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1.
Childs Nerv Syst ; 36(9): 1853-1857, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32661641

RESUMO

PURPOSE: Self-limited epilepsy with centrotemporal spikes, formerly called benign epilepsy with centrotemporal spikes, or rolandic epilepsy, is an age-related and well-defined epileptic syndrome. Since seizures associated with rolandic spikes are infrequent and usually occur during sleep, and repetitive or prolonged EEG recording for diagnostic purposes is not necessary for diagnosis, reports of ictal video-electroencephalographic seizures in this syndrome are rare. We aimed to show ictal video-EEG of typical rolandic seizures. METHODS: We report the ictal video-EEG recordings of two children with rolandic epilepsy who presented typical rolandic seizures during routine recording. RESULTS: Case 1: A 9-year-old boy, with normal development, had his first seizure at 8 years old, characterized by paresthesia in his left face, blocking of speech, and drooling. Carbamazepine was started with seizure control. Case 2: A 10-year-old boy, with normal development, started with focal seizures during sleep, characterized by eye and perioral deviation, and speech arrest at age of 7. He started using oxcarbazepine. Both patients underwent routine electroencephalography for electroclinical diagnosis and presented a seizure. CONCLUSION: Although self-limited epilepsy with centrotemporal spikes is a very common epileptic syndrome, seizure visualization is very difficult, and these videos may bring didactical information for recognition of this usual presentation of benign childhood focal epilepsy.


Assuntos
Eletroencefalografia , Epilepsia Rolândica , Carbamazepina/uso terapêutico , Criança , Documentação , Epilepsia Rolândica/complicações , Epilepsia Rolândica/diagnóstico , Epilepsia Rolândica/tratamento farmacológico , Humanos , Masculino , Convulsões/complicações , Convulsões/diagnóstico
2.
J Mot Behav ; : 1-11, 2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38811009

RESUMO

Attention Deficit Hyperactivity Disorder (ADHD) is characterized by inappropriate levels of activity, impulsivity, and inattention. Developmental Coordination Disorder (DCD) is a condition involving challenges in acquiring and executing motor skills. This cross-sectional study aimed to distinguish motor symptoms between ADHD and ADHD/DCD. A total of 283 children from two elementary schools underwent screening, leading to the identification of 27 children with ADHD. The assessment encompassed the Swanson, Nolan, and Pelham-IV Questionnaire (SNAP-IV), the Movement Assessment Battery for Children (MABC-2), and the Motor Development Scale (MDS). The groups consisted of ADHD (14) and ADHD/DCD (13). Statistical analysis revealed significant differences in general motor age means between groups (p = 0.016), indicating inferior performance in the ADHD/DCD group. The coexistence of DCD significantly influenced the motor performance of children with ADHD, particularly in fine motor skills (p = 0.018) and balance (p = 0.033). Both groups exhibited mild to moderate risk of motor development delay. It is suggested that ADHD is associated with motor problems, even when DCD is not co-occurring. Specific domain-based analysis could demonstrate how the co-occurrence with DCD affects the motor performance of children with ADHD, with statistically significant differences observed in fine motor skills and balance.

3.
Einstein (Sao Paulo) ; 20: eAO6360, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35544890

RESUMO

OBJECTIVE: To analyze data from children who were previously healthy and presented with post-varicella arterial ischemic stroke upon arrival when admitted to the emergency room, with focus on the clinical/laboratory aspects, and neurocognitive performance after four-year follow-up. METHODS: Seven children presenting with arterial ischemic stroke after varicella were evaluated at pediatric emergency services in the city of São Paulo (SP), Brazil. Ischemic stroke was determined by magnetic resonance imaging/magnetic resonance angiography in a topography compatible with the areas supplied by the middle cerebral or internal carotid arteries. IgG-class antibodies against varicella zoster virus and varicella-zoster virus DNA by polymerase chain reaction in cerebrospinal fluid were tested. Patients with prothrombotic conditions were excluded. The Pediatric Stroke Outcome Measure was applied upon admission and 4-years after the stroke. RESULTS: All patients (age range: 1.3 to 4 years) included presented chickenpox 5.1 (±3.5) months before. All patients had analysis of anti-varicella-zoster-virus-IgG in cerebrospinal fluid, but only three (43%) had a positive result. Of the patients 43% had no vascular lesions identified in magnetic resonance angiography. All patients showed improvement in their sequela scores. After 4 years, five patients displayed good evolution in the Pediatric Stroke Outcome Measure, and only one patient presented with a score of 2 in the sensorimotor and cognition areas. No recurrence of arterial ischemic stroke was observed. CONCLUSION: We reinforced the non-progressive course of post-varicella arterial ischemic stroke after 4-year follow-up. The presence of varicella-zoster-virus-DNA detected by polymerase chain reaction, and/or intrathecal IgG antibody against varicella zoster virus, and angiopathy location in magnetic resonance angiography were not determining for the diagnosis. Invasive tests, with low sensitivity, should be well considered in the diagnosis of post-varicella arterial ischemic stroke.


Assuntos
Varicela , Herpes Zoster , AVC Isquêmico , Acidente Vascular Cerebral , Brasil/epidemiologia , Criança , Pré-Escolar , DNA , Seguimentos , Herpesvirus Humano 3 , Humanos , Imunoglobulina G , Lactente , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/patologia
4.
Arq Neuropsiquiatr ; 78(4): 193-198, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32130296

RESUMO

OBJECTIVE: To compare the ways of evaluating arithmetic skills in Brazilian children with ADHD by combining three validated neuropsychological tests and determining whether they are sensitive to the methylphenidate treatment. METHODS: Forty-two children (9‒12 years old) participated in the present study: 20 were children with ADHD (DSM-IV) and 22 were age-matched controls. A classification criterion was used for each test separately and one, for their combination to detect the presence of arithmetic difficulties at two time points: baseline (time 1); and when children with ADHD were taking 0.3‒0.5 mg/kg of methylphenidate (time 2). The study also assessed children's subtraction performance, combining parts of these tests. RESULTS: Separately, the tests were only sensitive to differences between groups without medication. However, by combining the three neuropsychological tests, we observed a difference and detected a reduction in arithmetic difficulties associated with the methylphenidate treatment. The same effects were found in subtraction exercises, which require a borrowing procedure. CONCLUSIONS: The present study detected arithmetic difficulties in Brazilian children with ADHD and the effects of methylphenidate. Given this improvement in sensitivity, combining tests could be a promising alternative when working with limited samples.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Brasil , Estimulantes do Sistema Nervoso Central , Criança , Humanos , Metilfenidato , Testes Neuropsicológicos
5.
Atten Defic Hyperact Disord ; 11(2): 149-158, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30191501

RESUMO

Altered reinforcement sensitivity is hypothesized to underlie symptoms of attention deficit hyperactivity disorder (ADHD). Here we evaluate the behavioral sensitivity of Brazilian children with and without ADHD to a change in reward availability. Forty typically developing children and 32 diagnosed with DSM-IV ADHD completed a signal-detection task in which correct discriminations between two stimuli were associated with different frequencies of reinforcement. The response alternative associated with the higher rate of reinforcement switched, without warning, after 30 rewards were delivered. The task continued until another 30 rewards were delivered. Both groups of children developed a response bias toward the initially more frequently reinforced alternative. This effect was larger in the control group. The response allocation of the two groups changed following the shift in reward availability. Over time the ADHD group developed a significant response bias toward the now more frequently reinforced alternative. In contrast, the bias of the control group stayed near zero after an initial decline following the contingency change. The overall shift in bias was similar for the two groups. The behavior of both groups of children was sensitive to the asymmetric reward distribution and to the change in reward availability. Subtle group differences in response patterns emerged, possibly reflecting differences in the time frame of reward effects and sensitivity to reward exposure.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Esquema de Reforço , Recompensa , Adolescente , Estudos de Casos e Controles , Criança , Condicionamento Operante , Discriminação Psicológica , Feminino , Humanos , Masculino
6.
Arq Neuropsiquiatr ; 65(2B): 381-4, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17665000

RESUMO

Ketogenic diet (KD) is a high fat and low carbohydrate diet, which controls refractory epilepsy. We analyzed the KD effects on 54 children of the Children's Institute of the University of São Paulo. Efficacy, tolerability, and adverse effects were studied. Response to KD was effective (E) if seizure control was >75%, good (G) when 50-75%. When possible, we correlated the results with the epileptic syndrome and patient's age. By the second month on diet, 57.4% of the patients had E response and 31.4% G results. At the 6th month, 63.8% had E response and 25.5% G. At the 12th month, 71.8% had E and 25.6% G. At the 24th month, 62.1% had E and 37.9% G. Antiepileptic drugs have been reduced, and generalized epilepsy was the most sensitive. Age-related differences were not observed. Adverse effects were rarely observed. In conclusion, KD proved to be an effective treatment for refractory epilepsy.


Assuntos
Dieta com Restrição de Carboidratos , Gorduras na Dieta/administração & dosagem , Epilepsia/dietoterapia , Criança , Pré-Escolar , Dieta com Restrição de Carboidratos/efeitos adversos , Gorduras na Dieta/efeitos adversos , Humanos , Lactente , Resultado do Tratamento
7.
Arq Neuropsiquiatr ; 75(8): 563-569, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28813087

RESUMO

OBJECTIVE: To validate the parent-rated Expression and Emotion Scale for Children (EESC) for patients with attention-deficit/hyperactivity disorder (ADHD). METHODS: The EESC was applied to parents of children with and without ADHD. The children were divided into age groups: Group A, between six and eight years old; Group B, between nine and 11 years old; and Group C, between 12 and 15 years old. The validation was carried out according to the steps proposed by Guillemin et al. For the statistical calculation, Cronbach's α, Pearson's correlation, the ICC and ROC curve were used. RESULTS: The statistical tests showed satisfactory coefficients: Cronbach's α = 0.76; Pearson's correlation r = 0.91 with CI 95%; replicability ICC = 0.66; sensitivity 0.75; specificity 0.67; accuracy 71%. CONCLUSION: According to psychometric data on internal and external consistency (reliability, reproducibility), sensitivity, and specificity, the parent-rated EESC for ADHD is useful in assessing emotional expression.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Emoções Manifestas , Escalas de Graduação Psiquiátrica/normas , Adolescente , Brasil , Criança , Estudos Transversais , Feminino , Humanos , Idioma , Masculino , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários , Traduções
8.
Arq Neuropsiquiatr ; 75(4): 204-208, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28489138

RESUMO

OBJECTIVE: To compare children with attention-deficit/hyperactivity disorder (ADHD), before and after the use of methylphenidate, and a control group, using tests of working memory, inhibition capacity and mental flexibility. METHODS: Neuropsychological tests were administrated to 53 boys, 9-12 years old: the WISC-III digit span backward, and arithmetic; Stroop Color; and Trail Making Tests. The case group included 23 boys with ADHD, who were combined type, treatment-naive, and with normal intelligence without comorbidities. The control group (n = 30) were age and gender matched. After three months on methylphenidate, the ADHD children were retested. The control group was also retested after three months. RESULTS: Before treatment, ADHD children had lower scores than the control group on the tests (p ≤ 0.001) and after methylphenidate had fewer test errors than before (p ≤ 0.001). CONCLUSION: Methylphenidate treatment improves the working memory, inhibitory control and mental flexibility of ADHD boys.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/administração & dosagem , Memória/efeitos dos fármacos , Metilfenidato/administração & dosagem , Estudos de Casos e Controles , Estimulantes do Sistema Nervoso Central/farmacologia , Criança , Humanos , Masculino , Metilfenidato/farmacologia , Testes Neuropsicológicos , Resultado do Tratamento
9.
Einstein (Säo Paulo) ; 20: eAO6360, 2022. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1375349

RESUMO

ABSTRACT Objective To analyze data from children who were previously healthy and presented with post-varicella arterial ischemic stroke upon arrival when admitted to the emergency room, with focus on the clinical/laboratory aspects, and neurocognitive performance after four-year follow-up. Methods Seven children presenting with arterial ischemic stroke after varicella were evaluated at pediatric emergency services in the city of São Paulo (SP), Brazil. Ischemic stroke was determined by magnetic resonance imaging/magnetic resonance angiography in a topography compatible with the areas supplied by the middle cerebral or internal carotid arteries. IgG-class antibodies against varicella zoster virus and varicella-zoster virus DNA by polymerase chain reaction in cerebrospinal fluid were tested. Patients with prothrombotic conditions were excluded. The Pediatric Stroke Outcome Measure was applied upon admission and 4-years after the stroke. Results All patients (age range: 1.3 to 4 years) included presented chickenpox 5.1 (±3.5) months before. All patients had analysis of anti-varicella-zoster-virus-IgG in cerebrospinal fluid, but only three (43%) had a positive result. Of the patients 43% had no vascular lesions identified in magnetic resonance angiography. All patients showed improvement in their sequela scores. After 4 years, five patients displayed good evolution in the Pediatric Stroke Outcome Measure, and only one patient presented with a score of 2 in the sensorimotor and cognition areas. No recurrence of arterial ischemic stroke was observed. Conclusion We reinforced the non-progressive course of post-varicella arterial ischemic stroke after 4-year follow-up. The presence of varicella-zoster-virus-DNA detected by polymerase chain reaction, and/or intrathecal IgG antibody against varicella zoster virus, and angiopathy location in magnetic resonance angiography were not determining for the diagnosis. Invasive tests, with low sensitivity, should be well considered in the diagnosis of post-varicella arterial ischemic stroke.

10.
Arq Neuropsiquiatr ; 64(3B): 845-8, 2006 Sep.
Artigo em Português | MEDLINE | ID: mdl-17057895

RESUMO

Benign paroxysmal torticollis of infancy is an episodic disorder that occurs suddenly and spontaneously in the first months of life. The patient's head tilts to one side for hours or days, and sometimes it can be associated with other symptoms like vomiting, sweating, pallor, irritability, headache and unstable gait. We report six patients with benign paroxysmal torticollis of infancy, whose symptoms began within the first six months of life and disappeared by five years of age. It is important that the physician be able to recognize this benign disorder to provide appropriate prognosis and not do unnecessary exams which would only cause expenses and anxiety for the child and their parents.


Assuntos
Torcicolo/diagnóstico , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Imageamento por Ressonância Magnética , Masculino , Remissão Espontânea , Tomografia Computadorizada por Raios X
11.
Codas ; 28(2): 123-31, 2016 Apr.
Artigo em Inglês, Português | MEDLINE | ID: mdl-27191875

RESUMO

Purpose to analyze and classify the spelling performance according to the semiology of spelling error of children with developmental dyslexia (DD) and with developmental dyslexia associated to attention deficit disorder and hyperactivity(DD and ADHD) comparing them to a group of children without learning process complaints. Methods Seventy students, from the third to fifth grade, participated in this study divided as follows: 32 children without complaints of learning difficulties (GI), mean age 9.5 years; 22 students with developmental dyslexia (GII), mean age 10 years; 16 scholars with developmental dyslexia associated to attention deficit disorders and hyperactivity (GIII), mean age 9.9. Spelling skills were assessed through a standardized word dictation task. Results Data indicated that GII and GIII children presented lower performance when compared with typically developed children. There was no statistical difference between the performance of GII and GIII children regarding the score reached in spelling, although GIII children presented the lowest performance. We observed differences between GII and GIII only in the type of misspelling. Conclusion Data from this research contribute to develop better programs for intervention in the studied population.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Dislexia/fisiopatologia , Escrita Manual , Estudantes , Brasil , Estudos de Casos e Controles , Criança , Avaliação Educacional , Feminino , Humanos , Testes de Linguagem , Deficiências da Aprendizagem/fisiopatologia , Masculino , Fonética , Estatísticas não Paramétricas
12.
Neurol Genet ; 2(1): e40, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27066577

RESUMO

Benign hereditary chorea (BHC) was originally described in 1967, but it was not until 2002 that linkage analysis and positional cloning identified the causative gene, NKX2-1 (also known as TTF-1).(1,2) The range of manifestations spans from isolated chorea, pulmonary disease, or thyroid dysfunction, with one-third of patients having the full brain-lung-thyroid syndrome.(3) Recent reports have expanded the NKX2-1 phenotype, as patients may present with additional movement disorders such as dystonia and myoclonus.(3) We present a case with early-onset chorea, ataxia, and dystonia.

13.
Brain Dev ; 27(8): 592-4, 2005 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-16310594

RESUMO

Vitamin B12 deficiency can cause serious developmental regression, hypotonia and cerebral atrophy in infants. We report a 6-month-old infant, with insidious developmental regression and brain atrophy showed by CT scan, secondarily to vitamin B12 deficiency. His mother was a strict vegetarian and the patient was exclusively breastfed. The clinical symptoms and the brain CT were normalized after vitamin B12 administration.


Assuntos
Deficiências do Desenvolvimento/etiologia , Dieta Vegetariana/efeitos adversos , Deficiência de Vitamina B 12/complicações , Atrofia , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Aleitamento Materno , Humanos , Lactente , Masculino , Hipotonia Muscular/etiologia , Radiografia , Vitamina B 12/uso terapêutico , Deficiência de Vitamina B 12/tratamento farmacológico
14.
Rev Saude Publica ; 49: 32, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26061456

RESUMO

A Brazilian Health Technology Assessment Bulletin (BRATS) article regarding scientific evidence of the efficacy and safety of methylphenidate for treating attention deficit hyperactivity disorder (ADHD) has caused much controversy about its methods. Considering the relevance of BRATS for public health in Brazil, we critically reviewed this article by remaking the BRATS search and discussing its methods and results. Two questions were answered: did BRATS include all references available in the literature? Do the conclusions reflect the reviewed articles? The results indicate that BRATS did not include all the references from the literature on this subject and also that the proposed conclusions are different from the results of the articles chosen by the BRATS authors themselves. The articles selected by the BRATS authors showed that using methylphenidate is safe and effective. However, the BRATS final conclusion does not reflect the aforementioned and should not be used to support decisions on the use of methylphenidate.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Metilfenidato/uso terapêutico , Brasil , Criança , Humanos , Guias de Prática Clínica como Assunto
15.
Arq. neuropsiquiatr ; 78(4): 193-198, Apr. 2020. tab
Artigo em Inglês | LILACS | ID: biblio-1098090

RESUMO

Abstract Objective: To compare the ways of evaluating arithmetic skills in Brazilian children with ADHD by combining three validated neuropsychological tests and determining whether they are sensitive to the methylphenidate treatment. Methods: Forty-two children (9‒12 years old) participated in the present study: 20 were children with ADHD (DSM-IV) and 22 were age-matched controls. A classification criterion was used for each test separately and one, for their combination to detect the presence of arithmetic difficulties at two time points: baseline (time 1); and when children with ADHD were taking 0.3‒0.5 mg/kg of methylphenidate (time 2). The study also assessed children's subtraction performance, combining parts of these tests. Results: Separately, the tests were only sensitive to differences between groups without medication. However, by combining the three neuropsychological tests, we observed a difference and detected a reduction in arithmetic difficulties associated with the methylphenidate treatment. The same effects were found in subtraction exercises, which require a borrowing procedure. Conclusions: The present study detected arithmetic difficulties in Brazilian children with ADHD and the effects of methylphenidate. Given this improvement in sensitivity, combining tests could be a promising alternative when working with limited samples.


Resumo Objetivo: Comparar as formas de avaliar as habilidades aritméticas em crianças brasileiras com TDAH, combinando três testes neuropsicológicos validados, e verificar se são sensíveis ao tratamento com metilfenidato. Métodos: Quarenta e duas crianças (9‒12 anos) participaram deste estudo: 20 eram crianças com TDAH (DSM-IV) e 22 eram controles pareados por idade. Usamos um critério de classificação para cada teste separadamente e outro para a combinação entre eles, visando detectar a presença de dificuldades aritméticas em dois momentos: início (tempo 1) e quando as crianças com TDAH estavam tomando 0,3‒0,5 mg/kg de metilfenidato (tempo 2). O estudo também avaliou o desempenho dessas crianças em operações de subtração, combinando partes desses testes. Resultados: Separadamente, os testes foram sensíveis apenas às diferenças entre os grupos sem medicação. Entretanto, ao combinar os três testes neuropsicológicos, foi possível observar uma diferença e detectar uma redução das dificuldades aritméticas associadas ao tratamento com metilfenidato. Os mesmos efeitos foram encontrados em exercícios de subtração que exigem o procedimento de empréstimo. Conclusões: O estudo foi capaz de detectar dificuldades aritméticas em crianças brasileiras com TDAH e os efeitos do metilfenidato. Dada essa melhora na sensibilidade, combinar testes poderia ser uma alternativa promissora ao trabalhar com amostras limitadas.


Assuntos
Humanos , Criança , Transtorno do Deficit de Atenção com Hiperatividade , Brasil , Estimulantes do Sistema Nervoso Central , Metilfenidato , Testes Neuropsicológicos
16.
Arq Neuropsiquiatr ; 60(2-A): 224-30, 2002 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-12068349

RESUMO

We describe seven cases of children (ages 2 to 14 years) with myeloradiculopathy caused by infection with S. mansoni. None of them presented hepatosplenic involvement and one presented an intestinal picture. The myeloradicular and pseudotumoral forms were observed in four and three patients, respectively. Comparing the reports in the literature, we found that the pseudotumoral form is more similarly frequent among children than in adults, while the myelitic and myeloradicular forms are the most frequent and distributed across all age groups. Diagnosis is based on clinical and epidemiological findings in association with laboratory tests. The diagnosis was confirmed by the presence of S. mansoni eggs in feces (5 cases) and / or the positivity in specific immunological tests (5 cases) associated with a cerebrospinal fluid inflammatory pattern with presence of eosinophils (between 1 and 24%). Magnetic resonance image, although it does not enable an etiological diagnosis, helped to confirm the form and spinal cord level of the lesion.


Assuntos
Esquistossomose mansoni/diagnóstico , Doenças da Medula Espinal/diagnóstico , Adolescente , Anti-Helmínticos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Criança , Pré-Escolar , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Oxamniquine/uso terapêutico , Praziquantel/uso terapêutico , Prednisona/uso terapêutico , Esquistossomose mansoni/tratamento farmacológico , Esquistossomose mansoni/parasitologia , Esquistossomicidas/uso terapêutico , Doenças da Medula Espinal/tratamento farmacológico , Doenças da Medula Espinal/parasitologia
17.
Arq Neuropsiquiatr ; 62(2B): 421-8, 2004 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-15273838

RESUMO

OBJECTIVE: To evaluate the effectiveness of dexamethasone as an adjunctive therapy to antibiotics in children with meningococcal meningitis. METHOD: A total of 81 children diagnosed with meningococcal meningitis hospitalized in sequence were studied at the University Hospital of São Paulo University, with the objective of evaluating the presence of sequelae in four different groups of patients, following the administration of dexamethasone: Group I - 25 patients who received the first dose at least 10 minutes before the introduction of the antibiotic therapy; Group II - 19 patients who received the corticosteroid concomitantly; Group III - 14 patients for which the dexamethasone was administered after beginning the antibiotic scheme; Group IV - 23 patients that did not receive dexamethasone. The groups were evaluated for homogeneity through the prognostic indexes and clinical and laboratory characteristics, based on the records obtained at hospitalization. RESULTS: Some degree of sequelae occurred in 16 (26.22%) of the survivors and 23 patients (28.39%) coursed with sequelae or died. The mean period of neurological attendance was 36.97 months and neurological alterations were detected in 16.17% of the patients. No significant difference was found between the four groups. There was also no statistical difference in the comparison of the neurological sequelae in the children from group IV with the children of groups I and II or even with groups I, II and III analyzed as a whole. The presence of hearing loss occurred in 11.11% of the patients, again there was no significant difference between the four groups. Psychological evaluation was performed using the WPSSI and WISC tests. A mild mental disability was detected in one patient from group I and another in group III. The overall analysis of the sequelae (neurological, auditory and intellectual level) also did not demonstrate any significant difference between the four groups. Comparing the children from groups I and II together and also groups I, II and III as a whole with the children in group IV also failed to detect a significant difference arising from the use or nonuse of the corticosteroid. CONCLUSION: Dexamethasone was not proven to be effective in decreasing the number of sequelae among patients with meningococcal meningitis.


Assuntos
Dexametasona/uso terapêutico , Glucocorticoides/uso terapêutico , Meningite Meningocócica/complicações , Meningite Meningocócica/tratamento farmacológico , Antibacterianos/uso terapêutico , Quimioterapia Adjuvante , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Estatísticas não Paramétricas , Resultado do Tratamento
18.
Arq. neuropsiquiatr ; 75(8): 563-569, Aug. 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-888307

RESUMO

ABSTRACT Objective To validate the parent-rated Expression and Emotion Scale for Children (EESC) for patients with attention-deficit/hyperactivity disorder (ADHD). Methods The EESC was applied to parents of children with and without ADHD. The children were divided into age groups: Group A, between six and eight years old; Group B, between nine and 11 years old; and Group C, between 12 and 15 years old. The validation was carried out according to the steps proposed by Guillemin et al. For the statistical calculation, Cronbach's α, Pearson's correlation, the ICC and ROC curve were used. Results The statistical tests showed satisfactory coefficients: Cronbach's α = 0.76; Pearson's correlation r = 0.91 with CI 95%; replicability ICC = 0.66; sensitivity 0.75; specificity 0.67; accuracy 71%. Conclusion According to psychometric data on internal and external consistency (reliability, reproducibility), sensitivity, and specificity, the parent-rated EESC for ADHD is useful in assessing emotional expression.


RESUMO Objetivo Validar o instrumento Expression and Emotion Scale for Children (EESC) versão pais para crianças com transtorno do déficit de atenção e hiperatividade (TDAH). Métodos O instrumento EESC foi aplicado aos pais de crianças e adolescentes com e sem TDAH. Estes foram divididas em grupos etários: Grupo A entre 6 -8 anos; Grupo B, entre 9-11; Grupo C, entre 12-15 anos de idade. A validação da EESC seguiu as seguintes etapas propostas por Guillemin et al. Para cálculo estatístico: α de Cronbach, Pearson, CIC e Curva ROC. Resultados Os testes estatísticos apresentaram coeficientes satisfatórios: Cronbach α = 0,76; correlação de Pearson r = 0,91 com IC 95%; replicabilidade CIC = 0.66; sensibilidade 0,75; especificidade 0,67; acurácia 71%. Conclusão Conforme dados psicométricos de consistência interna, externa (confiabilidade, reprodutibilidade), sensibilidade e especificidade, a EESC versão pais é válida para avaliar a Expressão Emocional de crianças e adolescentes com TDAH.


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Escalas de Graduação Psiquiátrica/normas , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Emoções Manifestas , Psicometria , Traduções , Brasil , Estudos Transversais , Inquéritos e Questionários , Reprodutibilidade dos Testes , Idioma
19.
Arq. neuropsiquiatr ; 75(4): 204-208, Apr. 2017. tab
Artigo em Inglês | LILACS | ID: biblio-838898

RESUMO

ABSTRACT Objective To compare children with attention-deficit/hyperactivity disorder (ADHD), before and after the use of methylphenidate, and a control group, using tests of working memory, inhibition capacity and mental flexibility. Methods Neuropsychological tests were administrated to 53 boys, 9–12 years old: the WISC-III digit span backward, and arithmetic; Stroop Color; and Trail Making Tests. The case group included 23 boys with ADHD, who were combined type, treatment-naive, and with normal intelligence without comorbidities. The control group (n = 30) were age and gender matched. After three months on methylphenidate, the ADHD children were retested. The control group was also retested after three months. Results Before treatment, ADHD children had lower scores than the control group on the tests (p ≤ 0.001) and after methylphenidate had fewer test errors than before (p ≤ 0.001) Conclusion Methylphenidate treatment improves the working memory, inhibitory control and mental flexibility of ADHD boys.


RESUMO Objetivo Comparar crianças com transtorno de déficit de atenção/hiperatividade (TDAH) com controles, utilizando testes de memória de trabalho, capacidade inibitória e flexibilidade mental, em meninos de 9 a 12 anos. Métodos Testes neuropsicológicos administrados: teste de ordem inversa dos dígitos, teste aritmético (WISC-III), Teste Stroop e Teste de Trilhas. Grupo experimental meninos (n=23), com TDAH combinado, virgens de tratamento, inteligência normal sem comorbidades. Grupo controle (n = 30) com as mesmas características do grupo experimental em termos de idade e sexo. Após três meses com metilfenidato, os grupos TDAH e controle foram novamente testadas. Resultados Antes do tratamento, as crianças com TDAH apresentaram menor pontuação do que o grupo controle nos testes analisados (p≤ 0.001) e o grupo com TDAH apresentou menos erros nos testes após metilfenidato (p ≤ 0.001). Conclusão O tratamento com metilfenidato melhora a memória de trabalho, controle inibitório e flexibilidade mental de meninos com TDAH.


Assuntos
Humanos , Masculino , Criança , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/administração & dosagem , Memória/efeitos dos fármacos , Metilfenidato/administração & dosagem , Estudos de Casos e Controles , Resultado do Tratamento , Estimulantes do Sistema Nervoso Central/farmacologia , Metilfenidato/farmacologia , Testes Neuropsicológicos
20.
CoDAS ; 28(2): 123-131, mar.-abr. 2016. tab, graf
Artigo em Português | LILACS | ID: lil-782146

RESUMO

RESUMO Objetivo Analisar e classificar o desempenho ortográfico, de acordo com a semiologia dos erros, de crianças com dislexia do desenvolvimento e com dislexia do desenvolvimento e transtorno do déficit de atenção e hiperatividade em relação a um grupo de crianças sem queixas de aprendizagem escolar. Métodos Participaram da pesquisa 70 crianças, estudantes do 3º ao 5º distribuídas em três grupos: 32 escolares sem queixa de dificuldade de aprendizagem (GI), média de idade de 9,5 anos; 22 escolares com dislexia do desenvolvimento (GII), média de idade de 10 anos; e 16 escolares com dislexia do desenvolvimento e transtorno do déficit de atenção e hiperatividade (GIII), média de idade de 9,9. A habilidade de ortografia das crianças foi avaliada por meio de um ditado de palavras padronizado. Resultados Os dados indicaram que os escolares do GII e do GIII apresentaram um pior desempenho quando comparados ao GI. Não houve diferença estatística entre o desempenho dos escolares do GII e do GIII quanto ao número de acertos na ortografia, embora o desempenho do GIII tenha sido pior. Os escolares do GII e do GIII diferiram apenas quanto ao tipo de erro ortográfico produzido por cada grupo. Conclusão Os dados da presente pesquisa contribuem para o delineamento de melhores programas interventivos para a população estudada.


ABSTRACT Purpose to analyze and classify the spelling performance according to the semiology of spelling error of children with developmental dyslexia (DD) and with developmental dyslexia associated to attention deficit disorder and hyperactivity(DD and ADHD) comparing them to a group of children without learning process complaints. Methods Seventy students, from the third to fifth grade, participated in this study divided as follows: 32 children without complaints of learning difficulties (GI), mean age 9.5 years; 22 students with developmental dyslexia (GII), mean age 10 years; 16 scholars with developmental dyslexia associated to attention deficit disorders and hyperactivity (GIII), mean age 9.9. Spelling skills were assessed through a standardized word dictation task. Results Data indicated that GII and GIII children presented lower performance when compared with typically developed children. There was no statistical difference between the performance of GII and GIII children regarding the score reached in spelling, although GIII children presented the lowest performance. We observed differences between GII and GIII only in the type of misspelling. Conclusion Data from this research contribute to develop better programs for intervention in the studied population.


Assuntos
Humanos , Masculino , Feminino , Criança , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Estudantes , Dislexia/fisiopatologia , Escrita Manual , Fonética , Brasil , Estudos de Casos e Controles , Estatísticas não Paramétricas , Avaliação Educacional , Testes de Linguagem , Deficiências da Aprendizagem/fisiopatologia
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