[Sleep disturbances among children and adolescents with learning disabilities. Comparative study between students from a mainstream school and a special school in the Valencia Community (Spain)]. / Trastornos del sueño en niños y adolescentes con incapacidad psíquica. Análisis comparativo entre alumnos escolarizados en centros ordinarios y centros de educación especial de la Comunidad Valenciana.

INTRODUCTION: Sleep disturbances affect daytime behaviour and cognitive functions in children. These disorders make the situation worse in children who already have learning difficulties. The objective of the present study was to study the prevalence of sleep disturbances among children from special schools and carry out a comparative study with children from mainstream schools. PATIENTS AND METHODS: We use the Spanish version of the Paediatric Sleep Questionnaire, which was given out in three special schools of the Valencia Community. Results were compared with a previous study in children from mainstream schools. RESULTS: A significantly higher proportion of children in special schools had insomnia, 32.3 % against 10.5 % in main-stream school, and sleep breathing disorders, 26.8 % against 5.7 % in mainstream schools, and a lower proportion of parasomnias. Among the whole population with learning difficulties, children with cerebral palsy are the most affected. CONCLUSIONS: Our results clearly show that children with learning difficulties have a higher risk of sleep disturbances and these disturbances have repercussions on daily functioning. It is important to rule out sleep disturbances when we see children with learning difficulties.

Detecting anti-SSA and anti-SSB antibodies in routine analysis: a comparison between double immunodiffusion and immunoblotting.

The aim of this study was to assess the performance of a commercially available procedure for detecting anti-Sjögren's syndrome A (anti-SSA) and anti-Sjögren's syndrome B (anti-SSB) antibodies by immunoblotting (IB) and compare it with double immunodiffusion (DID). We also studied the clinical significance of these profiles in a series of unselected anti-SSA positive patients. Serum samples from 534 patients that were positive on an immunofluorescent screening test using HEp-2 cells were analysed for anti-SSA and anti-SSB antibodies by DID and IB (Biolab Anablot System II), and the results on anti-SSA antibodies were confirmed by an enzyme-linked immunosorbent assay (ELISA). Fifty-five serum samples were found to be positive for anti-SSA antibodies. Among these, 24 were anti-SSA negative by IB but positive by DID and ELISA ('non-blotter sera'), whereas only three serum samples were anti-SSA negative by DID but positive by IB and ELISA. Of the 18 anti-SSB positive serum samples, eight were negative by DID. All the serum samples that were anti-SSB positive by DID were also positive by IB. Anti-SSB antibodies showed a significant association with eye dryness and leucopenia. Anti-52 kDa SSA antibodies were associated with anti-SSB antibodies but showed no significant association with sicca symptoms, while anti-60 kDa SSA antibodies were associated with lower rates of leucopenia. The 'non-blotter' profile showed no significant association with any clinical parameter. IB is less sensitive than DID for detecting anti-SSA antibodies but more sensitive than DID for detecting anti-SSB antibodies. The determination of anti-SSA immunoblotting profiles in patients positive for anti-SSA antibodies by DID does not significantly improve the clinical usefulness of this test. As expected, anti-SSB antibodies were associated with clinical features of Sjögren's disease. Non-blotting (probably conformational) anti-SSA antibodies did not show any further association with clinical parameters and seem to have no clinical relevance.