选择性激光小梁成形术治疗原发性开角型青光眼

目的评价选择性小梁激光成形术（SLT）治疗各类原发性开角性青光眼（POAG）的疗效观察。方法79例（93眼）根据种族的不同（小梁Seheie色素分级）、年龄及眼压情况分为3组,采用国通公司倍频Q-开关。532nmND：YAG激光器,单脉冲,时间为3ns,波长532nm,光斑直径400μm,脉冲能量设置0．4～1．6mJ。术前在盐酸奥布卡因表麻下放置前房角镜,瞄准功能小梁网,选择相应的脉冲能量、象限范围和激光点数进行治疗或重复治疗。术后随访眼压（1h、1d、1周、1个月、3个月、6个月、1年）、眼底及视野。结果3个组79例（93眼）术前1年平均眼压依次为（23．1±6．3）mmHg、（26．52±6．1）mmHg和（29．52±6．1）mmHg;术后1年眼压依次为（12．52±4．3）mmHg、（15．58±4．7）mmHg和（16．65±4．5）mmHg。术前与术后眼压相比有显著下降（P〈0．01）。3个组眼底C／D比,术前为0．50～0．70±0．15～0．13;术后为0．57～0．68±0．16～0．42。视力：术前0．85～0．57±0．32～0．29;术后0．91～0．58±0．30～0．27,两者比较其差异均无统计学意义。结论SLT对各类POAG均有显著降压作用。     

Child and adolescent obesity

Childhood obesity has reached epidemic proportions worldwide. With adult obesity-related co-morbidities now appearing in obese children, there has been a big push to educate the population and establish effective weight-losing initiatives. However, the limited success of non-operative methods has led to the introduction of bariatric surgery in the under 18-year olds. Laparoscopic Roux-en-Y gastric bypass is the most commonly performed operation, followed by the adjustable gastric band and sleeve gastrectomy. This review seeks to present the current position of bariatric surgery in the treatment of obese adolescents, and reviews the available evidence on selection and outcome, as well as the inherent uncertainties, particularly within the UK.     

Patients with aphasia and an infarct in Wernicke’s area benefit from early intensive speech and language therapy

Background: Considerable spontaneous recovery is observed in aphasia, but impaired communication ability remains a great problem. Almost half of the patients still have aphasia one year after stroke onset, but usually in a milder form.

Aim: The aim of this study was to assess the effect of very early intensive speech and language therapy (SLT) and correlate it with the location of the cerebral infarction in acute ischemic stroke patients with aphasia.

Methods & Procedures: In this randomised study, 118 patients with acute cerebral infarction and aphasia were included and assigned either for three weeks of intensive SLT or part of the control group. The patients were evaluated by a speech therapist regarding aphasia with two language tests, Norsk Grunntest for Afasi and Amsterdam–Nijmegen Everyday Language Test in the acute phase, after three weeks and after six months. All patients were radiologically examined in the acute phase and after three weeks.

Outcomes & Results: A total of 14 of 18 (78%) speech and language trained patients with infarction involving Wernicke’s and central areas, but with intact Broca’s area showed significant improvements of aphasia compared to 4 of 16 (25%) in the control group (p < 0.01). Patients with no visible radiological infarct had less severe initial language impairment and all of them in the training group showed significant improvements of aphasia.

Conclusions: Patients with radiologically proven cerebral infarct involving Wernicke’s area with or without infarctions centrally can benefit from early intensive SLT.