Construction of a model for early identification of spotted fever and severe fever with thrombocytopenia syndrome / 预防医学

Objective@#To construct a model for clinical identification of spotted fever (SF) and severe fever with thrombocytopenia syndrome (SFTS), so as to provide insights into early identification of SF and SFTS.@*Methods@#The clinical data of laboratory-confirmed SF and SFTS patients in secondary and tertiary hospitals in Lu'an City, Anhui Province from May 2017 to May 2021 were retrieved from Chinese Disease Prevention and Control Information System. Factors affecting SF were identified using a logistic regression model, and the model for early identification of SF and SFTS was created. The model fitting effect was evaluated using Hosmer-Lemeshow test, and the value of the model for identification of SF and SFTS was evaluated using the area under the receiver operating characteristic curve (AUC).@*Results@#Data of 62 SF cases and 115 SFTS cases were included. Multivariable logistic regression analysis showed that rash (β=5.994), C-reactive protein (β=4.409), white blood cell (β=-3.176) and platelet (β=-3.234) were included in the model, which were scored 6, 4, -3 and -3, with a total score ranging from -5 to 10. Hosmer-Lemeshow test revealed a high model fitting effect (χ2=3.245, P=0.662). The AUC of the model was 0.992, and the sensitivity and specificity were 0.935 and 0.991 if the cutoff was 1.@*Conclusion@#A model for early identification of SF and SFTS that includes four variables of rash, C-reactive protein, white blood cell and platelet has been created, which has a high accuracy.

Morphological Characteristics of Bone Marrow Cells in Patients with EB Virus Infection / 中国实验血液学杂志

OBJECTIVE@#Review and analyze the characteristics of bone marrow cell morphology in patients with Epstein-Barr virus (EBV) infection, and explore the diagnostic value of bone marrow cell morphology for the early identification of EBV infection.@*METHODS@#A total of 33 patients with EBV-DNA positive detection in the First Affiliated Hospital of Guangxi Medical University from January 2018 to May 2021 were collected as the research objects. Bone marrow cell morphology and peripheral blood cell analysis were performed, and the significance in disease diagnosis was analyzed by statistical methods.@*RESULTS@#The sampling satisfaction of 33 patients with EBV infection was 100%. In the clinical diagnosis of all cases, 7 cases were IM, 17 cases were EBV-HLH, 3 cases were lymphoma, 2 cases were EBV-associated lymphoid hyperplasia, and 4 cases were not diagnosed. Among them, 31 patients had active bone marrow hyperplasia or above, 26 patients had active granulocytic hyperplasia or above, 21 patients had active erythroid hyperplasia or above, and 17 cases of megakaryocyte production platelet function decreased. The abnormal components of bone marrow mainly indude atypical lymphocyte cells (33 cases), hemophagocytic cells (22 cases), abnormal histiocyte (10 cases).@*CONCLUSION@#According to the proliferation of granulocytes, erythrocytes and megakaryocytes in the bone marrow, and the emergence of abnormal components such as atypical lymphocytes, hemophagocyte, abnormal histiocyte. Bone marrow cell morphological examination can indicate the possibility of EBV infection, which is certain diagnostic value for early identification of EBV infection.

Clinical value of activin A in early identification of moderate and severe acute pancreatitis: a prospective study / 中华危重病急救医学

Objective:To explore the value of serum activin A (ACT-A) level in early identification of moderate and severe acute pancreatitis (AP).Methods:A prospective case control study was conducted. A total of 120 patients with AP admitted to department of hepatobiliary surgery of Affiliated Nanhua Hospital of Hengyang Medical College of University of South China between October 2020 and April 2022 were recruited. According to the revised Atlanta classification, all patients were classified into mild AP group and moderate-to-severe AP group. The blood samples within 24 hours of onset were drawn, and the serum ACT-A and C-reactive protein (CRP) levels were detected by enzyme-linked immunosorbent assay (ELISA). The Ranson score and the modified CT severity index (MCTSI) were performed. Pearson correlation method was used to analyze the correlation of various parameters. The receiver operator characteristic curve (ROC curve) was plotted to analyze the predictive value of ACT-A and CRP for moderate-to-severe AP.Results:A total of 120 patients with AP were enrolled, including 83 patients with mild AP and 37 patients with moderate-to-severe AP. Serum ACT-A and CRP levels within 24 hours of onset in the moderate-to-severe AP group were significantly higher than those in the mild AP group [ACT-A (ng/L): 140.4±37.7 vs. 53.9±30.5, lg CRP: 1.42±0.91 vs. 0.77±0.70, both P < 0.01], and the Ranson score and MCTSI score were also significantly higher than those in the mild AP group (Ranson score: 5.3±1.3 vs. 1.8±1.6, MCTSI score: 5.5±1.0 vs. 2.7±1.2, both P < 0.01). Correlation analysis showed that the serum ACT-A level was positively correlated with serum CRP level, Ranson score and MCTSI score ( R2 value was 0.272, 0.841, 0.616, respectively, all P < 0.05). ROC curve analysis showed that the serum ACT-A, CRP and Ranson score had predictive value for moderate-to-severe AP. The area under the ROC curve (AUC) was 0.948 [95% confidence interval (95% CI) was 0.909-0.986], 0.711 (95% CI was 0.606-0.815), 0.946 (95% CI was 0.910-0.982), respectively. When serum ACT-A > 112.6 ng/L, the sensitivity and specificity of predicting moderate-to-severe AP were 78.38% and 96.39%, respectively, which was better than serum CRP with sensitivity and specificity of 72.92% and 66.27%, respectively, and the specificity was better than Ranson score (71.08%). Conclusion:ACT-A can be detected in the early stage of AP, and it is positively correlated with the disease severity, which can early identify moderate-to-severe AP.

Clinical manifestation and early identification of amniotic fluid embolism / 中国实用妇科与产科杂志

Amniotic fluid embolism(AFE)is a rare and extremely dangerous condition in obstetrics.Clinical manifestations can be divided into cardiopulmonary failure and coagulation dysfunction.The onset can be acute or slow.The main clinical manifestations include prodrome,cardiopulmonary failure,bleeding and coagulation disorder,systemic organ damage,and fetal distress etc.The earlier we identify the symptom,the earlier we can intervene and perform the treatment in order to reduce the mortality of AFE.

Trastorno de alimentación: identificación y primeras intervenciones para los profesionales de salud / Eating disorders early identification and management: guidelines for health practitioners

Introducción: los trastornos de la alimentación e ingesta (TAI) son un complejo conjunto interdimensional de enfermedades mentales que afectan el rendimiento corporal, mental y social. El núcleo de la enfermedad es el miedo a ganar peso. Las estrategias de control de ingesta varían entre: restricción, selección y purga alimentaria. Afectan diferentes sexos, razas, etnias y edades. Con mayor frecuencia en adolescentes y mujeres jóvenes (9: 1). Presentan alta mortalidad, comorbilidad mental y conflictos familiares asociados. Método: integrar información disponible y útil según criterio de experto, orientada al manejo clínico de los TAI. Resultado: debido a que los profesionales de salud de diferentes áreas podrían ser el único contacto que el/la paciente busca para aliviar alguna dolencia aparentemente no relacionada con TAI, es necesario lograr identificar y diagnosticar los estadios patológicos e indicar las primeras conductas, así como hacer una referencia exitosa. El retraso en el diagnóstico causa alteraciones severas y crónicas en la fisiología, el comportamiento, la cognición y el funcionamiento psicosocial. Los objetivos de este estudio son: a. Presentar, en forma integrada, la información disponible de modo de facilitar a los profesionales de la salud la detección precoz de los TAI; b. Ofrecer un conjunto de acciones útiles que faciliten el diagnóstico TAI; c. Organizar la comprensión del riesgo TAI en un diagrama que facilite la construcción de la derivación utilizando las dimensiones: cuerpo, mente, relaciones; d. Mostrar las alternativas psicoterapéuticas en uso e. Proveer información para realizar las primeras intervenciones. Conclusión: reconocer tempranamente el cuadro TAI puede detener el curso patológico y los potenciales daños.(AU)

Introduction: eating disorders (ED) are a complex interdimensional set of mental disorders that affect social, bodily and mental performance. The core issue of the illness is the fear of weight gain. Food intake control strategies are displayed among eating restriction,selection and purging foods. ED affect people despite their sex, ethnicity or age often in adolescents and young women (9:1). EDhave been associated with high mortality, mental disorders comorbidity, and family conflicts. Method: to integrate expert selectedrelevant information to improve ED clinical management by health practitioners. Results: because health practitioners from differentareas may be the only contact the patient is looking for to alleviate an ailment apparently not related to ED, it is necessary to identifyand diagnose the pathological stages and indicate the first behaviors, as well as make a successful reference. Diagnosis delay causes severe and chronic alterations in physiology, behavior, cognition and psychosocial functioning. The objectives of this study are: a.To present integrated information about ED I order to facilitate early detection and diagnosis to health practitioners; b. To offer a setof useful actions that facilitate early ED detection; c. To organize the understanding of ED risk in a diagram that facilitates derivationusing the dimensions: body, mind, relationships; d. To show the current psychotherapies e. To provide information to perform the first interventions. Conclusion: early ED recognition can stop the pathological course and potential damage of the disease.(AU)

Application of response to name in early identification of infants with autism spectrum disorders / 中华实用儿科临床杂志

Objective To explore the behavioral characteristics of response to name in 16-30 months old infants with autism spectrum disorders (ASD),in order to provide a theoretical basis for the early identification and early diagnosis.Methods Two professionals,according to the scoring criteria and using video analysis methods,evaluated the response score (RS),reaction time (RT),duration time (DT) and the rate (RR) of response to their names among ASD infants (ASD group,61 cases),who were diagnosed at Child Developmental and Behavioral Center,the Third Affiliated Hospital of Sun Yat-Sen University from April to December 2017.Then they were compared with infants with developmental delays (DD group,32 cases) and neuro-typical (NT group,33 cases) infants.Finally,researchers predicted the diagnosis for ASD infants according to the behavioral indicators,which had significant differences compared with other groups.Results Compared with DD group [RS 2 (1) score,RT 1.32 (4.65) s,DT 2.69(1.84) s] and NT group [RS 2 (1) score,RT 1.37 (4.37) s,DT 2.90 (2.23) s],RS was significantly lower [1 (1)score],RT was significantly longer [5.87 (4.64) s],and DT was significantly shorter [0.77 (1.88) s] in ASD group,and the differences were statistically significant (H =-4.91,-5.94;5.36,5.41;-4.47,-5.78;all P ＜0.05);while the differences between DD group and NT group were not significant(all P ＞0.05).The RR was significantly lower in ASD group [0.25 (0.50)] and DD group [0.50 (0.25)],compared with NT group [0.75 (0.50)],and the differences were statistically significant (H =-6.39,-4.45,all P ＜ 0.01);while the differences between DDgroup and ASD group were not significant(P ＞0.05).When detecting ASD from ASD and NT infants,the area under the receiver operating characteristic curve (AUC) was 0.889 (P ＜0.01);when detecting ASD from ASD and DD infants,AUC was 0.924 (P ＜ 0.01);when detecting ASD from all infants,AUC was 0.868 (P ＜ 0.01),according to all indicators of response to name.Conclusions There are significant differences between ASD infants and DD and NT infants in response to name domain.Behavioral characteristics in the procedure of response to name can predict ASDwell.Response to name as an early social behavioral indicator,being tested at 2 years old,is still of importance for the early identification and early diagnosis of ASD.

Early identification of children with autism spectrum disorder / 国际儿科学杂志

Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders characterized by social communication disorders,narrow interest and repetitive behavior,which has an early childhood onset,resulting in high disability.The etiology of autism spectrum disorder is unknown and the prognosis is poor.There is no specific medication at present.Early diagnosis and intervention can improve the symptoms and prognosis of children with autism spectrum disorder.However,due to the lack of awareness of autism spectrum disorder among some medical staff and parents,the diagnosis and treatment of children are often delayed.This article reviews the early behavioral characteristics,screening tools,laboratory tests,diagnostic criteria,and the impact of early intervention on children with autism spectrum disorder,providing reference for early identification and intervention of children with autism spectrum disorder.

Ages and Stages Questionnaire: a global screening scale / Ages and Stages Questionnaire: una escala de evaluación global

Abstract: With standardized screening tools, research studies have shown that developmental disabilities can be detected reliably and with validity in children as young as 4 months of age by using the instruments such as the Ages and Stages Questionnaire. In this review, we will focus on one tool, the Ages and Stages Questionnaire, to illustrate the usefulness of developmental screening across the globe.

Resumen: Mediante el uso de herramientas de evaluación estandarizada, algunos estudios de investigación han demostrado que discapacidades de desarrollo se pueden detectar con fiabilidad y validez en niños desde los 4 meses de edad mediante el uso de los instrumentos estandarizados como el Ages and Stages Questionnaire (Cuestionario de las Edades y Etapas). Para ilustrar la utilidad de la evaluación del desarrollo infantil a escala global, en este trabajo se revisará la herramienta Ages and Stages Questionnaire.

Early identification and management of severe post-infectious bronchiolitis obliterans / 中国小儿急救医学

Post-infectious bronchiolitis obliterans is a severe form of chronic obstructive lung disease in children that follows an insult to the lower respiratory tract infection. It′s associated with viruses,bacteria and mycoplasma pneumoniae infection. Persist wheezing,recurrent exacerbation and exercise intolerance are the main manifestations. Mosaic attenuation and air trapping can be seen in HRCT. Lung function test shows obstructive dysfunction. Its prognosis is bad. Early identification and management of severe post-infectious bronchiolitis obliterans can improve prognosis greatly.

Early identification and intervention of cerebral palsy / 中华实用儿科临床杂志

Cerebral palsy (CP) describes a group of disorders of the development of movement and posture,causing activity limitation attributed to disturbances,which occurred in the fetal or infant brain.Early identification and intervention of CP has always been a difficult topic in the research of neuroscience.The intervention should be focused on infants showing early signs of CP.Such signs may be efficiently detected by a combination of neuroimaging and the General Movements Assessment.Besides movements,enriched environments,active participation,parental coaching have benefits to early intervention.In this investigation,the early identification and intervention in cerebral palsy were focused.

Autosomal dominant polycystic kidney disease in children's early identification and outcome / 中华实用儿科临床杂志

Autosomal dominant polycystic kidney disease( ADPKD)is the most common hereditary renal disease,which has an incidence of 1 / 1 000 to 1 / 500 in live births,was characterized by renal enlargement along with renal tubular cystic dilatation,approximately half of affected individuals reach end stage renal disease(ESRD)by 60 years of age,accounting for 7% - 10% of patients with ESRD. ADPKD could be diagnosed in children and even in ute-ro,early identification and intervention in children would ameliorate the progression of ADPKD to ESRD. Therefore,it is imperative for pediatricians to recognize the early clinical manifestations and outcome of the disease. The aim of this re-view will focus on the early identification,management and outcome in childhood.

Identificação dos primeiros sintomas do autismo pelos pais / Parents' perception of the first symptoms of autism

Dificuldades no desenvolvimento social são os indicadores mais prováveis de um futuro diagnóstico de autismo, entretanto o atraso da fala parece ser o motivo que mais mobiliza os pais na busca por assistência. Neste estudo foram investigados os primeiros sintomas percebidos pelos pais de crianças com autismo e a idade da criança na ocasião. Participaram 32 pré-escolares e o instrumento utilizado foi a Autism Diagnostic Interview-Revised. Comprometimentos no desenvolvimento da linguagem foram os sintomas mais frequentemente observados, porém os da socialização foram os mais precocemente identificados. No geral, a idade média em que os primeiros sintomas foram percebidos foi 15,2 meses. Os resultados corroboram achados de outros estudos, ressaltando a importância dos comprometimentos sociais para a identificação precoce do autismo.

The occurrence of problems related to social development is the best predictors of a future diagnosis of an Autistic Disorder. Speech delay, however, seems to be the main that reason that leads parents to seek assistance. The present study aimed to investigate the first symptoms observed by the parents of children with autism and the age that it occurred. Thirty-two preschool children participated in the study. The instrument used was the Autism Diagnostic Interviwed-Revised. Abnormalities in language development were the most frequent symptoms reported by the parents, but social impairment was the earliest that was noticed. The average age when the parents noticed the first symptoms was 15.2 months. The results corroborate other findings, highlighting the importance of social deficits for the early identification of autism.

Hypertension-induced target organ damage and early identification in children / 国际儿科学杂志

Hypertension is a global problem,affecting both developed and developing nations. The mor-bidity of hypertension in children and adolescents has increased year by year in recent years. Hypertension in children can cause target organ damages(mainly renal,cardiovascular,central neurological,or optic fundal). In clinical practice,we need to find simple and easy methods for early recognition of target organ damages,thus se-rious consequences in adult hypertension may be prevented.

Anorexia nervosa: diagnóstico, mudanças no perfil e tratamento / Anorexia nervosa: diagnosis, changes in profile and treatment

A anorexia nervosa é um transtorno alimentar grave, associado a altas taxas de mortalidade. Esta condição se caracteriza pela intensa perda de peso, de modo intencional, ocasionada por restrição alimentar e motivada pela distorção de imagem corporal dos pacientes. Afeta, sobretudo, adolescentes e adultos jovens do sexo feminino. Mudanças no perfil de pacientes com anorexia nervosa têm sido relatadas tanto por clínicos da área de saúde mental quanto por pesquisadores. Neste artigo serão explorados aspectos relacionados ao diagnóstico, a idade de início do transtorno - atualmente verificado em crianças - o aumento de sua prevalência entre homens e o tratamento. Conhecer os critérios diagnósticos da anorexia nervosa e as mudanças no perfil de pacientes afetados é tarefa premente, tanto para profissionais da área de saúde mental quanto para outros que acompanham o desenvolvimento infantil, como pediatras, dentistas e professores, que podem identificar os casos mais precocemente e encaminhá-los a tratamento específico...

Findings on sensory deficits in autism: implications for understanding the disorder

Among the many lines of research related to autism, investigations of sensory dysfunction have recently gained attention. The objective of this article is to briefly review the main findings of sensory deficits in autism, raise possibilities of early identification research in the area, and discuss the significance of these sensory problems for the understanding of autism. A review of the scientific literature with regard to sensory problems in autism was performed. A review of autobiographical reports of high-functioning autistic individuals was also performed. This review showed that sensory problems have always been mentioned in the autism literature, but their relevance has been underestimated. Scientific research and autobiographical reports suggest a high prevalence of sensory problems in autism. Although not yet considered in the official diagnosis of autism, sensory problems appear to not only exert a considerable impact on the configuration of the disorder but also directly influence autistic persons in their daily lives. Such impairments may begin to be thought of as fundamental in autism. However, these characteristics deserve to be further investigated by researchers who are dedicated to the study of autism.

Limites e possibilidades da identificação de risco de autismo no primeiro ano de vida / Limits and possibilities of identifying autism within the first year of life

Identificar risco de autismo no primeiro ano de vida possibilita intervir precocemente para um prognóstico mais favorável em crianças com autismo. O objetivo deste artigo é discutir limites e possibilidades metodológicas que viabilizem a identificação de sinais de risco de autismo entre 0-12 meses. A metodologia empregada em 24 estudos (retrospectivos e prospectivos) sobre identificação de sinais precoces e seus resultados foram analisados. Verificou-se que os limites da identificação de risco de autismo no primeiro ano parecem residir na buscar por categorias comportamentais discretas e que as possibilidades podem residir em analisar categorias de interação e de ordem afetiva.

Identifying signs of autism in the first year of life is justified by early intervention and better prognostic. This article aims at discussing methodological limits and possibilities of identifying risk of autism at 0-12 months. Methodology from 24 retrospective and prospective early signs studies and their outcomes were analyzed. Limits of identifying risk of autism in the 1st year of life lies in observing discrete behavioral categories, and possibilities seem to lie in analyzing interactional and affective categories.

Early Identification of Autism.

This study was carried out to determine the nature and timing of parents’ initial concerns and their subsequent help seeking behavior, so as to suggest ways to facilitate early identification of autism. The introductory part of the Autism Diagnostic Interview-Revised was used in a survey to elicit relevant information from parents of autistic children. Delayed/deviant speech and language development was the commonest early concern of parents. The mean age of parental recognition of any problem was 23.4 months. The mean time lag from first recognition of the problem to seeking professional help was 4 months and to diagnosis, 32 months. In 68% of cases, the first professional consulted was a child specialist.

Discapacidad y rezago escolar: riesgos actuales / Disability and low school achievement: present risks

Se realizó un estudio exploratorio para establecer el perfil de riesgo educativo de niños de primero y segundo grado de primaria, y analizar su relación con factores escolares y familiares. Se aplicó el WISC-RM a 206 niños, 51% de primer grado y 49% de segundo de una escuela pública. A quienes se les detectó algún tipo de dificultad, se les aplicaron instrumentos específicos, además de entrevistar a sus maestros y a 24 madres de estos niños. El perfil resultante mostró que un 37% de los menores que iniciaban la primaria, presentaban algún tipo de problema conjuntamente con factores de riesgo familiar y social. Se enfatiza la necesidad de evitar la deserción por discapacidad mediante la detección e intervención tempranas.

An exploratory study was conducted to establish the educational risk profile of first and second grade children and to analyze its relationship with school and family risk factors. The WISC-RM was administered to 206 children, who attended a public school; 51% of them were from first grade and 49%, from second grade. Other specific tests were administered to those children who showed some kind of disability. Their teachers were interviewed as well as 24 of their mothers. The resulting profile highlighted that a significant percentage (37%) of the children who had just started school showed some kind of problem related to school and family risk factors. The relevance of early detection and intervention is stressed in order to prevent school desertion.