Linguagem na Síndrome de Down

Language is the area of behavior development in Down syndrome bearers that is most impaired when comparedto other areas such as cognitive, socio-affective and motor development. Factors that interfere with the acquisitionprocess and development of language ability are discussed, among them mechanical problems of speech, sensory defects andneurological alterations. Phonetic and phonological aspects are also described in search for better understanding of the relationshipbetween speech perception and production. Finally, the relationship between language and cognition, and how auditoryprocessing dysfunction can interfere with the development of these abilities are discussed.A linguagem é a área do desenvolvimento do comportamento das pessoas com síndrome de Down mais comprometida quando comparada ao de outras áreas como desenvolvimento cognitivo, sócio-afetivo e motor. Alguns fatores que interferem no processo de aquisição e desenvolvimento da habilidade de linguagem nestas pessoas são descritos, entre eles problemas mecânicos da fala, defeitos sensoriais e alterações neurológicas. Aspectos fonéticos e fonológicos são também descritos no intuito de buscar uma melhor compreensão da relação entre percepção e produção de fala. Finalmente, discute-se a relação entre linguagem e cognição e o quanto disfunções no processamento auditivo podem interferir no desenvolvimento destas habilidade

Comparação do uso do EEG convencional, EEG de amplitude integrada e EEG geodésico em neonatos prematuros : uma revisão sistemática

Métodos para avaliar a atividade cortical em neonatos têm grande importância na Medicina moderna, pois permitem a observação e avaliação de diversos aspectos clínicos, garantindo que a equipe de saúde tenha conhecimento sobre possíveis medidas de intervenção que possam ser necessárias no tratamento de recém-nascidos. Objetivo: Esta revisão sistemática tem como objetivo comparar as principais tecnologias disponíveis para a avaliação das funções cerebrais em neonatos: eletroencefalograma convencional (EEG), eletroencefalograma de amplitude integrada (aEEG) e eletroencefalograma da rede do sensor geodésico. Métodos: Os artigos foram selecionados em periódicos nacionais e internacionais, incluídos nas bases de dados eletrônicas Web of Science, LILACS, SciELO e Medline. Resultados: Foram encontrados 39 artigos de interesse entre 155 artigos. As análises indicaram que, em relação ao ambiente clínico, o uso associativo de EEG convencional e aEEG é altamente recomendado, pois permite a combinação de funções, facilitando, por exemplo, que um maior número de convulsões sub-clínicas seja detectado. Por outro lado, o uso do eletroencefalograma da rede do sensor geodésico seria de grande valor, uma vez que permite que uma grande quantidade de dados seja analisada. Conclusão: Essa análise pode ser útil em estudos e pesquisas relacionados a doenças e sintomas, como convulsões, um desafio atual para a neuromonitorização neonatal, bem como aspectos de desenvolvimento neurológico e estudos funcionais. No entanto, apesar de muitos avanços tecnológicos, a eletroencefalografia em recém-nascidos prematuros ainda é um desafio em todo o mundo e requer pesquisas e esforços mais robustos para a melhor assistência clínica neste estágio extremamente precoce da vida.The use of methods to evaluate cortical activity in neonates has great importance in modern medicine, as it allows the observation and evaluation of several clinical aspects, which guarantees that the health team has knowledge about possible intervention measures that may be necessary in the treatment of newborns. Objective: This systematic review aimed to compare the main technologies available for the evaluation of brain functions in neonates, among them: the conventional electroencephalogram (EEG), the amplitude-integrated electroencephalogram (aEEG) and the geodesic sensor net EEG. Methods: A search was conducted forarticles from national and international periodicals included in the Web of Science, LILACS, SciELO and Medline electronic databases. Results: The search found 39 among 155 articles of interest and the analyses indicated that, in the clinical environment, the use of both conventional EEG and aEEG is highly recommended, as the combination of their functions allows, for example, a greater number of subclinical seizures to be detected. Conversely, the use of a geodesic sensor net EEG could be of great value, as it allows a large amount of data to be analyzed. Conclusion: This analysis may be useful in studies and research related to diseases and symptoms, such as seizures, a current challenge for neonatal neuromonitoring, as well as aspects of neurological development and functional studies. However, despite many advances in technology, electroencephalography in preterm neonates remains a challenge worldwide and still requires more robust research and efforts towards the best clinical assistance in this extremely early stage of life

Lactancia materna exclusiva y factores asociados a su interrupción temprana : estudio comparativo entre 1999 y 2008

OBJETIVO: Analisar os indicadores do aleitamento materno exclusivo (AME) do Hospital Universitário de Brasília (HUB) nos anos de 1999 e 2008 e identificar fatores associados a sua interrupção precoce MÉTODOS: Estudo retrospectivo transversal com análise de prontuários de crianças atendidas nos anos 1999 e 2008 no Ambulatório de Pediatria, Crescimento e Desenvolvimento do HUB. A duração do AME foi dicotomizada em até quatro meses e quatro meses ou mais, estimando as razões de prevalência para o desmame precoce (AME<4 meses), utilizando-se um modelo de regressão de Poisson com variância robusta e o teste não paramétrico de Mann-Whitney para comparação do tempo de AME nos anos estudados. RESULTADOS: Foi analisado um total de 2.173 pacientes, 1.443 referentes ao ano de 1999 e 730 referentes ao ano de 2008. Observou-se um incremento de 110,7 para 123,6 dias na duração do AME de 2008 em relação a 1999 (p<0,0001). O desmame precoce foi 12,6% maior em mães com até sete anos de estudo do que em mães com 11 ou mais anos de estudo (p<0,05). Os demais fatores analisados não mostraram relação estatística com o desmame precoce. CONCLUSÕES: Assim como o encontrado nas capitais brasileiras e Distrito Federal, verificou-se incremento no que diz respeito à duração do AME, associado positivamente ao nível educacional materno mais elevado. Convém ressaltar, porém, que a duração observada no estudo ainda se encontra abaixo dos 180 dias recomendados pela Organização Mundial de Saúde.OBJECTIVE: To analyze the indicators of exclusive breastfeeding (EB) in Brasilia's University Hospital (BUH) during a 10-year interval and to verify associated factors to early weaning. METHODS: A retrospective cross-sectional study was conducted by chart review of children attending the Pediatric Clinic during 1999 and 2008. The duration of exclusive breastfeeding was categorized at four months and four months or more. Prevalence ratios for early weaning (EB<4 months) were estimated with a model of Poisson regression and robust variance. Non-parametric Mann-Whitney test was used to compare the exclusive breastfeeding duration in the studied years. RESULTS: Among 2,173 patients, 1,443 in 1999 and 730 in 2008. There was an increase from 110.7 to 123.6 days in the duration of EB. A significant association between maternal education and early weaning was shown, with a 12.6% higher prevalence in mothers with less than eight years of schooling compared to those with 11 or more years. No other associations were found in the study. CONCLUSIONS: Similarly to what was found in Brazilian capitals and Brasilia, there was an increase in the length of exclusive breastfeeding related to mother educational level. Nevertheless, the duration exclusive breastfeeding is still below the threshold of 180 days recommended by the World Health Organization.OBJETIVO: Analizar los indicadores de lactancia materna exclusiva (LME) del Hospital Universitario de Brasília (HUB) los años de 1999 y 2008 e identificar factores asociados a su interrupción temprana. MÉTODOS: Estudio retrospectivo transversal con análisis de prontuarios de niños atendidos en los años de 1999 y 2008 en el Ambulatorio de Pediatría, Crecimiento y Desarrollo del HUB. La duración del LME fue dicotomizada en hasta cuatro meses y cuatro meses o más, estimando las razones de prevalencia para el desmame precoz (LME<4 meses), utilizando un modelo de regresión de Poisson con variancia robusta y la prueba no paramétrica de Mann-Whitney para comparación del tiempo de LME en los años estudiados. RESULTADOS: Se analizó un total de 2.173 pacientes, siendo 1.443 referentes al año de 1999 y 730 al año de 2008. Se observó un incremento del 110,7 para 123,6 días en la duración del LME de 2008 respecto a 1999 (p<0,0001). El desmame temprano fue el 12,6% superior en madres con hasta siete años de estudio que en madres con 11 o más años de estudio (p<0,05). Los demás factores analizados no mostraron relación estadísticamente significativa con desmame temprano. CONCLUSIONES: Así como encontrado en las capitales brasileñas y Distrito Federal, se verificó incremento en lo que se refiere a la duración del LME, asociado positivamente al nivel educacional materno más elevado. Conviene subrayar, sin embargo, que la duración observada en el estudio todavía es inferior a los 180 días recomendados por la Organización Mundial de Salud

Panoramic snapshot of serum soluble mediator interplay in pregnant women with convalescent COVID-19: an exploratory study

IntroductionSARS-CoV-2 infection during pregnancy can induce changes in the maternal immune response, with effects on pregnancy outcome and offspring. This is a cross-sectional observational study designed to characterize the immunological status of pregnant women with convalescent COVID-19 at distinct pregnancy trimesters. The study focused on providing a clear snapshot of the interplay among serum soluble mediators.MethodsA sample of 141 pregnant women from all prenatal periods (1st, 2nd and 3rd trimesters) comprised patients with convalescent SARS-CoV-2 infection at 3-20 weeks after symptoms onset (COVID, n=89) and a control group of pre-pandemic non-infected pregnant women (HC, n=52). Chemokine, pro-inflammatory/regulatory cytokine and growth factor levels were quantified by a high-throughput microbeads array.ResultsIn the HC group, most serum soluble mediators progressively decreased towards the 2nd and 3rd trimesters of pregnancy, while higher chemokine, cytokine and growth factor levels were observed in the COVID patient group. Serum soluble mediator signatures and heatmap analysis pointed out that the major increase observed in the COVID group related to pro-inflammatory cytokines (IL-6, TNF-α, IL-12, IFN-γ and IL-17). A larger set of biomarkers displayed an increased COVID/HC ratio towards the 2nd (3x increase) and the 3rd (3x to 15x increase) trimesters. Integrative network analysis demonstrated that HC pregnancy evolves with decreasing connectivity between pairs of serum soluble mediators towards the 3rd trimester. Although the COVID group exhibited a similar profile, the number of connections was remarkably lower throughout the pregnancy. Meanwhile, IL-1Ra, IL-10 and GM-CSF presented a preserved number of correlations (≥5 strong correlations in HC and COVID), IL-17, FGF-basic and VEGF lost connectivity throughout the pregnancy. IL-6 and CXCL8 were included in a set of acquired attributes, named COVID-selective (≥5 strong correlations in COVID and &lt;5 in HC) observed at the 3rd pregnancy trimester.Discussion and conclusionFrom an overall perspective, a pronounced increase in serum levels of soluble mediators with decreased network interplay between them demonstrated an imbalanced immune response in convalescent COVID-19 infection during pregnancy that may contribute to the management of, or indeed recovery from, late complications in the post-symptomatic phase of the SARS-CoV-2 infection in pregnant women

Música e Cognição

O organização neural para a música e o comportamento musical humano tem sido alvo de inúmeras discussões nas áreas de neurociências e de arte musical. Perpetua-se a discussão sobre a existência ou não de módulos neurais para música ou se esta função é compartilhada com outras áreas. Este artigo traça um panorama sobre estas discussões e apresenta os resultados de alguns dos estudos mais relevantes nesta área que vêem sendo realizados nas últimas décadas e que buscam compreender os meios pelos quais o cérebro humano processa armazena e produz música, concluindo com uma breve comparação entre música e fala. Tais estudos têm como base, principalmente, os avanços na neurociência cognitiva, que podem auxiliar no esclarecimento sobre a relação música-cognição e o papel da educação musical no desenvolvimento cognitivo. © Ciências & Cognição 2006; Vol. 09

Comparison of conventional, amplitude-integrated and geodesic sensor net EEG used in premature neonates: a systematic review

ABSTRACT The use of methods to evaluate cortical activity in neonates has great importance in modern medicine, as it allows the observation and evaluation of several clinical aspects, which guarantees that the health team has knowledge about possible intervention measures that may be necessary in the treatment of newborns. Objective: This systematic review aimed to compare the main technologies available for the evaluation of brain functions in neonates, among them: the conventional electroencephalogram (EEG), the amplitude-integrated electroencephalogram (aEEG) and the geodesic sensor net EEG. Methods: A search was conducted forarticles from national and international periodicals included in the Web of Science, LILACS, SciELO and Medline electronic databases. Results: The search found 39 among 155 articles of interest and the analyses indicated that, in the clinical environment, the use of both conventional EEG and aEEG is highly recommended, as the combination of their functions allows, for example, a greater number of subclinical seizures to be detected. Conversely, the use of a geodesic sensor net EEG could be of great value, as it allows a large amount of data to be analyzed. Conclusion: This analysis may be useful in studies and research related to diseases and symptoms, such as seizures, a current challenge for neonatal neuromonitoring, as well as aspects of neurological development and functional studies. However, despite many advances in technology, electroencephalography in preterm neonates remains a challenge worldwide and still requires more robust research and efforts towards the best clinical assistance in this extremely early stage of life

Sleep deprivation, pain and prematurity: a review study

The aim was to describe current reports in the scientific literature on sleep in the intensive care environment and sleep deprivation associated with painful experiences in premature infant. A systematic search was conducted for studies on sleep, pain, premature birth and care of the newborn. Web of Knowledge, MEDLINE, LILACS, Cochrane Library, PubMed, EMBASE, Scopus, VHL and SciELO databases were consulted. The association between sleep deprivation and pain generates effects that are observed in the brain and the behavioral and physiological activity of preterm infants. Polysomnography in intensive care units and pain management in neonates allow comparison with the first year of life and term infants. We have found few references and evidence that neonatal care programs can influence sleep development and reduce the negative impact of the environment. This evidence is discussed from the perspective of how hospital intervention can improve the development of premature infants