3 Strupp M, Brandt T, Muller A. Incidence of post-lumbar puncture syndrome reduced by reinserting the stylet: a randomised prospective study of 600 patients. J Neurol 1998;245:589-92. 4 Greene HM. Lumbar puncture and the prevention of post puncture headache. JAMA 1926;86:391-2. 5 Evans RW. Complications of lumbar puncture. Neurol Clin North Am 1998;16:83-105. 6 Carson D, Serpell M. Choosing the best needle for diagnostic lumbar puncture. Neurology 1996;47:33-7. 7 Muller B, Adelt K, Reichmann H, Toyka K. Atraumatic needle reduces the incidence of post-lumbar puncture syndrome. J Neurol 1994;241:376-80. 8 Kleyweg RP, Hertzberger LI, Carbaat PAT. Significant reduction in post-lumbar puncture headache using an atraumatic needle. A double-blind, controlled clinical trial. Cephalalgia 1998;18:635-7. 9 Braune HJ, Huffman G. A prospective double-blind clinical trial, comparing the sharp Quincke needle (22G) with an "atraumatic" needle (22G) in the induction of post-lumbar puncture. Acta Neurol Scand 1992;86:50-4. 10 Flaatten H, Krakenes J, Vedeler C. Post-dural puncture related complications after diagnostic lumbar puncture, myelography and spinal anaesthesia. Acta Neurol Scand 1998;98:445-51. 11 Lybecker H, Moller JT, May O, Nielsen HK. Incidence and prediction of postdural puncture headache. A prospective study of 1021 spinal anesthesias. Abstract Objectives To assess the ability of patients with binocular 6/9 or 6/12 vision on the Snellen chart (Snellen acuity) to read a number plate at 20.5 m (the required standard for driving) and to determine how health professionals advise such patients about driving. Design Prospective study of patients and postal questionnaire to healthcare professionals.

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Use of this in-line digestive cartridge was safe and well tolerated, and resulted in significantly increased levels of plasma omega-3 FA used with enteral formula, suggesting an overall increased fat absorption.

Objectives:Pancreatic insufficiency (PI) and malabsorption of fats lead to reduced caloric intake, inability to maintain weight, and increased gastrointestinal symptoms. Thus, enteral nutrition (EN) is used in patients with cystic fibrosis (CF) and poor nutritional status. The current study evaluated safety, tolerability, and improvement of fatty acid (FA) status in red blood cell (RBC) membranes, a marker of long-term FA absorption, with an in-line digestive cartridge (RELiZORB) that hydrolyzes fat in enteral formula.Methods:Patients with CF receiving EN participated in a multicenter, 90-day open-label study during which RELiZORB was used with overnight EN. The primary endpoint was change over time in RBC uptake of docosahexaenoic acid (DHA)+ eicosapentaenoic acid (EPA). Gastrointestinal symptoms were collected to evaluate safety and tolerability. Several clinical and anthropometric parameters were also assessed throughout the study.Results:A total of 36 subjects completed the study with a mean age of 13.8 years, body mass index of 17.7 and 6.2 years mean use of overnight EN. Fat absorption significantly improved as shown by increased RBC levels of DHA+EPA, improved ω-6/ω-3 ratio, and increased plasma levels of DHA+EPA. RELiZORB use was not associated with any unanticipated adverse events.Conclusions:RELiZORB use was found to be safe, well tolerated, and resulted in increased levels of FAs in RBCs and plasma. This is the first prospective study to show EN can improve FA abnormalities in CF. Because improvement in omega-3 levels has been shown to help pulmonary and inflammatory status as well as anthropometric parameters in CF, RELiZORB may have important long-term therapeutic benefits in patients with CF.

Applied Goldfriend and D'Zurilla's (1969) Behavior-Analytic Model to the development of a context-specific measure of stressful situations for adolescents with a serious, chronic illness. In completing the situational analysis phase of the model, 45 adolescents with cystic fibrosis (CF), 20 parents of adolescents with CF, and 8 health care professionals completed structured interviews or daily diaries to obtain the widest range of problematic situations. The adolescent sample was recruited from two different medical centers, and stratified by sex and illness severity. A total of 1,174 problem situations were elicited across all participants and then content-analyzed into 164 nonredundant items in 10 domains (e.g., Medications and Treatment, and School). Few relations were found between demographic variables (e.g., age and illness severity) and the number or difficulty of problematic situations. Both adolescents and parents mentioned the greatest number of problematic situations in the domains of School, Medications and Treatment, and Parent-Teen Relationship. In terms of difficulty, all three respondents (i.e., teens, parents, and health care professionals) rated problems with Clinic and Hospital Visits as very difficult. For the adolescent sample, problems in the Parent-Teen Relationship and Health Concerns were also highly difficult. Significant associations were found between the problematic situations we identified and standardized measures of social and emotional functioning. Adolescents who rated their problems as more difficult also endorsed more symptoms of depression and lower perceptions of social competence. In a future study, the most salient items will be selected to create a role-play measure to elicit adolescents' coping strategies.