ABSTRACT
OBJECTIVE: To document the clinical profile and academic history of children with borderline intellectual functioning ("slow learners"); and to assess parental knowledge and attitudes regarding this condition. METHODS: From November 2004 to April 2005, 55 children (35 boys, 20 girls) were diagnosed as slow learners based on current level of academic functioning and global IQ scores (71-84) done by the WISC test. Detailed clinical and academic history; and physical and neurological examination findings were noted. The parents were counseled about the diagnosis and the option of special education. RESULTS: The mean age of slow learners was 11.9 years (+/-SD 2.3, range 8-17). Eighteen (32.7%) children had a significant perinatal history, 15 (27.3%) had delayed walking, 17 (30.9%) had delayed talking, 17 (30.9%) had microcephaly, 34 (61.8%) had presence of soft neurologic signs, and 10 (18.2%) were on complementary and alternative medication therapy. There were no differentiating features between the two gender groups. Their chief academic problems were difficulty in writing (92.7%), overall poor performance in all subjects (89.1%), and difficulty in mathematics (76.4%). Forty-six (83.6%) children had failed in examinations, 34 (61.8%) had experienced grade retention, and 32 (58.2%) had behavior problems. Most parents (83.3%) were reluctant to consider the option of special education. CONCLUSION: Slow learners struggle to cope up with the academic demands of the regular classroom. They need to be identified at an early age and their parents counseled to understand their academic abilities.
Subject(s)
Adolescent , Child , Education, Special , Educational Status , Female , Health Knowledge, Attitudes, Practice , Humans , India , Intelligence Tests/statistics & numerical data , Learning Disabilities/diagnosis , Male , Parents , Psychological Tests/statistics & numerical data , Socioeconomic FactorsABSTRACT
OBJETIVO: Avaliar a progressão da mucopolissacaridose II, durante um período de 12 meses, em 11 pacientes brasileiros. MÉTODOS: Onze pacientes brasileiros com mucopolissacaridose II foram avaliados prospectivamente no Serviço de Genética Médica do Hospital de Clínicas de Porto Alegre. As avaliações realizadas na visita inicial e na de 12 meses foram: anamnese, exame físico, ressonância nuclear magnética abdominal, ecocardiograma, teste da caminhada em 6 minutos, audiometria, exames bioquímicos séricos e dosagem uriná- ria de glicosaminoglicanos. RESULTADOS: Os principais achados relativos à comparação entre as duas visitas foram: 1) dois pacientes apresentaram retardo de crescimento; 2) dois pacientes apresentaram variação negativa em relação ao peso; 3) um paciente apresentou variação de obesidade para sobrepeso; 4) três pacientes desenvolveram alargamento do ventrículo esquerdo; destes, dois aumentaram o número de lesões nas valvas cardíacas; 5) não foi encontrada diferença estatística significativa entre a média das distâncias percorridas no teste da caminhada em 6 minutos; 6) houve aumento do volume esplênico; 7) ocorreu aumento dos níveis de gamaglutamiltransferase; 8) não houve alteração dos níveis urinários de glicosaminoglicanos. CONCLUSÕES: De uma maneira geral, a única variável que apresentou, no período estudado, piora com potencial repercussão clínica imediata foram os achados ecocardiográficos. Embora o período de 12 meses seja curto para medir alterações na maioria dos parâmetros comprometidos na mucopolissacaridose II, sua natureza progressiva deve ser levada em conta na avaliação da eficácia dos protocolos de tratamento para essa condição.
OBJECTIVE: To assess the progression of mucopolysaccharidosis II in 11 Brazilian patients over a 12-month period. METHODS: Eleven Brazilian patients with mucopolysaccharidosis II were prospectively studied at the Division of Medical Genetics of Hospital de Clínicas de Porto Alegre. The initial assessment and the assessment at 12 months included: anamnesis, physical examination, abdominal nuclear magnetic resonance, echocardiogram, 6-minute walk test, audiometry, serum biochemical tests and urinary glycosaminoglycan concentration. RESULTS: The major findings after comparing the assessments were: 1) two patients had growth retardation; 2) two patients showed negative weight change; 3) one patient went from obese to overweight; 4) three patients revealed left ventricle hypertrophy; of these, two increased the number of cardiac valve lesions; 5) there was no statistically significant difference between the mean distances obtained on the 6-minute walk test; 6) there was splenic enlargement; 7) there was an increase in gamma-glutamyltransferase levels; 8) the urinary concentration of glycosaminoglycans remained unchanged. CONCLUSIONS: In general, echocardiographic findings were the only variable with deterioration and possible immediate clinical consequences. Although a 12-month period is too short to detect changes in most variables related to mucopolysaccharidosis II, its progressive nature should be taken into account when evaluating the efficiency of treatment protocols.
Subject(s)
Child , Child, Preschool , Humans , Mucopolysaccharidosis II/pathology , Brazil , Disability Evaluation , Disease Progression , Glycosaminoglycans/urine , Intelligence Tests/statistics & numerical data , Mucopolysaccharidosis II/complications , Mucopolysaccharidosis II , Prospective Studies , Statistics, Nonparametric , Time Factors , Walking/statistics & numerical dataABSTRACT
OBJETIVOS: Comparar la capacidad intelectual de niños con el antecedente de Apgar 0 a 3 y Apgar 4 a 6 a los 5 minutos de vida (casos), con niños de apgar normal 7 a 10 a los 5 minutos (controles). TIPO DE ESTUDIO: Estudio transversal analítico de casos y controles. LUGAR: IPSS. Hospital Nacional de Sur. (Ex-empleado). Arequipa. MUESTRA: Se seleccionó de los nacidos vivos entre el mes de junio de 1988 y junio de 1989. Tres grupos: Apgar 0 a 3, Apgar 4 a 6 y Apgar de 7 a 10 a los 5 minutos: 15 casos cada grupo. METODOS: De investigación: Se obtuvo el Apgar de la historia clínica del recién nacido. En la visita domiciliaria, se verificó si el niño tenía criterios para excluírlo del estudio, se le pesó y talló al niño, se procedió a realizar el TEST DE REVEN en forma individual, se obtuvo el diagnóstico de capacidad intelectual. Se utilizó la prueba de JI CUADRADO, y la prueba de Odds Ratio. Se utilizó criterios de inclusión y exclusión para seleccionar a los niños. RESULTADOS: Se encontró capacidad intelectual inferior: con Apgar 0 a 3, el 46.6 por ciento, con Apgar de 4 a 6, el 13.3 por ciento, con Apgar normal el 6.6 por ciento. Los niños con Apgar de 0 a 3 a los cinco minutos, tiene 12.25 veces más riesgo de tener capacidad intelectual inferior que los niños con Apgar normal a los cinco minutos. CONCLUSION: Existe diferencia significativa entre los Grupos I y III, siendo el Apgar de 0 a 3 a los 5 minutos u factor de riesgo para tener capacidad intelectual inferior o deficiente. El Apgar 4 a 6 no constituye un factor de riesgo para tener capacidad intelectual inferior, ya que no existe diferencia significativa entre el grupo II y el grupo III.