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: Case Reports
    围产期是缺血事件发生的高风险,导致终身发病。根据胎龄以及缺氧/缺血的程度,已经研究了胎儿和新生儿脑缺血性损伤的各种模式。我们介绍了一例推测的围产期缺血性左大脑中动脉卒中的病例,该病例通过磁共振成像(MRI)诊断为全球发育迟缓的儿童,脑瘫,和癫痫。有趣的是,大脑中动脉中风的典型特征通常不存在于围产期中风中,因此这些不是围产期成像的。由于对神经可塑性和神经调节的研究和研究是当前感兴趣的主题,并且正在进行一些研究,我们希望将这种情况添加到现有的科学文献中。
    The perinatal period is a high risk for ischemic events to occur leading to lifelong morbidity. Various patterns of ischemic injury to the fetal and neonatal brain have been studied depending on gestational age as well as the degree of hypoxia/ischemia. We present a case of presumed perinatal ischemic left middle cerebral artery stroke diagnosed by magnetic resonance imaging (MRI) in a child with global developmental delay, cerebral palsy, and epilepsy. Interestingly, the typical features of middle cerebral artery stroke are often not present in perinatal strokes, and hence these are not imaged perinatally. Since studies and research into neuroplasticity and neuromodulation are current topics of interest and several research studies are being conducted, we wish to add this case to the available scientific literature.
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  • 文章类型: Case Reports
    在幼儿中,一岁以下,耳蜗畸形伴有严重的听力损失,并伴有外淋巴瘘(PLF),提出了严峻的临床挑战,保证立即进行听力学和手术干预。及时检测和关闭PLF,早期CI可以显着改善此类患者的预后,并帮助他们实现最大的听力和发育潜力,从长远来看。
    内耳畸形(IEM)具有不完整的分区和囊性耳蜗,大多伴有严重的听力损失。它与其他畸形如淋巴瘘(PLF)进一步复杂化。此案涉及8个月大的儿童耳蜗畸形和严重的听力损失。手术干预在钉足底板发现了PLF,已成功关闭。手术还包括在右耳中放置耳蜗植入物(CI),通过圆窗。左耳装有助听器,持续的听力阈值在70-80分贝。在6岁的时候,儿童在CI中表现出良好的听力结果,只有适度的言语延迟。伴有外淋巴渗漏的耳蜗畸形需要立即手术关闭PLF,将细菌性脑膜炎的风险降至最低。只要有可能,在这种情况下,应探讨aCI的可行性,并应将aCI用于治疗听力损失。听力学和言语结果可能会随着CI的使用而变化,尤其是在IEM的情况下。然而,早期CI加上及时的PLF检测和关闭可以帮助严重听力损失的儿童,为了实现他们最大的听力和发展潜力,从长远来看。
    UNASSIGNED: In young infants, under the age of one-year, cochlear malformation with profound hearing loss complicated by a perilymphatic fistula (PLF), presents a serious clinical challenge, warranting immediate audiological and surgical intervention. Timely PLF detection and closure, along with an early CI can significantly improve the prognosis of such patients and helps them in achieving their maximum hearing and developmental potential, in the long term.
    UNASSIGNED: Inner ear malformation (IEM) with incomplete partition and cystic cochlea is mostly accompanied by profound hearing loss. It gets further complicated with other malformations such as a perilymphatic fistula (PLF). This case concerns an 8-month-old child cochlear malformation and profound hearing loss. Surgical intervention identified a PLF at the stapedial footplate, which was successfully closed. The surgery also included the placement of a cochlear implant (CI) in the right ear, via the round window. The left ear was equipped with hearing aids, with persistent hearing thresholds at 70-80 db. At the age of 6 years, the child showed a good hearing outcome with the CI, with only moderate speech delay. Cochlear malformation accompanied by a perilymphatic leakage warrants immediate surgical closure of the PLF, to minimize the risk of bacterial meningitis. Wherever possible, the feasibility of a CI should be explored in such cases and a CI should be placed for treatment of hearing loss. Audiological and speech outcomes may vary with the use of the CI, especially in cases of IEM. However, an early CI coupled with timely PLF detection and closure can help children with profound hearing loss, in achieving their maximum hearing and developmental potential, in the long run.
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  • 文章类型: Journal Article
    在印度,总的来说,发现1.5-19.8%的儿童发育迟缓。幼儿发育评估和卫生专业人员的早期转诊诊断评估将加速适当的早期干预。护士可以筛选孩子并通过提供必要的信息和支持来帮助父母。
    对初级保健护士进行儿童发育筛查和早期识别发育迟缓(DD)的培训,并发现其有效性。
    评估护士知识和筛查实践培训计划的有效性,以识别有DD风险的儿童,并找出护士知识和筛查实践之间的关系。
    准实验,一组预测试,69名护士采用测试后设计,他们提供儿童保育服务,并在班加罗尔选定的政府医院工作,南印度。培训前后对护士识别有DD风险儿童的知识和筛查实践进行了评估。SPSS软件包21.00版本用于分析描述性和推断性统计数据。
    该培训计划有效地提高了初级保健护士在识别五岁以下儿童DDs方面的知识和筛查实践。
    这项研究的结果得出结论,通过适当的培训计划,护士可以进行发育筛查。该培训计划在提高护士的知识和筛查实践中在5岁以下儿童的DDs识别方面发挥了重要作用。
    UNASSIGNED: In India, overall, 1.5-19.8% of the children were found to be developmentally delayed. The evaluation of development in young children and health professionals\' early referrals for diagnostic assessment will accelerate appropriate early intervention as early as possible. Nurses can screen the children and help the parents by providing the necessary information and support.
    UNASSIGNED: To train the primary care nurses on developmental screening and early identification of developmental delay (DD) in children and find the effectiveness of the same.
    UNASSIGNED: To evaluate the effectiveness of the training program on the knowledge and screening practice of the nurses towards the identification of children at risk for DD and to find out the relationship between nurses\' knowledge and screening practice.
    UNASSIGNED: A quasi-experimental, one-group pretest, post-test design was adopted among 69 nurses, who were providing child care services and working in the selected government hospitals in Bengaluru, South India. Nurses\' knowledge and screening practice in identifying children at risk for DD were assessed before and after the training. SPSS package 21.00 version was used to analyse the descriptive and inferential statistics.
    UNASSIGNED: The training program was effective in the enhancement of primary care nurses\' knowledge and screening practice in the identification of DDs in under-five children.
    UNASSIGNED: The findings of this study concluded that developmental screening can be performed by nurses with suitable training programs. The training program played a significant role in the enhancement of nurses\' knowledge and screening practice in the identification of DDs in under-five children.
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  • 文章类型: Case Reports
    背景:4号染色体短臂中的连续基因缺失与各种神经发育障碍有关。
    方法:在本研究中,我们对肛门闭锁的先证者进行了外周血染色体G显带核型分析和全外显子组测序(WES),全球发育迟缓,淋巴细胞增多,和其他多系统异常。此外,还对先证者的父母和兄弟进行了染色体G带核型分析。
    结果:发现7个月大的先证者具有26.738Mb4p15.33-p14缺失,如通过染色体G带核型分析和WES鉴定的。
    结论:我们通过核型和WES分析确定了一名患有近端4p缺失综合征的患者,这或许可以解释他的一些表型.我们的研究提高了临床医生对这种罕见疾病的认识,并为受影响的家庭提供有价值的遗传咨询。需要进一步的研究来确定与近端4p缺失综合征相关的致病基因或关键区域。
    BACKGROUND: Contiguous gene deletion in the short arm of chromosome 4 is linked to various neurodevelopmental disorders.
    METHODS: In this study, we conducted peripheral blood chromosome G-banding karyotyping and whole-exome sequencing (WES) on a proband presenting with anal atresia, global developmental delay, lymphocytosis, and other multisystem anomalies. Additionally, chromosome G-banding karyotyping was also carried out on the proband\'s parents and brother.
    RESULTS: The 7-month-old proband was found to have a 26.738 Mb 4p15.33-p14 deletion as identified by chromosome G-banding karyotyping and WES.
    CONCLUSIONS: We identified a patient with proximal 4p deletion syndrome by karyotype and WES analysis, which might explain some of his phenotypes. Our research enhances clinicians\' knowledge of this rare condition, and offers valuable genetic counseling to the affected family. Further research is necessary to identify the causative gene or critical region associated with proximal 4p deletion syndrome.
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  • 文章类型: Case Reports
    粘附蛋白复合物在各种细胞过程中起着至关重要的作用,如姐妹染色单体内聚,染色体缩合,DNA修复,和转录调控。它由SMC1,SMC3,RAD21,STAG1/STAG2亚基组成,和几种调节蛋白。这些成分的致病变异会导致粘附分子病,具有共同的临床特征,包括面部畸形,延迟生长,发育迟缓,和肢体异常.STAG1中的致病变体导致了一种新出现的综合征性发育障碍,文献中只有21例报道了病例。我们描述了一个3岁的女孩,患有先天性双侧马蹄内翻足和单侧小眼症的临床表现,以前在文献中未报道过。全外显子组测序揭示了一个新的从头无义变体(c.1183.C>T,p。(Arg395*))在STAG1中,扩大了与STAG1相关的遗传性肾病的临床和分子谱。该患者的独特表型突出了该病的临床多样性,强调它们在发育迟缓和畸形特征情况下的相关性。进一步研究,包括基因型-表型相关性分析和功能调查,对于增强我们对STAG1相关遗传病的理解至关重要。
    The cohesin protein complex plays a vital role in various cellular processes such as sister chromatid cohesion, chromosome condensation, DNA repair, and transcriptional regulation. It is constituted by SMC1, SMC3, RAD21, STAG1/STAG2 subunits, and several regulatory proteins. Pathogenic variants in these components cause cohesinopathies, with common clinical features including facial dysmorphism, delayed growth, developmental delay, and limb anomalies. Pathogenic variants in the STAG1 contribute to an emerging syndromic developmental disorder with only 21 reported cases in the literature. We describe a 3-year-old girl presenting with congenital bilateral clubfoot and unilateral microphthalmia-clinical manifestations not previously reported in the literature. Whole exome sequencing revealed a novel de novo nonsense variant (c.1183C>T, p.(Arg395*)) in the STAG1, expanding the clinical and molecular spectrum of STAG1-related cohesinopathy. This patient\'s unique phenotype highlights the clinical diversity within cohesinopathies, emphasizing their relevance in cases of developmental delay and dysmorphic features. Further studies, including genotype-phenotype correlation analyses and functional investigations, are essential for enhancing our understanding of STAG1-related cohesinopathy.
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  • 文章类型: Journal Article
    背景:拷贝数变异(CNVs)在理解所有疾病和表型的病因方面变得越来越重要,包括神经认知障碍(ND)。在与ND相关的已建立的区域中,有16号染色体缺失(16p11.2)和15号染色体重复(15q3)的一小部分。已经开发了各种方法来鉴定CNV和感兴趣的疾病之间的关联。大多数方法基于统计推断技术。然而,由于CNV特征的多维性质,这些方法还不成熟。另一个方面是不同方法发现的区域很大,而致病区域可能要小得多。
    结果:在这项研究中,我们提出了一个正则化的深度学习模型来选择目标疾病的因果区域。在近端[20]梯度下降算法的帮助下,该模型利用组LASSO概念,并在稀疏性框架中包含深度学习模型。我们对74,811名患有三种类型脑部疾病的个体进行了CNV分析,自闭症谱系障碍(ASD),精神分裂症(SCZ),和发育迟缓(DD),并执行累积分析以发现ND之间共有的区域。与疾病相关的基因的大脑表达平均增加了20%,和基因同源小鼠引起神经系统表型增加了18%(平均)。DECIPHER数据源还寻找与基因本体论分析相关的其他表型。目标疾病与一些未开发区域相关,例如1q21.1和1q21.2上的删除(对于ASD),20q12上的删除(对于SCZ),和8p23.3上的重复(对于DD)。此外,我们的方法与其他机器学习算法进行了比较。
    结论:我们的模型使用正则化深度学习有效识别与表型性状相关的区域。而不是试图分析整个基因组,CNVDeep允许我们只关注疾病的致病区域。
    BACKGROUND: Copy number variants (CNVs) have become increasingly instrumental in understanding the etiology of all diseases and phenotypes, including Neurocognitive Disorders (NDs). Among the well-established regions associated with ND are small parts of chromosome 16 deletions (16p11.2) and chromosome 15 duplications (15q3). Various methods have been developed to identify associations between CNVs and diseases of interest. The majority of methods are based on statistical inference techniques. However, due to the multi-dimensional nature of the features of the CNVs, these methods are still immature. The other aspect is that regions discovered by different methods are large, while the causative regions may be much smaller.
    RESULTS: In this study, we propose a regularized deep learning model to select causal regions for the target disease. With the help of the proximal [20] gradient descent algorithm, the model utilizes the group LASSO concept and embraces a deep learning model in a sparsity framework. We perform the CNV analysis for 74,811 individuals with three types of brain disorders, autism spectrum disorder (ASD), schizophrenia (SCZ), and developmental delay (DD), and also perform cumulative analysis to discover the regions that are common among the NDs. The brain expression of genes associated with diseases has increased by an average of 20 percent, and genes with homologs in mice that cause nervous system phenotypes have increased by 18 percent (on average). The DECIPHER data source also seeks other phenotypes connected to the detected regions alongside gene ontology analysis. The target diseases are correlated with some unexplored regions, such as deletions on 1q21.1 and 1q21.2 (for ASD), deletions on 20q12 (for SCZ), and duplications on 8p23.3 (for DD). Furthermore, our method is compared with other machine learning algorithms.
    CONCLUSIONS: Our model effectively identifies regions associated with phenotypic traits using regularized deep learning. Rather than attempting to analyze the whole genome, CNVDeep allows us to focus only on the causative regions of disease.
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  • 文章类型: Journal Article
    动机是儿童发展的关键因素,但是很少有研究检查儿童任务和感知动机的儿童和家庭预测因素。因此,这项为期6个月的全球发育迟缓(GDD)学龄前儿童纵向研究的三个目的是探索:1)认知领域的任务和感知动机之间的差异;2)感知动机的三个领域之间的差异:认知,毛马达,和社会;3)认知任务动机的早期儿童和家庭预测因子以及6个月后感知动机的三个领域。结果表明,患有GDD的学龄前儿童表现出比认知感知动机更高的认知任务动机,感知认知动机低于其他两个感知动机领域。不同的儿童和家庭因素预测认知任务动机和感知动机的三个领域。从业人员应教育照顾者如何观察儿童的动机,以增强儿童的积极参与。
    Motivation is a key factor for child development, but very few studies have examined child and family predictors of both child task and perceived motivation. Thus, the three aims of this 6-month longitudinal study in preschoolers with global developmental delays (GDD) were to explore: 1) differences between task and perceived motivation in cognitive domain; 2) differences among three domains of perceived motivation: cognitive, gross motor, and social; and 3) early child and family predictors of cognitive task motivation and the three domains of perceived motivation 6 months later. Results indicated that preschoolers with GDD showed higher cognitive task motivation than cognitive perceived motivation, and lower perceived cognitive motivation than the other two perceived motivation domains. Different child and family factors predicted cognitive task motivation and the three domains of perceived motivation. Practitioners should educate caregivers on how to observe children\'s motivation to enhance children\'s active participation.
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  • 文章类型: Journal Article
    背景:BCL11A基因与包括智力障碍综合征(IDS)在内的疾病有关,编码在造血和大脑中高度表达的锌指蛋白,并充当胎儿血红蛋白(HbF)的转录阻遏物。BCL11A的从头变异与IDS相关,其特点是发育迟缓,自闭症谱系障碍(ASD)和言语和语言延迟。关于BCL11A基因变异的报道在世界范围内仍然有限,和其他病例需要扩大变异和表型谱。
    方法:患者是一名5岁女孩,因发育迟缓住院。在分析了她的临床和病理特征后,对发育迟缓和行为差异的致病遗传变异进行全外显子组测序(WES).鉴定出BCL11A基因中的候选变体,并通过Sanger测序进一步验证。
    结果:杂合变体,c.1442delA(p。Glu481Glyfs*25),通过WES在BCL11A基因的外显子4中鉴定。该变体导致编码蛋白质的截短表达。通过Sanger测序证实了这种从头变体。在我们的患者中,语言延迟和行为差异显着。
    结论:我们的发现表明,BCL11A变异可能导致发育迟缓和行为差异,扩大了BCL11A基因的遗传谱。
    BACKGROUND: The BCL11A gene is involved in disorders including intellectual disability syndrome (IDS), encodes a zinc finger protein highly expressed in haematopoietic and brain and acts as a transcriptional repressor of foetal haemoglobin (HbF). De novo variants in BCL11A have been associated with IDS, which is characterized by developmental delays, autism spectrum disorder (ASD) and speech and language delays. The reports of BCL11A gene variants are still limited worldwide, and additional cases are needed to expand the variant and phenotype spectrums.
    METHODS: The patient is a 5-year-old girl who was hospitalized due to developmental delays. After analysing her clinical and pathological characterizations, whole-exome sequencing (WES) was performed for pathogenic genetic variants of developmental delay and behavioural differences. Candidate variant in BCL11A gene was identified and further validated by Sanger sequencing.
    RESULTS: A heterozygous variant, c.1442delA (p.Glu481Glyfs*25), was identified in exon 4 of the BCL11A gene through WES. This variant results in a truncated expression of the encoded protein. This de novo variant was confirmed by Sanger sequencing. The language delay and behavioural differences were prominent in our patient.
    CONCLUSIONS: Our finding demonstrates that BCL11A variant may cause developmental delay and behavioural differences, expanding the genetic spectrum of the BCL11A gene.
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  • 文章类型: Case Reports
    5岁以下儿童发育迟缓,全球发病率为10%-15%,是由包括遗传在内的多种因素引起的,产前条件,围产期并发症,产后影响,社会因素,和营养缺乏。诸如EFNB1,MECP2和TRAPPC9之类的基因变体在蛋白质变形和核因子κB(NF-κB)活性的下调中起着重要作用。
    一个3岁的女孩,表现出糟糕的运动技能,个人社会发展,听觉语言,手眼协调,和视觉表现,被诊断为全球发育迟缓。进行了Trio全外显子组测序以确定其病情的遗传病因。然后通过Sanger测序和定量聚合酶链反应(qPCR)验证鉴定的遗传病因。
    遗传分析显示患者在TRAPPC9基因中具有复合杂合变体。其中包括从未受影响的父亲继承的c.1928del移码变体和从未受影响的母亲继承的外显子12中的缺失。根据美国医学遗传学学院(ACMG)的指南,这些变异被归类为“可能致病”。
    研究表明,复合杂合TRAPPC9基因变异体可导致中国女孩的发育迟缓。根据ACMG标准,这些变体已被分类为具有显着的致病作用,提示隐性遗传模式,并强调产前检查对未来后代的重要性。此外,我们的发现扩大了TRAPPC9基因的基因型谱,并为经历发育迟缓的儿童提供更全面的遗传咨询信息。
    UNASSIGNED: Developmental delay in children under 5 years old, which occurs globally with an incidence of 10%-15%, is caused by multiple factors including genetics, prenatal conditions, perinatal complications, postnatal influences, social factors, and nutritional deficiencies. Gene variants such as EFNB1, MECP2 and TRAPPC9 play a significant role in protein deformation and downregulation of nuclear factor κB (NF-κB) activity.
    UNASSIGNED: A 3-year-old girl, who exhibits poor gross motor skills, personal-social development, auditory language, hand-eye coordination, and visual performance, was diagnosed with global developmental delay. Trio whole exome sequencing was conducted to identify the genetic etiology of her condition. The identified genetic etiology was then validated through Sanger sequencing and quantitative polymerase chain reaction (qPCR).
    UNASSIGNED: Genetic analysis revealed that the patient had compound heterozygous variants in the TRAPPC9 gene. These include a c.1928del frameshift variant inherited from the unaffected father and a deletion in exon 12 inherited from the unaffected mother. According to the American College of Medical Genetics (ACMG) guidelines, these variants were classified as \"likely pathogenic\".
    UNASSIGNED: The study revealed that compound heterozygous TRAPPC9 gene variants cause developmental delay in a Chinese girl. These variants have been classified as having significant pathogenic effect according to the ACMG criteria, suggesting a recessive genetic pattern and highlighting the importance of prenatal testing for future offspring. Furthermore, our findings expand the genotype spectrum of the TRAPPC9 gene, and provide more comprehensive information regarding genetic counseling for children experiencing developmental delay.
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