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L J Sanders

Publications and source records attributed to L J Sanders.

24 records · Page 2Linked to original sources
PubMed1977

Evaluation of syntax in three-year-old Spanish-speaking Puerto Rican children.

The performance of 30 normal and 30 language-deviant three-year-ols Spanish-speaking Puerto Rican children was compared on two measures of linguistic proficiency. They are mean length of utterance, following a scoring procedure adapted for Spanish speakers by the primary investigator, and Lees' Developmental Sentence Scoring procedure adapted for Spanish by Toronto. Results indicated that both methods of language assessment were sensitive to age and language status differences within the three-year age range. Accordingly, they can be usefully employed in research investigations to equate subjects on a linguistic basis, and in the clinical evaluation of small differences in the language maturity of preschool Spanish-speaking Puerto Rican children.

Child, Preschool↗
PubMedDate not supplied

Reproducibility and accuracy among primary care providers of a screening examination for foot ulcer risk among diabetic patients.

BACKGROUND: A clinical examination has been shown to stratify patients by risk for diabetic foot ulcer; it is unknown whether primary care providers can reproducibly perform this examination. METHODS: One hundred forty-seven consecutive diabetic patients at six Veterans Affairs Medical Centers received a structured history and physical examination of the feet from each of two primary care providers; 88 of these patients were also examined by a foot care specialist. The examination consisted of a previously validated four-component diabetic foot ulcer risk stratification examination and a vascular disease history and physical examination. RESULTS: Seventy-nine percent of patients were assessed as having elevated risk for development of foot ulcer. Interobserver agreement for risk stratification was moderate (kappa = 0.51; 95% CI 0.40, 0.62). The agreement for individual components of the stratification examination was variable, with kappa statistics ranging from 0.36 to 0.91. Primary care providers had good sensitivity and specificity for most components of the examination (compared with foot care specialist's examination as the criterion standard), but frequently were unable to identify pedal pulses [sensitivity 0.52 (95% CI 0.41, 0.61)] or foot deformity [sensitivity 0.51 (95% CI 0.46, 0.56)]. CONCLUSIONS: A validated risk stratification foot examination for diabetic patients is reproducible and largely accurate when performed by primary care providers.

Adult↗
PubMedDate not supplied

Wound management in the diabetic foot.

The multiple opinions expressed in this Grand Rounds section make it clear that management of the diabetic patient with a foot wound is complex at best. Several significant points are repeated many times. The need for a detailed history and physical exam, accurate assessment of neurologic, vascular, metabolic status, and addressing the etiologic factor involved are all essential. All authors point to multispecialty integrated treatment protocols to produce the greatest success. Little mention is made of the use of topical agents to accelerate healing. This is due to the lack of unbiased studies, and the many available reports that demonstrate rapid healing when a complete and objective protocol is followed. The aims of this Grand Rounds are to stimulate interest in this important subject, and to provide the practitioner with a scaffold with which to build their own wound care management protocols.

Arthropathy, Neurogenic↗