Sequence Processing in Music Predicts Reading Skills in Young Readers: A Longitudinal Study.

Musical abilities, both in the pitch and temporal dimension, have been shown to be positively associated with phonological awareness and reading abilities in both children and adults. There is increasing evidence that the relationship between music and language relies primarily on the temporal dimension, including both meter and rhythm. It remains unclear to what extent skill level in these temporal aspects of music may uniquely contribute to the prediction of reading outcomes. A longitudinal design was used to test a group-administered musical sequence transcription task (MSTT). This task was designed to preferentially engage sequence processing skills while controlling for fine-grained pitch discrimination and rhythm in terms of temporal grouping. Forty-five children, native speakers of Portuguese (Mage = 7.4 years), completed the MSTT and a cognitive-linguistic protocol that included visual and auditory working memory tasks, as well as phonological awareness and reading tasks in second grade. Participants then completed reading assessments in third and fifth grades. Longitudinal regression models showed that MSTT and phonological awareness had comparable power to predict reading. The MSTT showed an overall classification accuracy for identifying low-achievement readers in Grades 2, 3, and 5 that was analogous to a comprehensive model including core predictors of reading disability. In addition, MSTT was the variable with the highest loading and the most discriminatory indicator of a phonological factor. These findings carry implications for the role of temporal sequence processing in contributing to the relationship between music and language and the potential use of MSTT as a language-independent, time- and cost-effective tool for the early identification of children at risk of reading disability.

Collective screening tools for early identification of dyslexia.

Current response to intervention models (RTIs) favor a three-tier system. In general, Tier 1 consists of evidence-based, effective reading instruction in the classroom and universal screening of all students at the beginning of the grade level to identify children for early intervention. Non-responders to Tier 1 receive small-group tutoring in Tier 2. Non-responders to Tier 2 are given still more intensive, individual intervention in Tier 3. Limited time, personnel and financial resources derail RTI's implementation in Brazilian schools because this approach involves procedures that require extra time and extra personnel in all three tiers, including screening tools which normally consist of tasks administered individually. We explored the accuracy of collectively and easily administered screening tools for the early identification of second graders at risk for dyslexia in a two-stage screening model. A first-stage universal screening based on collectively administered curriculum-based measurements was used in 45 7 years old early Portuguese readers from 4 second-grade classrooms at the beginning of the school year and identified an at-risk group of 13 academic low-achievers. Collectively administered tasks based on phonological judgments by matching figures and figures to spoken words [alternative tools for educators (ATE)] and a comprehensive cognitive-linguistic battery of collective and individual assessments were both administered to all children and constituted the second-stage screening. Low-achievement on ATE tasks and on collectively administered writing tasks (scores at the 25th percentile) showed good sensitivity (true positives) and specificity (true negatives) to poor literacy status defined as scores ≤1 SD below the mean on literacy abilities at the end of fifth grade. These results provide implications for the use of a collectively administered screening tool for the early identification of children at risk for dyslexia in a classroom setting.

Caracterização do perfil cognitivo-linguístico de escolares com dificuldades de leitura e escrita / Cognitive-linguistic profile in students with reading and writing difficulties

Investigou-se o perfil cognitivo-linguístico de escolares com dificuldades na aquisição da linguagem escrita acrescentando-se testes específicos em um modelo de resposta à intervenção (identificação e intervenção precoces do risco para transtorno de leitura). Participaram 45 escolares do 2º ano, idade média de 7 anos de ambos os gêneros, divididos em grupo controle (sem dificuldades, n = 32) e grupo de risco (com dificuldades, n = 13). Escores mais de 1,65 DP abaixo da média do grupo controle para cada teste foram considerados déficits específicos. Enquanto a análise de grupo apontou os prejuízos fonológicos como único fator de risco, a individual acrescentou a inatenção e a nomeação rápida como fatores causais independentes. Um modelo ampliado de resposta à intervenção que inclui a avaliação cognitiva é proposto.

The cognitive-linguistic profile of students with reading difficulties was investigated by adding specific tests to a response to intervention model (early identification and intervention for reading disorders). Forty-five second graders of both sexes and mean age of 7 years were divided into control group (without reading difficulties, n = 32) and at-risk group (with reading difficulties, n = 13). Scores below the mean of the control group (SD > 1.65) for each test were considered as specific deficits. Whereas group analysis showed phonological impairments as the only risk factor, an individual analysis added inattention and rapid naming as independent causal factors. An extended response model to the intervention, which includes cognitive assessment, is proposed.

Musical, language, and reading abilities in early Portuguese readers.

Early language and reading abilities have been shown to correlate with a variety of musical skills and elements of music perception in children. It has also been shown that reading impaired children can show difficulties with music perception. However, it is still unclear to what extent different aspects of music perception are associated with language and reading abilities. Here we investigated the relationship between cognitive-linguistic abilities and a music discrimination task that preserves an ecologically valid musical experience. 43 Portuguese-speaking students from an elementary school in Brazil participated in this study. Children completed a comprehensive cognitive-linguistic battery of assessments. The music task was presented live in the music classroom, and children were asked to code sequences of four sounds on the guitar. Results show a strong relationship between performance on the music task and a number of linguistic variables. A principle component analysis of the cognitive-linguistic battery revealed that the strongest component (Prin1) accounted for 33% of the variance and Prin1 was significantly related to the music task. Highest loadings on Prin1 were found for reading measures such as Reading Speed and Reading Accuracy. Interestingly, 22 children recorded responses for more than four sounds within a trial on the music task, which was classified as Superfluous Responses (SR). SR was negatively correlated with a variety of linguistic variables and showed a negative correlation with Prin1. When analyzing children with and without SR separately, only children with SR showed a significant correlation between Prin1 and the music task. Our results provide implications for the use of an ecologically valid music-based screening tool for the early identification of reading disabilities in a classroom setting.

Identificação precoce do risco para transtornos da atenção e da leitura em sala de aula / Early identification of attention and reading disorders in the classroom

Testou-se a acurácia de atividades pedagógicas coletivas, baseadas em julgamentos fonológicos por meio do pareamento entre figuras e de figuras com palavras faladas, na identificação de escolares de risco para transtornos da atenção e da leitura em sala de aula. Quarenta e cinco escolares do 2º ano (idade média de 7 anos, 29 do gênero masculino), foram divididos em grupo controle, sem dificuldade de leitura-escrita (n=32), e grupo de risco, com dificuldade de leitura (n=13). O baixo desempenho nessas atividades, definido como os escores acima de 1,65 DP abaixo da média do grupo controle, apresentou boa sensitividade (verdadeiros positivos) e especificidade (verdadeiros negativos) na identificação precoce dos escolares de risco.

In this his study the accuracy was investigated of collective pedagogical activities, based on phonological judgments by matching figures and figures to spoken words, to identify students at risk for reading and/or attention disorders. Forty-five second graders (mean age of 7 years, 29 males) were divided into two groups, a control group, without reading difficulties (n=32), and an at-risk group, with reading difficulties (n=13). The low-achievement on these collective activities, defined by scores more than 1.65 SD below the mean of the control group, presented good sensitivity (true positives) and specificity (true negatives) in the early identification of at risk students.

Desenvolvimento de ferramentas pedagógicas para identificação de escolares de risco para a dislexia / Developing pedagogical tools for early identificationof students at risk for dyslexia

Objetivo: Elaborar e aplicar atividades pedagógicas coletivas, que avaliem as habilidades fonológicas em pré-leitores e leitores iniciantes e que sirvam como potenciais instrumentos de rastreamento para ajudar na identificação de escolares de risco para desenvolver dificuldades na leitura escrita. Método: As tarefas FAE (ferramentas alternativas do educador) basearam-se em tarefas fonológicas clássicas conhecidas como “categorizaçãode sons” e no Protocolo de Habilidades Cognitivo-Linguísticas. As FAE consistiram basicamente no pareamento entre figuras e de figuras com palavras que apresentam similaridades fonológicas no início (aliteração) ou no final (rima) e foram aplicadas em 45 escolares, de ambos os gêneros, com idade média de 7 anos e 4 meses, juntamente com o referido protocolo. Resultados: O protocolo comprovou sua eficácia confirmando que a consciência fonológica, a memória de trabalho verbal e a nomeação rápida consistem nos principais fatores de risco para a dislexia e com as quais as FAE apresentaram suas mais fortes correlações, além da discriminação fonêmica. As tarefas FAE também foram fortemente correlacionadas com a leitura e a escrita. Conclusão: Escolares de risco para dislexia podem ser identificados por meio de ferramentas pedagógicas desenvolvidas, testadas e adaptadas para a realidade educacional brasileira, sendo este um promissor campo de pesquisa com potencial para ajudar a evitar o atual excessivo númerode escolares equivocadamente considerados disléxicos e indevidamente encaminhados para os serviços públicos competentes, bem como indicar as abordagens teórico-empíricas mais adequadas para orientar nossa educação.

Chemoprevention of precancerous gastric lesions with antioxidant vitamin supplementation: a randomized trial in a high-risk population.

BACKGROUND: Gastric cancer is one of the most common malignancies worldwide. Histopathologic studies have identified a sequence of changes in the gastric mucosa that mark the slow progression from normal tissue to carcinoma. Epidemiologic evidence suggests that a diet rich in fresh fruit and vegetables could be a protective factor against this disease. This effect may be mediated through antioxidant vitamins. METHODS: A randomized, double-blind chemoprevention trial was conducted among 1980 subjects in Tachira State, Venezuela (whose population is at high risk for gastric cancer), to determine the effect of dietary supplementation with vitamin C, vitamin E, and beta-carotene on the progression and regression of precancerous gastric lesions. Subjects were randomly assigned to receive either a combination of vitamin C (750 mg/day), vitamin E (600 mg/day), and beta-carotene (18 mg/day) or placebo for 3 years. Changes in the gastric mucosa were determined by histologic diagnosis based on five biopsies taken from prespecified areas of the stomach at baseline and annually for 3 years. All biopsies were reviewed by a single expert pathologist. Progression rates (and regression rates) were calculated by comparing the first and last available gastroscopies for each subject and dividing the number of subjects whose diagnoses increased (decreased) in severity by the total follow-up time. Overall rate ratios were calculated by Poisson regression, controlling for baseline diagnosis. All statistical tests were two-sided. RESULTS: Median plasma vitamin levels were increased in the treatment group between baseline and 1 year after randomization from 0.43 micromol/L (interquartile range [IQR] = 0.26-0.69) to 2.89 micromol/L (IQR = 1.76-4.22) for beta-carotene, from 26.7 micromol/L (IQR = 23.1-31.2) to 54.9 micromol/L (IQR = 42.8-67.6) for alpha-tocopherol, and from 47.70 micromol/L (IQR = 36.9-58.5) to 61.9 micromol/L (IQR = 52.2-72.7) for vitamin C. Overall progression rates per 100 person-years were 74.3 in the placebo group and 67.8 in the group randomly assigned to vitamins. Overall regression rates were 109.4 in the placebo group and 116.5 in the group randomly assigned to vitamins. There was no statistically significant difference in progression rate (rate ratio = 0.92, 95% confidence interval [CI] = 0.74 to 1.15) or regression rate (rate ratio = 1.09, 95% CI = 0.90 to 1.33) between vitamin and placebo groups. CONCLUSION: Supplementation with antioxidant micronutrients is not an effective tool for gastric cancer control in this high-risk population. The results of this trial are consistent with previous findings on the lack of effect of nutritional supplementation on precancerous gastric lesions.

Environmental factors in Helicobacter pylori-related gastric precancerous lesions in Venezuela.

Although Helicobacter pylori (HP) infection has been acknowledged to play an etiological role in gastric carcinogenesis, its relatively weak association particularly in developing countries suggests critical roles of cofactors. Among a population with an extremely high prevalence of HP infection ( approximately 95%) in Venezuela, we examined the relationship of household characteristics, smoking, alcohol drinking, dietary consumption, and plasma nutrient levels with the prevalence of three different stages of gastric precancerous lesions, chronic atrophic gastritis (AG; n = 337), intestinal metaplasia (IM; n = 551), and dysplasia (n = 157), in comparison with those without any of these lesions (n = 1154). Length of refrigerator use was marginally inversely associated with the prevalence of the precursor lesions studied. The association was most pronounced for AG followed by dysplasia. On the other hand, smoking status was a significant predictor for IM and dysplasia. Those smoking >/=>10 cigarettes/day had 1.8-fold risk of IM and 3.6-fold risk of dysplasia compared with never smokers. There were no associations with alcohol consumption. When six food groups known to be associated with stomach cancer risk in Venezuela were tested, the prevalence of these lesions progressively increased with increasing starchy vegetable consumption and decreasing fresh fruit/fruit juice consumption. The association with fruits was more evident for dysplasia and AG and that with starchy vegetables for IM and AG. However, there were no inverse associations with plasma antioxidant vitamins. These findings offer important public health implications in preventing progression of HP-associated gastric precancerous lesions in high-risk populations.

Tratamiento endoscópico del cáncer precoz del tracto digestivo superior / Endoscopic treatment for early cancer in upper digestive tract

Los Programas de Pesquisa para Cáncer Gástrico en zonas de alta incidencia de esta neoplasia, ha permitido el diagnóstico de lesiones incipientes en el esófago. Este hecho, aunado a la poca posibilidad de metástasis a ganglios linfáticos regionales, cuando las lesiones invaden solo la mucosa, garantiza el tratamiento endoscópico curativo, permitiendo una excelente calidad de vida a los pacientes. En este trabajo presentamos 26 casos de cáncer precoz del tracto digestivo superior en los cuales realizamos tratamiento endoscópico: De ellos 25 casos correspondieron a cáncer gástrico precoz (CGP) y 1 caso a cáncer precoz del esófago. Macroscópicamente, de los CGP, 11 casos correspondían al tipo I, 11 casos al tipó IIa, 3 casos a lesiones tipo IIb y 1 caso a una lesión tipo IIc. De estos pacientes 3 han fallecido por causas no relacionadas con cáncer. Los restantes están vivos y en buenas condiciones de salud, en 7 pacientes, la sobrevida es mayor de 5 años

Criptosporidiosis gastrointestinal: presentación de tres casos / Criptosporidiosis in the gastrointestinal tract: report of three cases

Se informan tres casos de criptosporidiosis gastrointestinal en tres pacientes, edad promedio 41 años, pertenecientes todos al sexo masculino, en dos de ellos el criptosporidium se localizó en la mucosa gástrica y en el tercero en el apéndice cecal. Los tres casos mostraron numerosos microorganismos en el epitelio gástrico y del apéndice. El primer caso resultó positivo para VIH (Test de Elisa y para el Western Blot); este paciente falleció 10 meses después del diagnóstico de SIDA: El segundo caso resultó negativo al test de determinación de VIH para el momento de esta publicación y se encuentra en buenas condiciones. El tercer caso se determinó el VIH posterior a la intervención quirúrgica y falleció 13 meses después. La criptoporidiosis una enfermedad poco frecuente que afecta a inmunocompetentes e inmunocomprometidos y actualmente se demuestra la importancia de la identificación histológica de seguir conducta terapéutica

Validación del modelo CIMDER como sistema de evaluación nutricional por la comunidad / Validation of the CIMDER model as sistem of nutritional evaluation by the community

La investigación tuvo como objetivo principal la validación del método CIMBER como instrumento de diagnóstico nutricional por parte de la comunidad. Se estudiaron 212 niños que presentan el 60 por ciento de la población de niños menores de seis años en el área de estudio y participaron 12 voluntarios comunales de salud. El diseño fue de tipo transversal, descriptivo y de observación con la aplicación de una serie de inplementos destinados a evaluar el estado nutricional por medio del modelo CIMBER y a través de los indicadores peso/talla de la Organización Mundial de la Salud e Instituto Nacional de nutrición de Venezuela. Los resultados obtenidos al aplicar Chi Cuadrado (X²), así como la determinación de los valores de especificidad (76,5 por ciento), sensibilidad (70 por ciento) y valores predictivos positivos (47,9 por ciento) y negativo (89,8 por ciento) condujeron a determinar que, es un instrumento útil para ser utilizado por la comunidad en el diagnóstico del estado nutricional de los niños menores de 6 años.

Respuesta inflamatoria asociada con infección por helicobacter pylori en mucosa gástrica con metaplasia intestinal en una población de alto riesgo para cáncer gástrico / Inflamatory answer asociated with helicobacter infection in gastric mucosa with metaplasia intestinal in a cancer gastric high risk poblation

La metaplasia intestinal (MI), y la infección por Helicobacter Pylori (HP), han sido relacionadas con la carcinogénesis gástrica. Con el propósito de conocer la relación entre la infección por HP, la metaplasia intestinal y la respuesta inflamatoria de la mucosa gástrica en una población con alta prevalencia para este cáncer, estudiamos 800 personas que acudieron a la pesquiza masiva de cáncer gástrico, que se realiza en el Estado Táchira, Venezuela desde 1981. De estos sujetos, 259 tenían diagnóstico histológico de MI (32,4 por ciento);52,1 por ciento presentaban MI tipo I, 19,3 por ciento tipo II y 28,8 por ciento tipo III (sulfosecretora). Histológicamente con la coloración de Giemsa, se demostró HP en el 94,6 por ciento de los casos. La asociación entre HP y respuesta inflamatoria en la mucosa con MI fue estadísticamente significativa (p-0,0001). Se encontró una mayor cantidad de bacterias en la MI tipo I con respecto a la tipo III, pero sin significancia estadística. Consideramos que la MI es una respuesta hostil de la mucosa gástrica con infección por HP, para restringir el crecimiento bacteriano. Este fenómeno, junto con otros oncógenos, pueden inducir la aparición de lesiones pre-malignas y, eventualmente, el cáncer gástrico

Leiomioblastoma gástrico: análisis histomorfológico e inmunológico de tres casos / Gastric leiomioblastoma: presentation of three cases

Se presentan tres casos de Leiomioblastoma gástrico diagnósticados en la Unidad de Patología del Centro de Control de Cáncer Gástrico "Dr. Luis E. Anderson" - San Cristóbal Estado Táchira Venezuela. Las lesiones se analizaron desde el punto de vista clínico patológico e inmunohistoquímico utilizando técnicas de Vimentina y Queratina. Esta neoplasia no es frecuente, pero interesante debido a que su comportamiento biológico no siempre se corresponde con la histología

Esfinterotomía endoscópica experiencia en el centro de control de cancer / Endoscopic sphincterotomy: experience in the cancer control center

La Esfinterotomía endoscópica es un procedimiento terapeútico importante en la solución de los trastornos biliopancreáticos. En este trabajo presentamos nuestra experiencia en larealización de este procedimiento. La indicación principal para realizarlo fue litiasis coledociana la cual constituyó el 83 por ciento con respecto al total de casos. En los casos de litiasis coledociana el 67 por ciento de los casos correspondió a litiasis residual post colecistectomía tanto convencional como laparoscópica; el 33 por ciento fue realizada con vesícula in situ. En 5 pacientes hicimos el diagnóstico de disfunción del esfinter de Oddi partiendo de criterios clínicos, bioquímicos y radiológicos. En casos poco comunes como el síndrome de Sumidero y Coledococele también realizamos Esfinterotomía. Hubo complicaciones en 5 pacientes tales como sangramiento y pancreatitis las cuales se resolvieron con tratamiento médico o espontáneamente

Uso del test urea carbono en el aliento como método de diagnóstico de infección por helicobacter pylory / 14C-urea breath test for the diagnosis of helicobacter pylori infection

La implicación del Helicobacter Pylori como agente involucrado en la patogénesis de la gastritis antral, enfermedad ulceropéctica y probablemente en el carcinoma gástrico, aunado a la alta prevalencia de infección por este agente en nuestra región creó la necesidad de implementar y validar un método de diagnóstico rápido, sensible y no invasivo para este agente. El test de la Urea Carbono en el aliento, ha representado esta alternativa, y se basa en la capacidad de producción de ureasa por esta bacteria. Hemos encontrado, utilizando dosis de 1 uCi, una alta correlación con los diagnósticos por biopsia, determinando como rango límite de negatividad 100 DPM, dudoso 100-200 DPM y francamente positivo sobre 200 DPM, guardando estrecha relación el pico máximo con el grado de infección, demostrado al realizar supresión del crecimiento de la bacteria con Subsalicilato de Bismuto, además mostró una alta sensibilidad (100 por ciento ) y especificidad (85.71 por ciento ). Esto nos permite concluir que el test de la Urea 14C en el aliento es una forma alternativa de diagnóstico y seguimiento de infección por Helicobacter Pylori, altamente sensible, reproducible y no invasivo aplicable en nuestra región

Aspecto macroscópico y microscópico en cáncer gástrico precoz / Microscopic and macroscopic aspect in early gastric cancer

La profundidad es un parámetro importante a evaluar en el Cáncer Gástrico Precoz. Nosotros revisamos 78 casos de Cáncer Gástrico Precóz diagnosticados en nuestro Programa y operados en Instituciones públicas y privadas de la localidad. Establecimos la relación entre 3 variables macroscópicas (localización, tamaño y forma macroscópica) y profundidad. Observamos que las lesiones localizadas en fundus aunque se diagnostican con menor frecuencia, tienen mayor distribución hacia la submucosa (50 por ciento ) con respecto a otras localizaciones. No encontramos una relación estadísticamente significativa entre tamaño y profundidad X2=3.76 P:58 df :5. Las formas macroscópicasintermedias IIa + IIc y el Cáncer Gástrico Precoz ulcerado tipo III, tienen tendencia a mayor invasión hacia la submucosa (53,8 por ciento ) y (66,67 por ciento ) respectivamente. Las lesiones protruidas tipo I y IIa son en su gran mayoría intramucosas, lo cual las hace susceptible de tratamiento endoscópico en pacientes de alto riesgo quirúrgico y edad avanzada

Investigación histológica de helicobacter pylori en 265 biopsias gástricas cosecutivas / Histologic study of Helicobacter pylori in 265 consecutive gastric biopsies

Se evalúan 265 biopsias gástricas endoscópicas provenientes de pacientes del Programa de Pesquisa de Cáncer Gástrico del Estado Táchira, Venezuela, de ellos 157 masculinos y 113 femeninos en edades comprendidas entre 18 y 70 años. El propósito fue establecer la presencia del Helicobacter pylori en relación con los diferentes diagnósticos histológicos y la localización de lasbiopsias en el estómago. Se utilizaron las coloraciones de Hematoxilina y Eosina Giemsa y la Técnica de Giménez. La bacteria fue identificada en el 81

Metástasis a ganglios linfáticos en cáncer gástrico precoz / Metastasis of lymph nodes in early gastric cancer

La presencia de metástasis a ganglios linfáticos es uno de los aspectos más importantes a evaluar en el cáncer gástrico precoz (CGP). En este trabajo analizamos la presencia de dichas metástasis en 70 CPG, en 66 pacientes estudiados en nuestro instituto y operados en el Hospital Central de San Cristóbal. Encontramos 3 casos con metástasis a ganglios linfaticos regionales (N1) y 1 con metástasis extraperigástrica (ganglios N3), lo cual representa el 5.7