Characterization of the electrocardiographic pattern of individuals with cerebral palsy.

BACKGROUND: Dentists of Lar São Francisco observed during dental treatment that children with cerebral palsy (CP) had increased heart rate (HR) and lower production of saliva. Despite the high prevalence of CP found in the literature (2.08-3.6/1000 individuals), little is known about the electrocardiographic (ECG) characteristics, especially HR, of individuals with CP. OBJECTIVE: This study aimed to investigate the hypothesis that individuals with CP have a higher HR and to define other ECG characteristics of this population. METHODS: Ninety children with CP underwent clinical examination and 12-lead rest ECG. Electrocardiographic data on rhythm, HR, PR interval, QRS duration, P/QRS/T axis, and QT, QTc and T(peak-end) intervals (minimum, mean, maximum, and dispersion) were measured and analyzed then compared with data from a control group with 35 normal children. Fisher and Mann-Whitney U tests were used, respectively, to compare categorical and continuous data. RESULTS: Groups cerebral palsy and control did not significantly differ in age (9 ± 3 × 9 ± 4 years) and male gender (65% × 49%). Children with CP had a higher HR (104.0 ± 20.6 × 84.2 ± 13.3 beats per minute; P < .0001), shorter PR interval (128.8 ± 15.0 × 138.1 ± 15.1 milliseconds; P = .0018), shorter QRS duration (77.4 ± 8.6 × 82.0 ± 8.7 milliseconds; P = .0180), QRS axis (46.0° ± 26.3° × 59.7° ± 24.8°; P = .0024) and T-wave axis (34.3° ± 28.9° × 42.9° ± 17.1°; P = .034) more horizontally positioned, and greater mean QTc (418.1 ± 18.4 × 408.5 ± 19.4 milliseconds; P = .0110). All the electrocardiogram variables were within the reference range for the age group including those with significant differences. CONCLUSION: Children with CP showed increased HR and other abnormal ECG findings in the setting of this investigation. Further studies are needed to explain our findings and to correlate the increased HR with situations such as dehydration, stress, and autonomic nervous disorders.

Validation of a food frequency questionnaire for assessing dietary nutrients in Brazilian children 5 to 10 years of age.

OBJECTIVE: This study aimed to assess the relative validity of a food frequency questionnaire (FFQ), previously validated to measure usual intakes in adults, for measuring dietary intakes in children 5 to 10 y of age. METHODS: Dietary intakes were measured using an FFQ and a 3-d dietary record. Healthy children, 5 to 10 y old (n = 151), were recruited from public schools and asked to answer the questions in the FFQ and to provide non-consecutive 3-d dietary records based on reported estimated portion sizes. Paired sample t tests and Pearson's correlation coefficients were conducted to determine whether the two instruments reported similar values for energy and nutrients. The agreement of quartile categorization between the two instruments was also examined. RESULTS: Estimated energy and nutrient intakes derived from the FFQ were significantly higher than those derived from 3-d dietary records. As expected, Pearson's correlations increased after adjusting for residual measurement error, presumably due to exclusion of the high within-person variability in intake of these nutrients. Moderate to high (r > 0.50) correlation coefficients were verified for some nutrients such as calcium, folate, vitamin B2, vitamin A, and vitamin C. CONCLUSION: This FFQ, originally developed for use in adults, appears to overestimate usual energy and nutrient intakes in children 5 to 10 y of age. Further work is necessary to conduct a calibration study to establish adequate portion sizes before instrument adoption in this population.