Overexpression of a membrane transport system MSMEG_1381 and MSMEG_1382 confers multidrug resistance in Mycobacterium smegmatis

Mycobacterium tuberculosis is a leading cause of human mortality worldwide, and the emergence of drug-resistant strains demands the discovery of new classes of antimycobacterial that can be employed in the therapeutic pipeline. Previously, a secondary metabolite, chrysomycin A, isolated from Streptomyces sp. OA161 displayed potent bactericidal activity against drug-resistant clinical isolates of M. tuberculosis and different species of mycobacteria. The antibiotic inhibits mycobacterial topoisomerase I and DNA gyrase, leading to bacterial death, but the mechanisms that could cause resistance to this antibiotic are currently unknown. To further understand the resistance mechanism, using M. smegmatis as a model, spontaneous resistance mutants were isolated and subjected to whole-genome sequencing. Mutation in a TetR family transcriptional regulator MSMEG_1380 was identified in the resistant isolates wherein the gene was adjacent to an operon encoding membrane proteins MSMEG_1381 and MSMEG_1382. Sequence analysis and modeling studies indicated that MSMEG_1381 and MSMEG_1382 are components of the Mmp family of efflux pumps and over-expression of either the operon or individual genes conferred resistance to chrysomycin A, isoniazid, and ethambutol. Our study highlights the role of membrane transporter proteins in conferring multiple drug resistance and the utility of recombinant strains overexpressing membrane transporters in the drug screening pipeline.

Two new species of Platensina Enderlein (Diptera, Tephritidae, Tephritinae, Dithrycini) from India

Two new species of Platensina Enderlein, P.rabbanii David & Hancock, sp. nov., and P.flavistigma David & Hancock, sp. nov., are described from Meghalaya and southern India, respectively. Platensinarabbanii can be differentiated from P.alboapicalis Hering by the presence of a single hyaline indentation in cell r₁ and the apical hyaline band in cell r₂₊₃ restricted to the apex; P.flavistigma differs from P.quadrula Hardy by the presence of a yellow/fulvous pterostigma and shape of the epandrium. DNA barcode sequences of P.acrostacta (Wiedemann), P.flavistigma and P.platyptera Hendel were obtained and reported. Postabdominal descriptions and illustrations of P.acrostacta, P.platyptera and P.zodiacalis (Bezzi) are also provided along with keys to all 23 species and the 7 known from India.

Halyomorpha picus (Hemiptera: Heteroptera: Pentatomidae): first confirmed record from Pakistan and two new junior synonyms

We provide the first confirmed record of Halyomorpha picus (Fabricius, 1794) (Hemiptera: Heteroptera: Pentatomoidea: Pentatomidae: Pentatominae: Cappaeini) from Pakistan: Islamabad Capital Territory, and provide habitus photographs and electron scanning micrographs of the male genitalia of the voucher specimens. Two species previously described from Pakistan are found to fit within the morphological variability of H. picus and the following two junior subjective synonyms are proposed: Halyomorpha picus (Fabricius, 1794) = Halyomorpha punjabensis Ahmad Kamaluddin, 1977, syn. nov., = Halyomorpha azhari Ahmad Zaidi, 1989, syn. nov. The record of Halyomorpha scutellata Distant, 1879, from Pakistan by Sharif et al. (2020) is based on misidentification of a species of Neohalys Ahmad Perveen, 1982 (Pentatominae: Halyini) and excluded from Pakistan fauna. Based on the analysis of female genitalia figures provided by Gadalla (2004), the record of H. picus from Egypt represents a misidentification of H. halys Stl, 1855, which extends the distribution of that invasive species to North Africa.

Review of the Oriental species of the genus Brachycerocoris Costa, 1863 (Hemiptera: Pentatomoidea: Pentatomidae: Podopinae s.l.) with description of two new species

The Oriental species belonging to genus Brachycerocoris Costa, 1863 (Hemiptera: Pentatomoidea: Pentatomidae: Podopinae s.l.) are revised with description of two new species, B. petrii sp. nov. and B. davidii sp. nov. from India and Philippines respectively. Brachycerocoris camelus Costa, 1863 is diagnosed and illustrated for female genitalia and B. dromedarius (Vollenhoven, 1863) is diagnosed and illustrated for both male and female genitalia. Additionally, host record, bionomics of B. petrii sp. nov. and a key to the Oriental species are provided.

The genera emAgathocles/em and emSurenus/em (Hemiptera: Heteroptera: Pentatomidae): tribal reassessment, redescription, new synonyms, and description of two new species

The genus Surenus Distant, 1901 (Hemiptera: Heteroptera: Pentatomoidea: Pentatomidae: Pentatominae: Halyini) is revisited and found to be a junior subjective synonym of the genus Agathocles Stål, 1876 (currently Pentatominae: Rolstoniellini). The genus Agathocles and its type species, Agathocles limbatus Stål, 1876, are redescribed. Lectotype of Surenus normalis Distant, 1901 (= Agathocles normalis (Distant, 1901) comb. nov.) is designated and the unknown male of the species is described. Agathocles yunnanensis Zhang Lin, 1984, syn. nov., is considered junior subjective synonym of A. limbatus. Two new species are described: Agathocles flavipes sp. nov. from India (Andhra Pradesh, Karnataka, Maharashtra, and Tamil Nadu) and A. joceliae sp. nov. from Malaysia (Kelantan, Perak). The new species differ from their congeners mainly by the morphology of mandibular plates, length of antennomeres I, IIa and IIb, body length, and structure of male genitalia. Agathocles dubius Distant, 1921 is transferred to the genus Caystrus Stål, 1861 (Pentatominae: Caystrini) based on examination of its holotype with the resulting new combination: Caystrus dubius (Distant, 1921), comb. nov. One new combination is proposed, Paramecocoris ruficornis (Fieber, 1851), comb. nov. (from preoccupied Paramecus Fieber, 1851), and its type locality is clarified as Tenasserim (south Myanmar). Gender agreement and authorship of the name Riazocoris niger Ahmad Afzal, 1977 in Ahmad et al. (1977: 161) are corrected and status of its name bearing type is clarified as lectotype. The following new distribution records are given: A. limbatus from Cambodia, China (Guangxi, Tibet), Laos and Thailand, A. normalis, Caystrus obscurus (Distant, 1901a) and Critheus lineatifrons Stål, 1869 from Laos, Amasenus corticalis Stål, 1863 from Cambodia, Indonesia (E Kalimantan), Laos, Myanmar and Thailand, and Rolstoniellus boutanicus (Dallas, 1849) from Vietnam. Based on characters of external morphology and genitalia, the genus Agathocles is compared with representatives of the genera Halys Fabricius, 1803 (Halyini), Caystrus (Caystrini), Laprius Stål, 1861 (Myrocheini), and Exithemus Distant, 1902 (currently in Rolstoniellini). As a result, the genus Agathocles is here transferred to the tribe Caystrini. The genus Kyrtalus Van Duzee, 1929 is tentatively placed in Myrocheini based on the presence of sulcate mesosternum and femora provided with teeth.

Taxonomic notes on emSarju/em Ghauri, 1977 (Hemiptera: Heteroptera: Pentatomidae) with description of a new species from India

The genus Sarju Ghauri, 1977 (Hemiptera: Pentatomidae: Pentatominae: Halyini) is redescribed along with the description of a new species, Sarju brevirostrata sp. nov. S. farida Ghauri, 1977 and S. nigricollis (Westwood, 1837) are redescribed based on the availability of specimens and the species Cahara nodula Fan and Liu, 2013 was transferred from Cahara to Sarju and proposed Sarju nodula comb.nov. Therefore, at present Sarju comprises 11 species worldwide. A key to the eight species of Sarju occurring in India is also provided.

Functional outcome and multidimensional evaluation of patients with Mutars® reconstructions post lower limb tumor resection and rehabilitation: preliminary results

Modular prostheses are commonly used to reconstruct defects of the distal femur and proximal tibia after bone tumor resection. Improving patient's autonomy and giving them a better quality of life are the main goals. Post-surgical rehabilitation is very relevant after surgery. The aim of this paper is to study the short and mean time functional outcomes in patients treated with Mutars® reconstructions after proximal and distal lower limb tumor resection with a multidimensional analysis and a standardized stabilometric examination. Twenty-one patients (7 male and 14 women, mean age and standard deviation: 61.76±14.68) affected by primitive bone tumor (28.6%) or metastatic bone tumor (71.4%), treated with MUTARS® reconstructions after proximal (71%) , distal(23.8%) and both (4.8%) lower limb tumor resections, accepted to take part to the study. They were evaluated after one week (T0), one month (T1), three months (T2), six months (T3) and one year (T4) after surgery with standardized clinic evaluation and with multidimensional validated scales. Visual Analogic Scale (VAS during active movement), Short Physical Performance Battery (SPPB), Eastern Cooperative Oncology Group (ECOG), Karnofsky Performance Status (KPS), MusculoSkeletal Tumor So¬ciety rating (MSTS), Toronto Extremity Salvage Score scale (TESS). Patients underwent to an instrumental standardized stabilometric test after one month from surgery and in following evaluations to measure stand¬ing balance. Patients underwent to a rehabilitation program during three months after surgery. There was a significant improvement of hip flexion range of movement (p level: 0.008), and gait modalities (without aids) after three months from surgery (p level 0.02). There was a significant reduction in VAS after one month of surgery (p level 0.00). It was observed an increase of the SPPB value at T3 (p level 0.01), of MSTS and TESS at T2. Balance stabilometric evaluation did not showed significant increase at each timing also if Romberg perimeter decrease progressively. These preliminary results showed that, oncological patients, affected by bone tumors or metastasis, surgical treated with MUTARS® implant and admitted to the rehabilitation programs, can improve their gait modalities and functional daily life outcomes, until three months from surgery. A large sample will allow, necessary to define standardized rehabilitation protocols after oncological orthopedic sur¬gery, in order to introduce guidelines that can be applied routinely.

Evaluation of quality of life and static balance in postmenopausal osteoporosis women after Tai Chi Chuan practice: an observational randomized case control study

Post-menopausal osteoporosis women are at increased risk for skeletal fractures with higher mortality and lower quality of life. Some studies have reported fall risk reduction in the elderly after Tai chi practice. Tai chi is a weight bearing mind-body exercise that has been reported to positively influence bone mineral density and improve postural control in different pathologies. The aim of this observational randomized case control study is to evaluate the effect of Tai chi on balance and quality of life in postmenopausal women with osteoporosis. A total of 98 postmenopausal osteoporosis women, aged 70.6±8.2 years (mean and standard deviation), (mean T-score of the hip and spine were-2.9± 0.92 and -2.8±1.08), have been recruited in outpatients University Physical Medicine and Rehabilitation Hospital between June 2016 and September 2018. They have been randomized to a Tai group (56 patients, mean age 71.61±7.97 years) practiced 6-month Tai chi program, two times week, plus standard care or to a Control Group (42 patients, mean age 69.71±8.61 years) practiced usual care. Patients with oncological, neurological, cognitive, vestibular and visual diseases were excluded. Patients were evaluated at baseline (T0), prior Tai chi and after 6 month (T1) with 36-Item Short Form Health Survey (SF-36), and a stabilometric-standardized exam performed for the evaluation, respectively, of the quality of life and the static balance. The groups were homogenous at baseline. T1 evaluation showed better results in Tai chi group, in SF36 Physical functioning (p level: 0.021), Physical health pain (p level: 0.020), Physical composite score (p level: 0.003) scores, compared with control group. There were not significant differences between groups in stabilometric analysis. Tai chi group showed significant better stabilometric values at T1 compared with T0 in mean anterior-posterior (p level: 0.001) and medio-lateral (p level: 0.019) velocity, in perimeter (p level 0.001) , and in the area of the ellipse ( p level 0.006) in a within group analysis. Tai chi seemed to be effective in improving physical aspects of quality of life, in postmenopausal women with osteoporosis. Standing balance seems to increase after 6 months Tai chi program, in post-menopausal also if results were not significant. Further studies will be useful to measure effects of a Tai chi longer practice, as literature suggests, and a possible reduction of falling risk and fractures.

The association between sarcopenia and functional outcomes among older patients with hip fracture undergoing in-hospital rehabilitation

This study evaluates the prevalence of sarcopenia among older people admitted to a rehabilitation unit after hip fracture and the association between sarcopenia and functional outcomes. The results show that sarcopenia had a negative impact on functional recovery. The assessment of sarcopenia among older adults receiving rehabilitation programs is crucial.

INTRODUCTION

Sarcopenia is a highly prevalent geriatric syndrome associated with adverse outcomes, including falls, disability, institutionalization, and mortality. Few studies assessed sarcopenia among older adults receiving rehabilitation programs.

METHODS

Patients aged 70 years or more consecutively admitted to in-hospital rehabilitation programs that had suffered from hip fracture entered the study. Sarcopenia was defined according to the Foundation for National Institutes of Health (FNIH) criteria. Multivariable linear regression models were used to analyze the association between the sarcopenia and functional recovery.

RESULTS

The recruited population was composed of 127 patients, with a mean age of 81.3 ± 4.8 years, predominantly females (64.6%). Using the criteria proposed by the FNIH, patients with a diagnosis of sarcopenia were 43 (33.9%). After adjustment for potential confounders, participants with sarcopenia had a significant increased risk of incomplete functional recovery compared with non-sarcopenic patients (OR 3.07, 95% CI 1.07-8.75). Compared with participants without sarcopenia, those with sarcopenia showed lower Barthel index scores at the time of discharge from the rehabilitation unit (69.2 versus 58.9, respectively; p < 0.001) and after 3 months of follow-up (90.9 versus 80.5, respectively; p = 0.02).

CONCLUSIONS

These findings support the systematic assessment of sarcopenia among older adults receiving rehabilitation programs to assist in the development of personalized treatment plans aimed at improving functional outcomes.

<b>First record of <I>Neojurtina typica</I> from India (Hemiptera: Heteroptera: Pentatomidae)</b>

The genus Neojurtina Distant, 1921, represented by the species Neojurtina typica Distant, 1921 (Hemiptera: Pentatomidae: Pentatominae: Pentatomini), is illustrated and redescribed based on the female genitalia.  Neojurtina typica is recorded for the first time from India (Meghalaya) and distribution of the species is reviewed based on all the available literature.  The present taxonomic placement of the genus Neojurtina is discussed.

Animal-Derived Protein Consumption Is Associated with Muscle Mass and Strength in Community-Dwellers: Results from the Milan EXPO Survey

OBJECTIVES

Behavioral factors, including protein intake, influence the quantity and quality of skeletal muscle. The aim of this study was to explore the relationship between animal-derived protein intake and muscle mass and function in a large sample of unselected community-dwellers.

MATERIAL AND METHODS

The VIP (Very Important Protein) study, conducted during Expo 2015 in Milan, was a population survey aimed at assessing major health metrics in a population outside of the research setting, with a special focus on the relation between animal-derived protein intake and muscle mass and function. A brief questionnaire exploring lifestyle habits, dietary preferences and the consumption of selected foods was administered. Muscle mass was estimated by calf circumference (CC) and mid-arm muscle circumference (MAMC) of the dominant side. Muscle strength of upper and lower extremities was assessed through handgrip strength testing and repeated chair stand test, respectively.

RESULTS

The mean age of the 1,853 participants was 50.3 years (standard deviation: 15.7; range: 18-98 years), of whom 959 (51.7%) were women. Participants in the highest tertile of protein consumption showed better performance at both the handgrip strength (p <0.001) and chair stand tests than those in the lowest tertile (p <0.01). The same results were found for CC (p <0.001) and MAMC (p <0.001). Participants with high protein intake and engaged in regular physical activity showed the higher scores in all the assessed domains.

CONCLUSIONS

The results of the VIP survey suggest an association between animal-derived protein intake and muscle mass and strength across ages. Our findings also indicate a synergistic effect of animal-derived protein intake and physical activity on muscle-related parameters.

Melatonin reduces the need for sedation in ICU patients: a randomized controlled trial

BACKGROUND

Critically ill patients suffer from physiological sleep deprivation and have reduced blood melatonin levels. This study was designed to determine whether nocturnal melatonin supplementation would reduce the need for sedation in patients with critical illness.

METHODS

A single-center, double-blind randomized placebo-controlled trial was carried out from July 2007 to December 2009, in a mixed medical-surgical Intensive Care Unit of a University hospital, without any form of external funding. Of 1158 patients admitted to ICU and treated with conscious enteral sedation, 82 critically-ill with mechanical ventilation >48 hours and Simplified Acute Physiology Score II>32 points were randomized 1:1 to receive, at eight p.m. and midnight, melatonin (3+3mg) or placebo, from the third ICU day until ICU discharge. Primary outcome was total amount of enteral hydroxyzine administered.

RESULTS

Melatonin treated patients received lower amount of enteral hydroxyzine. Other neurological indicators (amount of some neuroactive drugs, pain, agitation, anxiety, sleep observed by nurses, need for restraints, need for extra sedation, nurse evaluation of sedation adequacy) seemed improved, with reduced cost for neuroactive drugs. Post-traumatic stress disorder prevalence did not differ between groups, nor did ICU or hospital mortality. Study limitations include the differences between groups before intervention, the small sample size, and the single-center observation.

CONCLUSION

Long-term enteral melatonin supplementation may result in a decreased need for sedation, with improved neurological indicators and cost reduction. Further multicenter evaluations are required to confirm these results with different sedation protocols.

Genera of Pentatomidae (Hemiptera: Pentatomoidea) from south India--an illustrated key to genera and checklist of species

Family Pentatomidae is represented by four subfamilies (Asopinae, Pentatominae, Phyllocephalinae and Podopinae) and 86 genera in south India. Pentatominae are the dominant group represented by 29 tribes and 72 genera. An illustrated key including the habitus of majority of genera as well as illustrations of important diagnostic features are given for the subfamilies, tribes and genera occurring in south India. In addition, a key to families of Pentatomoidea and a checklist of species of Pentatomidae occurring in south India are also included.

Hypothyroidism with scholastic excellence

A 9-year-old boy had presented with not gaining adequate height with complaints of constipation from 5 years, lethargy and loss of appetite from past 6 months. He was diagnosed to have hypothyroidism with high thyroid antibody levels. Though he was stunted his neurocognition and scholastic performance was excellent as evidenced by his school rank cards. His physical symptoms had improved after thyroxin supplement

Cytotoxic and antioxidant properties of selected Scutellaria species from the Western Ghats of Peninsular India

CONTEXT

Scutellaria (Lamiaceae), commonly known as 'Skullcaps', has been extensively used in Traditional Chinese Medicine (TCM). Recently, much emphasis has been given to this genus due to the rich source of bioflavonoids that contribute to its biological properties. Therefore, different species of Scutellaria are being explored worldwide.

OBJECTIVES

Cytotoxic, antioxidant, and phytochemical properties of Scutellaria colebrookiana Benth and S. violacea (Heyne ex Benth) Don collected (October 2009-February 2010) from Western Ghats of India have been analysed.

MATERIALS AND METHODS

In vitro cytotoxicity and free radical scavenging effects of root extracts in various solvents were analysed. Spectrophotometric and HPLC methods were performed for phytochemical analysis.

RESULTS

Chloroform extract exhibited significant cytotoxicity in Dalton's Lymphoma Ascites (DLA) and Ehrlich Ascites Carcinoma (EAC) cells with IC(50) values 150 and 140 µg/mL for S. colebrookiana and 250 and 280 µg/mL for S. violacea, respectively. Moreover, the extract was effective in scavenging free radicals and inhibiting membrane peroxidation in vitro with IC(50) values 158.3 and 167.5 (superoxide), 17.5 and 28.0 (hydroxyl), 76.25 and 69.75 (DPPH), 24.5 and 28.0 (ABTS), 69.75 and 64.6 (lipid peroxidation), 41 and 31.5 µg/mL (erythrocyte hemolysis), respectively. Antioxidant effect observed with acetone extract was also comparable to that of chloroform extract. Phytochemical screening revealed the presence of baicalein.

DISCUSSION AND CONCLUSION

Scutellaria species of Western Ghats showed cytotoxic and antioxidant potential and the presence of baicalein. This suggests that S. colebrookiana and S. violacea could be used as alternative sources for baicalein in view of the reported scarcity of S. baicalensis.

Neoangiogenesis is reduced in chronic tendinopathies of type 2 diabetic patients

In diabetes, the prevalence of tendon degeneration is increased. As neoangiogenesis is impaired in several diabetic complications, the aim of this study is to evaluate the neovessel formation in tendinopathies. Patients aged > 55 years were selected, and divided in two groups: a) type 2 diabetic patients, and b) non-diabetic subjects. In both groups, those with ultrasound features of tendinopathy were included, and intratendinous vascularisation was estimated by means of Power Doppler. Ultrasound features of tendinopathy were observed in 104 diabetic subjects and in 221 controls. Neovascularisation, with higher Power Doppler scores, was found more frequently in controls, while lower Power Doppler scores were prevalent in diabetic subjects. In subjects with diabetes, tendinopathic features are significantly higher than healthy controls, while the prevalence of neovascularisation inside tendons is less represented.

Migraine with aura with onset in childhood and adolescence: long-term natural history and prognostic factors

The long-term course of migraine with aura (MA) has been poorly explored. The present 11-year follow-up study assessed the long-term natural history and possible prognostic factors of MA with onset in childhood or adolescence. Patients were recruited from the original case records of our department, which are specifically designed to report all headache characteristics, aura symptoms and electroencephalogram (EEG) findings. A total of 77 patients (47 females; 30 males) whose records contained detailed descriptions of both headache and aura symptoms apparently meeting the International Classification of Headache Disorders (ICHD)-II criteria for MA (i.e., 1.2.1, 1.2.2, 1.2.6) underwent structured face-to-face follow-up headache interviews, all of which were conducted by the same neurologist, who has particular expertise in this field. A multivariate model (logistic regression analysis) was used to investigate the association between possible prognostic factors and the remission of both aura and headache at follow-up. The results of our study showed that 23.4% of the MA patients were headache-free at follow-up, 44.1% still had MA and 32.5% had a transformed headache diagnosis (i.e., fulfilling the criteria for ICHD-II 1.1. or 2). Patients with basilar-type migraine (1.2.6) showed the highest headache remission rate (38.5%). Our study seems to show that migraine with typical aura (1.2.1-1.2.2) is associated with a favourable evolution of aura symptoms over time (remission of aura in 54.1% of patients). Subjects experiencing only visual aura had a lower remission rate compared with those with visual +/- sensory +/- aphasic aura symptoms (36.8% vs. 61.5%, p = 0.054). A short headache duration (<12 hrs) and the presence of EEG abnormalities at baseline were the only significant predictors of aura remission at follow-up (odds ratio [OR] = 9.12, 95% confidence interval [CI]: 1.79 +/- 46.51, and OR = 4.76, 95% CI: 1.18 +/- 19.15, respectively). No significant predictors of headache remission were found. In conclusion, our results suggest that MA shows a favourable course. Further prospective studies with detailed EEG analysis both at baseline and at follow-up are needed in order to confirm the possible prognostic role of EEG abnormalities in MA. That said, it would, in our opinion, be highly premature at present to submit children with MA to EEG examinations for prognostication purposes.

Maugeri Respiratory Failure questionnaire reduced form: A method for improving the questionnaire using the Rasch model

PURPOSE

The Maugeri Respiratory Failure questionnaire (MRF-28) is the first instrument specifically developed for use with chronic respiratory failure (CRF) patients. The 28 items were selected using classical test theory. The purpose of the current analysis was to further refine the questionnaire using item response theory, specifically, the Rasch model analysis.

METHODS

Three hundred and seventeen CRF patients (mean aged 66.7 yrs; Male 219, Female 98) completed the MRF-28 health status measure. Data were collected through the self-report questionnaire and analyzed using 1-parameter logistic models by means of RUMM software.

RESULTS

The 28-item questionnaire has good psychometric properties in terms of discriminant power because the Person Separation Index is 0.896. However, the item-trait interaction was not good as shown by the total-item Chi-square (chi(2)(112), p<0.001). Removing two items that did not fit the Rasch model well, produced a minor improvement in Person Separation Index to 0.899 and the item-trait interaction improved (chi(2)(104), p = NS). In the preliminary analysis we identified 21 patients who were outliers; when they were excluded the distribution of the residuals, according to the Kolmogorov-Smirnov statistics, was normal and factor analysis of the item residuals showed that the components had similar eigenvalues and no strong correlation with items. These results suggest that the MRF-26 is a unidimensional measure of health-related quality of life impairment for chronic respiratory failure patients.

CONCLUSIONS

A combination of classical psychometric tests and Rasch analysis produced an instrument of moderate size that covers a wide range of effects of CRF and has interval scaling properties.

Neuropsychological profile of pre-schoolers with metaphonological difficulties: results from a non-clinical sample

BACKGROUND

The level of language development reached in pre-school age is considered the most reliable predictor of reading acquisition. In normally developing children, learning to read is strongly related to early language skills, and in particular to phonological processing abilities. In dyslexic children, reading abilities seem to show a correlation with phonological awareness.

METHODS

A group of 65 children (aged 5-6 years) were recruited and submitted to an in-depth neuropsychological assessment [i.e. metaphonological skills, intelligence, verbal short-term memory (VSTM) and other aspects of receptive and expressive language]. We were able to identify 14 children with significant metaphonological difficulties (MD): 11 children with exclusively MD, and the other three children with specific language impairment. This study compares the neuropsychological profile obtained from children with MD with that of a peer group without any language impairment (N).

RESULTS

The performances of the MD were within the normal ability range in almost all the administered tests but significantly lower compared with those of their peers without language impairment (N) in some items of the intelligence scale (Wechsler Preschool and Primary Scale of Intelligence) and in the tests of VSTM and of receptive/expressive language. Nevertheless, there were not statistically significant differences between MD and N in output phonology.

CONCLUSIONS

In pre-school age, in a group of non-clinical children, with a range of abilities, those with MD appear to be at the lower end of the normal range in many other verbal skills. These children could be considered at-risk for possible subsequent difficulties learning to read and thus need to be identified and to warrant prompt treatment.