Structural basis of TFIIIC-dependent RNA polymerase III transcription initiation.

RNA polymerase III (Pol III) is responsible for transcribing 5S ribosomal RNA (5S rRNA), tRNAs, and other short non-coding RNAs. Its recruitment to the 5S rRNA promoter requires transcription factors TFIIIA, TFIIIC, and TFIIIB. Here, we use cryoelectron microscopy (cryo-EM) to visualize the S. cerevisiae complex of TFIIIA and TFIIIC bound to the promoter. Gene-specific factor TFIIIA interacts with DNA and acts as an adaptor for TFIIIC-promoter interactions. We also visualize DNA binding of TFIIIB subunits, Brf1 and TBP (TATA-box binding protein), which results in the full-length 5S rRNA gene wrapping around the complex. Our smFRET study reveals that the DNA within the complex undergoes both sharp bending and partial dissociation on a slow timescale, consistent with the model predicted from our cryo-EM results. Our findings provide new insights into the transcription initiation complex assembly on the 5S rRNA promoter and allow us to directly compare Pol III and Pol II transcription adaptations.

Structural basis of TFIIIC-dependent RNA Polymerase III transcription initiation.

RNA Polymerase III (Pol III) is responsible for transcribing 5S ribosomal RNA (5S rRNA), tRNAs, and other short non-coding RNAs. Its recruitment to the 5S rRNA promoter requires transcription factors TFIIIA, TFIIIC, and TFIIIB. Here we use cryo-electron microscopy to visualize the S. cerevisiae complex of TFIIIA and TFIIIC bound to the promoter. Brf1-TBP binding further stabilizes the DNA, resulting in the full-length 5S rRNA gene wrapping around the complex. Our smFRET study reveals that the DNA undergoes both sharp bending and partial dissociation on a slow timescale, consistent with the model predicted from our cryo-EM results. Our findings provide new insights into the mechanism of how the transcription initiation complex assembles on the 5S rRNA promoter, a crucial step in Pol III transcription regulation.

Long-Term Improvement and Safety of Aripiprazole for Irritability and Adaptive Function in Asian Children and Adolescents with Autistic Disorder: A 52-Week, Multinational, Multicenter, Open-Label Study.

Objective: Evaluate the long-term improvement and safety of aripiprazole in treating irritability in Asian children and adolescents (6-17 years) with autistic disorder. Methods: A 52-week, open-label, flexibly dosed (2-15 mg/day) study on the improvement and safety of aripiprazole in patients with autistic disorder who had completed an antecedent 12-week open-label study. The evaluation of efficacy was conducted using the Aberrant Behavior Checklist (ABC), Clinical Global Impression (CGI) scale, Child Yale-Brown Obsessive-Compulsive Scale (CY-BOCS), Vineland Adaptive Behavior Scale (VABS), and the Parenting Stress Index-Short Form (PSI-SF). Safety and tolerability measurements included adverse events, vital signs, electrocardiography, laboratory tests, body weight, and extrapyramidal symptoms (EPSs). Results: During the 52-week treatment, all effectiveness variables, including ABC, CGI, CY-BOCS, VABS, and PSI-SF scores, showed improvement. Regarding safety, the proportion of patients who experienced any treatment-emergent adverse events (TEAEs) was 58.62% (34/58 subjects, 75 cases). The most common TEAE was nasopharyngitis reported in 20.69% (15/58 subjects, 15 cases) and the other TEAE with an incidence of ≥10% was weight increases in 18.97% (11/58 subjects, 11 cases). Of them, 27.59% (16/58 subjects, 28 cases) experienced adverse drug reactions (ADRs). The most common ADR was weight increase reported in 15.52% (9/58 subjects, nine cases). The incidence of serious adverse events (SAEs) was 5.17% (3/58 subjects, three cases), which were epiphysiolysis, seizure, and a suicide attempt, but these were not ADRs. There were no clinically significant changes found in the evaluation of EPSs. Conclusions: Aripiprazole showed improvement for behavioral problems and adaptive functioning and was well tolerated in patients with autistic disorder until nearly a year after drug use. The Clinical Trial Registration number: NCT02069977.

First report of Lasiodiplodia mahajangana causing canker of mango (Mangifera indica) in Puerto Rico.

Mango originated in the Indo-Burmese region (Alphonse de Candolle, 1885). In the Caribbean, Puerto Rico currently produces and exports mangoes to the United States and Europe. Globally, an important disease affecting mango production is dieback, caused by fungi belonging to Botryosphaeriaceae family. During a one-year survey from 2019 to 2020, conducted at the mango germplasm collection of the Agricultural Experiment Station of the University of Puerto Rico, located at Juana Díaz, PR, symptoms of dieback were observed in shoots, descending towards the woody part, and vascular necrosis. We sampled bimonthly, 35 Keitt trees for one year. At the end of the evaluation, we detected that a 74% disease incidence was caused by Botryosphaeriaceae. Lasiodiplodia mahajangana (syn. L. caatinguensis) was associated with 4% disease incidence. In addition, we identified other Botryosphaeriaceae species causing 70% of disease incidence. To identify the causal agent, sections of symptomatic tissue (4mm2) were surface disinfected by immersion in 70% ethanol, 10% sodium hypochlorite and rinsed with sterile-distilled water for 1 minute at each solution. Sections were transferred to petri dishes containing potato dextrose agar acidified with 85% lactic acid (aPDA). Ten fungal isolates were obtained with similar morphological characteristics such as colony color and texture, after 12 days. Of these, one representative (isolate 17) was selected and identified as L. mahajangana (Lm) using morphological parameters and sequences of four nuclear genes (Zhang, W. et al., 2021). In aPDA, Lm colonies showed sparse and slow-growing aerial mycelium with dark gray-greenish color at the center and light gray edges. Black pycnidia were observed after 15 days of incubation at 28°C and dark conditions. Hyaline, ovoid to ellipsoid immature conidia (n=40) with average size of 22 µm long and 12 µm wide were observed. Mature bicellular pigmented conidia (n=40) had longitudinal striate and its average size was 23 µm long and 12 µm wide. Internal transcribed spacer (ITS), ß-tubulin (ßtub), elongation factor 1-alpha (EF1-α) and large ribosomal subunit (LSU) genetic regions were amplified by PCR from the original and pathogenicity test recovered isolates. Sequences of PCR products were compared with NCBI database BLAST tool with other Lm sequences. Sequence accession numbers of the four genetic regions of Lm are as follows: OL375401 and OL375402 for the ITS region; OL405579 and OL405580 for ß-tubulin; OL455922 and OL455923 for EF1-α; and OL375648 and OL375649 for LSU. All the sequences were grouped with the ex-type CMM1325 of Lm (BS=84). Pathogenicity tests were performed on 6-month-old mango trees of cv. Keitt. Three healthy trees were inoculated with 5 mm mycelial disks of Lm, on stems, with and without wounds. Controls were inoculated with aPDA disks only. Inoculated trees were covered for 3 days with plastic bags, keeping them in conditions of high relative humidity with constant irrigation, temperature of 28°C, and 12 hours of light and 12 hours of darkness for 12 days. Twelve days after inoculation, Lm isolates caused stem necrosis and canker, with differences in lesion severity from 2 to 17 mm2 with wound, and 0 to 6 mm2 without wound. Untreated controls showed no symptoms of canker. Lasiodiplodia mahajangana was re-isolated from diseased stems fulfilling Koch's postulates, and a sequence of the recovered isolate from the pathogenicity test was compared and included in the phylogenetic analysis. Lasiodiplodia mahajangana has been reported to cause stem-end rot of mango in Malaysia (Li, L. et. al., 2021). To our knowledge, this is the first report of Lm causing canker of mango in Puerto Rico. Knowing L. mahajangana as a new pathogen that causes canker of mango is important to establish an adequate and effective control management of this disease in mango producing countries worldwide.

Structural and functional analysis of the SET3 histone deacetylase complex.

The SET3 complex (SET3C) is a seven-subunit histone deacetylase complex that is capable of transcriptional regulation. Methylated histone 3 marks recruit SET3C to the nucleosome, and the SET3C catalytic subunits deacetylate the histone 3 and 4 tails. There is very limited structural knowledge of the SET3C subunits, with most subunits having unknown structures or functions. Here, a catalytically active SET3 complex was endogenously purified from Saccharomyces cerevisiae and utilized for negative-stain electron microscopy (EM) to determine an apo model for the holo complex. The negative-stain EM 3D model revealed a three-lobe architecture, with each lobe extending from a central point.

Structure and Function of Chromatin Remodelers.

Chromatin remodelers act to regulate multiple cellular processes, such as transcription and DNA repair, by controlling access to genomic DNA. Four families of chromatin remodelers have been identified in yeast, each with non-redundant roles within the cell. There has been a recent surge in structural models of chromatin remodelers in complex with their nucleosomal substrate. These structural studies provide new insight into the mechanism of action for individual chromatin remodelers. In this review, we summarize available data for the structure and mechanism of action of the four chromatin remodeling complex families.

Structural Insights into the Evolutionarily Conserved BAF Chromatin Remodeling Complex.

The switch/sucrose nonfermentable (SWI/SNF) family of proteins acts to regulate chromatin accessibility and plays an essential role in multiple cellular processes. A high frequency of mutations has been found in SWI/SNF family subunits by exome sequencing in human cancer, and multiple studies support its role in tumor suppression. Recent structural studies of yeast SWI/SNF and its human homolog, BAF (BRG1/BRM associated factor), have provided a model for their complex assembly and their interaction with nucleosomal substrates, revealing the molecular function of individual subunits as well as the potential impact of cancer-associated mutations on the remodeling function. Here we review the structural conservation between yeast SWI/SNF and BAF and examine the role of highly mutated subunits within the BAF complex.

Cryo-EM structure of SWI/SNF complex bound to a nucleosome.

The chromatin-remodelling complex SWI/SNF is highly conserved and has critical roles in various cellular processes, including transcription and DNA-damage repair1,2. It hydrolyses ATP to remodel chromatin structure by sliding and evicting histone octamers3-8, creating DNA regions that become accessible to other essential factors. However, our mechanistic understanding of the remodelling activity is hindered by the lack of a high-resolution structure of complexes from this family. Here we report the cryo-electron microscopy structure of Saccharomyces cerevisiae SWI/SNF bound to a nucleosome, at near-atomic resolution. In the structure, the actin-related protein (Arp) module is sandwiched between the ATPase and the rest of the complex, with the Snf2 helicase-SANT associated (HSA) domain connecting all modules. The body contains an assembly scaffold composed of conserved subunits Snf12 (also known as SMARCD or BAF60), Snf5 (also known as SMARCB1, BAF47 or INI1) and an asymmetric dimer of Swi3 (also known as SMARCC, BAF155 or BAF170). Another conserved subunit, Swi1 (also known as ARID1 or BAF250), resides in the core of SWI/SNF, acting as a molecular hub. We also observed interactions between Snf5 and the histones at the acidic patch, which could serve as an anchor during active DNA translocation. Our structure enables us to map and rationalize a subset of cancer-related mutations in the human SWI/SNF complex and to propose a model for how SWI/SNF recognizes and remodels the +1 nucleosome to generate nucleosome-depleted regions during gene activation9.

Updates in the correlation of electroneuromyographic findings in diabetic polyneuropathy / Actualidades en la correlación de hallazgos electroneuromiográficos en polineuropatía diabética

Background: The diabetic neuropathy is the most common microvascular complication of diabetes mellitus. The reported prevalence ranges from 10-90%. Electrophysiological alterations can be demonstrated in nearly 100% of diabetics. Objective: To know the current profile of the patient with diabetic polyneuropathy. Methods: Retrospective and descriptive study from 2015 to 2016. Reports of electroneuromyography with diabetic polyneuropathy result were analyzed, evaluating neuroconduction parameters of motor and sensory nerves, late F responses and myography. Descriptive statistics, Student's t-test and Pearson's correlation coefficient were used. Results: The sample included 72 men (65.5%) and 38 women (34.5%), mean age 61.2 years, mean duration of diabetes of 9.9 years. The most affected nerve was superficial peroneus, absent in 70% of the population.A positive correlation was found (p < 0.001) for the affection of all the nerves symmetrically and predominantly in neuroconduction velocities of the lower and upper limbs. Conclusion: The most frequent electrophysiological finding in diabetic polyneuropathy was sensory affection, being more severe in lower limbs. A finding in patients with recent diagnosis is the prolongation of proximal latencies in the lower extremities.

Introducción: la neuropatía diabética es la complicación microvascular más frecuente de la diabetes mellitus. Las prevalencias reportadas oscilan del 10 al 90%. Se pueden demostrar alteraciones electrofisiológicas en casi el 100% de los diabéticos. Objetivo: conocer el perfil actual del paciente con polineuropatía diabética. Métodos: estudio retrospectivo y descriptivo del año 2015 a 2016. Se analizaron reportes de electroneuromiografía con resultado de polineuropatía diabética, evaluando parámetros de neuroconducción de nervios motores y sensoriales, respuestas tardías F y miografía. Se utilizó estadística descriptiva, la prueba de t de Student y el coeficiente de correlación de Pearson. Resultados: la muestra incluyó a 72 hombres (65.5%) y 38 mujeres (34.5%), con edad media de 61.2 años, todos con diagnóstico de diabetes mellitus tipo 2, con duración media de la diabetes de 9.9 años. El nervio más afectado fue el peroneo superficial, ausente en el 70% de la población. Se encontró una correlación positiva(p < 0.001) para la afección de todos los nervios de forma simétrica y de predominio en velocidades de neuroconducción de miembros inferiores y superiores. Conclusión: el hallazgo electrofisiológico más frecuente en polineuropatía diabética fue la afección sensorial, siendo más severa en miembros inferiores. Un hallazgo en pacientes con reciente diagnóstico es la prolongación de latencias proximales en extremidades inferiores.

Aripiprazole for Irritability in Asian Children and Adolescents with Autistic Disorder: A 12-Week, Multinational, Multicenter, Prospective Open-Label Study.

OBJECTIVES: We investigated the effectiveness and tolerability of aripiprazole in the treatment of irritability in Asian children and adolescents (6-17 years) with autistic disorder in a 12-week, multinational, multicenter, open-label study. METHODS: Sixty-seven subjects (10.0 ± 3.1 years old, 52 boys) were enrolled and treated with flexibly dosed aripiprazole for 12 weeks (mean dose, 5.1 ± 2.5 mg; range 2-15 mg). RESULTS: Aripiprazole significantly reduced the mean caregiver-rated scores for the Irritability, Lethargy/Social Withdrawal, Stereotypy, Hyperactivity, and Inappropriate Speech subscales of the Aberrant Behavior Checklist from baseline to week 12 (p < 0.001 for all subscales). Clinician-rated Clinical Global Impression Severity of Illness scale score also improved from baseline through week 12 (p < 0.001). The most common adverse event was weight gain and no serious adverse event related to aripiprazole treatment was noted. CONCLUSION: Our results suggest that aripiprazole is effective and generally tolerable in the treatment of irritability in Asian children and adolescents with autistic disorder. Further studies with larger sample sizes and longer treatment durations are required.

Caracterización de los adolescentes comisores del intento suicida del Consejo Popular Siboney. Octubre de 2010 a Marzo de 2011 / Characterization of the adolescents with suicide attempt in the Popular Council of Siboney. October, 2010 to March, 2011

Se realizó un estudio cuantitativo con el objetivo de identificar los factores que a nivel personal están asociados a la comisión del intento suicida en un grupo de adolescentes del consejo popular Siboney perteneciente al policlínico docente René Vallejo Ortíz de Bayamo en el período de Octubre de 2010 a Marzo de 2011. El universo está compuesto por 16 adolescentes que a su vez constituyen la muestra con edades comprendidas entre 12 y 19 años comisores de actos suicida. La importancia de nuestra investigación radica en el análisis psicológico presente en esta etapa como proceso que dinamiza la conducta suicida en el adolescente, así como su percepción del funcionamiento familiar en el cual se encuentra inmerso. Para el desarrollo de la investigación los objetivos fueron evaluados mediante la aplicación de las siguientes técnicas: análisis documental, entrevistas semiestructuradas a (adolescentes y familia), observación, FF-sil, Rotter y 10 deseos. Como resultado se obtuvo que en la comisión del intento suicida de estos adolescentes influyeron de manera significativa la percepción que ellos tienen de su funcionamiento familiar y las necesidades presentes(AU)

It was performed a quantitative study with the objective to identify the factors that were personally associated with the suicide attempt in a group of adolescents from the Popular Council Siboney, belonging to René Vallejo Ortiz Polyclinic in Bayamo during the period October 2010 to March 2011. The universe was formed by 16 adolescents who also constituted the sample in ages between 12 and 19 years with suicide attempt. The significance of our research consisted on the psychological analysis at this stage as a process that rushed the suicidal behavior in adolescents and their perception of the family functioning in which they were immersed. For the development of this research the objectives were assessed through the application of the following techniques: documentary analysis, semi-structured interviews (adolescent and family), observation, FF-sil, Rotter and 10 wishes. As a result it was found that in the suicide attempt of these adolescents there was a significant influence in their perception of their family functioning and present needs(EU)

Fetal exposure to propoxur and abnormal child neurodevelopment at 2 years of age.

OBJECTIVE: Our aim was to determine the effects of fetal exposure to propoxur and pyrethroids, on child neurodevelopment at 2 years of age. PATIENTS AND METHODS: Mothers were prospectively recruited during mid-pregnancy in Bulacan, Philippines where multiple pesticides including propoxur, cyfluthrin, chlorpyrifos, cypermethrin, pretilachlor, bioallethrin, malathion, diazinon and transfluthrin are used. To detect prenatal exposure to these pesticides, maternal hair and blood, infant's hair, cord blood, and meconium were analyzed for the pesticides by gas chromatography/mass spectrometry. Infants were examined at 2 years of age with 95.1% follow up rate and their neurodevelopment outcome was assessed by the Griffiths mental developmental scale (N=754). RESULTS: Meconium analysis was the most sensitive method to detect fetal exposure to pesticides and exposure was highest for propoxur (21.3%) and the grouped pyrethroids (2.5% - bioallethrin, transfluthrin, cyfluthrin and cypermethrin). Path analysis modeling was performed to determine the effects of fetal exposure to propoxur and pyrethroids on the child's neurodevelopment at 24 months of age while controlling for confounders. Only singletons and those with complete data for the path analysis were included (N=696). Using a path analysis model, there was a significant negative (ß=-0.14, p<0.001) relationship between prenatal pesticide exposure to propoxur and motor development at 2 years of age after controlling for confounders, e.g., infant gender, socioeconomic status, maternal intelligence, home stimulation (HOME), postnatal exposure to propoxur and blood lead level at 2 years of age. CONCLUSION: At 2 years of age, prenatal exposure to propoxur was associated with poorer motor development in children.

Auditory brainstem response latencies of infants and maternal eposure to environmental toxic product

OBJECTIVE: To explore the effects of pesticide exposure on the auditory system, specifically on hearing status based on auditory brainstem responses. METHODS: A cohort of pregnant women was identified in several communities in a rural area from April 2002 to February 2003 and followed up until delivery. Mother-infant dyads were assessed for exposure to pesticides. Maternal and fetal exposures to environmental toxic products were determined by measuring levels in maternal hair and blood, and infant cord blood, hair, and meconium, respectively. Hearing status was measured using otoacoustic emissions (OAE) and confirmed by diagnostic auditory brainstem responses (ABR) measured at 80, 60, and 40 decibels. Waves I, III, V were identified and absolute latencies measured, including inter-peak latencies from waves 11III, I-V, and III-V. Pesticide exposure was then correlated with latencies of Waves I, III, V, and interpeak latencies of waves I-III, IIV, and III-V. Hearing loss and pesticide exposures were correlated with Griffiths Mental Development Scores (GMDS). RESULTS: Significant delays in the ABR wave latencies were noted in the group with exposure to pesticides. Propoxur was the most common toxic product detected in infants and meconium the best substrate for its detection. There was a 1.4% risk of hearing loss with exposure to propoxur (RR=0.52 (0.12-2.30), p = 0.06), a 6.25% risk with cypermethrin exposure (RR= 4.53 (0.61133.64), P = 0.10) and 6.25% risk with pretilachlor exposure (3.13 (0.44-22.30), p = 0.07). Griffith's Mental Developmental Scale scores (GMDS- hearing and speech subscale and general quotient scores) were not significantly different between exposed and unexposed groups. However, three infants with positive exposures and hearing loss had below average, or low to average scores using this scale. CONCLUSION: Maternal exposure to environmental toxic products may affect the auditory pathway in infants at birth. Pregnant women should limit their exposure to such toxic products in order to avoid neurodevelopmental effects particularly on hearing because this is very important in the critical stage of language and speech development.

Validation of the pictorial pediatric symptom checklist - Filipino version for the psychosocial screening of children in a low-income urban community

RATIONALE. The timely identification of children with psycho social problems is very important in facilitating early intervention. Detection of these children in the community setting requires the development of an easy-to-use screening tool that can be used by community health workers. OBJECTIVE. To develop a valid and reliable screening tool that can be easily used by community health workers for the detection of psycho social problems in Filipino children. Specifically, 1) To develop a Filipino version of the Pictorial Pediatric Symptom Checklist (PPSC) for use by community health workers; and 2) To culturally validate the PPSC-Filipino version in a low-income urban community. METHODS. This study consisted of three phases: Phase 1 (Exploratory Study) consisted of focus group discussions and key informant interviews for content validation. Phase 2 (Questionnaire Development) involved refinement of the Filipino translation of the PPSC. In Phase 3 (Actual Survey), the PPSC was administered by health workers to 127 primary caregivers of children aged 4 to 7 years residing in a low-income community in Pandacan, Manila. Data gathered were subjected to reliability testing and factor analysis for construct validation. Chi-square analyses were done to determine the association of sociodemographic factors to overall PPSC results. RESULTS. Construct and content validity were confirmed. The Filipino PPSC showed high internal consistency (Cronbachs alpha 0.89). Factor analysis resulted in three new domains: 1) Attention & Externalizing Problems, 2) Internalizing Problems, and 3) School & Learning Problems. Among the 127 children screened, 24 (18.9%) were positive for psychosocial problems. Externalizing behaviors (fighting, rule-breaking, teasing) dominated among those who screened positive. The child age and number of siblings were the factors significantly associated with the overall PPSC results. CONCLUSIONS. The Pictorial Pediatric Symptom Checklist-Filipino Version is a valid and reliable tool in screening for psychosocial problems in children aged 4 to 7 years old residing in a low-income urban community. Administration by community health workers is feasible and its use in the community setting is particularly relevant since many cases of psychosocial disorders remain undetected.

Correlation of hearing screening with developmental outcomes in infants over a 2-year period.

CONCLUSION: Evoked otoacoustic emission (OAE) and auditory brainstem response (ABR) results for hearing screening among infants have good concordance. However, good correlation with the Griffiths Developmental Scales remains to be desired. OBJECTIVE: To correlate hearing screening outcomes of a cohort of infants with developmental outcomes at 6 and 12 months. SUBJECTS AND METHODS: A cohort of pregnant women was identified in several communities in a rural area (Bulacan province) from April 2002 to February 2003 as part of a population-based study determining maternal exposure to pollutants and infant outcomes, with a total follow-up of 2 years. Pregnant mothers were identified and followed up until delivery at a secondary, provincial hospital. Hearing screening was performed with OAEs and ABR. Mental development of infants was assessed at 6 and 12 months using Griffiths Mental Developmental Scales - locomotor, personal-social, hearing and speech, hand and eye coordination, performance tests. RESULTS: Among the 1086 babies recruited, there were 724 with hearing assessment. Of these 724 babies, 565 had both OAE testing and ABR. Overall in 1130 ears, OAE and ABR testing showed an observed agreement of 99%, agreement due to chance of 96%, and kappa agreement of 79% (p=0.00) in diagnosing bilateral hearing losses. OAEs had a sensitivity of 86.4% (95% CI 64-96.4%) and a specificity of 99.4% (95% CI 98.6-99.7%). At the end of the study, there were 708/724 (97.8%) infants with normal hearing, 7/724 (1.0%) with unilateral hearing loss, 8/724 (1.1%) with bilateral mild hearing loss, and 1/724 (0.1%) with bilateral profound hearing loss, who demonstrated consistent mental delay throughout. Follow-up rates for developmental examinations at 6 and 12 months were 98% and 81.25%, respectively. In these groups, there were 8 (1%) infants at 6 months and 18 (2.4%) at 12 months with developmental delay (Griffiths Mental Developmental Scales).

A five-year review of referrals to the developmental pediatrics section of a major tertiary hospital

Developmental disabilities involve a delay in development based on that expected for a given age level or stage of development.1 These impairments which originate before age 18 are expected to continue indefinitely and constitute a substantial impairment that may create a burden to the family and society. In a developing country like the Philippines, it is a public health problem that remains largely undetected and neglected. Local attempts to organize more systematic diagnostic services are needed.Objectives. To review the referrals made to the Section of Developmental Pediatrics for evaluation and to describe the demographic and clinical patterns of the more common developmental disabilities identified.Methods. This was a retrospective study based on the clinical census of patients seen over a five-year period from January 2004 to December 2008 by the Section of Developmental Pediatrics.Results. Referrals made to the Section of Developmental Pediatrics were usually seen during the first decade of life, were mostly males and were usually referred for developmental delay. The three most common developmental disabilities identified were mental retardation or global developmental delay, autistic spectrum disorders and cerebral palsy.