Κυριακή 18 Απριλίου 2021

Phonological awareness, rapid automatized naming, and reading of functionally illiterate adults

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RESUMO Objetivo O presente estudo tem como objetivo descrever o perfil de adultos analfabetos funcionais em tarefas de leitura, consciência fonológica (CF), e nomeação automática rápida (NAR); bem como correlacionar o desempenho dessas tarefas. Além disso, buscou-se compreender quanto que o desempenho em CF e NAR predizem o resultado em leitura de palavras e pseudopalavras. Método Foram avaliados 23 adultos analfabetos funcionais em tarefas de inteligência, leitura, CF e NAR. Resultados Os participantes apresentaram dificuldades em CF, tendo pobre desempenho em tarefas que envolviam análise e manipulação de fonemas. Em NAR, apresentaram maior facilidade na nomeação de itens alfanuméricos. Em relação à leitura, houve dificuldades no processamento fonológico, apresentando erros por troca fonológica. Análises de correlação indicaram que a leitura apresentou maiores correlações com NAR do que com CF. Por fim, a análise de regressão indicou que o desemp enho em NAR é capaz de explicar mais da metade do resultado em leitura dos participantes. Conclusão De modo geral, o perfil dos adultos analfabetos funcionais se caracteriza por apresentar prejuízos nas habilidades avaliadas, sendo esses prejuízos mais evidentes em CF ao nível dos fonemas, bem como na nomeação de itens não-alfanuméricos. Além disso, os resultados em NAR explicam melhor os resultados de leitura de palavras e pseudopalavras do que os resultados em CF.
ABSTRACT Purpose The study's purpose is to describe the cognitive profile of a sample of functionally illiterate individuals in reading, phonological awareness (PA) and rapid automatized naming (RAN), as well as to correlate the performance of these tasks. Moreover, it sought to understand how the performances in PA and RAN predict results in reading of words and pseudowords. Methods 23 functionally illiterate adults were assessed for intelligence, reading, PA and RAN tasks. Results Participants showed difficulties in PA, performing poorly in tasks involving phoneme analysis and manipulation. In RAN, they found it easier to name alphanumeric items. Regarding reading, they presented difficulties in phonological processing, with errors caused by phonological exchange. Correlation analyses indicated that reading presented higher correlations with RAN than PA. Finally, a regression analysis indicated that performance in RAN can account for more than half of participants' reading results. Conclusion In general, the profile of functionally illiterate adults presents impairment in the abilities assessed that are more evident in PA at phoneme levels as well as in naming of non-alphanumerical items. Moreover, the results in RAN explain those in word and pseudowords reading better than the results in PA.
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Adaptation of the Brazilian Functional Auditory Performance Indicators - Short Version

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RESUMO Objetivo Adaptar o protocolo Indicadores de Performance Funcional Auditiva Brasileiro para uma versão reduzida, incluindo a produção de material e de um manual de aplicação. Método Estudo do tipo metodológico, descritivo e transversal, com abordagem quantiqualitativa, realizado com sete fonoaudiólogos que aplicaram o protocolo em 34 crianças com deficiência auditiva e seus responsáveis. Cumpriram-se a análise da validade de conteúdo, bem como da confiabilidade do instrumento por meio da avaliação da equivalência semântica, da análise da satisfação dos fonoaudiólogos e dos testes estatísticos alfa de Cronbach e coeficiente de Kappa. Resultados Foi adaptada a versão reduzida denominada FAPI-r, com coeficientes que indicaram consistência interna e concordância interavaliadores quase perfeitos. Os fonoaudiólogos referiram satisfação com o instrumento e relataram que o manual de aplicação facilitou o entendimento sobre a aplicação do teste. Observou-se, no entanto, a não concordância entre a avaliação dos fonoaudiólogos e as respostas das famílias, indicando a necessidade de maior inserção destas no cenário terapêutico. Conclusão Realizada a adaptação do FAPI-r, constatando-se sua validade e confiabilidade, com futuros desdobramentos para a pesquisa e atuação clínica na população de crianças com deficiência auditiva.
ABSTRACT Purpose To adapt the Brazilian Functional Auditory Performance Indicators protocol to a short version including the production of material and an application manual. Methods Methodological, descriptive, cross-sectional study with a quantitative and qualitative approach conducted with seven speech-language therapists who applied the protocol to 34 children with hearing loss and their guardians. The analysis of content validity and the instrument reliability evaluated the semantic equivalence, analysis of satisfaction of speech therapists, and statistical tests of Cronbach� ��s Alpha and Kappa coefficient. Results The short version, called FAPI-r, was adapted considering coefficients that indicate internal consistency and almost perfect inter-evaluator agreement. Speech-language therapists reported satisfaction with the instrument and stated that the manual facilitates the understanding of the test application. However, there was no agreement between the assessment of speech-language therapists and the answers of families, indicating a need for a greater insertion of families in the therapeutic scenario. Conclusion The adapted FAPI-r has validity and reliability, promising future developments for research and clinical performance in the population of hard of hearing children.
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Weight Gain and Severe Obstructive Sleep Apnea in Adolescents with Down Syndrome

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Objectives/Hypothesis

To determine whether the severity of obstructive sleep apnea (OSA) is affected by weight gain velocity (WGV) in adolescents with Down syndrome.

Study Design

Retrospective case series.

Methods

We performed a retrospective case series of children with Down syndrome, aged 9–19, referred for polysomnography (PSG) due to suspected OSA at an academic children's hospital. We determined the velocity (slope of change) of yearly weight gain using a mixed effect linear regression model. Subsequently, we determined if velocity of yearly weight gain was greater in adolescents with severe OSA (apnea‐hypopnea index > 10). Significance was set at P < .05.

Results

A total of 77 adolescents with Down syndrome were identified. The average age was 12.5 years (standard deviation = 3.1); 44 (57%) were male and 46 (60%) were Hispanic. The majority, 51 (66%) had severe OSA. The velocity of yearly weight gain prior to PSG in Down syndrome adolescents was similar regardless of OSA severity (mean diff in weight gain at PSG between severe and nonsevere OSA = −1.42, 95% confidence interval = −5.8 to 2.9, P = .52). Down syndrome adolescents with severe OSA weighed more at PSG (58.4 kg vs. 40.9 kg, P < .001) and all years prior to PSG. These findings remained even when controlling for age at PSG.

Conclusions

Severe OSA in adolescents with Down syndrome is associated with weight. There was no significant difference in WGV in children with Down syndrome with or without severe OSA.

Level of Evidence

3 Laryngoscope, 2021

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Sensorineural Hearing Loss Caused by Labyrinthine Erosion Due to a Cerebrospinal Fluid Diverticulum

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Otol Neurotol. 2021 Apr 14. doi: 10.1097/MAO.0000000000003184. Online ahead of print.

ABSTRACT

OBJECTIVE: To present a case of progressive sensorineural hearing loss (SNHL) caused by labyrinthine erosion secondary to expanding geniculate ganglion cerebrospinal fluid (CSF) diverticulum extending along the path of the facial nerve.

PATIENT: Thirteen-year-old man with no past medical history or risk factors presented with unilateral progressive SNHL and no other otologic or neurologic symptoms.

INTERVENTIONS: Audiological data as well as imaging studies including a magnetic resonance imaging (MRI) of the brain and internal auditory canal and a temporal bone computed tomography (CT) are presented. Partial labyrinthectomy, CSF leak closure, and cochlear implantation were performed. A lumbar puncture was obtained 2 months postoperatively.

MAIN OUTCOME MEASURE: Closure of the CSF leak.

RESULTS: Mastoidectomy revealed a wide a rea of CSF leak through the geniculate ganglion and fallopian canal with partial destruction of the superior and lateral semicircular canals by an expanding diverticulum.

CONCLUSIONS: This is an unusual presentation of progressive SNHL due to partial labyrinthine erosion due to a meningocele of the geniculate ganglion along the fallopian canal. It is likely that the patient had a congenital open pathway through the labyrinthine segment of the facial nerve and CSF pulsations created the meningocele over a few years. This case argues for early closure of such CSF diverticula to prevent possible SNHL due to labyrinthine erosion.

PMID:33859132 | DOI:10.1097/MAO.0000000000003184

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The Effects of Human Dermal‐derived Mesenchymal Stem Cells on the Keratinocyte Proliferation and Apoptosis in Psoriasis

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Abstract

Psoriasis is a common chronic inflammatory skin disease, characterized by epidermal hyperproliferation. Mesenchymal stem cells (MSCs) regulate inflammation and vascular proliferation in the psoriasis lesions. Whether dermal‐derived mesenchymal stem cells (DMSCs), the main MSCs in the dermis regulate keratinocyte proliferation and apoptosis remains unknown. In the present study, we assessed the proliferation and apoptosis of keratinocytes co‐cultured with DMSCs isolated from either normal or psoriatic involved skin. Cell growth and apoptotic rates were determined, using Cell Count Kit‐8 and annexin V‐FITC staining, respectively. In addition, EDU kit was also used to measure the rate of keratinocyte proliferation. Our results showed that psoriatic DMSCs (pDMSCs) were more potent than normal DMSCs (nDMSCs) in stimulating keratinocyte proliferation. In contrast, the apoptotic rate and expression levels of caspase 3 protein were lower in pDMSC‐treated than nDMSC‐t reated keratinocytes (p<0.001). Moreover, significantly higher contents of IL‐6, IL‐8, TNFα and IFN‐γ were found in the culture medium of pDMSCs than in that of nDMSCs. In conclusion, pDMSCs were more potent than nDMSCs in stimulation of keratinocyte proliferation and secretion of proinflammatory cytokines , while weaker in promoting apoptosis.

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Pathobiology questions raised by telogen effluvium and trichodynia in COVID‐19 patients

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Abstract

We recently observed 39 patients in Italy presenting with telogen effluvium, including 7 patients with severe trichodynia. These include 9 men and 30 women ageing 48 to 73 years (mean age 64.6). In 16 patients, COVID‐19 presented with severe interstitial pneumonia, requiring hospitalization and Continuous Positive Airway Pressure (CPAP) therapy. Medications included paracetamol (39) systemic steroids ( 25) anticoagulants (16). Symptoms developed eight weeks to three months after clinical manifestations COVID‐19.

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Epigenetic and metabolic interplay in cutaneous squamous cell carcinoma

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Abstract

With the aging of the population and increased levels of recreational sun exposure and immunosuppression, cutaneous squamous cell carcinoma (cSCC), is both an enormous and expanding clinical and economic issue. Despite advances in therapy, up to 5,000‐8,000 people are estimated to die every year from cSCC in the U.S., highlighting the need for both better prevention and treatments. Two emerging areas of scientific discovery that may offer new therapeutic approaches for cSCC are epigenetics and metabolism. Importantly, these disciplines display extensive crosstalk, with metabolic inputs contributing to the chromatin landscape, while the dynamic epigenome shapes transcriptional and cellular responses that feedback into cellular metabolism. Recent evidence suggests that indeed, epigenetic and metabolic dysregulation may be critical contributors to cSCC pathogenesis. Here, we synthesize the latest findings from these fast‐moving fields, including how they may drive cSCC, yet also be harnessed for therapy.

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Innate lymphoid cells in peripheral blood of patients with American Cutaneous Leishmaniasis

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Abstract

Innate lymphoid cells (ILCs) are classified by the expression of specific transcription factors: ILC1 depending on T‐bet for IFN‐γ production; ILC2 depending on GATA3 for IL‐5 and IL‐13; and ILC3 depending on ROR‐γτ and AHR for IL‐17 and IL‐22. This study aimed to determine circulating ILCs in 23 patients with localized (LCL) = 7, mucocutaneous (MCL) = 10, intermediate (ICL) = 3 and diffuse (DCL) = 3 cutaneous leishmaniasis and 17 healthy controls from endemic area (EC) = 9 and non‐endemic area (HC) = 8. Results evidenced a higher proportion of ILC1 in LCL than controls and MCL. ILC2 was higher in DCL compared with controls. ILC3 s were abundant in MCL and DCL concerning controls. A prevalence ratio was calculated to approach cell plasticity: in LCL, the ratio showed a prevalence of ILC1/ILC3 (plasticity 1), in contrast to DCL, and controls, where ILC2/ILC3 (plasticity 3) is prevalent. Also, MCL an d ICL showed higher ILC1/ILC2 (plasticity 2). These results suggest that ILC1 and ILC3 in LCL are associated with disease control and regulation of inflammation, while MCL and ICL are related to immunopathology and uncontrolled inflammation. In DCL, ILC2 is associated with the tolerogenic state of these patients.

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Effects of metformin on experimentally induced acne on rabbit ear

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Abstract

Evidence for the effectiveness of metformin in the treatment of acne is limited. To assess its efficacy, comedones were experimentally induced in young New Zealand rabbit ear using Isopropyl Myristate (IM) followed by metformin treatment (30 mg/kg bodyweight) for 60 days with continued IM application. In another group, to check whether metformin pre‐treatment affects subsequent comedone development by IM, metformin was given for 14 days and then withdrawn (14 days) followed by comedone development with IM and metformin treatment. At different time points, dermatoscopic images of rabbit ear were taken for clinical assessment. Blood and biopsy samples were taken for hormonal assessment, histological examination and gene expression. Histologically confirmed acne model was developed in rabbit ear. Follicular size increased significantly (p = 0.0004 in both groups) upon IM application. Metformin significantly decreased comedones size as observed i n dermatoscopic (p = 0.0003 in group I, p = 0.0190 in group II) and histological examination (p = 0.0313 in group I and II). However, size of comedones developed after metformin pretreatment was significantly (p < 0.0001) smaller. The lipid content of sebaceous glands decreased with metformin without any significant changes in the assessed hormones and genetic expression. Overall, metformin was found to be clinically effective in experimentally induced acne and can be used in humans.

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5‐Aminolaevulinic acid photodynamic therapy amplifies intense inflammatory response in the treatment of acne vulgaris via CXCL8

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Abstract

Acne vulgaris is a chronic inflammatory cutaneous disease. 5‐Aminolaevulinic acid photodynamic therapy (ALA‐PDT) is a novel and effective approach for severe acne vulgaris treatment. However, its specific treatment mechanism still remains unclear. In the present study, we investigated the potential mechanism of how ALA‐PDT regulated intense inflammatory response in acne vulgaris. It appeared that ALA‐PDT suppresses proliferation and lipid secretion of primary human sebocytes. Besides, ALA‐PDT could up‐regulate the expression of CXCL8 in vivo and in vitro, amplifying the inflammatory response by recruiting T cells, B cells, neutrophils and macrophages. We also found that ALA‐PDT elevated the expression of CXCL8 via p38 pathway. SB203580, a p38 pathway inhibitor, decreased the expression of CXCL8 in sebocytes after ALA‐PDT. These findings indicate that ALA‐PDT amplifies the intense inflammatory response in treatment of acne vulgaris via CXCL8. Our data deciphers th e mechanism of intense inflammatory response after ALA‐PDT for acne vulgaris.

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Superficial Siderosis: A Clinical Review

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Ann Neurol. 2021 Apr 15. doi: 10.1002/ana.26083. Online ahead of print.

ABSTRACT

Superficial siderosis of the central nervous system results from subpial hemosiderin deposition due to chronic low-grade bleeding into the subarachnoid space. The confluent and marginal subpial hemosiderin is best appreciated on iron-sensitive magnetic resonance imaging sequences. With widespread use of magnetic resonance imaging, the disorder is increasingly being recognized, including in asymptomatic individuals. Gait ataxia, often with hearing impairment is a common clinical presentation. A clinical history of subarachnoid hemorrhage is generally not present. A macrovascular pathology is generally not causative. The most common etiology is dural disease, often dural tears. Prior or less commonly ongoing symptoms of craniospinal hypovolemia may be present. Common etiologies for dural tears include disc disease and trauma, including surgical trauma. Patients wit h dural tears due to herniated and calcified discs often have a ventral intraspinal fluid collection due to cerebrospinal fluid leak. A precise identification of the dural tear relies on multi-modality imaging. It has been speculated that chronic bleeding from fragile blood vessels around the dural tear may be the likely underlying mechanism. Surgical correction of the bleeding source is a logical therapeutic strategy. Clinical outcomes are variable though neuroimaging evidence of successful dural tear repair is noted. The currently available data regarding use of deferiprone in patients with superficial siderosis is insufficient to recommend its routine use in patients. This article is protected by copyright. All rights reserved.

PMID:33860558 | DOI:10.1002/ana.26083

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Age-related hearing loss, depression and auditory amplification: a randomized clinical trial

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Eur Arch Otorhinolaryngol. 2021 Apr 16. doi: 10.1007/s00405-021-06805-6. Online ahead of print.

ABSTRACT

PURPOSE: Our study investigates the effectiveness of aural rehabilitation to decrease depressive symptoms in older adults, and the relationship between hearing loss and depression.

METHODS: A randomized controlled study was conducted at a hearing rehabilitation center with people over 65 years old. Participants were randomly allocated to the intervention group who received hearing aids, or to the control group. Data collection included pure-tone audiometry and a Portuguese version of the Geriatric Depression Scale assessed at two time points: baseline (P0) and after 4-week period (P1).

RESULTS: The results show that the increase of hearing thresholds in pure-tone audiometry is associated with a significant increase in depressive symptoms (p = 0.001). The effect of aural rehabilitation for improving depressive symptoms wa s significant in intervention group (p = 0.000) and between groups (p = 0.003) in P1.

CONCLUSION: Age-related hearing loss has adverse effects on older adults' mental health, due to reduced hearing inputs that may increase levels of effort to communicate and affect social engagement, which lead to depression. Hearing aid use improves levels of depression and can promote greater quality of life in older adults.

PMID:33860839 | DOI:10.1007/s00405-021-06805-6

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