This study examined the evolution of individuals with cerebral palsy (CP) from childhood to adulthood. Seventy-two adults with a diagnosis of CP born between 1934 and 1980 were studied. Individuals were recruited and data comprehensively collected using case notes and through direct assessments of the majority of participants from three rehabilitation units in Bologna, Padua, and Rovigo in Italy. The main findings can be summarized as follows: contact with health and rehabilitation services was radically reduced once individuals reached adulthood; more individuals who were integrated into mainstream schools achieved and maintained literacy than those who had attended special schools; in a high number of participants, motor performance deteriorated once into adulthood. Independent walking or other forms of supported locomotion were lost in many on reaching adulthood. Of those who continued to walk, walking deteriorated in terms of distance. It was concluded that even though CP has been considered as predominantly a childhood pathological condition, the evolution of the effects of CP do not stop at 16 or 18 years of age. For this reason, the traditional child- (or infant-) oriented approach concentrating mainly or exclusively on the achievement of independent walking, may not be an ideal approach to children with CP. Instead a more independence-oriented therapeutic approach would be appropriate.

Our findings confirm that, by comparison with indomethacin, ibuprofen has fewer effects on renal function in terms of urine output and fluid retention, with much the same efficacy and safety in closing patent ductus arteriosus in preterm infants with respiratory distress syndrome. In particular, no increased incidence of intracranial haemorrhage was observed after ibuprofen treatment.

This study examined the evolution of individuals with cerebral palsy (CP) from childhood to adulthood. Seventy-two adults with a diagnosis of CP born between 1934 and 1980 were studied. Individuals were recruited and data comprehensively collected using case notes and through direct assessments of the majority of participants from three rehabilitation units in Bologna, Padua, and Rovigo in Italy. The main findings can be summarized as follows: contact with health and rehabilitation services was radically reduced once individuals reached adulthood; more individuals who were integrated into mainstream schools achieved and maintained literacy than those who had attended special schools; in a high number of participants, motor performance deteriorated once into adulthood. Independent walking or other forms of supported locomotion were lost in many on reaching adulthood. Of those who continued to walk, walking deteriorated in terms of distance. It was concluded that even though CP has been considered as predominantly a childhood pathological condition, the evolution of the effects of CP do not stop at 16 or 18 years of age. For this reason, the traditional child-(or infant-) oriented approach concentrating mainly or exclusively on the achievement of independent walking, may not be an ideal approach to children with CP. Instead a more independence-oriented therapeutic approach would be appropriate.Cerebral palsy (CP) has been viewed for many years predominantly as a paediatric condition and for this reason the therapeutic approach to it has not focussed much on the transition into adulthood. Many individuals with CP, however, show a survival rate not far from average or near average as indicated by Cohen and Kohn (1979) and Evans and colleagues (1990). Both these studies stressed that there was a survival rate of over 60% in affected children who had survived the first year of life, even among those with the most severe disabilities. In the more mildly involved individuals with CP survival was found to exceed 90%.Furthermore, the number of adults with CP is growing due to advances in specific medical care and to the increased life expectancy of adults in general. Despite this, services for adults with physical disabilities are often inadequate, even in developed countries. In contrast to the care provided for children with disabilities, organized health care for these patients has been described as very poor, with a notable reduction of provision once a patient reaches adulthood (Ingram 1964;Lang 1982;Hirst 1983 Hirst , 1984Bax et al. 1988;Thomas et al. 1989). Apart from the disparity between the amount of care provided to these patients as youngsters and then as adults, another major issue is the different types of approaches used by professionals who work with children and adults with disability. For instance, Bryce (1983) suggested that the apparent low priority given to adults with CP is, at least partly, because physiotherapists consider that their efforts are better concentrated on the young child. The child-(o...

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Provision of mechanical insufflation-exsufflation in combination with standard chest physical treatments may improve the management of airway mucous encumbrance in neuromyopathic patients; its use should be included in the noninvasive approach to treatment of respiratory tract infections with impaired mucous clearance.