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At least 1,423 records · Page 79Linked to original sources
PubMed2005

A school-based application of modified habit reversal for Tourette syndrome via a translator: a case study.

A school-based modified habit reversal intervention was utilized with an adolescent diagnosed with Tourette syndrome who recently immigrated from Mexico. Because the student possessed little proficiency of the English language, an interpreter was needed to help implement the procedure. The frequency of motor tics markedly decreased from baseline to intervention across classroom settings. Results of two follow-up phases revealed that motor tic levels remained below those observed in the baseline phase. Implications and limitations of these findings are noted.

Adolescent↗
PubMed1992

Hormone therapy to prevent disease and prolong life in postmenopausal women.

PURPOSE: To critically review the risks and benefits of hormone therapy for asymptomatic postmenopausal women who are considering long-term hormone therapy to prevent disease or to prolong life. DATA SOURCES: Review of the English-language literature since 1970 on the effect of estrogen therapy and estrogen plus progestin therapy on endometrial cancer, breast cancer, coronary heart disease, osteoporosis, and stroke. We used standard meta-analytic statistical methods to pool estimates from studies to determine summary relative risks for these diseases in hormone users and modified lifetable methods to estimate changes in lifetime probability and life expectancy due to use of hormone regimens. RESULTS: There is evidence that estrogen therapy decreases risk for coronary heart disease and for hip fracture, but long-term estrogen therapy increases risk for endometrial cancer and may be associated with a small increase in risk for breast cancer. The increase in endometrial cancer risk can probably be avoided by adding a progestin to the estrogen regimen for women who have a uterus, but the effects of combination hormones on risk for other diseases has not been adequately studied. We present estimates for changes in lifetime probabilities of disease and life expectancy due to hormone therapy in women who have had a hysterectomy; with coronary heart disease; and at increased risk for coronary heart disease, hip fracture, and breast cancer. CONCLUSIONS: Hormone therapy should probably be recommended for women who have had a hysterectomy and for those with coronary heart disease or at high risk for coronary heart disease. For other women, the best course of action is unclear.

Breast Neoplasms↗
PubMed2003

[Agreement between clinical practice guidelines for management of community-acquired pneumonia. A retrospective study of 101 hospitalized patients].

INTRODUCTION: Management guidelines for acute community acquired pneumonia vary considerably. The objective is to estimate by a retrospective study the uniformity of the recommendations for the management of patients and the choice of initial empirical antibiotic therapy. METHODS: Eight English and French language guidelines published between 1998 and 2001 were identified by a search of the literature. They were applied retrospectively to a sample of 101 patients admitted to a university hospital in 2000 with a diagnosis of pneumonia. RESULTS: Hospital admission was advocated for between 61% and 95% and admission to intensive care for between 8% and 35% of the patients, depending on the guidelines under consideration. The actual management conformed to that advocated for between 34% and 94% of the patients (kappa=0.27 [0,19; 0,34]). Compliance of the empirical antibiotic therapy (drug, dose, mode of administration) with the recommendations varied from 0% to 68% of the patients depending on the guidelines considered (kappa=0.01 [-0,10; 0,12]). CONCLUSIONS: The heterogeneity of the guidelines is manifest by important variations in the recommendations for management and initial empirical therapy. These differences are due, in part, to a paucity of evidence based data upon which to base the guidelines. It would appear essential to harmonise the guidelines in a way that is appropriate for the country of their intended use.

Acute Disease↗
PubMed2006

Current trends in behavioral interventions for children with autism.

This chapter focuses on behavioral interventions involving skill acquisition for children and adolescents with autism over the last 12 years. Literature and outcome data are reviewed with respect to three categories: language, social skills, and self-management. Generalization of results is somewhat problematic, as all of the interventions discussed consist of relatively small sample sizes and utilize single case design methodology. However, expansion and refinement of research methodology over the last decade, with more researchers replicating previous studies, may make broader application of research findings possible.

Adolescent↗
PubMed1983

Language-related skills in children with acute lymphocytic leukemia.

The success of cranial irradiation and chemotherapy in the treatment of acute lymphocytic leukemia (ALL) has raised concerns about possible central nervous system damage in long-term survivors. The current study focused on language-related skill measures obtained as part of a neuropsychological test battery. Performance was analyzed as a function of age at diagnosis and age at evaluation in a sample of 110 children with ALL (mean age = 13.28 years). Results, although for the most part nonsignificant, do reveal significantly poorer performance on an Aphasia Screening Test rating by those diagnosed early (at or before five years of age) and assessed at or before 13 years of age when contrasted with those diagnosed early and assessed after their thirteenth year. Further analysis revealed a significant decline in spelling scores for those off therapy for more than two years. There was also a consistent trend for decline across most language-related skills measures as time off therapy increased. These results reflect either recovery from mild acute language dysfunction over time superimposed on a general trend for decline in language-related skills as time off therapy increases, or sampling error. Suggestions for future lines of investigation are discussed.

Achievement↗
PubMed1996

Moving toward a systemic training model in a university program.

While the medical model continues to provide a basis for clinical service and the preparation of future speech-language pathologists, the instructor who teaches and uses systemic principles enriches the world view of students and prepares them for new roles being assumed by speech-language pathologists. Experiences of the author are described as she became aware of systemic principles and began teaching them to undergraduate and graduate students. Two formal strategies are discussed. These are linked to a Triadic Interaction Model and a Family-Based Treatment model. Students commented favorably on their experiences as they attempted to learn systemic principles and put them into practice in their clinical practicum.

Humans↗
PubMed2001

A double-blind, placebo-controlled study of the use of amphetamine in the treatment of aphasia.

BACKGROUND AND PURPOSE: A number of studies suggest that drugs which increase the release of norepinephrine promote recovery when administered late (days to weeks) after brain injury in animals. A small number of clinical studies have investigated the effects of the noradrenergic agonist dextroamphetamine in patients recovering from motor deficits following stroke. To determine whether these findings extend to communication deficits subsequent to stroke, we administered dextroamphetamine, paired with speech/language therapy, to patients with aphasia. METHODS: In a prospective, double-blind study, 21 aphasic patients with an acute nonhemorrhagic infarction were randomly assigned to receive either 10 mg dextroamphetamine or a placebo. Patients were entered between days 16 and 45 after onset and were treated on a 3-day/4-day schedule for 10 sessions. Thirty minutes after drug/placebo administration, subjects received a 1-hour session of speech/language therapy. The Porch Index of Communicative Ability was used at baseline, at 1 week off the drug, and at 6 months after onset as the dependent language measure. RESULTS: Although there were no differences between the drug and placebo groups before treatment (P=0.807), by 1 week after the 10 drug treatments ended there was a significant difference in gain scores between the groups (P=0.0153), with the greater gain in the dextroamphetamine group. The difference was still significant when corrected for initial aphasia severity and age. At the 6-month follow-up, the difference in gain scores between the groups had increased; however, the difference was not significant (P=0.0482) after correction for multiple comparisons. CONCLUSIONS: Administration of dextroamphetamine paired with 10 1-hour sessions of speech/language therapy facilitated recovery from aphasia in a small group of patients in the subacute period after stroke. Neuromodulation with dextroamphetamine, and perhaps other drugs that increase central nervous system noradrenaline levels, may facilitate recovery when paired with focused behavioral treatment.

Adrenergic Uptake Inhibitors↗
PubMed1993

Dermatologic therapy: 1992.

This article reviews therapeutic studies reported in the English-language literature during 1992. Readers should review the original article in full before attempting any experimental or controversial therapy.

Acne Vulgaris↗
PubMed1991

Coronary angiography after thrombolytic therapy for acute myocardial infarction.

PURPOSE: To review the status of emergency, urgent, routine, and selective angiography after intravenous thrombolytic therapy. DATA SOURCES: Relevant English-language articles published from January 1985 to July 1990 were identified through MEDLINE. STUDY SELECTION: For emergency angiography, four major randomized studies were reviewed and data from nine studies that incorporated rescue coronary angioplasty were pooled for meta-analysis. For urgent angiography, two controlled trials were reviewed. Comparisons of routine and selective angiography were done using data from two dedicated, large-scale, controlled trials and the ancillary findings of four other studies of reperfusion that incorporated angiography. DATA EXTRACTION: The review emphasizes the findings from multicenter, randomized, controlled trials. DATA SYNTHESIS: Emergency coronary angiography is done primarily in preparation for primary or rescue angioplasty; the value of rescue angioplasty has yet to be assessed in a randomized trial, but technical success and reocclusion improve significantly after therapy with nonspecific plasminogen activators compared with relatively specific agents (success rate, 86% compared with 75%, respectively; P = 0.03; reocclusion rate, 10.9% compared with 26.8%, respectively; P less than 0.001). Urgent coronary angiography has value for treating recurrent ischemia, but patients who develop this complication after thrombolysis are likely to have a suboptimal outcome despite aggressive care. Studies support the use of either selective or routine angiography in uncomplicated patients after thrombolytic therapy; either approach is acceptable, but the former is more practical and may prove to be cost effective. CONCLUSIONS: Optimal follow-up for patients with evolving myocardial infarction who receive thrombolysis may incorporate coronary angiography at various stages. Although our ability to noninvasively detect reperfusion, reocclusion, or viable but ischemic myocardium is limited at present, available data may assist in selecting a catheterization strategy.

Cardiac Catheterization↗
PubMed1988

Diurnal rhythms in performance tests of school children with and without language disorders.

Time-of-day related changes on four tests used by speech therapists and four other performance tests, in addition to oral temperature, were documented in 16 school children (7-9 years of age). Six of them had language disorders and were receiving speech therapy. Children were synchronized with diurnal activity from around 0730 to around 2100 and nocturnal rest. For each child, at each test time point (e.g. 0900, 1100, 1530 and 1930) tests were performed three times, with two different speech therapists, in a random order, with only one session per day. Conventional methods (t-tested mean differences; ANOVA; correlation tests) were used for statistical analyses. Among 29 parameters (items) which were analyzed, only nine exhibited time-of-day related changes, mainly in speed to-perform measures. In most detected rhythms best performance occurred either at 1100 or at 1530 with no difference in subgroups except for the fastest performance of the sentence repetition test. With regard to the daily mean M, controls performed better than children with language disorders for the word (syllabic) repetition test (P less than 0.0004) but this was reversed for both computing and colouring skill tests (P less than 0.04 and less than 0.002). A difference related to sex (but not to language disorders) was observed in the Ms of speed in sign reproduction (P less than 0.0000) and sorting cards (P less than 0.01), with boys being faster than girls. In children, as in adults, time-of-day effects should be considered when the quantification of performance is desired.

Body Temperature↗
PubMed2002

Combining lithium and anticonvulsants in bipolar disorder: a review.

While the benefits of lithium in bipolar disorder are evident, its limitations as monotherapy are well recognized, particularly in bipolar depression. This has propelled trials of combined lithium-anticonvulsant therapy in many bipolar patients. The present review of the English-language literature examines both controlled and open studies of such combination therapy, including the risk of drug-drug interactions. Trials of lithium plus either carbamazepine or divalproex have generally produced favorable results, although increased rates of adverse effects may reduce treatment adherence. More recent reports suggest that lithium may be safely and effectively combined with lamotrigine, and perhaps with topiramate, although controlled studies are required. The combined use of lithium with newer, putative mood stabilizers, such as zonisamide or levetiracetam, cannot yet be recommended, but is an important area for future research. Provisional recommendations for combined treatment are provided.

Anticonvulsants↗
PubMed1992

Voice therapy practices and techniques: a survey of voice clinicians.

Members of the American Speech-Language-Hearing Association Special Interest Division on Voice were asked to rate statements which emanated from a previously conducted national survey regarding the practice of voice therapy (Larson and Mueller, 1991). Respondents rated eight data-based statements on a five-point scale as to agreement/disagreement. Results indicated strong agreement with previous findings with the exception of the item addressing treatment time. Implications of these results are discussed.

American Speech-Language-Hearing Association↗
PubMed1992

Thrombolytic therapy of acute myocardial infarction. Keeping the unfulfilled promises.

OBJECTIVE: To assess the use of thrombolytic therapy for acute myocardial infarction, evaluating whether inclusion and exclusion criteria should be altered as well as the public health implications of any such alterations. DATA SOURCES: Data obtained were from English-language articles on the use of thrombolytic therapy in acute myocardial infarction. Articles that reported on inclusion and exclusion criteria as well as specific complications of this therapy were specifically sought. The review included articles under the terms thrombolytic therapy and acute myocardial infarction in the National Library of Medicine's MEDLINE database. STUDY SELECTION: Studies selected for detailed review were those reporting specifics about inclusion and exclusion criteria and efficacy. Data extraction guidelines for assessing data quality included study size, patient population, detail of patient information acquired, and consecutive patient enrollment. DATA SYNTHESIS: Thrombolytic therapy can provide substantial decrements of morbidity and mortality of acute myocardial infarction in the subset of patients who receive this therapy, but is underused in the United States. Advanced age per se should not be an exclusion criterion. Improvements can be made in electrocardiographic diagnosis of acute myocardial infarction. Many of the clinical conditions initially excluded from thrombolytic consideration, such as hypertension or having received cardiopulmonary resuscitation, are only relative contraindications. The benefit/risk ratio in treatment of these patients is often acceptable. Several well-documented points of delay from onset of symptoms to treatment can be minimized, and accelerated therapy can result in a reduction in mortality rates. CONCLUSION: Significant public health benefits will result from greater use of thrombolytic therapy in acute myocardial infarction.

Contraindications↗
PubMed1990

Matching client and therapist ethnicity, language, and gender: a review of research.

The purpose of this article is to examine whether therapy process and outcome are influenced by a client-therapist ethnicity, language, or gender match. A review of research in this area does not demonstrate support for a client-therapist match on any of these variables. The methodological problems and unresolved conceptual issues involved in this research may limit the findings. The ethical and political context of the research and the implications for mental health nursing are explored.

Cultural Characteristics↗
PubMed2004

Assessing and managing medically fragile children: tracheostomy and ventilatory support.

Over the past decade, there has been an increase in premature births. Children born prematurely often present with complex medical conditions; some require a tracheostomy. Although many children with tracheostomies require assistance to achieve effective communication, speech-language pathologists may have limited information with respect to the medical issues and communication needs of this population. The purpose of this article is twofold. First, a review of basic information on tracheostomy and ventilatory support in the pediatric population is provided. Second, information on the assessment of communication skills and intervention specific to voice for the child with a tracheostomy is detailed. Two case studies are presented. The case studies illustrate the diversity and medical complexity common to this population and provide practical information for the clinician working with a child with a tracheostomy.

Child↗
PubMed2003

Language recovery following subthalamic nucleus stimulation in Parkinson's disease.

Neuropsychological consequences of stimulation of the subthalamic nucleus for treatment of drug-resistant Parkinson's disease (PD) have been studied previously. However, no detailed investigations of linguistic function modifications have been carried out. We studied four consecutive patients with PD who underwent chronic bilateral stimulation of the subthalamic nuclei. Neuropsychological and linguistic evaluations were performed before and 2 weeks after surgery. Linguistic abilities were studied also 1 year after surgery with stimulators both off and on. Intraphrasal hesitation pauses, phonemic paraphasias and morpho-syntactic errors were significantly reduced and lexical retrieval improved with stimulation of the subthalamic nuclei. Implicit linguistic phenomena, mainly occurring within basal ganglia circuitry, benefited by recovery of functional equilibrium within basal nuclei and between overall basal ganglia circuitry and cerebral cortex.

Aged↗
PubMedDate not supplied

Use of speech pathology services in the burn unit.

Speech-language pathologists (SLPs) provide intervention for communication challenges and swallowing disorders (dysphagia) that are common in cases of severe burns because of ventilator use, prolonged or multiple intubations, and tracheostomy tubes. To identify current inclusion of SLP services in burn care management, a survey was sent to 139 burn units across the United States. Results revealed limited inclusion of SLPs in burn care despite pertinent areas of SLP expertise. Education of burn care teams on the benefits of SLP inclusion is needed. Potential benefits in pain and medical management reducing length of hospitalization and increasing cost-effective care by inclusion of SLPs in burn care management warrants further research.

Adolescent↗