TEXTO – New Data on Autism Spectrum Disorder in 4- Year-Old Children.
CDC scientists published a report on the prevalence and characteristics of autism spectrum disorder (ASD) among 4-year-old children. This report is based on information from the Early Autism and Developmental Disabilities Monitoring (ADDM) Network. Early ADDM is a subset of the broader ADDM Network, which has been doing ASD surveillance among 8-year-old children since 2000.
In this report, published in the Morbidity and Mortality Weekly Report (MMWR) Surveillance Summaries, scientists analyzed information from the health and/or education records of preschool-aged children. Identifying children with ASD early helps families get access to services in their communities. This report provides valuable information on progress made toward early identification of children with ASD, and informs providers, particularly public schools, of upcoming service needs. The data in this report demonstrate a continued need to identify children with ASD sooner and refer them to early intervention.
Seven sites from across the United States were included in this report. These sites participated in Early ADDM for at least one year during surveillance years 2010, 2012, and 2014. However, trends in the prevalence and characteristics of ASD could only be analyzed across three sites: Arizona, Missouri, and New Jersey. This is because not all seven sites participated and had consistent data sources for all three surveillance years.
(Adapted from: www.cdc.gov)
Choose the proper question tag for the following sentence adapted from the text:
"This report is based on information from the Early Autism and Developmental Disabilities Monitoring, __________”.
TEXTO – The Challenge of Identifying Sjogren’s Syndrome
Angelica Divinagracia, a 54-year-old fitness instructor in Los Angeles, woke one morning with her tongue literally stuck to the roof of her mouth. Though she normally drank lots of water, especially after strenuous workouts with clients, she thought her chronically dry mouth, was due to dehydration. That is, until an even more troublesome symptom — excruciating scratchy eye pain unrelieved by drops — prompted an immediate visit to her ophthalmologist. “Do you also have dry mouth?” the eye doctor asked. Given her response, he suspected an autoimmune disease called Sjogren’s syndrome, sent her for blood work and, based on the results, told her to see a rheumatologist. That doctor had 12 more vials of blood analyzed at six different laboratories to confirm the diagnosis of Sjogren’s (pronounced SHOW-grins). The disorder is named after Dr. Henrik Sjogren, a Swedish ophthalmologist who in 1933 described 19 women suffering from dry eyes and mouth.
This chronic and usually progressive syndrome attacks secretory tissues throughout the body, primarily, but not exclusively, salivary and lacrimal glands of the mouth and eyes, the respective sources of saliva and tears. It can occur as a primary disorder or secondary to another autoimmune condition like rheumatoid arthritis or scleroderma.
The primary form affects between three and 10 of every 10,000 people, and nine women for every one man, mostly around the time of menopause. Including people with secondary Sjogren’s doubles the prevalence. The cause or causes are not known, though genetic, environmental and hormonal factors are strong suspects and are likely to work in concert. The triggering factor for its expression is often a microbial infection.
Diagnosis can be challenging because the main symptoms — dry eyes and mouth, fatigue and limb pain — are common complaints associated with any number of health problems. Yet, Dr. Lindsey A. Criswell, a rheumatologist at the University of California, San Francisco, told me that few doctors are aware of a relatively simple test — an in-office biopsy of tiny salivary glands from the inner surface of the lip — that can be definitive for Sjogren’s. “Patients with Sjogren’s often have symptoms for years before being diagnosed,” Dr. Criswell said. Ms. Divinagracia, for example, had dry mouth for about three years and dry eyes for two years and had attributed her occasional limb pain and fatigue to her demanding workouts. “My eyes were sensitive to everything — bright light, wind, cold air, hot air,” she said. “I found myself wearing sunglasses in the house. I would wake up in the morning with my lids stuck to my eyeballs and feeling like there was glass in my eyes.”
Dr. Criswell said Ms. Divinagracia was fortunate to have a tuned-in ophthalmologist. “Sadly,” she said, “most doctors are narrowly focused on a particular organ. They don’t think outside their specialty, and patients may not mention other symptoms unless they’re asked. The manifestations of Sjogren’s are numerous and doctors generally are not familiar with them, which results in huge delays in diagnosis.”
A report Dr. Criswell published last year with Dr. Xavier Mariette in The New England Journal of Medicine listed possible manifestation of Sjogren’s in lymph nodes, lungs, kidneys, muscles, nervous system, skin and brain, as well as various glands and joints. Some patients experience constitutional symptoms like fever, involuntary weight loss or night sweats.
Since dental health requires saliva, Ms. Divinagracia was wisely advised by the rheumatologist to see her dentist, who told her to always brush after eating, floss twice a day, suck on sugar-free lozenges and drink water all day to reduce the risk of rampant dental decay and tooth loss.
For someone as active as she has been for decades, the bouts of fatigue that usually accompany Sjogren’s are especially hard to take. “I could sleep for eight hours and wake up feeling like I hadn’t slept at all,” she said. “Or sometimes the fatigue will hit in the afternoon when I’m supposed to be starting supper for the family.”
As life-disrupting as the syndrome can be, its worst possible consequence is the occurrence of B-cell lymphoma, a cancer of the immune system that afflicts 5 percent to10 percent of those with primary Sjogren’s, a risk 15 to 20 times higher than in the general population. Blood tests every year or two to check for lymphoma are recommended, especially for patients with severe disease, and swollen lymph nodes should be assessed without delay.
Ideally, patients are best managed by a medical team. Dr. R. Hal Scofield, a Sjogren’s specialist at Oklahoma Medical Research Foundation, where patients are seen by a rheumatologist, dentist and eye doctor, runs one of the few multidisciplinary clinics in the country.
Ms. Divinagracia, who knows coordinated treatment can help to minimize symptoms and slow progression, said she’d have to travel from Los Angeles to San Francisco to get to a Sjogren’s clinic. However, she has taken a proactive approach to learn about the disease, reduce expenses and limit distressing side effects of treatment. She also joined a Sjogren’s support group through the Sjogren’s Syndrome Foundation.
“My list of medications is a mile long, and most have to be taken several times a day,” she said. One of the drugs prescribed, Restasis, is so expensive she got a prescription for a generic form available in Canada but not in the United States.
(Adapted from: www.www.nytimes.com )
Choose the correct grammatical class that the fragment “higher” fits best:
“...15 to 20 times higher than in the general population”.
TEXTO – The Challenge of Identifying Sjogren’s Syndrome
Angelica Divinagracia, a 54-year-old fitness instructor in Los Angeles, woke one morning with her tongue literally stuck to the roof of her mouth. Though she normally drank lots of water, especially after strenuous workouts with clients, she thought her chronically dry mouth, was due to dehydration. That is, until an even more troublesome symptom — excruciating scratchy eye pain unrelieved by drops — prompted an immediate visit to her ophthalmologist. “Do you also have dry mouth?” the eye doctor asked. Given her response, he suspected an autoimmune disease called Sjogren’s syndrome, sent her for blood work and, based on the results, told her to see a rheumatologist. That doctor had 12 more vials of blood analyzed at six different laboratories to confirm the diagnosis of Sjogren’s (pronounced SHOW-grins). The disorder is named after Dr. Henrik Sjogren, a Swedish ophthalmologist who in 1933 described 19 women suffering from dry eyes and mouth.
This chronic and usually progressive syndrome attacks secretory tissues throughout the body, primarily, but not exclusively, salivary and lacrimal glands of the mouth and eyes, the respective sources of saliva and tears. It can occur as a primary disorder or secondary to another autoimmune condition like rheumatoid arthritis or scleroderma.
The primary form affects between three and 10 of every 10,000 people, and nine women for every one man, mostly around the time of menopause. Including people with secondary Sjogren’s doubles the prevalence. The cause or causes are not known, though genetic, environmental and hormonal factors are strong suspects and are likely to work in concert. The triggering factor for its expression is often a microbial infection.
Diagnosis can be challenging because the main symptoms — dry eyes and mouth, fatigue and limb pain — are common complaints associated with any number of health problems. Yet, Dr. Lindsey A. Criswell, a rheumatologist at the University of California, San Francisco, told me that few doctors are aware of a relatively simple test — an in-office biopsy of tiny salivary glands from the inner surface of the lip — that can be definitive for Sjogren’s. “Patients with Sjogren’s often have symptoms for years before being diagnosed,” Dr. Criswell said. Ms. Divinagracia, for example, had dry mouth for about three years and dry eyes for two years and had attributed her occasional limb pain and fatigue to her demanding workouts. “My eyes were sensitive to everything — bright light, wind, cold air, hot air,” she said. “I found myself wearing sunglasses in the house. I would wake up in the morning with my lids stuck to my eyeballs and feeling like there was glass in my eyes.”
Dr. Criswell said Ms. Divinagracia was fortunate to have a tuned-in ophthalmologist. “Sadly,” she said, “most doctors are narrowly focused on a particular organ. They don’t think outside their specialty, and patients may not mention other symptoms unless they’re asked. The manifestations of Sjogren’s are numerous and doctors generally are not familiar with them, which results in huge delays in diagnosis.”
A report Dr. Criswell published last year with Dr. Xavier Mariette in The New England Journal of Medicine listed possible manifestation of Sjogren’s in lymph nodes, lungs, kidneys, muscles, nervous system, skin and brain, as well as various glands and joints. Some patients experience constitutional symptoms like fever, involuntary weight loss or night sweats.
Since dental health requires saliva, Ms. Divinagracia was wisely advised by the rheumatologist to see her dentist, who told her to always brush after eating, floss twice a day, suck on sugar-free lozenges and drink water all day to reduce the risk of rampant dental decay and tooth loss.
For someone as active as she has been for decades, the bouts of fatigue that usually accompany Sjogren’s are especially hard to take. “I could sleep for eight hours and wake up feeling like I hadn’t slept at all,” she said. “Or sometimes the fatigue will hit in the afternoon when I’m supposed to be starting supper for the family.”
As life-disrupting as the syndrome can be, its worst possible consequence is the occurrence of B-cell lymphoma, a cancer of the immune system that afflicts 5 percent to10 percent of those with primary Sjogren’s, a risk 15 to 20 times higher than in the general population. Blood tests every year or two to check for lymphoma are recommended, especially for patients with severe disease, and swollen lymph nodes should be assessed without delay.
Ideally, patients are best managed by a medical team. Dr. R. Hal Scofield, a Sjogren’s specialist at Oklahoma Medical Research Foundation, where patients are seen by a rheumatologist, dentist and eye doctor, runs one of the few multidisciplinary clinics in the country.
Ms. Divinagracia, who knows coordinated treatment can help to minimize symptoms and slow progression, said she’d have to travel from Los Angeles to San Francisco to get to a Sjogren’s clinic. However, she has taken a proactive approach to learn about the disease, reduce expenses and limit distressing side effects of treatment. She also joined a Sjogren’s support group through the Sjogren’s Syndrome Foundation.
“My list of medications is a mile long, and most have to be taken several times a day,” she said. One of the drugs prescribed, Restasis, is so expensive she got a prescription for a generic form available in Canada but not in the United States.
(Adapted from: www.www.nytimes.com )
Read the options in the sentences below and choose the main goal of the text:
TEXTO – The Challenge of Identifying Sjogren’s Syndrome
Angelica Divinagracia, a 54-year-old fitness instructor in Los Angeles, woke one morning with her tongue literally stuck to the roof of her mouth. Though she normally drank lots of water, especially after strenuous workouts with clients, she thought her chronically dry mouth, was due to dehydration. That is, until an even more troublesome symptom — excruciating scratchy eye pain unrelieved by drops — prompted an immediate visit to her ophthalmologist. “Do you also have dry mouth?” the eye doctor asked. Given her response, he suspected an autoimmune disease called Sjogren’s syndrome, sent her for blood work and, based on the results, told her to see a rheumatologist. That doctor had 12 more vials of blood analyzed at six different laboratories to confirm the diagnosis of Sjogren’s (pronounced SHOW-grins). The disorder is named after Dr. Henrik Sjogren, a Swedish ophthalmologist who in 1933 described 19 women suffering from dry eyes and mouth.
This chronic and usually progressive syndrome attacks secretory tissues throughout the body, primarily, but not exclusively, salivary and lacrimal glands of the mouth and eyes, the respective sources of saliva and tears. It can occur as a primary disorder or secondary to another autoimmune condition like rheumatoid arthritis or scleroderma.
The primary form affects between three and 10 of every 10,000 people, and nine women for every one man, mostly around the time of menopause. Including people with secondary Sjogren’s doubles the prevalence. The cause or causes are not known, though genetic, environmental and hormonal factors are strong suspects and are likely to work in concert. The triggering factor for its expression is often a microbial infection.
Diagnosis can be challenging because the main symptoms — dry eyes and mouth, fatigue and limb pain — are common complaints associated with any number of health problems. Yet, Dr. Lindsey A. Criswell, a rheumatologist at the University of California, San Francisco, told me that few doctors are aware of a relatively simple test — an in-office biopsy of tiny salivary glands from the inner surface of the lip — that can be definitive for Sjogren’s. “Patients with Sjogren’s often have symptoms for years before being diagnosed,” Dr. Criswell said. Ms. Divinagracia, for example, had dry mouth for about three years and dry eyes for two years and had attributed her occasional limb pain and fatigue to her demanding workouts. “My eyes were sensitive to everything — bright light, wind, cold air, hot air,” she said. “I found myself wearing sunglasses in the house. I would wake up in the morning with my lids stuck to my eyeballs and feeling like there was glass in my eyes.”
Dr. Criswell said Ms. Divinagracia was fortunate to have a tuned-in ophthalmologist. “Sadly,” she said, “most doctors are narrowly focused on a particular organ. They don’t think outside their specialty, and patients may not mention other symptoms unless they’re asked. The manifestations of Sjogren’s are numerous and doctors generally are not familiar with them, which results in huge delays in diagnosis.”
A report Dr. Criswell published last year with Dr. Xavier Mariette in The New England Journal of Medicine listed possible manifestation of Sjogren’s in lymph nodes, lungs, kidneys, muscles, nervous system, skin and brain, as well as various glands and joints. Some patients experience constitutional symptoms like fever, involuntary weight loss or night sweats.
Since dental health requires saliva, Ms. Divinagracia was wisely advised by the rheumatologist to see her dentist, who told her to always brush after eating, floss twice a day, suck on sugar-free lozenges and drink water all day to reduce the risk of rampant dental decay and tooth loss.
For someone as active as she has been for decades, the bouts of fatigue that usually accompany Sjogren’s are especially hard to take. “I could sleep for eight hours and wake up feeling like I hadn’t slept at all,” she said. “Or sometimes the fatigue will hit in the afternoon when I’m supposed to be starting supper for the family.”
As life-disrupting as the syndrome can be, its worst possible consequence is the occurrence of B-cell lymphoma, a cancer of the immune system that afflicts 5 percent to10 percent of those with primary Sjogren’s, a risk 15 to 20 times higher than in the general population. Blood tests every year or two to check for lymphoma are recommended, especially for patients with severe disease, and swollen lymph nodes should be assessed without delay.
Ideally, patients are best managed by a medical team. Dr. R. Hal Scofield, a Sjogren’s specialist at Oklahoma Medical Research Foundation, where patients are seen by a rheumatologist, dentist and eye doctor, runs one of the few multidisciplinary clinics in the country.
Ms. Divinagracia, who knows coordinated treatment can help to minimize symptoms and slow progression, said she’d have to travel from Los Angeles to San Francisco to get to a Sjogren’s clinic. However, she has taken a proactive approach to learn about the disease, reduce expenses and limit distressing side effects of treatment. She also joined a Sjogren’s support group through the Sjogren’s Syndrome Foundation.
“My list of medications is a mile long, and most have to be taken several times a day,” she said. One of the drugs prescribed, Restasis, is so expensive she got a prescription for a generic form available in Canada but not in the United States.
(Adapted from: www.www.nytimes.com )
Is this statement true or false according to the Text?
Mark T (true) or F (false)
( ) Patient are better assisted if a team of doctors are managing the treatment.
( ) Sometimes the treatment can be so expensive in the United States that patients get a prescription referring them to Canada.
( ) The only way knowing about the disease is when you wake up with your tongue stuck to the roof of your mouth.
The correct sequence from top to bottom is:
TEXTO – The Challenge of Identifying Sjogren’s Syndrome
Angelica Divinagracia, a 54-year-old fitness instructor in Los Angeles, woke one morning with her tongue literally stuck to the roof of her mouth. Though she normally drank lots of water, especially after strenuous workouts with clients, she thought her chronically dry mouth, was due to dehydration. That is, until an even more troublesome symptom — excruciating scratchy eye pain unrelieved by drops — prompted an immediate visit to her ophthalmologist. “Do you also have dry mouth?” the eye doctor asked. Given her response, he suspected an autoimmune disease called Sjogren’s syndrome, sent her for blood work and, based on the results, told her to see a rheumatologist. That doctor had 12 more vials of blood analyzed at six different laboratories to confirm the diagnosis of Sjogren’s (pronounced SHOW-grins). The disorder is named after Dr. Henrik Sjogren, a Swedish ophthalmologist who in 1933 described 19 women suffering from dry eyes and mouth.
This chronic and usually progressive syndrome attacks secretory tissues throughout the body, primarily, but not exclusively, salivary and lacrimal glands of the mouth and eyes, the respective sources of saliva and tears. It can occur as a primary disorder or secondary to another autoimmune condition like rheumatoid arthritis or scleroderma.
The primary form affects between three and 10 of every 10,000 people, and nine women for every one man, mostly around the time of menopause. Including people with secondary Sjogren’s doubles the prevalence. The cause or causes are not known, though genetic, environmental and hormonal factors are strong suspects and are likely to work in concert. The triggering factor for its expression is often a microbial infection.
Diagnosis can be challenging because the main symptoms — dry eyes and mouth, fatigue and limb pain — are common complaints associated with any number of health problems. Yet, Dr. Lindsey A. Criswell, a rheumatologist at the University of California, San Francisco, told me that few doctors are aware of a relatively simple test — an in-office biopsy of tiny salivary glands from the inner surface of the lip — that can be definitive for Sjogren’s. “Patients with Sjogren’s often have symptoms for years before being diagnosed,” Dr. Criswell said. Ms. Divinagracia, for example, had dry mouth for about three years and dry eyes for two years and had attributed her occasional limb pain and fatigue to her demanding workouts. “My eyes were sensitive to everything — bright light, wind, cold air, hot air,” she said. “I found myself wearing sunglasses in the house. I would wake up in the morning with my lids stuck to my eyeballs and feeling like there was glass in my eyes.”
Dr. Criswell said Ms. Divinagracia was fortunate to have a tuned-in ophthalmologist. “Sadly,” she said, “most doctors are narrowly focused on a particular organ. They don’t think outside their specialty, and patients may not mention other symptoms unless they’re asked. The manifestations of Sjogren’s are numerous and doctors generally are not familiar with them, which results in huge delays in diagnosis.”
A report Dr. Criswell published last year with Dr. Xavier Mariette in The New England Journal of Medicine listed possible manifestation of Sjogren’s in lymph nodes, lungs, kidneys, muscles, nervous system, skin and brain, as well as various glands and joints. Some patients experience constitutional symptoms like fever, involuntary weight loss or night sweats.
Since dental health requires saliva, Ms. Divinagracia was wisely advised by the rheumatologist to see her dentist, who told her to always brush after eating, floss twice a day, suck on sugar-free lozenges and drink water all day to reduce the risk of rampant dental decay and tooth loss.
For someone as active as she has been for decades, the bouts of fatigue that usually accompany Sjogren’s are especially hard to take. “I could sleep for eight hours and wake up feeling like I hadn’t slept at all,” she said. “Or sometimes the fatigue will hit in the afternoon when I’m supposed to be starting supper for the family.”
As life-disrupting as the syndrome can be, its worst possible consequence is the occurrence of B-cell lymphoma, a cancer of the immune system that afflicts 5 percent to10 percent of those with primary Sjogren’s, a risk 15 to 20 times higher than in the general population. Blood tests every year or two to check for lymphoma are recommended, especially for patients with severe disease, and swollen lymph nodes should be assessed without delay.
Ideally, patients are best managed by a medical team. Dr. R. Hal Scofield, a Sjogren’s specialist at Oklahoma Medical Research Foundation, where patients are seen by a rheumatologist, dentist and eye doctor, runs one of the few multidisciplinary clinics in the country.
Ms. Divinagracia, who knows coordinated treatment can help to minimize symptoms and slow progression, said she’d have to travel from Los Angeles to San Francisco to get to a Sjogren’s clinic. However, she has taken a proactive approach to learn about the disease, reduce expenses and limit distressing side effects of treatment. She also joined a Sjogren’s support group through the Sjogren’s Syndrome Foundation.
“My list of medications is a mile long, and most have to be taken several times a day,” she said. One of the drugs prescribed, Restasis, is so expensive she got a prescription for a generic form available in Canada but not in the United States.
(Adapted from: www.www.nytimes.com )
According to the text, it can be understood that “approach” (in paragraph 11) brings an idea of:
Choose the correct options in order to complete the text below, while keeping the same meaning from the original text.
“Blood tests every year or two to check for lymphoma are recommended, especially for patients with severe disease.
“Blood ________ every year or two to ________ for lymphoma are _________, especially for patients with _________ disease.