Background and Purpose-Hematomas that enlarge following presentation with primary intracerebral hemorrhage (ICH) are associated with increased mortality, but the mechanisms of hematoma enlargement are poorly understood. We interpreted the presence of contrast extravasation into the hematoma after CT angiography (CTA) as evidence of ongoing hemorrhage and sought to identify the clinical significance of contrast extravasation as well as factors associated with the risk of extravasation. Methods-We reviewed the clinical records and radiographic studies of all patients with intracranial hemorrhage undergoing CTA from 1994 to 1997. Only patients with primary ICH were included in this study. Univariate and multivariate logistic regression analyses were performed to determine the associations between clinical and radiological variables and the risk of hospital death or contrast extravasation. Results-Data were available for 113 patients. Contrast extravasation was seen in 46% of patients at the time of CTA, and the presence of contrast extravasation was associated with increased fatality: 63.5% versus 16.4% in patients without extravasation (Pϭ0.011). There was a trend toward a shorter time (medianϮSD) from symptom onset to CTA in patients with extravasation (4.6Ϯ19 hours) than in patients with no evidence of extravasation (6.6Ϯ28 hours; Pϭ0.065).Multivariate analysis revealed that hematoma size (Pϭ0.022), Glasgow Coma Scale (GCS) score (Pϭ0.016), extravasation of contrast (Pϭ0.006), infratentorial ICH (Pϭ0.014), and lack of surgery (PϽ0.001) were independently associated with hospital death. Variables independently associated with contrast extravasation were hematoma size (Pϭ0.024), MABP Ͼ120 mm Hg (Pϭ0.012), and GCS score of Յ8 (PϽ0.005). Conclusions-Contrast extravasation into the hematoma after ICH is associated with increased fatality. The risk of contrast extravasation is increased with extreme hypertension, depressed consciousness, and large hemorrhages. If contrast extravasation represents ongoing hemorrhage, the findings in this study may have implications for therapy of ICH, particularly with regard to blood pressure management. (Stroke. 1999;30:2025-2032.)
Objective: The aim of this study was to collect the normative values of nasalance for Egyptian Arabic speakers in different age groups, using Arabic speech samples in order to compare patients with disturbed nasality. Material and Methods: This study included 300 normal Egyptian volunteers divided into three groups according to their ages: group I = children (n = 92; age 3 years, 3 months to 9 years), group II = teenagers (n = 76; age 9–18 years) and group III = adults (n = 132; age above 18 years). The Nasometer II 6400 was used for the analysis of speech samples. All subjects were asked to perform four speech tasks that were based on the MacKay-Kummer SNAP Test-R and modified to be applicable to the Arabic language, especially to the Egyptian dialect. Results: The normative values for nasometric assessment in the different age groups were studied. The results demonstrated nasalance score variations according to age and gender. Most of the nasalance score norms of the Egyptian children demonstrated statistically significant differences when compared with the norms of children for the MacKay-Kummer Test-R. Conclusion: The Egyptian Arabic SNAP test is an easy, noninvasive and objective procedure that is suitable for all age groups.
Background The following position statement from the Union of the European Phoniatricians, updated on 25th May 2020 (superseding the previous statement issued on 21st April 2020), contains a series of recommendations for phoniatricians and ENT surgeons who provide and/or run voice, swallowing, speech and language, or paediatric audiology services. Objectives This material specifically aims to inform clinical practices in countries where clinics and operating theatres are reopening for elective work. It endeavours to present a current European view in relation to common procedures, many of which fall under the aegis of aerosol generating procedures. Conclusion As evidence continues to build, some of the recommended practices will undoubtedly evolve, but it is hoped that the updated position statement will offer clinicians precepts on safe clinical practice.
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