Tuberöse-Sklerose-Komplex: Analyse des okulären Phänotyps und assoziierter Komplikationen

2019 ◽  
Vol 236 (04) ◽  
pp. 462-468
Author(s):  
Florian Zweipfenning ◽  
Sandra Toelle ◽  
Christina Gerth-Kahlert
Keyword(s):  
Tuberöse Sklerose

Zusammenfassung Hintergrund Evaluation und Vergleich des okulären Phänotyps von Patienten, die mit tuberöser Sklerose (TSC) diagnostiziert wurden. Analyse der okulären Komplikationen während der Untersuchungsperiode. Methoden Es wurde eine retrospektive Datenanalyse von Patienten mit TSC, die ophthalmologische Untersuchungen an der Augenklinik des Universitätsspitals Zürich erhalten hatten, durchgeführt. Bestkorrigierter Visus, Refraktion, Gesichtsfeld, Vorderabschnitts- und Fundusbefunde mit Unterscheidung der Hamartomarten wurden aus den Patientenakten extrahiert. Die Studie wurde durch die kantonale Ethikkommission Zürich bewilligt. Resultate Insgesamt wurden Daten von 30 Patienten (19 weiblich, 11 männlich) mit TSC identifiziert. Das Alter bei der Erstuntersuchung variierte von 7 Monaten bis 44 Jahre (median 13,3 Jahre, Standardabweichung [SD] 11,31). Bei 17 von 30 Patienten lagen Daten der Follow-up-Untersuchung zwischen 4 Monaten und 19 Jahren vor (median 4,3 Jahre, SD 5,24). Daten der quantitativen Visusüberprüfung lagen von 26/30 Patienten vor, wobei 22/26 einen beidseitig altersentsprechenden Visus aufwiesen. Die Ursache der Visuseinschränkung bei 4 Patienten waren: Komplikation eines subependymalen Riesenzellastrozytoms mit einer beidseitigen Optikusatrophie; retinale Toxizität bei Vigabatrinmedikation; Vorderabschnittsdysgenesie und einseitige Amblyopie ex Anisometropie. Retinale Hamartome waren in 15/30 Patienten dokumentiert: bei 8 Patienten einseitig, bei 7 beidseitig. Der flache Hamartomtyp wurde häufiger als der multinoduläre Typ (10/15 vs. 6/15) beschrieben. Schlussfolgerungen Der okuläre Phänotyp unserer Patientenkohorte zeigt Übereinstimmungen mit der Literatur. Mit TSC diagnostizierte Patienten erfordern regelmäßige ophthalmologische Kontrollen, um sekundäre Komplikationen wie ein Papillenödem, starken Visusverlust oder Gesichtsfeldeinschränkung frühzeitig zu diagnostizieren.

Therapy and prevention for mental health: What if mental diseases are mostly not brain disorders?

2019 ◽  
Vol 42 ◽  
Author(s):  
John P. A. Ioannidis
Keyword(s):  
Mental Health ◽  
Mental Disease ◽  
Brain Disorders ◽  
Social Stressors ◽  
Labor Education ◽  
Mental Diseases ◽  
Long Term Follow Up ◽  
Political Decisions

AbstractNeurobiology-based interventions for mental diseases and searches for useful biomarkers of treatment response have largely failed. Clinical trials should assess interventions related to environmental and social stressors, with long-term follow-up; social rather than biological endpoints; personalized outcomes; and suitable cluster, adaptive, and n-of-1 designs. Labor, education, financial, and other social/political decisions should be evaluated for their impacts on mental disease.

Brief summary of Kleť photographic search programme for minor planets

1999 ◽  
Vol 173 ◽  
pp. 189-192
Author(s):  
J. Tichá ◽  
M. Tichý ◽  
Z. Moravec
Keyword(s):  
Ccd Camera ◽  
Minor Planet ◽  
Minor Planets ◽  
Main Belt

AbstractA long-term photographic search programme for minor planets was begun at the Kleť Observatory at the end of seventies using a 0.63-m Maksutov telescope, but with insufficient respect for long-arc follow-up astrometry. More than two thousand provisional designations were given to new Kleť discoveries. Since 1993 targeted follow-up astrometry of Kleť candidates has been performed with a 0.57-m reflector equipped with a CCD camera, and reliable orbits for many previous Kleť discoveries have been determined. The photographic programme results in more than 350 numbered minor planets credited to Kleť, one of the world's most prolific discovery sites. Nearly 50 per cent of them were numbered as a consequence of CCD follow-up observations since 1994.This brief summary describes the results of this Kleť photographic minor planet survey between 1977 and 1996. The majority of the Kleť photographic discoveries are main belt asteroids, but two Amor type asteroids and one Trojan have been found.

Intranuclear Crystals in Regenerating Canine Kidneys

1973 ◽  
Vol 31 ◽  
pp. 412-413
Author(s):  
D.G. Osborne ◽  
L.J. McCormack ◽  
M.O. Magnusson ◽  
W.S. Kiser
Keyword(s):  
Epithelial Cell ◽  
Epithelial Cells ◽  
Tubular Epithelial Cell ◽  
Tubular Epithelial Cells ◽  
Cell Nuclei ◽  
Crystalline Structures ◽  
Small Crystals ◽  
Membrane Bound

During a project in which regenerative changes were studied in autotransplanted canine kidneys, intranuclear crystals were seen in a small number of tubular epithelial cells. These crystalline structures were seen in the control specimens and also in regenerating specimens; the main differences being in size and number of them. The control specimens showed a few tubular epithelial cell nuclei almost completely occupied by large crystals that were not membrane bound. Subsequent follow-up biopsies of the same kidneys contained similar intranuclear crystals but of a much smaller size. Some of these nuclei contained several small crystals. The small crystals occurred at one week following transplantation and were seen even four weeks following transplantation. As time passed, the small crystals appeared to fuse to form larger crystals.

Electron Microscopy of Human Gallstones

1971 ◽  
Vol 29 ◽  
pp. 296-297
Author(s):  
C. Wolpers ◽  
R. Blaschke
Keyword(s):  
Electron Microscopy ◽  
Room Temperature ◽  
Bile Pigment ◽  
X Ray Diffraction ◽  
Triclinic Crystal System ◽  
X Ray ◽  
Follow Up Study ◽  
Infra Red ◽  
Main Components

Scanning microscopy was used to study the surface of human gallstones and the surface of fractures. The specimens were obtained by operation, washed with water, dried at room temperature and shadowcasted with carbon and aluminum. Most of the specimens belong to patients from a series of X-ray follow-up study, examined during the last twenty years. So it was possible to evaluate approximately the age of these gallstones and to get information on the intensity of growing and solving.Cholesterol, a group of bile pigment substances and different salts of calcium, are the main components of human gallstones. By X-ray diffraction technique, infra-red spectroscopy and by chemical analysis it was demonstrated that all three components can be found in any gallstone. In the presence of water cholesterol crystallizes in pane-like plates of the triclinic crystal system.

Articulatory Intervention for the Visually Impaired

1979 ◽  
Vol 10 (3) ◽  
pp. 139-144
Author(s):  
Cheri L. Florance ◽  
Judith O’Keefe
Keyword(s):  
High School ◽  
High School Students ◽  
Behavior Change ◽  
Visually Impaired ◽  
School Students ◽  
Handicapped Children ◽  
Paired Stimuli ◽  
Visually Handicapped ◽  
Parent Program

A modification of the Paired-Stimuli Parent Program (Florance, 1977) was adapted for the treatment of articulatory errors of visually handicapped children. Blind high school students served as clinical aides. A discussion of treatment methodology, and the results of administrating the program to 32 children, including a two-year follow-up evaluation to measure permanence of behavior change, is presented.

What Does Evidence-Based Practice Mean to You? A Follow-Up Study Examining School-Based Speech-Language Pathologists' Perspectives on Evidence-Based Practice

2020 ◽  
Vol 29 (2) ◽  
pp. 688-704
Author(s):  
Katrina Fulcher-Rood ◽  
Anny Castilla-Earls ◽  
Jeff Higginbotham
Keyword(s):  
Clinical Practice ◽  
Research Evidence ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Speech Language Pathologists ◽  
School Based ◽  
Research Findings ◽  
Ebp Implementation

Purpose The current investigation is a follow-up from a previous study examining child language diagnostic decision making in school-based speech-language pathologists (SLPs). The purpose of this study was to examine the SLPs' perspectives regarding the use of evidence-based practice (EBP) in their clinical work. Method Semistructured phone interviews were conducted with 25 school-based SLPs who previously participated in an earlier study by Fulcher-Rood et al. 2018). SLPs were asked questions regarding their definition of EBP, the value of research evidence, contexts in which they implement scientific literature in clinical practice, and the barriers to implementing EBP. Results SLPs' definitions of EBP differed from current definitions, in that SLPs only included the use of research findings. SLPs seem to discuss EBP as it relates to treatment and not assessment. Reported barriers to EBP implementation were insufficient time, limited funding, and restrictions from their employment setting. SLPs found it difficult to translate research findings to clinical practice. SLPs implemented external research evidence when they did not have enough clinical expertise regarding a specific client or when they needed scientific evidence to support a strategy they used. Conclusions SLPs appear to use EBP for specific reasons and not for every clinical decision they make. In addition, SLPs rely on EBP for treatment decisions and not for assessment decisions. Educational systems potentially present other challenges that need to be considered for EBP implementation. Considerations for implementation science and the research-to-practice gap are discussed.

The Link Between Verbal Short-Term Memory and Anomia Treatment Gains

2019 ◽  
Vol 28 (3) ◽  
pp. 1039-1052
Author(s):  
Reva M. Zimmerman ◽  
JoAnn P. Silkes ◽  
Diane L. Kendall ◽  
Irene Minkina
Keyword(s):  
Short Term Memory ◽  
Controlled Trial ◽  
Treatment Success ◽  
Linear Regression Models ◽  
Language Performance ◽  
Short Term ◽  
Term Memory ◽  
Treatment Gains ◽  
Post Hoc

Purpose A significant relationship between verbal short-term memory (STM) and language performance in people with aphasia has been found across studies. However, very few studies have examined the predictive value of verbal STM in treatment outcomes. This study aims to determine if verbal STM can be used as a predictor of treatment success. Method Retrospective data from 25 people with aphasia in a larger randomized controlled trial of phonomotor treatment were analyzed. Digit and word spans from immediately pretreatment were run in multiple linear regression models to determine whether they predict magnitude of change from pre- to posttreatment and follow-up naming accuracy. Pretreatment, immediately posttreatment, and 3 months posttreatment digit and word span scores were compared to determine if they changed following a novel treatment approach. Results Verbal STM, as measured by digit and word spans, did not predict magnitude of change in naming accuracy from pre- to posttreatment nor from pretreatment to 3 months posttreatment. Furthermore, digit and word spans did not change from pre- to posttreatment or from pretreatment to 3 months posttreatment in the overall analysis. A post hoc analysis revealed that only the less impaired group showed significant changes in word span scores from pretreatment to 3 months posttreatment. Discussion The results suggest that digit and word spans do not predict treatment gains. In a less severe subsample of participants, digit and word span scores can change following phonomotor treatment; however, the overall results suggest that span scores may not change significantly. The implications of these findings are discussed within the broader purview of theoretical and empirical associations between aphasic language and verbal STM processing.

Facilitating Parental Involvement in Speech Therapy for Children With Speech Sound Disorders: A Survey of Speech-Language Pathologists' Practices, Perspectives, and Strategies

2020 ◽  
Vol 29 (4) ◽  
pp. 1987-1996
Author(s):  
Sherine R. Tambyraja
Keyword(s):  
Parental Involvement ◽  
Online Survey ◽  
Speech Therapy ◽  
Speech Sound ◽  
Speech Sound Disorders ◽  
Speech Sound Disorder ◽  
Speech Language Pathologists ◽  
School Based ◽  
Homework Completion

Purpose This study investigated the extent to which speech-language pathologists (SLPs) facilitate parents' completion of homework activities for children with speech sound disorder (SSD). In addition, this study explored factors related to more consistent communication about homework completion and strategies considered particularly effective for supporting this element of parental involvement. Method Licensed SLPs serving at least one child with SSD were invited to participate in an online survey. Questions relevant to this study gathered information regarding (a) frequency of communication about homework distribution and follow-up, (b) demographic and workplace characteristics, and (c) an open-ended question about the specific strategies used to support parental involvement and completion of homework activities. Results Descriptive results indicated considerable variability with respect to how frequently SLPs engaged in communication about homework completion, but that school-based SLPs were significantly less likely to engage in this type of follow-up. Strategies considered effective, however, were similar across therapy contexts. Conclusion These results suggest potentially important differences between school-based services and therapy in other contexts with respect to this particular aspect of service provision for children with SSD.

Clinical Success Using the Audio-Visual Feedback Training for Cluttering

2019 ◽  
Vol 4 (6) ◽  
pp. 1589-1594
Author(s):  
Yvonne van Zaalen ◽  
Isabella Reichel
Keyword(s):  
Visual Feedback ◽  
Clinical Success ◽  
Pause Duration ◽  
Digital Audio ◽  
Male Adolescents ◽  
Feedback Training ◽  
Positive Effects ◽  
Speech Monitoring ◽  
Adolescents And Adults

Purpose Among the best strategies to address inadequate speech monitoring skills and other parameters of communication in people with cluttering (PWC) is the relatively new but very promising auditory–visual feedback (AVF) training ( van Zaalen & Reichel, 2015 ). This study examines the effects of AVF training on articulatory accuracy, pause duration, frequency, and type of disfluencies of PWC, as well as on the emotional and cognitive aspects that may be present in clients with this communication disorder ( Reichel, 2010 ; van Zaalen & Reichel, 2015 ). Methods In this study, 12 male adolescents and adults—6 with phonological and 6 with syntactic cluttering—were provided with weekly AVF training for 12 weeks, with a 3-month follow-up. Data was gathered on baseline (T0), Week 6 (T1), Week 12 (T2), and after follow-up (T3). Spontaneous speech was recorded and analyzed by using digital audio-recording and speech analysis software known as Praat ( Boersma & Weenink, 2017 ). Results The results of this study indicated that PWC demonstrated significant improvements in articulatory rate measurements and in pause duration following the AVF training. In addition, the PWC in the study reported positive effects on their ability to retell a story and to speak in more complete sentences. PWC felt better about formulating their ideas and were more satisfied with their interactions with people around them. Conclusions The AVF training was found to be an effective approach for improving monitoring skills of PWC with both quantitative and qualitative benefits in the behavioral, cognitive, emotional, and social domains of communication.

Sound Production Treatment for Acquired Apraxia of Speech: An Examination of Dosage in Relation to Probe Performance

2020 ◽  
pp. 1-16
Author(s):  
Julie L. Wambaugh ◽  
Lydia Kallhoff ◽  
Christina Nessler
Keyword(s):  
Retrospective Analysis ◽  
Sound Production ◽  
Apraxia Of Speech ◽  
Practice Schedule ◽  
Practice Schedules ◽  
Baseline Performance ◽  
The Mean ◽  
Number Of Treatment ◽  
The Impact

Purpose This study was designed to examine the association of dosage and effects of Sound Production Treatment (SPT) for acquired apraxia of speech. Method Treatment logs and probe data from 20 speakers with apraxia of speech and aphasia were submitted to a retrospective analysis. The number of treatment sessions and teaching episodes was examined relative to (a) change in articulation accuracy above baseline performance, (b) mastery of production, and (c) maintenance. The impact of practice schedule (SPT-Blocked vs. SPT-Random) was also examined. Results The average number of treatment sessions conducted prior to change was 5.4 for SPT-Blocked and 3.9 for SPT-Random. The mean number of teaching episodes preceding change was 334 for SPT-Blocked and 179 for SPT-Random. Mastery occurred within an average of 13.7 sessions (1,252 teaching episodes) and 12.4 sessions (1,082 teaching episodes) for SPT-Blocked and SPT-Random, respectively. Comparisons of dosage metric values across practice schedules did not reveal substantial differences. Significant negative correlations were found between follow-up probe performance and the dosage metrics. Conclusions Only a few treatment sessions were needed to achieve initial positive changes in articulation, with mastery occurring within 12–14 sessions for the majority of participants. Earlier occurrence of change or mastery was associated with better follow-up performance. Supplemental Material https://doi.org/10.23641/asha.12592190

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