Persistencia del cavum septum pellucidum y cavum vergae asociado a retraso psicomotor. Informe de caso

Fundamento: Dos de las tres formas en que se presentan los quistes intracraneales de la línea media anterior son: cavum septum pellucidum y cavum vergae; estos normalmente desaparecen después del nacimiento, de persistir suelen ser asintomáticos, pero también pueden estar asociados a manifestaciones obstructivas, trastornos psicóticos o alteraciones del neurodesarrollo que demandan de un seguimiento clínico. Objetivo: Reportar el caso de un paciente de 6 meses con persistencia de estructuras del periodo embrionario en posible asociación con retraso del desarrollo psicomotor. Presentación de caso: Por lo infrecuente que resulta en la práctica, se informa el caso de un paciente de 6 meses con una persistencia del cavum septum pellucidum y cavum vergae en el que se destaca la posible asociación del retraso del neurodesarrollo a la persistencia de estas estructuras. El diagnóstico se realizó de forma precoz y se intervino oportunamente. Conclusiones: La presentación del caso aportó evidencias epidemiológicas que favorecen la posible asociación entre la persistencia de estas estructuras embrionarias y el retraso del desarrollo psicomotor.

Background: Two out of the three forms in which intracranial anterior midline cysts present are: These usually disappear after birth; if they persist, they are often asymptomatic, but may also be associated with obstructive manifestations, psychotic disorders or neurodevelopmental disorders that require clinical follow up. Objective: To report a case of a 6-month-old patient with persistence of embryonic period structures in possible association with psychomotor developmental retardation. Case presentation: Because of how infrequent it is in practice, a case of a 6-month-old patient with a persistent cavum septum pellucidum and cavum vergae is reported in which the possible association of neurodevelopmental delay with the persistence of these structures is pointed out. The diagnosis was made in an early manner and it was timely intervened. Conclusions: The case presentation provided epidemiological evidences that encourage the possible association among the persistence of these embryonic structures and psychomotor developmental retardation.

Atención temprana a niños con retardo del desarrollo psicomotor / Early care for children with delayed psychomotor development / Cuidados precoces para crianças com desenvolvimento psicomotor atrasado

RESUMEN Introducción: los programas de Atención Temprana son favorecedores del neurodesarrollo y resultan altamente eficaces en su conjunto para los niños con trastornos en el desarrollo. Objetivo: determinar factores epidemiológicos y clínico-terapéuticos en niños con retardo del desarrollo psicomotor tratados en consulta de Atención Temprana del policlínico Jimmy Hirzel, Bayamo, Granma, durante 2018-2019. Métodos: se realizó un estudio epidemiológico observacional descriptivo, longitudinal, que incluyó a 88 niños diagnosticados con retardo del desarrollo psicomotor y tratados en la consulta de Atención Temprana del policlínico Jimmy Hirzel, Bayamo, Granma, durante 2018-2019. Variables estudiadas: edad en el momento del diagnóstico en la consulta de Atención Temprana, sexo, procedencia, factores de riesgo perinatal y evolución a los 12 meses del diagnóstico e inicio del tratamiento rehabilitador. Se empleó la estadística descriptiva para el procesamiento de los datos. Resultados: predominaron los niños diagnosticados entre los 6 meses y 11 meses y 29 días (52.3%), del sexo femenino (65,9%) y procedencia urbana (69,3%). El 82.9 % presentó factores de riesgo perinatal, con predominio del bajo peso al nacer y las infecciones perinatales. El 90.9% evolucionó favorablemente, destacando los diagnosticados entre 6 y 11 meses y 29 días, y los que no tuvieron o tuvieron uno o dos factores de riesgo perinatal. Conclusiones: la mayoría de los niños estudiados fueron diagnosticados en consulta de Atención Temprana entre los seis y doce meses de edad, presentaron uno o dos factores de riesgo perinatal (siendo el más frecuente el bajo peso al nacer), y evolucionaron favorablemente.

ABSTRACT Introduction: Early Care programs are pro-developmental and highly effective as a whole for children with developmental disorders. Objective: to determine epidemiological and clinical-therapeutic factors in children with psychomotor development delay treated in the Early Care consultation of the Jimmy Hirzel Polyclinic, Bayamo, Granma, during 2018-2019. Methods: a descriptive, longitudinal observational epidemiological study was conducted, which included 88 children diagnosed with psychomotor developmental delay and treated in the Early Care consultation of the Jimmy Hirzel Polyclinic, Bayamo, Granma, during 2018-2019. Variables studied: age at the time of diagnosis in the Early Care consultation, sex, origin, perinatal risk factors and evolution at 12 months of diagnosis and initiation of rehabilitative treatment. Descriptive statistics were used for data processing. Results: children diagnosed between 6 months and 11 months and 29 days (52.3%), female (65.9%) and urban origin (69.3%) predominated. 82.9% presented perinatal risk factors, with a predominance of low birth weight and perinatal infections. 90.9% evolved favorably, highlighting those diagnosed between 6 and 11 months and 29 days, and those who did not have or had one or two perinatal risk factors. Conclusions: most of the children studied were diagnosed in the Early Care consultation between six and twelve months of age, presented one or two perinatal risk factors (the most frequent being low birth weight), and evolved favorably.

RESUMO Introdução: Os programas de Atenção Precocesão pró-desenvolvimento e altamente eficazes como um todo para crianças com transtornos do desenvolvimento. Objetivo: determinar fatores epidemiológicos e clínico-terapêuticos em crianças com atraso no desenvolvimento psicomotor tratado na consulta de Atenção Precoce da Policlínica Jimmy Hirzel, Bayamo, Granma, durante 2018-2019. Métodos: foi realizado um estudo epidemiológico observacional descritivo e longitudinal, que incluiu 88 crianças diagnosticadas com atraso no desenvolvimento psicomotor e tratadas na consulta de Cuidados Precoces da Policlínica Jimmy Hirzel, Bayamo, Granma, durante 2018-2019. Variáveis estudadas: idade no momento do diagnóstico na consulta de Atenção Precoce, sexo, origem, fatores de risco perinatais e evolução aos 12 meses de diagnóstico e início do tratamento reabilitatório. Foram utilizadas estatísticas descritivas para o processamento de dados. Resultados: predominaram as crianças diagnosticadas entre 6 meses e 11 meses e 29 dias (52,3%), do sexo feminino (65,9%) e da origem urbana (69,3%). 82,9% apresentaram fatores de risco perinatais, com predominância de baixo peso ao nascer e infecções perinatais. 90,9% evoluíram favoravelmente, destacando aqueles diagnosticados entre 6 e 11 meses e 29 dias, e aqueles que não tinham ou tinham um ou dois fatores de risco perinatais. Conclusões: a maioria das crianças estudadas foi diagnosticada na consulta de Atenção Precoce entre seis e doze meses de idade, apresentou um ou dois fatores de risco perinatais (sendo o mais frequente o baixo peso ao nascer) e evoluiu favoravelmente.

Evaluación del desarrollo infantil en niños menores de 1 año en una unidad médica / Evaluation of child development in children under 1 year in a medical unita

Introducción: el desarrollo psicomotor es un fenómeno de adquisición continua y progresiva de habilidades a lo largo de la infancia, afectado por la herencia genética y factores psicosociales y biológicos. Objetivo: evaluar el desarrollo infantil en niños menores de 1 año mediante la prueba Evaluación del Desarrollo Infantil en una unidad de medicina familiar. Metodología: estudio descriptivo con 62 niños menores de 1 año, en el módulo de PREVENIMSS, de octubre de 2018 a octubre de 2019. Se realizó un muestreo no probabilístico. Para el análisis de los datos se utilizó estadística descriptiva (media, desviación estándar, frecuencias y porcentajes); el análisis inferencial se realizó mediante la prueba de ji al cuadrado, considerando como significancia estadística p < 0.05. Resultados: el 42% (26) fueron niños y el 58% (36) niñas. En el resultado global, el 68% (42) obtuvieron desarrollo normal, el 29% (18) rezago en el desarrollo y el 3% (2) riesgo de retraso en el desarrollo. Las áreas del desarrollo afectadas fueron motricidad fina y lenguaje. Conclusiones: es necesario implementar estrategias institucionales para que se cumplan las políticas públicas de la primera infancia y que todos los niños derechohabientes del Instituto Mexicano del Seguro Social cuenten con evaluaciones periódicas de su desarrollo.

Introduction: Psychomotor development is a phenomenon of continuous and progressive acquirement of skills throughout childhood, affected by genetic inheritance and psychosocial and biological factors. Objective: To evaluate child development to children under 1 year old, through the Child Development Assessment test in a family medicine unit. Methods: Descriptive study in 62 children under 1 year of age, in the PREVENIMSS module, from October 2018 to October 2019. A non-probability sampling was carried out. Descriptive statistics (mean, standard deviation, frequencies and percentages) were used for data analysis, inferential analysis was performed using Chi Square, statistical significance of p < 0.05. Results: 42% (26) were men and 58% (36) women. In the overall result: 68% (42) obtained normal development, 29% (18) lag in development and 3% (2) risk of delay in development. The developmental areas affected were fine motor skills and language. Conclusions: It is necessary to implement institutional strategies so that early childhood public policies are complied with and that all IMSS eligible children have periodic evaluations of their development.

Caracterización de pacientes ingresados en consulta de atención temprana. Policlínico Jimmy Hirzel, 2018 / Characterization of patients admitted to early care consultation. Jimmy Hirzel Polyclinic, 2018 / Caracterização dos pacientes admitidos na consulta de atenção precoce. Jimmy Hirzel Polyclinic, 2018

RESUMEN La Atención Tempana(AT) reduce los efectos de las discapacidades o de los factores de riesgo y optimiza, en la medida de lo posible, el curso del desarrollo del niño. Se realizó un estudio observacional descriptivo de corte transversal para caracterizar a los niños que recibieron tratamiento rehabilitador en la consulta de AT del policlínico Jimmy Hirzel, durante el año 2018. El universo estuvo constituido por 1560 casos atendidos en la consulta durante ese periodo y la muestra la conformaron los 199 casos ingresados para tratamiento en el Servicio de Rehabilitación Integral. Los datos fueron tomados de la base de datos de los registros estadísticos del centro y de las historias clínicas individuales. Se emplearon como medidas de resumen, de la estadística descriptiva, las frecuencias absolutas y relativas. Como resultados principales,el 44,2% de los casos fue remitido por retardo del desarrollo psicomotor, siendo más frecuentes los niños menores de seis meses de edad (38,7%), del sexo femenino (53,8%), con antecedentes perinatales positivos (83,9%) y del área urbana Jesús Menéndez(46,7%). La evolución fue favorable en la mayoría de los casos.

ABSTRACT Early Attention (TA) reduces the effects of disabilities or risk factors and optimizes, as far as possible, the course of the child's development. A descriptive cross-sectional observational study was conducted to characterize children who They received rehabilitative treatment in the AT clinic of the Jimmy Hirzel polyclinic during 2018.The universe consisted of 1,560 cases attended in the clinic during that period and the sample was made up of 199 cases admitted for treatment at the Comprehensive Rehabilitation Service. The data was taken from the database of the statistical records of the center and from the individual medical records. Absolute and relative frequencies were used as summary measures of descriptive statistics. As main results, 44.2% of the cases were referred for retardation of psychomotor development, being more frequent the children younger than six months of age (38.7%), of the female sex (53.8%), with a history positive perinatals (83.9%) and Jesús Menéndez urban area (46.7%). The evolution was favorable in most cases.

RESUMO A Atenção Precoce (AT) reduz os efeitos de incapacidades ou fatores de risco e otimiza, na medida do possível, o curso do desenvolvimento da criança. Um estudo observacional transversal descritivo foi conduzido para caracterizar crianças que Eles receberam tratamento reabilitador na consulta AT da policlínica Jimmy Hirzel, durante o ano de 2018. O universo consistiu em 1560 casos atendidos na consulta durante esse período e a amostra foi composta por 199 casos admitidos para tratamento no Serviço de Reabilitação Integral. Os dados foram coletados do banco de dados dos registros estatísticos do centro e dos registros médicos individuais. Frequências absolutas e relativas foram usadas como medidas resumidas da estatística descritiva. Como principais resultados, 44,2% dos casos foram encaminhados para retardo do desenvolvimento psicomotor, sendo mais frequentes as crianças menores de seis meses (38,7%), do sexo feminino (53,8%), com histórico perinatais positivos (83,9%) e área urbana de Jesús Menéndez (46,7%). A evolução foi favorável na maioria dos casos.

Efecto de la intervención psicomotriz con participación del cuidador sobre la comunicación gestual de una niña con autismo / Effect of psychomotor intervention with the participation of a caretaker on the gesture communication of a child with autism

Se presenta el caso de una niña de 3 años, con trastorno del espectro autista que mostraba dificultades para relacionarse e integrar los gestos faciales y corporales a su lenguaje verbal; además, se mostraba inflexible a los cambios posturales y presentaba fuerte apego a objetos inanimados. Se brindó una nueva herramienta de intervención en base al movimiento y el afecto a través de las relaciones primarias. El objetivo fue facilitar el gesto motor, de manera que se lograse una comunicación gestual integrada a la verbal y se favoreciese la conexión espontánea de la niña con su cuidador y el entorno. (AU)

We present the case of a 3-year-old girl with autism that showed difficulties to stablish relationships and to integrate facial and body gestures to her verbal language. In addition, she showed inflexibility to postural changes and strong bond to inanimate objects. A new intervention tool was offered based on providing affection and movement through primary relationships. The objective was to facilitate motor gesture to achieve gesture communication integrated to verbal language favoring spontaneous connection of the girl with her caretaker and with her surroundings. (AU)

Bainbridge-Ropers syndrome with ASXL3 gene variation in a child and literature review / 中华儿科杂志

Objective@#To investigate the clinical manifestations and genetic features of a child with Bainbridge-Ropers syndrome caused by ASXL3 gene variation and review the literature.@*Methods@#Clinical data and genetic features were collected and analyzed from a child with Bainbridge-Ropers syndrome who was diagnosed in Bao'an Maternity and Child Health Hospital in November 2016. "ASXL3" and "Bainbridge-Ropers" were used as key words to search at China National Knowledge Infrastructure, Wangfang Data Knowledge Service Platform, PubMed and Human Gene Mutation Database up to June 2017.@*Results@#A 29/12 years old girl was presented with psychomotor retardation, feeding difficulty, hypotonia and specific craniofacial phenotype. She showed severe growth retardation (height: 84 cm, body weight: 8.0 kg (both were less than 3rd percentile rank of the children at the same age) and head circumference: 46 cm(=3rd percentile rank)), without obvious abnormalities in laboratory tests and neuroimaging tests. A de novo heterozygous nonsense variation: c.3349C>T(p.R1117*) in ASXL3 gene was identified by the whole exome sequencing, and the novel variation was classified into pathologic variant based on Standards and guidelines for the interpretation of sequence variants from ACMG. According to literature retrieval, no Chinese cases with ASXL3 variation had been reported. Totally 28 cases including the present girl harboring ASXL3 variations with detailed clinical information were reported. Thirty-one variations in ASXL3 gene were involved, including 1 missense variation and 30 loss of function variations, which were all de novo variations.@*Conclusions@#The clinical features of Bainbridge-Ropers syndrome include severe psychomotor retardation, feeding difficulties, hypotonia and specific facial features. The heterozygous nonsense variation in ASXL3 gene is the cause of the patient. All the pathogenic variations in ASXL3 gene are de novo and loss of function variations.

The general movement assessment in non-European low- and middle-income countries

ABSTRACT Abnormal general movements are among the most reliable markers for cerebral palsy. General movements are part of the spontaneous motor repertoire and are present from early fetal life until the end of the first half year after term. In addition to its high sensitivity (98%) and specificity (91%), the assessment of general movements is non-invasive and time- and cost-efficient. It is therefore ideal for assessing the integrity of the young nervous system, most notably in lowresource settings. Studies on the general movements assessment in low- and middle-income countries such as China, India, Iran, or South Africa are still rare but increasing. In Brazil, too, researchers have demonstrated that the evaluation of general movements adds to the functional assessment of the young nervous system. Applying general movements assessment in vulnerable populations in Brazil is therefore highly recommended.

Desempenho percepto-motor, psicomotor e intelectual de escolares com queixa de dificuldade de aprendizagem / Perceptual-motor performance, psychomotor and intellectual of students with learning disability complaints

OBJETIVOS: Este estudo teve como objetivo comparar o desempenho percepto-motor, psicomotor e a capacidade intelectual de escolares com e sem queixa de dificuldade de aprendizagem indicados por seus professores, e associar esse desempenho ao processo de aprendizagem da escrita. MÉTODO: Participaram do estudo 26 escolares com idade entre 7 e 9 anos, frequentando o Ensino Fundamental, com e sem queixa de dificuldade de aprendizagem por parte dos professores, respectivamente, o grupo experimental (GE), com 14 escolares, e o grupo controle (GC), com 12. Os instrumentos utilizados foram: Teste Gestáltico Visomotor de Bender, Escala de Desenvolvimento Motor, Desenho da Figura Humana, e Avaliação de Dificuldades de Aprendizagem na Escrita - ADAPE. RESULTADOS: As crianças com queixa de dificuldades de aprendizagem apresentaram pior desempenho em comparação ao grupo controle, em todas as áreas avaliadas. O GE teve resultado inferior ao esperado para sua idade na avaliação psicomotora e percepto-motora, indicando risco para aquisição da aprendizagem da escrita, o que foi confirmado com o resultado do teste ADAPE, que os classificou como tendo dificuldades na escrita de grau leve a moderado. A avaliação intelectual revelou melhor desenvolvimento cognitivo no GC. CONCLUSÃO: Os resultados encontrados sugerem que o desempenho psicomotor, percepto-motor e intelectual estão estritamente ligados e que alterações em quaisquer dessas habilidades compõem fator de risco para a aquisição da escrita. Sugere-se a continuidade e ampliação dos estudos nesta área, com enfoque na estimulação percepto e psicomotora, como ferramenta que auxilie o desenvolvimento global e a aprendizagem escolar.

OBJECTIVES: This study aimed to compare the perceptual-motor performance, psychomotor and intellectual capacity of students with and without complaints of learning disability nominated by their teachers, and associate this performance when writing learning process. METHOD: The study included 26 school aged 7 and 9 years old, attending the elementary school, with and without complaints of learning disability by teachers, respectively, the experimental group (EG) with 14 children and the control group (CG ) with 12. The instruments used were: Bender-Gestalt Test, Development Scale Motor, the Human being Figure Drawing, and Learning Disabilities Assessment in Writing - ADAPE. RESULTS: Children with complaints of learning difficulties presented a lower performance compared to the control group in all areas assessed. GE had a lower result than expected for their age in psychomotor and perceptual-motor tests, indicating risk for acquisition of literacy, and this was confirmed with the results of ADAPE test, which classified them as having writing difficulties from easy to moderate. Intellectual assessment showed better cognitive development in the GC. CONCLUSION: The results suggest that the psychomotor performance, perceptual-motor and intellectual are closely linked, and changes in any of these skills make up a risk factor for the acquisition of writing. We suggest the continuity and expansion of studies in this area, focusing on perceptual and psychomotor stimulation as a tool to assist the overall development and school learning.

Implicaciones de la desnutrición en el desarrollo psicomotor de los menores de cinco años / Implications of malnutrition in the psychomotor development of children under five years

Aim: To describe psychomotor development of children with chronic malnutrition attending a nutritional recovery clinic in Medellin, Colombia. Methodology: descriptive, cross-sectional study. The sample consisted of 60 children under 5 years of age with malnourishment according to height/age index. Informed consent was signed. Risk of delayed psychomotor development was evaluated using the Abbreviated Scale of Development. Univariate analysis was performed to characterize the population. In bivariate analysis Chi2 and Fisher exact test were used to test the relationship between categorical and outcome variables. We used a 95% confidence level and p<0.05 represented statistical significance. Results: The main finding was no association between the degrees of chronic malnutrition with the risk of delayed psychomotor development, however the prevalence of risk of delay was 38.3%, which is clinically relevant. Conclusion: An optimal nutritional status determines the psychomotor development of children, as it has positive neurophysiological effects.

Objetivo: Describir el nivel de desarrollo psicomotriz de niños con desnutrición crónica, que asisten a recuperación nutricional, en Medellín, Colombia. Metodología: Estudio descriptivo, transversal. La muestra fue de 60 niños menores de 5 años con desnutrición según el índice talla/edad, se firmó consentimiento informado. Se evaluó riesgo de retraso en el desarrollo psicomotriz, utilizando la Escala Abreviada del Desarrollo. Se realizó análisis univariado para caracterizar la población. En el análisis bivariado se utilizaron pruebas Chi² y Test Exacto de Fisher relacionando algunas variables categóricas y de resultado. Se utilizó un nivel de confianza 95% y p<0,05. Resultados: Se observó una nula asociación entre el grado de desnutrición crónica con el riesgo del retraso en el desarrollo psicomotriz, sin embargo la prevalencia del riesgo de retraso del 38,3% cobra relevancia desde la clínica. Conclusión: Un óptimo estado nutricional determina el desarrollo psicomotriz de los niños, dado que tiene efectos neurofisiológicos positivos.

Analysis of psychomotor development and level of physical activity of children with extracurricular physical activities / Análise do desenvolvimento psicomotor e nível de atividade física de crianças em atividades físicas extracurriculares

Objective: The objective was to evaluate the psychomotor development in the areas of global motor skills, balance and body structure and level of school extracurricular physical activity. Method: The sample consisted of 30 individuals of both sexes from 6 to 10 years old, divided into two groups: Active Extracurricular Group and Sedentary Extracurricular Group. Data collection included the characterization of the subjects, anthropometric data, and the tests Development Scale Motor and the IPAQ short version. The variables were expressed as frequencies and proportions, the normality was tested with the Shapiro-Wilk test. Student t test was used to determine the statistical significance of normal data and Mann Whitney test for the non-normal data. Statistical significance was set at p <0.05. Results: The classification of BMI / age of both groups was eutrophic (53.3%) and the remainder (46.6%) were overweight. The sedentary group had better results in overall motor development, and the active group in balance and body scheme. Conclusion: The children who engage in extracurricular physical activity showed better development in balance and body structure, when compared to those that do not

Primeras manifestaciones clínicas de un síndrome de X frágil en la comunidad / First clinical manifestations of a case of fragile X syndrome in the community

Fundamento: el síndrome del X frágil es el más común de los trastornos de retraso mental ligados al cromosoma X. Objetivo: presentar las primeras manifestaciones clínicas de un caso de síndrome de X frágil que no comenzó con retardo del desarrollo psicomotor. Caso clínico: paciente que es remitido a consulta de genética por presentar macrocráneo y orejas displásicas en forma de copa. Al año y seis meses presentó retardo del desarrollo psicomotor. El examen físico, los exámenes complementarios dieron el diagnóstico de un síndrome del X Frágil. Se le puso tratamiento en consulta de estimulación temprana y el paciente mejoró el desarrollo psicomotor. Conclusiones: la aparición de macrocefalia y el retardo del desarrollo psicomotor contribuyeron a realizar el diagnóstico oportuno de esta enfermedad. La estimulación temprana permitió avances en el desarrollo psicomotor del paciente.

Background: fragile X Syndrome is the most common mental retardations disorders linked to X chromosome. Objective: to show the first clinical manifestations of a case of Fragile X Syndrome case that did not began with psychomotor development retardation. Clinical case: a patient who is transferred to genetic consult for presenting macrocranium, dysplastic ears in form of cup. Aged one year and six month old, he had psychomotor development retardation. Physical examinations and complementary test confirmed Fragile X Syndrome diagnosis. The patient was treated in early stimulation consult which improved the psychomotor development retardation. Conclusions: the presence of macrocephaly and later psychomotor development retardation helped to make the appropriate diagnosis of that disorder. Early stimulation permitted advances in psychomotor development in this patient.

Assistência a crianças com atraso neuromotor: perfil epidemiológico e experiência interdisciplinar / Assistance to children with neuromotor delay: epidemiologic profile and interdisciplinary experience

O atendimento ao paciente pediátrico com atraso no desenvolvimento neuromotor (ADNM), em particular aqueles com diagnóstico de paralisia cerebral (PC), é um grande desafio para os serviços públicos de saúde em todo o mundo. A complexidade do manejo clínico torna relevante uma abordagem integrada e interdisciplinar. O objetivo deste estudo foi conhecer o perfil epidemiológico e as principais comorbidades dos pacientes com ADNM, particularmente com PC, atendidos em um serviço interdisciplinar de referência com 10 anos de experiência no manejo desses pacientes. Estudo transversal descritivo e retrospectivo por meio de análise de prontuários dos pacientes do Ambulatório de Pacientes Especiais do Hospital de Clínicas de Uberlândia no período de 2010 a 2012. Foram analisados 136 prontuários, 79 (58,1%) do sexo masculino e 70 (51,5%) procedentes de Uberlândia. O diagnóstico frequente foi PC 113 (83,1%). A obstipação intestinal (OI) e a doença do refluxo gastroesofágico (DRGE) foram as comorbidades mais frequentes, respectivamente, 85 (62,5%) e 80 (58,8%). Alimentação por via alternativa foi observada em 71 (52,2%), sendo 61 (44,8%) por gastrostomia e 10 (7,3%) por sonda nasoenteral. Doenças respiratórias ocorreram em 59 (43,3%) pacientes e foram responsáveis por internação em 22 (16,1%); 98 (72,0%) pacientes realizavam fisioterapia, 62 (45,6%) fonoterapia e 46 (33,8%) terapia ocupacional. Acompanhamento odontológico foi observadoem 49 (36,0%) deles. O reconhecimento do perfil epidemiológico, comorbidades e complicações mais prevalentes auxiliam a equipe interdisciplinar especializada a desenvolver estratégias para melhor assistência e cuidados aos pacientes com ADNM.

Care rendered to pediatric patients with neuromotor delay, particularly those diagnosed with Cerebral Palsy (CP), is a major challenge to public health services worldwide. The complexity of clinical management makes an integrated and multidisciplinary approach relevant. The aim of this study was to get to know the epidemiological profile and the main co- morbidities of patients with neuromotor delay, who are attended in a multidisciplinary referral service which has 10 years experience in the management of these patients. This study was carried out through cross descriptive and retrospective analysis of medical records of patients at the Special Patient Clinic at the University Hospital of Uberlândia, during the period of 2010-2012. One hundred and thirty six (136) records were analyzed, 79 (58.1%) were male and 70 (51.5 %) coming of Uberlândia. The more frequent diagnosis is CP in 113 (83.1%) Intestinal Constipation (IC) and gastro-esophageal reflux disease (GERD) were the most frequent co-morbidities, 85 (62.5%) and 80 (58.8%) respectively. Feeding by way of alternative means was observed in 71 (52.2%), with 61 (44.8%) gastrostomy and 10 (7.3%) through a nasogastric tube. Respiratory disorders occurred in 59 (43.3%) patients and were responsible for hospitalization in 22 (16.1%) cases. 98 (72.0%) patients underwent physical therapy, 62 (45.6%) speech therapy and 46 (33.8%) occupational therapy. Dental care was observed in 49 (36.0%) patients. Recognition of the epidemiological profile, comorbidities and more prevalent complications assist the specialized interdisciplinary team in developing strategies to best support and care for patients with neuromotor delay

Análise da efetividade da fisioterapia através da psicomotricidade em idosos institucionalizados / Analysis of the effectiveness of physical therapy through psychomotricity in institutionalized elderly / Análisis de la efectividad de la fisioterapia a través de la psicomotricidad en mayores institucionalizados

OBJETIVO: Analisar a percepção dos idosos a respeito da efetividade da fisioterapia através de atividades psicomotoras. MÉTODOS: Tratou-se de um estudo de natureza descritiva, com abordagem qualitativa, realizado com 19 idosos, independentemente do sexo, que praticavam atividades psicomotoras regularmente no Lar Torres de Melo, uma instituição filantrópica localizada em Fortaleza-CE. As informações foram coletadas a partir de uma entrevista semiestruturada entre o período de fevereiro a maio de 2013. Após transcrição, leitura e releitura das entrevistas, emergiram as seguintes categorias temáticas: percepção dos benefícios; sensação percebida após as atividades psicomotoras; percebendo a importância da fisioterapia; e contribuição da psicomotricidade para o emocional. RESULTADOS: Pode-se observar nas falas dos idosos que as atividades psicomotoras estabelecem uma melhora na sua qualidade de vida, ajudando-os a manter suas capacidades funcionais com autonomia e independência, criando forças para enfrentar suas limitações e superá-las. Há uma melhora do bem-estar geral, ajuda na preservação do viver independente e minimiza as consequências de certas incapacidades. Os idosos percebem também a importância da fisioterapia para sua capacidade funcional, e que a psicomotricidade contribui para o seu emocional. CONCLUSÃO: Os idosos institucionalizados sentem que a psicomotricidade contribui para o emocional deles e que as atividades auxiliam o desempenho físico e mental, melhorando a autonomia e capacidade de enfrentar suas limitações, proporcionando uma melhor condição de vida

OBJECTIVE: To assess the elderly's perception of the effectiveness of physical therapy through psychomotor activities. METHODS: This is a descriptive study, with a qualitative approach, performed with 19 elderly individuals, regardless of gender, who attended regular psychomotor activities at Lar Torres de Melo, a philanthropic institution in Fortaleza, CE, Brazil. Information was collected using a semi-structured interview in the period between February and May 2013. After transcription, reading and rereading of the interviews, the following thematic categories emerged: perceived benefits, feelings after the psychomotor activity, realizing the importance of physical therapy; and psychomotricity contribution to the emotional domain. RESULTS: Through the elderly's speech, one can observe that the psychomotor activities provide an improvement in their quality of life, helping them to maintain their functional capabilities with autonomy and independence, creating the strength to confront their limitations and overcome them. There is an improvement in general wellbeing, support for the preservation of independent living, and reduction in the effects of certain disabilities. The elderly also realized the importance of physical therapy for their functional ability, and that psychomotricity contributes to their emotional life. CONCLUSION: The institutionalized elderly feel that psychomotricity contributes to their emotional wellbeing, and that the activities contribute to physical and mental performance, and thereby improve their autonomy and ability to cope with their limitations, providing a better quality of life

OBJETIVO: Analizar la percepción de los mayores respecto la efectividad de la fisioterapia a través de actividades psicomotoras. MÉTODOS: Se trato de un estudio de naturaleza descriptiva de abordaje cualitativa realizado con 19 mayores, independiente del sexo y que practicaban actividades psicomotoras regulares en el Lar Torres de Melo, institución filantrópica de FortalezaCE. Las informaciones fueron recogidas a través de una entrevista semi-estructurada entre febrero y mayo de 2013. Después de la transcripción y varias lecturas de las entrevistas surgieron las siguientes categorías temáticas: la percepción de los beneficios; la sensación percibida después de las actividades psicomotoras; la importancia de la fisioterapia; y la contribución de la psicomotricidad en el emocional. RESULTADOS: Se observa en las hablas de los mayores que las actividades psicomotoras generan mejoría en su calidad de vida, contribuyendo para el mantenimiento de sus capacidades funcionales con autonomía e independencia creando fuerzas para afrontar sus limitaciones y superarlas. Hay una mejoría en el bienestar general, ayuda en la preservación del vivir independiente y minimiza las consecuencias de determinadas incapacidades. Los mayores también perciben la importancia de la fisioterapia en la capacidad funcional y que la psicomotricidad contribuye para su estado emocional. CONCLUSIÓN: Los mayores institucionalizados sienten que la psicomotricidad contribuye para su estado emocional y que las actividades ayudan en el desempeño físico y mental mejorando la autonomía y la capacidad de afrontar sus limitaciones promoviendo una mejor condición de vida

Efecto de la terapia física y terapia ocupacional en una paciente con Síndrome de West: Reporte de un caso / Effects of physical and occupational therapies in a patient with West syndrome: Case report

Se presenta el caso de una niña de 12 años con diagnóstico de Síndrome de West. Asistió a consulta médica por primera vez a los 8 meses de edad, sus convulsiones se acentuaron a la edad de dos años y medio, lo que agravó el retraso psicomotor. Inicio terapia física y terapia ocupacional, empleando técnicas de neurodesarrollo y marcos de referencia respectivamente. A la presentación del caso se observaron avances favorables en aspectos cualitativos más que cuantitativos. (AU)

We present the case of a 12 year-old girl with the diagnosis of West syndrome, she sought medical attention for the first time at the age of 8-months, her seizure problem worsened at the age of 2 years and a half, which worsened her psychomotor development. She started physical and occupational therapy using neurodevelopment techniques and framework references. Qualitative more than quantitative improvement was observed. (AU)

Reeducación psicomotriz en personas con enfermedad de Alzheimer / Impact of a psychomotor re-education guide on the quality of life of patients with Alzheimer's disease

Background: We developed a psychomotor re-education guide (PSEG) adapted to people with Alzheimer disease (AD), including a cognitive stimulation program integrated with the exercise recommendations of the American College of Sports Medicine. Aim: To evaluate the effect of the PSEG on cognitive and functional parameters among patients with AD. Patients and Methods: We applied the PSEG to 64 participants with AD aged 64 to 87 years (55% women) during 12 months. At baseline and the end of the intervention, cognitive abilities (Mini Mental State), fitness (Chair Stand test), level of independence (Barthel Index) and quality of life (QoL) (SF-12) were assessed. Results: The application of PSEG resulted in a significant improvement in the QoL and physical capacity of patients with AD. Cognitive ability declined along with disease progression. Conclusions: These results demonstrate the effectiveness of the guide in mild and moderate stages of AD improving the physical fitness and the QoL.

Alteración del desarrollo psicomotor en hijos de mujeres con depresión posparto de la ciudad de Valdivia-Chile / Psychomotor development in offspring of mothers with post partum depression

Background: Postpartum depression (PPD) has adverse effects on psychomotor development of the offspring. Aim: To evaluate the relationship between PPD and psychomotor development in children aged 18 months, consulting in primary care. Material and Methods: Cross-sectional study with 360 infants and their mothers. Children had their psychomotor evaluation atl8 months and mothers completed the Edinburgh Postnatal Depression Scale at 4 and 12 weeks postpartum. The prevalence of both PPD and psychomotor alteration was estimated. The association between PPD and psychomotor alteration, including confounding variables, was estimated through logistic multiple regression analysis. Results: The prevalence of PPD and psychomotor alteration was 29 and 16%, respectively Mothers with PPD had twice the probability of havingan offspring with psychomotor alteration (Odds ratio = 2.0, confidence intervals = 1.07-3.68). This probability was significantly higher among single mothers or those with an unstable partner. Conclusions: PPD has a detrimental impact on psychomotor development of children.

Relationship between early brain damage in preterm infants detected by magnetic resonance imaging and neurodevelopmental outcome / 中华围产医学杂志

Objective To investigate the relationship between early brain menifestation such as white matter damage and ventriculomegaly detected by magnetic resonance imaging(MRI) and adverse neurodevelopmental outcome in preterm infants.Methods From March 15,2007 to April 12,2011,122 preterm infants accepted MRI examination 8-14 days after birth in Chinese People's Liberation Army 202 Hospital.Totally,115 preterm infants were followed up at 12 months old and mental development index(MDI) and psychomotor development index (PDI) score were measured.MDI＜70 was as mental dysfunction,-84 as borderline dysfunction and-114 as normal; PDI＜70 was as psychomotor dysfunction,-84 as borderline dysfunction and-114 as normal.The relationship between clinical characteristics of preterm infants,MRI abnormalities and neurodevelopmental outcome were analyzed by analysis of variance,LSD and Kruskal-Wallis H test.Results The 122 premature infants included 69 males and 53 females with the median gestational age of 32 weeks(28-36 weeks)and the median birth weight of 2050 g (1270-3110 g).In 24 premature infants with mentaldysfunction,the average gestational age [(28.7 ± 1.7) weeks],birth weight[(1520.1-44.8) g] and 1 min Apgar score (5.5 ± 0.8) were all lower than those in normal infants [n =59,(33.5 ± 2.2)weeks,(2240.4 ± 47.1) g and 7.1 ± 0.8],while the average mechanical ventilation time was longer [(20.4±5.8) dvs (5.6±2.7) d](t=2.37,2.49,2.13 and 2.44,P＜0.05).In 20 premature infants with psychomotor dysfunction,the average gestational age [(27.9 ±± 1.4) weeks],birth weight [(1515.6±43.7) g],1 min Apgar score (5.6t0.5) were lower than those in normal infants [n=62,(33.2±2.4) weeks,(2264.3±42.5) g and 7.2±0.6],while the mechanical ventilation time was longer [(18.2±4.7) dvs (5.3±2.2) d](t=2.28,2.52,2.09 and 2.38,P＜0.05).Among thirteen preterm infants with severe white matter damage,eleven and nine developed mental or psychomotor dysfunction respectively.Among eleven preterm infants with moderate and severe ventriculomegaly,seven and six developed mental or psychomotor dysfunction respectively.The more severe the white matter damage and ventriculomegaly,the higher the incidence of mental (H=16.23 and 14.33,P＜0.05) and psychomotor dysfuction (H =18.63 and 12.69,P ＜ 0.05).Conclusions White matter damage is common in preterm infants.Prognosis of preterm infants with mental and psychomotor dysfunction is related with the degree of white matter damage and ventriculomegaly.

Progress of diagnosis and treatment of Rett syndrome / 中华实用儿科临床杂志

Rett syndrome (RTT) is a disorder characterized by regression of spoken language and hand use,distinctive hand stereotypies,accompanying with severe psychomotor developmental retardation and retrogression.RTT becomes recognizable at 6-18 months and female are absolutely susceptive.MECP2 mutations are closely related to the development of RTT.Revised diagnostic criteria for RTT (2010) ensure a high degree of homogeneity in cases enrolled in treatment and clinical studies throughout the world.As for the treatment,no crucial advancement has been clinically applied recently,but some valuable basic research is in progress.This paper reviews the genetic research,clinical diagnosis and treatment of RTT,and promotes understanding of the new diagnostic criteria and basic research.

Descrição do desenvolvimento neuropsicomotor e visual de crianças com deficiência visual / Description of the neuropsychomotor and visual development of visually impaired children

Objetivo: Avaliar o desenvolvimento neuropsicomotor e visual de crianças com deficiência visual. Métodos: Foram avaliadas 45 crianças, de ambos os gêneros, em um período de 6 meses. As crianças foram distribuidas em dois grupos de estudo: experimental e de controle. Dessa forma aplicou-se a avaliação do desenvolvimento neuropsicomotor e da funcionalidade visual. Resultado: No grupo controle 86,66 por cento da amostra estava inadequado quanto ao comportamento da coordenação, entretanto, todos os aspectos analisados estavam inadequados. As diferenças entre os grupos mostraram-se significativas, já que valores como p<0,05 foram evidenciados, tanto no comportamento da funcionalidade visual, quanto no desenvolvimento neuropsicomotor. Conclusão: Na amostra estudada, observou-se que os deficientes visuais caracterizavam-se por apresentar atraso global, do desenvolvimento, principalmente no comportamento da coordenação.

Purpose: To assess the neuropsychomotor and visual development of visually impaired children. Methods: Fourty-five children of both genders were evaluated in a 6-months period. The children were distributed into two study groups: experimental and control. The neuropsychomotor development and visual efficiency were evaluated in the two groups. Results: In the control group, 86.66 percent of the sample was inappropriate on the coordination behavior, however, all aspects were considered inadequate. The differences among the groups were significant, since p values<0.05 were evidenced in the visual efficiency behavior as well as in the neuropsychomotor development. Conclusion: It was observed in the studied sample that the visually impaired were characterized by a global delay in the neuropsychomotor development, mostly in the coordination behavior.