Speech delay: some possible factors (a research on 3-6 years old children)

This qualitative research was to describe the language development of children who indicated speech delay and to find out what factors make these children delay in speech. The data were got from a depth-observation of three children indicating speech delay; 4 and 6 years old children of the first writer’s, and a 3 year- old-child of the writer’s friend’s. The observation was done since the children were indicating speech delay until November 2019. Besides, an open-ended interview was also administered with the mother of the youngest subject. The data were analyzed by using the normal pattern of children’s speech development by Blum and Baron (1997) and main possible factors of speech delay as presented by Shetty (2012). This research found that the subjects experienced speech delay at the ages of 1 year. However, the development of speaking started to increase at the age of 3. Some factors that caused the condition to the subjects were maturation delay, developmental expressive aphasia, bilingualism, and social deprivation.

P1360ARTERIOVENOUS FISTULA MATURATION DELAY - ENDOVASCULAR TREATMENT IS A VALID APPROACH

Background and Aims Arteriovenous fistula is the optimal vascular access for hemodialysis as it has the best long-term patency rate and the lowest complication rate among hemodialysis vascular accesses. However, its occasional delayed maturation poses a challenge. Surgery has been advocated as the best treatment option. We proposed to evaluate the results of endovascular approach of arteriovenous fistula’s maturation delay in our hospital. Method We conducted a retrospective study, selecting patients referenced to our diagnostic and therapeutic angiography unit due to arteriovenous fistula delayed maturation, between April 2017 and October 2019. Physical examination and echography were used to confirm arteriovenous fistula delayed maturation. Results Thirty patients were referenced. Nine were excluded as maturation delay was not confirmed. Three patients were excluded due to extensive outflow stenosis since they were proposed to new vascular access creation. The other 18 patients were subjected to percutaneous endovascular treatment. Mean patient’s age was 65 years old. Twelve patients (66,7%) had forearm fistulas and the remaining (33,3%) had arm fistulas. Fourteen patients (77,7%) had maturation delay due to peri-anastomotic stenosis. The mean follow-up time was 14 months, (minimum - 3 months; maximum - 33 months). Seventeen fistulas (94,4%) were salvaged, although 3 (16,7%) needed a second intervention. Primary and secondary patencies at 3, 6 and 12 months were 77,8% vs. 94,4%, 69,2% vs. 92,3% and 75% vs. 100%, respectively. Arm fistulas had 83,3% of primary and secondary patencies. Forearm fistula’s primary and secondary patencies were 66,7% vs. 91,6%, 57,1% vs. 100% and 60% vs. 100%, at 3, 6 and 12 months, respectively. When maturation failure was due to peri-anastomotic stenosis, primary and secondary patencies were 71,4% vs. 92,9%, 66,7% vs. 100% and 66,7% vs. 100% at 3, 6 and 12 months, respectively. Conclusion Even though we are still lacking consensus about the best treatment option for fistula’s maturation delay, current guidelines suggest that, at least in delayed maturation due to peri-anastomotic stenosis, surgery may be the best treatment. Our results point out that endovascular treatment is a good treatment option for arteriovenous fistulas with maturation delay, mainly in the arm fistulas. Even though surgical treatment appears to have better primary patency, a step by step approach seems to be a valid approach, as our secondary patency shows.

An improved fluorescent protein-based expression reporter system that utilizes bioluminescence resonance energy transfer and peptide-assisted complementation

A peptide-assisted complementation strategy with screened peptides has succeeded to eliminate maturation delay of a bioluminescence resonant energy transfer reporter for gene expression monitoring.