Newborn Hearing Screening and Intervention in Children with Unilateral Hearing Impairment: Clinical Practices in Three Nordic Countries

Studies have limitedly considered children with early-identified unilateral hearing impairment (UHI), and clinical practices regarding screening, diagnostics and habilitation in this group are rarely documented. In this study, routines for newborns with UHI from screening to diagnostics and habilitation were explored in Norway, Sweden and Finland. An online survey was sent to hospitals responsible for the hearing diagnostics of children requesting information about their practices regarding congenital UHI. Responses covered 95% of the children born in the three included countries. The results revealed large variations in ways of organising healthcare and in clinical decisions regarding hearing screening, diagnostics and habilitation of children with congenital UHI. Finally, implications for policy making and research are also discussed.

Methodology for screening assessment of the presence of hospitalism in patients of gerontopsychiatric hospital

Summary. The aim of the study was to identify nosologically nonspecific signs of hospitalism in patients of a gerontopsychiatric hospital and to develop, on their basis, a method for screening diagnostics of hospitalism.Materials and methods. We examined 194 inpatients aged 55 to 91 years, hospitalism was detected in 102 people, 92 people made up the comparison group. The survey was carried out at the stage of preparation for discharge in the form of a semi-structured interview, supplemented by the collection of anamnestic and follow-up data.Results. The most common signs of hospitalism in this sample were the deterioration of the mental and somatic state before discharge (78% of the examined patients of the main group, a confidence interval (CI) of 68–85%), a long duration of the current hospitalization (73%, CI 64–82%), violations of compliance (73%, CI 63-81%), long duration of inpatient treatment in anamnesis (71%, CI 61-80%), deterioration soon after discharge (67%, CI 52-80%), a large number of hospitalizations during the entire period of illness (67%, CI 57-76%), lack of discharge intention (62%, CI 51-72%), tendency to increase the duration of hospitalizations (54%, CI 43-64%), high level of anxiety before discharge (50% , CI 34-66%), reduction in the intervals between hospitalizations (49%, CI 38-59%), p <0.05.Conclusion. The proposed methodology is intended for screening assessment of the presence of hospitalism and identification of the circle of persons for whom an in-depth assessment of social and psychological adaptation is advisable in order to prevent the adverse effects of hospitalization.

Synchronization Of Autonomic Control Loops Of Blood Circulation In Patients With COVID-19

This study aims to investigate the strength of synchronization between the autonomic control loops of the cardiovascular system (CVS) in patients with COronaVIrus Disease 2019 (COVID-19). Methods — We calculated the total percent of phase synchronization index (S index) between the loops of autonomic control of heart rate and vascular tone in two sample groups: healthy individuals and COVID-19 patients. Results — The group-average value of the S index in COVID-19 patients is lower comparing to healthy individuals, the Mann-Whitney U-test confirmed that the differences are statistically significant. Conclusion — Obtained results suggest that the decreased value of the S index reflects the presence of a viral disease, and the S index is a promising basis for non-invasive screening diagnostics of viral diseases, particularly of COVID-19.

SOCIAL AND ECONOMIC ASPECTS OF THE INCREASING INCIDENCE OF DIABETES IN VARNA AND BULGARIA

Objective: The impact of socio-economic factors on the increased incidence of chronic diseases requires changes in the policy of health authorities. In view of that, the study tried to investigate the role and consequences of those factors on T2DM and thus contribute to future development of comprehensive programmes for screening, diagnostics and treatment. Methods and materials: Forecasting the incidence rates of diabetes on a national and regional scale using regression analysis of results from municipal programs between 2015 and 2019 in Varna. The following models were studied: linear, cubic, quadratic, exponential, logarithmic, power, growth and inversion. Data processing and analysis were performed with the software set SPSS Statistics and graphical analysis with Microsoft Excel. Results: A constant rise in the number of diabetes cases was identified. At national level, mortality among females was higher than mortality in males, while at local level (Varna), such correlation was not established. Costs for the studied groups steadily increased during the studied period. Healthcare services for people with diabetes mellitus cost 2.5 times more than that of people without diabetes of the same age group.

ASSESSMENT OF LOW-INTENSITY FACTORS IN OIL REFINING

Potential priority air pollutants in the working area have been identified to assess the effect of low-intensity production factors during oil refining. Modern methods of early screening diagnostics were used. The general morbidity and morbidity with temporary disability were analyzed. The studies carried out became the evidence base on the presence of reliable specific changes in the body of workers under the influence of factors of low intensity during oil refining. A «List of a complex of chemicals affecting the health of workers employed in the main professions of chemical industries and not exceeding the MPC» has been developed, which is included in the documents regulating the certification of workplaces. An algorithm has been developed to identify causal relationships and substantiate the causation of certain forms of diseases and an algorithm for the prevention of non-infectious pathology with the identification of personalized risks during mandatory preliminary and periodic medical examinations.

Consensus guidelines of congenital hypothyroidism by the European Society for pediatric endocrinology and the European Society for Endocrinology: key points and comments

Congenital hypothyroidism is an actual clinical problem in pediatric practice. Previous clinical guidelines were published in 2014. The presented clinical recommendations are based on articles published from January 2013 to early 2020. The consensus guidelines include such sections as results of neonatal screening, diagnostics and criteria for treatment, lifelong follow-up, genetics of congenital hypothyroidism, family genetic counselling. The key points of new congenital hypothyroidism guidelines were commented by pediatric endocrinologists of Russians.

Screening methods for autism spectrum disorders in the study of neuropsychological development of preschool children

Aim. To assess the effectiveness of screening methods for diagnosing autism spectrum disorders available to the pediatric service; to prove in practice impossibilities to identify signs of autism spectrum disorders by using the existed pediatric methods. Methods. The neuropsychological development of 187 preschool children (56 years old) was investigated. The neurological status, anxiety according to A.M. Parishioners, level of intelligence using Raven's Progressive Matrices, the presence of hyperactivity according to the method of V.R. Kuchma, mental performance according to V.Ya. Anfimov, screening diagnostics of autism spectrum disorders were studied. Results. Assessment of the neurological status showed an increase in tendon reflexes in 10.22.2% of children, a decrease in 12.32.4%. The study of the intelligence levels in the Ravenna test showed that the average intelligence level was in 47.13.7% of the studied children, the intelligence was below the average in 52.93.7% of children. Screening diagnostics of autism spectrum disorders did not reveal abnormalities, however, 5.31.6% of children had signs of predisposition to the autism spectrum disorder (decreased adaptation to changes, nervousness and fears, verbal and non-verbal communication, level of activity and consistency of intellectual response). The indicator of the productivity of mental performance of preschool children was 5.40.5. Attention deficit was detected in 5.91.7% of children (according to the parent's questionnaire) and 8.62.0% children (according to the teachers' questionnaire). The level of anxiety was 9.60.3 points. Conclusion. The currently known screening methods for detecting autism spectrum disorders, available to the pediatric service, in our opinion, are uninformative; the search for the most sensitive markers of autism should be based on an understanding of the epigenetic mechanisms of autism spectrum disorders.

Technical Innovations in Pneumology: E-Health, Screening, Diagnostics, and Therapy

At the 2020 “Luftschlösser” (castles in the air) conference, experts from a wide range of pneumological fields discussed technical innovations in pneumology, which can be seen in many different areas of the field, including e-health, screening, diagnostics, and therapy. They contribute to substantial advancements ranging from the innovative use of diagnostic tools to novel treatments for chronic lung diseases. Artificial intelligence enables broader screening, which can be expected to have beneficial effects on disease progression and overall prognosis. There is still a high demand for clinical trials to investigate the usefulness and risk-benefit ratio. Open questions remain especially about the quality and utility of medical apps in an inadequately regulated market. This article weighs the pros and cons of technical innovations in specific subspecialties of pneumology based on the lively exchange of ideas among various pneumological experts.

Thermosemiotics of the hands. Report 2. Thermal patterns of the hands in patients with upper limbs vascular disorders, Raynaud’s phenomenon, after thoracic sympathectomy, in ischemic heart disease and a number of other diseases

This review is devoted to the thermogaphic hands examination in patients with upper limbs vascular disorders (both arterial and venous), Raynaud’s phenomenon, ischemic heart disease and after surgical interventions on the vessels of the upper extremities, thoracic sympathectomy, as well as a number of more rare diseases and clinical situations. Studies of temperature distributions on the hands of such patients are promising in terms of creating, on their basis, decision support systems in screening, diagnostics and treatment monitoring.