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Biomedical subjects

V Ferraro

Publications and source records attributed to V Ferraro.

5 recordsLinked to original sources

Bilingual signed and spoken language acquisition from birth: implications for the mechanisms underlying early bilingual language acquisition.

Divergent hypotheses exist concerning the types of knowledge underlying early bilingualism, with some portraying a troubled course marred by language delays and confusion, and others portraying one that is largely unremarkable. We studied the extraordinary case of bilingual acquisition across two modalities to examine these hypotheses. Three children acquiring Langues des Signes Québécoise and French, and three children acquiring French and English (ages at onset approximately 1;0, 2;6 and 3;6 per group) were videotaped regularly over one year while we empirically manipulated novel and familiar speakers of each child's two languages. The results revealed that both groups achieved their early linguistic milestones in each of their languages at the same time (and similarly to monolinguals), produced a substantial number of semantically corresponding words in each of their two languages from their very first words or signs (translation equivalents), and demonstrated sensitivity to the interlocutor's language by altering their language choices. Children did mix their languages to varying degrees, and some persisted in using a language that was not the primary language of the addressee, but the propensity to do both was directly related to their parents' mixing rates, in combination with their own developing language preference. The signing-speaking bilinguals did exploit the modality possibilities, and they did simultaneously mix their signs and speech, but in semantically principled and highly constrained ways. It is concluded that the capacity to differentiate between two languages is well in place prior to first words, and it is hypothesized that this capacity may result from biological mechanisms that permit the discovery of early phonological representations. Reasons why paradoxical views of bilingual acquisition have persisted are also offered.

Child, Preschool↗

Current spectrum of intestinal obstruction.

In a 12-month prospective study incorporating four neighbouring district general hospitals, 228 patients required a total of 236 admissions with intestinal obstruction. The aetiological factors included adhesions 75 (32 per cent), malignant disease 61 (26 per cent), strangulated hernias 59 (25 per cent), volvulus 10 (4 per cent), acquired megacolon 6 (3 per cent), pseudo-obstruction 4 (2 per cent), faecal impaction 6 (3 per cent) and miscellaneous 15 (6 per cent). The peak incidence for obstruction due to adhesions, malignant disease and strangulated hernias each occurred in the eighth decade. Surgery was performed within 48 h of admission in 29 per cent adhesive obstructions (22), 30 per cent obstructions due to malignant disease (18) and 68 per cent strangulated hernias (40)--bowel resection rates in these three groups were 13.5, 50 and 29 per cent, respectively. The overall mortality was 11.4 per cent (26 deaths) and postoperative mortality was 12.3 per cent (19 deaths). During the 12-month study period, 228 patients required a total of 2993 inpatient hospital days as a result of intestinal obstruction. Postoperative adhesions have become the commonest cause of intestinal obstruction but strangulated hernias and intra-abdominal malignant disease still account for 50 per cent of all cases and mortalities. Obstruction due to strangulated hernias and intra-abdominal malignant disease typically occurs in the elderly age group where a more aggressive policy of elective surgical intervention is likely to be associated with increased postoperative morbidity and mortality.

Abdominal Neoplasms↗

A ten year prospective experience with semi-elective shunt in selected patients for bleeding oesophageal varices.

In a prospective study from 1972 to 1982, 38 patients with bleeding oesophageal varices and relatively good liver function were treated by semi-elective or emergent shunt 2-4 weeks after admission. There were no deaths within 3 months of surgery. This constituted 30% of the total 125 patients admitted with bleeding varices during that period. No referred case for treatment of portal hypertension was included in this study. The procedures performed were end-to-side portacaval shunt in 30 cases, lieno renal shunt in seven cases and interposition mesenterico-caval shunt in one case. All patients were admitted to a special unit with a two stage policy of management. Immediate endoscopic diagnosis and balloon tamponade in those with continued bleeding was followed by shunt in selected cases. Follow-up of the 38 patients showed a cumulative survival at 1 year of 89%, at 3 years of 75% and 5 years of 65%. In four cases (13%) a clinical diagnosis of portal systemic encephalopathy was made, all were controlled by medical management. In four of ten follow-up deaths, liver failure was the cause, in none of these cases was encephalopathy a problem. It is concluded that with a policy of early diagnosis and control of haemorrhage, 30% of a typical series of prospectively studied patients admitted with bleeding varices can be treated without mortality by definitive surgery. There was low incidence of encephalopathy and no cases of incapacitating mental confusion. Centralization of treatment and prospective study is essential for the implementation of such a policy of management.

Adult↗

Perforation in Crohn's disease of the small bowel.

During a five-year period, three patients with general peritonitis, secondary to perforation of the small bowel in Crohn's disease, were successfully treated by resection and primary anastomosis. During this period, 30 patients presented with small bowel or ileocaecal Crohn's disease. The possibility of perforation should be considered when evaluating the need for surgery in patients with Crohn's disease with symptoms of obstruction.

Abdomen, Acute↗

[Not Available].

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Botany↗