Prevalence of non-obstructive dysphagia in patients with heartburn and regurgitation

OBJECTIVE: Heartburn and regurgitation are the most common gastroesophageal reflux symptoms, and dysphagia could be a possible symptom. This investigation aimed to evaluate the prevalence of non-obstructive dysphagia in patients with heartburn and regurgitation. METHODS: A total of 147 patients (age, 20-70 years; women, 72%) complaining of heartburn and regurgitation, without esophageal stricture, previous esophageal surgery, or other diseases, were evaluated. Twenty-seven patients had esophagitis. The Eating Assessment Tool (EAT-10) was employed to screen for dysphagia; EAT-10 is composed of 10 items, and the patients rate each item from 0 to 4 (0, no problems; 4, most severe symptom). Results of the 147 patients were compared with those of 417 healthy volunteers (women, 62%; control group) aged 20-68 years. RESULTS: In the control group, only two (0.5%) had an EAT-10 score ≥5, which was chosen as the threshold to define dysphagia. EAT-10 scores ≥5 were found in 71 (48.3%) patients and in 55% of the patients with esophagitis and 47% of the patients without esophagitis. This finding indicates a relatively higher prevalence of perceived dysphagia in patients with heartburn and regurgitation and in patients with esophagitis. We also found a positive correlation between EAT-10 scores and the severity of gastroesophageal reflux symptoms based on the Velanovich scale. CONCLUSION: In patients with heartburn and regurgitation symptoms, the prevalence of dysphagia was at least 48%, and has a positive correlation with the overall symptoms of gastroesophageal reflux.

Desempenho ortográfico de escolares do 2º e 5º ano do ensino privado do município de Londrina / Spelling performance of students of 2nd to 5th grade from private education in the city of Londrina

Objetivos: Elaborar uma bateria de provas que visam a avaliar o nível de conhecimento ortográfico do sistema de escrita alfabético do português do Brasil; caracterizar, comparar e classificar o desempenho dos escolares de 2º ao 5º ano do ensino particular segundo a semiologia dos erros. Método: Foram elaboradas provas específicas para esse fim, seguindo os princípios ortográficos da língua portuguesa do Brasil. Foram avaliados 120 escolares do 2º ao 5º ano, sendo 30 de cada série escolar divididos em quatro grupos, respectivamente GI, GII, GIII e GIV. As provas elaboradas e aplicadas foram divididas em: versão coletiva (escrita das letras do alfabeto, ditado aleatório das letras do alfabeto, ditado de palavras, ditado de pseudopalavras, ditado com figuras, escrita temática induzida por figura) e versão individual (ditado de frases, erro proposital, ditado soletrado, memória lexical ortográfica). Resultados: Houve diferença estatisticamente significante na comparação intergrupos, indicando o aumento da média de acertos em todas as provas da versão coletiva e individual. Com o aumento da seriação escolar, os grupos diminuíram a média de erros na escrita com base na semiologia do erro. Conclusão: Os dados deste estudo indicam que o perfil da aquisição da ortografia do sistema de escrita do português encontrado nesses escolares do ensino privado pode ser indicativo do funcionamento normal de desenvolvimento da escrita infantil nessa população.

Aims: To elaborate a battery of tests that aimed to determine the level of orthographic knowledge of the alphabetic writing system of Brazilian Portuguese, to characterize, to compare and to classify the performance of students from 2nd to 5th grades of private education according to the semiology of errors. Methods: We developed specific tests for this purpose, following the spelling principles of Portuguese in Brazil. We evaluated 120 children from the 2nd to 5th grades, 30 students of each level divided into four groups, respectively, GI, GII, GIII and GIV. The tests elaborated and applied were divided into: collective version (written in letters of the alphabet, randomized dictation of letters, word dictation, nonword dictation, dictation with pictures, thematic writing induced by picture) and individual version (dictation of sentences, purposeful error, spelled dictation, spelling lexical memory). Results: There was a statistically significant difference in inter-group comparison indicating that there was an increase in average accuracy for all tests of the individual and collective version. With the increase of grade level, the groups decreased the average of writing errors based on the semiology of the error. Conclusion: Our data indicate that the profile of spelling acquisition of the Portuguese writing system found in these private students may be indicative of normal development of children's writing in this population.

Avaliação e intervenção da disortografia baseada na semiologia dos erros: revisão da literatura / Evaluation and intervention of dysortographia based on error semiology: literature review

TEMA: avaliação e intervenção na disortografia. OBJETIVO: descrever e discutir os achados encontrados na literatura sobre a disortografia segundo a sua definição, etiologia, classificação da semiologia dos erros, quadro clínico, avaliação e intervenção. CONCLUSÃO: a avaliação e a intervenção fonoaudiológica com a disortografia devem estar baseadas na classificação semiológica dos erros, pois desta forma, pode-se compreender cada tipo de erro e os fatores cognitivos ou linguísticos implicados. Isso se associa às orientações aos pais e professores de como enfocar o trabalho com a ortografia, seja em casa ou na escola sem gerar angústia e ansiedade na criança.

BACKGROUND: evaluation and intervention in dysortographia. PURPOSE: to describe and discuss findings from researches concerning dysortographia according to its definition, etiology, errors semiology classification, clinical findings, evaluation, and intervention. CONCLUSION: speech language evaluation and intervention should be based on error semiology classification because in this way it is possible to understand each type of error and the linguistic and cognitive factors related to them. This is associated with the orientations to parents and teachers on how to work with orthography at home or at the classroom without causing distress and anxiety to the children.