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Motor Learning Theory Based Treatment for an Adolescent with CAS: A Single Subject Design
No full textDespite a considerable amount of research on intervention approaches for CAS (childhood apraxia of speech), little work has been done on the effectiveness of motor learning theory based treatment for adolescents with CAS. This study investigates the effect of a motor learning theory based treatment approach on an adolescent with CAS whose severity ranged from mild to moderate. A multiple baseline design across behaviors (target words and sentences) was used in this study. Three sets (20 words for Group 1 and 10 sentences each for Groups 2 and 3) of target stimuli were created (based on high functionality) by the participant and his primary caregiver. The subject was instructed to produce the target word or sentences five times with a 4-second pause between each attempt. Knowledge of results (KR) feedback was given after 5 attempts regarding his performance. The subject repeated each target stimulus 25 times and received 20 % feedback between each trial 5 times. The results showed that the mean scores of speech intelligibility increased during the sessions for target words and sentences and this effect was substantially transferred to untrained target words and sentences
Foreign Bodies Ingestion in Children
No full textBackground: Foreign body (FB) ingestion is a worldwide problem, commonly occurs in children younger than 6 years, and the incidence of FBI has increased in recent years.Aim: To review our experience of FB ingestions management in children over a 7 year period and compared our findings with previous reports. Patients and Methods: The medical records of 250 patients who were hospitalized for FB ingestion between 2007 and May 2014 were evaluated retrospectively. The age and sex, clinical findings, diagnostic methods, modalities of treatment as well as outcome of all patients were noted.Statistical Analysis: Descriptive.Results: There were 250 patients enrolled into the study. The main presenting symptoms were abdominal pain (38%), vomiting (6.4%), dysphagia (3.2%), chest pain (3.2%), cough (2.4%), and melena (1.2%). No symptom was encountered in the remaining (45.6%) patients. Radiological examinations showed that FB was located in the esophagus in 44.8%, in the stomach of 35.2%, in the duodenum of 1.2%, and in the intestine or colon segments in 18.8% (n = 47) patients.Conclusions: We concluded that the public health education could reduce exposure to injuries from FB ingestion and we found the endoscopic extraction of FB is safe and effective
Inhibition of Vascular Endothelial Growth Factor Synthesis in Human Retinal Pigment Epithelial Cells by Pazopanib
No full textAge-related macular degeneration (AMD) is a leading cause of central vision blindness in most developed countries. Several new drugs are now available to attempt to prevent progression or treat AMD, however, they have limited effectiveness and therefore are of limited use. Human retinal pigment epithelial (hRPE) cells have been implicated in pathogenesis of AMD via the synthesis of vascular endothelial growth factor (VEGF), which can result in pathological proliferation of vascular endothelial cells and hRPE cells via tyrosine-kinase signaling pathways. Therefore, tyrosine-kinase inhibitors should be considered as potential pharmaco-therapeutic agents in the prevention and treatment of AMD. Since pazopanib (PZB) is a tyrosine-kinase inhibitor of VEGF-R1/VEGF-R2, we investigated its effect on hRPE cell proliferation and VEGF synthesis. We showed that PZB inhibited hRPE cell proliferation and VEGF synthesis in hRPE cells, and therefore it may be of therapeutic value in AMD
Safety of Blumgart´s Anastomosis During Traverso Operation is Independent of Diagnosis and Risk Factors for Pancreaticojejunal Anastomotic Failure
No full textBackground: The partial pancreaticoduodenectomy, either known as pylorus-preserving Traverso-Longmire procedure, is a sophisticated operation which is associated with a high morbidity. Morbidity is primarily caused by leakage of the pancreatic anastomosis with its consecutive complications like fistula. We investigated the safety of the Blumgart´s anastomosis during Traverso operation and analysed well-established risk factors regarding an association to pancreatic anastomotic failure.Methods: In this retrospective study we included 133 consecutive patients, who underwent a Traverso-Longmire operation from 2007-2014. Analysis contained risk factors (gender, age, ASA, BMI, final diagnosis, prolonged jaundice, presurgical pancreatic duct stenting, operating room time, postoperative morbidity, length of postoperative hospital stay) hospital mortality, surgical and perioperative management. Chi-Square Test was used to analyze a statistical significance.Results: The overall pancreatic anastomotic failure rate was n=21/133 (15,8%). Most events were pancreatic leakage grade A (n=14/133; 10,5%). Grade B occurred in 5 cases (n=5/133; 3,8%), grade C occurred in 2 cases (n=2/133; 1,5%). Mortality was 1,5% (n=2/133). No suggestible or independent risk factors were detected as predictors of postoperative anastomotic failure.Conclusion: The Blumgart anastomosis during Traverso operation is a safe technique and its feasibility is independent of diagnosis and risk factors for pancreaticojejunal anastomotic failure
Lessons Learned: A Qualitative Study of Integrated Care for HIVInfected Injecting Drug Users in Lviv, Ukraine
No full textOf an estimated 170,000 individuals in Ukraine living with HIV, approximately 60% are injecting drug users (IDUs). Despite demonstrated need for increased access to both antiretroviral therapy (ART) and opioid substitution therapy (OST) in Ukraine, integrated, comprehensive care for HIV-infected IDUs remains limited. For this study, semi-structured interviews with 15 healthcare staff were conducted at the Lviv Regional AIDS Center. These interviews explored the perspectives of the AIDS Center’s integrated ART and OST program staff on patient care-seeking behavior as well as potential barriers to treatment for HIV-infected IDUs. Findings from this single-site, qualitative study highlight themes such as adherence, the value of support services, and the continued discrimination of IDUs by local community members. This study offers useful insights from healthcare providers on the efficacy of co-located care for HIV-infected IDUs in Lviv, as well as valuable suggestions for improving services for this patient population
Involving Men in Family Planning: The Male Motivation Campaign in the Rural Areas of Abia State of Nigeria
No full textIntroduction: Study intends to increase male involvement in contraceptive use (particularly condoms) by training men as change agents. This study is important because men using condom as family planning method is still an alien concept and chances of its easy acceptability in the face of dislike are doubtful. Study highlights strategies necessary to increase condom use among men in rural areas.Materials and Method: Study was done in three randomly selected rural areas of Abia State. Sample of 138 men between (25-59 years) was randomly selected for study.A 5-day training centered on role models, self-reliance, and teamwork approaches was conducted. Pre-contraceptive and post-contraceptive interviews were also conducted. Data were analysed qualitatively and quantitatively.Finding: Pre-contraceptive campaign showed that 12 (8.7%) men supported condom use while in post- contraceptive campaign 34(24.6%) men supported condom use. In pre-contraceptive campaign only 8(5.8%) men jointly made decisions on reproductive and family planning issues with their wives, while for post- contraceptive campaign, 35(25.4%) jointly did.Reasons men who refused condom use had include: “inconvenience to use, lack of sexual enjoyment, and others.Though drama was scripted for male audience, finding showed that it attracted unexpected large number of women listenership, 65 of them attended corresponding to 47% of the sample studied. The most innovative and attractive activity to men during the campaign was football tournament with pictures of some local football heroes who promoted condom use
Effects of Client Perceptions of Therapeutic Alliance, Empowerment, Attitudes Toward Medication and Insight on Functioning
No full textBackground: Limited research is available on how Assertive Community Treatment (ACT) clients’ cognitions, attitudes and behaviours experienced over time during the therapeutic process and recovery, affect functioning.Aims: This prospective study investigated whether changes in 1) clients’ ratings of therapeutic alliance, sense of empowerment over their illness, attitudes toward medication and insight, 2) clinicians’ assessment of medication adherence and 3) delivered services predicted functioning of ACT clients in southern Ontario, Canada.Method: Hierarchical Linear Modelling was used to assess time-varying and invariant predictors of overall functioning, over a two-year follow-up period.Results: The study found that during each 6 month follow-up time period about 90% of clients achieved successful community tenure and overall functioning increased between baseline and year 1 and decreased between baseline and year 2. Clients’ ratings of therapeutic alliance on functioning were moderated by previous lifetime days in hospital, while change in ratings of empowerment was moderated by age and previous lifetime days in hospital. Improved insight and medication adherence predicted functioning. Number of client contacts by ACT staff was not associated with functioning.Conclusions: These findings suggest that changes in client’s cognitions, attitudes and behaviours experienced during the therapeutic process and recovery can predict client functioning
Facebook Support Groups in Systemic Lupus Erythematosus: A Content Analysis
No full textBackground: There are many disease-specific groups on Facebook, which offer a convenient way to exchange information and support. This may be particularly helpful for patients affected with uncommon diseases, such as systemic lupus erythematosus (SLE). The content of SLE-related Facebook support groups, however, has yet to be explored and evaluated.Objective: The objective of this study was to analyze the content of Facebook support groups related to SLE, specifically evaluating the nature of the information shared and the pattern of use.Methods: Two independent investigators searched for the term “lupus†on Facebook’s native search function, from 10/08/2011 to 01/04/2012. Groups related to SLE, operating in English and/or French, and publicly accessible, were included for analysis. Information regarding the purpose of the group, its administrator, as well as the number and type of user-generated contributions were extracted. The content of support groups were then analyzed using a previously developed coding scheme.Results: We found 173 SLE groups on Facebook containing a total of 42,240 members. Roughly half (53%) of the groups were created for support, while 33% were for disease awareness, and 14% for fundraising. The largest group included 30,972 members and was intended for raising awareness. 3,469 members were found in support groups, representing 8% of the overall membership (but 31% of the overall membership when excluding the largest group). The median number of members was 11 (interquartile range, IQR, 39). The most frequent locations of support groups were the United States (44%), Canada (10%), and United Kingdom (10%). In support groups, the total number of user-generated contributions was 1932, including wall posts (54%), comments (32%), discussion posts (10%), and discussion threads (4%), while the median number of user-generated contributions was 5 (IQR 20).Conclusions: Support groups for SLE patients represent a substantial proportion of Facebook groups dedicated to SLE. Given their convenience, accessibility, and potential audience, Facebook support groups might represent an efficient way to reach patients with SLE who are internet users and improve their health-related quality of life. Further research is needed to evaluate the effects of this type of support groups on patients with SLE
Cannabinoid Receptor Type 2 (CB2) Dependent and Independent Effects of WIN55,212-2 on Atherosclerosis in Ldlr-null Mice
No full textPurpose: WIN55,212-2, a potent synthetic agonist of cannabinoid receptor type 1 (CB1) and cannabinoid receptor type 2 (CB2), reduces atherosclerosis in apolipoprotein E (ApoE) null mice. Although pharmacologic evidence suggests the anti-atherosclerotic effects of WIN55,212-2 are mediated via CB2, this remains to be confirmed by genetic studies. Therefore, in this study, we investigated the effects of WIN55,212-2 on development of atherosclerosis in low-density lipoprotein receptor (Ldlr) null mice with and without homozygous deletion of the CB2 gene.Methods: After 6 weeks on an atherogenic diet, groups of CB2+/+ and CB2-/- Ldlr-null mice received a daily intraperitoneal injection of WIN55,212-2 or vehicle. After two weeks, plasma lipid levels and atherosclerosis in the aortic root were quantified.Results: Plasma cholesterol and triglyceride levels did not differ between CB2+/+ and CB2-/- mice and WIN55,212-2 had no effect on total cholesterol levels in either genotype. However, triglyceride levels in both CB2+/+ and CB2-/- mice were significantly lowered by WIN55,212-2. The size of aortic root lesions did not differ significantly between CB2+/+ and CB2-/- mice with or without WIN55,212-2 treatment. However, WIN55,212-2 treatment significantly lowered lesional macrophage accumulation in CB2+/+ mice, and lesional smooth muscle content in both CB2+/+ and CB2-/- mice. Lesional apoptosis was also greater in CB2+/+ mice compared to CB2-/-mice, and only reduced by WIN55,212-2 in CB2+/+ mice. Collagen content and elastin fiber fragmentation were unaffected by genotype or WIN55,212-2.Conclusions: WIN55,212-2 treatment does not alter lesion size in Ldlr null-mice, but does modify lesion cellularity via CB2-dependent and CB2-independent mechanism
Imitation and Naming in Childhood Apraxia of Speech
No full textImitation and object naming are the first steps in language acquisition. While in typical development, imitation is easier than naming, there is a lack of agreement about the role of imitation in language impairment in general, and in Childhood Apraxia of Speech (CAS), in particular. Hence, the aim of this study is to compare imitation and naming in CAS and to analyze the nature of errors according to the complexity of the word and across the three levels of the prosodic hierarchy: the segmental level, the syllabic level and the prosodic word level.Sixteen children diagnosed with CAS (average age 3;11) participated in the study. The data, collected from each child in the course of eight weekly meetings, are drawn from naming and imitating single words. The results indicate that imitation seems to be an easier task than naming; both tasks are more difficult as the words get longer. Fewer errors are seen on the prosodic level, while most of the errors occur on the segmental and syllabic levels