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At least 991 records · Page 55Linked to original sources
PubMed2005

[Parental attitudes at the beginning of child's stuttering].

OBJECTIVES: Stuttering is a communication disorder that frequently starts at the age of three or four years. Its appearance and progression may impose psychological effects on children and their families. We evaluated parental attitudes in the initial period of stuttering. PATIENTS AND METHODS: Twenty-two children or adolescents (16 males, 6 females; mean age 8.8+/-4.4 years; range 4 to 18 years) were assessed. A semi-structured clinical interview was administered to all the patients to determine whether stuttering was triggered by stressors and to examine the attitudes of parents and the course of their applying for treatment. RESULTS: After the onset of stuttering symptoms, the most frequent parental attitude was found as punishment and warning to their child (54.5%). Before stuttering appeared, the most frequent triggering event was of being excessively scared of anything (68.2%). The mean age of onset of stuttering was 3.4+/-1.1 years (range 2 to 7 years). CONCLUSION: The events that trigger stuttering also continue in the attitudes and thoughts of parents concerning stuttering. After the diagnosis, the parental attitude plays a significant role in the effectiveness of treatment. In this respect, parents should be informed during their first application for treatment.

Adolescent↗
PubMed2005

Guillain-Barré syndrome in Ethiopian patients.

This is a ten years retrospective study conducted to assess the clinical profile and outcome of Guillain-Barré Syndrome (GBS) in Ethiopian patients. The medical records of all patients admitted with the diagnosis of GBS to the Department of Internal Medicine, Tikur Anbessa University Hospital, Addis Ababa, Ethiopia during the period September 1992 to September 2001 were reviewed. During the ten-year review period ninety-five patients were admitted with the diagnosis of GBS, of which eighty-one met the National Institute of Neurological and Communicative Disorders and Stroke diagnostic criteria. The mean age (SD) of patients was 34.4 +/- 14.4 years. The male to female ratio was 1.25:1. History of antecedent event such as upper respiratory tract infection, diarrhea and vaccination was obtained in 47/81 (58.1%) of patients. The majority of the patients 62 (78.5%), presented with an ascending areflexic quadriparesis while 10 (12.7%) presented with a descending type of arefilexic quadriparesis, but in 6 (7.4%) of the patients the weakness was confined to the lower extremities (i.e. Paraparetic variant). Signs of autonomic involvement were seen in 25/81 (30.9%). Cytoalbzuminological dissociation in the cerebrospinal fluid was demonstrated in 62.3%. EMG was done in 47 patients The commonest electrophysiologic abnormality encountered was demyelinating picture in 26 (55.3%) followed by mixed and axonal in 12 (25.5%) and 9 (19.1%) respectively). Nineteen (70.3% of 27 GBS patients for whom serology for HIV was done were seropositive. The clinical findings were similar in both groups, except for a higher frequency of CSF pleocytosis, need for ventilatory support and mortality among HIV-positive patients. The overall mortality was 25.9%. This study highlights the importance of GBS as a cause of peripheral nerve disease in our setup. The higher mortality rate observed in this study appeared to be related mainly to the lack of adequate intensive carefacility and highlights the need to improve these services. Further-more, the finding of high frequency of seropositivity among GBS patients in this study underlines the need for further prospective research on the association and clinical course of GBS and HIV, particularly in Africa where HIV/AIDS has become an important public health problem.

Adolescent↗
PubMed2006

[Specificity of pain assessment in the aged].

Pain is frequent in older subjects but remains under diagnosed and treated. Systematic evaluation of pain is recent and the assessment tools, although well known, are only occasionally used. The main progress in the evaluation of pain in the elderly is the concept of behavioral assessment. Two assessment scales have been designed for people with communication disorders: the DOLOPLUS and the ECPA. Every carer should be skilled in the use of at least one auto and one hetero assessment scale to recognize and treat pain in the older subjects.

Aged↗
PubMed1991

Concepts in stroke rehabilitation.

The identification and management of neurological deficit are each essential for stroke rehabilitation. Management of the two most commonly encountered deficits, hemiplegia and communication disorder, is discussed. An eleven point Stroke Rehabilitation Outcome plan forms a good basis for discussion with relatives about what to expect.

Activities of Daily Living↗
PubMed1991

Discourse analyses with closed head injured adults: evidence for differing patterns of deficits.

To better characterize the verbal impairments of higher level closed head injured (CHI) adults, we used narrative stories to longitudinally sample their discourse abilities. Stories were analyzed at the levels of intersentential cohesion and story grammar. Two differing patterns of deficits that emerged are described. In the first, a CHI subject demonstrated excessive verbalization characterized by poorly organized, but task-appropriate, content. In the second, a CHI subject demonstrated fair to good organization but little appropriate content. Prognostically, the presence of appropriate, although disorganized, content was an early indication that the subject was able to appreciate potential relationships of characters in the stimulus picture. The second pattern represented a more severe cognitive dysfunction. This subject's attempts at stories, although well organized, were merely elaborate descriptions of the picture. Discourse analyses appear to be well suited for the assessment of CHI adults.

Adult↗
PubMed1991

Placenta within the medicolegal imperative.

Bad pregnancy outcome includes abortion, stillbirth, neonatal death, morbidity, malformation, cerebral palsy, and mental retardation. These afflictions cause devastating personal impact. In the United States, almost 10% of all school-aged children are handicapped. Neurologic and communicative disorders affect 42 million people and cost $114 billion each year. The cause of cerebral palsy is known in less than 10% of these cases. Enormous litigations have threatened clinicians, paramedical personnel, hospitals, and insurance carriers. The placenta is an important potential means of establishing that fetal damage causes bad pregnancy outcome independently of clinical care. All pathologists serve an important role in the documentation of gross placental features and in the procurement of appropriate light microscopic slides. Pathologic placentas are common. Only an expert can determine whether an abnormal placenta represents the probable cause of bad pregnancy outcome.

Chorioamnionitis↗
PubMed1990

Early onset sensorineural hearing loss: association studies with major histocompatibility class III (complement) markers.

In 39 families with at least one child suffering from moderate or severe bilateral sensorineural hearing loss (SNHL), major histocompatibility complex (MHC) class III complement phenotypes were retrospectively determined by standard methods; MHC class I segregation data was also available. The families were treated in the Hospital for Communication Disorders and selected for the HLA-B16 and B18 specificities, respectively. Haplotype and allele frequencies were derived from segregation analysis in the families. From 31 unrelated children with random and familiar forms of SNHL significant deviations in the distribution were seen for the following MHC class III alleles using as a control population 60 German healthy individuals: duplicated C4A alleles (C4"DA") p = 0.009, silent C4A alleles (C4A*Q0) p = 0.006, duplicated heavy C4 beta-chain alleles (C4 beta"DHH") p = 0.0003, and silent C4 beta-chain alleles (C4 beta*Q0) p = 0.0075. In serum samples from patients with an assumed genetic disposition according to clinical criteria indications for an association were found for C4"DA" (p = 0.03), C4A*Q0 (p = 0.003), C4B*3 (p = 0.046), C4 beta"DHH" (p = 0.004), and C4 beta*Q0 (p = 0.02). The underrepresentation of C4A*Q0 may be an indicator for aberrant or duplicated C4 alleles on the same haplotype or exhibit a protection mechanism for acquiring the inheritable forms of early onset SNHL.

Adolescent↗
PubMed1990

Play and imitation skills in the diagnosis of autism in young children.

Play behaviors and motor imitation skills of 91 children between the ages of 3 and 6 years were investigated to determine their utility in distinguishing autism from mental retardation and other communication disorders. The performance of 22 autistic children was compared with that of 15 mentally retarded, 15 hearing-impaired, 19 language-impaired, and 20 non-handicapped children. Play behaviors were assessed using structured observations of free-play activities, and imitation skills were measured using a set of 12 individually administered tasks. The autistic group spent less total time interacting with toys and using toys appropriately, engaged in fewer functional play acts, and obtained lower imitation scores compared with all other groups. Discriminant function analysis revealed that the latter three variables discriminated the autistic children from the nonautistic handicapped children, with motor imitation emerging as the most important differentiating measure. These results suggest that measuring play and imitation skills may be useful in the clinical diagnosis of autism.

Autistic Disorder↗
PubMed1989

[Dynamics and state of occupational diseases in the Hungarian People's Republic].

The modern stage of development of Hungary is characterized by positive trends in occupational morbidity. Ear disorders, communicable and skin diseases are listed as the biggest health problems in the structure of occupational morbidity. The highest disease rates are registered in mining, food, chemical, metallurgical+ branches of industry, in forestry and in the production of building materials.

Humans↗
PubMed1989

Squamous cell carcinoma of the external auditory canal.

Squamous cell carcinoma of the external auditory canal is an unusual head and neck malignancy. It may occur in an ear in which there had previously been chronic inflammation, either in the external canal or middle ear. However, in most cases the etiology of the cancer is unclear. Treatment modalities have ranged from full therapy irradiation to formal temporal bone resection. Morbidity and mortality with these treatment plans alone have not been satisfactory. The purpose of this paper is to describe diagnostic and therapeutic approaches to squamous cell carcinoma of the external auditory canal used in the Department of Otolaryngology and Communicative Disorders of the Cleveland Clinic Foundation for the last 10 years.

Carcinoma, Squamous Cell↗
PubMed1988

Psychosocial aspects of head and neck cancer.

The major psychosocial issues in managing the patient with a head and neck tumor are dealing with the emotional reactions to structural and functional deficits, recognizing and treating preexisting personality problems, especially those related to alcohol and tobacco abuse, which frequently complicate their treatment course. These factors influence the rehabilitation process which should begin in the preoperative period with careful attention to psychologic and social assessment and psychiatric evaluation; if an alcoholic history is elicited. Important continuity in rehabilitation can be accomplished by contact with the rehabilitative team members before surgery, preoperative chemotherapy or radiation. Attention to appropriate adaptation to facial prostheses and dealing early with communication disorders requires a specialized staff and a rehabilitative team which can call on a range of skills including a psychiatric consultant. While the ordeal of the head and neck cancer patient is psychologically difficult and challenging, most patients are able, with the proper help, to resume full and productive lives.

Alcoholism↗
PubMed1988

Oral and written language abilities of XXY boys: implications for anticipatory guidance.

Previous studies of XXY boys suggest that they are at risk for certain communication disorders involving oral and written language. In this study, the language, reading, and spelling skills of a group of 14 XXY boys identified during neonatal cytogenetic screening were compared with those of a group of 15 control children. The two groups were matched for age, grade, race, parity, birth weight, parental age and education, and socioeconomic status. The mean age of the XXY group was 9 years 7 months and that of the control group was 9 years 3 months. The mean academic grade level for both groups was at the transition between third and fourth grade. There was selective reduction in verbal IQ scores for the XXY group and no significant differences apparent between groups for performance IQ scores. The decrease in verbal IQ was associated with a reduced full-scale IQ and also with significant problems in expressive language, auditory processing abilities, and auditory memory. Word-finding difficulties and problems in the production of syntax were major components of the specific expressive language deficit. Except for difficulties in the understanding of complex sentence structures, the receptive language skills of XXY boys did not differ significantly from those of the control group. These reductions in speech and language abilities correlated with decreased achievement by the XXY group on a variety of reading and spelling tasks. These results suggest that difficulty learning how to read and spell may be due to a preexistent language disability. Early attention to such expressive language problems may be essential to ameliorate secondary maladaptive behaviors due to chronic language-related learning disabilities.

Auditory Perceptual Disorders↗
PubMed1986

Higher maternal levels of free estradiol in first compared to second pregnancy: early gestational differences.

Serum samples drawn from 34 women in the early part of both their first and their second pregnancies were assayed for estradiol (E2), percentage of free E2, and sex hormone-binding globulin-binding capacity (SHBG-bc). Subjects were participants in the Collaborative Perinatal Study conducted by the National Institute of Neurological and Communicative Disorders and Stroke (Bethesda, MD) to evaluate factors related to adverse pregnancy outcome. All pregnancies were full term, and no offspring had a congenital malformation. After adjustment for week of pregnancy, the percentage of free E2 was 9% higher (two-sided P = .007) and the amount of free E2 was 17% higher (two-sided P = .03) in first-pregnancy sera. Total E2 was also 7% higher in first-pregnancy sera after adjustment for week of pregnancy; SHBG-bc was 7% lower after adjustment for week of pregnancy and 9% lower after simultaneous adjustment for week of pregnancy and weight at the start of pregnancy; but these differences were not statistically significant. These findings confirm our previously published hypothesis that the early part of a woman's first pregnancy differs endocrinologically from her second and may provide further insight into pregnancy-related risk factors for testis cancer and cryptorchidism and into the protection afforded by first full-term pregnancy against breast cancer.

Adult↗
PubMed1986

Comparison of Tonar II, pressure-flow, and listener judgments of hypernasality in the assessment of velopharyngeal function.

The purpose of the present investigation was to study the interrelationships among Tonar II, pressure-flow, and listener judgments of hypernasality in a consecutive series of patients. The subjects employed were 124 children and adults seen for evaluation at the University of North Carolina Oral-Facial and Communicative Disorders Program. The results indicated that nasalance scores and clinical ratings of hypernasality change systematically among patients as a function of their pressure-flow categorization. A discussion is presented concerning the impact that differential use of information from these assessment techniques can have upon patient management.

Adolescent↗