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Biomedical subjects

J Wojcieszek

Publications and source records attributed to J Wojcieszek.

10 recordsLinked to original sources

Cervical dystonia severity scale reliability study.

Cervical dystonia (CD) is characterized by sustained contractions of the neck musculature, resulting in abnormal head postures. The Cervical Dystonia Severity Scale (CDSS) was developed to provide a reliable measure of treatment response in patients with CD. The CDSS uses a protractor and wall chart to rate the severity of the head's deviation from neutral in each of three planes of motion (rotation, laterocollis, anterocollis/retrocollis), which is then scored in 5 degree intervals (1 degree to 5 degrees deviation = 1; 86 degree to 90 degrees deviation = 18). To test the reliability of the CDSS, four centers, each with two independent examiners, evaluated 42 patients with CD. At each site, each of the two examiners used the CDSS to evaluate the head position of each patient twice, on the same day, for a total of four evaluations. The kappa value for intra-examiner agreement was 0.94 (95% confidence limit of 0.900-0.972), indicating excellent intra-examiner reliability. The kappa value for interexaminer reliability was 0.79 for the first evaluation and 0.86 for the second evaluation (95% confidence limits of 0.668-0.920 and 0.790-0.920) indicating excellent interexaminer reliability. Thus, the CDSS was highly reliable in both intra-examiner and interexaminer scoring comparisons.

Adult↗

Tracing Woody Guthrie and Huntington's disease.

Tracing the outlines of Woody Guthrie's life can be maddening. His outpouring of songs, words, and images attests to the rare creative spirit which possessed him like a devil, or angel, more often both. He was a figure which many of us hold dear as an emblematic American symbol of outspoken and independence-minded social consciousness. Drawn from Guthrie's collection of published and unpublished material in the Woody Guthrie Archives, including song lyrics, poems, prose, artwork--in short, every imaginable form of manuscript--the shadows that form and delineate Guthrie's life keep moving, much like dancing flames reflecting off a wall, illuminating some details while obscuring others. Guthrie, of course, had no choice about Huntington's disease (HD) or how it would impact his life. Characteristically, he moved with it, sang with it, and even danced with it. When HD finally silenced Guthrie in 1967, it nevertheless spurred his second wife, Marjorie Mazia, to action-action which continues today with the commitment and work of the Huntington's Disease Society of America (HDSA). Was it tragic? Or just the natural course of the disease? The interplay between artistry, inspiration, and devastation is what we explore here.

Alcoholism↗

Patients' perception of stopping or continuing treatment of cervical dystonia with botulinum toxin type A.

Despite widespread commercial acceptance of botulinum toxin (BTX) for idiopathic cervical dystonia (ICD), no follow up has been performed to determine when and why some patients stop therapy. It has been suggested that some patients who stop BTX treatment may do so because of permanent improvement. We surveyed 155 patients with ICD who were treated over 6 years with BTX to determine when and why patients stopped treatment with BTX, and what adverse events and changes in dose and/or frequency of treatments occurred in those who continued treatment. Of the 133 (86.6%) individuals returning the surveys, 104 continued on BTX treatment and 29 had stopped therapy. Of the 29 subjects no longer receiving BTX, 11 individuals had only received one or two injections. Prior surgical treatment for ICD did not influence their decision to stop therapy. Of those 104 of 133 continuing on BTX treatments, two thirds of the subjects reported the injections always help, whereas one quarter estimated one set of injections did not help. One third of those continuing treatment reported the first injection was most helpful, whereas another one third felt all injections were similarly effective. After an initial adjustment, BTX dosages and frequency of treatment remained stable in this group.

Adult↗