A Simplified Approach to Quantifying a Child's Bilingual Language Experience.

Purpose Bilingual children's linguistic experience can vary markedly from child to child. For appropriate audiological assessment and intervention, audiologists need accurate and efficient ways to describe and understand a bilingual child's dynamic linguistic experience. This report documents an approach for quantitatively capturing a child's language exposure and usage in a time-efficient manner. Method A well-known pediatric bilingual language survey was administered to 83 parents of bilingual children, obtaining information about the child's exposure to (input) and usage of (output) Spanish and English for seventeen 1-hr intervals during a typical weekday and weekend day. Results A factor analysis indicated that capturing linguistic exposure and usage over three grouped-time intervals during a typical weekday and weekend day accounted for ≥ 74% of the total variance of the linguistic information captured with the full-length survey. Conclusions Although further confirmation is required, these results suggest that collecting language exposure and usage data from parents of bilingual children for three grouped-time intervals provides similar information as a comprehensive hour-by-hour approach. A time-efficient method of capturing the dynamic bilingual linguistic experience of a child would benefit pediatric audiologists and speech-language pathologists alike.

Dynamic Assessment Language Tasks and the Prediction of Performance on Year-End Language Skills in Preschool Dual Language Learners.

Purpose Early identification is a key element for accessing appropriate services for preschool children with language impairment. However, there is a high risk of misidentifying typically developing dual language learners as having language impairment if inappropriate tools designed for monolingual children are used. In this study of children with bilingual exposure, we explored performance on brief dynamic assessment (DA) language tasks using graduated prompting because this approach has potential applications for screening. We asked if children's performance on DA language tasks earlier in the year was related to their performance on a year-end language achievement measure. Method Twenty 4-year-old children from Spanish-speaking homes attending Head Start preschools in the southwestern United States completed three DA graduated prompting language tasks 3-6 months prior to the Head Start preschools' year-end achievement testing. The DA tasks, Novel Adjective Learning, Similarities in Function, and Prediction, were administered in Spanish, but correct responses in English or Spanish were accepted. The year-end achievement measure, the Learning Accomplishment Profile-Third Edition (LAP3), was administered by the children's Head Start teachers, who also credited correct responses in either language. Results Children's performance on two of the three DA language tasks was significantly and positively related to year-end LAP3 language scores, and there was a moderate and significant relationship for one of the DA tasks, even when controlling for age and initial LAP3 scores. Conclusions Although the relationship of performance on DA with year-end performance varies across tasks, the findings indicate potential for using a graduated prompting approach to language screening with young dual language learners. Further research is needed to select the best tasks for administration in a graduated prompting framework and determine accuracy of identification of language impairment.

Working Memory and Linguistic Performance of Dual Language Learners With and Without Developmental Language Disorders.

Purpose This research note describes the use of working memory measures as potential indicators of developmental language disorders (DLD) in preschool-age dual language learners from Spanish-speaking backgrounds. This report is an extension of early work, completed by the same authors that described the diagnostic accuracy of a Spanish nonword repetition task. Method One hundred thirty Spanish-speaking families with preschool-age children participated; 37 children had DLD, and 93 were typically developing. Families were recruited from early childhood programs in three states in the western region of the United States. Working memory and linguistic measures were collected from the children; parents completed a vocabulary checklist and reported on their child's longest utterances. Results Nonverbal working memory was not associated with other measures, but verbal working memory was associated with linguistic measures. Although there were no group differences on nonverbal working memory, group differences (DLD vs. typical development) were detected on verbal working memory and linguistic measures. Verbal working memory combined with vocabulary scores resulted in 79% of cases correctly classified. Conclusions Working memory tasks yielded different results depending on the type of task (verbal vs. nonverbal). Outcomes from this study showed that a nonverbal working memory task (hand movement) was not useful in distinguishing preschool-age dual language children with DLD from typical peers, but a verbal working memory task (nonword repetition) may be useful if combined with other more robust linguistic measures.

The Relationship Between Culture, Quality of Life, and Stigma in Hispanic New Mexicans With Dysphagia: A Preliminary Investigation Using Quantitative and Qualitative Analysis.

Purpose The purpose of this investigation was to (a) identify the relationship between level of acculturation, and quality of life (QOL) and stigma and (b) explore the QOL experiences for Hispanic New Mexicans with dysphagia. Method This study includes 7 New Mexicans who self-identified as Hispanic. This prospective investigation was completed in 2 phases. In the quantitative phase, all participants completed the (a) the SWAL-QOL ( McHorney et al., 2000 ), (b) the Neuro-QoL Stigma subtest ( Gershon et al., 2012 ), and (c) the Acculturation Rating Scale for Mexican Americans-II (ARSMA-II; Cuellar, Arnold, & Maldonado, 1995 ). In the qualitative phase, 3 participants were selected from the quantitative phase to complete the qualitative phase. These participants were selected to allow for distribution across levels of acculturation, and each of them participated in interviews designed to explore QOL experiences. Interviews were analyzed to identify themes. The occurrence of themes is discussed as a function of level of acculturation. Results There is no clear relationship between acculturation and QOL. A strong nonsignificant correlation was observed between acculturation and stigma. QOL experiences, as identified from the interviews, were classified into 2 broad categories: emotional experiences (stigma, distrust, fear, frustration, religion, and impact) and swallow safety (symptoms, treatment, triggers, and compensatory strategies). Conclusions Level of acculturation did not relate to measures of mental health or fatigue. Yet, both quantitative and qualitative analyses support a relationship between level of acculturation, and symptom reporting and religion, as well as patient perception of stigma.

Effects of Home Language, Oral Language Skills, and Cross-Linguistic Phonological Abilities on Whole-Word Proximity in Spanish-English-Speaking Children.

Purpose This study examined language use and language ability factors that predict phonological whole-word proximity in young Spanish-English-speaking children. Method Participants were 199 Latino children aged 3;0-6;6 (years;months) and their mothers. Children's speech sound production in English and Spanish was assessed using the Bilingual Phonological Assessment ( Miccio & Hammer, 2006 ). Vocabulary and story retell abilities were assessed using the Woodcock-Muñoz Language Survey-Revised ( Woodcock, Muñoz-Sandoval, Ruef, & Alvarado, 2005 ), and information regarding the children's exposure to and use of English and Spanish was collected by means of a parent survey. Hierarchical regression analyses were used to determine the degree to which exposure to and use of each language in the home, oral language abilities, and phonological proficiency as measured by the proportion of whole-word proximity (PWP; Ingram, 2002 ) in the other language were able to predict the PWP scores in English and Spanish. Results A large portion of the variance in English and Spanish PWP scores ( R 2 = .66 and .51, respectively) was predicted by the language children use when communicating with their mothers, children's vocabulary scores, and children's PWP scores in the other language. Conclusion Language use, vocabulary, and phonological whole-word proximity in the other language are significant factors in predicting bilingual children's whole-word proximity in English and Spanish. Children's phonological abilities in one language are highly predictive of those same abilities in the other, suggesting underlying shared phonological skills across languages.

Accuracy of Telehealth-Administered Measures to Screen Language in Spanish-Speaking Preschoolers.

INTRODUCTION: There is a critical need for telehealth language screening measures for use with Spanish-speaking children because of the shortage of bilingual providers and the current lack of psychometrically sound measures that can be administered via telehealth. The purpose of the current study was to describe the classification accuracy of individual telehealth language screening measures as well as the accuracy of combinations of measures used with Spanish-speaking preschoolers from rural and underserved areas of the country. MATERIALS AND METHODS: This study applied a hybrid telehealth approach that implemented synchronous videoconferencing, videocasting, and traditional pen and paper measures. Screening measures included a processing efficiency measure (Spanish nonword repetition [NWR]), language sampling, and a developmental language questionnaire. Eighty-two mostly Spanish-speaking preschool-age children and their parents participated. Thirty-four children had language impairment (LI), and 48 had typical language development. RESULTS: Although many of the individual measures were significantly associated with standardized language scores (r=0.27-0.55), not one of the measures had classification values of 0.8 or higher, which is recommended when screening for LI. However, when NWR scores were combined with language sample or parent survey measures, promising classification accuracy values that approached or were higher than 0.8 were obtained. CONCLUSIONS: This research provides preliminary evidence showing the effectiveness of a hybrid telehealth model in screening the language development of Spanish-speaking children. A processing efficiency measure, NWR, combined with a parent survey or language sample measure can provide informative and accurate diagnostic information when screening Spanish-speaking preschool-age children for LI.

Nonword Repetition in Spanish-Speaking Toddlers with and without Early Language Delays.

BACKGROUND/AIMS: Nonword repetition (NWR) studies with English-speaking toddlers indicate favorable diagnostic accuracy for identifying early language delays and strong associations with early vocabulary. While scarce, studies of Spanish NWR have revealed strong diagnostic accuracy with preschool- and school-age children. This study aimed to (1) establish the association between Spanish NWR and early linguistic measures, (2) compare the Spanish NWR skills of typical Spanish-speaking toddlers and those of toddlers with early language delays (ELD), and (3) establish the diagnostic accuracy of a Spanish NWR task. METHODS: Sixty-five Spanish-speaking toddlers were given a NWR task and a language assessment while parents completed a vocabulary checklist and reported their child's longest utterances. RESULTS: NWR scores were moderately correlated with vocabulary and language. The ELD group had significantly lower NWR scores than peers, and 68% of the sample was classified correctly, with desirable sensitivity but inadequate specificity obtained. CONCLUSION: Findings from this study revealed developmental trends in Spanish-speaking toddlers' ability to repeat nonwords and that most toddlers were not able to repeat 4- and 5-syllable nonwords. Furthermore, Spanish-speaking children with ELD had more difficulties with NWR than typical peers. The diagnostic accuracy results indicated that the clinical use of a Spanish NWR task for toddlers can serve to detect early language-learning difficulties, especially if used as one of multiple diagnostic sources of information to establish ELD.

Rasch analysis of a Spanish language-screening parent survey.

The purpose of this study was to evaluate and refine items from a parent survey designed to screen the language skills of Spanish-speaking preschoolers. This investigation applied Rasch modeling to systematically evaluate and identify items that demonstrated favorable qualities. A set of 124 parent survey items was administered to 107 Spanish-speaking parents of preschool age children. Parents completed survey items intended to provide a global measure of preschool language abilities. Rasch analyses of the survey items were conducted using WINSTEPS. Results indicated that 59 items, all vocabulary items, fit the Rasch model. Sufficient unidimensionality was obtained, with the model accounting for 58% of the variance. Item difficulty estimates ranged from -7.43 to 4.12, with a shortage of items at both the lower ability level and at the higher ability level. Analyses of pruned and remaining items identified the type of items that may be most useful for a refined item bank. These results will inform the development of new items for a Spanish language-screening parent survey for preschool age children.

Enfermedad de Still del adulto / Adult Still´s disease

Se presenta un paciente masculino de 17 años con antecedentes de salud, hospitalizado por odinofagia, fiebre superior a 39oC, oligoartritis, linfoadenopatias, epatoesplenomegalia, rash cutáneo que coincidía con la fiebre, leucocitosis con neutrofilia, eritrosedimentación acelerada, hipertransaminasemia y factor reumatoideo negativo. Durante el ingreso se constata artritis de carpo derecho, derrame pericárdico Se inició tratamiento con antinflamatorios no esteroideos, indometacina 150 mg diarios. La respuesta fue favorable cediendo la fiebre y mejorando las manifestaciones clínicas, siete años después fiebre superior a 39oC, decaimiento ,el examen físico mostró esplenomegalia, no artritis, se decidió tratamiento con indometacina 150 mg diarios pero la evolución no fue favorable y se añadió 15 mg de prednisona por 6 semanas logrando buena respuesta .Se trata de la variante intermitente o policiclica de la enfermedad de Still que es la más frecuente, en la misma se experimentan episodios que se repiten a intervalos variables pero de menor intensidad(AU)

Response to dynamic language tasks among typically developing Latino preschool children with bilingual experience.

PURPOSE: The purpose of this study was to determine whether typically developing preschool children with bilingual experience show evidence of learning within brief dynamic assessment language tasks administered in a graduated prompting framework. Dynamic assessment has shown promise for accurate identification of language impairment in bilingual children, and a graduated prompting approach may be well-suited to screening for language impairment. METHOD: Three dynamic language tasks with graduated prompting were presented to 32 typically developing 4-year-olds in the language to which the child had the most exposure (16 Spanish, 16 English). The tasks were a novel word learning task, a semantic task, and a phonological awareness task. RESULTS: Children's performance was significantly higher on the last 2 items compared with the first 2 items for the semantic and the novel word learning tasks among children who required a prompt on the 1st item. There was no significant difference between the 1st and last items on the phonological awareness task. CONCLUSIONS: Within-task improvements in children's performance for some tasks administered within a brief, graduated prompting framework were observed. Thus, children's responses to graduated prompting may be an indicator of modifiability, depending on the task type and level of difficulty.

Classification accuracy of nonword repetition when used with preschool-age Spanish-speaking children.

PURPOSE: The purpose of the present study was to (a) describe and compare the nonword repetition (NWR) performance of preschool-age Spanish-speaking children (3- to 5-year-olds) with and without language impairment (LI) across 2 scoring approaches and (b) to contrast the classification accuracy of a Spanish NWR task when item-level and percentage of phonemes correct (PPC) scoring methods are applied. METHOD: Forty-four Spanish-speaking children participated. Twenty-one children had LI and 23 had typically developing (TD) language. Children were administered a Spanish NWR task and a standardized Spanish language measure. RESULTS: A developmental pattern in NWR performance was observed, and the children with LI had NWR scores that were significantly lower than those of the TD children. Whereas item-level scoring of NWR items indicated acceptable levels of sensitivity and specificity and suggested positive and negative likelihood ratios, PPC scoring of NWR items resulted in less than desirable levels of sensitivity and adequate specificity. CONCLUSION: Item-level scoring of 3- to 5-syllable Spanish NWR items may be useful as part of an assessment battery for preschool-age Spanish-speaking children.

¿Es siempre un factor reumatoideo positivo indicador de enfermedad reumática? / Is it always a positive rheumatoid factor indicator of rheumatic disease?

El factor reumatoideo se ha usado ampliamente como útil herramienta en el diagnóstico diferencial en pacientes con artritis reumatoidea, pues puede estar presente en el suero de estos enfermos en un 80 por ciento, de los casos, por lo que son remitidos a nuestra consulta pacientes con factor reumatoideo positivo sin síntomas ni signos articulares y con un examen físico normal; otros pacientes recibieron indicación de esteroides, por el erróneo diagnóstico de artritis reumatoidea. Esto nos motivó a realizar la presente revisión, con el objetivo de esclarecer la correcta indicación y el verdadero significado de este estudio, en aras de que sea mejor utilizado, pues si bien constituye un examen complementario muy útil con valor pronóstico en enfermos con artritis reumatoidea, no es patognomónico de esta enfermedad, ya que también se observa en enfermedades infecciosas, inmunológicas, neoplásicas e, incluso, en un 5 por ciento de pacientes sanos, cifras que se incrementan con la ancianidad(AU)

Predicting Spanish-English bilingual children's language abilities.

PURPOSE: In this study, the authors investigated factors that affect bilingual children's vocabulary and story recall abilities in their 2 languages. METHOD: Participants included 191 Latino families and their children, who averaged 59 months of age. Data on parental characteristics and children's exposure to and usage of Spanish and English were collected. The authors assessed children's Spanish and English vocabulary and story recall abilities using subtests of the Woodcock-Muñoz Language Survey-Revised ( Woodcock, Muñoz-Sandoval, Ruef, & Alvarado, 2005). RESULTS: Sizeable percentages of variation in children's English (R2 = .61) and Spanish (R2 = .55) vocabulary scores were explained by children's exposure to, and usage of, each language and maternal characteristics. Similarly, variations in children's story recall scores in English (R2 = .38) and Spanish (R2 = .19) were also explained by the factors considered in this investigation. However, the authors found that different sets of factors in each category affected children's vocabulary and story recall abilities in each language. CONCLUSIONS: Children's exposure to and usage of their two languages as well as maternal characteristics play significant roles in bilingual individuals' language development. The results highlight the importance of gathering detailed sociolinguistic information about bilingual children when these children are involved in research and when they enter the educational system.

Classification accuracy of brief parent report measures of language development in Spanish-speaking toddlers.

PURPOSE: The purpose of the current study was to examine the concurrent validity and classification accuracy of 3 parent report measures of language development in Spanish-speaking toddlers. METHOD: Forty-five Spanish-speaking parents and their 2-year-old children participated. Twenty-three children had expressive language delays (ELDs) as determined through multiple sources of information, and 22 had typical language development (TD). Parents completed the Spanish version of the Ages and Stages Questionnaire (Spanish ASQ; Squires, Potter, & Bricker, 1999) and the short-form of the Inventarios del Desarrollo de Habilidades Comunicativas Palabras y Enunciados (INV-II; Jackson-Maldonado, Bates, & Thal, 1992; Jackson-Maldonado et al., 2003), which is the Spanish version of the MacArthur-Bates Communicative Development Inventories Words and Sentences form, and reported children's 3 longest utterances (M3L-W). Children were administered the Preschool Language Scale, Fourth Edition, Spanish Edition (SPLS-4; Zimmerman, Steiner, & Pond, 2002) at early childhood centers. RESULTS: All 3 parent report measures were significantly correlated with the SPLS-4, establishing their concurrent validity. Children with ELDs scored significantly lower than TD children on all 3 parent report measures. The Spanish ASQ demonstrated less than desirable levels of sensitivity and specificity; both the short-form INV-II and M3L-W measures demonstrated favorable sensitivity and specificity. Of these measures, M3L-W demonstrated the strongest classification accuracy qualities, including sensitivity, negative predictive value, and area under the receiver operating characteristics curve. CONCLUSION: The short-form INV-II and M3L-W demonstrated highly satisfactory classification accuracy of ELDs, but M3L-W demonstrated slightly stronger accuracy. These results indicate that these measures may be useful in screening for ELDs in Spanish-speaking toddlers.

Measurement properties and classification accuracy of two spanish parent surveys of language development for preschool-age children.

PURPOSE: To describe the concurrent validity and classification accuracy of 2 Spanish parent surveys of language development, the Spanish Ages and Stages Questionnaire (ASQ; Squires, Potter, & Bricker, 1999) and the Pilot Inventario-III (Pilot INV-III; Guiberson, 2008a). METHOD: Forty-eight Spanish-speaking parents of preschool-age children participated. Twenty-two children had expressive language delays, and 26 had typical language development. The parents completed the Spanish ASQ and the Pilot INV-III at home, and the Preschool Language Scale, Fourth Edition: Spanish Edition (PLS-4 Spanish; Zimmerman, Steiner, & Pond, 2002) was administered to the children at preschool centers. RESULTS: The Spanish ASQ and Pilot INV-III were significantly correlated with the PLS-4 Spanish, establishing concurrent validity. On both surveys, children with expressive language delays scored significantly lower than children with typical development. The Spanish ASQ demonstrated unacceptably low sensitivity (59%) and good specificity (92%), while the Pilot INV-III demonstrated fair sensitivity (82%) and specificity (81%). Likelihood ratios and posttest probability revealed that the Pilot INV-III may assist in detection of expressive language delays, but viewed alone it is insufficient to make an unconditional screening determination. CONCLUSIONS: Results suggest that Spanish parent surveys hold promise for screening language delay in Spanish-speaking preschool children; however, further refinement of these tools is needed.

Mexican American mothers of low and middle socioeconomic status: communication behaviors and interactive strategies during shared book reading.

PURPOSE: The aim of this investigation was to describe and compare the communication behaviors and interactive reading strategies used by Mexican American mothers of low- and middle-socioeconomic status (SES) background during shared book reading. METHOD: Twenty Mexican American mother-child dyads from the Southwestern United States were observed during two book reading sessions. The data were coded across a number of communication behavior categories and were analyzed using the Adult/Child Interactive Reading Inventory (ACIRI; A. DeBruin-Parecki, 1999). RESULTS: Mexican American mothers used a variety of communication behaviors during shared book reading with their preschool children. Significant differences between the SES groups regarding the frequency of specific communication behaviors were revealed. Middle-SES mothers used positive feedback and yes/no questions more often than did low-SES mothers. Mexican American mothers also used a variety of interactive reading strategies with varying frequency, as measured by the ACIRI. They enhanced attention to text some of the time, but rarely promoted interactive reading/supported comprehension or used literacy strategies. There were no significant differences between the SES groups regarding the frequency of interactive reading strategies. CONCLUSION: Parent literacy programs should supplement Mexican American mothers' communication behaviors and interactive reading strategies to improve effectiveness and participation.

Parent Reading Belief Inventory: Reliability and Validity With a Sample of Mexican American Mothers.

RESEARCH FINDINGS: The purpose of the current study was to (a) evaluate the internal consistency of the 7 scales of the Parent Reading Belief Inventory (PRBI), (b) assess the factor structure, and (c) examine concurrent validity in a sample of Mexican American mothers from low-income homes. Two hundred and seventy-four mothers of preschool children completed the PRBI and the Home Literacy Activities Questionnaire. Five of the seven scales demonstrated adequate internal consistency. Principal component and parallel analyses revealed that one component provided the best summary of the observed variables. Preliminary evidence of concurrent validity was revealed. PRACTICE OR POLICY: Future qualitative research is needed to explore mothers' interpretations of the items and to examine modifications to the PRBI.

Puerto Rican mothers' beliefs and home literacy practices.

PURPOSE: The aims of this investigation were to examine the parenting beliefs and literacy practices of mothers of Puerto Rican descent and to determine if relationships existed between the mothers' beliefs and practices. METHOD: Eighty-one mothers of bilingual children who attended Head Start programs participated in the project. As part of a larger project, the children were divided into 2 groups depending on the timing of when they were exposed to English. Children who were exposed to Spanish and English from birth were classified as having home English communication (HEC); children who were not expected to communicate in English until age 3 when they entered Head Start were classified as having school English communication (SEC). Trained home visitors used questionnaires to collect information from the mothers on their background, beliefs about parenting and education, and home literacy practices. RESULTS: The results revealed that Puerto Rican mothers held both traditional and progressive beliefs. Additionally, differences between the mothers of children in the HEC and SEC groups were observed on some of the measures of beliefs and practices. Relationships between beliefs and practices were not observed. IMPLICATIONS: The findings demonstrated that Puerto Rican mothers integrated aspects of both the Puerto Rican culture and the mainstream culture of the U.S. mainland into their views concering child rearing and education. Implications for practice are discussed.

La quinina y sus congéneres. Interacciones y reacciones adversas de importancia clínica / Quinine and its congenerous. Clinically important interactions and adverse drug reactions

Muy a pesar de la existencia de variados grupos de fármacos antimaláricos, en muchas partes del mundo continúan siendo fármacos de primera línea para el tratamiento de la malaria o paludismo la Quinina y sus congéneres. Dado que esta patología es capaz de afectar al ser humano expuesto en cualquier etapa de la vida, la posibilidad de interacción de los fármacos antimaláricos conjuntamente con cualquier otro tipo de medicación, ya por la presencia en el paciente afecto de malaria, de alguna otra patología, sea esta de carácter agudo o crónico, nos motivaron a la ejecución de la presente revisión, sumándole a ello además variadas reacciones adversas de importancia clínica. En lo que respecta al embarazo y lactancia podemos considerar que, en general, la mayoría de estos antimaláricos son seguros y eficaces durante el embarazo, no constituyendo este estado fisiológico una contraindicación absoluta para su empleo, sin embargo, debe valorarse en cada caso la relación riesgo/beneficio.

La quinina y sus congéneres: interacciones y reacciones adversas de importancia clínica / Quinine and its congenerous: clinically important interactions and adverse drug reactions

Muy a pesar de la existencia de variados grupos de fármacos antimaláricos, en muchas partes del mundo continúan siendo fármacos de primera línea para el tratamiento de la malaria o paludismo la Quinina y sus congéneres. Dado que esta patología es capaz de afectar al ser humano expuesto en cualquier etapa de la vida, la posibilidad de interacción de los fármacos antimaláricos conjuntamente con cualquier otro tipo de medicación, ya por la presencia en el paciente afecto de malaria, de alguna otra patología, sea esta de carácter agudo o crónico, nos motivaron a la ejecución de la presente revisión, sumándole a ello además variadas reacciones adversas de importancia clínica. En lo que respecta al embarazo y lactancia podemos considerar que, en general, la mayoría de estos antimaláricos son seguros y eficaces durante el embarazo, no constituyendo este estado fisiológico una contraindicación absoluta para su empleo, sin embargo, debe valorarse en cada caso la relación riesgo/beneficio(AU)

Despite the existence of varied groups of antimalarial drugs, Quinine and its structural similarities keep on being first line drugs in the treatment of malaria in most parts of the world. Becausethis disease can affect human beings at any time in life and there is also a real possibility of antimalarial drug interaction with other kinds of medication, adding up clinically important varied adverse drug reactions. These issues led the authors into the current bibliographic investigation. Regarding pregnancy and breast feeding it is considered that most of antimalarial drugs are safe with less potential harm during this physiological state. Pregnancy is not an absolute contraindication in using such drugs. However in each patient the relationshiprisk/benefit should be assessed(AU)