Correlates of social functioning in autism spectrum disorder: The role of social cognition

BackgroundIndividuals with autism spectrum disorder (ASD) experience marked challenges with social function by definition, but few modifiable predictors of social functioning in ASD have been identified in extant research. This study hypothesized that deficits in social cognition and motor function may help to explain poor social functioning in individuals with ASD.MethodCross-sectional data from 108 individuals with ASD and without intellectual disability ages 9 through 27.5 were used to assess the relationship between social cognition and motor function, and social functioning.ResultsResults of hierarchical multiple regression analyses revealed that greater social cognition, but not motor function, was significantly associated with better social functioning when controlling for sex, age, and intelligence quotient. Post-hoc analyses revealed that better performance on second-order false belief tasks was associated with higher levels of socially adaptive behavior and lower levels of social problems.ConclusionsOur findings support the development and testing of interventions that target social cognition in order to improve social functioning in individuals with ASD. Interventions that teach generalizable skills to help people with ASD better understand social situations and develop competency in advanced perspective taking have the potential to create more durable change because their effects can be applied to a wide and varied set of situations and not simply a prescribed set of rehearsed situations.     

小儿肱骨髁上骨折的手法复位的临床研究

目的：研究手法复位结合中医药疗法治疗小儿肱骨髁上骨折的效果。方法：对我院收治的74名患儿实施手法复位辅助夹板固定,观察其骨折愈合及功能恢复情况,并与同期行手术切开的51名患儿进行对比,比较两组患者治疗后恢复优良率和并发症情况。结果：手法复位优良率可到91.9%,与手术组90.2%相当;术后并发症发生率16.5%,与手术组15.7%也相当。结论：手法复位结合中医治疗在术后恢复优良率和并发症发生率上与手术切开效果相当,但手法复位操作简便,几乎无创伤,避免了手术切开造成的迟愈合及感染,可减轻患儿心理和经济负担。     

良性阵发性位置性眩晕52例治疗经验总结

目的回顾性总结我科对BPPV患者的诊疗情况,探讨在基层医院开展BPPV诊疗的可行性。方法回顾2006年7月-2007年12月间在我科确诊的BPPV患者52例,后半规管及上半规管BPPV按照Epley所描述的CRP方法进行复位治疗,水平半规管BPPV患者按照Barbecue翻滚法进行复位治疗,并于治疗结束后3个月内复查和评价疗效。结果52例患者中,46例为后半规管BPPV,5例为水平半规管BPPV,1例为上半规管BPPV,手法复位后,50例痊愈,治愈率为96.2%。结论手法复位治疗BPPV患者是一种非常有效的方法,其方法简单、易行,无需特殊贵重器械,可以在基层医院推广。     

手法为主治疗儿童髋关节急性软组织损伤

儿童髋关节急性软组织损伤多见“髋关节急性滑膜炎”或“髋关节软组织嵌顿症”。其临床特点是,患儿因运动后跌碰损伤或急性扁桃体炎等出现下肢跛行。早期多以膝痛为主诉,伴髋关节疼痛,腹股沟深压痛,髋内旋、外展活动受限,X线片检查发现髋关节间隙增宽,部分患者可见关节囊阴影增大。笔者运用手法加外用活血止痛中药制剂治疗30例(治疗组)与用患肢皮牵引和活血止痛中药内服治疗15例(对照组)。结果:两组愈显率比较,(治疗组96.7%,对照组73.3%),有显著差异P<0.05。经治疗2天内膝痛消失,治疗组29例(96.7%),对照组14例(93.3%),无显著差异,(P<0.05)。治疗1周内髋关节疼痛消失,治疗组28例,(93.3%),对照组7例(46.7%),有显著差异,(P<0.05)。故笔者认为以手法与外用药治疗优于下肢皮牵引和内服中药之法。膝痛是儿童髋关节软组织损伤早期的主诉之一,但临床检查膝部无阳性体征,经早期处理,膝痛症状消失较快,探其机理,认为与闭孔神经其分枝所支配区有关。当髋关节损伤或炎症反应刺激影响到闭孔神经或其分支时,闭孔神经所行经的膝关节因反射或放射等因素影响而出现疼痛。再者,患儿神经系统发育未成熟、对疼痛来源分辩定位能力差,诉说膝痛而不说髋关节疼痛,如忽视对髋关节的必要检查,会因漏诊而延误治疗。儿童髋关节暂时性滑膜炎与髋关节软组织嵌顿,发病机理多与运动损伤或急性炎症有关。临床表现大致相同,但其病理改变有轻重之别,故临床检查须细致加以分辩。手法治疗可根据其病理机制不同而灵活运用,通过手法可达到松解关节滑膜嵌顿与软组织痉挛,改善血液循环,增加组织新陈代谢而收到活血、消肿止痛的功效。手法治疗比传统患肢皮牵引疗法更直接、快速产生治疗效果,且方法简便,时间短、手法轻柔使患儿感觉舒适而易于接受。     

管石复位法治疗良性阵发性位置性眩晕的影响因素分析

目的观察管石复位法治疗良性阵发性位置性眩晕的长期效果，探讨影响治疗预后的相关因素。方法回顾性分析59例后半规管良性阵发性位置性眩晕患者治疗和随访结果．并对管石复位法治疗成功的良性阵发性位置性眩晕患者进行多因素COX回归分析。结果59例患者中有54例（91．5％）治愈。治愈的54例患者在随访中有21例（38．9％）复发，其中有10例患者伴有半规管轻瘫。对患者的性别、年龄、发病时间、病因、半规管功能等指标进行多因素分析，只有半规管轻瘫一项指标进入COX模型，说明半规管轻瘫是影响治疗预后的因素。结论半规管轻瘫是影响BPPV患者管石复位法治疗预后的影响因素。     

Benign paroxysmal positional vertigo as the cause of dizziness in patients after severe traumatic brain injury: diagnosis and treatment

Objectives: To identify patients with benign paroxysmal positional vertigo (BPPV) among patients with severe traumatic brain injury (TBI) and to evaluate the effectiveness of the Particle Repositioning Maneouvre (PRM).

Design and methods: Eighteen months prospective study of 150 consecutive patients with severe TBI referred to an in-patients rehabilitation department.

Interventions: A structured interview emphasizing the possible presence of vertigo followed by a detailed neuro-otological examination. Patients diagnosed with BPPV were immediately treated with the PRM.

Main outcomes and results: BPPV diagnosis was based on a positive Dix-Hallpike positional test. PRM efficacy was determined by repeating the positional test 1 or 2 weeks after treatment. Twenty out of 150 (13.3%) patients complained about positional vertigo. The diagnosis of BPPV was confirmed in 10 patients. Signs and symptoms were completely relieved in six patients after a single PRM, while the other four patients needed repeated treatment for complete resolution of BPPV.

Conclusions: About half of the patients with severe TBI who complain about positional vertigo suffer from BPPV. These patients can be efficiently treated by physical maneouvres improving the rehabilitation outcome.     

Variables affecting treatment in benign paroxysmal positional vertigo

OBJECTIVE: To identify variables affecting outcome in patients with benign paroxysmal positional vertigo (BPPV) treated with canalith repositioning maneuvers. STUDY DESIGN: Retrospective review of patients at a tertiary vestibular rehabilitation center. METHODS: Variables identified for statistical analysis included method of diagnosis, age, sex, onset association with trauma, semicircular canal involvement, presence of bilateral disease, treatment visits, and cycles of canalith repositioning maneuvers per treatment visit. Multivariate statistical analysis using Pearson chi2, likelihood ratio, linear-by-linear association, and cross-tabulation tests were performed. RESULTS: Two hundred fifty-nine patients with BPPV who received treatment were identified from 1996 to 1998. Average follow-up time was 16.9 months. 74.8% required one treatment visit, 19.0% required a second treatment visit, and 98.4% were successfully treated after three treatment visits. The remainder required up to seven treatment visits for relief of symptoms. Variables affecting the number of treatment visits included bilateral disease or location of disease other than in the posterior semicircular canal. Patient age, sex, method of diagnosis, and onset association with trauma had no statistically significant impact. CONCLUSION: Patients with benign paroxysmal positional vertigo not located in a single posterior semicircular canal are more likely to require multiple visits for canalith repositioning.     

水平半规管良性阵发性位置性眩晕的眼震特点和治疗

目的:探讨水平半规管良性阵发性位置性眩晕(HSC-BPPV)的眼震特点和治疗方法.方法:对43例HSC-BPPV患者应用红外线视频眼动记录仪分析其变位试验诱发的眼震特点,进行分型、定侧,并采用相应的耳石复位法治疗.结果:43例患者中:①水平向地性眼震患者27例,其中19例接受Barbecue翻滚疗法,或结合强迫侧卧体位疗法,8例不适于翻滚或体位维持困难者接受AspreUa法治疗;②水平背地性眼震16例,其中自行或采用Gufoni疗法后转变为水平向地性眼震12例,方向不能转换4例,采用Barbecue翻滚和(或)强迫侧卧体位疗法.1周后随访总有效率为72.1%,3个月后总有效率为81.4%.结论:HSC-BPPV的诊断和治疗应根据不同变位试验诱发的眼震特征判别耳石位于半规管的不同部位及不同发病机制类型,并选择合适的耳石复位技术治疗.     

局部阻滞与手法复位治疗麻醉后颞下颌关节脱位3例报告

颢下颌关节脱位是全麻气管插管的并发症之一，本文报告3例行局部阻滞后采用口内法1例，外口法2例3次手法复位成功。处理的关键在于早期发现，术后麻醉科医师一定要随访患者，及早治疗。