1/10. Syntax PAL: a system to improve the written syntax of language-impaired users.In our work with children who have difficulty with spelling or with the physical action of writing, we have found a number of children who also have difficulty with written grammar. As an extension of PAL, an existing predictive spelling and typing aid, we have developed a writing aid to help these children with sentence construction. The enhanced system uses the syntax of the initial part of a sentence to enhance the position in the prediction list of syntactically correct words. It was postulated that this would discourage the use of incorrect syntax and encourage the use of correct syntax. In two case studies, the use of Syntax PAL significantly improved the quality and quantity of one child's written output, but had little effect on the other child's work.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/10. behavior modification in physical therapy.Behavioral techniques reported to improve ambulation skills among physically handicapped persons include both reward and desensitization procedures. This report describes the application of other behavior modification principles to two patients who resisted physical therapy (PT) designed to educate them in the use of orthopedic assistive devices. Peer modeling was used with case 1, a 2 1/2-year-old girl with complete L4 spina bifida who cried frequently when wearing her brace, and refused to walk except with much assistance. Case 2 was a 21-year-old hemiplegic man seen two years after a severe head injury. Initially, severe tantrum behavior accompanied all demands placed on him. Treatment involved a combination of contingent music for being quiet and contingent aversive auditory feedback for yelling. In both cases clinically significant behavioral changes were observed. Results are discussed with respect to the cost effectiveness of behavioral interventions and the interdisciplinary coordination of rehabilitation team members.- - - - - - - - - - ranking = 6keywords = physical (Clic here for more details about this article) |
3/10. delayed diagnosis of voiding dysfunction: occult spinal dysraphism.The recognition of spinal dysraphism as a potential cause of voiding dysfunction is of the utmost importance if appropriate treatment and followup are to be initiated. We present 2 women with prolonged voiding dysfunction who had spinal dysraphism, intradural lipoma and related urodynamic abnormalities. The importance of initial symptom recognition, physical examination, urodynamic evaluation, appropriate treatment and periodic re-examination to detect progressive neurological impairment is emphasized.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/10. The cerebro-costo-mandibular syndrome: third report of familial occurrence.Two male sibs with cerebro-costo-mandibular syndrome and spina bifida are described. The parents are physically and radiologically normal. A short review of the pertinent literature is given with special emphasis on the mode of inheritance.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/10. female epispadias: report of a case and review of the literature.female epispadias is a congenital anomaly representing a mild form of the spectrum of exstrophy of the bladder. Unrecognized an untreated, the handicap associated with the physical malformation can create overwhelming clinical and psychological problems for the affected female. Radiographic findings of spinal dysrhaphism with diastasis of the public bones are often associated with, and can afford the first clue to, the physical findings of absent clitoris, ununited labia and patulous and foreshortned urethra.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
6/10. The child with spina bifida. role of the pediatrician.Pediatricians commonly have patients with multiple physical and/or mental handicaps. Though many such children receive care at a multispecialty center, the role of the pediatrician is an important one, not only in providing primary care but also in helping to manage ongoing care of a multisystem disorder. Spina bifida is one such disorder, and children with this condition have many medical needs (pediatric, neurosurgical, orthopedic, urologic, gastrointestinal), as well as potential educational, emotional, and psychosocial problems. The pediatrician can effectively promote optimal interaction between patient, family, and community.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/10. staphylococcus epidermidis meningitis and an intraspinal abscess associated with a midthoracic dermal sinus tract.Congenital neuroectodermal defects are associated with meningitis that is unresponsive to conventional antibiotic therapy, recurrent bacterial meningitis, or meningitis due to an organism that is not usually the cause of this disease. Midthoracic dermoid and epidermoid cysts occur rarely and are easily overlooked. We report the case of a 13-month-old boy with meningitis that was unresponsive to antimicrobial therapy. We subsequently identified an intraspinal abscess, an infection due to staphylococcus epidermidis, and a midthoracic dermoid cyst. We emphasize the need for clinicians to have a high index of suspicion and to make a careful physical examination when antibiotic treatment fails in patients with meningitis. We also provide a detailed anatomy of a midthoracic dermoid cyst and illustrate the usefulness of magnetic resonance imaging in preoperative diagnosis of congenital neuroectodermal defects.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
8/10. Tethered thoracic cord resulting from spinal cord herniation.Tethered cord syndrome (TCS) usually involves tethering of the lower cord at the conus medullaris from dural abnormalities, but may occur after spinal cord herniation. A tethered thoracic spinal cord is rare. We present an unusual case of a 30-year-old woman with a history of myelopathy presumed to be secondary to T6 cord compression resulting from T6-T8 arachnoid cyst. She continued to deteriorate after partial excision of the cyst. Repeat magnetic resonance imaging suggested recurrence of the presumed arachnoid cyst with cord compression and showed tethering at T6-T8. Surgical exploration revealed myelocele with cord herniation through the anterior thoracic dura. Pathologic diagnosis showed neural tissue with gliosis. After physical therapy treatments, the patient had increased lower extremity strength, ambulated with a cane, and regained some bladder control. Progressive myelopathy may represent tethering of the cord resulting from cord herniation. Early recognition of TCS, even in patients with minimal neurologic deficits, could prevent progressive disability.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
9/10. Recurrent meningitis associated with congenital paravertebral dermal sinus tract.Recurrent meningitis is a rare but important event that needs to be searched for a predisposing factor. Congenital dermal sinuses occurring in the midline are among the etiological factors. Here, an 18-month-old boy with three attacks of recurrent meningitis due to a paramedian dermal sinus tract is presented. klebsiella was the cultured causative agent. The lesion was suspected on physical examination and demonstrated by lumbosacral magnetic resonance imaging. To the best of our knowledge, this is the first case in English-language literature of the paravertebrally located dermal sinus tract resulting in recurrent meningitis. Therefore, a careful physical examination, especially including the paravertebral region beside the midline, is essential. magnetic resonance imaging is a non-invasive descriptive method in the evaluation of congenital dermal sinus tracts.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
10/10. General anaesthetic for a pilonidal sinus excision in a patient with hereditary angio-oedema.Hereditary angio-oedema is an autosomal dominant condition resulting in a deficiency of C1 esterase inhibitor protein in serum. The condition is characterized by oedematous attacks in the skin, mucous membranes and gastrointestinal tract triggered by mental and physical stress. We present the rare case of a young girl with known hereditary angio-oedema and spina bifida occulta being admitted for an elective pilonidal sinus excision. This case presented different challenges for the anaesthetists and surgeons.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
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