Parents and Siblings of Children With Autism Spectrum Disorder

The presence of a child with autism spectrum disorder (ASD) has impact on members of the family. This study explored social, behavioral, and emotional characteristics and perceptions of parents and typically developing (TD) siblings of children with ASD, sibling relationship, and family satisfaction of parents. Of 21 families who participated in study, mother, father, and one TD sibling of school age provided demographic information and completed a series of questionnaires. The majority of parents and TD children showed positive adjustment, moderate level of family satisfaction, and satisfying sibling relationships. Various difficulties were recorded by a small percentage of participants, including high and clinically significant parenting stress, mothers with severe degree of negative emotional status, and a few TD children with externalizing and internalizing problems. The study provided preliminary overview of Greek families of children with ASD, which indicates that the majority cope well with the situation, but some family members could benefit from identification of related problems and professional intervention.

Evaluation of Risk Factors and Approach to Screening for Asymptomatic Neonatal Hypoglycemia

<b><i>Introduction:</i></b> Protocols to identify asymptomatic neonatal hypoglycemia (NH) rely on the presence of established risk factors (late preterm gestation, large or small for gestational age, and infant of a diabetic mother) for inclusion. We analyzed the performance of these risk factors in identifying hypoglycemia in modern practice, and additionally evaluated the optimal duration of screening blood glucose measurements. <b><i>Methods:</i></b> We analyzed a retrospective cohort of 830 infants with 1 or more known risk factor(s) for NH admitted to the mother-baby unit of a single tertiary-care center from May 2017 to April 2018. Manual chart review was performed for data extraction and confirmation of risk factor(s). Infants were excluded if glucose measurements were obtained for any reason other than screening for asymptomatic NH. <b><i>Results:</i></b> Of the 830 included infants, 31 (3.7%) ultimately received intravenous dextrose (IVD). Most screened infants (<i>n</i> = 510, 61.4%) did not develop hypoglycemia. None of the established risk factors showed strong association with hypoglycemia. Cesarean delivery was associated with hypoglycemia, although not strongly. All infants who received IVD for feeding-refractory hypoglycemia were identified by the first 2 measurements with nearly all (30/31, 97%) identified at the initial measurement. <b><i>Conclusions:</i></b> Currently accepted risk factors are limited in their ability to identify infants who subsequently develop hypoglycemia, and as a result, most screened infants do not develop hypoglycemia. The majority of infants in our cohort who did develop hypoglycemia achieved normoglycemia with feeding-based interventions and did not require IVD. Those that received IVD were more likely to develop hypoglycemia early and to a more severe degree. Together, our data suggest further refinement of protocol duration and risk factors utilized for screening as potential areas of screening protocol optimization.

Neutrophil-Lymphocyte Ratio and Procalcitonin as Predictors of the Severity of Acute Pancreatitis

The Neutrophil-Lymphocyte Ratio (NLR) and procalcitonin are used to indicate systemic inflammation in variousmedical disorders. Both parameters were determined in this study to predict the severity of acute pancreatitis. This studywas a cross-sectional study using a retrospective approach to patients diagnosed with acute pancreatitis by using medicalrecord data from patients at Dr. Wahidin Sudirohusoso Hospital, Makassar, from January 2014 to May 2019. This studycomprised 35 patients hospitalized with acute pancreatitis, with a similar proportion of males and females. This studydiscovered that the mean age in this study was 44.17±12.9 years. The most prevalent cause was Gallstones (77.1%), themost severe degree was mild (54.2%), and the highest outcome was survival (77.1%). The NLR (9.93±11.19, p=0.011)increased in proportion to severity. However, additional analysis based on classification of disease severity revealed thatonly mild-severe NLR was significant (p=0.005). Procalcitonin (8.13±11.25, p=0.001) increased along with the increaseddisease severity, and the subsequent analysis showed that the distribution of severity was similar. The NLR can predict theseverity of acute pancreatitis but is less effective than procalcitonin. This study required a more proportional subjectpopulation and consideration of other factors.

Ultrasonic diagnostics of vascular complications after laser procedures

A clinical case of treatment of rosacea with a high-intensity laser at different stages, performed under control of high-resolution ultrasound (HRU), is presented. According to clinical guidelines, patients in the erythematous stage of rosacea (stage I) undergo selective coagulation of superficial vessels with a neodymium laser. Diagnosis and determination of the severity of the disease are carried out based on the presence of primary and secondary elements of the rash. There are no criteria for ultrasound assessment of the skin and its vascularization in patients with rosacea. During ultrasound examination after 4 laser procedures in B-mode, the dermis is heterogeneous due to hypoechoic papillary and hyperechoic reticular layers, without signs of infiltrative changes, in the color Doppler mapping mode there is a pronounced vascularization of the papillary dermis in the area of interest, represented by multiple vessels in contrast to single vascular structures seen on ultrasound after two laser treatments. According to the results of ultrasound examination, a more severe degree of the disease was diagnosed, which served as the basis for prescribing therapy with systemic retinoids. Clinical observation demonstrates the capabilities of ultrasound in planning laser procedures in order to reduce the risk of complications, their early diagnosis and monitoring of treatment if they occur.

Upright epiglottis prevents aspiration in patients with nasopharyngeal carcinoma post-chemoradiation

NPC is the most widely found malignant tumor in the head and neck region in Indonesia. Chemoradiation therapy for NPC can induce swallowing disorders (dysphagia) that adversely affects a patients quality of life. This study aimed to assess the swallowing process by flexible endoscopic evaluation of swallowing in patients with nasopharyngeal carcinoma after chemoradiation. Thirty-nine patients with NPC who had chemoradiation therapy more than one month previously underwent flexible endoscopic evaluation of swallowing and were assessed for oral transport time, sensation, standing-secretion, pre-swallowing leakage, residue, penetration, aspiration, and silent aspiration. The most common structural abnormalities were an upright and swollen epiglottis (89.4%), poor oral hygiene, and velopharyngeal closure defects (56.4%). This examination also revealed a mild degree of standing secretion (38.5%) and aspiration (10.3%). No penetration was observed in 64.1% of the patients, and no silent aspiration was observed in any of the patients. A severe degree of residue (45.7%) was observed when administering oatmeal, while the residue was mild to moderate when administering gastric rice, crackers, and milk. The residue changed to a mild degree (32.3%–51.4%) in all food administrations after the watering maneuver. The highest penetration was noted after oatmeal administration (42.8%), and the highest aspiration was found after milk administration (8.6%). Standing secretion in almost all patients was caused by hyposensitivity of the hypopharynx. Persistent residue and hyposensitivity of the hypopharynx led to aspiration. The low percentage of aspiration and silent aspiration might have been caused by the upright and swollen epiglottis that prevented aspiration. Poor oral hygiene and a dry mouth led to prolonged oral transport. Therefore, most patients had hypopharyngeal abnormalities in the form of a swollen and upright epiglottis. Secretion and food residue were also detected. Drinking helps to expedite the swallowing process by facilitating oral phase transport and reducing residues.

Necessary diagnostic criteria of dental crowding in children during mixed dentition with different facial skeleton growth patterns

Annotation. Pathology of dental crowding during mixed dentition is one of the most common and difficult in the practice of dentist-orthodontist. Its prevalence, according to modern scientific data reaches 77% and occurs in all pathologies of occlusion (malocclusions). The aim of our study is to establish the relationship between the formation of dental crowding and the growth patterns of facial skeleton during mixed dentition in order to improve the effectiveness of orthodontic treatment. We used 42 pairs of plaster models and 42 slices of cone-beam computed tomography images (CBCT) for patients aged 7 to 11 years. Randomization of patients into study groups was performed according to the facial skeleton growth patterns and the Little index value. The analysis was performed by the method of variation statistics taking into account the mean values (mode, median, arithmetic mean) and mean error (M) with the assessment of reliable values by Student’s t-test, as well as determining the correlation coefficient using the Pearson pairwise method to detect connections between the obtained indicators at the minimum probability threshold p<0.05 using the statistical package EZR v. 1.35. According to the results of the examined patients: 30 people (71.4%) had a severe degree of dental crowding on both maxilla and mandible (LII> 8 mm.), more often it was associated with the neutral type of growth – 82% (with vertical – 60%). Statistically significant correlations were found between severe degree of dental crowding and vertical and neutral facial skeleton growth patterns (p<0.05). The results of the CBCT study showed that narrowing of the upper pharyngeal airway (UP) according to McNamara was more common in patients with neutral (85%) and vertical (80%) growth patterns with skeletal II and I class malocclusions according to Engle, which were 55% and 35%, respectively. The study revealed that the vast majority of children with dental crowding with different facial skeleton growth patterns had clinically significant disorders of the development of both maxillary and mandibular apical bases and airways which required immediate interceptive orthodontic treatment.

Possibility of using recombinant monoclonal antibodies in the treatment of the coronavirus infection

Monoclonal antibodies are successfully used to treat a number of viral diseases; they are produced by the plasma cells of the human immune system and are the result of a natural humoral response to the ingress of a certain antigen. Antibodies designed to target only one specific protein — in this case, the protein of the virus that causes COVID-19 — are called «monoclonal». Their purpose is to block the COVID-19 virus and prevent its penetration and replication in human cells, and their ultimate focus is on combating infectious manifestations. They are believed to cause fewer undesirable effects than convalescent plasma, which is essentially a complex of polyclonal antibodies and circulating immune complexes. Monoclonal antibodies can be synthesized in the laboratory using the blood serum of patients who have undergone this disease as a starting material. The use of monoclonal antibodies is indicated for patients with a mild and moderate form of the disease at a high risk of progression of the pathological process to a severe degree, which implies the need for hospitalization and a high probability of a fatal outcome.

Dilated Cardiomyopathy in Children and Adolescents in the South Region of Kyrgyzstan

Research relevance: in recent decades, there has been a significant increase in interest in cardiomyopathies, mainly of the heart muscle, often characterized by an unclear etiology, chronic progressive course and, ultimately, cardiomegaly, progressive heart failure, arrhythmic, thromboembolic syndromes, often ending in sudden cardiac death. Materials and research methods: presentation of results after statistical studies on the clinic, diagnostics of a violation of the conducting system by cardiomyopathy in children aged 1 to 16 years, who underwent inpatient treatment in the cardioreumatology department of the Osh medical children’s clinical hospital from 2016 to 2020, according to clinical material on 67 children with dilated cardiomyopathy. Research objectives: analysis of data on 67 children from 0 to 16 years old who received inpatient treatment for heart disease at the Osh interregional children's clinical hospital from 2016 to 2020. Research results: analysis of the EchoCG data of the study showed that the nature of changes in intracardiac hemodynamics depends on the age of the child: the most pronounced shifts in EchoCG indicators, as a rule, are inherent in young children with inflammatory changes in the myocardium and dilated cardiomyopathy, less pronounced for children of other age groups. Conclusions: indicators reflect severe degree of heart damage in children of this age and indicate, most likely, a weak level of heart compensatory-adaptive mechanisms.

Bmal1- and Per2-mediated Regulation of the Osteogenic Differentiation and Proliferation of Mouse BMSCs by Modulating the Wnt/β-catenin Pathway

Bmal1 and Per2 are the core components of the circadian clock genes(CCGs). Bmal1−/− mice exhibited premature aging characterized by osteoporosis and reduced proliferation ability. The same thing occurred in Per2−/− mice, albeit to a less severe degree. However, whether the effects of Bmal1 and Per2 on proliferation and osteogenic differentiation are synergistic or antagonistic remains unclear. To figure this out, we constructed lentiviral and adenoviral vectors to silence or overexpress Bmal1 or Per2 in bone marrow mesenchymal stem cells (BMSCs), and applied MTT, flow cytometry, RT-qPCR, WB, and ChIP-Seq analyses to identify the underlying mechanism. The results showed Bmal1 and Per2 had synergistic effects on the proliferation and differentiation of BMSCs. Furthermore, Bmal1 and Per2 inhibited the Wnt/β-catenin signaling pathway, accompanied by downregulating Rorα expression and upregulating Rev-erbα expression, both of which were also key elements of CCGs. This may be the mechanism by which Bmal1 and Per2 negatively regulate the osteogenic differentiation of BMSCs.

Treatment of Developmental Reading Disorders: A Visual Attention Span Deficit Approach

<p>A current theory of the cognitive underpinnings of developmental reading disorders supposes that two impairments contribute to the overall profile of disordered reading: one of phonological awareness and one of visual attention span. The severity of each impairment is different for each child. By identifying children that display a severe degree of one impairment, but a limited degree of the other, each impairment can be investigated. The current study identified one participant with a stronger phonological impairment, and one with a stronger impairment of visual attention span. They completed two training programs: one program tailored to improve phonology, and one tailored to improve visual span. Both treatments improved reading performance in both participants. It was expected that the treatment targeting each participant‟s particular cognitive impairment would prove more effective for that participant. However, both treatments were found to show similar levels of improvement with both participants.</p>