Home About us Contact
|
Home About us Contact | ||
|
|
||
Clinical Subgroups (clinical + subgroup)
Selected AbstractsAssessment of cerebral visual impairment with the L94 visual perceptual battery: clinical value and correlation with MRI findingsDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 3 2009E ORTIBUS MD In this article we describe visual perceptual abilities of a clinical population, referred for visual problems to our multidisciplinary team and assessed with the five computer tasks from the L94 visual perceptual battery. Clinical and neuroimaging findings were correlated with the findings on this task battery. Seventy children (35 males, 35 females) constituted our cohort. Age ranged from 4 to 20 years (mean 7y [SD 3y]). Forty children were born before 37 weeks gestational age. Thirty-six children had cerebral palsy (CP), of whom 24 had spastic diplegia, five had spastic hemiplegia, and four had spastic quadriplegia. Three children had ataxic CP. Perceptual visual impairment (PVI) was established in comparison to the performance age obtained on non-verbal intelligence subtests, instead of chronological age. Our results suggest that children with a history of preterm birth and a clinical CP picture are most at risk for a specific PVI. Correlations among other clinical variables did not define a clinical subgroup more at risk. Children with periventricular leucomalacia were almost equally represented in both PVI and non-PVI groups. Normal magnetic resonance imaging did not exclude the presence of PVI. In these children, however, we found another impairment profile, more in favour of dorsal stream impairment. [source] Predicting developmental deficiencies at the age of four based on data from the first seven months of life,INFANT MENTAL HEALTH JOURNAL, Issue 6 2008Anne Margrethe Rostad The study examines very young children with the aim of identifying precursors of developmental problems during the first 7 months of age. Information from screening and observations in the birth clinic, in the first level of health care, and from parents was collected on five different occasions. The information that was included concerning the child and family was defined as either optimal or nonoptimal. At the age of 4 years, a clinical group was identified (11.1% of the total population). Logistic regression analyses were performed to detect risk factors. Twenty-one precursors were used to create a screening questionnaire that provided useful information (sensitivity = 56.1%, specificity = 98.8%) for predicting developmental problems of the children. The contribution of sociodemographic data was significant; medical information was less significant. The highest prediction rate surprisingly was found in the moderate clinical subgroup (62.1%), compared to the group with more severe problems that had a slightly lower rate (46.7%). The conclusion of the study is that it is possible to detect infants in need of early intervention using a continuous process of observation and screening. [source] Role of neurophysiology in the clinical practice of primary pediatric headachesDRUG DEVELOPMENT RESEARCH, Issue 7 2007V. Raieli Abstract The role of electrophysiological studies in pediatric headaches is controversial. In childhood headaches, neurophysiological examinations are of interest for potential clinical use because they are noninvasive and are scarcely influenced by environmental factors or drug use. Electrophysiological studies in childhood headache principally explored the role of electroencephalographic (EEG) evaluations in migraine, while less evidence has been reported about other neurophysiological techniques, such as evoked potentials, event-related potentials, and, less often, transcranial magnetic stimulation. In this brief review, we point out our attention to the aid of neurophysiological methods in the clinical diagnosis of pediatric headaches. Although many examinations are actually of little value in the clinical setting, they may have a potential role in some clinical subgroups or in monitoring and evaluating the effects of pharmacological treatment. Drug Dev Res 68:389,396, 2007. © 2008 Wiley-Liss, Inc. [source] Twenty-five strategies for improving the design, implementation and analysis of health services research related to alcohol and other drug abuse treatmentADDICTION, Issue 11s3 2000Michael L. Dennis While some aspects of addiction can be studied in laboratory or controlled settings, the study of long-term recovery management and the health services that support it requires going out into the community and dealing with populations and systems that are much more diverse and less under our control. This in turn raises many methodological challenges for the health service researchers studying alcohol and other drug abuse treatment. This paper identifies some of these challenges related to the design, measurement, implementation and effectiveness of health services research. It then recommends 25 strategies (and key primers) for addressing them: (1) identifying in advance all stakeholders and issues; (2) developing conceptual models of intervention and context; (3) identifying the population to whom the conclusions will be generalized; (4) matching the research design to the question; (5) conducting randomized experiments only when appropriate and necessary; (6) balancing methodological and treatment concerns; (7) prioritizing analysis plans and increasing design sensitivity, (8) combining qualitative and quantitative methods; (9) identifying the four basic types of measures needed; (10) identifying and using standardized measures; (11) carefully balancing measurement selection and modification; (12) developing and evaluating modified and new measures when necessary; (13) identifying and tracking major clinical subgroups; (14) measuring and analyzing the actual pattern of services received; (15) incorporating implementation checks into the design; (16) inc rporating baseline measures into the intervention; (17) monitoring implementation and dosage as a form of quality assurance; (18) developing procedures early to facilitate tracking and follow-up of study participants; (19) using more appropriate representations of the actual experiment; (20) using appropriate and sensitive standard deviation terms; (21) partialing out variance due to design or known sources prior to estimating experimental effect sizes; (22) using dimensional, interval and ratio measures to increase sensitivity to change; (23) using path or structural equation models; (24) integrating qualitative and quantitative analysis into reporting; and (25) using quasi-experiments, economic or organizational studies to answer other likely policy questions. Most of these strategies have been tried and tested in this and other areas, but are not widely used. Improving the state of the art of health services research and bridging the gap between research and practice do not depend upon using the most advanced methods, but rather upon using the most appropriate methods. [source] A population- and family-based study of Canadian families reveals association of HLA DRB1*0103 with colonic involvement in inflammatory bowel diseaseINFLAMMATORY BOWEL DISEASES, Issue 1 2003Dr. Mark S. Silverberg Abstract The aim of this study was to identify major histocompatibility complex alleles associated with the development and clinical features of inflammatory bowel disease (IBD). Genotyping at the human leukocyte antigen (HLA) DRB1 and DQB1 loci was performed on individuals from 118 Caucasian IBD sibling pair families and on 216 healthy controls. Both population- and family-based association tests were used to analyze data obtained on the entire study population and on clinical subgroups stratified by diagnosis, ethnicity, and disease distribution. HLA DRB1*0103 was significantly associated with IBD (OR = 6.0, p = 0.0001) in a case,control analysis of non-Jewish IBD-affected individuals. This association was apparent among both Crohn's disease (OR = 5.23, p = 0.0007) and ulcerative colitis (OR = 7.9, p = 0.0001) patients and was confirmed in the non-Jewish IBD population by results of family-based association analysis using the transmission disequilibrium test. HLA DQB1*0501 was also associated with IBD (OR = 1.64, p = 0.02) in the non-Jewish population, but statistically significant association of this allele with disease was not detected for Crohn's disease and ulcerative colitis separately. No significant associations were identified among the Jewish patients. In the non-Jewish IBD families, IBD was as strongly associated with the DRB1*0103 DQB1*0501 haplotype as with the DRB1*0103 allele alone. The carrier frequency of the DRB1*0103 allele was found to be 10-fold higher in Crohn's disease patients with pure colonic involvement than in healthy controls (38.5% vs. 3.2%; p = 0.0002). These data demonstrate the association of the HLA DRB1*0103 allele with both Crohn's disease and ulcerative colitis and with large intestine,restricted disease in non-Jewish IBD patients and therefore identify HLA DRB1*0103 as a potentially important contributor to disease susceptibility and to expression of colonic involvement in IBD. [source] The Relationship Between Serotonin Receptor 1B Polymorphisms A-161T and Alcohol DependenceALCOHOLISM, Issue 9 2009Sheng-Yu Lee Background:, Several studies have suggested that the serotonin receptor 1B gene (5HT1B) may be important in the pathogenesis of alcohol dependence (alcoholism; ALC; AD). We examined whether 5HT1B gene A-161T polymorphisms (rs130058) are a susceptibility factor for total AD and subgroups of AD. We further explored correlation of this 5HT1B gene variant between anxiety,depression alcoholism (ANX/DEP ALC) and antisocial alcoholism (antisocial ALC) subgroups because of the high comorbidity of anxiety,depression, antisocial personality disorder, and AD. Methods:, We recruited 522 Han Chinese in Taiwan for this study: 322 AD patients and 200 controls. The patient group was recruited primarily from medical teaching hospitals; patients with antisocial alcoholism were recruited from Taiwanese prisons. Individuals with AD were classified into 3 homogeneous clinical subgroups,pure alcoholism (pure ALC), ANX/DEP ALC, and antisocial ALC,using DSM-IV diagnosis. The 5HT1B gene A-161T polymorphism was determined using PCR,RFLP. Results:, No significant differences in genotypic and allelic frequencies were found between controls and the total AD group or between controls and the 3 AD subgroups. However, there were significant differences in the 5HT1B gene A-161T polymorphism at both the genotype and allelic levels between the ANX/DEP ALC and antisocial ALC subgroups. Conclusions:, This study suggests that the 5HT1B gene A-161T polymorphism alone is not a risk factor for increasing susceptibility to either AD or its subtypes. However, 5HT1B gene A-161T polymorphisms might be one of the common genetic factors between the ANX/DEP ALC and antisocial ALC subgroups. [source] Language Processing in Frontotemporal Dementia: A Brief ReviewLINGUISTICS & LANGUAGE COMPASS (ELECTRONIC), Issue 1 2008Jonathan E. Peelle Frontotemporal dementia (FTD) is a neurodegenerative condition that presents with a number of distinct behavioral phenotypes. Here we review language-processing deficits in three subgroups of FTD patients: progressive nonfluent aphasia (PNFA), semantic dementia (SD), and nonaphasic FTD patients with a disorder of social and executive functioning (SOC/EXEC). These three clinical subgroups have contrasting patterns of regional cortical atrophy that can be linked to their language impairments. PNFA patients' disease includes left ventral inferior frontal cortex, resulting in impaired grammatical processing. SD patients demonstrate a profound impairment for semantic knowledge related to atrophy of the left temporal lobe. SOC/EXEC patients' frontal atrophy tends to be more right lateralized and is associated with declines in executive functioning. SOC/EXEC patients' limited executive resources impact language processing in a variety of ways, including slowed grammatical processing and impaired narrative discourse. FTD patients therefore provide converging evidence regarding dissociable components of language processing and their neuroanatomical bases. [source] | |||||||||||||