Frequência de fatores de risco para dificuldade de aprendizagem em pré-escolares com baixo nível socioeconômico, na Cidade do México

The objective was to identify the frequency of risk factors for Learning Disabilities (LD) in low socioeconomic level children in Mexico City. We studied children by means of: Wechsler, Bender-Gestalt, and Human drawing tests. Average age of male subjects was 5.6±0.9 years, while that of the female group was 5.4±0.5 years. In male subjects, average Total intelligence quotient (T-IQ) score was 98±12.2 while, in the female group, this was 99±12.2. On the Bender-Gestalt test, male subjects had a mental and visual-motor average age ofNuestro objetivo fue identificar la frecuencia de factores de riesgo para problemas de aprendizaje (PA) en niños de bajo nivel socioeconómico de la Ciudad de México. Se utilizaron las pruebas de inteligencia de Wechsler, Gestáltica Visuomotora de Bender y del Dibujo de la figura humana. La edad promedio en el grupo masculino fue 5,6±0,9 años, del femenino fue 5,4±0,5. En los hombres, el cociente intelectual total (CI-T) fue 98±12,2, en mujeres fue 99±12,2. En la prueba de Bender, los hombres mostraron una edad mental y visuomotora un año menor que la cronológica, las mujeres tuvieron una edad mental y visuomotora 7-8 meses por debajo de la norma. En la Prueba de la figura humana, los hombres y mujeres mostraron mayor frecuencia de: auto-aislamiento 25%, timidez 22,4% y controles internos pobres 22%. En conclusión encontramos una alta frecuencia de factores de riesgo en preescolares de bajo nivel socioeconómico, destacamos la importancia de identificar a los preescolares propensos a tener problemas de aprendizaje (PA).Este estudo objetivou identificar a frequência de fatores de risco para dificuldade de aprendizagem (DA) em crianças com baixo nível socioeconômico, na Cidade do México. A escala de inteligência Wechsler, desenho da figura humana e o teste gestáltico visomotor de Bender foram utilizados. A idade média do grupo masculino foi de 5,6±0,9 anos e do grupo feminino 5,4±0,5 anos. O quociente intelectual total (QI-T) foi de 98±12 no grupo masculino e 99±12,2 no grupo feminino. No teste de Bender, os meninos apresentaram idade mental e visomotora um ano abaixo da idade cronológica, enquanto que as meninas apresentaram idade mental e visomotora 7-8 meses abaixo do normal. As características de alto risco que apresentaram maior frequência, tanto nos meninos como nas meninas, no teste do desenho de figura humana, foram: autoisolamento 25%, timidez 22,4 e controle interno deficiente 22%. Concluindo, alta frequência de fatores de risco para DA foi encontrada em crianças de baixo nível socioeconômico. É importante destacar a importância de se identificar pré-escolares em risco de DA

Clinical Study Hearing and Neurological Impairment in Children with History of Exchange Transfusion for Neonatal Hyperbilirubinemia

The objective was to determine frequency of sensorineural hearing loss (SNHL), identified by abnormal threshold in evoked potentials, absence of otoacoustic emissions and behavioral responses, auditory neuropathy (AN) (absence of evoked potentials, with preservation of otoacoustic emissions), and neurological comorbidity in infants with hyperbilirubinemia (HB) treated with exchange-transfusion (ET). From a total of 7,219 infants, ET was performed on 336 (4.6%). Inclusion criteria were fulfilled in 102; 234 children did not meet criteria (182 outside of the study period, 34 did not have complete audiological evaluation, and 18 rejected the followup). Thirty-five children (34%) were born at-term and 67 (66%) were preterm. Children had a mean age of 5.5 ± 3.9 years. Main causes of ET were Rh isoimmunization in 48 (47%), ABO incompatibility in 28 (27.5%), and multifactorial causes in 26 (25.5%). Fifteen (15%) children presented with SNHL. Preterm newborns presented more often with SNHL. Indirect bilirubin level was higher in children with SNHL (22.2 versus 18.7 mg/dL, = 0.02). No cases of AN were documented. An increased risk of neurologic sequelae was observed in children with SNHL. In conclusion, we disclosed a high frequency of SNHL in children with neonatal HB and ET and neurological alterations. No cases of AN were observed

Characterization of cyclic alternating pattern in infants with laryngomalacia

Objective: Cyclic alternanting pattern (CAP) has been considered a marker of sleep instability in children. The aim of this study was to evaluate the CAP in infants with laryngomalacia. Material and Methods: CAP were quantified in 15 infants with laryngomalacia (mean age 167.2±97.21 days) and 10 controls (mean age of 158.5±116.2 days) using polysomnography. Results: The distribution of the A2 subtypes across NREM stages in infants with laryngomalacia showed a decrease, as well as in the mean duration of CAP sequences. The A3 CAP and arousals increased in infants with laryngomalacia. Our data showed a stronger correlation between the mean duration of A1 CAP and the age in healthy controls than in infants with laryngomalacia. In accordance to previous reports infants with laryngomalacia exhibited an increase in total awake time, apnea-hypopnea index, and a decrease in N3 stage compared to controls. Discussion: Our findings add to a growing body of literature of CAP as an indicator of brain maturatio