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Biomedical subjects

A Kertesz

Publications and source records attributed to A Kertesz.

At least 109 records · Page 6Linked to original sources

Reliability and validity characteristics of the Western Aphasia Battery (WAB).

The reliability and validity characteristics of the Western Aphasia Battery (WAB) are described. High internal consistency measures and high test-retest reliability argue for stability of the test both because its parts contribute to the composite index and because of its temporal reliability. Inter- and intrajudge reliability are both very high, suggesting consistent scoring within and between scorers. The WAB satisfies face- and content-validity criteria. Results from the WAB and the Neurosensory Center Comprehensive Examination for Aphasia (NCCEA) highly correlate, indicating good construct validity. WAB AQ scores and Raven's Coloured Progressive Matrices scores significantly correlate, suggesting that the language portions of the WAB are not totally independent from nonverbal functioning. WAB AQ scores reliably differentiate between aphasic and control groups, with only a small overlap for high functioning anomic aphasic subjects.

Adolescent↗

Chronic progressive myelopathy: investigation with CSF electrophoresis, evoked potentials, and CT scan.

Chronic progressive myelopathy (CPM) is a difficult clinical problem. Many patients who present with CPM turn out to have a spinal form of multiple sclerosis (MS), but until there is clear lesion dissemination, a definite clinical diagnosis cannot be made. We have looked for MS-related abnormalities in 72 patients with CPM. The mean age of onset was 42 years, mean duration was ten years, and mean Kurtzke disability rating was 4.5. Studies performed were cerebrospinal fluid electrophoresis for oligoclonal banding, pattern-reversal visual evoked responses, blink reflex latencies, and computerized axial tomography. Oligoclonal banding was found in 32 patients (44%), patterned visual evoked responses were abnormal in 32 (44%), and blink latencies were abnormal in 40 (56%). A least one of these studies was abnormal in 61 patients (85%) and at least two in 48 (66%). The CT scan was abnormal in 38 )53%), 36 with atrophy and 3 with low-density or enhancing lesions. These results suggest that at least 44% of patients with CPM may have MS that could be diagnosed by oligoclonal bands. Other physiological tests suggesting diffuse or disseminated disease bring the total to 85%. Only autopsy follow-up will tell us the exact diagnostic accuracy of these studies in this complex syndrome.

Adult↗

Visual agnosia: the dual deficit of perception and recognition.

This case of visual agnosia is of special interest because of its causation by trauma, of the unusually long follow-up (10 1/2 years), and the evidence for dual deficits of recognition and perception. Although most of the findings were characteristic of associative visual agnosia with preserved perceptual function, the poor copying, contrasted to better spontaneous drawing, suggested apperceptive agnosia as well. Prosopagnosia, alexia without agraphia, Balint's syndrome, visual static agnosia and simultanagnosia were also observed. The patient had persisting amnestic syndrome, but no dementia or aphasia. The responses to visual stimulation were perseverations, form confusions and confabulations. Visual evoked potentials were severely, bilaterally abnormal and computerized tomographic localization showed bilateral lesions also. The stages of recognition are analysed through this case of visual verbal disconnection and the importance of memory in perception is highlighted.

Adult↗

Isotope localization of infarcts in aphasia.

Radionucleide localization of infarcts producing aphasia was undertaken in 65 patients with a scan-test and onset-test interval of one months or less. The scans were traced on anatomical templates without knowledge of the aphasias. A phasics were classified by their test scores according to taxonomic criteria, independently from localization. Scans belonging to each clinically distinct group were overlapped "blindly". The results showed distinct areas for Broca's conduction and Wernicke's aphasics along the parasylvian axis of the lateral templates. Lesions of global aphasics covered all these areas, while transcorticals were outside of them. Lesion size and severity of aphasia showed significant correlation. It is concluded that a brief systematic survey of aphasia like ours is useful in predicting the anteroposterior location and often the depth and extent of lesions.

Aphasia↗

Recovery patterns and prognosis in aphasia.

Ninety-three aphasics were studied with repeated language assessment by a scorable test (the Western Aphasia Battery). Recovery rates were determined by measuring language performance (Aphasia Quotient) at nought to forty-five days post-onset, and three, six and twelve months and yearly after. Recovery rates were higher in post-traumatic than in cerebrovascular cases. When the stable infarcts were separately studied, the greatest recovery was seen in "Broca's" aphasics, followed by the "conduction" group. Anomic aphasia appeared to be a common end-stage of evolution. Long-term follow-up (twelve months or more) demonstrated that global aphasics have a poor prognosis, while Broca's and Wernicke's have an intermediate one. Complete recovery occurred frequently among anomic, conduction and transcortical aphasics and in more than half of the traumatic cases. Initial severity and outcome correlated significantly. Age and rate of initial recovery showed a trend of negative correlation; younger patients recovered better, but there were frequent exceptions, depending on other factors, such as the initial severity of aphasia. Although some cases recovered exceptionally well while under therapy, there was no significant difference between the treated and untreated groups, where such a comparison was possible.

Adolescent↗

Low back pain in the workman in Canada.

Groups of 25 Workmen's Compensation Board patients (WCP group) and 25 non-Workmen's Compensation Board patients (NWCP group) hospitalized because of low back pain were compared. The WCP group had a significantly higher male:female ratio, incidence of sudden onset and precipitating factors, and prevalence of weakness, decreased reflexes and sensory loss. Surgical treatment and multiple operations were significantly more frequent in the WCP group, as was complete long-term relief or worsening after operation. Adequate partial relief was significantly more frequent in the NWCP group. The differences suggest more severe conditions in the workmen. Prevalence of psychological factors was not significantly different, although a trend was observed for this to be greater in the WCP group.

Adult↗

Pathophysiologic studies in human rabies.

Six patients with proved rabies were studied with a combination of clinical, physiologic and pathologic technics. Three were given a type of intensive care but died with evidence of respiratory failure. Although circulatory failure did not develop in any of the six patients, three had supraventricular arrhythmias: interstitial myocarditis was found in one of these and rabies virus was isolated from the myocardium of another. Inspiratory muscle spasm was the dominant clinical feature in all cases. This occurred as part of the hydrophobic response and followed stimulation of the upper respiratory tract and skin. Hydrophobia may represent an exaggerated respiratory tract irritant reflex with associated arousal. Later in the course of the disease, various patterns of periodic and ataxic breathing were observed. Widespread brain stem encephalitis was discovered at autopsy, with particular involvement of the neighborhood of the nucleus ambiguous in two of three patients examined. In one patient cerebral metabolism was grossly abnormal, with greatly reduced cerebral oxygen consumption suggesting irreversible brain damage. Respiratory and circulatory disturbances may well be immediate causes of death in patients with rabies, but the present studies reemphasize the severity of the encephalitis which remains the ultimate barrier to survival. In the developing countries in which rabies is still a major problem and in which the cost precludes intensive care, the clinical management of rabies can aim only to reduce suffering by heavy sedation.

Adolescent↗

Classification of aphasic phenomena.

A brief but comprehensive survey of classifying aphasia reveals that most investigators describe at least four major groups, conveniently labelled Broca's, Wernicke's, anomic and global. Conduction and transcortical aphasias are less generally described and modality specific syndromes rarely, if ever, exist purely. The controversy between unifiers and splitters continues but objective numerical taxonomy may solve some of the problems of classification.

Aphasia↗

Alpha methyldopahydrazine as an adjunct to levodopa therapy in Parkinson's disease.

A double-blind, double-observer study was carried out in twenty-five patients with Parkinson's disease. Alpha methyldopahydrazine in combination with L-dopa was compared to placebo with L-dopa. Combination therapy resulted in a reduction in L-dopa dosage to 1/3 of the amount required during the baseline. There were no side effects attributed directly to the alpha methyldopahydrazine. The overall incidence of side effects in the two groups was similar but the combination therapy significantly reduced the incidence of nausea and vomiting. The limiting factor in the combination therapy was the presence of L-dopa induced dyskinesias.

Adult↗