Occupational therapists are becoming increasingly involved with interface assessments. This involvement is improving the ability of persons with physical disabilities to interact with computers, augmentative communication aids, and other devices. The ability to use these devices facilitates participation in activities that would otherwise be much more difficult to pursue, such as communication, education, work, and recreation. The purpose of the present study was to systematically compare three basic modes of scanning--automatic, inverse, and step--with the use of a single-subject experimental design. Six subjects--3 with spastic and 3 with athetoid cerebral palsy--from a local school volunteered for the study. Results indicated that the 3 subjects with spastic cerebral palsy had the greatest difficulty using the automatic scanning mode. The 3 subjects with athetoid cerebral palsy had the most difficulty using the step scanning mode. The results of this study suggest that clients should attempt each scanning mode and that their performance with each mode be compared to ensure the most appropriate recommendations. 相似文献
This article is a retrospective study comparing the efficacy of Regnauld arthroplasty to first ray osteotomies for the treatment of hallux valgus. One hundred consecutive cases of Regnauld arthroplasties were compared with 100 consecutive first ray osteotomies. One hundred fourty-one patients were available for follow-up, and based on clinical/radiographic examinations, 72 were treated with the osteotomy protocol (group A) and 69 with Regnauld arthroplasty (group B). Age at surgery, clinical symptoms, and preoperative radiologic findings were similar for the 2 groups; there was a preponderance of female patients (90%). The average follow-up was 49 months in group A and 51 months in group B. Clinical evaluation showed in the osteotomy group a more stable correction (79% v 49%), greater pain reduction (measured in a visual analog scale from 0 = pain free to 10 = deep intolerable pain), increased residual articular excursion of the first metatarsophalangeal joint (27 degrees of active dorsiflexion from neutral position v 8 degrees ), and less presence of central metatarsalgia (15% v 34%) (P <.05). The radiographic evaluation expressed more stable correction values in group A for the following parameters: joint preservation, sesamoid position, intermetatarsal angle (7 degrees v 12 degrees ), abduction angle of the hallux (14 degrees v 20 degrees ), and proximal articular set angle (8 degrees v 18 degrees ) (P <.05). 相似文献
In an Italian hospital, we observed that hand hygiene was performed in 638 (19.6%) of 3,253 opportunities, whereas gloves were worn in 538 (44.2%) 1,218 of opportunities. We observed an inverse correlation between the intensity of care and the rate of hand hygiene compliance (R2=0.057; P<.001), but no such association was observed for the rate of glove use compliance (R2=0.014; P=.078). Rates of compliance with hand hygiene and glove use recommendations follow different behavioral patterns. 相似文献
Summary We studied paired cerebrospinal fluid (CSF) and peripheral blood (PB) samples from 18 inactive multiple sclerosis (MS) patients and 10 with non-inflammatory neurological diseases. By means of a dual-colour cytofluorimetric micromethod we were able to count 1500 cells on average in each CSF sample. We found a significant reduction of CD45RA+ and CD4+CD45RA+ cells in the CSF of MS patients. Similarly, CD45RA+ and CD4+CD45RA+ CSF/PB ratios were lower compared with controls. The reduction of suppressor-inducer T-cells did not correlate with CD8+ cell levels in the CSF. The CD4+ subset ratio (CD4+CD45RA–/CD4+CD45RA+) was significantly increased in the CSF of MS patients. Our data suggest that the reduction of CD4+CD45RA+ cells in the PB is not due to a segregation of such cells in the CSF. Conversely, CSF changes reflect changes in the PB similar to these found for other T-cell subsets. 相似文献
We report a patient with a progressive, predominantly sensory neuropathy and a IgM kappa M-protein that binds to Schmidt-Lantermann incisures. A sural nerve biopsy showed primary axonal damage and IgM deposits at Schmidt-Lantermann incisures were seen by direct immunoperoxidase. Serum from the patient injected into rat sciatic nerve reacts with the incisures as with those in the patient's nerve. The IgM kappa M-protein reacts with chondroitin sulfate C and binds to a broad nerve protein band with a mobility of between 170 and 118 kDa. Peripheral neuropathy may be related to the M-protein, which had immunocytochemical reactivity not previously described for patients with polyneuropathy and IgM monoclonal gammopathy. 相似文献
We describe the clinical and pathological findings of the hemolytic uremic syndrome (HUS) in two children with human immunodeficiency
virus (HIV) infection. Both patients presented with microangiopathic hemolytic anemia, thrombocytopenia, and subsequently
developed renal failure. The diagnosis of HUS was confirmed by renal histopathology in both patients. None of these children
presented with bloody diarrhea, evidence of circulating antibody response to Escherichia coli O157 lipopolysaccharide, or other known risk factors for HUS, except for the presence of HIV infection. Each patient was
treated with intravenous plasma infusion and renal replacement therapy. Their clinical course was characterized by non-oliguria
and lack of significant hypertension throughout the acute phase of the disease. Despite these favorable clinical parameters,
both patients developed end-stage renal failure. The etiology of this atypical HUS characterized by poor renal survival remains
unknown and the role of HIV infection in its pathogenesis, although possible, is unclear.
Received March 5, 1996; received in revised form and accepted October 15, 1996 相似文献
The aim of this study was to determine the diagnostic accuracy of technetium-99m tetrofosmin myocardial imaging for the localization
of coronary artery stenoses of different degrees of severity. Stress-rest single-photon emission tomography (SPET) was performed
on separate days in 80 patients (64 males, 16 females; mean age 61 years; 43 patients with previous myocardial infarction;
18 patients with pharmacological stress), within 6 months of coronary angiography. Scintigraphic images were blindly and independently
evaluated by three observers. Coronary stenosis was defined as a >50% narrowing in luminal diameter; severe stenosis was defined
as a proximal stenosis of >75% or a peripheral stenosis of >90%. Coronary angiography revealed normal coronary arteries or
insignificant coronary stenosis in 13 patients and significant coronary stenoses in 67 patients. The sensitivity and specificity
of 99mTc-tetrofosmin SPET in respect of severely stenosed vessels were, respectively, 80% and 65% for the left anterior descending
artery (LAD), 100% and 46% for the right coronary artery (RCA) and 58 and 78% for the left circumflex artery (LCx) territories.
Considering all the significantly stenosed vessels, a significant decrease in sensitivity was observed for LAD territories
(to 59%, P=0.05), and a nonsignificant decrease for RCA (88%) and LCx (47%) territories while specificity values remained essentially
unchanged. No significant changes in sensitivity or specificity were observed when regions with previous myocardial infarction
were excluded. In conclusion, the sensitivity of 99mTc-tetrofosmin SPET for the localization of individual stenosed vessels is only moderate when all significant stenoses are
considered, but the ability of this technique to predict the location of severe coronary artery stenoses seems satisfactory,
with the exception of the low specificity in respect of RCA territories.
Received 26 April and in revised form 7 June 1997 相似文献
The micrografting technique, employed to treat patients with extensive TBSA burns and reduced areas of healthy donor skin, was assessed simultaneously with traditional mesh grafts (STSG) or Tiersch grafts in the treatment five severely burned subjects (average TBSA burned 35.6 per cent; average per cent of full thickness wounds 32.6 per cent).
At the first clinical control on day 6 post-surgery 93 per cent of the micrografted area was in situ and healthy: epithelialization of the wound sites was complete at day 21. Meshed STSG yielded 90 per cent attachment at day 6 post-surgery, with epithelialization complete at 12 ± 2 days post-surgery.
Functional results were equivalent no matter what technique was used, while aesthetic results were better in the areas where micrografting was carried out.
Although the micrograft technique is labour-intensive, if the expansion needed is at least 1:6, the aesthetic and functional results obtained are comparable to, or better than, those with meshed grafts. Also, large segments of micrograft are not compromised if a small area of mesh becomes detached, and epithelialization is faster and more uniform, enabling a reduction in both infection and length of hospital stay. 相似文献