Characteristics of speech following cervical spinal cord injury

The present study examined 24 individuals with either complete or incomplete injuries to the cervical spinal cord through the use of standardized assessments of dysarthria and a perceptual rating scale. Perceptual assessment revealed predominantly prosodic and phonatory disturbances, while physical impairments were common in the respiratory and laryngeal subsystems of speech production. A reduction in intelligibility and speaking rate resulted in a diminished communicative effectiveness ratio for most participants. Individuals showed a high degree of variation, with no clear relationship between lesion type and impairments present. Further investigation is required to verify the physiological nature of the respiratory and laryngeal impairments found in the present investigation and to determine the relative contributions of these to the overall presentation of speech and voice post cervical spinal cord injury (CSI).

A pilot study of online assessment of childhood speech disorders

We investigated the feasibility of assessing childhood speech disorders via an Internet-based telehealth system (eREHAB). The equipment provided videoconferencing through a 128 kbit/s Internet link, and enabled the transfer of pre-recorded video and audio data from the participant to the online clinician. Six children (mean age = 5.3 years) with a speech disorder were studied. Assessments of single-word articulation, intelligibility in conversation, and oro-motor structure and function were conducted for each participant, with simultaneous scoring by a face to face and an online clinician. There were high levels of agreement between the two scoring environments for single-word articulation (92%), speech intelligibility (100%) and oro-motor tasks (91%). High levels of inter- and intra-rater agreement were achieved for the online ratings for most measures. The results suggest that an Internet-based assessment protocol has potential for assessing paediatric speech disorders.

Prevalence of drug-resistance mutations and non-subtype B strains among HIV-infected infants from New York State

Summary: Prevalence studies indicate that transmission of drug-resistant HIV has been rising in the adult population, but data from the perinatally infected pediatric population are limited. In this retrospective study, we sequenced the pol region of HIV from perinatally infected infants diagnosed in New York State in 2001-2002. Analyses of drug resistance, subtype diversity, and perinatal antiretroviral exposure were conducted, and the results were compared with those from a previous study of HIV-infected infants identified in 1998-1999. Eight of 42 infants (19.1%) had provirus carrying at least 1 drug-resistance mutation, an increase of 58% over the 1998-1999 results. Mutations conferring resistance to nucleoside reverse transcriptase inhibitors, nonnucleoside reverse transcriptase inhibitors, and protease inhibitors were detected in 7.1%, 11.9%, and 2.4% of specimens, respectively. Consistent with previous results, perinatal antiretroviral exposure was not associated with drug resistance (P = 0.70). Phylogenetic analysis indicated that 16.7% of infants were infected with a non-subtype B strain of HIV. It seems that drug-resistant and non-subtype B strains of HIV are becoming increasingly common in the perinatally infected population. Our results highlight the value of resistance testing for all HIV-infected infants upon diagnosis and the need to consider subtype diversity in diagnostic and treatment strategies.

Mice lacking the vascular endothelial growth factor-B gene (Vegfb) have smaller hearts, dysfunctional coronary vasculature, and impaired recovery from cardiac ischemia

Vascular endothelial growth factor-B (VEGF-B) is closely related to VEGF-A, an effector of blood vessel growth during development and disease and a strong candidate for angiogenic therapies. To further study the in vivo function of VEGF-B, we have generated Vegfb knockout mice (Vegfb(-/-)). Unlike Vegfa knockout mice, which die during embryogenesis, Vegfb(-/-) mice are healthy and fertile. Despite appearing overtly normal, Vegfb(-/-) hearts are reduced in size and display vascular dysfunction after coronary occlusion and impaired recovery from experimentally induced myocardial ischemia. These findings reveal a role for VEGF-B in the development or function of coronary vasculature and suggest potential clinical use in therapeutic angiogenesis. The full text of this article is available at http://www.circresaha.org.

Assessment of motor speech disorders online: A pilot study

We have conducted a preliminary validation of an Internet-based telehealth application for assessing motor speech disorders in adults with acquired neurological impairment. The videoconferencing module used NetMeeting software to provide realtime videoconferencing through a 128 kbit/s Internet link, as well as the transfer of store-and-forward video and audio data from the participant to the clinician. Ten participants with dysarthria following acquired brain injury were included in the study. An assessment of the overall severity of the speech disturbance was made for each participant face to face (FTF) and in the online environment, in addition, a 23-item version of the Frenchay Dysarthria Assessment (FDA) (which measures motor speech function) and the Assessment of Intelligibility of Dysarthric Speech (ASSIDS) (which gives the percentage word and sentence intelligibility, words per minute and a rating of communication efficiency) were administered in both environments. There was a 90% level of agreement between the two assessment environments for the rating of overall severity of dysarthria. A 70-100% level of agreement was achieved for 17 (74%) of the 23 FDA variables. On the ASSIDS there was a significant difference between the FTF and online assessments only for percentage word intelligibility. These findings suggest that Internet-based assessment has potential as a reliable method for assessing motor speech disorders.