Hidden Hearing Loss, Cochlear Synaptopathy and Occupational Noise / Pérdida Auditiva Oculta, Sinaptopatía Coclear y Ruido Ocupacional

Introducción: La sinaptopatía coclear por exposición a ruido (SCER) es definida como una alteración funcional transitoria o permanente de las sinapsis en cinta de las células pilosas internas de la cóclea. Este artículo tiene el objetivo de comentar la utilidad de la identificación temprana de la pérdida auditiva oculta por SCER basado en marcadores audiológicos y en la metodología usada en grupos clínicos para su búsqueda.Método: Revisión de la literatura relacionada en bases científicas y la narración descriptiva de los resultados.Resultados: La SCER produce una pérdida auditiva oculta en pacientes con audiograma normal, principalmente obreros o individuos expuestos a niveles de ruido intenso. Los principales estudios de identificación de la SCER han sido realizados principalmente en estudiantes universitarios o en músicos.Conclusiones: Son necesarios ajustes en la política de salud auditiva para una amplia identificación temprana de la SCER en las poblaciones en riesgo para la pérdida auditiva oculta y luchar por una regulación del daño. (AU)

Introduction: Cochlear synaptopathy after noise exposure (CSNE) is defined as the transient or permanent func-tional damage to the ribbon synapsis of the inner hair cells of the cochlea. This article has the objective of comment the usefulness of early identification of the hidden hearing loss after CSNE based on audiological markers and in changes in the clinical methodology in clinical groups for its searching.Method: Review of related literature in scientific databases and narrative description of results.Results: CSNE results in a hidden hearing loss in patients with normal pitch audiogram, mainly workers or indi-viduals exposed to high noise levels. The main studies of identification have been performed mainly in groups of students from college or musicians.Conclusions: Is necessary adjustments in hearing health policy for an wide early identification of CSNE in at risk populations for the identification of the hidden hearing loss and fight for its damage regulation. (AU)

Hidden Hearing Loss, Cochlear Synaptopathy and Occupational Noise / Pérdida Auditiva Oculta, Sinaptopatía Coclear y Ruido Ocupacional

Introducción: La sinaptopatía coclear por exposición a ruido (SCER) es definida como una alteración funcional transitoria o permanente de las sinapsis en cinta de las células pilosas internas de la cóclea. Este artículo tiene el objetivo de comentar la utilidad de la identificación temprana de la pérdida auditiva oculta por SCER basado en marcadores audiológicos y en la metodología usada en grupos clínicos para su búsqueda.Método: Revisión de la literatura relacionada en bases científicas y la narración descriptiva de los resultados.Resultados: La SCER produce una pérdida auditiva oculta en pacientes con audiograma normal, principalmente obreros o individuos expuestos a niveles de ruido intenso. Los principales estudios de identificación de la SCER han sido realizados principalmente en estudiantes universitarios o en músicos.Conclusiones: Son necesarios ajustes en la política de salud auditiva para una amplia identificación temprana de la SCER en las poblaciones en riesgo para la pérdida auditiva oculta y luchar por una regulación del daño (AU)

Introduction: Cochlear synaptopathy after noise exposure (CSNE) is defined as the transient or permanent func-tional damage to the ribbon synapsis of the inner hair cells of the cochlea. This article has the objective of comment the usefulness of early identification of the hidden hearing loss after CSNE based on audiological markers and in changes in the clinical methodology in clinical groups for its searching.Method: Review of related literature in scientific databases and narrative description of results.Results: CSNE results in a hidden hearing loss in patients with normal pitch audiogram, mainly workers or indi-viduals exposed to high noise levels. The main studies of identification have been performed mainly in groups of students from college or musicians.Conclusions: Is necessary adjustments in hearing health policy for an wide early identification of CSNE in at risk populations for the identification of the hidden hearing loss and fight for its damage regulation (AU)

Seguimiento de egresados de la especialidad en Medicina Familiar y el grado de satisfacción de sus empleadores / Follow-Up of Family Medicine Graduates and Degree of Satisfaction of Their Employers

Introducción: el proceso de globalización de la atención a la salud, la educación, la tecnología y las nuevas formas de organización del trabajo, exigen a los países generar mecanismos de evaluación a sus sistemas educativos. Objetivo: conocer el nivel de satisfacción de los empleadores de unidades médicas con relación al desempeño profesional de los médicos egresados Programa de especialización en medicina familiar para médicos generales del Instituto Mexicano del Seguro Social, de la Facultad de Medicina de la Universidad Nacional Autónoma de México. Métodos: estudio observacional, descriptivo y transversal. Se aplicó un cuestionario por profesores de la Subdivisión de Medicina Familiar, de la Facultad de Medicina de la Universidad Nacional Autónoma de México, que constó de 10 preguntas dirigidas a los directivos de las unidades médicas donde trabajaban (antes y después de la especialización), los egresados del Programa de Especialización en Medicina Familiar para Médicos Generales, relacionadas con el grado de satisfacción de las autoridades con el trabajo desempeñado por los médicos egresados de la especialización bajo la modalidad de capacitación en servicio. Resultados: los resultados generales muestran alta satisfacción de los directivos en cuanto al desempeño profesional de los médicos egresados. Conclusiones: para los empleadores, de Especialización en Medicina Familiar para Médicos Generales, produce una alta satisfacción el desempeño profesional de los egresados(AU)

Objective: Know the level of satisfaction of medical units' employers with respect to professional performance of family medicine graduates from the specialization programs for general practitioner of the Mexican social-security, Medical Faculty Institute of the Autonomous National University from Mexico. Methods: An observational, descriptive study was conducted at the Faculty of Medicine of the National Autonomous University of Mexico. A questionnaire of 10 questions was applied to managers of medical units, related to the satisfaction of the authorities with the work performed by doctors specializing graduates in the form of in-service training where graduates worked, before and after specialization, within the specialization program in Family Medicine for General Practitioners. Results: The general results evidence high satisfaction of the executives as to the professional performance of the graduate doctors. Conclusions: High satisfaction is produced by the professional performance of Family Medicine graduates, to the employers(AU)

Sound localization and word discrimination in reverberant environment in children with developmental dyslexia.

OBJECTIVE: Compare if localization of sounds and words discrimination in reverberant environment is different between children with dyslexia and controls. METHOD: We studied 30 children with dyslexia and 30 controls. Sound and word localization and discrimination was studied in five angles from left to right auditory fields (-90o, -45o, 0o, +45o, +90o), under reverberant and no-reverberant conditions; correct answers were compared. RESULTS: Spatial location of words in no-reverberant test was deficient in children with dyslexia at 0º and +90o. Spatial location for reverberant test was altered in children with dyslexia at all angles, except –-90o. Word discrimination in no-reverberant test in children with dyslexia had a poor performance at left angles. In reverberant test, children with dyslexia exhibited deficiencies at -45o, -90o, and +45o angles. CONCLUSION: Children with dyslexia could had problems when have to locate sound, and discriminate words in extreme locations of the horizontal plane in classrooms with reverberation.

Sound localization and word discrimination in reverberant environment in children with developmental dyslexia / Localización sonora y discriminación de palabras en ambientes reverberantes en niños con dislexia del desarrollo

Objective Compare if localization of sounds and words discrimination in reverberant environment is different between children with dyslexia and controls. Method We studied 30 children with dyslexia and 30 controls. Sound and word localization and discrimination was studied in five angles from left to right auditory fields (-90o, -45o, 0o, +45o, +90o), under reverberant and no-reverberant conditions; correct answers were compared. Results Spatial location of words in no-reverberant test was deficient in children with dyslexia at 0º and +90o. Spatial location for reverberant test was altered in children with dyslexia at all angles, except –-90o. Word discrimination in no-reverberant test in children with dyslexia had a poor performance at left angles. In reverberant test, children with dyslexia exhibited deficiencies at -45o, -90o, and +45o angles. Conclusion Children with dyslexia could had problems when have to locate sound, and discriminate words in extreme locations of the horizontal plane in classrooms with reverberation. .

Objetivo Comparar localización de sonidos y localización-discriminación de palabras bajo reverberación y sin reverberación en niños disléxicos y controles. Método Estudiamos 30 niños disléxicos y 30 controles, pareados por edad. La localización sonora y discriminación a palabras fue estudiada en cinco ángulos horizontales en los campos izquierdo y derecho (-90o, -45o, 0o, +45o, +90o), bajo reverberación y sin reverberación; las respuestas correctas fueron comparadas Resultados: La localización sonora sin reverberación fue deficiente en niños disléxicos a 0º y +90º. La localización bajo reverberación falló en niños disléxicos en todos los ángulos, excepto –-90o. Durante la discriminación a palabras, sin reverberación, los niños disléxicos fallaron en ángulos izquierdos. En la prueba reverberante, los niños disléxicos fallaron a -–45o, -90o y +45o. Conclusion Los niños con dislexia pueden tener problemas cuando tienen que localizar sonidos y discriminar palabras en las localizaciones extremas del plano horizontal en salones de clases típicos con reverberación. .

Right cerebral hemisphere and central auditory processing in children with developmental dyslexia / El hemisferio cerebral derecho y el procesamiento auditivo central en ninos con dislexia del desarrollo

Objective We hypothesized that if the right hemisphere auditory processing abilities can be altered in children with developmental dyslexia (DD), we can detect dysfunction using specific tests. Method We performed an analytical comparative cross-sectional study. We studied 20 right-handed children with DD and 20 healthy right-handed control subjects (CS). Children in both groups were age, gender, and school-grade matched. Focusing on the right hemisphere’s contribution, we utilized tests to measure alterations in central auditory processing (CAP), such as determination of frequency patterns; sound duration; music pitch recognition; and identification of environmental sounds. We compared results among the two groups. Results Children with DD showed lower performance than CS in all CAP subtests, including those that preferentially engaged the cerebral right hemisphere. Conclusion Our data suggests a significant contribution of the right hemisphere in alterations of CAP in children with DD. Thus, right hemisphere CAP must be considered for examination and rehabilitation of children with DD. .

Objectivo Examinamos si las habilidades del procesamiento auditivo central (PAC) del hemisferio derecho se encuentran alteradas en niños con dislexia del desarrollo (DD), por medio de pruebas específicas. Método Realizamos un estudio comparativo transversal. Estudiamos 20 niños diestros con DD y 20 niños controles (C) sanos. Los niños de ambos grupos fueron pareados por edad, género y grado escolar. Utilizamos varias pruebas para medir alteraciones del PAC, tales como: determinación de patrones de frecuencia; duración del sonido; reconocimiento de tono musical e identificación de sonidos ambientales, enfatizando la contribución del hemisferio derecho. Comparamos los resultados entre los niños con DD y C. Resultados Los niños con DD mostraron menores puntuaciones que los C en todas las subpruebas del PAC, incluyendo aquellas que involucran preferencialmente al hemisferio cerebral derecho. Conclusión Los datos obtenidos sugieren una contribución significativa del hemisferio derecho para producir alteraciones del PAC en niños con DD. Por lo tanto, las PAC que involucran al hemisferio derecho deben ser consideradas en la evaluación y rehabilitación de niño s con DD. .

Right cerebral hemisphere and central auditory processing in children with developmental dyslexia.

OBJECTIVE: We hypothesized that if the right hemisphere auditory processing abilities can be altered in children with developmental dyslexia (DD), we can detect dysfunction using specific tests. METHOD: We performed an analytical comparative cross-sectional study. We studied 20 right-handed children with DD and 20 healthy right-handed control subjects (CS). Children in both groups were age, gender, and school-grade matched. Focusing on the right hemisphere's contribution, we utilized tests to measure alterations in central auditory processing (CAP), such as determination of frequency patterns; sound duration; music pitch recognition; and identification of environmental sounds. We compared results among the two groups. RESULTS: Children with DD showed lower performance than CS in all CAP subtests, including those that preferentially engaged the cerebral right hemisphere. CONCLUSION: Our data suggests a significant contribution of the right hemisphere in alterations of CAP in children with DD. Thus, right hemisphere CAP must be considered for examination and rehabilitation of children with DD.

Evaluación de procesos centrales de la audición con pruebas psicoacústicas en niños normales / Central auditory processes evaluated with psychoacoustic tests in normal children

Objetivo: Identificar las tendencias naturales de aciertos y calcular el punto de corte para 6 pruebas de procesos centrales de la audición (PCA): fusión binaural, palabra filtrada, dígitos dicóticos, patrones de frecuencia y patrones de duración y sonidos ambientales en el niño de 5, 7, 9 y 11 años de edad. Material y método: Se evaluaron 369 niños de la escuela pública urbana del Estado de Puebla con 6 pruebas de PCA, dos binaurales y 4 monoaurales; utilizando un audiómetro Madsen a 50dB SL re/umbral en 1 kHz, por medio de disco grabado en el Centro de Ciencias Aplicadas y Desarrollo Tecnológico de la Universidad Nacional Autónoma de México e Instituto Nacional de Rehabilitación. Resultados: Se determinaron los puntos de corte para las 6 pruebas incluidas y se determinó que tres pruebas son útiles. Adicionalmente los resultados obtenidos en niños de 11 años difirieron de los obtenidos en niños de menos de 11 años. Conclusión: Los resultados significan un avance en los criterios normativos en materia de las pruebas psicoacústicas para PCA en español y en un contexto socioeducativo frecuente en el país. Se requiere evaluar estos resultados frente a condiciones de trastornos en PCA (AU)

Objective: To identify the natural tendencies of hits and calculate the cut-off for a test group of central auditory processes (CAP): binaural fusion, filtered words, dichotic digits, frequency patterns and duration patterns, and ambient sounds in normal 5-, 7-, 9-, and 11-year-old children. Material and methods: We studied 369 children (738 ears) who attend public schools in Puebla City, administering 6 CAP tests (2 binaural and 4 monaural); we used an audiometer at 50dB SL re-threshold at 1kHz, from a CD recorded at the CCECADET-UNAM-INR (Centre for Applied Science and Technological Development at the National Autonomous University of Mexico and the National Institute for Rehabilitation). Results: We determined the cut-off points for the 6 tests. Conclusion: This information represents an advance in the normative standards in the field of psychoacoustic tests for CAP in Spanish and in the socio-educational context prevalent in Mexico. It is important to evaluate these results against CAP disorders (AU)

[Central auditory processes evaluated with psychoacoustic tests in normal children]. / Evaluación de procesos centrales de la audición con pruebas psicoacústicas en niños normales.

OBJECTIVE: To identify the natural tendencies of hits and calculate the cutoff for a test group of central auditory processes (CAP): binaural fusion, filtered words, dichotic digits, frequency patterns and duration patterns and ambient sounds in normal 5-, 7-, 9- and 11-year-old children. MATERIAL AND METHODS: We studied 369 children (738 ears) who attend public schools in Puebla City, administering 6 CAP tests (two binaural and four monaural); we used an audiometer at 50dB SL re-threshold at 1 kHz, from a CD recorded at the CCECADET-UNAM-INR (Centre for Applied Science and Technological Development at the National Autonomous University of Mexico and the National Institute for Rehabilitation). RESULTS: We determined the cutoff points for the six tests. CONCLUSION: This information represents an advance in the normative standards in the field of psychoacoustic tests for CAP in Spanish and in the socio-educational context prevalent in Mexico. It is important to evaluate these results against CAP disorders.

Procesos centrales de la audición evaluados en español en escolares con dislexia y controles. Pruebas de fusión binaural y de palabras filtradas / Assessment of central auditory processes in evaluated in Spanish in children with dyslexia and controls. Binaural Fusion Test and Filtered Word Test

Objetivo: El objetivo es evaluar la habilidad para distinguir palabras usando dos pruebas psicoacústicas verbales de procesos centrales de la audición (PCA) en español: la prueba de fusión binaural (PFB) y la prueba de palabra filtrada (PPF), en niños con dislexia y en niños controles. Métodos: Cuarenta niños con dislexia seleccionados de grupos de terapia y 40 niños seleccionados de 298 niños de una escuela pública como controles, pareados por sexo y edad. Resultados: Hubo predominio masculino 2/l en los niños disléxicos. Los promedios de acierto para la PFB fueron del 65 al 66% para los niños con dislexia y del 78 al 80% para los niños control. Para la PPF éstos fueron del 50 al 55% para los niños con dislexia y del 67 al 71% para los controles (t de Student <0,05). Conclusiones: Estos resultados contribuyen a evidenciar alteraciones de los PCA para estímulos psicoacústicos verbales en niños con dislexia. Se propone evaluar cada paciente con pruebas de PCA para definir el plan de rehabilitación (AU)

Objectives: The aim is to assess the ability to discriminate words, using two psychoacoustic verbal tests of Central auditory processes in Spanish: Binaural Fusion Test (BFT in its Spanish version) and Filtered Word Test (FWT in its Spanish version) in children with dyslexia and controls. Methods: One group of 40 dyslexic children was receiving therapy for dyslexia at the time of the tests. 40 children without dyslexia were selected as controls, out of 298 children who attended a public school. Results: The rate of males to females was 2/1 in the dyslexic group. The average correct answers for the BFT were 65–66% in dyslexic group and 75–80% in the control group. For the FWT they were 50–54% in the dyslexic group and 67–71% in the control group (student t <0.05). Conclusions: These results contribute to make evident disorders in central auditory processing in children with dyslexia. We suggest using the tests with each patient in order to elaborate a rehabilitation plan (AU)

[Assessment of central auditory processes in Spanish in children with dyslexia and controls. Binaural Fusion Test and Filtered Word Test]. / Procesos centrales de la audición evaluados en español en escolares con dislexia y controles. Pruebas de fusión binaural y de palabras filtradas.

OBJECTIVES: The aim is to assess the ability to discriminate words, using two psychoacoustic verbal tests of central auditory processes in Spanish: Binaural Fusion Test (BFT in its Spanish version) and Filtered Word Test (FWT in its Spanish version) in children with dyslexia and controls. METHODS: One group of 40 dyslexic children was receiving therapy for dyslexia at the time of the tests. 40 children without dyslexia were selected as controls, out of 298 children who attended a public school. RESULTS: The rate of males to females was 2/1 in the dyslexic group. The average correct answers for the BFT were 65-66% in dyslexic group and 75-80% in the control group. For the FWT they were 50-54% in the dyslexic group and 67-71% in the control group (student t <0.05). CONCLUSIONS: These results contribute to make evident disorders in central auditory processing in children with dyslexia. We suggest using the tests with each patient in order to elaborate a rehabilitation plan.

[Auditory and corporal laterality, logoaudiometry, and monaural hearing aid gain]. / Lateralidad auditiva y corporal, logoaudiometría y ganancia del audífono monoaural. Aplicación en hipoacusia bilateral simétrica.

INTRODUCTION AND OBJECTIVE: To identify the auditory or clinical test that has the best correlation with the ear in which we apply the monaural hearing aid in symmetric bilateral hearing loss. MATERIAL AND METHOD: A total of 37 adult patients with symmetric bilateral hearing loss were examined regarding the correlation between the best score in speech discrimination test, corporal laterality, auditory laterality with dichotic digits in Spanish and score for filtered words with monaural hearing aid. RESULTS: The best correlation was obtained between auditory laterality and gain with hearing aid (0.940). CONCLUSIONS: The dichotic test for auditory laterality is a good tool for identifying the best ear in which to apply a monaural hearing aid. The results of this paper suggest the necessity to apply this test in patients before a hearing aid is indicated.

Lateralidad auditiva y corporal, logoaudiometría y ganancia del audífono monoaural. Aplicación en hipoacusia bilateral simétrica / Auditory and corporal laterality, logoaudiometry, and monaural hearing aid gain

Introducción y objetivo: Identificar la correlación de las pruebas audiológicas o clínicas respecto al lado en que se obtiene la mejor ganancia del auxiliar auditivo monoaural en hipoacusia bilateral simétrica. Material y método: Se examinó a 37 pacientes adultos con hipoacusia bilateral simétrica, respecto a la correlación entre la máxima captación fonémica de la logoaudiometría, la lateralidad corporal, la lateralidad auditiva con la prueba de dígitos dióticos en español, la utilidad social de la audición y la ganancia de auxiliares auditivos. Resultados: La correlación más alta se obtuvo para lateralidad auditiva respecto a la ganancia del audífono (0,940). Conclusiones: La prueba de dígitos dióticos para la lateralidad auditiva es útil para identificar el mejor oído para la aplicación monoaural de auxiliar auditivo en casos de hipoacusia bilateral simétrica. Este resultado es importante, ya que indica la necesidad de aplicar la prueba de lateralidad auditiva antes de indicar el uso de auxiliar auditivo

Introduction and objective: To identify the auditory or clinical test that has the best correlation with the ear in which we apply the monaural hearing aid in symmetric bilateral hearing loss. Material and method: A total of 37 adult patients with symmetric bilateral hearing loss were examined regarding the correlation between the best score in speech discrimination test, corporal laterality, auditory laterality with dichotic digits in Spanish and score for filtered words with monaural hearing aid. Results: The best correlation was obtained between auditory laterality and gain with hearing aid (0.940). Conclusions: The dichotic test for auditory laterality is a good tool for identifying the best ear in which to apply a monaural hearing aid. The results of this paper suggest the necessity to apply this test in patients before a hearing aid is indicated

Prevalence of migraine in Latin America.

OBJECTIVE: To determine the 1-year point prevalence of migraine among residents > or =15 years old in 12 Latin American urban communities, and record medical consultation preferences of the identified migraineurs. BACKGROUND: Prevalence of migraine with or without aura in Latin American urban communities has not been established by large-scale population studies. METHODS: A validated face-to-face interview questionnaire based on International Headache Society criteria was completed for all headache sufferers within selected households, in a cross-sectional study. The randomly selected populations were representative of urban communities from the six participating Latin American countries. The questionnaire used was identical in each of the six participating countries. RESULTS: Of the 8618 people available for screening, 62% reported headache and 2637 completed interview questionnaires. Age-adjusted 1-year prevalence of migraine with or without aura for each country was (female/male, %): Argentina 6.1/3.8, Brazil 17.4/7.8, Colombia 13.8/4.8, Ecuador 13.5/2.9, Mexico 12.1/3.9, and Venezuela 12.2/4.7. Migraine prevalence was highest in women aged 30 to 50 years. In the year prior to the study, 42% of individuals interviewed and identified with migraine reported consulting a health professional about their headaches, most frequently (14%) a general practitioner. No previous diagnosis of migraine was reported by 65% of individuals with headache. CONCLUSIONS: In agreement with previous epidemiologic reports, migraine is also a common disorder in Latin American urban communities and predominantly affects women aged 30 to 50 years. Consultation preferences are also similar to those of previous reports.

Clinical characteristics and patterns of medication use of migraneurs in Latin America from 12 cities in 6 countries.

OBJECTIVE: The objective of this study was to document the clinical characteristics of migraine and patterns of medication use in residents > or =15 years old in 12 Latin American urban communities. BACKGROUND: Few large-scale population studies have established the symptoms and disability associated with migraine with or without aura in Latin American urban communities or the pattern of medication use in these regions. METHODS: In this study, subjects in 12 urban communities, from 6 Latin American countries, were surveyed with a validated face-to-face interview questionnaire based on International Headache Society criteria for migraine. The questionnaire was completed during face-to-face interviews with headache sufferers within selected households and included questions about migraine symptoms, migraine-related disability, and the use of health-care resources and medications to treat migraines. RESULTS: Of the 8618 people available for screening, 62% suffered from headaches. Of individuals with migraine, 42% reported consulting a health-care professional about their headaches. Of the migraineurs, 94.2% reported moderate to severe pain. Associated symptoms of nausea or vomiting, photophobia, phonophobia, and osmophobia were common during migraine attacks in 30.3, 76.4, 85.1, and 47.7% of subjects, respectively. The majority of subjects suffered between one and eight migraines each month. Although no previous diagnosis of migraine was reported by 65% of headache sufferers, migraineurs lost an average of 8 days in the preceding 3 months in any of the following areas: school, work, household chores, and/or social, family, or leisure activities. The agents used most widely to treat migraine were paracetamol and salicylates, while nonsteroidal anti-inflammatory drugs, dypirone, and ergotamines were also commonly used. Medication use varied widely among countries, but was predominantly nonprescription. CONCLUSIONS: Migraine is a common disorder in Latin American urban communities imposing significant burden on individuals, families, and communities. The magnitude of the impact and the range of activities affected by migraine are similar to those of previous reports in other regions. The preponderance of nonprescription medications and the scarcity of migraine-specific triptans from the study findings are especially striking.

Motor control alteration in posturography in learning-disabled children.

BACKGROUND: Some authors have mentioned that intersensory integration is damaged in children with learning disabilities (LDs), and other investigators point to motor control alterations in the same patients. Thus, we decided to study these hypotheses by means of posturographic recordings. METHODS: A highly selected group of 27 children with LDs was compared with 27 children of control group without LDs. Patients and controls were placed on the Equitest equipment platform. Sensory organization tests evaluated different test conditions that systematically vary visual, vestibular, and foot somatosensory cues available to subjects while they attempt to maintain a stable, quiet stance. Movement coordination test involved sudden posterior and anterior translations of the patient support surface. RESULTS: No significant correlations between scholastics and posturographic performance were observed. No difference in the six conditions and in sensory organization ratios or in visual preference between both groups was disclosed. Motor control test on children with LDs showed significant higher values in latencies in averages of large translations. CONCLUSIONS: Our data suggest that vestibular-visual-somatosensory organization for posture control are not abnormal in children with LDs; instead, motor controls show higher latencies with large translation movements, which suggest abnormal rate and timing precision motor coordination.

Characteristics of specific reading disability in children from a neuropsychological clinic in Mexico City.

OBJECTIVE: This report describes the main clinical features associated with specific reading disability (RD) in a group of 778 school-age children studied in a Neuropsychological Clinic in Mexico City. MATERIAL AND METHODS: The study was performed retrospectively, using data abstracted from clinical records of subjects seen in 1995-1996. Children were mainly from low and middle economic strata and aged between 6 to 12 years. The following data were collected: age, gender, diagnosis, school grade, food intake, maternal complications during pregnancy, perinatal and postnatal neurological risk factors, and neurological signs and handedness. RESULTS: Subjects with RD had a mean age of 102.9 months, were predominantly male (male female ratio, 2:1). Among the study group, 49.1% of the children were diagnosed with RD of a visuo-sensory-motor type, and 75.1% were from early school years (1st to 3rd grades); 27.6% showed evidence of malnutrition. A previous history of language disorders (49.2%), and a high frequency of perinatal risk factors and neurological soft signs were also found. CONCLUSIONS: This study shows that variables such as gender, food intake, and genetic and neurological risk factors, were associated with reading disabilities in school children. The English version of this paper is available too at: http://www.insp.mx/salud/index.html.

Characteristics of specific reading disability in children from a neuropsychological clinic in Mexico City

OBJECTIVE: This report describes the main clinical features associated with specific reading disability (RD) in a group of 778 school-age children studied in a Neuropsychological Clinic in Mexico City. MATERIAL AND METHODS: The study was performed retrospectively, using data abstracted from clinical records of subjects seen in 1995-1996. Children were mainly from low and middle economic strata and aged between 6 to 12 years. The following data were collected: age, gender, diagnosis, school grade, food intake, maternal complications during pregnancy, perinatal and postnatal neurological risk factors, and neurological signs and handedness. RESULTS: Subjects with RD had a mean age of 102.9 months, were predominantly male (male female ratio, 2:1). Among the study group, 49.1 of the children were diagnosed with RD of a visuo-sensory-motor type, and 75.1 were from early school years (1st to 3rd grades); 27.6 showed evidence of malnutrition. A previous history of language disorders (49.2), and a high frequency of perinatal risk factors and neurological soft signs were also found. CONCLUSIONS: This study shows that variables such as gender, food intake, and genetic and neurological risk factors, were associated with reading disabilities in school children.

La sordera congénita en México / Congenital deafness in Mexico

Objetivo: contribuir a definir a la sordera congénita (SC) como problema de salud pública para actualizar sus políticas de prevención y control en México. Se discute su definición, etiología, diagnóstico y clasificación; así como la utilidad de los estudios sobre la respuesta acústica del tallo cerebral, emisiones otoacústicas y la audiometría en el diagnóstico del problema auditivo. Se comenta la información disponible sobre la frecuencia de la SC en México. En la experiencia clínica del Instituto Nacional de la Comunicación Humana al parecer el problema está en ascenso de acuerdo a un período estudiado de 5 años (37.2 vs 52 por ciento). La explotación de un grupo de sordomudos mexicanos en la ciudad de Nueva York, entre otros es comentada como ejemplo de la trascendencia social de la SC. Se comentan los resultados de algunos programas preventivos en otros países que han logrado coberturas de 95 por ciento de todos los recién nacidos y detectado a 100 por ciento de la SC, y otros que han evaluado el impacto de la inmunización contra la rubéola y la parotiditis en la disminución de la prevalencia de la SC. Se concluye que es conveniente completar la definición de la SC como problema de salud pública en México. Para lo cual es necesario promover, ejecutar y evaluar estudios epidemiológicos, cuyos resultados contribuyan a actualizar las políticas de salud y sus consecuentes programas en beneficio de las personas con SC en el país.

La atención médica de las enfermedades neurológicas por niveles en México / Medical practice for neurologic disease in Mexico: use of the levels of attention model

En este trabajo se revisan algunos de los logros y la problemática mundial de la atención médica. Se describen las causas de mortalidad, morbilidad y casos nuevos de las enfermedades de sistema nervioso en México para 1991; junto con algunos de los recursos humanos y materiales que dispone el país para atender las enfermedades en general; además se anotan los principales ordenamientos legales que permiten aprovechar los recursos disponibles para mejorar la salud de la población nacional. Se actualizan los parámetros para organizar la atención médica por niveles, en términos de calidad, costo y acceso. Se propone a la educación médica continua por niveles de atención de las enfermedades neurológicas, como una estrategia para mejorar la calidad y el costo de la atención médica en México