Acute rheumatic fever: Findings of a hospital-based study and an overview of reported outbreaks

To review the characteristics of reported outbreaks of acute rheumatic fever in the United States, and to determine if there is an increase in the incidence of acute rheumatic fever in the population served by the Hospital for Sick Children, Toronto, Ontario, the authors conducted a literature search and a retrospective review of inpatients and outpatients, satisfying the revised Jones criteria for the diagnosis of acute rheumatic fever, from 1972 to 1988. Patients satisfying the revised Jones criteria for the time period 1972–88 were included in the study. There have been eight articles reporting an increase in acute rheumatic fever in the United States. In three, the majority of children were white and from middle class suburban/rural communities in different geographic locations. Mucoid strains of group A streptococci were implicated but not confirmed as being associated with the outbreaks in three. The results of the chart review at the Hospital for Sick Children revealed that 83 cases satisfied the revised Jones criteria. The number of cases per 100,000 children (aged 18 years or less) per year, decreased progressively over the study period. Polyarthritis was the most frequently seen major criterion occurring in 73% of patients (61 of 83). The most frequently affected ethnic groups were Italians 23%, Afro-Canadians 19% and Orientals 8%. The reported outbreaks in the United States are multifocal and predominantly confined to white middle class children residing in suburban/rural communities. There was no evidence of an increase in the number of cases of acute rheumatic fever seen in the population served by the Hospital for Sick Children; there was a progressive decline in number of cases over the study period. The results facilitate the characterization of acute rheumatic fever within North America into three different patterns of occurrence

THE ONTOGENESIS OF SPEECH DEVELOPMENT

The purpose of this article is to acquaint the specialists, working with children having developmental disorders, with age-related norms for speech development. Many well-known linguists and psychologists studied speech ontogenesis (logogenesis). Speech is a higher mental function, which integrates many functional systems. Speech development in infants during the first months after birth is ensured by the innate hearing and emerging ability to fix the gaze on the face of an adult. Innate emotional reactions are also being developed during this period, turning into nonverbal forms of communication. At about 6 months a baby starts to pronounce some syllables; at 7–9 months – repeats various sounds combinations, pronounced by adults. At 10–11 months a baby begins to react on the words, referred to him/her. The first words usually appear at an age of 1 year; this is the start of the stage of active speech development. At this time it is acceptable, if a child confuses or rearranges sounds, distorts or misses them. By the age of 1.5 years a child begins to understand abstract explanations of adults. Significant vocabulary enlargement occurs between 2 and 3 years; grammatical structures of the language are being formed during this period (a child starts to use phrases and sentences). Preschool age (3–7 y. o.) is characterized by incorrect, but steadily improving pronunciation of sounds and phonemic perception. The vocabulary increases; abstract speech and retelling are being formed. Children over 7 y. o. continue to improve grammar, writing and reading skills. The described stages may not have strict age boundaries, as soon as they are dependent not only on environment, but also on the child’s mental constitution, heredity and character

Delayed speech development in children: Introduction to terminology

There has been recently an increase in the number of children diagnosed with delayed speech development. There is delay compensation with age, but mild deficiency often remains for life. Delayed speech development is more common in boys than in girls. Its etiology is unknown in most cases, so a child should be followed up to make an accurate diagnosis. Genetic predisposition or environmental factors frequently influence speech development. The course of its delays is various. In the history of a number of disorders (childhood disintegrative disorder, Landau–Kleffner syndrome), there is evidence for the normal development of speech to a certain period and then stops or even regresses. By way of comparison, there are generally speech developmental changes in autism even during the preverbal stage (a complex of revival fails to form; babbling is poor, low emotional, gibberish; at the same time, the baby recipes whole phrases without using them to communicate). These speech disorders are considered not only as a delay, but also as a developmental abnormality. Speech disorders in children should be diagnosed as early as possible in order to initiative corrective measures in time. In this case, a physician makes a diagnosis and a special education teacher does corrective work. The successful collaboration and mutual understanding of the specialists in these areas will determine quality of life for a child in the future. This paper focusses on the terminology and classification of delays, which are necessary for physicians and teachers to speak the same language

Comparative effects of limited tryptic hydrolysis on physicochemical and structural features of seed 11S globulins

The effect of the limited proteolysis by trypsin on selected seed storage 11S globulins (broad bean and pea legumins, glycinin and helianthinin) was studied by high-sensitive differential scanning calorimetry, fluorescence spectroscopy and analysis of proteolysis kinetics. Different behaviour of glycinin and helianthinin, on one hand, and broad bean and pea legumins, on the other, were observed: in the first group changes in the physicochemical characteristics of the proteins due to their limited proteolysis are more pronounced in comparison with the second one, in relation with the extent of primary structure modifications. The differences observed have been evaluated in relation with the amino acid sequence features of the four 11S globulin studied and agree with the literature data concerning the protein structural changes in the course of the limited proteolysis

Motor and sensory alalia: diagnostic difficulties

Alalia is a speech disorder that develops due to organic brain damage in children with normal hearing and intelligence during the first three year of life. Systemic speech underdevelopment in alalia is characterized by violations in the phonetic, phonemic, lexical, and grammatical structure. Patients with alalia can also have non-speech related impairments, including motor (impaired movement and coordination), sensory (impaired sensitivity and perception), and psychopathological disorders. There are three types of alalia: motor, sensory, and mixed. Children with motor alalia have expressive language disorders, speech praxis, poor speech fluency, impaired articulation, and other focal neurological symptoms; however, they understand speech directed to them. Patients with motor alalia are often left-handed. Regional slowing and epileptiform activity are often detected on their electroencephalogram.  Children with sensory alalia are characterized by poor speech understanding (despite normal hearing) resulting in secondary underdevelopment of their own speech. These patients have problems with the analysis of sounds, including speech sounds (impaired speech gnosis), which prevents the development of association between the sound image and the object. Therefore, the child hears, but does not understand the speech directed at him/her (auditory agnosia). Differential diagnosis of alalia is challenging and may require several months of observation. It also implies the exclusion of hearing loss and mental disorders

Gelatin hydrogel as a model for assessment of the wettability and water-resistance of polypeptide materials

This paper is in Russian. The English translation of this paper appears in Colloid Journal, 77 (3), pp. 321-326 and is available at http://dx.doi.org/10.1134/S1061933X1503014X