Developmental delay

发育延迟
  • 文章类型: Journal Article
    在发育迟缓的儿童中经常观察到自我护理技能方面的困难。鉴于缺乏支持该群体自我护理干预的有力证据,本范围审查旨在汇总有关实施此类干预措施的现有文献.因此,本范围综述旨在整理有关自我护理干预实施性质的文献,以增加对当前实践的了解,并为未来的研究方向提供信息.本范围审查旨在探索有关自我护理干预措施的存在及其在发育迟缓儿童中的实施策略的文献。通过搜索以下数据库确定相关研究:WebofScience(W0S),Scopus,东盟引文索引(ACI)CINAHLEBSCO和PubMed。确定了使用各种方法的六种类型的干预措施。职业治疗师主要管理多学科共同促进者和父母参与的干预提供者。虽然会话信息各不相同,一些证据表明,每次至少30分钟,至少每周一次,每周两次,从10到23个疗程,可能就足够了。干预计划应该针对每个孩子的独特需求,考虑到可用干预措施的多样性。职业治疗师之间的合作,父母,家庭计划中的教育工作者和卫生专业人员提高了自我护理干预效果。这些结果旨在为未来的研究和实践提供信息,为发育迟缓儿童的支持和改善结果铺平道路。
    Difficulties with self-care skills are frequently observed in children with developmental delays. Given the scarcity of robust evidence backing self-care interventions for this group, this scoping review is designed to aggregate existing literature on the implementation of such interventions. Therefore, this scoping review aims to collate literature on the nature of self-care intervention implementation to increase understanding of the current practice and inform future research directions. This scoping review endeavoured to explore the body of literature concerning the existence of self-care interventions and their implementation strategies in children who have developmental delays. Relevant studies were identified by searching through the following databases: Web of Science (W0S), Scopus, ASEAN Citation Index (ACI), CINAHL EBSCO and PubMed. Six types of interventions using various approaches were identified. Occupational therapists mainly manage intervention providers with multidisciplinary co-facilitator and parents\' involvement. Whilst session information varied, some evidence suggests that at least 30 min per session, minimum once per week up to twice per week, ranging from 10 to 23 sessions, may be sufficient. Intervention plans should be tailored to each child\'s unique needs, taking into account the variety of available interventions. Collaboration among occupational therapists, parents, educators and health professionals in home programmes enhances self-care intervention outcomes. These results are set to inform future research and practice, paving the way for enhanced support and improved outcomes for children with developmental delays.
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  • 文章类型: Journal Article
    单羧酸转运蛋白8(MCT8)缺乏是一种罕见的,由SLC16A2基因突变引起并由甲状腺激素转运功能失调引起的X连锁疾病。这种疾病的特征是由于大脑中缺乏甲状腺激素而导致严重的神经发育迟缓和运动障碍,和共存的内分泌症状,由于慢性甲状腺毒症,由于中枢神经系统(CNS)外的甲状腺激素升高。2024年2月,我们回顾了已发表的文献,以确定有关MCT8缺乏症患者当前未满足需求的相关文章。MCT8缺乏症的诊断和治疗存在几个主要挑战,与误诊和诊断延迟相关的医疗保健专业人员(HCP)对MCT8缺陷的认识和认识下降。诊断延迟也可能归因于其他因素,包括MCT8缺乏症的复杂症状学仅在出生后几个月才变得明显,以及未常规进行的病理学血清三碘甲状腺原氨酸(T3)检测。对于MCT8缺乏的患者,多学科团队护理对于优化为患者及其护理人员提供的支持至关重要。尽管目前尚无专门针对MCT8缺乏症的批准治疗方法,该疾病的早期识别和诊断可以更早地获得支持性治疗,并开发专注于改善患者和护理人员结局和生活质量的治疗方法.
    Monocarboxylate transporter 8 (MCT8) deficiency is a rare, X-linked disorder arising from mutations in the SLC16A2 gene and resulting from dysfunctional thyroid hormone transport. This disorder is characterized by profound neurodevelopmental delay and motor disability due to a lack of thyroid hormone in the brain, and coexisting endocrinological symptoms, due to chronic thyrotoxicosis, resulting from elevated thyroid hormone outside the central nervous system (CNS). In February 2024, we reviewed the published literature to identify relevant articles reporting on the current unmet needs of patients with MCT8 deficiency. There are several main challenges in the diagnosis and treatment of MCT8 deficiency, with decreased awareness and recognition of MCT8 deficiency among healthcare professionals (HCPs) associated with misdiagnosis and delays in diagnosis. Diagnostic delay may also be attributed to other factors, including the complex symptomology of MCT8 deficiency only becoming apparent several months after birth and pathognomonic serum triiodothyronine (T3) testing not being routinely performed. For patients with MCT8 deficiency, multidisciplinary team care is vital to optimize the support provided to patients and their caregivers. Although there are currently no approved treatments specifically for MCT8 deficiency, earlier identification and diagnosis of this disorder enables earlier access to supportive care and developing treatments focused on improving outcomes and quality of life for both patients and caregivers.
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  • 文章类型: Case Reports
    METTL23属于甲基化非组蛋白蛋白的蛋白赖氨酸甲基转移酶家族。最近,据报道,METTL23基因与智力发育障碍有关,常染色体隐性遗传44.出现发育迟缓的患者,智力残疾(ID),和可变的变形特征。这里,我们报道了一个出现全球发育迟缓的中国女孩,大脑结构异常,和多发性面部畸形,包括一个短的/向上弯曲的鼻子和一个下沉的桥,薄嘴唇,和扁平枕骨。全外显子组测序鉴定了METTL23基因上的新变体(NM_001080510.5:c.322+1del)。该变体未在诸如gnomAD之类的公共人类变体数据库中收集,预测影响剪接作为经典剪接变体,并根据美国医学遗传学和基因组学学院(ACMG)指南分类为致病性。由于患有METTL23相关ID的患者很少见,我们总结并比较了报告的METTL23变异患者的临床表型.我们的报告进一步扩展了METTL23变体,并为METTL23相关ID的临床诊断提供了新的证据。
    METTL23 belongs to a family of protein lysine methyltransferases that methylate non-histone proteins. Recently, the METTL23 gene has been reported to be related to an intellectual developmental disorder, autosomal recessive 44. Patients present with developmental delay, intellectual disability (ID), and variable dysmorphic features. Here, we report on a Chinese girl who presented with global developmental delay, abnormal brain structure, and multiple facial deformities, including a short/upturned nose with a sunken bridge, thin lips, and flat occiput. Whole-exome sequencing identified a novel variant (NM_001080510.5: c.322+1del) on the METTL23 gene. This variant was not collected on public human variants databases such as gnomAD, predicted to influence the splicing as a classical splicing variant, and classified as Pathogenic according to the American College of Medical Genetics and Genomics (ACMG) guidelines. Since patients with METTL23-related ID are rare, we summarize and compare the clinical phenotype of reported patients with METTL23 variants. Our report further expands the METTL23 variants and provides new evidence for clinical diagnosis of METTL23-related ID.
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  • 文章类型: Journal Article
    背景:许多专家和社区对如何向原住民和托雷斯海峡儿童提供国家残疾保险计划服务感到担忧。这项研究是应NPY妇女理事会的要求与研究人员合作进行的,探索对在偏远地区生活残疾的土著和托雷斯海峡岛民儿童的支持。
    目标:本范围界定综述旨在(a)探讨为居住在该地区的年轻土著和托雷斯海峡岛民儿童(0-8岁)的家庭获得残疾支持服务的障碍和促成因素,农村和远程设置,(b)总结在这些环境中获得幼儿支持的最佳做法。
    方法:搜索在三个电子数据库中运行,以及灰色文献来源。我们使用土著慢性病知识翻译和交流工具研究卓越中心评估了纳入出版物的质量。专题分析支持叙述综合。
    结果:从最初的搜索(557次引用),我们确定了13份符合条件的文件。大多数文件是同行评审的定性研究文章。确定的关键主题包括:(1)整体方法,(2)理解残疾,(3)一致的关系,(4),灵活性,(5)简化系统,(6)加强沟通。
    结论:本次范围审查揭示了质量提供方面的差距,为居住在该地区的土著和托雷斯海峡岛民儿童的家庭提供文化上敏感的残疾服务,澳大利亚的农村和偏远地区。以家庭为中心,灵活的方法将有助于满足他们的需求。需要进行未来的研究来设计和评估土著和托雷斯海峡岛民儿童的护理模型。
    BACKGROUND: Many experts and communities have concerns about how National Disability Insurance Scheme services are provided to Aboriginal and Torres Strait children. This study was undertaken at the request of the NPY Women\'s Council in partnership with the researchers, to explore supports for Aboriginal and Torres Strait Islander children living with a disability in their remote areas.
    OBJECTIVE: This scoping review aims to (a) explore the barriers and enablers to accessing disability support services for families of young Aboriginal and Torres Strait Islander children (0-8 years) living in regional, rural and remote settings, and (b) summarise best practice approaches for accessing support for young children in these settings.
    METHODS: The search was run in three electronic databases, as well as grey literature sources. We assessed the quality of included publications using the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange tool. A narrative synthesis was supported by thematic analysis.
    RESULTS: From an initial search (557 citations), we identified 13 eligible documents. Most documents were peer-reviewed articles of qualitative studies. Key themes identified included the following: (1) Holistic approach, (2) Understanding disability, (3) Consistent relationships, (4), Flexibility, (5) Simplify system and (6) Enhance communication.
    CONCLUSIONS: This scoping review has revealed gaps in the provision of quality, culturally responsive disability services for families of Aboriginal and Torres Strait Islander children living in regional, rural and remote areas of Australia. A family-centred, flexible approach will help address their needs. Future research is required to design and evaluate models of care for Aboriginal and Torres Strait Islander children.
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  • 文章类型: Journal Article
    背景:SMARCB1基因编码BRG1相关因子(BAF)复合物的一个亚基,该基因的突变与Coffin-Siris综合征(CSS)3型有关。CSS的特点是一系列的发育障碍,面部畸形特征,和喂养困难。在CSS中注意到基因型-表型相关性,涉及SMARCB1突变的病例通常表现出更严重的语言障碍和智力障碍。方法:我们对已报告的CSS3型病例进行了回顾,并提出了与SMARCB1变体相关的CSS的第一例,其中患者表现出正常的智力,而仅表现出轻度的选择性神经心理缺陷。患者接受了喂养挑战的评估,生长延迟,和第二年的畸形特征。随后,CSS诊断是由于从头杂合c.568C>T(p。Arg190Trp)在SMARCB1基因中的变异体。由于学习困难,患者接受了全面的神经心理学评估,这与她的医学和发育历史的回顾性重建有关。结果:患者表现出正常的智力和适应功能,在算术和语言学习和长期记忆方面有特定的缺陷和选择性困难。在儿童早期观察到的喂养困难和语言延迟随着时间的推移显着改善。讨论:我们将此案例与先前报告的CSS类型3案例进行讨论,强调神经心理学方面。很明显,CSS的神经心理学特征在受影响的个体之间可能有所不同,强调医疗保健专业人员针对特定认知和情感需求量身定制的个性化支持和干预措施的重要性。我们的案例为未来的研究提供了途径,以鉴定表型表达的特定修饰剂,以解释患者之间智力的变异性并确定基因治疗的潜在靶标。
    Background: The SMARCB1 gene encodes a subunit of the BRG1-Associated Factor (BAF) complex, and mutations in this gene have been linked to Coffin-Siris Syndrome (CSS) type 3. CSS is characterized by a range of developmental disabilities, facial dysmorphic features, and feeding difficulties. There\'s been noted genotype-phenotype correlation in CSS, with cases involving SMARCB1 mutations often exhibiting more severe language impairment and intellectual disability. Method: We conducted a review of reported CSS type 3 cases and presented the first instance of CSS associated with a SMARCB1 variant wherein the patient exhibited normal intelligence and only mild selective neuropsychological deficits. The patient underwent evaluation for feeding challenges, growth delay, and dysmorphic features during their second year of life. Subsequently, CSS diagnosis was confirmed due to a de novo heterozygous c.568C > T (p.Arg190Trp) variant in the SMARCB1 gene. Due to learning difficulties, the patient underwent a comprehensive neuropsychological assessment, which was related to the retrospective reconstruction of her medical and developmental history. Results: The patient demonstrated normal intelligence and adaptive functioning, with specific deficits in arithmetic and selective difficulties in verbal learning and long-term memory. Feeding difficulties and language delay observed in early childhood showed significant improvement over time. Discussion: We discuss this case in relation to previously reported CSS type 3 cases, emphasizing neuropsychological aspects. It\'s evident that neuropsychological features of CSS can vary among affected individuals, highlighting the importance of personalized support and interventions tailored to specific cognitive and emotional needs by healthcare professionals. Our case suggests avenues for future research to identify specific modifiers of phenotypic expression to explain variability in intellect among patients and pinpoint potential targets for gene therapy.
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  • 文章类型: Case Reports
    X连锁肾上腺脑白质营养不良(ALD)是由ABCD1基因的致病变体引起的一种罕见的遗传性疾病,导致过氧化物酶体功能受损和非常长链脂肪酸(VLCFAs)的积累。ALD表现出广泛的神经和肾上腺症状,从儿童脑肾上腺脑白质营养不良到肾上腺神经神经病和肾上腺功能不全。某些地区可以进行ALD的新生儿筛查(NBS),但在其他地区仍然缺乏。比如印度。
    我们介绍了一个10岁的ALD男孩,他出现了癫痫发作,进步的弱点,视力障碍,肾上腺功能不全.尽管有症状管理和饮食调整,疾病进展迅速,导致呼吸衰竭和最终死亡。通过分子分析和升高的VLCFA水平证实了诊断。神经影像学显示特征性白质变化与ALD一致。
    ALD是一种无法治愈的毁灭性疾病,强调通过新生儿筛查和基因检测早期发现的重要性。管理策略包括肾上腺激素治疗,基因治疗,和同种异体干细胞移植,以及研究性治疗,如VLCFA正常化。我们的案例主张需要全球NBS和儿科神经系统随访,以实现早期干预并改善患者预后。此外,ALD之间的联系,复发性高热惊厥,和无法解释的发育延迟需要进一步研究,以更好地了解疾病进展和潜在的治疗目标.
    UNASSIGNED: X-linked adrenoleukodystrophy (ALD) is a rare genetic disorder caused by a pathogenic variant of the ABCD1 gene, leading to impaired peroxisomal function and the accumulation of very long-chain fatty acids (VLCFAs). ALD presents a wide range of neurological and adrenal symptoms, ranging from childhood cerebral adrenoleukodystrophy to adrenomyeloneuropathy and adrenal insufficiency. Newborn screening (NBS) for ALD is available in some regions but remains lacking in others, such as India.
    UNASSIGNED: We present a case of a 10-year-old boy with ALD who presented with seizures, progressive weakness, visual impairment, and adrenal insufficiency. Despite symptomatic management and dietary adjustments, the disease progressed rapidly, leading to respiratory failure and eventual demise. The diagnosis was confirmed through molecular analysis and elevated VLCFA levels. Neuroimaging revealed characteristic white matter changes consistent with ALD.
    UNASSIGNED: ALD is a devastating disease with no cure, emphasizing the importance of early detection through newborn screening and genetic testing. Management strategies include adrenal hormone therapy, gene therapy, and allogenic stem cell transplantation, as well as investigational treatments such as VLCFA normalization. Our case advocates the need for worldwide NBS and pediatric neurologic follow-up to enable early intervention and improve patient outcomes. Additionally, the association between ALD, recurrent febrile seizures, and unexplained developmental delay warrants further investigation to better understand disease progression and potential therapeutic targets.
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  • 文章类型: Case Reports
    先天性四肢和面部挛缩,低张力,和发育迟缓(CLIFAHDD)综合征(OMIM#616266)是一种常染色体显性遗传性疾病,可导致四肢和面部的先天性挛缩,低张力,和发育迟缓。此外,它可能导致生长迟缓并出现各种临床症状,比如脑萎缩,一个小脑垂体,肌肉骨骼异常,呼吸异常,腹疝,和异常的面部特征。在这里,我们描述了钠泄漏通道中的一种新的从头错义遗传变异,与CLIFAHDD综合征相关的非选择性(NALCN)基因。
    这项研究描述了一位双脚内翻畸形的患者,手指尺侧的偏差,和严重的低张力症.该患者随后通过基因检测被证实患有CLIFAHDD综合征,这也揭示了NALCN基因中的一种新的从头错义遗传变异(c.3553G>A,p.Ala1185Thr)。
    我们的发现进一步丰富了NALCN基因的已知变异谱,并可能扩大治疗NALCN相关疾病的临床选择范围。
    UNASSIGNED: Congenital contractures of the limbs and face, hypotonia, and developmental delay (CLIFAHDD) syndrome (OMIM #616266) is an autosomal dominant hereditary disease that can lead to the congenital contracture of the limbs and face, hypotonia, and developmental delay. In addition, it may result in growth retardation and present various clinical symptoms, such as brain atrophy, a small pituitary gland, musculoskeletal abnormalities, abnormal breathing, abdominal hernia, and abnormal facial features. Herein, we describe a novel de novo missense genetic variant in the sodium leak channel, non-selective (NALCN) gene that is associated with CLIFAHDD syndrome.
    UNASSIGNED: This study describes a patient with varus deformities in both feet, deviation of the ulnar side of the fingers, and severe hypotonia. This patient was subsequently confirmed to have CLIFAHDD syndrome through genetic testing, which also revealed a novel missense de novo genetic variant in the NALCN gene (c.3553G > A, p.Ala1185Thr).
    UNASSIGNED: Our findings further enrich the known variant spectrum of the NALCN gene and may expand the range of clinical options for treating NALCN-related disorders.
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  • 文章类型: Meta-Analysis
    发展延迟是低收入和中等收入国家的公共卫生问题。然而,在低收入和中等收入国家没有关于发展延迟的总结证据,关于这个问题的初步研究表明,结果各不相同,没有定论。本系统评价和荟萃分析旨在评估低收入和中等收入国家儿童中确认的发育迟缓及其决定因素的汇总程度。
    我们遵循系统评价和荟萃分析(PRISMA)指南的首选报告项目撰写本系统评价和荟萃分析。主要研究从PubMed搜索,PsycINFO,Hinari,科学直接,非洲在线杂志,WebofScience,和谷歌学者数据库。纽卡斯尔-渥太华量表,适应横断面研究,用于评估纳入研究的质量。通过I2和Eggers检验评估异质性和发表偏倚,分别。由于高度的异质性,采用随机效应模型进行分析。具有95%置信区间(CI)的赔率(OR)用于显示发育延迟与其决定因素之间的关联。
    确认发育迟缓的合并患病率为18.83,95%CI(15.53-22.12)。在亚组分析中,在非洲进行的研究中观察到发育迟缓的高患病率[26.69%(95%CI,15.78-37.60)].母亲教育[3.04;95%CI(2.05,4.52)]和低出生体重[3.61;95%CI(1.72,7.57)]是发育迟缓的重要决定因素。
    与高收入国家相比,低收入和中等收入国家的发展延迟合并流行率高。母亲的教育水平和出生时的体重与发育迟缓显着相关。因此,低出生体重率和生活在低收入和中等收入国家的文盲母亲人数。
    PROSPERO,CRD42024513060。
    Developmental delay is a public health problem in low- and middle-income countries. However, there is no summarized evidence in low- and middle-income countries on developmental delay, and primary studies on this issue show varied and inconclusive results. This systematic review and meta-analysis aimed to assess the pooled magnitude of confirmed developmental delay and its determinants among children in low- and middle-income countries.
    We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to write this systematic review and meta-analysis. Primary studies were searched from PubMed, PsycINFO, Hinari, Science Direct, African Journal of Online, Web of Science, and Google Scholar databases. The Newcastle-Ottawa Scale, adapted for the cross-sectional studies, was used to assess the quality of the included studies. Heterogeneity and publication bias were assessed by the I2 and Eggers tests, respectively. Due to the high heterogeneity, the random effects model was used for analysis. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to show the association between developmental delay and its determinants.
    The pooled prevalence of confirmed developmental delay was 18.83, 95% CI (15.53-22.12). In the subgroup analysis, a high prevalence of developmental delay [26.69% (95% CI, 15.78-37.60)] was observed in studies performed in Africa. Maternal education [3.04; 95% CI (2.05, 4.52)] and low birth weight [3.61; 95% CI (1.72, 7.57)] were significant determinants of developmental delay.
    The pooled prevalence of developmental delay in low- and middle-income countries was high as compared to that in high-income countries. Maternal education level and weight at birth were significantly associated with developmental delays. Therefore, strategies should be designed to decrease the rate of low birth weight and the number of illiterate mothers living in low- and middle-income countries.
    PROSPERO, CRD42024513060.
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  • 文章类型: Case Reports
    Joubert综合征(Joubertsyndrome,JS)是一种罕见的常染色体隐性遗传神经发育疾病,其特征是先天性中后脑异常和多种临床表现。本文介绍一例21型Joubert综合征伴小头症,癫痫发作,发育迟缓和语言回归,由CSP1基因变异引起,并检查了贡献变量。本文通过总结文献,为临床怀疑JS的从业人员提供检测模式,提高对JS的认识。
    Joubert syndrome (JS) is a rare autosomal recessive neurodevelopmental condition characterized by congenital mid-hindbrain abnormalities and a variety of clinical manifestations. This article describes a case of Joubert syndrome type 21 with microcephaly, seizures, developmental delay and language regression, caused by a CSPP1 gene variant and examines the contributing variables. This paper advances the understanding of JS by summarizing the literature and offering detection patterns for practitioners with clinical suspicions of JS.
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  • 文章类型: Journal Article
    文献中已经报道了OTUD6B基因中的双等位基因变异与以畸形相为特征的智力发育障碍有关,癫痫发作,和远端肢体异常。针对受影响个体描述的身体差异表明该疾病可能是临床上可识别的,但以前的出版物报道了一些受影响的个体最初的Kabuki综合征(KS)临床怀疑.这里,我们报道了三个在OTUD6B中具有双等位基因变异的兄弟姐妹与神经发育迟缓共分离,共同的身体差异,和其他与先前报道的个体相似的临床发现。然而,临床表现,如长睑裂,突出和杯状的耳朵,发育迟缓,生长不足,持久的胎儿指尖垫,椎体异常,先证者中的癫痫发作最初提示KS。此外,以前未报告的临床表现,如原发性牙列的延迟萌出,柔软的面团状皮肤,出汗减少,我们的患者中存在的镜像运动表明表型的扩展,我们进行了文献综述,以更新与OTUD6B和人类基因-疾病相关的当前信息.
    Biallelic variants in the OTUD6B gene have been reported in the literature in association with an intellectual developmental disorder featuring dysmorphic facies, seizures, and distal limb abnormalities. Physical differences described for affected individuals suggest that the disorder may be clinically recognizable, but previous publications have reported an initial clinical suspicion for Kabuki syndrome (KS) in some affected individuals. Here, we report on three siblings with biallelic variants in OTUD6B co-segregating with neurodevelopmental delay, shared physical differences, and other clinical findings similar to those of previously reported individuals. However, clinical manifestations such as long palpebral fissures, prominent and cupped ears, developmental delay, growth deficiency, persistent fetal fingertip pads, vertebral anomaly, and seizures in the proband were initially suggestive of KS. In addition, previously unreported clinical manifestations such as delayed eruption of primary dentition, soft doughy skin with reduced sweating, and mirror movements present in our patients suggest an expansion of the phenotype, and we perform a literature review to update on current information related to OTUD6B and human gene-disease association.
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