984 resultados para Clinical study


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The spondylothoracic dysplasia syndrome is characterized by congenital malformations of vertebrae and ribs. As a consequence of the anomalous development of the vertebral column, the neck and thorax are short, and the normal head looks as if emerging from the shoulders. The thorax is short and asymmetric with an increased anteroposterior diameter. Dorsolumbar lordosis and a protuberant abdomen are present. The extremities though normal in length appear long relative to the shortened trunk. Short stature results from the vertebral abnormalities. The syndrome was seen in 2 siblings of nonconsanguineous parents.

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Calves aged 3 mth were readily infected with oocysts and cysts of Toxoplasma gondii administered by the oral route. Fever, respiratory distress, nasal discharge, and hyperemia of the conjunctivas were the most significant clinical signs noted in the infected animals. Parasitemia was demonstrated in all infected calves. It occurred on different days and up to 62 days after the infection. Toxoplasma was demonstrated in tissues of all infected calves, and the organ most frequently parasitized was the lymph node. Parasitism of the retina was demonstrated in 2 calves. All infected animals had antibody against T. gondii in their serum. The Sabin-Feldman dye test and the indirect immunofluorescent test were both useful in detecting antitoxoplasma antibody.

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To find a valuable tool in achieving a good accuracy in predicting the outcome from sympathectomy, changes in limb skin temperatures (LST) before and after epidural lumbar anesthesia (ELA) and before and after lumbar sympathectomy were studied in 13 patients with thrombangiitis obliterans or arteriosclerosis obliterans. The results were compared with the clinical course and follow-up from 1 to 5 years. In seven patients there was a rise in LST after ELA and after sympathectomy, and this pattern of variation was associated with good clinical course. In three patients there was decrease in the LST after ELA and after sympathectomy and they did not do well. In two patients there was no change in temperature before or after the procedure; one of them had a good and the other a bad clinical course. The same measurements were performed in three other patients who had had a sympathectomy some years previously and the data showed that LST was lowered after ELA. It is concluded that the measurement of limb skin temperature before and after epidural lumbar anesthesia aids in determining which patients are more likely to benefit from sympathectomy.

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Raven's Progressive Matrices were completed by 536 school children. Wechsler's Intelligence Scale for Children was applied to children who performed badly on Raven's Test (percentile 5 or less). Father's occupation and education, items of property and sums of spending money were assessed in all families. Clinical history and physical examination were recorded for deficient children. Mental deficiency was present in 94 children (17.5%); it was more frequent in those from lower socioeconomic classes (90 deficient children in a total of 427); it was more frequent in the peripheral school (69 deficient children) than in the midtown school (relatively less poor children); no significant difference was found in sex distribution among social classes. 67 children had an intelligence quotient between 50 and 69. Undernourishment was severe marked (18 children), moderate (48 children) or absent (26 children). Most children (67) were insufficiently stimulated by their parents.

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Twenty children with diagnosed meningitis were available for prospective study; each was submitted to neurological and electroencephalographic examination, Distractability Quotient (Gesell) and Intelligence Quotient (Raven) tests. Patients were followed from 6 months to 3 years after the acute phase of the disease. There is a statistically significant difference between the D.Q of post-meningitic children and the D.Q. of non meningitic controls of the same social class and ages, when the onset of illness was before 30 months of age. No statistically significant correlation was found between the D.Q. and the patient's length of hospitalization or the first cerebrospinal fluid protein level. There is a possibility that significant correlation between the D.Q. and age at onset of illness may be observed by studying a larger number of patients. No statistically significant difference was found between the I.Q. of post-meningitic children and controls when the onset of illness was after age 4.

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Humoral and cell-mediated immunity was investigated in fourteen patients with non-toxic multinodular goitre and ten healthy controls by in vitro methods. These included determination of sheep erythrocyte and complement rosette-forming cells in the peripheral blood, immunoglobulin levels, titres of thyroglobulin and microsomal antibodies and migration inhibition test using thyroid extract and phytohemagglutinin. When compared with controls the patients showed high IgA levels and positive response to thyroid antigen in the leucocyte migration inhibition test. There was no correlation between the leucocyte migration results and the presence of auto-antibodies. These findings indicate a possible role of cell-mediated immunity in non-toxic multinodular goitre.