Short and long term neuro-behavioral alterations in type 1 diabetes mellitus pediatric population

Type 1 diabetes mellitus(T1DM) is one of the most prevalent chronic conditions affecting individuals under the age of 18 years, with increasing incidence worldwide, especially among very young age groups, younger than 5. There is still no cure for the disease, and therapeutic goals and guidelines are a challenge. Currently, despite T1 DM intensive management and technological interventions in therapy, the majority of pediatric patients do not achieve glycemic control goals. This leads to a potential prognosis of long term diabetic complications, nephrological, cardiac, ophthalmological and neurological. Unfortunately, the neurological manifestations, including neurocognitive and behavioral complications, may present soon after disease onset, during childhood and adolescence. These manifestations may be prominent, but at times subtle, thus they are often not reported by patients or physicians as related to the diabetes. Furthermore, the metabolic mechanism for such manifestations has been inconsistent and difficult to interpret in practical clinical care, as reported in several reviews on the topic of brain and T1 DM. However, new technological methods for brain assessment, as well as the introduction of continuous glucose monitoring, provide new insights and information regarding brain related manifestations and glycemic variability and control parameters, which may impact the clinical care of children and youth with T1 DM. This paper provides a comprehensive review of the most recently reported behavioral, cognitive domains, sleep related, electrophysiological, and structural alterations in children and adolescences from a novel point of view. The review focuses on reported impairments based on duration of T1 DM, its timeline, and modifiable disease related risk parameters. These findings are not without controversy, and limitations of data are presented in addition to recommendations for future research direction.     

Psychopathologie de l'errance dans ses rapports avec la culture contemporaine

The increasing phenomenum of wandering for young people in our cities led many clinical psychopathologists specialists of adolescence to pay more attention to it, and to try and understand its fundamental psychopathological motivations. In general, studies on adolescence insist on the relations between the symptomatic outward signs and the social and cultural organisation. The phase of adolescence is related so much, to the world in which it develops. As well as presenting a synthetic picture of the psychopathology of wandering, this study suggests the reading of hypothesis concerning the links it has with some aspects of contemporary culture. If the clinical observations and the anthropological works have constantly stressed the lack of rituals in life and lack of symbols in space, it seems to us that modern culture has nowadays created around the concept of “programme”, a way of structuring the connection to the world, founded on science and technique that must be taken in to account. Our hypothesis is that psychopathology of wandering for young people seems to be in opposite to this way of structuring, and sometimes, its rejection through its symptoms.     

蒙古族地区女性月经初潮母女配对的调查

目的:通过调查通辽市女性月经初潮年龄,建立蒙古族地区汉族和蒙古族女性发育基础数据。方法:采用横断面分层整群抽样方法,在规范调查流程和质量控制标准下于2015年9~12月对本地区3所高中1728名在校女生进行回顾性问卷调查,采集母女月经初潮年龄相关数据,以农村蒙古族、农村汉族、城镇蒙古族、城镇汉族4组进行分析。结果:问卷回收率97.97%,合格率96.16%;女学生月经初潮发生在调查前2~5年者占92.39%,母女记忆明确率均94.01%。女儿和母亲的月经初潮年龄分别为12.6±1.2(9~16)岁和14.8±1.7(11~18)岁,女儿比母亲平均提前了2.14岁(P0.0001),且城镇早于农村(P0.05、P0.001)。蒙古族与汉族间未见差异。女儿月经初潮发生发生在11、12、13、14岁的比例分别为6.45%、46.11%、81.57%、94.60%,母亲分别为0.42%、18.50%、38.98%、61.46%。月经初潮发生率按季节从高到低在母女均表现为夏季、冬季、秋季、春季的顺序。女生月经初潮发生在小学阶段者占50.28%,在初中1、2年级时分别达到了80.44%、96.22%。结论:通辽地区属于蒙古族聚集地,其女性月经初潮年龄有逐渐提前趋势,建议对该地区青少年的青春期教育应从小学4年级开始。     

A systematic review of population-based gingival health studies among children and adolescents with autism spectrum disorder

The prevalence of autism spectrum disorder (ASD) is close to 1% in the United States of America and other countries. Special attention should be given to oral health in individuals with ASD as they are often affected by oral diseases. However, gingival health in children with ASD and adolescents is controversial in terms of the severity of disease and number of people affected.AimTo conduct a systematic review and meta-analysis to assess the gingival health status of children and adolescents with ASD.MethodsThe search was conducted using eight databases for articles that met the inclusion and exclusion criteria. This search produced 742 relevant papers, but only five with sufficient data on gingival and plaque indices were eligible for inclusion in this systematic review and meta-analysis.ResultsThe homogeneity of the sample was tested using the Cohen Q test, which identified significant heterogeneity (P < 0.0001), indicating the use of the random effect’s standard mean difference. Significantly higher gingival index and plaque index values were found in children and adolescents with ASD than in children without ASD.ConclusionIndividuals with ASD need help and better access to oral healthcare. Further investigation is needed with regard to gingival health in individuals with ASD and caries risk assessment to understand how this disorder affects oral health. A standardized index for gingival health will help in the inclusion of more studies to assess gingival health in children and adolescents with ASD.     

1990年与2017年中国0~19岁人群跌倒疾病负担分析

目的 分析和比较1990年和2017年中国0~19岁人群跌倒疾病负担,为制定该人群的跌倒预防控制策略措施提供依据。方法 利用全球疾病负担2017研究结果,选取因跌倒死亡数、死亡率、过早死亡损失寿命年（YLL）、YLL率、伤残损失寿命年（YLD）、YLD率、伤残调整寿命年（DALY）和DALY率等指标,对中国0~19岁人群跌倒疾病负担进行描述,通过比较1990年和2017年相应指标的变化,描述疾病负担变化情况。结果 2017年中国0~19岁人群因跌倒造成的死亡人数、YLL、YLD和DALY分别是5 321人、42.86万人年、14.24万人年和57.10万人年;死亡率、YLL率、YLD率和DALY率分别为1.76/10万、141.49/10万、46.99/10万和188.48/10万。男童跌倒疾病负担大于女童,年龄越低跌倒造成的疾病负担越重。与1990年相比,2017年0~19岁人群中各年龄组的男童、女童跌倒导致的疾病负担均有不同程度下降,死亡数、死亡率、YLL率和DALY率分别下降65.08%、46.63%、47.38%和36.33%;低年龄组疾病负担下降幅度较大。2017年YLD率较1990年增加了73.31%。YLL占DALY比例由1990年的90.84%下降为2017年的75.07%,下降幅度17.36%。结论 与1990年相比,中国0~19岁人群疾病负担有一定幅度下降;跌倒仍然给中国0~19岁人群造成一定的疾病负担,以0~4岁人群为重点人群,应继续开展预防跌倒相关研究和工作。     

青少年膳食及生活方式与近视的危险因素分析(附251例报告)

目的探讨导致青少年近视发病的日常膳食和生活方式相关危险因素,为青少年近视的防治提供依据。方法随机选择6～18岁青少年进行调查,采用问卷调查的方式调查与青少年近视发病相关的日常膳食和生活方式因素,共获有效问卷251份。采用非条件Logistic回归分析近视的危险因素。结果 251例青少年近视率为52.59%。多因素非条件Logistic回归分析表明,经常饮用含糖饮料(OR=4.831),偶尔或不吃粗粮(OR=2.880),偶尔或不吃动物肝脏及水产品(OR=2.318),每日摄入新鲜水果和蔬菜600g以下(OR=5.076),喜欢吃质地软的食物(OR=1.998),读写姿势不规范(OR=2.518)均是青少年近视的危险因素;而膳食平衡不挑食(OR=0.442),每天参加体育锻炼﹥1h(OR=0.392),每天睡眠时间﹥8h(OR=0.508)是青少年近视的保护因素。结论青少年近视患病率较高,应加强对青少年不良的膳食和生活习惯进行早期干预,从而防止近视的发生。