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发育性语言障碍学龄前诊断的预测价值

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世界核心医学期刊文摘（神经病学分册） 2005年第7期1卷 35-35页

作者： webster R.I. Majnemer A. Platt R.W. Shevell M.I. 方伯言 Montreal Ch ildren's Hospital 2300 Tupper St.Montreal Que. H3H 1P3 Canada Dr.

Objective: To evaluate language and cognitive outcomes in elementary school ch ildren with a prior preschool diagnosis of developmental language impairment (DL I). Design/methods:A cohort of preschool children, consecutively diagnosed with isolated language impairment, was reassessed in elementary school. Measures used were the communication domains of the Battelle Developmental Inventory (BDI) an d the Vineland Adaptive Behavior Scale, Peabody Picture Vocabulary and Expressiv e One Word Picture Vocabulary. Cognition was assessed using the BDI cognitive do main. Language impairment was defined as performance more than 1.25 SD below nor mative means on a language measure. Specific language impairment (SLI)was define d as language impairment concurrent with a cognitive score not more than one SD below the normative mean. Results:A total of 43/70 (61%) children were reassess ed. Mean age in preschool was 3.6 ±0.7 years and 7.4 ±0.7 years at follow up. A total of 36/43 (84%) showed persistent language impairment. The mean BDI cogn itive domain score was 80.0±14.2 (15/42 below -2 SDs). Only 11/42 (26%) child ren met current research criteria for SLI, 24/42 (57%) had language impairment but had cognitive scores more than one SD below normative means, and 4/42 (10%) had normal language and cognitive skills. No factors could be identified at int ake that predicted language outcome using univariate or multivariate analysis. C onclusions: While a preschool diagnosis of developmental language impairment pre dicted persisting language impairment, the specificity of this impairment did no t persist. This suggests either undiagnosed cognitive impairment in preschool ch ildren with apparently isolated language impairment or an evolving profile of mo re global developmental impairment.

关键词：发育性语言障碍预测价值 impairment 认知功能发育障碍 children 行为量表 concurrent 演变情况 univariate

学龄前诊断为发育性语言功能减退的儿童在学龄期的运动功能

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世界核心医学期刊文摘（儿科学分册） 2005年第6期1卷 36-36页

作者： webster R. I. Majnemer A. Platt R. W. Shevell M. I. 虎小毅

To evaluate fine motor (FM) and gross motor (GM) function shortly after school entry in children with a preschool diagnosis of developmental language impairment (DLI). A cohort of children (n = 70) diagnosed at pre-school age with DLI was reevaluated in elementary school. Language, cognitive, and motor outcomes were assessed through the use of the Battelle Developmental Inventory (BDI). Languagewas further assessed through the use of the Vineland Adaptive Behavior Scale, Peabody Picture Vocabulary, and Expressive One Word Picture Vocabulary Tests. Performance below -1.5 SD of the normative mean on any test was considered to represent impairment. Forty-three children (mean age, 7.4 ±0.7 years) underwent reassessment at a mean of 3.8 ±0.7 years after initial preschool assessment. Mean scores for BDI motor domains (FM, 78.3 ±11.4; GM, 84.9 ±13.3) fell below normative values. Twenty-two children (52%) had motor impairment (FM, 17 of 42; GM, 15 of 42); 35 of 43 (81%) continued to have language impairment. BDI communication raw scores correlated most strongly with FM (ρ= 0.73, P <.001) and GM (ρ= 0.58, P =.003) raw scores but showed only moderate correlations with cognitive raw scores (ρ= 0.41, P =.05). Impaired motor function is an important comorbidity in DLI. Factors critical to motor performance may also contribute to language deficits in DLI.

关键词：发育性学龄期语言功能词汇测验行为评分发育调查语言能力影响因素

压力性尿失禁手术后顽固性紧迫尿失禁的骶神经调节治疗

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世界核心医学期刊文摘（妇产科学分册） 2006年第8期2卷 10-10页

作者： Sherman N.D. Jamison M.G. webster G.D. Amundsen C.L. 党慧敏 Duke University Medical Center Division of Urology DUMC 3146 Durham NC 27710 United States Dr.

Objective: This study was undertaken to evaluate the response to sacral neuromodulation in women with refractory, nonobstructive urinary urge incontinence after stress incontinence surgery. Study design: We reviewed the medical records of women in whom sacral neuromodulation was performed for worsening or de novo urinary urge incontinence after a stress incontinence procedure. All patients had undergone preliminary test stimulation. Demographics, surgical and urogynecologic history, including bladder diary and pad weight test, and urodynamic parameters were evaluated. Results: Of 34 women, 22 (65% ) responded to the test stimulation and underwent permanent lead implant. There was no difference between responders and nonresponders with respect to type of stress incontinence surgery. Incontinence or urodynamic parameters were not different between responders and nonresponders. Factors that were predictive of a positive response were women aged less than 55 years (P = .01), the test stimulation performed within 4 years of the stress incontinence procedure (P = .01), and evidence of pelvic floor muscle activity (P = .03). Conclusion: Sacral neuromodulation is a viable option for the treatment of refractory urinary urge incontinence that occurs after stress urinary incontinence surgery. Older women with no pelvic floor activity who are remote from their incontinence surgery may have a suboptimal response.

关键词：压力性尿失禁骶神经盆底肌肉膀胱排尿反应者尿动力学非梗阻型妇产科学预试验统计学特征