Caregivers' Perceptions Regarding Oral Health Status of Children and Adolescents with Cerebral Palsy.

Objectives: The aim of the present study was to compare the perception of caregivers regarding the oral health status of children and adolescents with cerebral palsy (CP) and those with typical development. Study Design: Study group (SG) was composed of 35 children and adolescents with a clinical diagnosis of CP and their caregivers. Control group (CG) was composed of 35 individuals with typical development (matched with the SG for age, sex and caries activity) and their caregivers. Questionnaire was administered to caregivers addressing the oral health of individuals under their care. Caries activity, dmft/DMFT index, visible plaque index (VPI) and occlusal characteristics were determined. Results: Statistically significant differences were found in the perceptions of dental problems (p = 0.004) and gingival bleeding (p = 0.013). Individuals in SG whose caregivers perceived dental problems had a higher mean VPI (50.84 ± 5.11%) than those in CG (27.97 ± 6.50%). The mean dmft/DMFT in the SG was 2.77 ± 3.20. Class II molar relationship, overjet and anterior open bite were more prevalent in the SG. Conclusion: Caregivers of children/adolescents with CP perceive more oral problems, such as visible plaque, gingival bleeding and malocclusion, than caregivers of children/ adolescents with typical development.

Cerebral palsy: association between nutritional status and occurrence of oropharyngeal dysphagia / Paralisia cerebral: associação entre estado nutricional e ocorrência de disfagia orofaríngea

ABSTRACT Objective: to verify the association between nutritional status and the occurrence of oropharyngeal dysphagia in individuals with cerebral palsy. Methods: a cross-sectional, quantitative study with people aged between two and 20 years. Neuromotor impairment, occurrence and degree of dysphagia, anthropometry, food consumption, feeding route, diet fractionation and consistency were evaluated. Swallowing evaluation was performed by a skilled speech-language-hearing therapist, through the Clinical Evaluation Protocol of Pediatric Dysphagia (PAD-PED, Portuguese acronym).The statistical analysis was performed adopting p<0.05%. Results: 40 subjects with a median of 8.7 (5.45-14.5) years, 65% of whom were males. Concerning neuromotor impairment, 72.5% were classified at levels IV and V. The prevalence of dysphagia was 70%, the feeding route being predominantly oral (77.5%) with a normal diet consistency (55%). In the growth curves, all of them were classified within an adequate height for their age. As for weight, body mass index and skinfolds, 82.5%, 85% and 62.5% were eutrophic, respectively. Statistically significant association was found between dysphagia and body mass index (p=0.018). The mean daily caloric and proteic intake was 1427.29±338.62 kcal and 56.86±17.57 grams, respectively. Statistically significant association was found between the feeding route and the amount of protein ingested daily (p=0.041). Conclusion: most subjects presented oropharyngeal dysphagia and more severe motor impairment; they were fed orally with a normal diet consistency. It was observed that the greater the difficulty in swallowing, the greater the impairment of nutritional status.

RESUMO Objetivo: verificar a associação entre estado nutricional e ocorrência de disfagia orofaríngea em indivíduos com paralisia cerebral. Métodos: estudo transversal, quantitativo, realizado com indivíduos entre dois e 20 anos. Foi avaliado comprometimento neuromotor, ocorrência e grau de disfagia, antropometria, consumo alimentar, via alimentar, fracionamento e consistência da dieta. A avaliação da deglutição foi realizada por fonoaudióloga capacitada, por meio do Protocolo para Avaliação Clínica da Disfagia Pediátrica. Foi realizada análise estatística pertinente, adotando p<0,05%. Resultados: participaram 40 indivíduos com mediana de 8,7 (5,45-14,5) anos, sendo 65% do sexo masculino. Quanto ao comprometimento neuromotor, 72,5% foram classificados no nível IV e V. A prevalência de disfagia foi de 70%, via alimentar predominantemente oral (77,5%) e consistência da dieta normal (55%). Nas curvas de crescimento, todos foram classificados com estatura adequada para idade. Para peso, índice de massa corporal e dobras cutâneas houve, respectivamente, 82,5%, 85% e 62,5% em eutrofia. Foi encontrada associação estatisticamente significante entre disfagia e índice de massa corporal (p=0,018). A média diária de ingestão calórica e proteica foi de 1427,29±338,62 kcal e 56,86±17,57 gramas, respectivamente. Foi encontrada associação estatisticamente significante entre via alimentar e quantidade de proteína ingerida diariamente (p=0,041). Conclusão: a maioria dos indivíduos apresentou disfagia orofaríngea e comprometimento motor mais grave, alimentavam-se por via oral com consistência de dieta normal. Observou-se que quanto maior a dificuldade de deglutição, maior o comprometimento do estado nutricional.

Cuidando de um filho com diagnóstico de paralisia cerebral: sentimentos e expectativas / Taking care of a child diagnosed with cerebral palsy: feelings and expectations / Cuidar a un niño com diagnóstico de parálisis cerebral: sentimientos y expectativas

Este estudo objetivou compreender a experiência da maternidade em mulheres que são mães de um filho com diagnóstico de Paralisia Cerebral. Participaram 26 mães, que responderam a uma entrevista semiestruturada. A Análise Textual Qualitativa da entrevista resultou nas categorias: "o momento do diagnóstico"; "a percepção em relação à maternidade"; "preocupações, dificuldades e desejos" e "expectativas para o futuro". Elas atribuíram a causa da Paralisia Cerebral ao erro médico ou à negligência dos profissionais da saúde durante o pré-parto e o parto, à precariedade de recursos do hospital ou à própria responsabilidade. Entre as preocupações, estão o temor de adoecer e morrer, a falta de capacitação de profissionais da saúde, o receio de que o filho sofra algum tipo de exclusão na escola e a necessidade de promover o máximo de autonomia. Quanto às dificuldades, elas apontaram que o transporte público para locomoção dos seus filhos, as situações em que o filho não é bem aceito ou sofre preconceitos, as críticas recebidas em relação ao cuidado exercido e a falta de respeito por parte das pessoas nas ruas. Quanto às expectativas sobre o futuro, as mães salientaram a aspiração de poder trabalhar, voltar a estudar, investir no cuidado pessoal e dispor de momentos de lazer. O exercício da maternidade requer constante adaptação às necessidades de cuidado do filho com paralisia cerebral, é explícita a importância do apoio familiar e da orientação que as mães recebem dos profissionais da saúde

This study aimed at understanding the maternity experience for women who are mothers of a child diagnosed with cerebral palsy. Twenty-six mothers answered a semi-structured interview. The qualitative textual analysis of the interview resulted in the following categories: "the diagnosis moment"; "the perception of motherhood"; "worries, difficulties and aspirations" and "expectations for the future". The interviewed mothers attributed the cause of Cerebral Palsy to medical error or to the negligence of health professionals during the pre-labor and labor phases, to the precariousness of resources in thehospital, or to their own fault. Among the concerns, the fear of becoming sick and dying, the lack of qualified health professionals, the worry that their child will suffer some kind of exclusion at school, and the need to promote the maximum autonomy possible. As for the difficulties, they mentioned public transportation for their children's locomotion, the situations in which their child is not well accepted or suffers with prejudice, the criticisms towards the way that they care for their children and the lack of respect from some people on the streets. Concerning the future expectations, the mothers revealed that they would like to be able to work, to go back to school, to invest in their personal care, and to be able to have leisure time. The results indicate that motherhood requires constant adaptation to the needs of the child with cerebral palsy and highlight the importance of family support and the advising that mothers receive from health professionals.

Este estudio tuvo como objetivo comprender la experiencia de la maternidad en las mujeres que son madres de un niño diagnosticado con parálisis cerebral. Se recolectaron los datos por intermedio de la aplicación de entrevista semiestructurada y la evaluación de la función motora gruesa. Participaron 26 madres que respondieron a una entrevista semiestructurada. Un análisis textual de la entrevista cualitativa resultó en las categorías: "El momento del diagnóstico"; "La percepción de la maternidad"; "Las preocupaciones, problemas y deseos" y "las expectativas para el futuro". Ellos atribuyeron la causa de la parálisis cerebral a un error o negligencia médica de los profesionales de la salud durante el preparto y el trabajo de parto, la precariedad de los recursos hospitalarios o de poseer responsabilidad. Entre las preocupaciones son el miedo a la enfermedad y la muerte, la falta de formación de los profesionales de la salud, el temor de que el niño sufre algún tipo de exclusión de la escuela y la necesidad de promover la máxima independencia. En cuanto a las dificultades, señalaron que el transporte público para el transporte de sus hijos, las situaciones en las que el niño no es bien aceptado o perjudicado, críticas recibidas en relación con el cuidado ejercido y la falta de respeto por parte de la gente en las calles. Lo que les gustaría hacer y no pueden por falta de tiempo, las madres destacaron la aspiración atrabajar, volver a la escuela, invertir en el cuidado personal y tener tiempo de ocio. Los resultados indican que el ejercicio de la maternidad requiere una adaptación constante a las necesidades de cuidado infantil, y explican la importancia del apoyo familiar y orientación que las madres reciben de los profesionales de la salud.

Qualidade de vida de sujeitos com doença de Parkinson e seus cuidadores / Quality of life of subjects with Parkinson?s disease and caregivers

Introdução A doença de Parkinson (DP) interfere na autonomia e independência do sujeito, afetando sua qualidade de vida (QV). Cuidadores podem ter sua QV comprometida, em função das dificuldades com o cuidado. Objetivo Avaliar e comparar a QV de sujeitos com DP e seus cuidadores e correlacionar a qualidade de vida com as características dos sujeitos. Material e métodos Foram avaliados 10 sujeitos com DP, com idade média de 65,4 anos, e 8 cuidadores, com idade média de 60,6 anos, de ambos os gêneros. Os instrumentos utilizados foram ficha de avaliação, Questionário PDQ-39, Questionário SF-36, UPDRS e Escala de Hoehn e Yahr modificada. Os dados foram analisados por meio de estatística descritiva e coeficiente de correlação de Pearson e Spearman, utilizando nível de significância de α igual a 5%. Resultados A percepção geral sobre a QV foi moderadamente boa tanto para os sujeitos com DP quanto para cuidadores. No entanto, aspectos motores e emocionais influenciam negativamente a QV dos sujeitos com DP. Do contrário, aspectos sociais, mentais e demográficos parecem não exercer influência significativa. Para os cuidadores, fatores emocionais, sociais e físicos, além de características pessoais, estão relacionados com pior percepção sobre sua QV. As características dos sujeitos com DP e aquelas relacionadas ao cuidado não apresentaram correlação significativa com a QV dos cuidadores. Considerações finais Conhecer os principais fatores que interferem na QV ajuda a direcionar estratégias de prevenção, orientação, suporte e tratamento de pessoas com DP e seus cuidadores. A atenção deve ser integral, voltada para um conjunto de aspectos. .

Background Parkinson´s disease (PD) interferes in the autonomy and independence of the subjects and affects their quality of life (QoL). Due to difficulty with the care, the QoL of caregivers can also be impaired. Purpose To assess and to compare the QoL of subjects with Parkinson´s disease and their caregivers and to correlate quality of life and subjects´ characteristics. Material and methods Ten subjects with PD, mean age of 65.4 years, and eight caregivers, mean age of 60.6 years, both gender, took part in this study. A questionnaire comprising characteristics of the subjects, PDQ-39 questionnaire, SF-36 questionnaire, UPDRS and modified Hoehn and Yahr scale were used to evaluation. Data were analyzed through descriptive statistics, Pearson and Spearman correlation coefficient, using 5% level of significance. Results General perception about QoL of subjects with PD and their caregivers was moderately good. However, motor and emotional aspects have a negative impact on QoL of subjects with PD. On the other hand, social, mental and demographic aspects seem not to influence significantly. Emotional, social and physical factors and, personal characteristics are related to worse perception of caregivers about your QoL. Characteristics of the subjects with PD and those related to care not presented significant correlation with QoL of caregivers. Conclusions To know the main factors that interfere in the QoL helps to address prevention strategies, orientation, support and treatment of subjects with PD and their caregivers. Attention to health should be integral considering a group of aspects. .

Baker yeast-induced fever in young rats: characterization and validation of an animal model for antipyretics screening.

In this study we describe a low-cost and reliable method for inducing fever in young male rats (28-30 days of age, 75-90 g), which seems suitable for the screening of new antipyretics. The effects of temperature measuring procedure-induced stress on the basal rectal temperature and on Baker yeast-induced hyperthermia was assessed. Rectal temperature (T) was recorded every hour for 12 h (07:00-19:00 h) with a lubricated thermistor probe. The animals were injected intraperitoneally with baker yeast (0.25, 0.135, 0.05 g/kg) or the equivalent volume of saline at 7:00 h. The administration of 0.135 g/kg baker yeast induced a sustained increase in rectal temperature for 4 h. Classical (dipyrone and acetaminophen) and novel (MPCA and FPCA) antipyretics, at doses that had no effect per se, reverted baker yeast-induced fever. The method presented induces a clear-cut fever, which is reverted by antipyretics commonly used in human beings and selected novel antipyretics in small animals. The method also allows antipyretic evaluation with low amount of drugs, due to the use of small animals and to the small variability of the pyretic response, which ultimately causes a significant reduction in the number of animals necessary for antipyretic evaluation. Therefore, this study describes an animal model of fever that is not only advantageous from the economical and technical point of view, but that also bears ethical concerns.