Evaluation of Antimicrobial Photodynamic Therapy as an Adjuvant in Periodontal Treatment in Individual with Down Syndrome

Abstract Objective: To evaluate the effectiveness of Antimicrobial Photodynamic Therapy (aPDT), associated with scaling and root planing in the non-surgical periodontal treatment of individuals with Down Syndrome. Material and Methods: A controlled, randomized, split-mouth study was conducted. A total of 8 participants diagnosed with Down Syndrome aged 17-38 years of both sexes with clinical periodontitis were included in the study. Participants were treated at least three times: at the baseline, Plaque Index (PI), Bleeding on Probing (BOP), and Probing Pocket Depth (PPD) were obtained. After one week, conventional scaling and root planing were performed, and two quadrants were randomly selected for aPDT application. The reassessment was obtained one month after the aPDT application. The significance level was set at 5%. Analyses were performed considering a 95% confidence interval. Results: In the intergroup evaluation, no statistically significant differences were observed (p>0.05). In the intragroup evaluation, no statistically significant variations were observed in relation to the PI (p>0.05) and PPD (p>0.05); however, a statistically significant reduction in the BOP was observed between the test group (p=0.013) and control group (p=0.015). Conclusion: The use of aPDT as adjuvant therapy did not promote additional benefits in decreasing PI and PPD after 1 month of treatment. However, a significant reduction in the BOP was observed in the intragroup evaluation.

Defectos bucodentales en personas con síndrome de Down: una prioridad en salud bucal / Oral-dental defects in people with Down's syndrome: a priority in oral health

RESUMEN El síndrome de Down con frecuencia se acompaña de defectos bucodentales que comprometen la función masticatoria y fonatoria del paciente. Las acciones de prevención y promoción de salud bucal, el diagnóstico precoz y seguimiento de estas enfermedades, contribuyen al logro del verdadero enfoque interdisciplinario que demandan estos pacientes, para lograr una plena inclusión social. Se realizó una búsqueda bibliográfica sobre el tema, con el objetivo de estructurar los referentes teóricos relacionados con los principales defectos bucodentales -congénitos y adquiridos- que afectan a la población con síndrome de Down, para lograr la prevención de estos defectos y el incremento de la calidad de vida de los pacientes. Los defectos bucodentales congénitos más frecuentes encontrados en la trisomía 21, fueron la microdoncia, la macroglosia y la erupción dental tardía. La enfermedad periodontal fue el defecto adquirido de mayor presentación, al que se asocian diversos factores de riesgo, muchos modificables. Las intervenciones tempranas en salud bucal pueden incrementar la calidad de vida de los niños y adultos que padecen este trastorno, ayudándolos a lograr un pleno desarrollo como seres humanos (AU).

ABSTRACT Down's syndrome is frequently accompanied by oral-dental defects compromising the masticatory and phonatory function of the patients. Oral health promotion and prevention actions, precocious diagnosis and follow-up of these diseases contribute to achieving the true interdisciplinary approach these patients demand to reach their full social inclusion. A bibliographic search on the theme was carried out, with the objective of structuring the theoretical referents related to the main oral-dental defects -congenital and acquired-, affecting the population with Down's syndrome to reach these defects prevention and increasing these patients' life quality. The congenital oral-dental defects more commonly found in trisomy 21 were microdontia, macroglossia, and delayed tooth eruption. Periodontal disease was more frequently found acquired defect, to which several risk factors are associated, many of them modifiable. Early interventions in oral health may improve the life quality of these children and adults, helping them to achieve a full development as human beings (AU).

Prevalencia e Incidencia de Síndrome de Down en los Certificados Médicos Oficiales / 9 DESCRIPTIVE STUDY ON PREVALENCE AND INCIDENCE OF DOWN SYNDROME IN OFFICIAL MEDICAL CERTIFICATES

Estudio descriptivo sobre la prevalencia e incidencia de Síndrome de Down en los Certificados Médicos Oficiales firmados en nuestro servicio en el período comprendido entre los años 2017- 2019, la prevalencia de cardiopatías congénitas en los mismos y la prevalencia de nacimientos con esta anomalía genética en nuestro hospital. Comparación con estadística nacional e internacional

Descriptive study on prevalence and incidence in Down Syndrome in the Official Medical Certificates signed by our service between years 2017-2019, the prevalence of con genital heart disease on these and the prevalence of birth with this genetic anomaly on our hospital. National and International comparison of statistics

Evaluation of Oral Hygiene in Children with Down Syndrome Using the Busy Book Ayo Sikat Gigi as an Educational Toy

Abstract Objective: To evaluate the oral hygiene status of children with Down syndrome using the busy book Ayo Sikat Gigi as an educational toy. Material and Methods: We ran an experimental study involving 25 educable and trainable children with Down syndrome, comprising 17 males and 8 females aged 7-12 years, who were free from other disabilities and did not use orthodontic or prosthodontic appliances. Parents were instructed to educate their children using the busy book Ayo Sikat Gigi and also to guide their children in brushing their teeth effectively at home. We evaluated the OHI-S score over two visits, one before and the other after education using the busy book Ayo Sikat Gigi over a 7 day period. The Wilcoxon test with the p-value set at 0.05 was used Results: It was noted a statistically significant decrease in the OHI-S scores of children with Down syndrome (p<0.05), reflecting an improvement in their dental health, after education using the busy book Ayo Sikat Gigi (median scores before and after education: 2.30 and 1.84, respectively) Conclusion: The busy book Ayo Sikat Gigi is a highly effective educational toy for children with Down syndrome, and in our study, it was demonstrated to decrease their OHI-S scores after education for 7 days.

Prevalence of Dental Anomalies in Indonesian Individuals with Down Syndrome

Abstract Objective: To determine the frequency distribution of dental anomalies in people with Down syndrome. Material and Methods: This cross-sectional study was developed in Jakarta, Indonesia, and evaluated 174 individuals with Down syndrome aged 14-53 years. Were collected information regarding the tooth number, tooth size, shape, and structure. Descriptive statistics were used to calculate the absolute and relative frequencies. The Pearson chi-square test was used in bivariate analysis. The significance threshold was set at 5% Results: There were 70 female subjects (40.2%) and 104 male subjects (59.8%) with an average age of 19.2 years. In terms of anomalies of tooth number, hypodontia (80.9%), supernumerary teeth (12.4%), and combined hypodontia and supernumerary teeth (12.4%) were identified. In terms of anomalies of tooth size, microdontia (98.8%) is the most common anomaly. Anomalies of tooth shape included fusion (66.67%) and talon's cusp (33.3%), whereas anomalies of tooth structure included enamel hypoplasia (70.8%), enamel hypocalcification (4.2%), combined enamel hypoplasia and hypocalcification (12.5%), and tooth discoloration (12.5%) Conclusion: Individuals with Down syndrome in Jakarta showed a high prevalence of dental anomalies, with hypodontia and microdontia being the most common anomalies showing a tendency to occur predominantly in males.

¿Cuál es el nivel de desarrollo esperable para un niño con síndrome de Down en sus primeros años de vida? / What is the Level of Development Expected for a Child with Down syndrome in their First Years of Life?

El síndrome de Down es la causa genérica más frecuente de discapacidad vinculada con el desarrollo. La falca de valores normativos para los niños que padecen este trascomo, dificulta una valoración temprana y seguimiento del curso evolutivo. El objetivo del presente artículo es describir el perfil evolutivo de escos niños durante los primeros tres años de vida. Se realizó un estudio de cohorte de cipo prospectivo durante 9 años, en el cual se incluyeron 156 niños menores de 37 meses. Ellos tuvieron 528 evaluaciones con la "Escala Abreviada del Desarrollo" (EAD4), una prueba válida y confiable estandarizada en Colombia para valorar el nivel evolutivo en niños menores de 6 años. Se establecieron los cocientes de desarrollo por trimestres, valores percentil, las variaciones entre las áreas evaluadas, las curvas evolutivas estudiadas en cada área y los períodos más críticos en los diferentes semestres. Estos valores posibilitarán el seguimiento al curso evolutivo de estos niños, la identificación temprana de las áreas de mayor vulnerabilidad y necesidad de intervención, la evaluación del impacto de acciones terapéuticas o programas de estimulación, y la orientación a los padres y agentes sociales y de salud vinculados al desarrollo y la supervivencia del niño y la niña.

Down syndrome is the most frequent genetic cause of disability associated with development. The lack of normative values for these children, hinders an early assessment and monitoring of the clinical course. The objective was to describe the evolutionary profile of these children during the first three years of life. A prospective cohort study was performed, for 9 years, in which 156 children under 37 months were included. They had 528 evaluations by "Abbreviated Scale Development" (EAD -I), a valid and reliable standardized test in Colombia to assess the developmental level in children under 6 years. We obtained quarterly developmental quotients, percentile values, variations between the areas assessed, the evolutionary curve in each area studied and the most critical periods in different semesters. These values will enable monitoring the clinical course of these children, early identificación of areas of greatest vulnerability and need for intervención, assessment of the impact of therapeucic interventions or programs of stimulation and guidance co parents and related health and social agencs to development and survival of che boy and che girl.

Protocolo de estimulação motora à criança e ao adolescente dos 4 aos 17 anos de idade do ambulatório de cuidado à pessoa com síndrome de Down / Motor stimulation protocol for children and adolescents 4 to 17 years old in an outpatient clinic for persons with Down?s syndrome

O estágio de desenvolvimento motor é o período em que a criança vivencia suas capacidadesmotoras e conforme a estimulação do ambiente e a proposta de tarefas poderá alcançardesenvolvimento global satisfatório. As crianças com síndrome de Down podem alcançardesenvolvimento satisfatório e até adequado para sua idade cronológica se receberem estímulosadequados, mesmo apresentando atraso para adquirir habilidades motoras. Na adolescência otrabalho de desenvolvimento motor deve ser continuado com atividades especializadas como asesportivas para que assim, mantenha-se e refine-se o desenvolvimento adquirido. O objetivo desseartigo é apresentar o programa de estimulação motora desenvolvido do Instituto de MedicinaFísica e Reabilitação do Hospital das Clinicas da Faculdade de Medicina da Universidade de SãoPaulo (IMREA-HCFMUSP). Acredita-se que, um trabalho de estimulação motora estruturado demaneira adequada para crianças e adolescentes com síndrome de Down atua como importantemeio de intervenção para proporcionar desenvolvimento adequado das habilidades motorasfundamentais e especializadas.

The motor development stage is the period in which children explore their motor skills and,depending on the stimulation of the environment and the proposal of tasks, they may achievea satisfactory global development. Children with Down?s Syndrome can achieve satisfactoryand even adequate development for their chronological age if they receive the appropriatestimulation, even if late in acquiring motor skills. In adolescence, the work of motor developmentshould be continued with specialized activities such as sports so that the development acquired ismaintained and refined. The objective of this article is to present the motor stimulation programdeveloped at the HCFMUSP Physical Medicine and Rehabilitation Institute. It is believed that anappropriately structured motor stimulation program for children and adolescents with Down?sSyndrome acts as an important means of intervention to provide the proper development ofessential and specialized motor skills.

Genetics analysis with down syndrome and histopathological examination of buccal epithelial cells / Análisis genético y examen histopatológico de las células epiteliales bucales en pacientes con síndrome de down

Down syndrome is primarily caused by trisomy of chromosome 21. We reviewed cytogenetic studies performed on 1048 patients who were referred to the Cytogenetics Unit at Dicle University Hospital, Diyarbakir, Southeast Turkey, between 2000 and 2009. The cases were grouped according to the reason of referral for cytogenetic analysis. The highest frequencies of abnormal karyotypes were found among cases that were referred due to suspicion of Down syndrome (84.8 percent). For histologic examination to persons with Down syndrome and normal, buccal mucosa smear was prepared by rubbing. Down syndrome are disabled and control groups were compared statistically buccal epithelial cells and nuclei (p<0.05). Periphery of the nucleus in some patients with Down's syndrome, while the bud structures in the form of micronuclei was observed in the karyolytic cells.

El síndrome de Down es causado principalmente por la trisomía del cromosoma 21. Se revisaron los estudios citogenéticos realizados en 1.048 pacientes que fueron remitidos a la Unidad de Citogenética del Dicle University Hospital, Diyarbakir, sudeste de Turquía, entre los años 2000 y 2009. Los casos se agruparon de acuerdo a la razón de referencia para el análisis citogenético. Las frecuencias más altas de cariotipos anormales se encontraron ent los casos que fueron remitidos por sospecha de síndrome de Down (84,8 por ciento). Para el estudio histológico de las personas con y sin síndrome de Down, se realizó el frotis de mucosa oral por hisopado. Los grupos con síndrome de Down y de control (sin síndrome) se compararon estadísticamente en relación a las células epiteliales orales y los núcleos (p <0,05). Se observaron núcleos periféricos en algunos pacientes con síndrome de Down, mientras que estructuras de tipo brotes en la forma de micronúcleos se observaron en las células cariolíticas.

La enfermedad periodontal asociada al paciente con síndrome de Down / Periodontal disease associated to the Down´s syndrome patient

El síndrome de Down es una de las condiciones de discapacidad más comunes. Dentro de las patologías bucales más prevalentes, la enfermedad periodontal es una de las asociadas con este síndrome. Se cxonsidera que la persona con síndrome de Down presenta una mayor susceptibilidad a contraer esta enfermedad. En este artículo se describen los factores etiológicos y las características clínicas de la enfermedad en este paciente.

Anemia y depleción de las reservas de hierro en niños con síndrome de down / Anemia y iron stores depletion in children with down syndrome

En el Síndrome de Down (SD) son escasos los estudios que determinan la prevalencia de anemia y deplecion de las reservas de hierro (DRFe). Evaluar la prevalencia de anemia y DRFe en ninos con SD de Maracaibo-Venezuela. Se realizó un estudio descriptivo en 169 ninos entre 4-14 años: ochenta y siete sin SD y 80 con SD, sin procesos infecciosos e inflamatorios activos. Se consideró anemia valores de hemoglobina <110 g/L en <5 años, <115 g/L entre 5-11 años y <120 g/L entre 12-14 años. Microcitosis vcm<80 fL, Hipocromía HCM<27 pg. Se consideró DRFe=ferritina<15µg/L; riesgo de DRFe (RDRFe) ferritina=15-20µg/L y reservas normales (RFe normal) ferritina>20µg/L. Los datos fueron analizados con el pregrama de estadísticas SAS, y se consideró como significación estadística una p<0,05. La prevalencia total de anemia fue 20,71 por ciento, significativamente más baja en niños con SD (5,92 por ciento) (p<0,01). La prevalencia de microcitosis (5,0 por ciento) e hipocromia (18,75 por ciento) también fue menor en estos niños (p<0,0001), no observándose casos de macrocitosis, pero si de hipercromía (7,50 por ciento). La prevalencia de DRFe en niños con SD (9,14 por ciento) fue superior a la observada en niños sin SD; sin embargo, la prevalencia de RDRFe (36,59 por ciento), fue más baja en niños con SD. No se observaron diferencias estadísticamente significativas en cuanto a edad, peso y estatura. La depleción y riesgo de depleción de las reservas de hierro son deficiencias nutricionales prevalentes en niños con Síndrome de Down, que requieren de una atención especial del estado nutricional y de salud en esta población.

There are few studies in relation to the prevalence of anemia and depletion of iron stores (DIS) in individuals with Down Syndrome (DS). To evaluate the prevalence of anemia and DIS in children with Down Syndrome from Maracaibo-Venezuela. A descriptive study was carried out on 169 chidren (aged 4 to 14 years); 87 without DS and 80 with DS; without infectious or inflammatory processes. Anemia was considered when Hemoglobin <110 g/L in <5y old, Hb<115 g/L in 5 to 11y old and Hb<120 g/L in 12 to 14 y old; microcytosis (mean corpuscular volume MCV<80 fL) and hypochromia (Mean Corpuscular Haemoglobin MCH<27 pg). DIS=ferritin<15µg/L; DIS risk ferritin=15-20µg/L and normal iron stores normal (NIS) ferritin>20µg/L. Statistical analysis was performed with SAS programs, Statistical significance was considered when p<0.05. The overall prevalence of anemia was 20.71%. This prevalence was much lower in children with DS (5.92%; p<0.01) Prevalence of microcytosis (5.0%) and hypochromia (18.75%) were also significantly lower in children with DS (p<0.0001). No macrocytosis was observed but hipercromia was detected in 7.50%. Although, the prevalence of DIS (9.14%) was higher in children with DS, the prevalence of DIS risk was lower (36.59%). Age, weight and height did not show statistical differences between groups. DIS and DIS risk are prevalent nutritional deficiencies in children with Down Syndrome, which require special attention in order to improve nutritional and health status in this population.

Perfil da função respiratória de crianças portadoras de Síndrome de Down na faixa etária de 5 a 12 anos / Respiratory function profile in 5-12 years old children with Down Syndrome

A Síndrome de Down (SD) é uma condição genética, cuja incidência é de 1: 700 nascidos vivos, caracterizada pela presença de um cromossomo extra no par 21 que leva o portador a apresentar uma série de características clínicas destacando-se em particular a hipotonia muscular. Isso se constitui fator colaborativo para o déficit de força muscular de tronco, que, por sua vez, resulta na perda de força da musculatura respiratória. Estudos prévios com adolescentes e adultos sinalizaram que tal debilidade reduz a mobilidade torácica, a capacidade respiratória e propicia maior susceptibilidade às infecções. O objetivo deste estudo foi traçar o perfil da função respiratória em crianças de 5 a 12 anos portadoras de Síndrome de Down. 20 crianças portadoras de Síndrome de Down, de ambos os gêneros, foram submetidas a um protocolo de avaliação do sistema respiratório: inspeção e palpação do tórax, cirtometria torácica, força muscular respiratória (Pimax e Pemax)e pico de fluxo expiratório (PFE). Paralelamente, foi aplicado um questionário/entrevista aos responsáveis, referente à investigação sobre a ocorrência de doenças associadas, condições sociais e familiares desses indivíduos. Na manovacuometria foram encontrados valores de PImax e PEmax médios de (-28,75 ± 1 0,24 cm H2O) e (37,35 ± 11,87 cm H2O), respectivamente, e PFE de (126,25 + 46,70 l/min), tais valores estavam significativamente (p < 0,001) abaixo dos preditos na literatura. Além disso, encontrou-se grande hipotonia da musculatura abdominal em 45 por cento da amostra, respiradores do tipo bucal em 60 por cento e infecções respiratórias de repetição em 40 por cento das crianças. A avaliação da função respiratória da amostra estudada produziu um perfil de crianças portadoras de SD entre 5 e 12 anos, além de revelar baixos valores de força muscular respiratória e PFE, em função da hipotonia muscular, inerente a SD.

Down syndrome (DS) is the most common chromosomal disorder, occurring in approximately one out of every 700 births. It is characterized by an extra chromosome in the 21st pair. There are a lot of clinical symptoms such as muscle hypotonia, which is a factor that reduce thoracic muscle force, resulting in a respiratory muscle weakness. Previous studies with adolescents and adults showed that there is a reduction of thoracic motion, respiratory capacity and, consequently, a higher susceptibility in developing respiratory infection. The aim of this study was to trace a respiratory function profile in children 5-12 years old with DS. Twenty children of both genders were submitted to an evaluation protocol of respiratory function: chest inspection and palpation, thoracic cirtometry, maximal respiratory pressures (PImax and PEmax), Peak Expiratory Flow (PEF). At the same time, a questionnaire was applied to child’s parent or legal guardian, to investigate family history, social and familiar conditions. Values of PImax and PEmax were (-28.75 ± 10,24 cm H2O) and (37.35 ± 11.87 cm H2O) respectively and PEF (126.25 + 46.70 l/min), these values were significant (p < 0,001) below values predicted in literature. In addition, it was found an abdominal muscle hypotonia in 45 percent of the sample, mouth breathing in 60 percent and repetitive respiratory disease in 40 percent of the children. The evaluation of respiratory function of the studied sample produced a profile of children aged between 5-12 with DS and also revealed low values of muscle force and PEF, due to muscle hypotonia, inherent to DS.

Síndrome de Patau: a propósito de un caso / Patau syndrome: a purpose of a case

Patología causada por tres copias del cromosoma 13 en el cariotipo, en la mayoría de los casos por una disyunción meiótica principalmente del gameto materno que conlleva a un síndrome congénito polimalformativo caracterizado por microftalmia, fisura labio palatina y polidactilia; acompañado o no de otras malformaciones. La prevalencia es de 1/12000 nacidos vivos, con un tiempo de supervivencia corto. Reportamos un caso diagnóstico de Patau confirmado por estudio citogénico en el que describimos las características clínicas y asociación con las descritas por la literatura.

Ocular disorders in children with down's syndrome

To find out the frequency and nature of ocular anomalies in children with Down's syndrome. All the Down's syndrome patients attending the outdoor clinic of the department of Paediatrics Ophthalmology from June 2005 to December 2005 were included in the study. Their records were reviewed and related information regarding age and sex distribution, ocular anomalies and mental status were noted on performa. Thirty seven patients with Down's syndrome reported during 7 month period. They were examined and evaluate for the characteristics and frequency of ocular conditions of these patients, 17 [45.9%] were hypermetropes, 13 [45.9%] emmetropes, and 4 [10.8%] myopes. Astigmatism of more than 3.00 diopters was present in 3 [8.1%], Strabismus was observed in 8 [27.8%] and eight patients had esotropia. Congenital nasolacrimal duct obstruction was present in 6 subjects [16, 2%] and blepharitis in 12 [37.8%]. Nystagmus occurred in 5 [13.5%]. Brushfield spots were detected in 2 [5.4%]. Lens opacities were diagnosed in 4 [10.8%] and all had successful cataract surgery. Significant correctable ocular problems are present in person with Down syndrome. It not connected they may interfere with binocular vision and the quality of life. Surgical intervention may be necessary for strabismus and cataracts

Guía anticipatoria quirúrgica del niño con síndrome de Down / Surgical guideline anticipate of the boy with syndrome of Down

Esta guía anticipatoria ha sido diseñada para responder a la inquietud que nos provoca el niño con Síndrome de Down. El énfasis ha sido puesto en los aspectos quirúrgicos del manejo del niño con Síndrome de Down.

Patrones de crecimiento en niños menores de 11 años edad con síndrome de Down / Growth patterns in children under 11 years old with Down syndrome

Para evaluar el patrón de crecimiento en niños con Síndrome de Down, se realizó un estudio descriptivo, transversal, en una muestra de 140 varones y 100 hembras menores de 11 años, realizándose en ellos 821 mediciones antropométricas. El 78.6% pertenecía a los estratos III y IV. Se tomaron las medidas de peso, talla, circunferencia cefálica, se calculó el índice de masa corporal (IMC), determinándose los percentiles para cada una; se comparó el percentil 50 con los valores reportados por Cronk en niños con Síndrome de Down y por Fundacredesa en la población venezolana. En el grupo estudiado no se encontró una diferencia estadísticamente significativa al compararlos con el grupo de Cronk, en ninguna de las variables antropométricas. El p50 del peso de los varones estudiados se ubica en general por debajo del p50 de Fundacredesa (-1DE), en las hembras osciló entre +1DE y -2DE según su edad. El IMC del grupo estudio fue mayor al de Fundacredesa, siendo la diferencia significativa en los niños de 3-10 años ambos sexos. El p50 de la talla fue menor al de Fundacredesa en un rango entre -1DE a -2DE. El p50 de la circunferencia cefálica nacional es superior al de la muestra en todas las edades y ambos sexos, siendo la diferencia significativa. Con este estudio se confirma la importancia de evaluar a los niños con Síndrome de Down con valores de referencia basados en una población que los represente.

Força de preensão palmar em portadores da síndrome de Down e análise dos músculos envolvidos neste movimento / Palmar force in Down syndrome people. Analysis of involved muscles

PURPOSE: To associate hipotony with grip strength in palmar prehension seeking to indicate parameters and a scale of force for bearers of the Down's Syndrome, once there is a growing increase of the longevity in that population and a lack of works, as well as to identify through literature revision and an anatomic and kinesiologic analysis of the muscles involved in this movement. METHODS: Transversal analytic study that had the participation of 138 individuals, distributed in two groups: group of study (GE) = 28 (Down Syndrome's bearers) and the group control (GC) = 110 (normal individuals). The instrument used was the JAMAR dynamometer. RESULTS: It was verified grip strength significantly smaller for the group GE in relation to the group GC. CONCLUSIONS: men has a prevalence palmar prehension grip strength in relation to women; it was verified a significant deficit of the palmar prehension grip strength in the group GE when compared with the group GC; the obtained results should be considered an indicative of force to rehabilitate the hand function in individuals with Down's Syndrome; it should be taken in consideration the hand's characteristics of the Down's Syndrome bearer, because perhaps they present better results for grip strength with the dynamometer in the position 1; the principal muscles involved in the movement are: long flexor of the thumb; tenars muscles (opponent of the thumb, adductor of the thumb and short flexor of the thumb); hypotenars muscles (short flexor of the minimum finger); superficial flexor of the fingers; deep flexor of the fingers and the 4 lumbrical.

Inteligibilidade4 da fala em portadores da síndrome de down, relaçöes com praxia motora oral, memória auditiva verbal, idade, sexo e nível intelectual / Speech intelligibility in individuals with Down`s syndrome and its relations to motor oral praxis, verbal auditory memory, age, gender and intellectual level

Foram estudados 45 portadores da síndrome de down, de idades entre 5 e 13 anos, quanto à inteligibilidade de fala. Mais de 70 por cento das emissöes näo repetitivas foram inteligíveis em 16 sujeitos, menos 40 por cento foram inteligíveis em 17, e 12 sujeitos ficaram em situaçäo intermediária

Concentraciones de hormona tirotropa y tiroxina libre en niños con síndrome de down / Concentration of thyrotropic hormone and free thyroxine in children with down syndrome

En los niños con sindrome de down la incidencia de hipotiroidismo es mayor que en los niños de la población general. Dado que la frecuencia de hipotiroidismo es mayor en áreas de bocio endémico, se planteó el siguiente trabajo, cuyo objetivo fue estudiar las concentraciones de hormona tirotropa (TSH) y tiroxina libre (T4-L) en niños con síndrome de down que habitan en Mérida, región ubicada en Los Andes Venezolanos. En el Centro de Estudio y Prevención del Retardo Mental y Alteraciones en el Desarrollo (CEPREMAD) se determinó la concentración de TSH y T4 en 48 niños con síndrome de down en edades comprendidas entre 1 mes y 6 años, y en 123 niños asintomáticos en edades similares, referidos al centro para evaluación de la función tiroidea. Dos de los 48 niños (4,2 por ciento) con síndrome de down tenían hipotiroidismo congénito; 22 (45,8 por ciento) tenían concentraciones elevadas de TSH con valores normales de tiroxina libre (T4-L) y 24 fueron eutiroideos. En los niños controles el 86 por ciento fueron eutiroideos y el 14 por ciento tenían niveles elevados de TSH. No se obtuvieron diferencias en relación al sexo. En conclusión la frecuencia de niños con síndrome de down y con concentraciones elevadas de TSH fue tres veces superior a la frecuencia observada en los niños sanos. Este resultado no difiere de lo reportado en regiones sin bocio endémico

niño con síndrome de Down y su entorno

Analiza las diferentes reacciones de las familias seleccionadas ante la llegada de un niño con Sídrome de Down. Describe el desempeño de estos niños en el entorno familiar y social. Además logra establecer de distintas bibliografías sus características físicas, psíquicas y afectivas