Maternidade e sindrome do down: Um estudo sobre o sentimento vinculado frente ao diagnóstico

Trata-se de um estudo de delineamento transversal de caráter multidisciplinar, o qual conta com um estatístico que contribuiu para o delineamento do estudo, realizando o cálculo amostral e contribuindo efetivamente para análise dos dados e alunos de psicologia e pediatrias que contribuíram para a coleta de dados. A literatura aponta que a transmissão inadequada do diagnóstico da Síndrome de Down pode prejudicar o vínculo mãe-bebê e o posterior desenvolvimento da criança. Sendo assim, este estudo objetivou analisar os sentimentos maternos frente a este diagnóstico, verificando diferentes formas de transmissão e possíveis facilitadores da aceitação da Síndrome. A amostra foi constituída por 20 mães cujos filhos apresentam Síndrome de Down, na faixa etária de 0 à 03 anos e que recebem atendimento em ambulatório de um Hospital Universitário de Pediatria. Para coleta dos dados fez-se uso de um questionário, após a assinatura do Termo de Consentimento Livre e Esclarecido. Os dados foram analisados através de dois softwares de processamento de dados, o SPSS e o ALCESTE (Análise Lexical por Contexto de um Conjunto de Segmento de Texto). Os dados indicaram que 90% das mães receberam o diagnóstico de Síndrome de Down depois do parto. 75% dos diagnósticos foram comunicados pelo médico pediatra e 15% pelas enfermeiras. As mãe referiram que o diagnóstico foi tardio, inadequado e insuficiente no informativo. Observouse que as entrevistadas viveram os mesmos sentimentos observados na literatura como: choque, negação, tristeza e ira, adaptação e reorganização. Tais resultados permitem concluir que o diagnóstico de SD nas mães investigadas foi em sua maioria tardio, realidade comum no Brasil, principalmente quando se trata de classes econômicas baixas. As mães apontam que percebem este diagnóstico como tardio, inadequado e insuficiente no informativo, e gera sentimentos que a literatura já cita como comuns frente a esse tipo de diagnóstico. Portanto, observamos que a notícia pode ser um fator que dificulte ou facilite o estabelecimento do vínculo mãe-bebê, comprometendo a busca de recursos para o desenvolvimento da criança

Função autonômica em pacientes portadores de lipodistrofia generalizada congênita - sindrome de berardinelli - SEIP

A Síndrome de Berardinelli-Seip ou Lipodistrofia Generalizada Congênita (LGC) é uma doença rara, com transmissão autossômica recessiva, caracterizada principalmente pela ausência quase total de tecido adiposo. Os pacientes afetados apresentam resistência a insulina, dislipidemia e hipertensão arterial. Estudos têm evidenciado que estas alterações metabólicas interferem na modulação autonômica para o nó sinusal. O principal objetivo deste estudo foi investigar a modulação autonômica em pacientes portadores de LGC, através da variabilidade de freqüência cardíaca (VFC), pelo método linear de domínio de tempo na Eletrocardiografia Dinâmica de 24 horas e estabelecer um critério relativamente simples, não invasivo, para diagnóstico de disfunção autonômica nestes pacientes. Participou voluntariamente deste estudo transversal, um grupo de pacientes portadores de LGC (n=18) na faixa etária de 9,3 a 39,8 anos (21,3 ± 8,3) cuja variabilidade de freqüência cardíaca foi comparada com um grupo de pacientes controles (n=19) com idade de 9,3 a 39,1 anos (21,4 ± 7,8). Todos os voluntários foram submetidos à avaliação clínica, laboratorial, antropométrica e análise de VFC no domínio de tempo através de eletrocardiografia dinâmica de 24 horas. Para análise dos dados relativos aos índices temporais de VFC foram utilizados o MeanRR, SSDN e rMSSD. Pacientes com LGC apresentavam aumento da pressão arterial comparados com indivíduos do grupo controle (sistólica, 131,1 vs 106,3 mmHg, p<0,05); diastólica, 85,0 vs 68,2 mmHg, p<0,05) e 10 tinham critérios para diagnóstico de Hipertensão Arterial e Hipertrofia do Ventrículo Esquerdo. Os níveis de glicose, triglicerídeos, colesterol e HOMA-R eram elevados e 12 pacientes tinham critérios para diabetes mellitus tipo 2. Comparado com os controles, pacientes com LGC tinham diminuição dos índices MeanRR (639,8 vs 780,5 ms, p<0,001), SDNN (79,2 vs 168,5 ms, p<0,001), e rMSSD (15,8 vs 59,6 ms, p<0,001). Em pacientes com LGC, a redução da VFC foi independente de distúrbios metabólicos e hemodinâmicos. Os resultados de nosso experimento indicam que pacientes com LGC apresentavam modulação autonômica anormal caracterizada pelo aumento da freqüência cardíaca e pronunciada redução da VFC, independente de distúrbios metabólicos e hemodinâmicos observados nesta síndrome. O caráter multidisciplinar desse estudo fica contemplado pela interação de profissionais de diversas áreas como: cardiologia, endocrinologia, metabolismo, neurologia, nutrição, etc

Efeitos do exercício físico aeróbio na modulação autonomica da frequência cardíaca de mulheres com sindrome dos ovários policisticos

Conselho Nacional de Desenvolvimento Científico e Tecnológico

O papel das interações no processo de inclusão de crianças com síndrome de Down

La inclusión actual está siendo orientada por diversos principios, tales como la cooperación, aceptación de las diferencias individuales, valoración de cada individuo y convivencia dentro de la diversidad. En esta perspectiva, se entiende la educación como un proceso, en que todos los alumnos con necesidades educativas especiales tienen el derecho de escolarización en el salón de clase general, visando el desarrollo máximo de su potencial. Es en la interacción con los otros que los niños desarrollan efectivamente sus capacidades, aprenden a descubrir al otro como portador de valores y, como consecuencia de esa relación, a tener más confianza en sí mismo. Es por lo tanto necesario que las influencias educativas sean recíprocas y que en la convivencia escolar, puedan ser constantes las relaciones interpersonales. Así, haciendo con que cada niño sea introducido a la vivencia de la ciudadanía, al aprendizaje que va más allá de los contenidos escolares y envolviendo también la construcción de valores, hábitos y actitudes. Con base en estos aspectos, nuestro trabajo tuvo como objetivo la interacción entre niños con síndrome de Down y sus compañeros, en dos clases regulares de una escuela pública em el nível de educación infantil, en la ciudad de Natal/RN. En este sentido, realizamos un estudio de caso con dos niños, envolviendo observación, aplicación de entrevistas y cuestionarios, además de la utilización de la sociometría. Los datos analizados apuntan la existencia de un espíritu de cooperación entre los niños, del respeto a la diversidad y también a sus limitaciones. Estos son valores que están siendo construidos y que son percibidos claramente en lo cotidiano de la escuela. De igual modo, de esta convivência resulta la construcción de vínculos afectivos y sociales entre los niños que presentan el síndrome de Down y sus compañeros, siendo estos similares a los desarrollados entre los niños en general. Sin embargo, se evidencia todavía, la necesidad de un incentivo mayor por parte de la comunidad escolar para que sean establecidos vínculos más significativos

O educando com síndrome de down: um estudo sobre a relação entre pais e profissionais na escola regular

This work makes a documental analise about the relationship between families of Down syndrome students and professionals of who teach them, in order to improve the process of developing teaching-learning, in an inclusive perspective. For this, we use a qualitative approach, because we believe that the object of research is not a passive and neutral knowledge, since it has meanings and relationships whose can be better interpreted and understood by the researcher in a real and active situation. For the development of this research, a bibliographical review was made about the subject, and a case studied in two regular education schools, both of them at the city of Natal/RN, one public and another one particular. We work on these educational institutions with professionals and parents of Down syndrome students. As an instrument of building information we used a semi-structured interview and to analise the results a qualitative method. Crossing the stages, we noticed: the pedagogical coordinators who made up both analyzed schools showed interest about doing an effective work with parents, regardless of Educational Policy Project of each school, predict or not the participation on educational undertaken process; On teachers discourses, reporting the relationship with the family, we realize that one of those teachers try to keep a good relationship with parents, permeated by learning exchanges, guidance and knowledge, in relation to another one, even existing an apparent openness to dialogue, when parents have any suggestions or criticism, that attitude is not always well coming. From the parents interviews, we can emphasize, first of all, that both of them recognize the benefits of inclusion, with regard to socialization - in general from the coexistence with pairs and the process of teaching and learning, as shown in a consistent way. Regarding school meetings with teachers, the studied parents agree about importance of such appointments and try to attend them, besides the other events organized by the school, beyond keeping individual touch with the teacher, when necessary. They are always present, looking for get envolved in everything that happens at school, in order to know better what is being done, listening and may suggest alternatives to improving the educational process. We perceive, from the study undertaken, that although the school inclusion is not an easy process to be built, is something that could be achieved. For this, is necessary that professionals of education and families recognize their functions in the educational process and act jointly on this direction

A escrita e a criança com síndrome de Down: uma relação possível na escola regular

The school inclusion is based on respect for diversity and the belief that everyone has the capacity to learn and develop, for this the school needs to prepare itself to meet the differences and provide a meaningful learning for everyone, including those with Down syndrome. It is in the interaction with others that children develop their skills and exchange substantial experiences to learn the school and non school knowledge. Among the knowledge the school must offer students, there is one that is indispensable to the present society; the writing, because writing is a way to Interact, to communicate and to build autonomy to relate in society. Before exposed, the research that started this study aimed to investigate the level of the writing conceptualization of children with Down syndrome during the literacy process in a regular school of the private school network in the city of Natal/RN. For carrying out this study, initially we conducted a qualitative research, using the bibliographical as a methodological recourse, seeking to the deepening of information, based on the literature about the subject, which allowed us to collect data about people with Down syndrome, their education and the process of the writing acquisition. Later, a case study was performed, involving free observation in the room and interviews with teachers and children, trying to verify how this writing acquisition process occurs by children with Down syndrome. The data analyzed and information recorded demonstrated that the school inclusion, when taken seriously, benefits the learning of writing for children who have intellectual deficit, and, mainly, they develop in this environment and are able to learn to write, as long as their own pace are respected

Efeitos da inclinação da esteira na marcha de crianças com síndrome de down

Background: Down syndrome (DS) is a genetic alteration characterized by being a nonprogressive congenital encephalopathy. Children with DS have hypotonia and developmental delays that interfere in the movement`s acquisition for these children. Objective: Analyze the effects of treadmill inclination on angle and spatiotemporal gait characteristics of these individuals. Methodology: We studied 23 subjects of both sexes, with ages ranged between 05 and 11 years, they presented ability to walk on level 5 classified according to the Functional Ambulation Category (FAC). Initially held a subjective evaluation of balance through a questionnaire (Berg Balance Scale-BBS) then the kinematic gait analysis was realized on a treadmill first, without inclination and then, with inclination of 10%, using the motion system analysis Qualisys System. Data analysis was done using BioStat 5.0 attributing significance level of 5%. Normality of data was verified using D'Agostino test and later was applied paired t-test to compare data in two experimental conditions. Results: There was a statistically significant difference in the spatiotemporal variables: reduction in the cadence (from 108.92 ± 39.07 to 99.11 ± 27.51, p <0.04), increase in cycle time (from 1.24 ± 0.27 to 1.36 ± 0.34, p = 0.03 ) and increase in time to take stock (from 0.77 ± 0.15 to 0.82 ± 0.18, p <0.001). Angular variables that showed statistically significant increasing were: the hip in the initial contact (12.23 ± 4.63 to 18.49 ± 5.17, p <0.0001) and max. flexion in balance (12.96±4:32 to 19.50 ± 4.51, p <0.0001 ), knee in the initial contact (15.59 to ± 6.71 to 21.63 ± 6.48, p <0.0001), the ankle in the initial contact (-2.79 ± 9.8 to 2.25 ± 8.79, p <0.0001), max dorsiflexion in stance (4.41 ± 10.07 to 7.13 ± 11.58, p <0.0009), maximum plantar flexion in the pre-assessment of the ankle joint (increase of -6.33 ± 8.77 to -2.69 ± 8.62, p <0.0004).Conclusions: The inclination acts in a positive way for angular and spatiotemporal features gait of children with Down syndrome, demonstrating possible benefit of using this surface in the gait rehabilitation of children with Down Syndrome

A memória de curto prazo e a síndrome de down: a relação entre contextos de desenvolvimento

Down syndrome (DS) is one of the most frequent causes of intellectual disability, affecting one in every 600 to 1000 live births. Studies have demonstrated that people with DS have a lower capacity for short-term memory (STM) and working memory (WM), which affects their capability to learn new words and to follow spoken instructions, specially when they involve multiple information or consecutive orders/orientations. It seems that the basis of the learning process, as it happens with language and mathematics comprehension and reasoning, relies in the STM and WM systems. Individuals with DS are increasingly included in mainstream education, and yet, very few researches have been conducted to investigate the influence of memory development and the type of enrollment (regular school and special school). This study investigated the relationship between the type of school enrollment with the performance on STM tests and also, the relationship of this performance with early stimulation (ES). The tests used in the first research were the digit span, free recall, word recognition and subtests of the Wechsler Intelligence Scale for Children Third Edition (WISC-III). Individuals enrolled in the regular schools group had higher scores on the digit span test and the subtests of the WISC-III. In the free recall and recognition tests, no differences were found. This study indicates that the type of enrollment might influence the memory development of individuals with DS and clearly points the need for future investigations. In the second research, the tests used were the digit span, free word recall and subtests of the WISC-III. The test results showed better performance by adults that received ES before six months of age. The studies showed improvement in STM both in people who attended or were attending regular school, as well as those who benefited from ES before six months of age. However, some issues still need to be better understood. What is the relation between this stimulation with the individual s education? Since ES may reflect a greater family involvement with the individual, what is the role of emotional components derived from this involvement in the cognitive improvement? These and other questions are part of the continuity of this study

Avaliação das características de afetividade em crianças e jovens com síndrome de down

This work presents the processes and the results of a research concerning the affectivity in children suffering from the Down´s Syndrome (DS). The relevance of the study is justified due to the need of the development of researches, in the area of psychological evaluation of people who suffers from Down´s Syndrome (DS), that are backed by the use of appropriate instruments for such purpose. The thematic discussed focuses the characteristics of the affectivity of children suffering from Down´s Syndrome. Affectivity, conceptually, is considered a wide phenomenon, including several aspects such as emotions, passions, anxiety, anguish, sadness, happiness and even the pleasure sensations and pain. The general objective of the study consisted of investigating the manifestation of the affectivity in children and young with Down´s Syndrome and the parents´ and educators´ perception concerning the expression of the affectivity in the behavior and in the social activities. The specific objectives were: to identify the parents' perceptions about the several manifestations of indicative behaviors of affectivity; to verify in the social atmosphere, outside home, through the teachers' perception, the several forms and intensities of the expression of the affectivity; and, to make possible the use of the technique of Zulliger (Z-test) in people with Down´s Syndrome. 70 (seventy) children and young with Down´s Syndrome participated in the research, in the age group from 04 to 26 years old, which are attended by Institutions of Paraíba and of Rio Grande do Norte. The instruments used were two questionnaires, applied with the parents and teachers, and the projective technique, Z-test, applied, individually, with the children and young with Down´s Syndrome. For analysis of the data of the questionnaires, the program Trideux-Mots was used, with the intention of selecting the main outstanding words for the parents and teachers concerning the expression of the children's affectivity and young with Down´s Syndrome. For so much, it was organized a database that was processed by that program and, soon after, interpreted through the Factorial Analysis by Correspondence (AFC), looking for to clear the modalities of presented answers in an organized way, through a graph. The data of the Z-test were analyzed, taking in consideration the need to characterize the aspects of the affectivity and the elaboration of specific norms for this sample type, through normalized scores. In agreement with the data presented by Tri-deux-Mots, it was observed that in the affective behavior and in the relationship with the other, home and in the school, the children and young with Down´s Syndrome they express your affectivity through positive and negative characteristics, in the same way that any other child that doesn't have to syndrome. The Z-test made possible initial elements to work with that population, however it is necessary that grow other researches with the intention of investigating the reason of the answers they present not the specific categories that you/they are related to the affectivity, since it was well-known the diversity of affective characteristics presented by the researched group

Fenótipo neuropsicológico de adolescentes com síndrome de Down

This research aimed to contribute to the characterization of a neuropsychological phenotype of adolescents with Down Syndrome (DS). A multicases study of six adolescents (three males and three females, aged 13 to 14 years) diagnosed with DS and treated at two institutions in the city of Natal (Brazil), was conducted. Participants were assessed using the methodological approach developed by Luria, which is composed by four complementary stages. The first one aimed to investigate the qualitative impact of DS in school life and social development of the adolescents; dimensions of behavior and social-affective aspects of the members of the study were investigated. In the second stage participants performed a battery of neuropsychological tests in order to identify strengths and weaknesses in their cognitive functioning. The third stage was incorporated into the second in order to analyze the quality of the activity of the participants along the quantitative evaluation, highlighting strategies used, errors produced among other indicators. Lastly, the fourth stage refers to the intervention with the participants. Although this is not a specific objective of the study, it is argued that the outcome of this research will subsidize the practice of different professionals working with this clinical group. The results of the first stage emphasized the presence of difficulties in social relationships and in school life of observed adolescents. In turn, the second and third stages pointed out to the presence of difficulties in tasks involving logical and abstract thinking, as well as difficulties in expressive language. In relation to visual memory, we observed a better performance in activities of lower complexity, ie, with less interference of executive functioning, particularly in terms of the functions of planning and initiative. Finally, it was found motor and mental retardation, affecting significantly the performance related to different cognitive areas. The results highlighted here can be considered as subsidies for future interventions, suggesting the need for developping projects that take into account different aspects constituents of the human subject, involving not only the individual with developmental changes, as well as their families, teachers, schools and society in general