Inquérito sobre a qualidade de vida relacionada à saúde em crianças e adolescentes portadores de artrites idiopáticas juvenis

Objective: to study the impact of chronic arthritis on health related quality of life by means of two self-reported tools: the parents' version of the Childhood Health Assessment Questionnaire (CHAQ) and the Childhood Health Questionnaire PF50® (CHQ). Methods: both tools were filled in after proper instructions by 36 parents, during 1-2 clinic visits. The Disability Index (CHAQ) and the Physical and Psychosocial scores (CHQ) were compared to the core set of outcome measures, namely 1) physician's global assessment, 2) parents' global assessment, both scored by 10 cm visual analogue scale, 3) number of joints with active arthritis, 4) number of joints with limited range of motion, 5) erythrocyte sedimentation rate. Results: there was significant difference for all measures of disease activity, being higher in the polyarticular as compared to oligoarticular except for erythrocyte sedimentation rate, parents' global assessment, and psychosocial score. This leads to different parents' perceptions of disease activity and outcome. The responsiveness of the outcome measures during two follow-up visits of patients receiving active treatment indicated better responsiveness of physicians' global assessment among the subjective measures, and intermediate responsiveness of the self-reported measures in comparison to the number of active and limited joints, and erythrocyte sedimentation rate. Conclusions: the responsiveness of two health related quality of life tools indicates their relative sensitivity for assessing clinical improvement during active treatment in Juvenile Idiopathic Arthritis patients. Copyright © 2003 by Sociedade Brasileira de Pediatria.

Photosynthetic responses and proline content of mature and young leaves of sunflower plants under water deficit

In mature and young leaves of sunflower (Helianthus annuus L. cv. Catissol-01) plants grown in the greenhouse, photosynthetic rate, stomatal conductance, and transpiration rate declined during water stress independently of leaf age and recovered after 24-h rehydration. The intercellular CO 2 concentration, chlorophyll (Chl) content, and photochemical activity were not affected by water stress. However, non-photochemical quenching increased in mature stressed leaves. Rehydration recovered the levels of non-photochemical quenching and increased the F v/F m in young leaves. Drought did not alter the total Chl content. However, the accumulation of proline under drought was dependent on leaf age: higher content of proline was found in young leaves. After 24 h of rehydration the content of proline returned to the same contents as in control plants.

Incidência de malformações congênitas em crianças concebidas através de injeção intracitoplasmática de espermatozóides

Purpose: to evaluate the incidence and types of major congenital malformations (MCM) in liveborn children conceived by intracytoplasmic sperm injection (ICSI). Methods: a total of 680 liveborn children resulted from 511 couples submitted to ICSI from January, 1999 to December, 2002. Data collection of the children was performed through standardized questionnaire and clinical examination. Of the 511 couples, 366 had been contacted for a sampling of 371 gestations. Of the 680 liveborn, 520 had been evaluated, 250 of them (48.1%) through questionnaire and 270 (51.9%) through questionnaire and physical examination. Two hundred and fifty children were from singleton pregnancies and 270 from multiple pregnancies. Malformations were classified according to the 10th revision of the International Statistical Classification of Diseases and Related Health. Only MCM were analyzed in this study. The incidence of MCM was compared with that of the general population obtained by the Latin American Collaborative Study of Congenital Malformations. The statistical analysis was performed by the χ 2 test (level of significance p<0.05). Results: of the 520 children, 15 presented MCM, resulting in an incidence of 2.9%. There was no difference in relation to the control group (p>0.05), which showed 2.6% incidence of MCM. The most frequent malformations were of cardiac origin (four isolated and two associated), corresponding to 40% of the total. The other types of MCM were: renal (three), neural tube (two), skull (one), cleft lip (one), genital (one), Down syndrome (associated with cardiac malformations) (two), and musculoskeletal (one). Six MCM occurred in children from singleton pregnancies and nine in children from multiple pregnancies. Conclusion: the liveborn children conceived by ICSI presented incidence of major congenital malformations (2.9%) near to the expected for the general population (2.6%). However, to establish the risks of MCM with precision it is necessary to continue the evaluation of the children conceived by ICSI.

Etiologia e incidência das fraturas faciais em adultos e crianças: Experiência em 513 casos

Facial trauma has presented an increasing occurrence in the last four decades, due especially to the growth of accidents with automobiles as well as to the urban violence. Both of which continue being the main cause of such traumas. Aim: To evaluate the features of the population victim of facial trauma as to gender, age, occupation, origin, type of fracture and its cause. Design study: retrospective clinical with transversal cohort. Material and Method: Retrospective study consulting hospital registers of 513 patients victms of the facial trauma. Results: There was a higher incidence of facial trauma on men (84,9%), white (82,7) and with an average age of 29. Regarding occupation, the trauma was mostly occurred to students (16,6%) and Masons (11,2%). The jaw was the most affected place (35%), followed by zygoma (24%) and by the nose (23%), though most patients presented a single facial fracture (82,5%). Among the causes, accidents with automobiles (28,3%), aggressions (21%) and accidental fall s (19,5%) were the most common. Conclusions: Accidents with automobiles continue being the main cause of facial trauma, especially of multiple factures due to the great transmission of kinetic energy.

Componente lento do V̇O2 em crianças durante exercício pesado de corrida: Análise com base em diferentes modelos matemáticos

The purpose of this study was to identify and quantify the magnitude of the slow component of VO2 (SC) in children during running exercise, performed at heavy intensity domain (75%Δ), using two different mathematical models: a) three-exponential model and; b) ΔVO2 6-3 min. Eight healthy male children (11.92 ± 0.63 years; 44.06 ± 13.01 kg; 146.63 ± 7.25 cm; and sexual maturity levels 1 and 2), not trained, performed in different days the following tests: 1) incremental running treadmill test to determine the peak oxygen uptake (VO2peak) and the lactate threshold (LT); and 2) two transitions from baseline to 75%Δ [75%Δ = LT + 0.75 x (VO2 peak - LT)] for six minutes on treadmill. The SC was determined by two models: a) three-exponential model (Exp3); and b) the VO2 difference between the sixth and the third exercise minute (ΔVO2 6-3min). The SC was expressed as the absolute (ml/min) and percent contribution (%) to the total change in VO 2. The SC values determined by model Exp3 (129.69 ± 75.71 ml/min and 8.4 ± 2.92%) and ΔVO2 6-3 min (68.69 ± 102.54 ml/min and 3.6 ± 7.34%) were significantly different. So, the SC values in children during running exercise performed at heavy intensity domain (75%Δ) are dependent of the analysis model (Exp3 x ΔVO2 6-3 min).

Incidência e evolução da polipose nasal em crianças e adolescentes com fibrose cística

Nasal polyps are a clinical sign of alert for investigating Cystic Fibrosis (CF). Aims: To study the incidence of nasal polyps in children and adolescents with cystic fibrosis, its possible association with age, gender, clinical manifestations, genotype and sweat chlorine level, and its evolution with topical steroid therapy. Methods: Clinical symptoms, sweat chlorine level and genotype were studied in 23 cystic fibrosis patients. Nasal polyps were diagnosed by nasal endoscopy and treated with topical steroids during 6 months, followed by a second nasal endoscopy. Fisher test was used for statistical analysis. Results: Nasal polyps were found in 39.1% of the patients (five bilateral, four unilateral), all older than six years, recurrent pneumonia in 82.6%, pancreatic insufficiency in 87% and malnutrition in 74%. No association was seen between nasal polyps and sweat chlorine level, genotype, clinical sings of severity and nasal symptoms. Seven patients improved in their nasal polyps with topical steroids, six showed complete resolution. Conclusion: The study showed a high incidence of nasal polyps in older children, who span the entire range of clinical severity, even in the absence of clinical nasal symptoms. Topical steroid therapy showed good results. An interaction among pediatricians and otolaryngologists is necessary for diagnosis and follow-up. 2008 © Revista Brasileira de Otorrinolaringologia. All Rights reserved.

Edema agudo de pulmão de pressão negativa como complicação grave de síndrome de apneia obstrutiva do sono em crianças. Relatos de casos

Introduction: Obstructive sleep apnea syndrome is related to cardiopulmonary complications in children. It is important to know its patophysiology and possible complications to help reduce risks in this group. Aims: To report three cases of severe cardiorespiratory complications of obstructive sleep apnea managed in the intensive care unit (ICU). Case report: Two children with no previous diagnosis of obstructive sleep apnea syndrome suffered acute congestive heart failure and acute lung oedema with need of ICU and improved after adenotonsillectomy. In a third case, the patient had acute lung oedema as a complication after adenotonsillectomy. Conclusions: Paediatricians and otolaryngologists must be aware of the clinical manifestations of severe sleep apnea. Early referring to treatment and special attention at pre and post surgical periods are essentials to avoid serious complications.

Caracterização de programas de intervenção com crianças e/ou adolescentes

The objective was to present a descriptive analysis of interventions to prevent and/or reduce children's and/or adolescents' problem behaviors. The study reviewed 192 abstracts from journal articles published between the 1986 and June 2006, available on the following databases: Index-Psi/Periódicos, Lilacs, PsycInfo, Scielo and Medline. Categories of analysis focused on bibliography, method, and studies' results. Data-analysis showed that most of the studies focused on groups and families, and samples with more than 30 participants. Study designs were experimental and quasi-experimental, combining observation and self report or just self report for data collection. Result analysis suggests that the intervention programs contributed specially for reducing behavior problems, and improving parental practices. Discussion evaluates contributions of the study and gaps in knowledge.

Conflitos conjugais e seus efeitos sobre o comportamento de crianças: Uma revisão teórica

Marital conflicts have been largely investigated in research, especially because of its impact on child development. Based on a literature review, this article aims to present some reflections about marital conflicts and its possible associations with children's behavior, particularly through parental practices. Emphasis is made on a systemic view of causality between marital conflict and child behavior, which offers a better comprehension of the family functioning. This perspective also allows us to enlarge the analysis scope beyond linear correlations between both variables.

Eletromiografia dos músculos temporal e masseter em crianças com mordida cruzada posterior direita

This study proposal was to evaluate the changes at a masticatory muscle temporalis and masseter, through a eletromyographic, at ponters of the right unilateral bite posterior, verifying the difference at the eletric activity between right and left sides. Twenty female volunteers, with ages between 7 and 8 (x = 7.4). The eletromyographics signals were collected in both sides in all volunteers in rest situations and in an usual isotonic mastication, right, left and bilateral and the maximun isometric constriction, which sinal was used to the eletric activity amplitude normalization. The results signed that the right masseter muscle presents an expressive statistic difference, if compared with the left masseter muscle during the left and right mastication, suggesting a right unilateral mastication. The muscle haven't gotten any expressive variance in this amplitude which remained to a proximate flat noticed in a right and habitual mastication, suggesting a right and one sided mastication during the left mastication occurs a raise of the eletric signal amplitude of the muscle left masseter. The right masseter muscle haven't gained any expressive variance, which remained in a proximate flat observed in an usual and right mastication, suggesting a muscular pattern hyperfunction next to the dental crossing.

Avaliação de grupo de intervenção para as mães/cuidadores de crianças pré-escolares com problemas de comportamento externalizantes

Negative parental practices may influence the onset and maintenance of externalizing behavior problems, and positive parenting seem to improve children's social skills and reduce behavior problems. The objective of the present study was to describe the effects of an intervention designed to foster parents' social skills related to upbringing practices in order to reduce externalizing problems in children aged 4 to 6 years. Thirteen mothers and two care taker grandmothers took part in the study with an average of four participants per group. To assess intervention effects, we used a repeated measure design with control, pre, and post intervention assessments. Instruments used were: (a) An interview schedule that evaluates the social interactions between parents and children functionally, considering each pair of child's and parent's behaviors as context for one another; (b) A Social Skills Inventory; (c) Child Behavior Checklist - CBCL. Intervention was effective in improving parent general social skills, decreasing negative parental practices and decreasing child behavior problems.

Assistência Odontológica em Crianças com Paralisia Cerebral e Perspectivas Tecnológicas de Reabilitação

The improvement of oral health and quality of life is closely related to transdisciplinary dialogue, technological development and social responsibility. In patients with cerebral palsy, the lesion of motor areas of the brain compromises the development and function of the craniofacial complex. Considering all the ethiopathogenic conditions, the treatment of such patients involves great difficulties. The dentist and other professionals related to their rehabilitation need to deal with difficulty in chewing, respiration, phonation, besides the poor oral hygiene resulted from abnormal involuntary movements of facial and masticatory musculature, tongue, and upper limb. It is also relevant the lack of understanding about the importance of oral health care due to mental deficits of these individuals. This study aims to review some aspects of oral health in patients with cerebral palsy proposing rehabilitation associated to technology. Few studies concerned about the effectiveness of therapies for oral rehabilitation in patients with cerebral palsy. Laser therapy, electromyography, electrostimulation and LED therapy should be analyzed as options for treatment of patients with cerebral palsy. Following research projects should focus more attention on the dynamic and oral function of these patients to achieve positive repercussions in their overall health. © ArquiMed, 2010.

Práticas educativas parentais e repertório comportamental infantil: Comparando crianças diferenciadas pelo comportamento

Identifying parental practices contingent to the behavior of children is important to support interventions. This study compares parental disciplinary practices with the behavior of children in a clinical group with behavioral problems (n = 27) and of a group of children without behavioral problems (n = 26). The criterion to assign children in the clinical and non-clinical groups was obtained from the Child Behavior Checklist (CBCL). Information concerning parents-children interaction was obtained through the application of the Parental Educative Social Skills Interview Script (RE-HSE-P), which evaluates positive and negative educational practices, context, behavioral problems and children's social skills. Qualitative and quantitative analyses (Mann Whitney's test) were used in the groups' comparison. The results indicate that behaviors that differentiate between the clinical and non-clinical groups are mainly those related to positive educational practices and children's social skills.

Violência denunciada: ocorrências de maus tratos contra crianças e adolescentes registradas em uma unidade policial.

This study aimed to investigate the profile of the occurrence of abuse against children and adolescents. We analyzed the data recorded in police reports from the Department of Women's Defense, Araçatuba-SP, in 2008, relating to assault, victim-offender relationship, sociodemographic characteristics of offenders and victims, and victims' demand for health services. Among the accusations, there was a higher prevalence of physical abuse, being the residence the place of higher incidence of aggression. In most cases, the aggressor was the mother of the child, being the subject of aggression not reported, in most cases. Thus, we can define the profile of violent incidents against children, contributing to the visualization, knowledge and to deal with the problem.

O papel dos sistemas visual, vestibular, somatosensorial e auditivo para o controle postural

The maintenance of a given body orientation is obtained by the complex relation between sensory information and muscle activity. Therefore, this study purpose was to review the role of visual, somatosensory, vestibular and auditory information in the maintenance and control of the posture. Method. a search by papers for the last 24 years was done in the PubMed and CAPES databases. The following keywords were used: postural control, sensory information, vestibular system, visual system, somatosensory system, auditory system and haptic system. Results. the influence of each sensory system and its integration were analyzed for the maintenance and control of the posture. Conclusion. the literature showed that there is information redundancy provided by sensory channels. Thus, the central nervous system chooses the main source for the posture control.