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1/3. Velocardiofacial syndrome in childhood-onset schizophrenia.

    OBJECTIVES: Deletion of chromosome 22q11 (velocardiofacial syndrome) is associated with early neurodevelopmental abnormalities and with schizophrenia in adults. The rate of 22q11 deletions was examined in a series of patients with childhood-onset schizophrenia (COS), in whom early premorbid developmental and cognitive impairments are more pronounced than in adult-onset cases. METHOD: Through extensive recruiting and screening, a cohort of 47 patients was enrolled in a comprehensive study of very-early-onset schizophrenia. All were tested with fluorescence in situ hybridization for deletions on chromosome 22q11. RESULTS: Three (6.4%) of 47 patients were found to have a 22q11 deletion. All 3 COS patients with 22q11 deletions had premorbid impairments of language, motor, and social development, although their physical characteristics varied. brain magnetic resonance imaging revealed increased midbody corpus callosum area and ventricular volume in relation both to healthy controls and to other COS patients. CONCLUSIONS: The rate of 22q11 deletions in COS is higher than in the general population (0.025%, p < .001) and may be higher than reported for adult-onset schizophrenia (2.0%, p = .09). These results suggest that 22q11 deletions may be associated with an earlier age of onset of schizophrenia, possibly mediated by a more salient neurodevelopmental disruption.
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ranking = 1
keywords = physical
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2/3. The modified superior based pharyngeal flap. Part III. A retrospective study.

    A retrospective study of 31 patients who had diagnosed velopharyngeal incompetence and were surgically managed with the modified superior based pharyngeal flap was completed. The following were analyzed: age at time of operation, gender, physical status, diagnostic protocol, length of operation (length of total surgery) and length of superior based pharyngeal flap, length of postoperative hospital stay, length of total hospital stay, length of follow-up, speech results, complications, patient care, and medication. The result showed that the optimal timing for correction of velopharyngeal incompetence was between 3 and 6 years of age. The mean length of total hospital stay was 2.7 days, postoperative complications were minimal, and speech results were generally good.
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ranking = 1
keywords = physical
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3/3. dysarthria in adults: physiologic approach to rehabilitation.

    A case study is used to illustrate a physical approach to the speech rehabilitation of adults with dysarthria. The approach emphasizes the component-by-component analysis of the peripheral speech mechanism, where the selection and sequencing of treatment procedures follow directly from the physiologic nature and severity of involvement in each component. The selection and sequencing of procedures also are conditioned by the inherent physical interdependencies of these component parts. Several biofeedback procedures of our own are incorporated that have not been reported previously. The case illustration is of a young man injured in an auto accident whose speech intelligibility improves from approximately 5-10% to 95% during the rehabilitation period. Effects of treatment upon individual components of the speech mechanism are illustrated.
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ranking = 2
keywords = physical
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