Concomitant paracentral acute middle maculopathy and acute macular neuroretinopathy in eyes post-blunt trauma

Purpose: To analyze the imaging characteristics and the clinical course of patients showing concomitant paracentral acute middle maculopathy (PAMM) and acute macular neuroretinopathy (AMN) post?blunt trauma. Methods: PAMM and AMN lesions post?blunt trauma diagnosed on enhanced depth imaging optical coherence tomography (EDI?OCT) were recruited for the study. Results: Thirteen eyes of 13 individuals with a history of blunt trauma were included in the study, of whom 11 (85%) were males. Mean age of the patients was 33.62 (range 16–67) years. Mean visual acuity at presentation and the last visit was 1.67 log of minimum angle of resolution (logMAR) and 0.82 logMAR, respectively. Mean interval between trauma and imaging was 5.08 (range 1–15) days. All patients had unilateral involvement, with the right eye being involved in 10 patients (77%). All patients had concomitant PAMM and AMN lesions. Conclusion: Presence of coincident PAMM and AMN suggests a common pathophysiologic etiology, but the description of concomitant PAMM and AMN in the setting of blunt trauma to eye is hitherto unreported. Identifying AMN in a setting of PAMM requires meticulous examination of the OCT and OCTA images. It can be a cause of suboptimal visual recovery in such eyes.

9. Equity, Diversity, and Inclusion Initiatives Regarding Sexual Orientation and Gender Identity at Canada's McGill University / 医学教育

This paper introduces the initiatives taken by McGill University, one of Canada's leading universities, towards equity, diversity, and inclusion (EDI) to ensure a safe space for students of all sexual orientations and gender identities (SOGI).

Changes of choroidal structure in children with hyperopic amblyopia observed by EDI-OCT technique / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the differences in choroidal structure between hyperopic amblyopia and normal children of the same age by the enhanced depth imaging optical coherence tomography(EDI-OCT)technique.METHODS: There were 35 cases in 50 eyes of children with hyperopic amblyopia visiting our hospital in January 2021 to December 2021 selected in the amblyopic group, and 30 cases in 51 eyes of healthy children who matched general data in the same period were selected in the control group. EDI-OCT examination was performed to measure the choroidal thickness(CT). After image processing, the total choroidal area(TCA), luminal area(LA), stromal area(SA)and choroidal vascularity index(CVI)were obtained.RESULTS: TCA(except inferior quadrant), SA(except inferior quadrant of the outer ring), LA and CT(except inferior and temporal quadrant )in the amblyopic group of each area were significantly larger than that in the control group(P<0.05), and there was no significant difference in CVI between the two groups except the temporal quadrant of the outer ring(P>0.05). There was no significant difference in CT for all degrees of hyperopic amblyopia, with the exception of the nasal quadrant(P>0.05).CONCLUSION: Hyperopic amblyopia is accompanied with abnormal choroidal structure. As the degree of hyperopia increases, TCA, LA and SA exhibit increasing trends. The changes in choroidal structure are presumed to be related to hyperopic amblyopia.

Elemental Study of Common Iced Fish Species Sold in Akure, Ondo State, Nigeria

There is a death of information on the mineral composition of essential, toxic elements of commonly consumed frozen fishes in Nigeria, hence, this study was conducted to determine the proximate, elemental composition and also estimate the daily intake of the minerals obtained in the frozen samples of Hake (Merluccius merluccius), Sardine (Sardinella eba), Chub Mackerel (Scomber jopanicus), Atlantic horse Mackerel (Trachurus trachurus) and, Croaker (Pseudolithus elongatus) obtained from four markets in Akure, Ondo State, Nigeria. The fish species examined contained appreciable concentrations of protein which ranged from 15.19% in Chub mackerel to 21.75 % in Atlantic horse mackerel. The ash and moisture content suggest that the fish species are a good source of minerals and a veritable medium for microbial proliferation respectively, while, the crude fat value ranging between 0.16 % in Atlantic horse mackerel to 0.27 % in Hake showed that they are lean fat fishes. The Estimated Dietary Intake (EDI) of the macro and microelements analysed in the fish species (except for phosphorus) fell short of the Dietary Reference Intake (DRI) that were established by the Institute of Medicine. However, the concentrations of toxic elements such as lead, arsenic and cadmium exceeded the maximum limits set for these elements in foods, and this consequently poses a long term risk as a result of the bioaccumulation and biomagnifications of these toxic elements in the body.

Characteristics of fundus structure in high myopia amblyopia and high myopia with the same refractive range / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the retinal thickness, choroidal thickness and optic disc nerve fiber layers thickness in high myopia amblyopia eyes and high myopia eyes with the similar diopter by using enhanced depth imaging optical coherence tomography(EDI-OCT).<p>METHODS:Nineteen Chinese children, 26 eyes were recruited. Those patients were divided into high myopia amblyopia group(11 eyes)and high myopia group(15 eyes). The thickness in the retina and choroid in different regions, as well as the thickness of optic disc nerve fiber layer were measured by EDI-OCT.<p>RESULTS: The retinal thickness at the 1.0mm, 1.5mm, 2.0mm, 2.5mm, 3.0mm to the fovea, in most directions, retinal thicknesses were statistically different between the two groups(<i>P</i><0.05). At the 3.0mm inferior to the fovea, the choroidal thickness in high myopia amblyopia was significantly thinner than high myopia(<i>P</i>=0.012). In the optic disc nerve fiber layer, there was no statistical difference between high myopia amblyopia and high myopia(<i>P</i>>0.05).<p>CONCLUSION: In the same diopter range, the retinal thickness around the fovea in the high myopia amblyopia was significantly thinner than high myopia, and the occurrence and development of amblyopia may be involved in its change process.

Application of Triamcinolone acetonide in cataract surgery with NPDR / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the changes of retina and choroid in macular region using EDI SD-OCT before and after phacoemulsification, and study the intervention and prevention effect of triamcinolone acetonide(TA)on macular edema.<p>METHODS: In a prospective randomized clinical trial, selected the cataract patients with NPDR in our hospital. They were randomly divided into two groups. The experimental group(group 1)received Tenon's injection of TA 40mg during phacoemulsification, while the control group(group 2)only received phacoemulsification. The changes of best corrected visual acuity(BCVA), intraocular pressure(IOP), central macular retinal thickness(CMT), subfoveal choroidal thickness(SFCT)before and after surgery were observed.<p>RESULTS: There were significant differences in BCVA between the two groups before and after operation(<i>P</i><0.05); at 1wk after operation, the SFCT of the control group was thicker than that of the experimental group(<i>t</i>=2.165, <i>P</i><0.05); at 2wk after operation, there were significant differences between the CMT and SFCT groups(<i>P</i><0.05). There were significant differences in BCVA and CMT between the two groups(<i>P</i><0.05), and no significant difference in IOP(<i>P</i>>0.05).The incidence of diabetic macular edema(DME)after surgery was 0 in group 1 and 11% in group 2.<p>CONCLUSION: Posterior subfascial injection of TA in NPDR patients during phacoemulsification may have a positive preventive effect on the occurrence of DME.

Analysis of different choroidal stratification thickness under macular fovea in patients with early graves ophthalmopathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To compare the difference of choroidal delamination thickness in macular fovea between patients with early active Graves ophthalmopathy and healthy subjects by optical coherence tomography(OCT)enhanced deep imaging.<p>METHODS:From December 2017 to May 2019, patients with early active Graves ophthalmopathy diagnosed in our hospital(GO group)and 31 patients(62 eyes)with age and sex matched healthy physical examination(control group)were selected. Diopter, best-corrected visual acuity(BCVA), intraocular pressure, exophthalmos, EDI-OCT and other examinations were performed on all the subjects. The differences of macular central concave choroidal thickness(SFCT), choroidal macrovascular layer thickness(LCVT)and choroidal capillary layer/middle vascular layer thickness(MCVT)between the two groups were compared.<p>RESULTS: There was no significant difference in equivalent spherical lens power, BCVA and eye axis between the two groups. However, the IOP(17.22±2.67mmHg), exophthalmos(15.44±0.92mm), SFCT(315.79±14.99μm), LCVT(234.66±14.90μm)in GO group were significantly higher than those in control group(13.35±1.54mmHg, 12.90±1.00mm, 239.00±12.67μm, 159.16±13.30μm)(all <i>P</i>Symbol|@@0.05), but there was no significant difference in MCVT between the two groups(81.13±7.46μm <i>vs</i> 80.13±7.63μm, <i>P></i>0.05).<p>CONCLUSION: SFCT and LCVT in patients with early active Graves ophthalmopathy are thickened, and MCVT has no obvious change, suggesting that EDI-OCT measurement of SFCT and LCVT has certain reference value for evaluating early active Graves ophthalmopathy.

Efficacy of conbercept in the treatment of central serous choroidal retinopathy by EDI-OCT / 眼科新进展

Objective To observe the efficacy and safety of conbercept in the treatment of central serous chorioretinopathy (CSC) by EDI-OCT.Methods From July 2015 to July 2017,42 patients (44 eyes) of central serous choriodal retinopathy received intravitreal injection of conbercept (0.5 mg,0.05 mL).Then,the best corrected visual acuity was recorded before injection and 1 week,4 weeks and 12 weeks after treatment;meanwhile,EDI-OCT was used to measure subfoveal choroidal thickness at different time points.Results In CSC patients,the BCVA of 1 week,4 weeks and 12 weeks after treatment were 0.57 ±0.23,0.62 ±0.23 and 0.59 ±0.71,respectively,which were significantly higher than those before treatment [(0.43 ± 1.11)] (all P ＜ 0.05).The subfoveal choroidal thickness was (308.17 ± 16.52) μm,(286.54 ± 37.52) μm and (274.58±41.38)μm at 1 week,4 weeks and 12 weeks after treatment,respectively,which were significantly lower than those before treatment [(346.31 ± 59.43) μm] (all P ＜ 0.05).Conclusion It is safe and effective for conbercept injection in the treatment of CSC.

Asociación entre el tiempo de permanencia en el Programa de Estancias Infantiles para niños en situación de pobreza y el nivel de desarrollo infantil / Association between time of permanence at early education program (Estancias Infantiles) and developmental level for children in situation of poverty

Resumen: Introducción: El Programa de Estancias Infantiles (PEI) se enfoca en padres de niños de 1-3 años en situación de pobreza. Incluye educación y cuidado de los niños por 8 h, 5 días por semana. El objetivo del estudio fue evaluar la asociación entre el tiempo de permanencia en el PEI y el nivel de desarrollo infantil. Métodos: Estudio transversal de base poblacional en dos estados de México. Se incluyeron todos los niños de 12-48 meses inscritos al PEI de noviembre de 2014 a enero de 2015. Se evaluó el nivel de desarrollo con la prueba EDI. Se calculó la razón de momios de prevalencia (RMP) para desarrollo normal por tiempo de estancia, ajustado por sexo, edad y discapacidad, teniendo como referencia a los niños que tenían < 30 días en el PEI. Resultados: Se incluyeron 3387 niños de 177 estancias infantiles: 53% de sexo masculino; 22.3% de 12-24 meses, 37.6% de 25-36 meses y 40.1% de 37-42 meses de edad. El RMP ajustado para desarrollo normal fue de 1.90 (IC95%:1.30-2.78) para 6-11 meses, 2.36 (IC95%:1.60-3.50) para 12-17 meses, 2.78 (IC95%:1.65-4.65) para 18-23 meses y 3.46 (2.13-5.60) para > 24 meses. Por área de desarrollo, se observó una mayor probabilidad de desarrollo normal a partir de 6 meses de estancia para lenguaje y social, y a partir de 12 meses para motor grueso, fino y conocimiento. Conclusiones: El tiempo de permanencia en el PEI a partir de 6 meses incrementa, de forma significativa y progresiva, la probabilidad de tener un desarrollo normal independiente del sexo y edad.

Abstract: Background: Early education program (EEP) was created to support parents with 1 to 3 year olds living in poverty situation in Mexico, and includes education and child daycare for 8 h five days per week. The objective of this study was to evaluate the association between length of stay in EEP and the level of development in children. Methods: Cross sectional, population-based study conducted in two Mexican states. All children aged between 12 to 48 months enrolled in EEP from November 2014 to January 2015 were included. Child Development Evaluation (CDE) test was used to screen early development in every child. Normal early development prevalence odds ratio (OR) was calculated adjusted by gender, impairment and state, using as a reference those children with less than 30 days in the program. Results: The study included 3,387 children from 177 EEP nurseries, from which 53% were male; age by group was divided in 12-24 months (22.3%), 25-36 months (37.6%) and 37-42 months (40.1%). Normal development adjusted OR by age was 1.9 (CI95%: 1.30-2.78) for 6-11 months, 2.36 (CI95%: 1.60-3.50) for 12-17 months, 2.78 (CI95%: 1.65-4.65) for 18-23 months and 3.46 (CI95%: 2.13-5.60) for >24 months. By area of development, a greater probability of having a normal result for language and social areas was observed after 6 months in the program, and for motor (both gross and fine) and knowledge areas after 12 months. Conclusion: The length of the stay in the EEP after 6 months significantly and progressively increases the probability of normal development regardless of gender and age.

Impacto de un modelo de capacitación de la prueba Evaluación del Desarrollo Infantil en la atención primaria / Impact of a training model for the Child Development Evaluation Test in primary care

ResumenIntroducción: La prueba Evaluación del Desarrollo Infantil (EDI) es una herramienta de tamiz para la detección oportuna de problemas del desarrollo, diseñada y validada en México. Para que sus resultados sean confiables, se requiere que el personal que la aplique haya adquirido los conocimientos necesarios previamente, a través de un curso de capacitación en la unidad de salud que labore. El objetivo de este trabajo fue evaluar el impacto de un modelo de capacitación impartido al personal que trabaja en atención primaria en seis entidades federativas en México. Lo anterior mediante la comparación de los conocimientos adquiridos en la capacitación.Método: Se realizó un estudio de evaluación de antes y después, considerando como intervención el haber acudido a un curso de capacitación sobre la prueba EDI de octubre a diciembre de 2013.Resultados: Se incluyeron 394 participantes. Las profesiones fueron las siguientes: medicina general (73.4%), enfermería (7.7%), psicología (7.1%), nutrición (6.1%), otras profesiones (5.6%). En la evaluación inicial, el 64.9% obtuvo una calificación menor a 20. En la evaluación final, disminuyó al 1.8%. En la evaluación inicial aprobó el 1.8% comparado con el 75.1% en la evaluación final. Las preguntas con menor porcentaje de respuestas correctas fueron las relacionadas con la calificación de la prueba.Conclusiones: El modelo de capacitación resultó adecuado para adquisición de conocimientos generales sobre la prueba. Para mejorar el resultado global se requiere reforzar los temas de calificación e interpretación de los resultados en futuras capacitaciones, y que los participantes realicen una lectura previa del material de apoyo.

AbstractBackground: The Child Development Evaluation (CDE) Test is a screening tool designed and validated in Mexico for the early detection of child developmental problems. For professionals who will be administering the test in primary care facilities, previous acquisition of knowledge about the test is required in order to generate reliable results. The aim of this work was to evaluate the impact of a training model for primary care workers from different professions through the comparison of knowledge acquired during the training course.Methods: The study design was a before/after type considering the participation in a training course for the CDE test as the intervention. The course took place in six different Mexican states from October to December 2013. The same questions were used before and after.Results: There were 394 participants included. Distribution according to professional profile was as follows: general physicians 73.4%, nursing 7.7%, psychology 7.1%, nutrition 6.1% and other professions 5.6%. The questions with the lowest correct answer rates were associated with the scoring of the CDE test. In the initial evaluation, 64.9% obtained a grade lower than 20 compared with 1.8% in the final evaluation. In the initial evaluation only 1.8% passed compared with 75.15% in the final evaluation.Conclusions:The proposed model allows the participants to acquire general knowledge about the CDE Test. To improve the general results in future training courses, it is required to reinforce during training the scoring and interpretation of the test together with the previous lecture of the material by the participants.

Diseño de un modelo de supervisión para la aplicación de la prueba de Evaluación del Desarrollo Infantil en las unidades de atención primaria en México / Design of a supervision model for administration of the Child Development Evaluation Test at primary care facilities in Mexico

ResumenIntroducción:La prueba Evaluación del Desarrollo Infantil (EDI), diseñada y validada en México, se ha aplicado en las unidades de atención primaria del país. Los resultados han sido heterogéneos entre los estados en que se aplicaron las pruebas, a pesar de haber utilizado un modelo de capacitación estandarizado con la misma metodología para la aplicación. El objetivo de este trabajo fue evaluar un modelo de supervisión que permita identificar la calidad de la aplicación de la prueba EDI a nivel poblacional.Métodos: Se realizó un estudio en la atención primaria tres estados del país para evaluar la aplicación de la prueba EDI por observación directa (estudio de sombra), y verificar la concordancia del resultado a través aplicar la prueba una vez más (estudio de consistencia).Resultados: Se realizaron 380 estudios de sombra a 51 psicólogos. Al comparar el resultado global, se observó una concordancia del 86.1% con el supervisor (n = 327): el 94.5% por resultado verde, el 73.2% por amarillo y el 80.0% por rojo. Se aplicó la prueba nuevamente en 302 casos, con una concordancia del 88.1% (n = 266): el 96.8% por resultado verde, el 71.7% por amarillo y el 81.8% por rojo. No se encontraron diferencias significativas por grupo.Conclusiones: Tanto el estudio de sombra como el de consistencia fueron adecuados para evaluar la calidad de la aplicación de la prueba, y pueden ser de utilidad para supervisar la aplicación de la prueba EDI en atención primaria. La decisión de uno u otro sistema depende de la disponibilidad de supervisores.

AbstractBackground:The Child Development Evaluation (CDE) test designed and validated in Mexico has been used as a screening tool for developmental problems in primary care facilities across Mexico. Heterogeneous results were found among those states where these were applied, despite using the same standardized training model for application. The objective was to evaluate a supervision model for quality of application of the CDE test at primary care facilities.Methods:A study was carried out in primary care facilities from three Mexican states to evaluate concordance of the results between supervisor and primary care personnel who administered the test using two different methods: direct observation (shadow study) or reapplication of the CDE test (consistency study).Results: There were 380 shadow studies applied to 51 psychologists. General concordance of the shadow study was 86.1% according to the supervisor: green 94.5%, yellow 73.2% and red 80.0%. There were 302 re-test evaluations with a concordance of 88.1% (n = 266): green 96.8%, yellow 71.7% and red 81.8%. There were no differences between CDE test subgroups by age.Conclusions: Both shadow and re-test study were adequate for the evaluation of the quality of the administration of the CDE Test and may be useful as a model of supervision in primary care facilities. The decision of which test to use relies on the availability of supervisors.

Evaluación diagnóstica del nivel de desarrollo en niños identificados con riesgo de retraso mediante la prueba de Evaluación del Desarrollo Infantil / Diagnostic evaluation of the developmental level in children identified at risk of delay through the Child Development Evaluation Test

ResumenIntroducción: La prueba Evaluación del Desarrollo Infantil (EDI), diseñada en México, clasifica a los niños de acuerdo con su desarrollo en desarrollo normal, rezago en el desarrollo y riesgo de retraso. La versión modificada se desarrolló y validó, pero no se conocen sus propiedades en base poblacional. El objetivo de este trabajo fue establecer la confirmación diagnóstica en niños de 16 a 59 meses identificados con riesgo de retraso por la prueba EDI.Métodos: Se realizó un estudio transversal de base poblacional en una entidad federativa de México. Se aplicó la prueba EDI a 11,455 niños de 16 a 59 meses, de diciembre de 2013 a marzo de 2014. Se consideró como población elegible al 6.2% (n = 714) que obtuvo como resultado riesgo de retraso. Para la inclusión en el estudio se realizó una aleatorización estratificada por bloques para sexo y grupo de edad. A cada participante se le realizó la evaluación diagnóstica utilizando el Inventario de Desarrollo de Battelle 2ª. edición.Resultados: De los 355 participantes incluidos, el 65.9% fue de sexo masculino y el 80.2% de medio rural. El 6.5% fueron falsos positivos (cociente total de desarrollo ¿ 90) y el 6.8% no tuvo ningún dominio con retraso (cociente de desarrollo de dominio < 80). Se calculó la proporción de retraso en las siguientes áreas: comunicación (82.5%), cognitivo (80.8%), personal-social (33.8%), motor (55.5%) y adaptativo (41.7%). Se observaron diferencias en los porcentajes de retraso por edad y dominio/subdominio evaluado.Conclusiones: Se corroboró la presencia de retraso en al menos un dominio evaluado por la prueba diagnóstica en el 93.2% de la población estudiada.

AbstractBackground: The Child Development Evaluation (or CDE Test) was developed in Mexico as a screening tool for child developmental problems. It yields three possible results: normal, slow development or risk of delay. The modified version was elaborated using the information obtained during the validation study but its properties according to the base population are not known. The objective of this work was to establish diagnostic confirmation of developmental delay in children 16- to 59-months of age previously identified as having risk of delay through the CDE Test in primary care facilities.Methods:A population-based cross-sectional study was conducted in one Mexican state. CDE test was administered to 11,455 children 16- to 59-months of age from December/2013 to March/2014. The eligible population represented the 6.2% of the children (n = 714) who were identified at risk of delay through the CDE Test. For inclusion in the study, a block randomization stratified by sex and age group was performed. Each participant included in the study had a diagnostic evaluation using the Battelle Development Inventory, 2nd edition.Results: From the 355 participants included with risk of delay, 65.9% were male and 80.2% were from rural areas; 6.5% were false positives (Total Development Quotient ¿90) and 6.8% did not have any domain with delay (Domain Developmental Quotient <80). The proportion of delay for each domain was as follows: communication 82.5%; cognitive 80.8%; social-personal 33.8%; motor 55.5%; and adaptive 41.7%. There were significant differences in the percentages of delay both by age and by domain/subdomain evaluated.Conclusions: In 93.2% of the participants, developmental delay was corroborated in at least one domain evaluated.

Escrutinio poblacional del nivel de desarrollo infantil en menores de 5 años beneficiarios de PROSPERA en México / Population-based study of child developmental screening in Mexican PROSPERA beneficiaries younger than 5 years old

ResumenIntroducción:La prueba de Evaluación del Desarrollo Infantil (EDI), diseñada y validada en México, clasifica a los niños de acuerdo con su desarrollo en desarrollo normal (verde) y desarrollo anormal (amarillo o rojo). No se conocen los resultados de su aplicación en base poblacional. El objetivo de este trabajo fue evaluar el nivel de desarrollo de niños menores de 5 años en situación de pobreza (beneficiarios del Programa PROSPERA) utilizando la prueba EDI.Método:La prueba EDI fue aplicada por personal capacitado y con los estándares para la aplicación de la prueba en menores de 5 años que acudieron al control del niño sano en unidades de atención primaria de noviembre de 2013 a mayo de 2014 en un estado del norte de México.Resultados: Se aplicó la prueba EDI a 5,527 niños de 1-59 meses de edad. El 83.8% (n = 4,632) se encontró con desarrollo normal y el 16.2%, con desarrollo anormal: amarillo con el 11.9% (n = 655) y rojo con el 4.3% (n = 240). La proporción con resultado anormal fue del 9.9% en < 1 año y del 20.8% a los 4 años. Por edad, las áreas más afectadas fueron el lenguaje a los 2 años (9.35%) y el conocimiento a los 4 años (11.1%). Las áreas motor grueso y social tuvieron mayor afección en el área rural. En el sexo masculino, las áreas de motor fino, lenguaje y conocimiento.Conclusiones: La proporción de niños con resultado anormal es similar a lo reportado en otros estudios de base poblacional. La mayor proporción de afección a mayores edades refuerza la importancia de la intervención temprana. La diferencia en las áreas afectadas entre el medio urbano y rural sugiere la necesidad de una intervención diferenciada.

AbstractBackground:Evaluación del Desarrollo Infantil or Child Development Evaluation (CDE) test, a screening tool designed and validated in Mexico, classifies child development as normal (green) or abnormal (developmental lag or yellow and risk of delay or red). Population-based results of child development level with this tool are not known. The objective of this work was to evaluate the developmental level of children aged 1-59 months living in poverty (PROSPERA program beneficiaries) through application of the CDE test.Methods: CDE tests were applied by specifically trained and standardized personnel to children <5 years old who attended primary care facilities for a scheduled appointment for nutrition, growth and development evaluation from November 2013 to May 2014.Results: There were 5,527 children aged 1-59 months who were evaluated; 83.8% (n = 4,632) were classified with normal development (green) and 16.2% (n = 895) as abnormal: 11.9% (n = 655) as yellow and 4.3% (n = 240) as red. The proportion of abnormal results was 9.9% in children <1 year of age compared with 20.8% at 4 years old. The most affected areas according to age were language at 2 years (9.35%) and knowledge at 4 years old (11.1%). Gross motor and social areas were more affected in children from rural areas; fine motor skills, language and knowledge were more affected in males.Conclusions: The proportion of children with abnormal results is similar to other population-based studies. The highest rate in older children reinforces the need for an early-based intervention. The different pattern of areas affected between urban and rural areas suggests the need for a differentiated intervention.

Pasos para transformar una necesidad en una herramienta válida y útil para la detección oportuna de problemas en el desarrollo infantil en México / Steps to transform a necessity into a validated and useful screening tool for early detection of developmental problems in Mexican children

ResumenUna prueba de tamiz es una herramienta cuya función es identificar individuos presuntamente enfermos en una población aparentemente sana al establecer el riesgo o sospecha de un problema de desarrollo. Debe tenerse precaución y ser muy cuidadoso al utilizar un instrumento de este tipo, por el riesgo de efectuar mediciones que no coincidan con la realidad y retrasar una intervención a quien lo requiere.Antes de incorporar una prueba de este tipo como parte de la práctica clínica rutinaria, es necesario certificar que posee ciertas características que hacen meritoria su utilización. A este proceso de certificación se le denomina validación. El objetivo de este artículo fue describir los diferentes pasos que se llevaron a cabo desde la identificación de una necesidad de detección hasta la generación de una prueba de tamiz validada y confiable, utilizando como ejemplo el proceso del desarrollo de la versión modificada de la prueba Evaluación del Desarrollo Infantil (EDI) en México.

AbstractA screening test is an instrument whose primary function is to identify individuals with a probable disease among an apparently healthy population, establishing risk or suspicion of a disease. Caution must be taken when using a screening tool in order to avoid unrealistic measurements, delaying an intervention for those who may benefit from it.Before introducing a screening test into clinical practice, it is necessary to certify the presence of some characteristics making its worth useful. This "certification" process is called validation. The main objective of this paper is to describe the different steps that must be taken, from the identification of a need for early detection through the generation of a validated and reliable screening tool using, as an example, the process for the modified version of the Child Development Evaluation Test (CDE or Prueba EDI) in Mexico.

Coping styles and vulnerability to eating disorders in adolescent girls, by age / Estrategias de afrontamiento y vulnerabilidad a los trastornos de la conducta alimentaria, en chicas adolecentes, en función de la edad

The main goal of the study is to explore the relationship between coping styles and vulnerability to eating disorders in a sample of adolescent girls, according to their age. The sample comprises 1396 girls, aged 13 to 18, who completed the eating Disorders Inventory-3 (EDI-3) and the Adolescent Coping Scale (ACS). The regression analysis shows that the coping strategy most closely linked to the likelihood of developing an Ed in all age groups is Intropunitive Avoidance. The scales of the Intropunitive Avoidance dimension that have the most explanatory power are Tension Reduction and Self-Blame. Girls aged 13 and 17 are identified as the highest risk groups. Physical and social changes are proposed as the hypothetical explanation for the difference between age groups. Emphasis is placed on the need for specific prevention programs for adolescents, particularly those at high risk.

El objetivo principal del estudio es explorar la relación entre estilos de afrontamiento y vulnerabilidad a trastornos de alimentación en una muestra de chicas adolescentes, según su edad. La muestra está compuesta por 1396 chicas de entre 13 y 18 años, que respondieron a los cuestionarios Eating Disorders Inventory-3 (EDI-3) y el Adolescent Coping Scale (ACS). Los análisis de regresión muestran que la estrategia de afrontamiento más relacionada con el riesgo de sufrir TCA es la Huída Intropunitiva, en todas las edades. Las escalas de la dimensión Huida Intropunitiva con mayor poder explicativo son Reducción de la Tensión y Autoinculparse. Las chicas de 13 y 17 años son los grupos identificados de mayor riesgo. Los cambios físicos y sociales se presentan como una explicación hipotética para la diferencia entre grupos de edad. Se enfatiza en la necesidad de programas de prevención específicos para adolescentes, especialmente aquellos con mayor riesgo.

Atrofia coroidea relacionada con la edad en pacientes hispanos: serie de casos / Age-related choroidal atrophy in hispanics patients: a case series

Propósito: describir los hallazgos y la medición del grosor coroideo subfoveal utilizando tomografía óptica coherente de imagen de profundidad mejorada (EDI OCT), en paciente hispanos con sospecha clínica de atrofia coroidea relacionada con la edad (ARCA). Métodos: estudio descriptivo y trasversal en 17 pacientes con impresión clínica de ARCA, basados en: disminución de la agudeza visual de reciente aparición, alteraciones pigmentarias en la macula, apariencia de fondo de ojo atigrado y atrofia peripapilar a pesar de no ser miope. A todos se les realizó examen oftalmológico completo, que incluía: Agudeza visual mejor corregida (BCVA), biomicroscopía con lámpara de hendidura y evaluación del fondo de ojo bajo dilatación. A estos pacientes se les realizó fotografía digital del fondo de ojo y tomografía óptica coherente de imagen de profundidad mejorada (EDI OCT). Se realizó un total de 5 mediciones del grosor coroideo en el área macular en cada ojo. Resultados: se evaluaron 26 ojos de 14 pacientes, con una edad media de 70,86 años (DS± 8,46 años). El 57.14% fueron mujeres y el 42.86% hombres. El promedio de la agudeza visual fue 20/47 (0,38 LogMAR), el 80.2% presentaron manifestación binocular. La media del grosor coroideo fue 119,53 µm (DS±49,68µm). No hubo correlación estadísticamente signifi cativa entre la BCVA y grosor coroideo (P=0.407). Conclusión: la atrofia coroidea relacionada con la edad es una condición que puede presentarse en pacientes hispanos de edad avanzada. Afecta igualmente a hombres y mujeres, es usualmente bilateral y el grado de adelgazamiento de la coroides no predice la agudeza visual final.

Purpose: to describe the findings and measure the subfoveal choroidal thickness with Enhanced Depth Imaging (EDI) OCT in hispanics subjects with clinical impression of age-related choroidal atrophy (ARCA). Methods: a descriptive and cross-sectional study of 17 subjects with clinical impression of ARCA: based on recently decreased visual acuity, pigmentary alterations in the macula, a tessellated fundoscopic appearance, and peripapillary atrophy despite being not myopic. All patients had a comprehensive ocular examination, including BCVA, biomicroscopic and fundus examination. They underwent color fundus photography and EDI OCT. A total of 5 measurements were took of each eye. Results: twenty six eyes were included from 14 patients, with a mean age 70,86 years (SD ± 8,46 years). The 57,14% were female and 42.86% male. The mean visual acuity was 20/47 (0,38 LogMAR Equivalent), 80.2% had bilateral disease. The mean choroidal thickness was 119,53 µm (SD ± 49,68 µm). There was no statistically significant correlation between BCVA and choroidal thickness (p =0,407). Conclusions: the ARCA is a condition that can be present in elderly Hispanics subjects. Affects equally male and female, it is usually bilateral and the degree of choroidal thinning does not predict the final visual acuity.

Child Development Evaluation Test analysis by field improves detection of developmental problems in children

Background: The Child Development Evaluation (CDE) Test is a screening instrument for developmental problems. In the validation study, a sensitivity of 81% and a specificity of 61% were reported, considering a cut-off value for both a total development quotient (TDQ) of 90. Given that the TDQ is obtained by calculation of the five evaluated fields in the Battelle Development Inventory, 2nd edition (BDI-2), it may occur that a child is classified as a false positive (TDQ ≥90) and may have a developmental delay in at least one of the fields (true positive). The objective of this work was to evaluate if the properties of the CDE Test are different when analyzing each field for the probability of a developmental delay. Methods: The information obtained for the study from the validation (Rizzoli-Córdoba, 2013) was analyzed. In the CDE Test, a true positive was considered when the result was yellow or red. A developmental delay was considered per domain with a scale score <80 in the BDI-2. The results were analyzed based on the correlation of what was evaluated between the CDE Test and the BDI-2. Results: For 438 children of 1- to 60-months of age, sensitivity (S) and specificity (Sp) per field were as follows: a) Motor: S=84.3% and Sp=87%; b) Communication: S=79.5% and Sp=79.4%; c) Personal-Social: S=86.9% and Sp=85%; d) Adaptive: S=91.7% and Sp=85.1%; and e) Cognitive: S=83.6% and Sp=88.8%. Conclusions: When analyzing each field separately, better scores for the CDE are observed compared with those reported for the TDQ in both sensitivity and specificity.

Propiedades psicométricas del Inventario de Trastornos Alimentarios - 3 (EDI-3) en mujeres adolescentes de Argentina / Psychometric properties of the Eating Disorders Inventory - 3 (EDI-3) among female adolescents from Argentina

El objetivo de este estudio es explorar la estructura factorial y la consistencia interna del Inventario de Trastornos Alimentarios-3 (EDI-3) en adolescentes mujeres de Buenos Aires (Argentina). 725 estudiantes de escuelas secundarias, entre 13 y 19 años, completaron el EDI-3 y un cuestionario sociodemográfico. Se evaluaron diferentes soluciones factoriales. La solución más satisfactoria se alcanzó al explorar, por un lado, los ítems de las tres escalas de riesgo de trastorno alimentario (buena estructura, varianza explicada 46,7%) y por el otro, los ítems de las escalas psicológicas (estructura parcialmente diferente de la teórica, varianza explicada: 44,1%). El cómputo por Índices (agrupación de distintas escalas propuesta por el autor) se adecua más a la versión original. Los coeficientes de consistencia interna fueron adecuados en la mayoría de las escalas. Al analizar la capacidad discriminante de los ítems, se observó un "efecto suelo" en algunas escalas, siendo esto esperable en población general. Se concluye que el EDI-3 resulta un instrumento estructuralmente válido para la evaluación de riesgo de trastorno alimentario en población general y, en consecuencia, su detección temprana. Se discute el uso del instrumento en población general.

The aim of this study is to explore the factor structure and internal consistency of the Eating Disorder Inventory-3 (EDI-3) among female adolescents from Buenos Aires (Argentina). 725 high school students, aged 13 to 19 years, completed the EDI-3 and a sociodemographic questionnaire. Different factor solutions were evaluated. The most satisfactory solution was reached to explore, first, the items of the three Eating Disorder Risk Scales (good structure, variance explained = 46.7%) and on the other, items of the Psychological Scales (with partial divergence from theoretical structure, variance explained = 44.1%). The computation of Composites (combining different scales proposed by the author) fitted more closely to the original version. Internal consistency coefficients for most scales were adequate. In analyzing the discriminatory power of the items, it was found a "floor effect" on some scales, this being expected in general population. We conclude that the EDI-3 is a valid instrument for the assessment of risk for eating disorders in general population and, consequently, its early detection. We discuss the use of this instrument in general population.

Insatisfacción corporal, búsqueda de la delgadez y malnutrición por exceso, un estudio descriptivo correlacional en una población de estudiantes de 13 a 16 años de la ciudad de Valparaíso / Body dissatisfaction, search of thinness and malnutrition excess, a descriptive correlational study in a population of students from 13 to 16 years of the Valparaíso city

Objetivo: Identificar la prevalencia de insatisfacción corporal y búsqueda de la delgadez en una población de estudiantes de 13 a 16 anos; exponer la correlación existente con la malnutrición por exceso y describir las diferencias por sexo. Sujetos y método: A 291 alumnos de 3 colegios mixtos, se les aplicó cuestionario EDI 2, se determinó el IMC (peso/talla²) a cada uno de ellos. Resultados: El 27,5 % de la población total (51% mujeres, 49% varones) tiene malnutrición por exceso. El 2,1% de los varones y el 13 % de las mujeres presentaron puntaje de riesgo en el ítem búsqueda de la delgadez (BD); el 11 % de los hombres y 21,9 % de las mujeres presentaron puntaje de riesgo en el item insatisfacción corporal (IC). Hubo diferencias de género estadísticamente significativas en ambos ítems BD (P < 0,001) y para IC (P < 0,011). La IC correlacionó con el IMC (Fisher's 0,006). No se observó correlación entre BD y estado nutricional (Fisher's 0,082). La IC y BD se correlacionaron con el género femenino (Fisher's 0.009. 0,000). Conclusión: Se detectan índices significativos de los factores evaluados (prevalencia y correlación entre variables), en una población no clínica. Las mujeres presentan un mayor riesgo.

Objective: To identify the prevalence ofbody dissatisfaction and search for thinness (ST) of a student population 13 to 16 years old, its correlation with overweight, and gender differences. Subjects and method: To 291 students of 3 coed schools (51% female) the EDI 2 questionnaire was applied to assess body dissatisfaction and ST and their IMC (weight/height2) were obtained. Results: The prevalence of malnutrition by excess reached 27.5 % in the total population. 2.1% of men and 13% of the women presented risk scores related to search for thinness; 11 % of men and 2.,9 % of women presented risk scores related to body dissatisfaction. There were statistically significant gender differences in both items (0.001). The body dissatisfaction was correlated with BMI (Fisher's 0,006). There was no correlation between ST and nutritional status (Fisher's 0.082). Body dissatisfaction and search for thinness was correlated with gender (Fisher's 0,009 - 0,000). Conclusion: Significant indices (prevalence and correlation) of the evaluated factors were found. Women presented increased risk compared to man.

Validation of the Korean Version of the Eating Disorder Inventory-2: Psychometric Properties and Cross-Cultural Comparison

PURPOSE: The purpose of the present study was to examine the validity and reliability of the Korean version of the Eating Disorder Inventory-2 (EDI-2) in Korean patients with eating disorders and healthy controls, and to investigate cultural differences of EDI-2 between a Korean group and a North American standardization sample. MATERIALS AND METHODS: The Korean version of the EDI-2 was prepared after comprehensive clinical assessment of Korean patients with eating disorders (n=327) as well as female undergraduates (n=176). Results were compared between eating disorder subgroups (anorexia nervosa, bulimia nervosa and eating disorders not otherwise specified) and those of a North American standardization sample and healthy controls. RESULTS: The results showed that the Korean EDI-2 had adequate internal consistency (0.77-0.93) and discriminated well between patients with eating disorders and healthy controls on all subscales. Significant differences in EDI-2 subscale scores between the eating disorder groups and the healthy control group were observed; however, there was no discernible difference among the eating disorder subgroups. When compared with a North American standardization sample, the Korean control group showed significantly higher scores for drive for thinness and asceticism. When patient groups were compared, the Korean group showed significantly lower scores for perfectionism. CONCLUSION: As expected, the results accurately reflected psychometric properties of the Korean version of EDI-2 for eating disorder patients in Korea. These findings also suggest that common characteristics for the eating disorder exist as a whole rather than with significant difference between each subgroup. In addition, significant differences between the Korean and the North American groups for both patients and controls also demonstrated specific cultural differences.