Speech and language screening for audiologists

Speech and language screening by audiologists is not new, although few audiologists screen speech and language, which should be an integral component of the audiological evaluation. This article considers ASHA's views about speech and language screening by audiologists, screening tests available to audiologists, and the training of audiologists to screen speech and language.     

Developing, enabling and facilitating practice-based research in primary dental care. Report of a one-day seminar, held at the Royal College of Surgeons of England on Friday, 1st February 2008

As part of the Faculty of General Dental Practice (UK)'s strategy to develop a research base for primary dental care, a one-day seminar was held at The Royal College of Surgeons of England on Friday, 1st February 2008. The aims for the day were to bring together the Divisional Research Contacts (DRCs), Faculty members with an interest in research, and regional and national leaders in primary care research; to update DRCs and Faculty members on developments and opportunities in primary care research; and to raise awareness of the Faculty's work among the leaders of primary care research. Of the 33 who attended the seminar, 12 were DRCs.     

Randomised primary health center based interventions to improve the diagnosis and treatment of undifferentiated fever and dengue in Vietnam

Background  

Fever is a common reason for attending primary health facilities in Vietnam. Response of health care providers to patients with fever commonly consists of making a presumptive diagnosis and proposing corresponding treatment. In Vietnam, where malaria was brought under control, viral infections, notably dengue, are the main causes of undifferentiated fever but they are often misdiagnosed and inappropriately treated with antibiotics.     

Phase I trial with biomarker studies of vatalanib (PTK787) in patients with newly diagnosed glioblastoma treated with enzyme inducing anti-epileptic drugs and standard radiation and temozolomide

Targeting angiogenesis in glioblastoma (GBM) may improve patient outcome by normalizing tumor vasculature and improving delivery of chemotherapeutics and oxygen. Consequently, concomitant administration of small molecule inhibitors of the VEGF pathway will likely have a positive impact on chemoradiation treatment outcome. We conducted a Phase I study of vatalanib, a small molecule inhibitor of VEGFR, PDGFR, and c-kit in patients with newly diagnosed GBM receiving radiation, temozolomide, and an enzyme-inducing anti-epileptic drug in order to determine the MTD of vatalanib in this patient population. We incorporated circulating biomarker and SNP analyses and pharmacokinetic studies. Nineteen patients were enrolled and the MTD was not reached at the time of study termination. Vatalanib was well tolerated with only 2 DLTs (thrombocytopenia and elevated transaminases). Other grade 3/4 toxicities included leukopenia, lymphopenia, neutropenia, and hand-foot syndrome. There were no wound-healing complications. Of the 13 patients evaluable for a radiographic response, 2 had a partial response and 9 had stable disease. Vatalanib significantly increased PlGF and sVEGFR1 in plasma circulation and decreased sVEGFR2 and sTie2. Plasma collagen IV increased significantly by day 50 of treatment. Vatalanib was well tolerated and this study demonstrates the safety of oral small molecule inhibitors in newly diagnosed GBM patients. Blood biomarkers may be useful as pharmacodynamic markers of response to anti-angiogenic therapies.     

The muscle twitch monitor: a rapid unequivocal method of monitoring free muscle transfers

A free latissimus dorsi muscle transfer, which required anastomotic revision on two occasions within twenty-four hours of operation, illustrates how the change in response of electrically induced muscle contraction to ischaemia can be used as a rapid and sensitive method of monitoring free muscle transfers. It is a response that has the great merit of being easily recognised by untrained observers because it relies on an absolute rather than a relative change in the measured modality. Furthermore it is not influenced by the clinical condition of the patient or by changes in the flap's environment. Its potential is discussed.     

Preliminary validation of a clinical scale for measuring the duration of post-traumatic amnesia

An operational definition of post-traumatic amnesia is presented and a standardized procedure for the measurement of post-traumatic amnesia, which has been clinically tested in over 100 patients with severe, closed head injury is described. Twenty patients with severe head injuries who were still experiencing post-traumatic amnesia (as defined in this study), were assessed on an independent test of learning ability, as were 20 other patients with severe head injury who were no longer suffering post-traumatic amnesia. The performance of the two groups differed significantly; those in a state of post-traumatic amnesia performed more poorly. Both these groups showed significant impairment when compared with a control group of 20 patients who were in hospital because of orthopaedic injuries that were suffered during a motor vehicle accident. These preliminary results are sufficiently encouraging to recommend this simple procedure for routine use in hospitals, to enhance the accuracy of measuring the severity of head injury. The medicolegal use of this measure is also discussed.