Auditory steady state response in hearing assessment in infants with cytomegalovirus

OBJETIVO:Relatar o caso de um lactente com citomegalovírus congênito e disacusia neurossensorial progressiva, analisado por três métodos de avaliação auditiva.DESCRIÇÃO DO CASO:Na primeira avaliação auditiva, aos quatro meses de idade, o lactente apresentou ausência de Emissões Otoacústicas (EOA) e Potencial Evocado Auditivo de Tronco Encefálico (PEATE) dentro dos padrões de normalidade para a faixa etária, com limiar eletrofisiológico em 30dBnHL, bilateralmente. Com seis meses, apresentou ausência de PEATE bilateral em 100dBnHL. A avaliação comportamental da audição mostrou-se prejudicada devido ao atraso no desenvolvimento neuropsicomotor. Aos oito meses, foi submetido ao exame de Resposta Auditiva de Estado Estável (RAEE) e os limiares encontrados foram 50, 70, ausente em 110 e em 100dB, respectivamente para 500, 1.000, 2.000 e 4.000Hz, à direita, e 70, 90, 90 e ausente em 100dB, respectivamente para 500, 1.000, 2.000 e 4.000Hz, à esquerda.COMENTÁRIOS:Na primeira avaliação, o lactente apresentou alteração auditiva no exame de EOA e PEATE normal, que passou a ser alterado aos seis meses de idade. A intensidade da perda auditiva só pôde ser identificada pelo exame de RAEE, permitindo estabelecer a melhor conduta na adaptação de aparelho de amplificação sonora individual. Ressalta-se a importância do acompanhamento audiológico para crianças com CMV congênito.

Tradução e adaptação transcultural do Minnesota Handwriting Assessment para aplicação no Brasil

Pós-graduação em Desenvolvimento Humano e Tecnologias - IBRC

Adaptação transcultural do Preschool Language Assessment Instrument (PLAI-2) em falantes do português brasileiro com desenvolvimento típico de linguagem

Pós-graduação em Fonoaudiologia - FFC

Adaptação cultural do Detailed Assessment of Speed of Handwriting (DASH) para escolares de ensino público

Pós-graduação em Fonoaudiologia - FFC

Gross Motor Deficits in Children Prenatally Exposed to Alcohol: A Meta-analysis

BACKGROUND AND OBJECTIVES: Gross motor (GM) deficits are often reported in children with prenatal alcohol exposure (PAE), but their prevalence and the domains affected are not clear. The objective of this review was to characterize GM impairment in children with a diagnosis of fetal alcohol spectrum disorder (FASD) or moderate to heavy maternal alcohol intake.METHODS: A systematic review with meta-analysis was conducted. Medline, Embase, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, PEDro, and Google Scholar databases were searched. Published observational studies including children aged 0 to <= 18 years with (1) an FASD diagnosis or moderate to heavy PAE, or a mother with confirmed alcohol dependency or binge drinking during pregnancy, and (2) GM outcomes obtained by using a standardized assessment tool. Data were extracted regarding participants, exposure, diagnosis, and outcomes by using a standardized protocol. Methodological quality was evaluated by using Strengthening the Reporting of Observational Studies in Epidemiology guidelines.RESULTS: The search recovered 2881 articles of which 14 met the systematic review inclusion criteria. The subjects' mean age ranged from 3 days to 13 years. Study limitations included failure to report cutoffs for impairment, nonstandardized reporting of PAE, and small sample sizes. The meta-analysis pooled results (n = 10) revealed a significant association between a diagnosis of FASD or moderate to heavy PAE and GM impairment (odds ratio: 2.9; 95% confidence interval: 2.1-4.0). GM deficits were found in balance, coordination, and ball skills. There was insufficient data to determine prevalence.CONCLUSIONS: The significant results suggest evaluation of GM proficiency should be a standard component of multidisciplinary FASD diagnostic services.

Motor profile of students with dyslexia

In the presence of developmental dyslexia, there is high probability of motor difficulties being present as well purposes: The purposes of this study were to characterize and compare the motor performance of students with dyslexia with students with good academic performance and to identify the presence of the DCD (developmental coordination disorder) co-occurring with developmental dyslexia. A total of 79 students participated in the research, both genders, from 8 to 11 years old, from 3rd to 5th grades, and were divided into Group I: 19 students with developmental dyslexia and Group II: 60 students with good academic performance. All the students were assessed using “The Bruininks-Oseretsky Test of Motor Proficiency” (second edition), to measure the motor skills and the pattern and differences between groups. The results of this study showed that the motor performance of Group II students was superior to the performance of students of Group I in almost all motor areas assessed but both groups performed less well than they should have for their chronological age. The results of this study indicate that occupational therapists, speech therapists and educators need to be aware of the presence of motor impairments and the need for early intervention in both the academic and clinical environments, in order to ensure that early identification and diagnosis of possible co-occurrences, such as DCD, and the impact on learning to guarantee more appropriate clinical and educational assistance for this population. This may also indicate that increased exposure to movement may be important to limit some of the secondary health consequences in children in Brazil.

Analysis of the positioning of the head, trunk, and upper limbs during gait in children with visual impairment

Background: This study analyzed the positioning of the head, trunk, and upper extremities during gait in children with visual impairment. Methods: A total of 11 children participated in this study: 6 with blindness and 5 with low vision. The kinematics of the positioning of the head, trunk, shoulders, and elbows in each participant was analyzed during the four phases of the gait cycle: foot strike, support, toe-off, and swing. Results: There were significant differences between children with blindness and low vision in the positioning of the trunk in the sagittal plane during the foot strike, support, and swing phases. Conclusions: The analysis identified postural alterations of the head, trunk, shoulder, and elbow during the children’s gait, highlighting the relevance of appropriate stimulation at an early age in orientation and mobility programs, as well as the essential presence of professionals who work with movement.

A systematic review and meta-analysis of cohort studies of echocardiographic findings in OSA children after adenotonsilectomy

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

Exposição ambiental ao chumbo: um problema de áreas contaminadas próximas a fábricas de baterias

The concentration of metal pollutants such as lead (Pb), has grown and developed in populated areas due to pollution and other human activities. Consequently, the potential for achieve this element food chain has also increased. Lead is very toxic to humans, especially to children, and exposure to lead can cause adverse health effects mainly on human nervous system, bone marrow and kidneys, interfering with chromosomal or genetic processes. This paper presents an overview of the main aspects related to environmental contamination by lead from battery plants. The assessment of an area contaminated by lead in Bauru-SP next a battery factory was reported in this work as well as the entire history of monitoring, classification and application of processes applied by CETESB since 2002. Analyzing the issue in its economic aspects, we found that the degradation of the environment is directly related to the development model adopted by the capitalist system, which is based on the law of supply and demand for products and services. The data presented indicate that Brazil still needs a broader policy where government agencies, industries and population through awareness can be united for the same purpose: to preserve life

Potencial Cognitivo Auditivo e vectoeletronistagmografia em escolares com dislexia e distúrbios de aprendizagem

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Comparação do desenvolvimento neurológico entre os gêneros em alunos ingressantes no ensino fundamental em uma escola municipal em Bauru

Human beings' motor capacity development is essential, because it facilitates movement, enabling the performance of motor activities and others. In pre-school, boys and girls acquire the motor capacity development considered basic that, through several factors such as neurological maturation, which is in charge of providing more complete movements, and body growth, which has the goal of a better body domain, makes them improve individually the performance of motor abilities, but it can minimize them if laterality does not develop spontaneously. There by, this study focused on assessing the neurological development between genders of students engaging in fundamental school. Forty-three children of both genders at age six took part in this study. The evaluation occurred through the LEFÉVRE protocol (1976), which aims at assessing the maturity and development of the Nervous System through tests of the Evolutionary Neurological Exam (ENE), which comprises a series of tests involving specific tasks, regarding age in the static balance items, dynamic balance, appendicular coordination, trunk-member coordination, motor persistency, sensibility and synkinesis. Neurological development comparisons were performed between boys and girls for each item of the battery of tests. The results of the motor persistency and sensitiveness and sensorial activity tests were below the average for six-year-old children, but there was not any difference in gender comparison for each item of the battery of tests, only a small tendency for one of the genders, but meaningless, having a variance in only two tests of the synkinesis exam (Foot-hand and paper ball with the dominant hand), in which boys had a bigger percentage of synkinesis presence than girls did. The results also showed that the majority of the children assessed, both boys and girls have a right manual and pedal preference and the ocular laterality is approximately the same for left and right-handers. It was..

Cumulative long-term safety, efficacy and patient-reported outcomes in children with juvenile idiopathic arthritis treated with intravenous abatacept: up to 7 years of treatment

The long-term efficacy and safety of intravenous abatacept in patients (pts) with juvenile idiopathic arthritis (JIA) have been reported previously from the Phase III AWAKEN trial ([1, 2]). Here, we report efficacy, safety and pt-reported outcomes from the open-label, long-term extension (LTE) of AWAKEN, with up to 7 years of follow-up. Pts entered the LTE if they were JIA ACR 30 non-responders (NR) at the end of the 4-month lead-in period (abatacept only), or if they received abatacept or placebo (pbo) in the 6-month double-blind (DB) period. The Child Health Questionnaire was used to evaluate health-related quality of life (HRQoL); physical (PhS) and psychosocial (PsS) summary and pain scores were analyzed. Pain was assessed by parent global assessment using a 100 mm visual analog scale. Efficacy and HRQoL evaluations are reported up to Day 1765 (~ Year 5.5). Safety is presented for the cumulative period (lead-in, DB and LTE), for all pts who received abatacept during the LTE. Of the 153 pts entering the LTE (58 from DB abatacept group, 59 from DB pbo group, 36 NR), 69 completed the trial (29 abatacept, 27 pbo, 13 NR). For pts treated in the LTE, mean (range) exposure to abatacept was 53.6 (5.6–85.6) months. During the LTE, incidence rates of AEs and serious AEs per 100 pt-years were 209.1 and 5.6. Thirty pts (19.6%) had serious AEs; most were unrelated and were musculoskeletal (8.5%) or infectious events (6.5%). No malignancy was reported. There was one death (accidental; unrelated). At Day 169, JIA ACR 50 and 70 response rates were 79.3% and 55.2% in the abatacept group, and 52.5% and 30.5% in the pbo group; 31.0% and 10.2% of pts in the abatacept and pbo groups, respectively, had inactive disease. By Day 1765, JIA ACR 50 and 70 response rates were 93.9% and 78.8% in the abatacept group, and 80.0% and 63.3% in the pbo group; 51.5% and 33.3% had inactive disease. In the NR group, 69.2% and 53.8% of pts achieved JIA ACR 50 and 70 responses at Day 1765, and 30.8% had inactive disease. In pts who entered the LTE, mean baseline PhS scores were below the range for healthy children (abatacept 30.2, pbo 31.0, NR 29.5). At Day 169, 38.3% of pts had reached a PhS score >50 ((1). By the end of the LTE, 43.5% of pts had reached a PhS score >50. At baseline, mean PsS scores for those who entered the LTE were slightly lower than the mean for healthy children (abatacept 43.5, pbo 44.2, NR 47.0). At Day 169, 54.9% of pts had a PsS score >50 (1). By Day 1765, 58.1% of pts had reached a PsS score >50. At baseline, the mean pain score was 42.9. By Day 169, 13.9% of pts were considered pain free (pain score = 0); this was maintained over the LTE (1).

Evaluation of the Computer-based Battery for Oral Language (BILOv3) through the Rasch model for a Brazilian Sample

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

Effect of an occlusal splint on sleep bruxism in children in a pilot study with a short-term follow up

The aim of the present study was to evaluate the effect of the use of an occlusal splint in children with bruxism in a pilot study with a short-term follow up. Seventeen children were recruited, only nine of whom formed the sample following the application of the inclusion criteria: presence of sleep bruxism for at least six months (based on parents' reports); presence of at least the first permanent molars; and no previous history of treatment involving an occlusal splint. The sample was submitted to a clinical exam. Other sleep problems were screened with the use of a sleep questionnaire filled out by parents before and after 90 days of occlusal splint usage. The children received a flat acrylic resin splint with full coverage of the occlusal surfaces to be worn in the maxilla. In children with erupting teeth, a space was created in the splint to allow normal eruption. After the 90-day period, the absence of sleep bruxism and sleep movements was noted in most of children. Moreover, snoring was reduced in nearly 50%, which raises a new issue to be investigated with regard to the pathophysiology of sleep bruxism. The use of an occlusal splint was effective in reducing the symptoms of sleep bruxism and other sleep problems. Further investigations should be carried out on the relationship between snoring and sleep bruxism in children.

Adaptação cultural e validação do JAMAR - Juvenile Arthritis Multidimensional Assessment Report para a artrite idiopática juvenil

Pós-graduação em Saúde Coletiva - FMB