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141.
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Johnny L. Matson Melissa L. Gonzalez Tessa T. Rivet 《Research in autism spectrum disorders》2008,2(4):696-706
A considerable amount of attention has occurred with respect to the diagnosis and treatment of Autism Spectrum Disorders (ASDs) of children and youth. Furthermore, the rationale for using the most restrictive of the applied behavior analysis methods and medication has been largely based on the presence of severe challenging behaviors such as self-injury, aggression, and stereotypes. Despite the extensive treatment efforts, there has not been a scale developed specifically to address the screening and identification of these problem behaviors for children with ASD. The present study was specifically designed to report on the reliability and factor structure of a brief behavior problem inventory, which is part of a diagnostic battery for children suspected of evincing autism, PDD-NOS, or Asperger's syndrome. The initial psychometric properties of the Autism Spectrum Disorders-Behavior Problems for Children (ASD-BPC) are described and the implications for future research are presented. 相似文献
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Xiaoyu Yang Tessa Janssen Mark P. Arts Wilco C. Peul Carmen L.A. Vleggeert-Lankamp 《The spine journal》2018,18(9):1678-1693
Objective
The objective of this study was to review current literature on the comparison of the radiological outcome of cervical arthroplasty with fusion after anterior discectomy for radiculopathy.Materials and Methods
A literature search was performed in PubMed, Embase, Web of Science, Cochrane, CENTRAL, and CINAHL using a sensitive search string combination. Studies were selected by predefined selection criteria (patients exclusively suffering from cervical radiculopathy), and risk of bias was assessed using a validated Cochrane checklist adjusted for this purpose. Additionally, an overview of results of articles published in 21 meta-analyses was added, considering a group of patients with myelopathy with or without radiculopathy.Results
Seven articles that compared intervertebral devices in patients with radiculopathy (excluding patients with myelopathy) were included in the study. Another 31 articles were studied as a mixed group, including patients with myelopathy and radiculopathy. Apart from three studies with low risk of bias, all other articles showed intermediate or high risk of bias. Heterotopic ossification was reported to be present in circa 10% of patients, seemingly predominant in patients with radiculopathy, with a very low level of evidence. Radiological signs of adjacent segment disease were present at baseline in 50% of patients, and there is a low level of evidence that this increased more (10%–20%) in the fusion group at long-term follow-up. However, this was only studied in the mixed study population, which is degenerative by diagnosis.Conclusion
Although the cervical disc prosthesis was introduced to decrease adjacent level disease, convincing radiological evidence for this benefit is lacking. Heterotopic ossification as a complicating factor in the preservation of motion of the device is insufficiently studied. Regarding purely radiological outcomes, currently, no firm conclusion can be drawn for implanting cervical prosthesis versus performing fusion. 相似文献147.
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BACKGROUND AND AIMS: Afferent large fibre impairment has been reported as a useful predictor of postherpetic neuralgia (PHN) in patients with acute herpes zoster infection, using an electromechanical device to provide quantitative vibrametry. We aimed to demonstrate a clinically significant increase in vibration threshold in individuals with PHN compared to age-matched controls, using the portable and affordable Rydel-Seiffer graduated tuning fork. METHODS: We studied 45 PHN subjects aged over 55 years, and 45 age-matched controls with no history of herpes zoster infection. We excluded subjects with a history of disorders associated with neuropathy or immunocompromise. Measurements were performed at the ulnar styloid process and the head of the first metatarsal on the right side, in a warm room with the subject seated. Readings were taken in triplicate and the data analysed by a repeated measures design. RESULTS: We observed a significant difference in vibration threshold at both wrist and toe between the PHN and control groups (p < 0.001). Age-stratification of subjects produced an increased and clinically useful difference between the two groups at both sites in subjects between 55 and 70 years (p < 0.0001). CONCLUSIONS: We have shown a statistically significant decrease in vibration sensitivity in individuals with PHN aged 55-70 years compared to age-matched healthy controls, using the Rydel-Seiffer graduated tuning fork. A prospective study of patients with acute zoster infection is needed to determine the sensitivity and specificity of the graduated tuning fork in predicting PHN in patients with acute zoster infection. 相似文献
149.
Tessa Garside Fiona M. Wood Ann-Maree Vallence 《Burns : journal of the International Society for Burn Injuries》2018,44(5):1195-1202
Objective
The study aimed to investigate intracortical inhibition following a burn injury, and to establish transcranial magnetic stimulation (TMS) as a useful and sensitive tool to investigate the cortical response to a burn injury.Methods
Thirteen burn injured patients and 12 uninjured subjects underwent TMS to measure the cortical silent period (cSP), a marker of intracortical inhibition.Results
In burn injury patients, cSP was similar in the burn-injured and less-injured arm (133 and 132 ms respectively; p = 0.96). cSP was numerically shorter in burns patients than control subjects, however, these differences were not statistically significant (133 vs 148 ms, p = 0.24). Subgroup analysis revealed cSP was shorter in the burn arm of patients compared to the uninjured control subjects in patients with upper-limb burn (cSP 120 ms vs 148 ms, p = 0.03), those with <10% TBSA (cSP 120 ms vs 148 ms, p = 0.01), those <2 years’ post-burn (cSP 110 ms vs 148 ms, p = 0.01), and patients with partial thickness burns (cSP 120 ms vs 148 ms, p = 0.02).Conclusions
These results demonstrate significantly shorter cSP in the burned arm in patients with upper limb burn sustained <2 years ago, those with partial thickness burns, those with upper limb burns only, and those with burns of less than 10% TBSA. The results are consistent with the existing literature, which demonstrates a reduction in cSP duration in patients with a range of peripheral nerve injuries. There is a strong suggestion that cortical inhibition is altered following burn injury, and that TMS is a useful and sensitive method for investigating changes in cortical inhibition in burn patients. 相似文献150.
ADC mapping of neurodegeneration in the brainstem and cerebellum of patients with progressive ataxias 总被引:1,自引:0,他引:1
Della Nave R Foresti S Tessa C Moretti M Ginestroni A Gavazzi C Guerrini L Salvi F Piacentini S Mascalchi M 《NeuroImage》2004,22(2):698-705
Analysis of the apparent diffusion coefficient (ADC) maps derived from diffusion-weighted MR imaging is emerging as a reproducible, sensitive, and quantitative tool to evaluate brain damage in diseases of the white and gray matter. To explore the potentials of ADC maps analysis in degenerative ataxias, we examined 28 patients and 26 age-matched controls with T1, T2, and diffusion (b values 0-1000 along the three main body axes)-weighted MR images. Twenty-four patients had inherited genetically proven diseases including spinocerebellar ataxia type 1 (SCA1) (n = 9), spinocerebellar ataxia type 2 (SCA2) (n = 8), and Friedreich's ataxia (FA) (n = 7), whereas four patients had sporadic adult onset pure cerebellar ataxia (three idiopathic, one gluten intolerance). Area and linear measurements of the CNS structures contained in the posterior cranial fossa (PCF) preliminary enabled classification of the patients in the three morphological categories reflecting the gross pathology findings, namely olivopontocerebellar atrophy (OPCA) (n = 10: six SCA2 and four SCA1), spinal atrophy (SA) (n = 7: all FA), and cortical cerebellar atrophy (CCA) (n = 4: three idiopathic and one gluten intolerance). Seven patients with SCA1 (n = 5) or SCA2 (n = 2) had morphologic changes reminiscent of OPCA, but their values were still in the lower normal range and were classified as undefined. Mean diffusivity (D) maps of the entire brain were generated and D was measured with regions of interest (ROI) in the medulla, pons, middle cerebellar peduncles, and the peridentate white matter. Moreover, after exclusion of the skull with manual segmentation and of the CSF with application of a threshold value, histograms were obtained for D of the brainstem and cerebellum and for D of the cerebral hemispheres. As compared to controls, a (P < 0.001) increase of D was observed in the medulla, middle cerebellar peduncles, and peridentate white matter in OPCA and undefined patients groups who had also significantly increased values of the 25th and 50th percentiles in the brainstem and cerebellum D histogram. In CCA (P = 0.01), an increase of the 25th and 50th percentile of the D value was observed in the brainstem and cerebellum histograms. The SA group showed (P < 0.001) an increased D in the medulla only. A correlation between clinical severity as assessed with the Inherited Ataxias Clinical Rating Scale (IACRS) and the 50th percentile of the D value in the brainstem and cerebellum histogram (r = 0.69) was observed in patients with SCA1 or SCA2. Diffusion MR imaging reveals variable patterns of increase of D in the brainstem, cerebellum, and cerebral hemispheres in degenerative ataxias that match the known distribution of the neuropathological changes. 相似文献