RESUMO
Angelman syndrome (AS) is a genetic disorder associated with severe developmental delay. The purpose of this study was to investigate cognitive and linguistic development in AS. Piaget's developmental model was used to evaluate the test results. The participants comprised 20 children (14 boys and 6 girls) aged 2-14 years (median age 7.4 years). AS was diagnosed either according to typical clinical criteria or confirmatory genetic testing. Cognitive functioning was evaluated with Griffiths' Mental Development Scale. Language development was also evaluated with Receptive-Expressive Emergent Language Scale 2 (REEL-2). Cognitive functioning, based on results on the Performance Scale, never exceeded Piaget's sensorimotor stage, 0-2 years. The median mental age for language development was 9 months. Expressive verbal vocabulary consisted of less than 2 words (n = 11), 2-3 words (n = 7) and 4-5 words (n = 2). Analyses according to REEL-2 did not indicate a consistent discrepancy between impressive and expressive language.
Assuntos
Síndrome de Angelman/complicações , Transtornos Cognitivos/etiologia , Transtornos do Desenvolvimento da Linguagem/etiologia , Adolescente , Criança , Linguagem Infantil , Pré-Escolar , Transtornos Cognitivos/diagnóstico , Feminino , Humanos , Transtornos do Desenvolvimento da Linguagem/diagnóstico , Testes de Linguagem , Masculino , Testes Neuropsicológicos , Índice de Gravidade de Doença , Percepção da Fala , Comportamento VerbalRESUMO
A total of 100 consecutive patients with AIDS were evaluated for efficacy and safety of treatment and secondary prophylaxis directed against Pneumocystis carinii pneumonia (PCP). 89 episodes of PCP were recorded in 75 patients. 63 of the 75 patients (84%) with a first episode of PCP were discharged. Of 72 patients with a first episode of PCP who were initially treated with trimethoprim-sulfamethoxazole. 76% completed therapy successfully. Side effects were common, but generally mild and tolerated during continued treatment. 7/11 patients (64%) with a first episode of PCP who required mechanical ventilation were discharged. Long term prognosis for these patients was not worse than for patients who did not require mechanical ventilation. Relapse of PCP occurred in 3/50 patients (6%) during secondary prophylaxis, 160 mg trimethoprim and 800 mg sulfamethoxazole (TMP-SMZ) every 24 h, compared to 11/16 (69%) patients who were not receiving prophylaxis (p less than 0.00001). No patients discontinued prophylaxis because of side effects. It is concluded that for most patients with AIDS and PCP, treatment and secondary prophylaxis with TMP-SMZ is safe and effective.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Infecções Oportunistas/tratamento farmacológico , Pneumonia por Pneumocystis/tratamento farmacológico , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico , Protocolos Clínicos , Estudos de Avaliação como Assunto , Humanos , Masculino , Infecções Oportunistas/complicações , Infecções Oportunistas/prevenção & controle , Pentamidina/uso terapêutico , Pneumonia por Pneumocystis/complicações , Pneumonia por Pneumocystis/prevenção & controle , Prognóstico , Recidiva , Combinação Trimetoprima e Sulfametoxazol/efeitos adversosRESUMO
The general design of a shock tube that was fabricated and used to produce a shock pulse having a relatively long duration (comparable to that produced by a nuclear detonation) is described. This shock tube used the reflected portion of the wave to produce the peak and early history wave pressure acting on the target, and nozzle flow through the rear of the driver tube to control the remainder of the decaying pressure pulse profile. The estimated pressure profile is compared with the profile obtained by a transducer that was located just above the target surface, and they are in general agreement. The general performance of the shock tube is discussed and suggestions made for further improvement of the technique.