Tuesday, February 10, 2009
Sunday, February 8, 2009
Computerized cognitive rehabilitative training of a traumatic brain injury patient: a seven year followup case study
Are mild head injuries as mild as we think? Neurobehavioral concomitants of chronic post-concussion syndrome
Mild traumatic brain injury (MTBI) can sometimes lead to persistent postconcussion symptoms. One well accepted hypothesis claims that chronic PCS has a neural origin, and is related to neurobehavioral deficits. But the evidence is not conclusive. In the attempt to characterise chronic MTBI consequences, the present experiment used a group comparison design, which contrasted persons (a) with MTBI and PCS, (b) MTBI without PCS, and (c) matched controls. We predicted that participants who have experienced MTBI but show no signs of PCS would perform similar to controls. At the same time, a subgroup of MTBI participants would show PCS symptoms and only these volunteers would have poorer cognitive performance. Thereby, the performance deficits should be most noticeable in participants with highest PCS severity.
38 patients with a single MTBI that had occurred at least 12 month prior to testing, and 38 matched controls, participated in the experiment. A combination of questionnaires and neuropsychological test batteries were used to assess the extent of PCS and related deficits in neurobehavioral performance.
11 out of 38 MTBI participants (29%) were found to suffer from PCS. This subgroup of MTBI patients performed poorly on neuropsychological test batteries. Thereby, a correlation was found between PCS symptom severity and test performance suggesting that participants with more pronounced PCS symptoms performed worse in cognitive tasks. In contrast, MTBI patients with no PCS showed performed similar to matched control. We further found that loss of consciousness, a key criterion for PCS diagnosis, was not predictive of sustained PCS.
The results support the idea that MTBI can have sustained consequences, and that the subjectively experienced symptoms and difficulties in everyday situations are related to objectively measurable parameters in neurocognitive function.
Can the Bruckner test be used as a rapid screening test to detect significant refractive errors in children?
Aims: To study the prevalence of asthenopia among computer operators and its association with various epidemiological factors.
Settings and Design: Community-based cross-sectional study of 419 subjects who work on computer for varying period of time.
Materials and Methods: Four hundred forty computer operators working in different institutes were selected randomly. Twenty-one did not participate in the study, making the nonresponse rate 4.8%. Rest of the subjects (n = 419) were asked to fill a pre-tested questionnaire, after obtaining their verbal consent. Other relevant information was obtained by personal interview and inspection of workstation.
Statistical Analysis Used: Simple proportions and Chi-square test.
Results: Among the 419 subjects studied, 194 (46.3%) suffered from asthenopia during or after work on computer. Marginally higher proportion of asthenopia was noted in females compared to males. Occurrence of asthenopia was significantly associated with age of starting use of computer, presence of refractive error, viewing distance, level of top of the computer screen with respect to eyes, use of antiglare screen and adjustment of contrast and brightness of monitor screen.
Conclusions: Prevalence of asthenopia was noted to be quite high among computer operators, particularly in those who started its use at an early age. Individual as well as work-related factors were found to be predictive of asthenopia.
Tourette Syndrome (TS) is a neurodevelopmental disorder of childhood. Learning disabilities are frequently comorbid with TS. Using the largest sample of TS patients ever reported, we sought to identify differences between subjects with TS only and subjects with TS and a comorbid learning disability.
We used the Tourette Syndrome International Consortium database (TIC) to compare subjects with comorbid Tourette Syndrome and learning disabilities (TS + LD) to subjects who did not have a comorbid learning disability (TS - LD). The TIC database contained 5,500 subjects. We had usable data on 5,450 subjects.
We found 1,235 subjects with TS + LD. Significant differences between the TS + LD group and the TS - LD group were found for gender (.001), age onset (.030), age first seen (.001), age at diagnosis (.001), prenatal problems (.001), sibling or other family member with tics (.024), two or more affected family members (.009), and severe tics (.046). We used logistic modeling to identify the optimal prediction model of group membership. This resulted in a five variable model with the epidemiologic performance characteristics of accuracy 65.2% (model correctly classified 4,406 of 5,450 subjects), sensitivity 66.1%, and specificity 62.2%.
Subjects with TS have high prevalence rates of comorbid learning disabilities. We identified phenotype differences between the TS - LD group compared to TS + LD group. In the evaluation of subjects with TS, the presence of a learning disability should always be a consideration. ADHD may be an important comorbid condition in the diagnosis of LD or may also be a potential confounder. Further research on etiology, course and response to intervention for subjects with TS only and TS with learning disabilities is needed.
Comparison of cognition abilities between groups of children with specific learning disability having average, bright normal and superior nonverbal in
Willcutt & Pennington, 2000). Results of population based surveys suggest that about
30% of learning disabled children have behavioural and emotional problems (Mc Gee et
al, 1984). Psychopathology worsens with age in children with non-verbal learning
disabilities (Rourke, 1988). Marked anxiety can appear when children with dyscalculia
are confronted with reasonably simple arithmetic problems (Garnett & Fleischner, 1987).
Ekblad (1990) found a positive correlation between psychological disturbance and poor
school achievement among Chinese children. Shenoy & Kapur (1996) noted that 21 out
of 88 children with learning disability had a co-morbid psychological diagnosis. Kishore
et al (2000) reported that 21 out of 56 children with specific developmental disorders of
scholastic skills had a co-morbid psychological
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From AOA FirstLook:
Cancer Consultants (2/6, Weaver) reports that, according to a study published in the Journal of the National Cancer Institute, there appears to be "a high risk of second cancers among survivors of hereditary retinoblastoma," a "rare cancer of the retina" that "most commonly occurs in young children." In arriving at that conclusion, "researchers in the Netherlands conducted a study among 668 patients who had been diagnosed with retinoblastoma between 1945 and 2005. The risk of cancer in the retinoblastoma survivors was compared to the risk of cancer in the general Dutch population." The authors found that, "among survivors of hereditary retinoblastoma, the risk of cancer was 20-times higher than in the general population," with "patients who had received radiation therapy for hereditary retinoblastoma" having "an even greater increase in subsequent cancer risk."
The Advisory Committee on Immunization Practices (ACIP) annually reviews the recommended Adult Immunization Schedule to ensure that the schedule reflects current recommendations for the licensed vaccines. In October 2008, ACIP approved the Adult Immunization Schedule for 2009. No new vaccines were added to the schedule; however, several indications were added to the pneumococcal polysaccharide vaccine footnote, clarifications were made to the footnotes for human papillomavirus, varicella, and meningococcal vaccines, and schedule information was added to the hepatitis A and hepatitis B vaccine footnotes.