Detection and prevalence of motor skill disorders

The main goal of this research was to establish the prevalence, form of manifestation, level and kind of motor skill disorders in three area of motor development functioning: neuromaturation, coordination and balance.The sample included 1165 children, between 6.5 and 11 years of age.The protocol was constructed and contained tests for the evaluation of neuromaturation, coordination and balance based on Levine tests [Levine, D. M. (1980). The child with learning disabilities. In P. A. Sheiner, The practical managment of the developmental disabled child. Toronto-London: C.V Mosby Company], Ozeretski's motoric test (1975) and ACADIA test (Atkinson, Johnston, & Lindsay, 1981).Extracted coordination disorders were noticed in 37.3%, disharmonic lateralization in 59.5%, balance disorders in 28.7%, and the malfunction of neuromaturation, in 38.9% of the total sample. The findings indicate a significant influence of the age of the pupils on the prevalence of symptoms of delaying in neuromaturation development, disbalance and dyscoordination, as well as the influence of the gender of the pupils on the appearance of delaying in neuromaturation.     

早产儿脑病的研究进展

随着低出生体重儿存活率的提高,早产儿脑损伤成为热点问题,损伤部位不仅局限于脑白质,灰质区域也有受累,故提出了“早产儿脑病”的概念。早产儿脑病包括脑白质损伤和神经元轴突病变。在缺血缺氧、围生期感染等致病因素作用下,脑组织发生直接或间接的神经细胞死亡或者是成熟障碍,最终导致脑性瘫痪、认知、语言、行为等能力障碍。该文总结了早产儿脑病的病理、发病机制、治疗及预后等情况。     

Chapter for antenatal steroids – Treatment drift for a potent therapy with unknown long-term safety seminars in fetal and neonatal medicine

This chapter on therapeutic drift with antenatal steroids will make the case that this pilar of treatment to improve the outcomes of preterm infants, despite multiple Randomized Control Trials (RCTs) and meta-analysis, has multiple gaps in solid clinical data to support any expanded use of Antenatal Corticosteroids (ACS). A basic problem is that agents used for ACS have never been evaluated to minimize fetal exposures. Based on the premise that all drug exposure to the fetus should be minimized and only used when necessary, ACS is a potent developmental modulator that has never been evaluated to minimize the dose and duration of fetal exposure. The use of ACS is expanding to late preterm infants where the benefit is modest, to elective C-sections, and periviable fetuses, with minimal RCT data of long-term benefit. Relevant animal experiments demonstrate that much lower doses will induce lung maturation in sheep and primates. Another area of drift in the use of ACS is based on the assumption that the old RCT data accurately predict the magnitude of benefit when ACS is used today with entirely different OB and neonatal care strategies to improve outcomes. We do not have data that demonstrate the effectiveness of ACS in very low resource environments, where most of the preterm mortality occurs. The final concern is the risk of ACS to the infant and child. Short-term risks are minimal but dysmaturation effects of ACS on multiple organ systems (lung, heart, brain, and kidney) may result in disease presentation in later life.