Early stimulation for neuropsychomotor development in children with microcephaly: a systematic review / Estimulação precoce para o desenvolvimento neuropsicomotor de crianças com microcefalia: uma revisão sistemática

ABSTRACT Objective: To systematically review studies on the effects of early stimulation on the neuropsychomotor development of children with microcephaly. Data source: A systematic review was conducted in PubMed/MEDLINE, Virtual Health Library, and Cochrane Library databases. Studies that addressed the use of early stimulation in playful and interactive environments in children with microcephaly were included. There were no restrictions on the publication date or language of the studies. The outcomes assessed were muscle tone, social interaction, fine and gross motor skills, intelligence quotient, socioemotional and adaptive behavior of the child. The methodological quality and the scientific evidence level were assessed using the Risk of Bias in Non-randomized Studies of Interventions, the Revised Cochrane risk of bias tool for randomized trials and the Grading of Recommendations Assessment, Development and Evaluation. Data synthesis: 264 articles were identified, but only 7 met the eligibility criteria. The included studies had a total population of 125 individuals, with sample sizes ranging from 1 to 71 participants. Conclusions: The studies showed low evidence of an effect of early intervention on the outcomes muscle tone, social interaction, fine and gross motor skills, intelligence quotient, and socioemotional and adaptive behavior in children with microcephaly. However, further randomized clinical trials are needed.

RESUMO Objetivo: Revisar, de forma sistemática, estudos sobre a interferência da estimulação precoce no desenvolvimento neuropsicomotor de crianças com microcefalia. Fontes de dados: Trata-se de uma revisão sistemática realizada nas bases de dados United States National Library of Medicine/ Medical Literature Analysis and Retrieval System Online (PubMed/MEDLINE), Biblioteca Virtual em Saúde (BVS) e Cochrane Library. Foram incluídos estudos que abordassem o uso de estímulo precoce em ambientes lúdicos e interativos em crianças com microcefalia. Não foram impostas restrições quanto à data de publicação e ao idioma dos estudos. Como desfechos, avaliaram-se tônus muscular, interação social, habilidades motoras fina e grossa, quociente de inteligência, comportamento socioemocional e adaptativo da criança. A qualidade metodológica dos estudos e o nível de evidência científica foram avaliados pelo Risk of bias in non-randomized studies of interventions, Revised Cochrane risk of bias tool for randomized trials e Grading of recommendations assessment, development and evaluation. Síntese dos dados: Foram identificados 264 artigos, entretanto apenas sete atenderam aos critérios de elegibilidade. Os estudos incluídos totalizam uma população de 125 indivíduos, com amostras que variaram de um a 71 participantes. Conclusões: Os estudos demonstraram a existência de baixa evidência quanto à interferência da intervenção precoce nos desfechos tônus muscular, interação social, habilidades motoras finas e grossas, quociente de inteligência e comportamento socioemocional e adaptativo em crianças com microcefalia. No entanto, novos ensaios clínicos randomizados ainda são necessários.

Osteochondritis dissecans of the hip in legg-calvé-perthes disease: case report and review / Osteocondrite dissecante do quadril na doença de legg-calvé-perthes: relato de caso e revisão

ABSTRACT Introduction: Legg-Calvé-Perthes disease (LCPD) is the idiopathic osteonecrosis of the capital femoral epiphysis in children. It is a self-healing condition, and the morphology of the hip may vary according to the severity of the disease, among several other factors. The treatment focuses on attempts to prevent femoral head collapse, obtain functional hip motion recovery, and reduce pain. Osteochondritis Dissecans (OCD) of the femoral head has been reported in 2% to 7% of patients diagnosed with healed LCPD. Although OCD may remain asymptomatic, the osteochondral fragment has the potential to become unstable, evolving into symptoms of pain, locking, catching, and snapping. Case report: We present a case report of a ten-year-old boy with an OCD lesion following LCPD who underwent effective osteochondral fixation through the surgical hip dislocation approach. The patient evolved to excellent functional recovery at 1 year post-operatively. Discussion: The surgical hip dislocation approach allows anatomical fixation of the OCD fragment, as well as improvement of hip biomechanics, decreasing pain, improving range of motion and joint congruency, and preserving the native articular cartilage. It also gives the surgeon the opportunity to assess hip stability, femoroacetabular impingement and labral tears, allowing a wide variety of options for the treatment of the healed LCPD. Level of Evidence IV; Type of study Case Report.

RESUMO Introdução: A Doença de Legg-Calvé-Perthes (DLCP) é a osteonecrose idiopática da epífise femoral proximal em crianças. É uma condição auto resolutiva, porém a morfologia final do quadril pode variar de acordo com a gravidade da doença. O tratamento concentra-se na tentativa de prevenir o colapso da cabeça femoral, obtendo recuperação funcional do movimento do quadril e redução da dor. A osteocondrite dissecante (OCD) da cabeça femoral foi relatada em 2% a 7% dos pacientes diagnosticados com DLCP já curada. Embora a OCD possa permanecer assintomática, o fragmento osteocondral tem potencial para se tornar instável, evoluindo para sintomas de dor, bloqueio, impacto e estalido. Relato de caso: Apresentamos o relato de caso de um menino de 10 anos com OCD da cabeça femoral após DLCP, submetido à fixação osteocondral do fragmento por meio da abordagem cirúrgica de luxação do quadril. O paciente evoluiu com excelente recuperação funcional 1 ano após a cirurgia. Discussão: A abordagem cirúrgica da luxação do quadril permite a fixação anatômica do fragmento da OCD, bem como a melhora da biomecânica do quadril, diminuindo a dor, melhorando a amplitude de movimento e a congruência articular e preservando a cartilagem articular nativa. Também dá ao cirurgião a oportunidade de avaliar a estabilidade do quadril, impacto femoroacetabular e lesões labrais, permitindo uma ampla variedade de opções para o tratamento das sequelas da DLCP. Nível de evidência IV; tipo de estudo Relato de Casos.

O que é a ecolalia para o autismo segundo a literatura? / What is echolalia for autism according to the literature?

Objetivo: Descrever, segundo a literatura, a relação entre o Transtorno do Espectro Autista e a ecolalia. Método: Realizou-se uma revisão integrativa da literatura científica na BVS, PubMed e Scielo, utilizando os descritores DECS/MESH "Transtorno do Espectro Autista AND ecolalia" e "Autism Spectrum Disorder AND Echolalia" combinados pelo operador booleano "AND". Resultados: Predominaram estudos qualitativos (35,7%) com baixo nível de evidência (92,8%). A maioria das pesquisas (78,6%) foi conduzida nos Estados Unidos da América em 2021, com participantes de 1 a 40 anos, sendo a ecolalia frequentemente observada em crianças de 2 anos (28,6%). A abordagem ao tratamento da ecolalia foi mencionada em apenas 21,4% dos estudos, destacando métodos comportamentais. Conclusão: A ecolalia, fenômeno persistente no TEA, é uma notável peculiaridade na comunicação verbal, apresentando variações imediatas, tardias e mitigadas. Suas implicações continuam a desafiar o desenvolvimento e as intervenções clínicas.(AU)

Objective: To describe, based on the literature, the relationship between Autism Spectrum Disorder and echolalia. Method: An integrative review of scientific literature was conducted using BVS, PubMed, and Scielo databases, employing the DECS/MESH descriptors "Autism Spectrum Disorder AND echolalia" and "Autism Spectrum Disorder AND Echolalia" combined with the Boolean operator "AND." Results: Qualitative studies predominated (35.7%) with low levels of evidence (92.8%). The majority of research (78.6%) was conducted in the United States in 2021, involving participants aged 1 to 40, with echolalia frequently observed in 2-year-old children (28.6%). The approach to echolalia treatment was mentioned in only 21.4% of the studies, emphasizing behavioral methods. Conclusion: Echolalia, a persistent phenomenon in Autism Spectrum Disorder, represents a notable peculiarity in verbal communication, exhibiting immediate, delayed, and mitigated variations. Its implications continue to challenge development and clinical interventions.(AU)

Objetivo: Describir, según la literatura, la relación entre el Trastorno del Espectro Autista y la ecolalia. Método: Se realizó una revisión integrativa de la literatura científica en las bases de datos BVS, PubMed y Scielo, utilizando los descriptores DECS/MESH "Trastorno del Espectro Autista AND ecolalia" y "Autism Spectrum Disorder AND Echolalia" combinados con el operador booleano "AND". Resultados: Predominaron los estudios cualitativos (35,7%) con un bajo nivel de evidencia (92,8%). La mayoría de las investigaciones (78,6%) se llevaron a cabo en Estados Unidos en 2021, con participantes de 1 a 40 años, siendo la ecolalia observada con frecuencia en niños de 2 años (28,6%). El enfoque para el tratamiento de la ecolalia se mencionó solo en el 21,4% de los estudios, destacando métodos conductuales. Conclusión: La ecolalia, un fenómeno persistente en el Trastorno del Espectro Autista, representa una notable peculiaridad en la comunicación verbal, mostrando variaciones inmediatas, tardías y mitigadas. Sus implicaciones siguen desafiando el desarrollo y las intervenciones clínicas.(AU)

Brazilian version of the CHOP INTEND scale: cross-cultural adaptation and validation / Versão brasileira da escala CHOP INTEND: adaptação transcultural e validação

Abstract Background Spinal muscular atrophy (SMA) is a rare genetic disease that causes progressive muscle weakness and impacts motor function. The type I is the most severe presentation and affects infants before 6 months old. In addition, the instruments available for assessing motor function have limitations when applied to infants with neuromuscular diseases and significant muscle weakness. Objective To translate, cross-culturally adapt, and validate the Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP INTEND) to Brazilian Portuguese. Methods The present study comprised the translation, synthesis of translations, backtranslation, consolidation by a committee of experts, and test of the final version of the CHOP INTEND in 13 patients with SMA type I. We also assessed the content validity and reliability of the translated version. Results The scale was translated considering semantic, structural, idiomatic, and cultural aspects. All agreement rates were > 0.8, the overall content validity index of the instrument was 0.98, and inter-rater reliability using the intraclass correlation coefficient was 0.998. Conclusion The Brazilian version of the CHOP INTEND met semantic and technical equivalence criteria with the original version and was valid and reliable for patients with SMA type I.

Resumo Antecedentes A atrofia muscular espinhal (AME) é uma doença genética rara que provoca fraqueza muscular progressiva com impacto sobre a motricidade dos pacientes. A AME tipo I é considerada o tipo mais grave e acomete lactentes antes dos 6 meses de idade. As escalas disponíveis para avaliação das aquisições motoras mostram limitações para uso com crianças pequenas com doenças neuromusculares e fraqueza importante. Objetivo Realizar a tradução, adaptação transcultural e validação para a língua portuguesa do Brasil da Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP INTEND, na sigla em inglês). Métodos O presente estudo seguiu as etapas de tradução, síntese das traduções, retrotradução, consolidação por comitê de especialistas e teste com 13 pacientes com AME tipo 1. Foi avaliada a validade de conteúdo e a confiabilidade do instrumento. Resultados A escala foi traduzida considerando os aspectos semânticos, estruturais, idiomáticos e culturais. Todas as taxas de concordância foram > 0,8. O índice de validade de conteúdo geral do instrumento foi de 0,98. A confiabilidade interavaliadores analisada através do coeficiente de correlação intraclasse (ICC, na sigla em inglês) demonstrou um valor de ICC = 0,998. Conclusão A versão da CHOP INTEND em português atende aos critérios de equivalência semântica e técnica em relação à versão original e apresenta validade de conteúdo e confiabilidade para seu uso na população de pacientes com AME tipo I.

Relación entre biometría fetal, producto de acumulación de los lípidos y condición trófica al nacer / Relationship between fetal biometry, lipid accumulation product and the trophic condition at birth

Fundamento: Las alteraciones del estado nutricional materno generalmente se relacionan con desviaciones del crecimiento fetal, que pueden detectarse por los parámetros biofísicos fetales e identifican la posible condición trófica al nacer. Objetivo: Determinar la posible relación entre los parámetros biométricos fetales, la condición trófica al nacer y el producto de acumulación de los lípidos. Metodología: Se realizó un estudio transversal en el Policlínico Chiqui Gómez Lubian del municipio Santa Clara, durante el año 2019, en una población de 253 gestantes normopeso supuestamente sanas al inicio de la gestación. La muestra no probabilística fue de 144 gestantes. Las variables de estudio fueron: producto de acumulación de los lípidos, biometría fetal y condición trófica al nacer. Se utilizaron métodos teóricos, empíricos y estadísticos. Resultados: En el segundo trimestre ningún parámetro biométrico coincidió con la condición al nacer de pequeño, mientras que para el grande coincidieron las circunferencias cefálica y abdominal. En el tercer trimestre la longitud del fémur y la circunferencia abdominal coinciden en la identificación del pequeño y del grande. El PAL se correlacionó con la circunferencia abdominal del tercer trimestre y con el peso al nacer; presentando mayor frecuencia de valores en el tercer tertil para los nacimientos grandes. Conclusiones: La circunferencia abdominal fue el parámetro biométrico con mayor coincidencia con la condición trófica al nacer, la que se asoció con valores en el tercer tertil del PAL para la detección de nacimientos grandes, relacionándose el fenotipo normopeso metabólicamente obeso con el crecimiento fetal por exceso.

Background: Maternal nutritional status disorders are usually related to fetal growth deviations, which can be detected by fetal biophysical parameters and identify the possible trophic condition at birth. Objective: To determine the possible relationship between fetal biometric parameters, the birth trophic state and lipid accumulation product. Methodology: A cross-sectional study was conducted at the Chiqui Gómez Lubian Polyclinic in Santa Clara municipality, during 2019, in a population of 253 normal-weight pregnant women who were apparently healthy at the beginning of their gestation. The non-probability sample was made up of 144 pregnant women. Study variables were: lipid accumulation product, fetal biometry and trophic condition at birth. Theoretical, empirical and statistical methods were used. Results: In the second trimester, none of the biometric parameters matched the condition at birth as a small child, while in the large one the head and abdominal circumferences matched. In the third trimester, femoral length and abdominal circumference coincide in identifying the small one and the large one. LAP correlated with third trimester abdominal circumference and birth weight, presenting higher frequency of values in the third tertile for large births. Conclusions: Abdominal circumference was the biometric parameter with the highest coincidence with trophic condition at birth, associated with values in the third tertile of the LAP for detecting large births, relating the metabolically obese normal weight phenotype with excessive fetal growth.

Dependence of radioactive iodine-131 capture by the lacrimal ducts on the tear production level

Purpose: Secondary acquired lacrimal duct obstruction (SALDO) is one of the complications of radioiodine therapy. SALDO is formed a few months after therapy if there is a sufficient uptake of radioactive iodine by the nasolacrimal duct. To date, risk factors leading to SALDO are unclear. The objective was to determine the correlation between the tear production level and radioactive iodine?131 uptake in the lacrimal ducts.Methods: Basal and reflex tear production was studied in 64 eyes prior to the therapy with radioactive iodine?131 after drug?induced hypothyroidism. The condition of the ocular surface was assessed using the Ocular Surface Disease Index (OSDI) questionnaire. Seventy?two hours after the radioactive iodine therapy, scintigraphy was performed, which determined the presence or absence of iodine?131 in the lacrimal ducts. T?statistics and the Mann–Whitney criterion were used to identify the differences between the groups. The differences were considered significant at P ? 0.05. The current tear production level in patients receiving radioiodine therapy was determined using a mathematical model. Results: A statistically significant difference between the basal (p = 0.044) and reflex (p = 0.015) tear production levels was found in cases with and without iodine?131 uptake by the lacrimal ducts. The probable current tear production level corresponds to the sum of basal and 10–20% of reflex tear production. The uptake of iodine?131 was found regardless of the OSDI results.Conclusion: The probability of iodine?131 uptake by the lacrimal ducts rises as the tear production level increases.

Percentiles de peso, talla e índice de masa corporal de escolares de Mendoza. Comparación con la referencia de la Organización Mundial de la Salud / Body mass index, weight, and height percentiles in school-aged children from Mendoza. A comparison with the WHO reference

Introducción. La Organización Mundial de la Salud (OMS) recomienda el uso de tablas de referencia para monitorear el crecimiento y estado nutricional de niños, niñas y adolescentes. El peso corporal, la talla y el índice de masa corporal (IMC) son las variables más utilizadas. El presente trabajo tiene como objetivos estimar los percentiles de peso, talla e IMC de escolares (2009-2011) residentes en el departamento San Rafael (Mendoza) y compararlos con la referencia internacional de la Organización Mundial de la Salud, a fin de establecer su pertinencia para la evaluación del crecimiento y estado nutricional de dicha población. Población y métodos. Se realizó un estudio antropométrico transversal en 3448 escolares de entre 4,00 y 13,49 años de edad. Se utilizó el programa LMS ChartMarker Pro para calcular los valores percentilares de peso/edad, talla/edad e IMC/edad, por sexo y edad, y se compararon con las curvas de la OMS. Además, se calcularon diferencias porcentuales (D%) para estimar las diferencias y su significación estadística mediante prueba de Wilcoxon. Resultados. La población de San Rafael mostró, en varones y mujeres, valores percentilares superiores de peso e IMC (D% ≈7 % y 9 %, respectivamente), y menores de talla (D% ≈0,8 %) que los de la OMS (p <0,05). Conclusión. Las diferencias encontradas alertan sobre el empleo de la referencia OMS en la población escolar de San Rafael, ya que sobreestimaría las prevalencias de sobrepeso, obesidad y desnutrición crónica, y subestimaría la de desnutrición aguda y global. Esta situación resalta la importancia de contar con una referencia local.

Introduction. The World Health Organization (WHO) recommends the use of reference tables to monitor the growth pattern and nutritional status of children and adolescents. Body mass index (BMI), weight, and height are the most commonly used variables. The objective of this study was to estimate the BMI, weight, and height percentiles for school-aged children (2009-2011) living in the department of San Rafael (Mendoza) and compare them to the international World Health Organization reference to establish their relevance for the evaluation of the growth pattern and nutritional status of this population. Population and methods. A cross-sectional anthropometric study was conducted in 3448 school-aged children aged 4.00 to 13.49 years. The LMS ChartMarker Pro software was used to estimate the BMI- for-age, weight-for-age, and height-for-age percentiles, by sex and age, and they were compared with the WHO curves. Besides, percentage differences (%D) were calculated to estimate the differences and their statistical significance using the Wilcoxon test. Results. The population of boys and girls in San Rafael showed higher weight and BMI (%D ≈ 7% and 9%, respectively) percentiles, and lower height (%D ≈ 0.8%) values than WHO reference (p < 0.05). Conclusion. The differences found warn about the use of the WHO reference in the school-aged population of San Rafael since it would overestimate the prevalence of overweight, obesity, and chronic malnutrition and underestimate the prevalence of acute and global malnutrition. This situation highlights the importance of having a local reference resource

Age estimation of Russian individuals by teeth using the London Atlas / Análise da estimativa de idade em indivíduos russos utilizando a metodologia London Atlas

Knowing an individual's age is necessary for several situations, both in the living and the deceased. The London Atlas uses dental development and eruption to estimate age. Testing the method in different populations is necessary to assess its performance. This study aimed to assess the performance of the London Atlas method in a Russian sample using panoramic radiographs. A sample of 703 panoramic radiographs of Russian individuals (n = 405 females, 57.61% and n = 298 males, 42.39%) with ages between 8 and 23 years were analyzed. The results showed overestimation in individuals from 8 to 14 years and underestimation from 15 to 23 years. The mean difference between estimated and chronological ages did not exceed 0.7 years among individuals with ages below 19 years. The difference increased to over three years in individuals from 20 to 23 years. Statistically significant differences were found between females and males between 17 and 18 years (p<0.05). The London Atlas is suitable for Russian children and adolescents aged between 8 and 19 years; however, it showed unsatisfactory results for application in individuals over 20 years (AU).

Conhecer a idade de um indivíduo, vivo ou morto, é essencial em diversas situações. O método London Atlas utiliza desenvolvimento e erupção dentais para estimar a idade. Testar o método em diferentes populações é importante para avaliar sua performance. Esse estudo objetivou analisar o desempenho do London Atlas em uma amostra de origem russa, utilizando radiografias panorâmicas. Uma amostra de 703 indivíduos russos (n = 405 mulheres, 57,61% e n = 298 homens, 42,39%), com idades entre 8 e 23 anos foram analisadas. Resultados obtidos mostram uma superestimação em indivíduos de 8 a 14 anos e subestimação nos grupos de 15 a 23 anos. A diferença média entre idades estimadas e reais não excederam o valor de 0,7 anos nos indivíduos com idade abaixo de 19 anos. Essa diferença aumentou em até três anos em indivíduos de 20 a 23 anos. Diferenças estatisticamente significantes foram encontradas entre homens e mulheres com 17 e 18 anos (p<0,05). O London Atlas é adequado para crianças e adolescentes de origem russa, com idades de 8 a 19 anos. No entanto, observou-se resultados insatisfatórios para sua aplicação em indivíduos acima de 20 anos (AU).

Incorporación a las estadísticas oficiales del Municipio de Pila de indicadores positivos de salud infantil: proyecto CREDEPILA / Incorporation of positive child health indicators to the official statistics of the Municipality of Pila: CREDEPILA project

RESUMEN INTRODUCCIÓN: El municipio bonaerense de Pila carecía de indicadores adecuados para monitorear la salud infantil de su población. El objetivo fue incorporar indicadores positivos de crecimiento físico y desarrollo psicomotor en niños de 0 a 5,99 años. MÉTODOS: Se convocó a toda la población objetivo (con consentimiento parental) a los jardines y centros de atención primaria. Personal capacitado midió peso, estaturalongitud corporal y administró 13 pautas de desarrollo de la Referencia Nacional (RN). Las medianas de datos antropométricos se obtuvieron con el método LMS; la edad de cumplimiento de pautas se estimó con regresión logística y el ajuste, con el test de Hosmer-Lemeshow. El índice de desarrollo (ID) se calculó con una regresión lineal entre las diferencias entre las edades de cumplimiento de los niños con las de la RN, y las edades de la RN. RESULTADOS: De un total de 321 niños, se evaluó a 307 (95,6% del total; 169 niñas). Las curvas de estatura fueron similares a las de la Organización Mundial de la Salud y a las argentinas actualizadas (los puntajes "z" no difirieron significativamente de cero); las de peso e índice de masa corporal mostraron un moderado sobrepeso: z= 0,38±0,07 de desvío estándar. No hubo diferencias significativas entre sexos. Con las 6 pautas que mostraron un ajuste adecuado, el ID fue 89. DISCUSIÓN: El método se implementó con éxito. Pila cuenta ahora con una línea de base para el monitoreo anual de la salud infantil.

ABSTRACT INTRODUCTION: The Buenos Aires municipality of Pila lacked adequate indicators to monitor child health in the population. The objective was to incorporate positive indicators based on physical growth and psychomotor development in children aged 0 to 5.99 years. METHODS: The entire target population was summoned to kindergartens and primary care centers (with parental consent). Trained health personnel measured weight, supine length/height and administered 13 developmental items taken from the National Reference (NR). Medians of anthropometric data were obtained with LMS method; the age of attainment of items was estimated with logistic regression and the fit was assessed with the Hosmer-Lemeshow test. Developmental index (DI) was calculated with linear regression of differences between children's attainment ages and those of the NR, and the ages of the NR. RESULTS: Of 321 children, 307 (95.6% of the total; 169 girls) were evaluated. Height curves were similar to those of the World Health Organization and updated Argentine curves (z-scores did not significantly differ from zero); weight and body mass index curves showed moderate overweight: z = 0.38±0.07 standard deviation. No significant sex differences were found. Based on the 6 items that showed a good fit, the DI was 89. DISCUSSION: The method was successfully implemented. Pila has now a baseline for annual monitoring of children's health.

Canalización del crecimiento entre los 2 y los 5 años en niños aparentemente sanos con talla baja a los 2 años / Canalization of growth between 2 and 5 years of age in apparently healthy children with short stature at age 2 years

Introducción. El tamaño del recién nacido se asocia a condiciones intrauterinas. El potencial genético se expresa más tarde; la canalización del crecimiento se describe clásicamente hasta los 24 meses. Objetivo. Describir la canalización del crecimiento entre los 2 y los 5 años en niños aparentemente sanos con talla baja a los 2 años. Población y métodos. Estudio de cohorte retrospectiva. Se incluyeron niños seguidos en un hospital universitario de comunidad entre 2003 y 2019, con puntaje Z de talla menor a -2 DE para edad y sexo a los 2 años. Se excluyeron los nacidos prematuros, con bajo peso y con enfermedades crónicas. Se evaluó la trayectoria de crecimiento. Se definió canalización como la adquisición de talla normal para la población general. Resultados. Se incluyeron 64 niños, de los cuales 37 (58 %) presentaron canalización del crecimiento a los 5 años (20 a los 3 años, 8 a los 4 años, y 9 a los 5 años). La velocidad de crecimiento a los 3 y a los 5 años fue significativamente mayor en los que canalizaron en comparación con los que no lo hicieron; hubo una tendencia similar a los 4 años. De los 27 niños con talla baja a los 5 años, 25 tuvieron al menos un registro de velocidad de crecimiento anual menor al percentil 25. Conclusiones. La mayoría de los niños aparentemente sanos con baja talla a los 2 años alcanzan una talla normal a los 5 años. La velocidad de crecimiento anual permite detectar a los niños con riesgo de no canalizar.

Introduction. Newborn size is associated with intrauterine conditions. Genetic potential is expressed later; the canalization of growth is typically described up to 24 months of age. Objective. To describe the canalization of growth between 2 and 5 years of age in apparently healthy children with short stature at age 2 years. Population and methods. Retrospective, cohort study. Children seen at a community teaching hospital between 2003 and 2019, who had a Z-score for height below -2 SDs for age and sex at age 2 years were included. Infants born preterm, with a low birth weight, and chronic conditions were excluded. Growth patterns were assessed. Canalization was defined as reaching a normal stature for the general population. Results. Sixty-four children were included; 37 (58%) showed canalization of growth at 5 years old (20 at 3 years, 8 at 4 years, and 9 at 5 years). The growth rate at 3 and 5 years of age was significantly higher among those who showed canalization compared to those who did not; a similar trend was observed at 4 years of age. Among 27 children with short stature at 5 years of age, 25 had at least 1 annual growth velocity below the 25th centile. Conclusions. Most apparently healthy children with short stature at 2 years old reached a normal stature at 5 years old. The annual growth velocity allows to detect children at risk of not showing canalization.

Avaliação do crescimento e desenvolvimento infantil e fatores de risco de um município que integra uma universidade brasileira de cunho internacional / Evaluation of childhood growth and development and risk factors of a municipality that is part of an international brazilian university / Evaluación de los factores de crecimiento y desarrollo infantil y de riesgo de un municipio que forma parte de una universidad brasileña internacional

Fatores de risco, incluindo os de cunho materno, interferem no crescimento e desenvolvimento infantil. Nesse sentido, o conhecimento desses fatores e avaliação ade- quada desses processos são necessários para articulação de estratégias preventivas de transtornos futuros. Assim, o estudo visou investigar o crescimento e desenvolvimento de crianças atendidas em consulta de puericultura em unidades básicas de saúde de um mu- nicípio cearense, que integra uma universidade brasileira de cunho internacional, e seus fatores de risco. Trata-se de estudo observacional, analítico, transversal e de abordagem quantitativa, conduzido com crianças e suas mães no Centro de Saúde de Acarape e Posto de Saúde São Benedito (Acarape ­ CE), no período de fevereiro a julho de 2021. Após consentimento, as mães preencheram um questionário, seguido de avaliação do cresci- mento e desenvolvimento das crianças. Os dados obtidos foram analisados. Das 70 crian- ças, 50,00% (n = 17) e 51,43% (n = 18) dos meninos e meninas tinham baixa estatura para idade, respectivamente. Para o desenvolvimento psicossocial, dos 284 testes condu- zidos, 86,27% (n = 245) foram realizados em plenitude pelas crianças. Observou-se as- sociação significativa entre a gestante ter concebido o filho com, no mínimo, 9 meses de período gestacional e esse apresentar relação Peso/Idade adequada e Estatura/Idade ina- dequada. Houve associação significativa entre a criança não ingerir refresco em pó e apre- sentar relação Peso/Idade adequada. Conclui-se que as crianças tinham idade gestacional adequada e apresentavam estado nutricional apropriado, apesar da baixa estatura para idade. Manifestavam desenvolvimento psicossocial, de linguagem e físico normais. Sobre os fatores de risco, esses envolveram os de cunho materno e o consumo de alimentos cariogênicos.

Risk factors, including maternal ones, interfere with child growth and de- velopment. In this sense, knowledge of these factors and adequate evaluation of these processes are necessary to articulate preventive strategies for future disorders. Thus, the study aimed to investigate the growth and development of children seen in childcare con- sultations in primary health units in Ceará, part of a Brazilian university of international character, and their risk factors. This is an observational, analytical, cross-sectional study with a quantitative approach, conducted with children and their mothers at the Acarape Health Center and São Benedito Health Center (Acarape ­ CE), from February to July 2021. After consent, the mothers completed a questionnaire, followed by an assessment of the children's growth and development. The data obtained were analyzed. Of the 70 children, 50.00% (n = 17) and 51.43% (n = 18) of the boys and girls were short for their age, respectively. Of the 284 tests conducted for psychosocial development, 86.27% (n = 245) were entirely performed by the children. A significant association was observed between the pregnant woman having conceived her child at least nine months of gestation and having an adequate Weight/Age and Height/Age ratio. There was a significant asso- ciation between the child not ingesting powdered soft drinks and having an appropriate Weight/Age ratio. It was concluded that the children had an adequate gestational age and had an appropriate nutritional status, despite their low height for their age. They showed normal psychosocial, language, and physical development. The risk factors involved those of mother nature and the consumption of cariogenic foods.

Los factores de riesgo, incluidos los maternos, interfieren en el crecimiento y desarrollo infantil. En este sentido, el conocimiento de estos factores y la evaluación adecuada de estos procesos son necesarios para articular estrategias preventivas de futu- ros trastornos. Así, el estudio tuvo como objetivo investigar el crecimiento y desarrollo de niños atendidos en consultas de puericultura en unidades básicas de salud de un muni- cipio de Ceará, que forma parte de una universidad brasileña de carácter internacional, y sus factores de riesgo. Se trata de un estudio observacional, analítico, transversal, con enfoque cuantitativo, realizado con niños y sus madres en el Centro de Salud de Acarape y el Centro de Salud São Benedito (Acarape ­ CE), de febrero a julio de 2021. Después del consentimiento, las madres completaron un cuestionario, seguido de una evaluación del crecimiento y desarrollo de los niños. Los datos obtenidos fueron analizados. De los 70 niños, el 50,00% (n = 17) y el 51,43% (n = 18) de los niños y niñas eran bajos para su edad, respectivamente. Para el desarrollo psicosocial, de las 284 pruebas realizadas, el 86,27% (n = 245) fueron realizadas íntegramente por los niños. Se observó una asociación significativa entre la gestante haber concebido a su hijo con al menos 9 meses de gesta- ción y tener una adecuada relación Peso/Edad y Talla/Edad. Hubo asociación significativa entre el niño que no ingiere gaseosas en polvo y presentar una adecuada relación Peso/Edad. Se concluyó que los niños tenían una edad gestacional adecuada y un estado nutricional adecuado, a pesar de su baja talla para su edad. Presentaron un desarrollo psi- cosocial, lingüístico y físico normal. En cuanto a los factores de riesgo, estos involucraron los de naturaleza materna y el consumo de alimentos cariogénicos.

Trends and influencing factors of endurance performance of Han college students in Hunan Province during 1985-2019 / 中国学校卫生

Objective@#To analyze the trends and influencing factors of endurance performance of 19-22 years old college students in Hunan Province from 1985 to 2019, so as to provide objective and scientific basis for sports and health work in colleges and universities.@*Methods@#A retrospective analysis was conducted on the data of 14 490 college students aged 19-22 in Hunan Province from 8 consecutive National Student Physical Fitness and Health Surveys conducted from 1985 to 2019. The analysis indexes were 1 000 m running for boys and 800 m running for girls.@*Results@#From 1985 to 2019, the endurance running time of 19-22 years old Han college students in Hunan Province showed an obvious trend of decline. The 1 000 m running time of urban and rural male students increased by 41.9 and 45.4 s on average, and the 800 m running time of urban and rural female students increased by 29.5 and 30.6 s on average, respectively. Multiple linear regression analysis showed that age ( β =0.17), urban students (rural students as reference; β =0.44), GDP ( β =0.94) and urbanization level ( β = 0.44 ) were positively correlated with the average endurance running time of males. Urban students ( β =0.92), GDP ( β = 1.38 ) and Engel coefficient ( β =0.93) were positively correlated with the average endurance running time of females. BMI ( β =-0.47) was negatively correlated with the females mean time of endurance running ( P ＜0.05).@*Conclusion@#The endurance performance of Han college students in Hunan Province showed a declining trend from 1985 to 2019,which is associated with age, urban and rural distribution, regional GDP, Engel s coefficient, urbanization level and BMI. Effective measures should be taken to improve the physical quality of college students.

Atypical developmental of the sensorimotor network optimal frequency in children with autism spectrum disorder / 中国学校卫生

Objective@#On the basis of the dominant frequency index of functional connectivity, the "brain age" analysis method was used to explore abnormal development patterns of sensorimotor networks in boys with autism spectrum disorder(ASD).@*Methods@#The resting state functional magnetic resonance data (7-12 years old) for 105 boys with ASD and 102 matched boys with normal development from the ABIDE public database were screened. Functional connection networks in different frequency bands of sensorimotor related brain regions were constructed for each individual, and the frequency of the strongest connection were constructed as the optimal frequency of the connection. Brain age analysis was used to explore the difference between brain age and chronological age in boys with ASD.@*Results@#The brain sensorimotor network of boys with ASD showed an abnormal development pattern of overdevelopment followed by underdevelopment, and the transition between the two patterns occurred at approximately 7.8 years of age. Older boys with ASD (older than 10 years) whose underdevelopment trend was suppressed had lower ASD severity( r=-0.43, P < 0.05 ).@*Conclusion@#The brain sensorimotor network in boys with ASD has an abnormal development process, and the brain chronological age difference in the sensorimotor network has potential as a neuroimaging marker to measure the development of ASD.

Association between dynamic cardiorespiratory fitness and aerobic endurance among university students / 中国学校卫生

Objective@#To screen dynamic cardiorespiratory fitness indices for effective assessment of aerobic endurance using incremental load exercise tests.@*Methods@#From March to November 2019, 266 volunteers who were able to understand the trial and voluntarily cooperated with the entire testing process were randomly recruited from 5 universities in Beijing. Gas metabolism and cardiac function were monitored in real time using the German Cortex Metalyzer 3B system and the US Cheetah NICOM system, and maximum oxygen uptake was measured by a linear incremental loading scheme. Aerobic endurance and dynamic cardiopulmonary function indices were selected according to the study design, and the relationship between the two indicators was analyzed using correlation and typicality correlation.@*Results@#The absolute maximum oxygen uptake (VO 2max ), relative maximum oxygen uptake, maximum stroke volume (SV max ), and maximum stroke volume index (SVI max ) were significantly higher in males than in females, and the dynamic cardiopulmonary function index K was significantly lower than in females ( t =17.8, 10.1, 8.5, 4.3 , -6.3, P < 0.05 ). Simple correlation revealed that absolute VO 2max and relative VO 2max were negatively correlated with K and b, and absolute VO 2max and relative VO 2max were positively correlated with SV max and SVI max ( P <0.01); Both dynamic cardiopulmonary function indices were significantly correlated with aerobic endurance. Aerobic endurance indexes closely related to dynamic cardiopulmonary function were absolute VO 2max , relative VO 2max ; dynamic cardiopulmonary function indexes closely related to aerobic endurance were K, b, SV max , SVI max .@*Conclusion@#Improvement of dynamic cardiorespiratory fitness contributes to the improvement of aerobic endurance, the dynamic cardiorespiratory fitness indices K, b, SV max , and SVI max can be used as important candidates to predict the assessment of aerobic exercise capacity.

Physical fitness and associated factors among primary and middle school students in Henan Province in 2019 / 中国学校卫生

Objective@#To understand physical fitness among primary and middle school students in Henan Province, so as to provide theoretical basis for physical fitness promotion among primary and middle school students.@*Methods@#Based on data of National Survey on Student Physical Fitness and Health in Henan Province in 2019, a total of 42 734 students were investigated. The Z value of each physical fitness index were calculated by Z method, physical fitness index (PFI) was obtained to reflect the physical fitness condition synthetically. Physical fitness of different groups were compared, and associated factors of PFI were analyzed by multiple linear regression.@*Results@#Lung capacity, grip strength, standing long jump, 50 m run, 50 m×8 shuttle run and PFI in boys were [(2 552.1±1 226.5)mL, (26.0±13.9)N, (171.0±43.7)cm, (9.3±1.8)s, (132.1±22.6)s, (1.4±3.6)], respectively, which were significantly higher than that of girls [(1 965.2±765.3)mL, (19.1±8.2)N, (142.4±26.6)cm, (10.5±1.4)s, (136.9±21.1)s, (-1.4±3.2)]( t =59.35,62.66,81.87,-74.92,-16.72,85.96, P <0.01). The seated forward flexion of boys [(7.0±7.5)cm] was significantly lower than that of girls[(11.8±7.1)cm], the difference was statistically significant ( t =-68.57， P <0.01). Significant sex differences were observed in physical fitness at different age ( P <0.01). There was a certain gap between urban boys and rural boys in terms of strength quality, endurance quality and flexibility quality, and the physical quality of urban girls was better than that of rural girls as a whole. The detection rates of poor eyesight, malnutrition, overweight and obesity, anemia and high blood pressure of primary and middle school students were 68.0%, 5.4%, 26.0%, 15.9% and 18.0%, respectively. Region, sex, age and nutritional status(malnutrition,overweight and obesity) were the influencing factors of PFI( β =-0.23,-2.92,-0.11,-1.19, -0.78 , P <0.05).@*Conclusion@#Physical fitness among primary and middle school students varies in gender, age group, region and disease condition in Henan Province. Scientific intervention should be administered, especially for rural, female students, senior students, undernourished and overweight and obese students, to improve health awareness and physical fitness.

Abnormal spinal curvature and associated factors among primary and secondary school students in Sichuan Province / 中国学校卫生

Objective@#To investigate abnormal spinal curvature among primary and secondary school students in Sichuan Province, so as to provide evidence for scientific prevention.@*Methods@#Using a stratified cluster random sampling method, a total of 210 713 students of grade 4 to grade 12 from 21 cities (prefectures) in Sichuan Province were selected for spinal curvature screening and questionnaire survey from September to November 2022. Chi-square test and multivariate Logistic regression model were used to analyze the influencing factors of abnormal spinal curvature.@*Results@#The detection rate of abnormal spinal curvature was 3.42%, with urban areas (4.54%) higher than that in suburban areas(2.57%), girls (3.86%) higher than that in boys(2.98%), high school students (4.70%) higher than that in middle school students (3.80%) and elementary school students(2.21%), the differences were statistically significant ( χ 2=606.96, 123.81, 645.24, P <0.01). Multivariate Logistic regression analysis showed that urban area, junior and senior high school, girl, carrying backpack on one shoulder, desks and chairs adjusted for student height less than ≤1 time every school year, moderate-to-vigorous physical activity less than 1 h per week, and indoors sedentary time more than 10 h/d were positively associated with abnormal spinal curvature ( OR=1.72, 1.75, 1.87, 1.26, 1.09, 1.07, 1.10, 1.25 , P <0.05).@*Conclusion@#The detection rate of abnormal spinal curvature of primary and secondary school students may be affected by the urbanicity, educational stage as well as gender in Sichuan Province. More attention should be paid to urban high school girls, and targeted strategies should be explored to reduce the incidence of abnormal spinal curvature.

A longitudinal study on association between puberty development and thyroid function of school aged girls in Minhang District, Shanghai / 中国学校卫生

Objective@#To observe the association between puberty development and thyroid function among school-aged girls in Minhang District of Shanghai, in order to explore the effect of puberty development on thyroid function. @*Methods@#The study was based on a cohort of adolescent girls recruited in iodine-suitable areas of Minhang District, and the baseline and follow-up survey have been carried out from January to March 2019. The method of phased cluster sampling was used to select one junior high school in the east, south, north and middle of Minhang District, Shanghai, respectively. Finally, 464 new junior high school girls were included in the Cohort study for physical examination, and girls were followed up from January to March 2021. The Puberty Development Scale (PDS) was used to assess the stage of puberty. Serum thyroid stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) were determined for each participant. Thyroid homeostasis structure parameters (THSPs) was calculated. Changes of Thyroid hormones at baseline and follow-up were compared by Wilcoxon signed rank sum test. Multiple linear regression analyses were used to evaluate the associations of thyroid hormones (THs) and THSPs changes with pubertal develepment.@*Results@#Serum TSH levels of female studentds decreased significantly, while their FT3 and FT4 levels increased significantly during the study period ( Z=-10.53, -4.71, -12.46, P <0.01). In multiple linear regression analysis after adjustment for co-variables (including baseline age, change of BMI and waist circumference), FT4 and thyroid feedback quantile-based index (TFQI) in the higher puberty category scores changes (△PCS) group were further reduced compared with those in the low △PCS group ( β =-0.66, -0.55 ). Compared to the late puberty at baseline and follow-up (BLFL) group, FT4 and TFQI showed higher decline in the pre-puberty at baseline and late puberty at follow-up (BPFL) group with the pre-puberty at baseline and end of puberty at follow-up (BPFT) group ( β =-0.55, -0.44)( P <0.05). There were no association of △TSH, △FT3, △FT4/FT3 and TSH index changes (△TSHI) with △PCS or the puberty pattern.@*Conclusion@#Serum TSH decreases while serum FT3 and FT4 increase among girls during puberty. Both the initial stage and the velocity of pubertal development are related to thyroid hormone fluctuations.

Análise léxica dos termos "crescimento e desenvolvimento" infantil / Análisis léxico de los términos "crecimiento y desarrollo" infantil / Lexical analysis of the terms "child growth and development"

Resumo Objetivo Analisar o léxico relacionado ao uso dos termos "crescimento e desenvolvimento" infantil, de acordo com a literatura da enfermagem. Métodos Trata-se de revisão integrativa desenvolvida nas bases de dados Lilacs, SciELO, Medline®, Web of Science, PsycInfo e Banco de Dados em Enfermagem: Bibliografia Brasileira. A busca foi operacionalizada usando-se os descritores "crescimento e desenvolvimento", "criança" e "saúde". Compuseram a amostra 22 documentos. O conteúdo referente ao crescimento e ao desenvolvimento da criança foi analisado no software IRAMUTEQ, por meio da classificação hierárquica descendente e de análise fatorial de correspondência. Os termos foram analisados de acordo com o referencial teórico das necessidades essenciais da criança. Resultados Foram determinadas cinco classes, que tinham relações léxicas e semânticas, representadas por: Crescimento; Desenvolvimento; Consulta de Enfermagem; Atividades de registro e Fatores influentes ao crescimento e ao desenvolvimento infantil. Conclusão Foi identificado o vocabulário léxico, sendo destrinchado, de forma minuciosa e profunda, o fenômeno "crescimento e desenvolvimento", o que pode facilitar o processo do raciocínio clínico e crítico do enfermeiro no momento da Consulta de Enfermagem, principalmente ao listar os Diagnósticos de Enfermagem e prescrever as Intervenções de Enfermagem.

Resumen Objetivo Analizar el léxico relacionados al uso de los términos "crecimiento y desarrollo" infantil, de acuerdo con la literatura de enfermería. Métodos Se trata de una revisión integradora realizada en las bases de datos Lilacs, SciELO, Medline®, Web of Science, PsycInfo y Banco de Datos en Enfermería: Bibliografía Brasileña. La búsqueda fue llevada a cabo utilizando los descriptores "crecimiento y desarrollo", "niño" y "salud". La muestra estuvo compuesta por 22 documentos. El contenido referente al crecimiento y al desarrollo del niño se analizó en el software IRAMUTEQ, mediante la clasificación jerárquica descendiente y del análisis factorial de correspondencia. Los términos fueron analizados de acuerdo con el marco referencial teórico de las necesidades esenciales de los niños. Resultados Se determinaron cinco clases, que tenían relaciones léxicas y semánticas, representadas por: Crecimiento; Desarrollo; Consulta de enfermería; Actividades de registro y Factores influyentes al crecimiento y al desarrollo infantil. Conclusión Se identificó el vocabulario léxico y se desenmarañó, de forma minuciosa y profunda, el fenómeno "crecimiento y desarrollo", lo que puede facilitar el proceso de razonamiento clínico y crítico de los enfermeros en el momento de la consulta de enfermería, principalmente al enumerar los diagnósticos de enfermería y prescribir las intervenciones de enfermería.

Abstract Objective To analyze the lexicon related to the use of terms "child growth and development", according to nursing literature. Methods This is an integrative review developed in the LILACS, SciELO, MEDLINE®, Web of Science, PsycInfo and Banco de Dados em Enfermagem: Brazilian Bibliography databases. The search was operationalized using the descriptors "growth and development", "children" and "health". The sample consisted of 22 documents. The content related to child growth and development was analyzed using the IRAMUTEQ software, using descending hierarchical classification and factorial correspondence analysis. The terms were analyzed according to children's essential needs theoretical framework. Results Five classes were determined, which had lexical and semantic relationships, represented by: Growth; Development; Nursing Consultation; Recording activities and Influential factors for child growth and development. Conclusion Lexical vocabulary was identified, and the phenomenon "growth and development" was carefully and deeply unraveled, which can facilitate nurses' clinical and critical reasoning at the time of the Nursing Consultation, mainly when listing Nursing Diagnoses and prescribing Nursing Interventions.

Correlation between cleft width and dental arch symmetry in cleft lip and palate: a longitudinal study

Abstract This study aimed to evaluate the influence of cleft width on dental arch symmetry of children with unilateral cleft lip and palate. Forty-one children were subjected to impression preoperatively (T1; mean age = 0.31 ± 0.07 years) and postoperatively (T2; mean age = 6 .73 ± 1.02 years). Eighty-two digitized dental casts were analyzed by stereophotogrammetry software. The cleft palate width was measured in the anterior (P-P'), middle (M-M'), and posterior (U-U') regions. Also, the following measurements were obtained: anterior intersegment (I-C') and intrasegment (I-C); total intersegment (I-T') and intrasegment (I-T); cleft-side (C'-T') and non-cleft-side (C-T) canine tuberosity. Paired t test and Pearson correlation coefficient were applied (α = 5%). Cleft width had the following means: 10.16 (± 3.46) mm for P-P', 12.45 (± 3.00) mm for M-M', and 12.57 (± 2.71) mm for U-U'. In the longitudinal analysis, I-C' had a significant reduction, while the other measurements significantly increased (p < 0.001). Asymmetry was verified in the following analyses at T1: I-C' vs. I-C and I-T' vs. I-T (p < 0.001); at T2, only in I-C' vs. I-C (p < 0.001). At T1, P-P' vs. I-C' (r = 0.722 and p < 0.001), P-P' vs. I-T' (r = 0.593 and p < 0.001), M-M' vs. I-C' (r = 0.620 and p < 0.001), and M-M' vs. I-T' (r = 0.327 and p < 0.05) showed a positive and significant correlation. At T2, there was a correlation between M-M' and I-C' (r = 0.377 and p < 0.05). In conclusion, the anterior and middle cleft widths influenced palatal asymmetry in the first months of life, while middle width influenced residual asymmetry.