Critically ill patients with COVID-19-associated acute kidney injury treated with kidney replacement therapy: Comparison between the first and second pandemic waves in São Paulo, Brazil.

INTRODUCTION: This study aimed to compare the characteristics and outcomes of critically ill patients with COVID-19-associated acute kidney injury (AKI) who were treated with kidney replacement therapy (KRT) in the first and second waves of the pandemic in the megalopolis of Sao Paulo, Brazil. METHODS: A multicenter retrospective study was conducted in 10 intensive care units (ICUs). Patients aged ≥18 years, and treated with KRT due to COVID-19-associated AKI were included. We compared demographic, laboratory and clinical data, KRT parameters and patient outcomes in the first and second COVID-19 waves. RESULTS: We assessed 656 patients (327 in the first wave and 329 in the second one). Second-wave patients were admitted later (7.1±5.0 vs. 5.6±3.9 days after the onset of symptoms, p<0.001), were younger (61.4±13.7 vs. 63.8±13.6 years, p = 0.023), had a lower frequency of diabetes (37.1% vs. 47.1%, p = 0.009) and obesity (29.5% vs. 40.0%, p = 0.007), had a greater need for vasopressors (93.3% vs. 84.6%, p<0.001) and mechanical ventilation (95.7% vs. 87.8%, p<0.001), and had higher lethality (84.8% vs. 72.7%, p<0.001) than first-wave patients. KRT quality markers were independently associated with a reduction in the OR for death in both pandemic waves. CONCLUSIONS: In the Sao Paulo megalopolis, the lethality of critically ill patients with COVID-19-associated AKI treated with KRT was higher in the second wave of the pandemic, despite these patients being younger and having fewer comorbidities. Potential factors related to this poor outcome were difficulties in health care access, lack of intra-hospital resources, delay vaccination and virus variants.

Environmental Factors at the Periconceptional Period and the Occurrence of Cleft Lip and Palate in a Midwest Brazil Population: A Case-Control Study.

OBJECTIVE: To investigate the association between periconceptional environmental exposures and the occurrence of cleft lips and palates. METHODS: This case-control study analyzed 150 mothers of children with cleft lips and palates living in the same city as 250 mothers whose children did not present with this malformation (controls). Environmental exposure data were gathered through a questionnaire (Latin American Collaborative Study of Congenital Malformations methodology). RESULTS: Multivariate analysis revealed that monthly income below minimum wage, having another malformed child, other diseases in the first gestational trimester (urinary infection), use of pesticides in home gardens, and pesticide use in farms close to the home were risk factors associated with the malformation, whereas taking vitamins was a protective factor. CONCLUSION: Maternal and paternal exposure to pesticides is associated with cleft lip and palate in Mato Grosso State, Brazil.

Pro-Oxidant and Cytotoxic Effects of Tucum-Do-Cerrado (Bactris setosa Mart.) Extracts in Colorectal Adenocarcinoma Caco-2 Cells.

Colorectal cancer is one of the most common types of cancer. Bioactive natural compounds can act in cancer chemoprevention as tumor growth inhibitors. Tucum-do-cerrado (Bactris setosa Mart.) is a Brazilian fruit that contains several phenolic compounds. This study investigated the effect of tucum aqueous extract in Caco-2 cells in comparison to primary human intestinal organoids and fibroblasts. Cells were exposed to 0.5 and 1 mg/ml of tucum aqueous extract for 24 h. ROS production, mRNA levels for SOD1 and SOD2, CAT, GPX1, NFE2L2, HIF1A and NOS2 were evaluated in Caco-2 cells exposed to tucum extract. Cell viability of Caco-2 cells was decreased upon tucum extract exposure. Mitochondrial ROS levels increased in Caco-2 cells exposed to tucum extract. The mRNA levels of SOD1, SOD2, CAT, GPX, NFE2L2 and HIF1A were downregulated in Caco-2 cells exposed to tucum extract, while NOS2 mRNA levels remained unchanged. Protein levels of SOD2, CAT and NRF2 remained unchanged in Caco-2 cells treated with tucum extract, indicating that catalase and SOD2 cellular functions may be unaffected by the tucum extract at 24 h, of exposure. Aqueous extract of tucum-do-cerrado may induce cellular toxicity in a cancer cell-specific manner, possibly through increased mitochondrial ROS production and gene expression regulation.

Diacerein-induced interleukin-1ß deficiency reduces the inflammatory infiltrate and immunoexpression of matrix metalloproteinase-8 in periodontitis in rat molars.

BACKGROUND: Periodontitis is an immunoinflammatory disease that involves the release of cytokines and enzymes, including interleukin-1 (IL-1) and matrix metalloproteinases (MMPs). Diacerein is an anti-IL-1 drug used for the treatment of osteoarthritis. The aim of the study was to evaluate whether diacerein suppresses the inflammatory reaction and reduces the collagen degradation in the gingival connective tissue in periodontitis. METHODS: Fifty-four male rats were distributed into three groups (n = 18 animals/group): 1) periodontitis + diacerein group (PDG), 2) periodontitis + saline group (PSG) and control Group (CG; without treatment). Periodontitis was induced for 7 days in the upper right first molars; after 7 days, the animals of PDG received 100 mg/kg of diacerein while in PSG, the animals received saline solution for 7, 15, and 30 days. The animals were killed and fragments of maxilla containing the right molars were processed for paraffin embedding. In hematoxlin & eosin-stained sections, the volume density of inflammatory cells (VvIC) and fibroblasts (VvFb) in the gingival mucosa, the distances between the junctional epithelium (JE) to the cemento-enamel junction (CEJ) and the CEJ to the alveolar process crest (AP) were obtained. The number of IL-1ß- and MMP-8-immunolabeled cells, and collagen content in the gingival mucosa were computed. Data were subjected to two-way analysis of variance and Tukey post-test (P ≤ 0.05). RESULTS: The PDG and PSG rats showed a significant increase in the distances of JE-CEJ and CEJ-AP. In all periods, the VvIC, the number of IL-1ß- and MMP-8-immunolabeled cells was significantly lower in PDG than in PSG while the collagen content was significantly greater in PDG than PSG. At 30 days, significant differences in the IL-1ß immunoexpression, collagen content, and in the MMP-8 immunostaining were not seen between PDG and CG groups. CONCLUSIONS: Our results show an inhibitory effect of diacerein on IL-1ß in the inflamed gingival mucosa of rat molars, decreasing the inflammatory infiltrate and immunoexpression of MMP-8, and restoring the collagen content.

COVID-19-associated acute kidney injury patients treated with renal replacement therapy in the intensive care unit: A multicenter study in São Paulo, Brazil.

INTRODUCTION: Multicenter studies involving patients with acute kidney injury (AKI) associated with the disease caused by the new coronavirus (COVID-19) and treated with renal replacement therapy (RRT) in developing countries are scarce. The objectives of this study were to evaluate the demographic profile, clinical picture, risk factors for mortality, and outcomes of critically ill patients with AKI requiring dialysis (AKI-RRT) and with COVID-19 in the megalopolis of São Paulo, Brazil. METHODS: This multicenter, retrospective, observational study was conducted in the intensive care units of 13 public and private hospitals in the metropolitan region of the municipality of São Paulo. Patients hospitalized in an intensive care unit, aged ≥ 18 years, and treated with RRT due to COVID-19-associated AKI were included. RESULTS: The study group consisted of 375 patients (age 64.1 years, 68.8% male). Most (62.1%) had two or more comorbidities: 68.8%, arterial hypertension; 45.3%, diabetes; 36.3%, anemia; 30.9%, obesity; 18.7%, chronic kidney disease; 15.7%, coronary artery disease; 10.4%, heart failure; and 8.5%, chronic obstructive pulmonary disease. Death occurred in 72.5% of the study population (272 patients). Among the 103 survivors, 22.3% (23 patients) were discharged on RRT. In a multiple regression analysis, the independent factors associated with death were the number of organ dysfunctions at admission and RRT efficiency. CONCLUSION: AKI-RRT associated with COVID-19 occurred in patients with an elevated burden of comorbidities and was associated with high mortality (72.5%). The number of organ dysfunctions during hospitalization and RRT efficiency were independent factors associated with mortality. A meaningful portion of survivors was discharged while dependent on RRT (22.3%).

COVID-19-associated acute kidney injury patients treated with renal replacement therapy in the intensive care unit: A multicenter study in São Paulo, Brazil

INTRODUCTION: Multicenter studies involving patients with acute kidney injury (AKI) associated with the disease caused by the new coronavirus (COVID-19) and treated with renal replacement therapy (RRT) in developing countries are scarce. The objectives of this study were to evaluate the demographic profile, clinical picture, risk factors for mortality, and outcomes of critically ill patients with AKI requiring dialysis (AKI-RRT) and with COVID-19 in the megalopolis of São Paulo, Brazil. METHODS: This multicenter, retrospective, observational study was conducted in the intensive care units of 13 public and private hospitals in the metropolitan region of the municipality of São Paulo. Patients hospitalized in an intensive care unit, aged ≥ 18 years, and treated with RRT due to COVID-19-associated AKI were included. RESULTS: The study group consisted of 375 patients (age 64.1 years, 68.8% male). Most (62.1%) had two or more comorbidities: 68.8%, arterial hypertension; 45.3%, diabetes; 36.3%, anemia; 30.9%, obesity; 18.7%, chronic kidney disease; 15.7%, coronary artery disease; 10.4%, heart failure; and 8.5%, chronic obstructive pulmonary disease. Death occurred in 72.5% of the study population (272 patients). Among the 103 survivors, 22.3% (23 patients) were discharged on RRT. In a multiple regression analysis, the independent factors associated with death were the number of organ dysfunctions at admission and RRT efficiency. CONCLUSION: AKI-RRT associated with COVID-19 occurred in patients with an elevated burden of comorbidities and was associated with high mortality (72.5%). The number of organ dysfunctions during hospitalization and RRT efficiency were independent factors associated with mortality. A meaningful portion of survivors was discharged while dependent on RRT (22.3%).

Effects of obesity on periodontal tissue remodeling during orthodontic movement.

INTRODUCTION: Orthodontic movement triggers a sequence of cellular and molecular events that may be affected by different systemic conditions. This study evaluated the effect of obesity on rat periodontal tissue remodeling induced by mechanical orthodontic force. METHODS: Thirty-two Holtzman rats were distributed into 4 groups: control, obesity induction (O), orthodontic movement (M), and obesity induction and orthodontic movement (OM). Obesity was induced by a high-fat diet for 90 days. After 15 days of orthodontic movement, the animals were killed. Obesity induction was confirmed by animal body weight, adipose tissue weight, and serologic analysis. Periodontal tissue remodeling was evaluated using microcomputed tomography and histologic analysis. The gene expression of adipokines and cytokines in gingival tissues was evaluated. RESULTS: An increase in body and adipose tissue weight was observed in the obesity induction groups. The O group presented an increase in lipids and blood glucose. The OM group showed a decrease in bone volume fraction and bone mineral density compared with all other groups and a tendency for more rapid tooth movement than the M group. The OM group showed a higher quantity of inflammatory cells and higher Mmp1 expression than the O group. The O and OM groups showed higher Nampt expression than the control group and lower Nampt expression than the M group. CONCLUSIONS: Obesity modulates periodontal tissue remodeling during orthodontic movement and results in more inflammation and bone loss than in nonobese animals.

ß-galactosidase Encapsulated in Carrageenan, Pectin and Carrageenan/Pectin: Comparative Study, Stability and Controlled Release.

The present study investigated the encapsulation of ß-galactosidase in carrageenan, pectin and its hybrid hydrogels by using the ionotropic gelation method. The material obtained was characterized by Fourier transform infrared spectroscopy (FTIR), thermogravimetric analysis (TG/DTG) and scanning electron microscopy (SEM). The effects of pH, temperature and storage time were evaluated in terms of the catalytic activity of the free and encapsulated enzyme. Addition studies were conducted evaluating the performance of catalytic activity in vitro conditions. Carrageenan, pectin and hybrid hydrogels presented encapsulation efficiency of 58 ± 1%, 72 ± 1% and 77 ± 2%, respectively. The pectin hydrogel showed the higher ß-galactosidase activity in pH and temperature tests. However, the carrageenan hydrogel exhibited best stability after been stored for three months. Carrageenan and pectin hydrogels were 2.0 and 2.4 times more efficiently than commercial tablet in the releasing ß-galactosidase under in vitro conditions, respectively. The results suggest that pectin and carrageenan hydrogels may be useful for the development of new formulation of ß-galactosidase.

Proteome Dataset of Qualea grandiflora Mart. (Vochysiaceae) by LC-MS/MS Label-Free Identification in Response to Aluminum.

This dataset brief is about the descriptive proteome of Qualea grandiflora plants by label free mass spectrometry (LC-MS/MS). Q. grandiflora is a plant that accumulates aluminum (Al) in high quantities and requires it for growth and development. Although quite relevant for the understanding of Al effects on plants, the proteome of Q. grandiflora has not been studied yet. Therefore, the current proteome analysis identifies a total of 2010 proteins. Furthermore, the identified Q. grandiflora root proteins are associated with several crucial molecular functions, biological processes, and cellular sites. Hence, the proteome analysis of Q. grandiflora will contribute to unravel how plants evolved to cope with high levels of Al in soils. All data can be accessed at the Centre for Computational Mass Spectrometry - MassIVE MSV000082284 - https://massive.ucsd.edu/ProteoSAFe/dataset.jsp?task=adb9647282a5421a9cffe3124c060f46.

Agente comunitário de saúde no espírito santo: do perfil às atividades desenvolvidas / Community health agent: from the profile to activities done / Agente comunitario de salud: del perfil a las actividades desarrolladas

Resumo Ao considerar a amplitude e a complexidade do papel que os agentes comunitários de saúde assumem na Estratégia Saúde da Família, constituiu-se objeto do estudo apresentado neste artigo conhecer o perfil e a realidade de trabalho desses profissionais, no sentido de contribuir para a consolidação do Sistema Único de Saúde. Tratou-se de estudo quantitativo, realizado em dez municípios com população superior a 50 mil habitantes no Espírito Santo, de julho de 2012 a agosto de 2013. Foram selecionadas unidades de saúde da família com equipes completas, totalizando 121 agentes comunitários de saúde participantes do estudo. Os dados foram coletados mediante questionário estruturado autoaplicável. Os resultados revelaram que as atividades realizadas com maior frequência pelos agentes eram: visita domiciliar, atualização de cadastro, reunião de equipe e acompanhamento dos grupos prioritários definidos pelo Ministério da Saúde. Embora grande parte dos agentes fizesse o mapa inteligente e o diagnóstico de saúde, somente 13,2% identificaram famílias de risco e 14,9% realizaram o levantamento de problemas de saúde de sua microárea. Assim, questionou-se a verdadeira finalidade do mapa inteligente e do diagnóstico de saúde, ou a forma de participação do agente na elaboração desses instrumentos, o que poderia estar restrito somente à formalização da prática.

Abstract Considering the breadth and complexity of the role that community health agents play in the Family Health Strategy, the purpose of the study presented in this article was to get to know the profile and the reality of these professionals' work to contribute to the consolidation of the Unified Health System. This was a quantitative study conducted in ten municipalities with more than 50,000 inhabitants in the state of Espírito Santo, Brazil, from July 2012 to August 2013. Family health units with complete teams were selected, and a total of 121 community health agents took part in the study. Data were collected through a self-administered structured questionnaire. The results showed that the agents' most frequent activities were home visits, registration updates, team meetings, and follow-up on the priority groups defined by the Ministry of Health. Although many of the agents completed the smart map and the health diagnosis, only 13.2 percent of them identified families at risk, and 14.9 percent surveyed the health issues of their micro-area. Thus, the true purpose of the smart map and of the health diagnosis, or of the agent's participation in the preparation of these instruments was questioned, which could be restricted only to formalize the practice.

Resumen Al considerar la amplitud y la complejidad del papel que los agentes comunitarios de salud asumen en la Estrategia Salud de la Familia, se constituyó en objeto de estudio presentado en este artículo, conocer el perfil y la realidad de trabajo de estos profesionales, desde el punto de vista de su contribución para consolidad el Sistema Único de Salud. Se trató de un estudio cuantitativo, realizado en diez municipios con población superior a 50 mil habitantes, en el estado de Espírito Santo, Brasil, de julio de 2012 a agosto de 2013. Se seleccionaron unidades de salud de la familia con equipos completos, totalizando 121 agentes comunitarios de salud participantes del estudio. Los datos se recolectaron mediante un cuestionario estructurado autoadministrado. Los resultados revelaron que las actividades realizadas con mayor frecuencia por los agentes eran: visita domiciliaria, actualización de registro, reunión de equipo y seguimiento de los grupos prioritarios definidos por el Ministerio de la Salud. Aunque gran parte de los agentes hizo el mapa inteligente y el diagnóstico de salud, sólo el 13,2% identificaron familias de riesgo y el 14.9% realizaron el relevamiento de problemas de salud de su microárea. Así, se cuestionó la verdadera finalidad del mapa inteligente y del diagnóstico de salud, o la forma de participación del agente en la preparación de estos instrumentos, que podría restringirse solamente a la formalización de la práctica.

Assessment of impact of late postoperative physical functional disabilities on quality of life in breast cancer survivors.

AIMS AND BACKGROUND: Breast cancer is the second most common malignancy among women. Surgical and supplemental (or adjuvant) therapies to combat the disease may implicate physical functional consequences for the ipsilateral upper extremity. These dysfunctions may persist for many years and have repercussions on the performance of daily living activities. The aim of this study was to assess the impact of physical functional disabilities on quality of life in women after breast cancer surgery. METHODS AND STUDY DESIGN: Eighty-two women in the postoperative period of conservative surgery for breast cancer participated in the study. Axillary lymph node dissection was performed in all patients and mean time since surgery was 5.78 (± 4.60) years. The women responded to a questionnaire to assess quality of life (FACT-B) and to another to assess functional capacity (QuickDASH). They were then referred to physical therapy examination to measure shoulder range of motion (flexion, abduction and external rotation) and arm volume. RESULTS: Range of motion in the ipsilateral shoulder was limited: shoulder flexion range of motion reached a mean value of 155.44º (± 28.31), mean abduction was 149.05º (± 29.51), and mean external shoulder rotation was 58.44º (± 29.17). These limitations had a negative impact on functional capacity and global quality of life. Lymphedema was present in 28.04% of women assessed and did not impair quality of life or functional capacity. CONCLUSION: Physical functional disabilities were present in the late postoperative period of breast cancer survivors and limited shoulder range of motion negatively influenced their functional capacity and quality of life. The presence of lymphedema did not impair functional capacity or quality of life in the postoperative period.

Terapia ocupacional e o uso de tecnologia assistiva como recurso terapêutico na artrogripose / Occupational therapy and the use of assistive technology as therapeutic resource in arthrogryposis

In this article, we present the intervention of occupational therapy through the use of Assistive Technology resources in a case of arthrogryposis multiplex congenita (AMC). It is a descriptive case study with qualitative research. We made use of two instruments: the Pediatric Evaluation of Disability Inventory (PEDI) was used for standardized assessment, while the International Classification of Functioning, Disability and Health (ICF) was used for classification. We observed improvement of functional abilities comparing the first and second assessments after occupational therapy intervention through the use of Assistive Technology. Improvement was noted mainly in the continuous PEDI score, which compares the patient with himself/herself. Regarding the ICF, case evolution was observed in the component "Activities and Participation and Environmental Factors" evaluated from the clinical history. The occupational therapist uses Assistive Technology as a therapeutic resource in rehabilitative care not only as a single resource, but also as a constituent element of clinical reasoning.

O trabalho apresenta a intervenção de Terapia Ocupacional utilizando recursos de tecnologia assistiva em um caso de artro-gripose múltipla congênita. Trata-se de um estudo de caso de caráter descritivo, com utilização dos recursos da pesquisa qualitativa. Foram utilizados dois instrumentos, um de classificação e outro de avaliação padronizada, a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) e o Inventário de Avaliação Pediátrica de Incapacidade (PEDI). Pôde-se observar melhora nas habilidades funcionais comparando-se a primeira com a segunda avaliação, após intervenção terapêutica ocupacional e utilização de recursos de tecnologia assistiva. Nota-se melhora principalmente do escore contínuo do PEDI, que compara a paciente com ela mesma. Quanto à CIF, nota-se evolução do caso no componente Atividades e Participação e Fatores Ambientais, avaliado a partir da história clínica. O terapeuta ocupacional tem a tecnologia assistiva como um recurso terapêutico que pode ser utilizado na intervenção de reabilitação, não sendo utilizado apenas como recurso único e sim como elemento constituinte do raciocínio clínico.

Terapia Ocupacional e o uso de tecnologia assistiva como recurso terapêutico na artrogripose - Occupational Therapy and the use of assistive technology as therapeutic resource in arthrogryposis / Occupational Therapy and the use of assistive technology as therapeutic resource in arthrogryposis

In this article, we present the intervention of occupational therapy through the use of Assistive Technology resources in a case of arthrogryposis multiplex congenita (AMC). It is a descriptive case study with qualitative research. We made use of two instruments: the Pediatric Evaluation of Disability Inventory (PEDI) was used for standardized assessment, while the International Classification of Functioning, Disability and Health (ICF) was used for classification. We observed improvement of functional abilities comparing the first and second assessments after occupational therapy intervention through the use of Assistive Technology. Improvement was noted mainly in the continuous PEDI score, which compares the patient with himself/herself. Regarding the ICF, case evolution was observed in the component "Activities and Participation and Environmental Factors" evaluated from the clinical history. The occupational therapist uses Assistive Technology as a therapeutic resource in rehabilitative care not only as a single resource, but also as a constituent element of clinical reasoning.(AU)

O trabalho apresenta a intervenção de Terapia Ocupacional utilizando recursos de tecnologia assistiva em um caso de artrogripose múltipla congênita. Trata-se de um estudo de caso de caráter descritivo, com utilização dos recursos da pesquisa qualitativa. Foram utilizados dois instrumentos, um de classificação e outro de avaliação padronizada, a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) e o Inventário de Avaliação Pediátrica de Incapacidade (PEDI). Pôde-se observar melhora nas habilidades funcionais comparando-se a primeira com a segunda avaliação, após intervenção terapêutica ocupacional e utilização de recursos de tecnologia assistiva. Nota-se melhora principalmente do escore contínuo do PEDI, que compara a paciente com ela mesma. Quanto à CIF, nota-se evolução do caso no componente Atividades e Participação e Fatores Ambientais, avaliado a partir da história clínica. O terapeuta ocupacional tem a tecnologia assistiva como um recurso terapêutico que pode ser utilizado na intervenção de reabilitação, não sendo utilizado apenas como recurso único e sim como elemento constituinte do raciocínio clínico.(AU)

Avaliação da linguagem oral e escrita em sujeitos com Síndrome de Asperger / Language assessment in subjects with Asperger Syndrome

OBJETIVO: avaliar e caracterizar provas fonoaudiológicas de linguagem oral e escrita de sujeitos com Síndrome de Asperger comparativamente a um grupo de sujeitos com desenvolvimento típico. MÉTODOS: avaliou-se 44 sujeitos que constituíram dois grupos: o grupo Asperger, composto por 22 sujeitos diagnosticados por equipe multidisciplinar como portadores de Síndrome de Asperger, conforme os critérios do DSM-IV; e o grupo de comparação, denominado grupo de baixo risco para alterações do desenvolvimento, também com 22 participantes, pareados com os sujeitos do grupo Asperger segundo a idade cronológica. Todos os sujeitos eram do sexo masculino, com idade cronológica entre 10 e 30 anos e quociente intelectual maior ou igual a 68 e foram submetidos à Prova de Consciência Fonológica, Teste de Vocabulário por Imagem Peabody, Prova de Leitura de Palavras e Pseudopalavras, Prova de Compreensão de Leitura, Prova de Escrita sob Ditado de Palavras e Pseudopalavras, Prova de Escrita Semidirigida de Textos. RESULTADOS: a análise estatística revelou diferenças estaticamente significantes entre as medianas da prova de consciência fonológica e entre as médias do teste de vocabulário por imagem Peabody e prova de compreensão de leitura nos dois grupos estudados (p<0,05). CONCLUSÃO: na avaliação da linguagem oral e escrita, o grupo de sujeitos com Síndrome de Asperger caracterizou-se por um desempenho pior do que o grupo de sujeitos de baixo risco para alterações do desenvolvimento nas provas fonoaudiológicas de consciência fonológica, teste de vocabulário por imagem Peabody e prova de compreensão de leitura, o que caracteriza prejuízo em níveis fonológico, semântico e pragmático da linguagem.

PURPOSE: to evaluate and characterize the oral and written language of subjects with Asperger Syndrome and compare them with a group of subjects with typical development. METHODS: a total of 44 subjects were assessed and divided in two groups. The Asperger group was composed by 22 subjects diagnosed with Asperger Syndrome by an expert clinical team following the DSM-IV criteria. The comparison group, referred to as low risk for developmental disorders was also composed by 22 subjects matched with the subjects in Asperger group by chronological age. All the assessed subjects were right-handed males, with chronological ages between 10 and 30 years and intelligence quotients above 68 according to Wechsler Scale. They completed the following assessment tools: phonological conscience proof, image Peabody vocabulary test, words and pseudo words reading proof, reading comprehension proof, writing proof of dictated words and pseudo words, and the semi-directed text writing proof. RESULTS: the statistical analysis revealed significant statistical differences between the medians obtained for the phonological conscience proof and the means of the image Peabody vocabulary test and the reading comprehension proof in both studied groups (p<0.05). CONCLUSION: for the oral and written language assessments the Asperger Syndrome group was characterized by a worse performance then the one displayed by the group of subjects with a typical development in the phonological conscience proof, Peabody vocabulary test and the reading comprehension proof, indicating handicaps in the phonological, semantic and pragmatic language levels.

Formaçäo de interlocutores para a construçäo da linguagem escrita: manual de orientaçäo a pais e professores de crianças com dificuldades escolares / Formation of interlocutors for the construction of writing: orientation guide for parents and teachers of children with school difficulties

Estudos recentes relatam que indivíduos que apresentam dificuldades escolares mantém pouco contato com as práticas discursivas relacionadas ao ato de ler e escrever. Atualmente na Clínica de Fonoaudiologia da UNESP/Marília, säo realizadas orientaçöes pais e professores de crianças com dificuldades escolares que recebem o diagnóstico fonoaudiológico de distúrbio específico de leitura e escrita e distúrbios de aprendizagem. A partir de nossa prática clínica, verificamos que tais pais como professores näo oferecem oportunidades de experiências adequadas e suficientes para a construçäo da linguagem escrita. Em decorrência deste fator e da necessidade do trabalho em conjunto com pais e professores desta crianças, elaboramos manual explicativo e informativo, com o objetivo de formar interlocutores para estimulaçäo e trabalho com as habilidades de leitura e escrita em casa e em situaçäo de sala de aula. O manual é composto por quatro partes: definiçäo de dificuldades escolares; como identificar as crianças com dificuldades escolares; informaçöes e atividades que favoreçam os pais a auxiliarem as crianças com dificuldades escolares em casa; informaçöes e atividades que favoreçam os professores a auxiliarem as crianças com dificuldades escolares em sala de aula

Formacao de interlocutores para a construcao da linguagem escrita? manual de orientacao a pais e professores de criancas com dificuldades escolares

Estudos recentes relatam que individuos que apresentam dificuldades escolares mantem pouco contato com as praticas discursivas relacionadas ao ato de ler e escrever. Atualmente na Clinica de Fonoaudiologia da UNESP/MARILIA, sao realizados orientacoes pais e professores de criancas com dificuldades escolares que recebem o diagnostico fonoaudiologico de disturbio especifico de leitura e escrita e disturbio de aprendizzagem. A partir de nossa pratica clinica, verificamos que tanto pais como professores nao oferecem oportunidades de experiencias adequadas e suficientes para a construcao da linguagem escrita. Em decorrencia deste fator e da necessidade de trabalho em conjunto com pais e professores destas criancas, elaboramos manual explicativo e informativo, com o objetivo de formar intelecutores para estimulacao e trabalho com as habilidades de leitura e escrita em casa e em situacao de sala de aula. O manual e composto por quatro partes: definicao de dificuldades escolares; como identificar as criancas com dificuldades escolares; informacoes e atividades que favorecam os pais a auxiliarem, as criancas com dificuldades escolares em casa; informacoes e atividades que favorecam os professores a auxiliarem as criancas com dificuldades escolares em sala de aula.