Correlación entre el test de la figura humana de F.L. Goodenough y Harris y las notas escolares de media general del curso anterior : Área de Ciencias Naturales y Dibujo y comprensión del hombre y de la mujer en dos muestras de 610 y 500 alumnos de Sevilla y Córdoba y Las Palmas de Gran Canaria, y dos pequeñas muestras de deficientes mentales escolarizados controlando las variables edad y sexo.

1) Realizar un trabajo experimental con sujetos normales y deficientes de Sevilla, Córdoba y Las Palmas de Gran Canaria 2) Averiguar la correlación existente entre el test de la figura humana de F.L. Goodenough y D.B Harris y las calificaciones escolares de media general de la muestra escogida 3) Ofrecer a dichas zonas una estandarización del test de la figura humana de Goodenough y Harris, y de este modo hacer extensible a la población española un nuevo elemento más en la diagnosis de la inteligencia. 610 sujetos de escuelas normales en edades comprendidas entre los 6 y 10 años y 162 deficientes mentales de 5 a 21 años escolarizados en centros específicos, todos ellos de Sevilla y Córdoba, 500 niños de escuelas normales de Las Palmas de Gran Canaria de edades comprendidas entre 6 y 10 años y 50 sujetos de centros específicos de 9 años de edad. Analiza las bases teóricas del test de Goodenough y Harris, relaciona los estudios españoles en torno al test de Goodenough y plantea algunas hipótesis para comprobarlas con una investigación que se realiza en dos muestras con niños normales y niños deficientes mentales en las provincias españolas de Sevilla, Córdoba y Las Palmas de Gran Canaria. Test del dibujo de la figura humana de Goodenough-Harris. El test de Goodneough y Harris ha sido aplicado según las normas indicadas en el manual del Test della figura umana (ed. Organizzazioni Speciali, Firenze) en cuanto a motivar a los niños en la realización del dibujo del hombre y de la mujer y siguiendo las pautas descriptivas. Terminado el dibujo del hombre se les presentaba otra hoja para que dibujasen una mujer y concluido éste, se les presentaba un cuestionario para que lo respondiesen teniendo delante la figura del hombre y de la mujer. La aplicación del test se realizó en las primeras horas de clase, bien de la mañana o de la tarde, para evitar momentos en que los alumnos se encontrasen cansados y dicho cansancio pudiese influir en los resultados del test. Se procuró durante la aplicación del test un ambiente de relax y simpatía entre testista y alumnos y se invalidaron todos aquellos protocolos que no cumplían las normas exigidas por el test, los cuales fueron 10 en total. 1) La obtención de una correlación positiva y significativa entre el dibujo del hombre y de la mujer en ambas muestras de sujetos normales, demuestran la fidelidad del test. 2) La correlación del test tanto en el dibujo del hombre como en el de la mujer, con las notas escolares de media del curso anterior, en las áreas de ciencias naturales y dibujo, son todas ellas positivas y en su mayoría significativas, lo que significa una efectiva correlación entre el test y el rendimiento escolar. 3) el resultado de las diversas correlaciones positivas y significativas entre las notas de media del curso anterior y de estas con el test, pueden ofrecer información del tipo de inteligencia que mide el test, pudiendo predecir el éxito escolar en las áreas tratadas más que en otras materias. Sin olvidar que la predicción debe ser estudiada y profundizada. 4) No existen diferencias significativas en los resultados del test entre una edad y la inmediatamente superior, pero en general, existe diferencia significativa cuando se trata de dos años de diferencia. 5) Las diferencias entre la muestra Sevilla y Córdoba con Las Palmas de Gran Canaria son significativas, a favor de los niños andaluces. 6) En la muestra de sujetos deficientes mentales existe entre el dibujo del hombre y de la mujer una correlación positiva y significativa en todos los casos, salvo en las niñas de la muestra de Las Palmas, que aunque positiva no es significativa. Por lo cual sólo se puede hablar de una moderada correlación entre los dos dibujos. 7) Nada certero se puede afirmar respecto a las diferencias significativas de medias tanto al comparar los resultados obtenidos por los deficientes mentales niños y niñas de la muestra Sevilla y Córdoba, como al compararlos con la muestra de Las Palmas. El pequeño número de sujetos, el grado diferente de deficiencia dentro de las diversas edades no controladas harían equívocas e infundadas cualquier afirmación. 1) Entre las técnicas y los tests que se emplean con niños, el test de la figura humana es significativo, interesante y agradable, ya que a la mayoría de los sujetos les encanta dibujar y pintar. Además, tanto los sujetos normales como los deficientes dibujan, en numerosas ocasiones, figuras humanas. La representación del dibujo de la persona humana en sus diversas etapas es un reflejo del desarrollo intelectual del niño, puesto que el niño no pinta lo que ve sino lo que sabe. Por consiguiente, los resultado con el uso del test utilizado han sido satisfactorios tanto en normales como en deficientes.

Migraine is the Most Prevalent Primary Headache in Individuals with Temporomandibular Disorders

Aims: To assess the prevalence of primary headaches (HA) in adults with temporomandibular disorders (TMD) who were assessed in a specialty orofacial pain clinic, as well as in controls without TMD. Methods: The sample consisted of 158 individuals with TMD seen at a university-based specialty clinic, as well as 68 controls. The Research Diagnostic Criteria for TMD were used to diagnose the TMD patients. HAs were assessed using a structured interview and classified according to the Second Edition of the International Classification for Headache Disorders. Data were analyzed by chi-square tests with a significance level of 5% and odds ratio (OR) tests with a 95% confidence interval (CI). Results: HAs occurred in 45.6% of the control group (30.9% had migraine and 14.7% had tension-type headache [TTH]) and in 85.5% of individuals with TMD. Among individuals with TMD, migraine was the most prevalent primary HA (55.3%), followed by TTH (30.2%); 14.5% had no HA. In contrast to controls, the odds ratio (OR) for HA in those with TMD was 7.05 (95% confidence interval [CI] = 3.65-13.61; P = .000), for migraine, the OR was 2.76 (95% CI = 1.50-5.06; P = .001), and for TTH, the OR was 2.51 (95% CI = 1.18-5.35; P = .014). Myofascial pain/arthralgia was the most common TMD diagnosis (53.2%). The presence of HA or specific HAs was not associated with the time since the onset of TMD (P = .714). However, migraine frequency was positively associated with TMD pain severity (P = .000). Conclusion: TMD was associated with increased primary HA prevalence rates. Migraine was the most common primary HA diagnosis in individuals with TMD. J OROFAC PAIN 2010;24:287-292

Estudos analíticos dos grafoelementos do eletroencefalograma em sono: fusos do sono, ondas agudas do vértex e o gradiente de freqüência e amplitude, como indicadores de comprometimento neurológico na criança

Innumerable studies have focused been reported on the sleep spindles (SS), Sharp Vertex Waves (SVW) and REM, NREM Sleep as indicators interpreting EEG patterns in children. However, Frequency and Amplitud Gradient (FAG) is rarely cited sleep parameter in children,that occurs during NREM Sleep. It was first described by Slater and Torres, in 1979, but has not been routinely evaluated in EEG reports. The aim of this study was to assess the absence of SS, SVW and FAG, as an indication of neurological compromise in children. The sample consisted of 1014 EEGs of children referred to the Clinical Neurophysiology Laboratory, Hospital Universitário de Brasília (HUB), from January 1997 to March 2003, with ages ranging from 3 months to 12 years old, obtained in spontaneous sleep or induced by choral hydrate. The study was transversal and analytical, in which, visual analysis of EEG traces was perfumed individually and independently by two electroencephalographers without prior knowledge of the EEG study or neurological findings. After EEG selection, the investigators analyzed the medical reports in order to define and correlate neurological pattern was classified according to the presence or absence of neurological compromise, as Normal Neurological Pattern (NNP), and Altered Neurological Pattern (ANP) respectively. From the visual analysis of the EEG(s), it was possible to characterize 6 parameters: 1- FAG present (64,1%); 2- FAG absent (35,9%); 3 - normal SS (87,9%); 4 - altered SS s (12,1%); 5 - normal SVW s (95,7%); 6 - altered SVW s (4,3%). The prevalence of well-formed FAG is found in the 3 months to 5 years age group in the children with NNF. FAG was totally absent from the age of 10 years. When comparing the three sleep graphielements, it was observed that SVW and SS were predominant in children with NNF. However, FAG absent was more prevalent in the ANF than in altered SS an SVW. The statistical analysis showed that there is a strong association of FAG absent, with isolated alteration, in ANF patients, in that the prevalence ratio was 6,60. The association becomes stronger when FAG absent + altered SS(s) is considered (RP= 6,68). Chi-square test, corrected by Yates technique, showed a highly significant relation for FAG ρ= 0,00000001, for error X of 5%, or else the 95% confidence interval (ρ<0,05). Thus, the FAG absent were more expressive in ANF patient than altered SS(s) and SVW(s). The association becomes stronger in order to establish a prognostic relation, when the FAG is combined with the SS. The results os this study allow us to affirm that the FAG, when absent at ages ranging from 3 months to 5 years , is an indication of neurological compromise. FAG is an age-dependent EEG parameter and incorporated systematically, in the interpretation criteria of the EEG of children s sleep, not only in the maturational point of view, but also neurological disturbances with encephalic compromise

Atividade epiléptica focal durante sono induzido na síndrome de Lennox-Gastaut secundária

Quinze pacientes com síndrome de Lennox-Gastaut secundária foram submetidos a exames clínicos e eletrencefalográficos mensais por períodos de tempo que variaram de 1 a 9 anos. Os exames eletrencefalográficos foram realizados durante sono induzido por barbitúrico. Doze pacientes apresentaram atividade epiléptica focal. No presente trabalho descrevemos a localização, morfologia e freqüência dos paroxismos epilépticos focais.

Confiabilidade de um formulário para diagnóstico da severidade da disfunção temporomandibular

CONTEXTUALIZAÇÃO: Disfunção temporomandibular (DTM) é um termo coletivo que engloba vários problemas clínicos envolvendo a musculatura da mastigação, as articulações temporomandibulares (ATM) e suas estruturas associadas, com alta prevalência nas populações. OBJETIVOS: Sabendo-se que estudos brasileiros vêm utilizando o instrumento proposto por da Fonseca et al. (1994) para diagnóstico da severidade desta disfunção, realizou-se este estudo com o objetivo de verificar e estimar a consistência interna e a reprodutibilidade do mesmo. MÉTODOS: O delineamento amostral adotado foi o probabilístico, e participaram 1230 indivíduos moradores da cidade de Ribeirão Preto (SP), maiores de 18 anos de idade. As entrevistas foram realizadas por um único entrevistador por meio de ligações telefônicas. Para estudo da consistência interna, calculou-se o Coeficiente de Kuder-Richardson (kr-20) e para estimar a reprodutibilidade, utilizou-se a estatística Kappa (κ). RESULTADOS: A consistência interna do formulário foi de 0,5594, apontando para uma validação abaixo do desejado. Observou-se maior contribuição das questões 1, 2, 3, 6 e 7 para o coeficiente kr-20 total e maior consistência do instrumento quando composto apenas pelas mesmas (0,7044). Observou-se reprodutibilidade Boa e Ótima para as questões. CONCLUSÕES: Frente ao exposto, sugere-se que o formulário proposto por da Fonseca et al. (1994) seja adaptado, ficando composto apenas pelas questões 1, 2, 3, 6 e 7 da versão inicial, colaborando, assim, para aumento da confiabilidade do instrumento. Deve-se ressaltar ainda a necessidade da realização de estudos de validade para assegurar adequadas características psicométricas à nova versão do instrumento.

Symptoms of Temporomandibular Disorders in the Population: An Epidemiological Study

Aims: To estimate the prevalence of symptoms of temporomandibular disorders (TMD) as a function of age and gender, in a representative urban sample from the Brazilian population. Methods: A total of 1,230 inhabitants (51.5% women) aged 15 to 65 years were interviewed by a validated phone survey. Sample size had been previously calculated. TMD symptoms were assessed through five questions, as recommended by the American Academy of Orofacial Pain, in an attempt to identify possible TMD. Data were derived by age and gender. Prevalence of each TMD symptom, and of combination of symptoms, was calculated. Results: At least one TMD symptom was reported by 39.2% of the individuals. Pain related to TMD was noted by 25.6% of the population. Temporomandibular joint (TMJ) sound was the most common symptom of TMD, followed by TMJ pain and masticatory muscle pain. All symptoms were more prevalent in women than in men. With men used as the reference, a relative risk (RR) of at least one TMD symptom in women was 1.31 (95% confidence interval [CI] = 1.14 to 1.52). When at least two symptoms were present, the RR was 1.93 (95% CI = 1.49 to 2.51). For three or more TMD symptoms, the RR was 2.49 (95% CI = 1.67 to 3.71). Women were also more likely than men to have TMD pain (RR = 1.78; 9% CI = 1.45 to 2.18). Conclusion: Individual symptoms, as well as a combination of TMD symptoms, are prevalent in the Brazilian urban population and are more frequent in women than in men. Additional studies should focus on risk factors for and relevance of TMD for the sufferers. J OROFAC PAIN 2010;24:270-278

Headache and Symptoms of Temporomandibular Disorder: An Epidemiological Study

Objectives.-A population-based cross-sectional study was conducted to estimate the prevalence of migraine, episodic tension-type headaches (ETTH), and chronic daily headaches (CDH), as well as the presence of symptoms of temporomandibular disorders (TMD) in the adult population.Background.-The potential comorbidity of headache syndromes and TMD has been established mostly based on clinic-based studies.Methods.-A representative sample of 1230 inhabitants (51.5% women) was interviewed by a validated phone survey. TMD symptoms were assessed through 5 questions, as recommended by the American Academy of Orofacial Pain, in an attempt to classify possible TMD. Primary headaches were diagnosed based on the International Classification of Headache Disorders.Results.-When at least 1 TMD symptom was reported, any headache happened in 56.5% vs 31.9% (P < .0001) in those with no symptoms. For 2 symptoms, figures were 65.1% vs 36.3% (P < .0001); for 3 or more symptoms, the difference was even more pronounced: 72.8% vs 37.9%. (P < .0001). Taking individuals without headache as the reference, the prevalence of at least 1 TMD symptom was increased in ETTH (prevalence ratio = 1.48, 95% confidence interval = 1.20-1.79), migraine (2.10, 1.80-2.47) and CDH (2.41, 1.84-3.17). At least 2 TMD symptoms also happened more frequently in migraine (4.4, 3.0-6.3), CDH (3.4; 1.5-7.6), and ETTH (2.1; 1.3-3.2), relative to individuals with no headaches. Finally, 3 or more TMD symptoms were also more common in migraine (6.2; 3.8-10.2) than in no headaches. Differences were significant for ETTH (2.7 1.5-4.8), and were numerically but not significant for CDH (2.3; 0.66-8.04).Conclusions.-Temporomandibular disorder symptoms are more common in migraine, ETTH, and CDH relative to individuals without headache. Magnitude of association is higher for migraine. Future studies should clarify the nature of the relationship.

Migraine is the Most Prevalent Primary Headache in Individuals with Temporomandibular Disorders

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Temporomandibular Disorders Are Differentially Associated With Headache Diagnoses A Controlled Study

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

How to Investigate and Treat: Migraine in Patients with Temporomandibular Disorders

Migraine and temporomandibular disorders (TMD) are highly prevalent conditions that frequently coexist in the same patient. The relationship between migraine and TMD is complex. Migraineurs often have pain in the TMD area; TMD sufferers, in turn, often experience headaches in addition to the pain in the jaw. Finally, migraine and TMD are comorbid, and the final phenotype of patients with the comorbidity may represent the aggregated contribution of both. Herein we briefly discuss the clinical commonalities of migraine and TMD, and the differential diagnosis of these conditions with other causes of facial pain. We close by presenting our experience in the treatment of patients with the comorbidity.