210]“
“The redox properties of the hydroethanol extract

(EE) and its ethyl acetate (EAF) and hydromethanol (HMF) fractions obtained from Abarema cochliacarpos (Gomes) Barneby & Grimes stem bark were evaluated. EAF had the highest total phenol content (848.62 +/- 78.18mgg(-1)), while EE showed the highest content of catechin (71.2 mu gg(-1)). EE, EAF and HMF exhibited the highest levels of antioxidant find more activity at 100 and 1000 mu gmL(-1) when the non-enzymatic antioxidant potential was evaluated by the total reactive antioxidant potential, total antioxidant reactivity and nitric oxide scavenging assays. In addition, EAF and HMF showed SOD-like activity. The results for EE, EAF and HMF in this study showed that A. cochliacarpos (Gomes) Barneby & Grimes stem bark have redox properties and may be able to help the endogenous enzymatic and non-enzymatic systems to keep the redox balance.”
“To assess the patterns of, and trends over time in, health-related

quality of life (HRQL) reporting in randomized controlled trials (RCTs).

The English-language literature of RCTs published in 2002-2008 was identified using Medline, Embase, and Healthstar Taselisib inhibitor databases, in addition to the Cochrane Clinical Trials Registry. Eligible trials were phase III studies that included an HRQL outcome. Data were abstracted on eight outcomes derived from previously recommended quality standards for reporting HRQL, and on four outcomes describing how HRQL data are presented in RCT reports. Two readers examined each article; discrepancies were resolved through discussion and third review if required.

A sample of 794 RCTs was identified. HRQL was a primary outcome in 25.4% (200/794). One hundred and ten RCTs (14%) used “”supplementary”" reports (separate from the first publication) to report HRQL findings. The proportion of RCTs that met the eight quality indicators ranged from 15% (HRQL used in the calculation of sample size) to 81% (reporting instrument validity). RCTs with HRQL as a primary outcome or with a supplementary report had higher concordance on the quality measures. Reporting improved on many indicators over time. Substantive variation in how HRQL data are presented in RCTs was evident.

53 +/- 1 00 cm(2)) were less accurately sized than defects on eit

53 +/- 1.00 cm(2)) were less accurately sized than defects on either of the condyles (p < 0.01). The areas of PX-478 concentration defects that were <2 cm(2) were overestimated (mean, 0.21 +/- 0.65 cm(2)) compared with other sizes of defects (p < 0.001), and the areas of defects that were >4 cm(2) were underestimated (mean, -0.87 +/- 1.83 cm(2)) compared with other defects (p < 0.001).

Conclusions and Clinical Relevance: Our current treatment algorithms rely heavily on the size of a cartilage

defect, but only 57% of the measurements in this study would have accurately led to the appropriate surgical procedure. There is a need to evaluate and quantify the size of a lesion more appropriately than current standards eFT508 allow and potentially revise existing

treatment algorithms.”
“Background: Physical functioning is without restriction in most pediatric heart transplant survivors, but only limited data are available about neuropsychologic outcomes in these children. in this study we assess neurodevelopmental outcomes in transplant survivors in comparison to population norms.

Methods: Neuropsychologic evaluations were performed 12 to 24 months (mean 16 months) post-transplant in 21 children ranging in age from I to 101 months (median 15 months) at time of transplant. Outcomes included verbal, non-verbal and overall intelligence; visual-motor integration skills; and adaptive functioning.

Results: Transplant recipients had a mean overall IQ of 86.7, verbal IQ of 88.4 and non-verbal IQ of 87.5, all significantly Autophagy Compound Library solubility dmso below the normative population mean of 100 (p < 0.01). Thirty-eight to 43% of subjects had low IQ scores (i.e., <85), significantly more than the normative 16% base rate (p < 0.02). Children with an initial diagnosis of congenital heart disease (CHD) had lower overall IQ (mean 78.6) than those with cardiomyopathy

(mean 91.7). The mean expressive language score was 88.1, significantly below norms (p < 0.01), with 46% having low scores (p = 0.01). Receptive language was normal in the same patients (mean 96.8). Finally, 63% of patients had visual-motor deficits and 48% had fine motor deficits (p < 0.005 compared with norms).

Conclusions: Although many pediatric heart transplant recipients display normal neurodevelopmental functioning, this population is at increased risk for cognitive difficulties, especially in expressive language, visual-motor integration and fine motor skills. Children with CHD may be at especially high risk. Early identification and intervention are essential to promote optimal neuropsychologic outcomes and overall quality of life in pediatric heart transplant recipients. J Heart Lung Transplant 2009;28: 1306-11. Copyright (C) 2009 by the International Society for Heart and Lung Transplantation.