PURPOSE: Congenital hypothyroidism (CH) is the most common endocrine disorder in children. Thyroid hormone deprivation results not only in mental retardation but also growth retardation. This study investigates the final height (FH) in Korean patients with CH detected by newborn screening and examines factors that may affect the FH. METHODS: The medical records of Korean CH patients (n=45) were reviewed. The FH was examined and target height (TH) was calculated based on mid-parental height. The FH z score (FHZ) and TH z score (THZ) were computed using the 2007 Korean National Growth Chart. The FHZ and THZ were compared with a Student t test. The impact of the etiology of CH (athyreosis, dyshormonogenesis, ectopic thyoid, hypoplastic thyroid), initial serum thyroid stimulating hormone (TSH) level, initial free thyroxine (T4) level, and time of therapy initiation based on FH was assessed. RESULTS: The mean FHZ was 0.10±1.01 for male patients and −0.11±1.09 for female patients. There were no significant differences between FHZ and THZ for both female (P=0.356) and male patients (P=0.237). No significant relationship was found between FH and the etiology of CH, initial TSH level, initial free T4 level, and the time of therapy initiation. CONCLUSION: Early intervention and satisfactory management do not appear to impede growth in Korean patients with CH. Thus, early detection and proper management of patients with CH detected by newborn screening program are necessary.
Child ; Congenital Hypothyroidism* ; Early Intervention (Education) ; Female ; Growth Charts ; Humans ; Infant, Newborn ; Intellectual Disability ; Male ; Mass Screening ; Medical Records ; Thyroid Gland ; Thyrotropin ; Thyroxine

As the physical abnormalities seen in eating disorders seem to be largely secondary to these patients' disturbed eating habits and their compromised nutritional state, most physical abnormalities associated with eating disorders are reversed by restoring healthy eating habits and sound nutrition. However, some medical consequences of eating disorders are irreversible or have later repercussions on health, especially those affecting the skeleton, the reproductive system, and the brain. Early medical intervention and psychiatric treatment are particularly important for those with or at risk of severe emaciation. Eating disorders are common among adolescent girls and young women and are associated with potentially serious medical complications, yet they often go undetected and untreated. All patients with eating disorders should be evaluated and treated for medical complications of the disease at the same time that psychotherapy and nutritional counseling are undertaken.
Adolescent ; Anorexia Nervosa ; Binge-Eating Disorder ; Brain ; Bulimia Nervosa ; Counseling ; Early Medical Intervention ; Eating ; Emaciation ; Feeding and Eating Disorders ; Female ; Humans ; Psychotherapy ; Skeleton

Cardiovascular diseases are the major threat to human health and underlie almost half of all deaths in China. Even more serious, obesity and cardiometabolic risk factors have emerged to be prevalent in children and adolescents of some affluent regions. As scientific knowledge emerges on the role of nutritional factors and exposures to environmental risk factors in the developmental origins of health and disease, evidence suggests that it is imperative to create and implement early effective prevention strategies, including optimisation of nutrition at first 1 000 days in life course and reduction of risk factors of obesity exposures during whole childhood, to suppress the rising trend of cardiovascular disease, otherwise, the future costs of diagnosis and treatment are likely to be unaffordable.
Adolescent ; Cardiovascular Diseases ; prevention & control ; Child ; China ; Early Medical Intervention ; Humans ; Pediatric Obesity ; epidemiology ; Risk Factors

Postnatal depression is a major public health problem with clearly established adverse effects in child outcomes. This study examines the 4-year outcomes of a screening and early intervention programme, in relation to improvement in symptoms, functioning and health quality of life. Women were prospectively recruited up to 6 months postdelivery, using the Edinburgh Postnatal Depression Scale (EPDS) as a screening tool. High-scorers (EPDS >13), were offered psychiatric consultation, and those with borderline scores (EPDS 10-12) were provided counselling, and offered follow-up phone counselling by the assigned case manager. Outcome measures were obtained at baseline, and at 6 months or discharge if earlier, for levels of symptoms, functioning, and health quality of life. From 2008 to 2012, 5245 women were screened, with 307 (5.9%) women with EPDS >13 receiving intervention. Of these, 70.0% had depression, 4.6% anxiety and 3.4% psychosis. In the depression subgroup, the net change was improvement of 93.4% EPDS symptom scores, 92.2% Global Assessment of Functioning (GAF) scores, and 88.3% visual analogue scale (EQ VAS) health quality of life scores. Outcome scores across diagnostic categories demonstrated median changes of 10 points on EPDS, 20 points on GAF, and 25 points on EQ VAS, reflecting 73.9%, 36.4% and 41.7% change from baseline scores. Women with psychosis showed the biggest (80.0%) relative change in GAF functioning scores from baseline to discharge but had the lowest median change in EPDS symptom scores. A screening and intervention programme rightly-sited within an obstetric setting can improve clinical outcomes because of early detection and intervention.
Adult ; Anxiety Disorders ; diagnosis ; therapy ; Case Management ; Counselors ; Delivery of Health Care ; Depression, Postpartum ; diagnosis ; therapy ; Early Medical Intervention ; Female ; Health Status ; Humans ; Mass Screening ; Obstetrics ; Outcome Assessment (Health Care) ; Prospective Studies ; Psychiatry ; Psychotic Disorders ; diagnosis ; therapy ; Puerperal Disorders ; diagnosis ; therapy ; Quality of Life ; Referral and Consultation ; Singapore

Accessory Nerve ; transplantation ; Birth Injuries ; complications ; surgery ; Brachial Plexus Neuropathies ; etiology ; surgery ; Child, Preschool ; Early Medical Intervention ; Elbow ; Humans ; Infant ; Intercostal Nerves ; transplantation ; Nerve Transfer ; methods ; Radial Nerve ; surgery ; Sural Nerve ; transplantation ; Time Factors ; Treatment Outcome ; Ulnar Nerve ; transplantation

Cerebral palsy (CP), known as "Little's disease" is the most common neurologic disorder in pediatric patients. The core problem of CP is the abnormal movement and posture which manifests very early in the development. The cornerstone to treat the children with CP is the conventional rehabilitation program based on neurodevelopmental approach that has been done for decades. Recently, various translational research has emerged, and focused on the changing therapeutic paradigm using high technologic equipment such as computer- or robotic-approach, botulinum toxin, or stem cell use with potential therapeutic effect. Many other trials using newly developed devices, or combination of old and new therapies are ongoing to demonstrate the evidence, however obstacles still remain. Regarding rehabilitative therapy, the use of exercise-based treatment such as early intervention, gross motor task training, hippotherapy, reactive balance training, treadmill training with/without body weight support, and trunk-targeted training are promising. Virtual reality, robot-assisted and computer-enhanced therapies are very potent therapeutic tools for CP under way of mass commercialization. Regarding medical therapy, botulinum toxin injection showed the most concrete benefit for CP children. Stem cell therapy is just beginning, performing experimental studies in vivo. The author reviewed the current research, expanding therapeutic options to improve the posture and movement control in children with CP.
Body Weight ; Botulinum Toxins ; Cerebral Palsy* ; Child ; Dyskinesias ; Early Intervention (Education) ; Equine-Assisted Therapy ; Humans ; Nervous System Diseases ; Posture ; Rehabilitation ; Stem Cells ; Translational Medical Research

Autism spectrum disorder (ASD) is a neurodevelopmental disorder typically identified in early toddlerhood. Both retrospective and prospective follow up studies of high risk infants reveal early risk signs of ASD at 12-24 months of age. The most frequently replicated early signs of ASD are atypical visual tracking and coordination, lack of social reciprocity, abnormal social communication and unusual patterns of manipulating objects, atypical sensory exploration, expressed as uncoordinated eye contact, unresponsiveness to naming, lack of social smile, delayed development of nonverbal communication and joint attention, less sharing interest, and unusually repetitive use of objects. Early intervention, before 2 years of age, appears to change the underlying developmental trajectories of the brain in individuals with ASD. In this review, the early risk signs of ASD in infancy and toddlerhood, along with early intervention and their implications, are discussed.
Autistic Disorder* ; Brain ; Child ; Autism Spectrum Disorder* ; Early Intervention (Education) ; Early Medical Intervention ; Follow-Up Studies ; Humans ; Infant ; Joints ; Nonverbal Communication ; Prodromal Symptoms ; Prospective Studies ; Retrospective Studies

OBJECTIVES: Due to the complex anatomy and function of the head and neck region, the reconstruction of ablative defects in this area is challenging. In addition, an increasing interest in improving the quality of life of patients and achieving good functional results has highlighted the importance of free flaps. The aim of this study was to summarize the results of free flap reconstruction and salvage of free flaps in a single institute, and to analyze differences in the results by the flap donor site, recipient site, and learning curve. METHODS: The medical records of patients who underwent free flap reconstruction from 2004-2012 were reviewed retrospectively. One hundred and fifty free flaps were used in 134 patients, who had an average age of 57.7 years. The types of flaps applied, primary defect sites, success rates, results of salvage operations for compromised flap, and the learning curve were analyzed. RESULTS: The anterolateral thigh flap was preferred for the reconstruction of head and neck defects. The overall success rate was 90.7%, with 14 cases of failure. A total of 19 salvage operations (12.7%) for compromised flap were performed, and 12 flaps (63.2%) were salvaged successfully. Dependency on the facial vessels as recipient vessels was statistically different when oral and oropharyngeal defects were compared to hypopharyngeal and laryngeal defects. The learning curve for microvascular surgery showed decrease in the failure rate after 50 cases. CONCLUSION: The free flap technique is safe but involves a significant learning period and requires careful postoperative monitoring of the patient. Early intervention is important for the salvage of free flaps and for lowering the failure rate.
Early Intervention (Education) ; Free Tissue Flaps* ; Head and Neck Neoplasms ; Head* ; Humans ; Learning ; Learning Curve ; Medical Records ; Neck* ; Quality of Life ; Reoperation ; Retrospective Studies ; Thigh ; Tissue Donors

OBJECTIVE: To identify the avoidable causes of childhood blindness and visual impairment in a school of the blind in the Philippines.

METHODS: The medical records of students enrolled at the Resources for the Blind early intervention and preschool program from 1999 to 2012 were reviewed. Demographic characteristics and causes of visual disability were abstracted and tabulated.

RESULTS: A total of 90 records were included in the study. Eighty six (76.7%) had visual acuity classified as blind (<20/400) or severe visual impairment (<20/200 - 20/400, 18.9%). Majority (69.8%) were below 6 years of age and most (44.2%) were below 1 year. Retinopathy of prematurity was the most common cause (47.7%), followed by retinablastoma (11.6%). Perinatal factors accounted for most of the etiologic causes (58.1%) of visual loss.

CONCLUSION: More than half of the causes of severe visual impairment and blindness were potentially avoidable, with retinopathy of prematurity as the leading etiology.

Human ; Male ; Female ; Child Preschool ; Infant ; Early Intervention (education) ; Retinopathy Of Prematurity ; Visually Impaired Persons ; Blindness ; Vision, Low ; Visual Acuity ; Students ; Medical Records

OBJECTIVES: Dealing with mental diseases is an overriding concern which could bring about improvement in mental health, social equity, and quality of life. This paper analyzes the current state of research infrastructure of national mental health research in Korea and other developed countries and suggests activation plans for psychiatric research. METHODS: After performance of comparative analysis, shortcomings of Korean infrastructure are examined and activation plans are suggested. RESULTS: Korea is comparatively and absolutely lagging behind in terms of mental health Research and Development (R&D), owing to the small investment in R&D, inadequate government-led long-term developmental strategy and supporting system, absence of industrialization of developed techniques and government-led R&D project, and insufficient human resources, which impedes facilitation of mental health research. Thus, in order to facilitate mental health research, 1) Reinforce international cooperation and research capability through cultivation of professionals equipped with international competitiveness. 2) Construct a government-led R&D system by establishment of a comprehensive R&D system and mental health research institutes. 3) Build cooperative systems between industry and academic circles and promote translational research and its practical use in order to lay the cornerstone for industrialization. CONCLUSION: Developed countries have achieved significant growth and superb investment performance in the mental health industry due to constant and active investment by government. In addition, basic-clinical-mental health research regarding early diagnosis, early intervention, and tailored treatment, is actively being put into practice. In Korea, government-led long-term investment plans in psychiatric research and researcher cultivation programs should be implemented. In addition, infrastructure for application of developed techniques should also be established. If so, it will provide momentum for growth and facilitation of psychiatric research.
Academies and Institutes ; Developed Countries ; Early Diagnosis ; Early Intervention (Education) ; Humans ; International Cooperation ; Investments ; Korea ; Mental Health ; Quality of Life ; Translational Medical Research