Quality of Pulmonary Function Tests in Participants with Down Syndrome

IntroductionPeople with Down syndrome (DS) have high respiratory morbidity, evaluating their respiratory health with standardized, objective tests is desirable. Thus, the objective of this study was to evaluate the technical quality of Pulmonary Function Tests (PFTs) to determine which ones are most suitable for this population.MethodsParticipants included children, teenagers and adults with DS, 5 years of age or older (n = 302). The technical quality of the impulse oscillometry system (IOS), forced spirometry, lung-diffusing capacity for carbon monoxide (DL_CO), and 6-min walk test (6MWT) were analyzed by age group. Capnography and pulse oximetry were included in the study. Technical quality was determined on the basis of current international PFTs standards.ResultsFifty-one percent of participants were males. A total of 184 participants (71%) who completed the IOS fulfilled the quality criteria, while 210 (70%) completed the 6MWT. Performance on forced spirometry and DL_CO was poor. All pulse oximetries and 96% percent heart rates obtained had good quality, but exhaled carbon dioxide (PetCO₂) and respiratory rate (RR) showed deficient repeatability.ConclusionsIOS appears to be the most reliable instrument for evaluating lung mechanics in individuals with DS.     

Assessment of sexual abuse and trauma: Clinical measures

Examined are several measures currently used in the assessment of child abuse, sexual abuse, and trauma. These measures include structured clinical interviews, self report measures, screening inventory, symptom checklist, and some measures that include decision making properties. Issues and implications for clinical practice are explored.     

Detection of low birth-weight new born babies by anthropometric measurements in Bangladesh

Birthweight is an important indicator of child survival. Appropriate and timely care of a newborn specially if he is born with low birthweight is important but this is difficult in developing countries since most of the deliveries are conducted at home where adequate facilities to weigh a new born does not exist. This study was conducted to find out a surrogate which could efficiently be used for detecting low birthweight babies at birth when no weighing machine is around. In this study 41% of the newborn babies were found to weigh less than 2,500 gm at birth. Out of this about 52% were females. The mean chest, thigh and mid-arm circumference at birth for males were 30.89 cm, 15.06 cm and 9.27 cm respectively with standard deviations of 1.83 cm, 1.30 cm and 1.04 cm. Corresponding figures for female babies were 30.69 cm, 15.14 cm and 9.25 cm respectively with standard deviations of 2.08 cm, 1.70 cm and 1.16 cm. Correlation co-efficient between normal birthweight and the chest, thigh and mid-arm circumference were 0.867, 0.845 and 0.842 respectively. A liner regression analysis showed that a chest circumference of 30.14 cm, a thigh circumference of 14.56 cm and a mid-arm circumference of 8.90 cm corresponded well with a birthweight of 2,500 gm. On this basis sensitivity, specificity and predictive values of the chest circumference was better than the other two measurements. However, the mid-arm circumference was observed to be more reliable than the other two measurements for detecting birthweight less than 2,000 gm. A home made measuring tape has been devised on this basis to detect brithweights with cut-off values for 2,500 gm, 2,000 gm to 2,500 gm and 2,000 gm in different shades of colour for illiterate birth attendants.     

83例住院患者念珠菌感染的菌株鉴定及药敏分析

目的 :探讨住院患者念珠菌感染的种类及耐药现状。方法 :用法国生物 -梅里埃公司酵母菌鉴定系统和药敏试纸条进行菌株鉴定和药敏试验。结果 :白色念珠菌检出率最高 (5 0 .6 0 % ) ,热带念珠菌次之 (2 6 .5 1% ) ,高里氏念珠菌、近平滑念珠菌、分别为 9.6 4%和 7.2 3% ,其它念珠菌均在 5 .0 %以下。 6种抗真菌药中 ,5 -氟胞嘧啶、两性霉素B、制霉菌素的耐药率最低 (1.2 0 % ) ,唑类抗真菌的耐药率最高 (8.43～ 18.0 7% )。结论 :结果提示临床医师治疗真菌感染时应先进行培养和药敏试验 ,以便合理治疗 ,预防医院内感染。     

Validierung eines klinischen Routine-Systems zur computerisierten Erstellung von MMPI-Befunden bei psychiatrischen Patienten

Zusammenfassung Das MMPI-Interpretationssystem von Lachar (1974), das gegenüber den bisher verfügbaren Systemen eine Reihe von Vorteilen aufweist, wurde in einer deutschen Version an 1190 stationären psychiatrischen Patienten auf seine Gültigkeit hin untersucht. Von den 153 Texten der Interpretationsbibliothek wurden diejenigen 114 Texte, die voneinander unabhängige Merkmale eines MMPI-Profils interpretieren, bei jedem Vorkommen im Einzelfall von dem behandelnden Psychiater hinsichtlich der interpretativen Treffsicherheit beurteilt. Im Durchschnitt wurden von jeweils 100 Texten 83 als zutreffend bezeichnet. Bei der Analyse der einzelnen Programmteile zeigte sich, daß die Treffsicherheit bei psychopathologisch auffälligen MMPI-Profilen wesentlich höher war als bei Profilen im Normbereich. Die in dieser Untersuchung gefundenen Trefferraten korrelierten hoch mit denen der amerikanischen Originaluntersuchung, was die spezifische und replizierbare Gültigkeit der einzelnen Texte bestätigt. Das vorliegende Interpretationssystem bietet damit auf der Grundlage des MMPI eine Persönlichkeitsbeschreibung, für die in verschiedenen psychiatrischen Einsatzbereichen und verschiedenen Sprachen eine gute interpretative Treffsicherheit im Einzelfall nachgewiesen ist.Eine frühere Fassung dieser Arbeit wurde auf dem 31. Kongreß der Deutschen Gesellschaft für Psychologie in Mannheim vorgetragen. Ich danke Frau Dipl. Psych. Kornelia Zangl und Frau Dr. Pola Engel-Sittenfeld für ihre Hilfe bei der Übersetzung der Interpretationstexte. Langjährige wertvolle Mitarbeit haben Frau Irmtraud Reinhold bei der Testdurchführung, Frau Gabi Kunze bei der Programmierung des Interpretationssystems und bei der Verarbeitung der Daten geleistet     

广东省增城市一起登革热爆发的调查

2002年8～9月增城市石滩镇和沙庄街相继爆发登革热。流行时间从8月9日至10月18日,发病136例,男性53例,女性83例,男女发病差异具有极显著意义(X~3=13.24,P<0.01);发病年龄最小2岁,最大77岁,以青壮年发病居多;农民发病最多,民工其次,学生再次。症状主要有畏寒、头痛、疲乏、全身肌肉酸痛、食欲不振、恶心呕吐和腹部不适。体征主要有发热、皮疹(多数在热退时出现,为充血性“斑丘疹”,出疹部位多在四肢和躯干,呈对称性分布),少数患者有出血倾向如鼻衄、便血、齿龈血等。患者末梢血白细胞和血小板计数普遍下降。采集急性期患者血清进行登革病毒IgM抗体检测,阳性率为71.83％,经PCR分型鉴定为登革Ⅰ型病毒。     

Effects of auditory training in individuals with high-frequency hearing loss

OBJECTIVE:To determine the effects of a formal auditory training program on the behavioral, electrophysiological and subjective aspects of auditory function in individuals with bilateral high-frequency hearing loss.METHOD:A prospective study of seven individuals aged 46 to 57 years with symmetric, moderate high-frequency hearing loss ranging from 3 to 8 kHz was conducted. Evaluations of auditory processing (sound location, verbal and non-verbal sequential memory tests, the speech-in-noise test, the staggered spondaic word test, synthetic sentence identification with competitive ipsilateral and contralateral competitive messages, random gap detection and the standard duration test), auditory brainstem response and long-latency potentials and the administration of the Abbreviated Profile of Hearing Aid Benefit questionnaire were performed in a sound booth before and immediately after formal auditory training.RESULTS:All of the participants demonstrated abnormal pre-training long-latency characteristics (abnormal latency or absence of the P3 component) and these abnormal characteristics were maintained in six of the seven individuals at the post-training evaluation. No significant differences were found between ears in the quantitative analysis of auditory brainstem responses or long-latency potentials. However, the subjects demonstrated improvements on all behavioral tests. For the questionnaire, the difference on the background noise subscale achieved statistical significance.CONCLUSION:Auditory training in adults with high-frequency hearing loss led to improvements in figure-background hearing skills for verbal sounds, temporal ordination and resolution, and communication in noisy environments. Electrophysiological changes were also observed because, after the training, some long latency components that were absent pre-training were observed during the re-evaluation.     

On the diagnosis of learning disabilities in the Austrian school system: Official directions and the diagnostic process in practice in Styria/Austria

There is no international consensus concerning the diagnostic criteria used to diagnose a learning disability (LD). In fact, various diagnostic criteria are used and interpreted differently in different countries. A common denominator can only be found in the fact that intelligence quotient (IQ) is often seen as important in order to identify LD, either in the framework of discrepancy models between cognitive ability and achievement or in the context of models relating LD to below-average IQ (Grünke, 2004). The present paper examines the criteria that are used for the diagnosis of LD in Styria, a federal state of Austria. For this purpose, 25 special educational needs (SEN) reports of children identified as having learning disabilities were examined. In addition, three expert interviews with school administration authorities were conducted. The results provide a first indication that IQ scores are not important for the diagnosis of LD in Styria. In fact, the diagnostic procedure seems to be quite unregulated and standardized tests are hardly ever used in this context. Moreover, the results show that a diagnosis of LD in Styria is usually based on poor reading skills, poor basic arithmetic skills, deficits in German language, and/or behavioral problems.