Biomedical subjects
Publications and source records attributed to J R Duffy.
Random samples of sera were analysed for copper and iron. Based on the data presented in this paper and substantiated by other workers, the ferrozine method for the determination of serum iron is the most sensitive method currently available, provided the interference due to copper is effectively eliminated.
A pantomime recognition test was developed to study the extent of impairment of pantomime recognition and the relationship between pantomime recognition and verbal deficits in asphasics. This test requires no verbal instructions to the subject and only a simple pointing response. A description and rationale for the test are presented. This new test and three tests of verbal abilities (Verbal Recognition Test, Naming Test, and the Porch Index of Communicative Ability) were administered to four groups of subjects: aphasics, right-hemisphere damaged, subcortically damaged, and normals. Results indicate (1) greater impairment of pantomime recognition ability in aphasics than the other groups of subjects and (2) high correlations between impairment of pantomime recognition and impairment of verbal abilities in aphasics. Our findings are consistent with previous clinical reports and experimental data showing that aphasics commonly demonstrate impairment in gesture and pantomime. We conclude that aphasia is best understood as a general impairment of symbolic communication that includes nonverbal as well as verbal deficits.
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Phonatory dysfunction is a frequent component of dysarthria and often is a primary feature noted in clinical assessment. But the vocal impairment can be difficult to assess because (a). the analysis of voice disorder of any kind can be challenging, and (b). the voice disorder in dysarthria often occurs along with other impairments affecting articulation, resonance, and respiration. A promising assessment tool is multi-parameter acoustic analysis, such as the Multi-Dimensional Voice Program (MDVP). Part 1 of this paper recommends procedures and standards for the acoustic analysis of voice, including (1). selection of the sample to be analyzed, (2). signal quality requirements, (3). availability of normative data for both genders and different ages of speakers, (4). reliability of analysis, and (5). correlation of acoustic results with results from other methods of analysis. In Part 2, acoustic data are reviewed for the dysarthria associated with Parkinson disease (PD), cerebellar disease, amyotrophic lateral sclerosis (ALS), traumatic brain injury (TBI), unilateral hemispheric stroke, and essential tremor. Tentative profiles of voice disorder are described for these conditions. These profiles may serve as hypotheses for future research. Although several issues remain to be resolved in the acoustic analysis of voice disorder in dysarthria, steps can be taken now to promote the reliability, validity, and clinical utility of such analyses. (1). As a result of this activity, the participant will be able to describe ways in which an optimal multi-dimensional analysis of voice can be performed with modern acoustic analysis systems. (2). As a result of this activity, the participant will be able to apply multi-dimensional acoustic analysis of voice to individuals who have a dysarthria-related voice disorder. (3). As a result of this activity, the participant will be able to identify major sources of normative data on the Multi-Dimensional Voice Program.
EDUCATIONAL OBJECTIVES: (1) The reader will be able to describe the major types of acoustic analysis available for the study of speech, (2) specify the components needed for a modern speech analysis laboratory, including equipment for recording and analysis, and (3) list possible measurements for various aspects of phonation, articulation and resonance, as they might be manifest in neurologically disordered speech.
Primary progressive aphasia is a recently described, uncommon language disorder with unclear etiological and clinical boundaries. The infrequency and ambiguity of the syndrome may prompt psychiatric consultation. The authors review the pertinent features of one such referral, including a brief literature review of the salient aspects of the differential diagnosis, and note the implications for appropriate treatment.
Multidisciplinary health care teams are trying to change practice in ways that will improve patient outcomes. Three case studies are presented that demonstrate such practice changes. The practice changes involved a multidisciplinary team working toward commonly defined goals over an 18-month period. Several goals were attained, and lessons learned are presented. Nursing staff played a significant role in identifying and implementing the recommended changes.