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Biomedical subjects

J Flax

Publications and source records attributed to J Flax.

14 recordsLinked to original sources

The usefulness of the Brief Symptom Inventory in the neuropsychological evaluation of traumatic brain injury.

Changes in the health care delivery system are forcing clinicians to use less timely and more cost efficient measures. In rehabilitation, more efficient measures of emotional-behavioural functioning are being administered to patients with traumatic brain injury (TBI), including the Brief Symptom Inventory (BSI), a 53 item short version of the Symptom Checklist-90 that assesses nine different dimensions of emotional-behavioural functioning. Because the BSI was developed for use with psychiatric populations, research of the measure with TBI populations is needed. The current study evaluated the utility of the BSI in a sample of 62 patients (34 male, 28 female, average age 35, average education 12 years) with TBI evaluated as outpatients at a midwestern rehabilitation hospital. Results indicated that: (1) subjects endorsed clinically elevated distress on seven of the nine subscales when compared to the normative sample; (2) the Obsessive-Compulsive (OC) subscale achieved the highest t-score (70.31); 3) the most frequent two-point profiles included the OC-Somatic (21%) and OC-Psychoticism (13%) subscales; and (3) the Global Symptom Index was significantly correlated with all nine subscales. It was concluded that caution must be used when administering the BSI to individuals with TBI due to a lack of a TBI standardization sample, the limited number of test items per subscale, and questionable labels for the different subscales (e.g. OC subscale items appear to be more reflective of TBI-related cognitive impairment than obsessive-compulsive traits).

Adult↗

Look who's talking: a prospective study of familial transmission of language impairments.

Language impairments have been hypothesized to have a genetic component. Previous studies of the familial aggregation of language impairments have relied on a retrospective approach based on parental/self-reported history of language development. This study examined familial aggregation prospectively, by investigating language acquisition and cognitive development in the younger siblings and offspring of individuals with well-defined language impairments. It was predicted that children with a positive family history for language impairments would be more likely to show delays in language acquisition than would age- and gender-matched controls. Similar delays were not expected in nonlinguistic domains, such as conceptual, gestural, or general cognitive development. Ten children with a positive family history and 10 age- and gender-matched controls were tested. Analyses of linguistic and cognitive assessments at 16 to 26 months confirmed the predictions. Children with a family history of language impairments had lower receptive and expressive language scores than controls, with 50% of them scoring at least 1.5 SD below the mean for their age. At the same time, performance on a number of tasks that did not rely on language abilities did not differ as a function of family history. These results indicate that children with a positive family history for language impairments are at risk for language delay; the results also support a familial component to language impairments.

Birth Order↗

The use of spontaneous language measures as criteria for identifying children with specific language impairment: an attempt to reconcile clinical and research incongruence.

Criteria for identification of children as specifically language impaired (SLI) vary greatly among clinicians and researchers. Standardized psychometric discrepancy criteria are more restrictive and perhaps less sensitive to language impairment than is clinical judgment based on a child's language performance in naturalistic contexts. This paper examines (a) differences in groups of preschool children clinically diagnosed as SLI who were and were not identified as SLI through standard psychometric discrepancy criteria, and (b) the validity of quantitative measures of mean length of utterance (MLU), syntax, and pragmatics derived from a spontaneous language sample as criteria for discriminating clinically diagnosed preschoolers from normally developing preschoolers. Spontaneous language data indicated that children clinically identified as SLI produced a significantly higher percentage of errors in spontaneous speech than normal children whether they met psychometric discrepancy criteria or not. Logistic regression analysis indicated that a combination of MLU, percent structural errors, and chronological age was the optimal subset of variables useful for predicting a clinical diagnosis of SLI. This combined criterion captured a larger proportion of the clinically identified SLI children than even the best psychometric discrepancy criteria.

Child↗

Oligodendroglial development in human fetal cerebrum.

We have successfully established mixed glial cell primary cultures prepared from individual fetal human brains (15-18 weeks' gestation in age). Cultures were maintained for as long as 3 months in either 10% fetal calf serum (FCS) or serum-free chemically defined medium (CDM). By morphological and immunohistochemical criteria, the precursor cell for human oligodendrocytes (O-2A cell) was identified. This cell exhibited the bipolar morphology and A2B5-positive (A2B5+) immunoreactivity typical of the O-2A precursor cell. With time in culture, cells possessing a stellate morphology appeared, some of which stained with the O4 antibody, indicative of cell differentiation in the oligodendroglial lineage. At yet older culture age, arborized cells bearing the O1 (galactocerebroside, GC) immunohistochemical marker and displaying the morphological characteristics typical of more mature oligodendrocytes were found, confirming their oligodendroglial identity. Oligodendroglial differentiation was supported best by CDM rather than FCS. To complement these observations, double immunofluorescent studies were performed on parietal sections from human fetal brains at 20 to 22 weeks of gestation. Bipolar A2B5+, multipolar A2B5+/O4+, and arborized A2B5-/O1+ cells were found, thus confirming the presence of oligodendrocytes in human fetal brain at this stage of prenatal development and consistent with the observations made in cell culture.

Brain↗

Tumor angiogenesis correlates with metastasis in invasive prostate carcinoma.

Tumor growth and metastasis require angiogenesis; and microvessel density, a measure of tumor angiogenesis, correlates with metastasis in breast and lung carcinoma. To determine how microvessel density correlated with metastasis in prostate carcinoma, we counted microvessels within the initial invasive carcinomas of 74 patients (29 with metastasis, 45 without). Microvessels were highlighted by immunostaining endothelial cells for factor VIII-related antigen. Without knowledge of the patient's cancer stage, microvessels were counted in a 200 field (0.739 mm2) in the most active areas of neovascularization. The mean microvessel count in tumors from patients with metastases was 76.8 microvessels per 200 field (median, 66; standard deviation, 44.6). The counts within carcinomas from patients without metastasis were significantly lower, 39.2 (median, 36; standard deviation, 18.6) (P < 0.0001). Microvessel counts increased with increasing Gleason's score (P < 0.0001), but this increase was present predominantly in the poorly differentiated tumors. Although Gleason's score also correlated with metastasis (P = 0.01), multivariate analysis showed that Gleason's score added no additional information to that provided by microvessel count alone. Assay of microvessel density within invasive tumors may prove valuable in selecting patients for aggressive adjuvant therapies in early prostate carcinoma.

Adult↗

Relations between prosodic variables and communicative functions.

Three children were observed interacting with their mothers at three different times: before the onset of single words, when vocabulary consisted of 10 words, and when vocabulary consisted of 50 words. Relations between communicative functions and acoustic analyses of prosodic variables (i.e. rise vs. nonrise of terminal contours) were studied. Considerable variability was found among the children in the number of rises produced overall and those produced for any function. Each child's use of rise was fairly constant over time and rises were produced relatively more frequently than nonrises with functions requiring a response from the listener. Factors affecting similarities and differences are discussed.

Child Language↗

Vasculitis complicating treatment with intravenous anisoylated plasminogen streptokinase activator complex in acute myocardial infarction.

Vasculitis developed in six of 253 patients treated with intravenous anisoylated plasminogen streptokinase activator complex (APSAC) after acute myocardial infarction. All patients recovered spontaneously with no evidence of renal impairment and no long term sequelae. Although leucocytoclastic vasculitis and serum sickness have been reported after streptokinase treatment, such allergic reactions have not been described as a complication of other thrombolytic agents.

Aged↗

A preliminary investigation of reduplication in children with specific language impairment.

The frequency of reduplication was examined in relation to syllable maintenance, final consonant production, and whole word repetitions in two preschool children with specific language impairment--one who reduplicated frequently and one who did so infrequently. Spontaneous speech was sampled for a period of 18 months. During the single-word utterance period, reduplication was associated with infrequent production of final consonants but frequent maintenance of multisyllabic structure. After the single-word utterance period the child who had frequently reduplicated during this period ceased reduplication but frequently produced whole word repetitions. Infrequent production of final consonants continued, but syllable maintenance decreased. The data are discussed in relation to hypotheses about the function of reduplication and the function of whole word repetitions in language development.

Child Language↗

Psychogenic parasitosis. A case series and literature review.

About 100 years ago, psychogenic parasitosis was first described in the literature. This peculiar symptom may complicate medical and psychiatric conditions or indicate the presence of a delusional disorder (somatic type). By using the authors' case series of 12 patients, which are reported in the article, and a review of the literature, an historical perspective and the authors' clinical orientation to evaluation and treatment of psychogenic parasitosis are presented.

Adult↗

Fluoxetine improves emotional incontinence.

Emotional incontinence is a behavioural syndrome characterized by involuntary weeping, grimacing, and/or laughter. We investigated the efficacy of fluoxetine in 13 patients with emotional incontinence. All 13 patients demonstrated dramatic improvement in emotional lability within 3 to 14 days.

Adult↗