Fernanda Costa de Queirós

Fatores etiológicos da deficiência auditiva em crianças e adolescentes de um centro de referência APADA em Salvador-BA

Hearing represents the main source for acquisition of language and speaking skills in childhood. In the first months of life, the hearing impaired child is deprived of sound stimulation in the most important period of development, and consequently, might present emotional, social and linguistic disorders. Therefore, it is of utmost relevance to learn about the main etiological factors that cause the auditory damage to trace a reliable nosological profile, and to take the appropriate measures to prevent and guide the family on the repercussions of hearing impairment in childhood. Aim: To characterize the etiology profile of hearing impairment in a reference center for hearing impaired children and adolescents. Methodology: We performed interviews, speech and hearing screening and analyses of medical charts of 87 hearing impaired children that were part of Associacao de Pais e Amigos dos Deficientes Auditivos do Estado da Bahia (APADA-BA), trying to define etiology, gender distribution, age at diagnosis, level of hearing loss, age at hearing aid fitting, and rehabilitation. Results: Among the 87 children and adolescents who had undergone speech and hearing screening, we select a sample of 53 subjects, whose parents had come for three sessions of anamnesis and assessment. The main responsible etiological factor for hearing loss in the evaluated population was maternal rubella, amounting to 32% of the cases of deafness, followed by pyogenic meningitis with 20%, idiopathic cause with 15%, prematurity with 9%, heredity (deaf father or mother) and neonatal jaundice, which also presented 6% incidence; chronic otitis media represented 4%, use of misoprostol in the gestation, measles, ototoxicity and mumps, each factor with 2%. Conclusion: The present study demonstrated the heterogeneity of factors that cause hearing impairment, and the two main causes (rubella and pyogenic meningitis) still present high incidence in the studied population. We believe that preventive measures must be taken, especially in the prophylaxis of maternal rubella and extended vaccination of neonates and infants against bacterial meningitis.

Electroencephalographic Patterns in Chronic Pain: A Systematic Review of the Literature

The main objective of this study is to review and summarize recent findings on electroencephalographic patterns in individuals with chronic pain. We also discuss recent advances in the use of quantitative Electroencephalography (qEEG) for the assessment of pathophysiology and biopsychosocial factors involved in its maintenance over time. Data collection took place from February 2014 to July 2015 in PubMed, SciELO and PEDro databases. Data from cross-sectional studies and longitudinal studies, as well as clinical trials involving chronic pain participants were incorporated into the final analysis. Our primary findings related to chronic pain were an increase of theta and alpha EEG power at rest, and a decrease in the amplitude of evoked potentials after sensory stimulation and cognitive tasks. This review suggests that qEEG could be considered as a simple and objective tool for the study of brain mechanisms involved in chronic pain, as well as for identifying the specific characteristics of chronic pain condition. In addition, results show that qEEG probably is a relevant outcome measure for assessing changes in therapeutic studies.

Periconceptional use of folic acid and risk of miscarriage – findings of the Oral Cleft Prevention Program in Brazil

Abstract Objective: We report on the risk of miscarriage with high- and low-dosage periconceptional folic acid (FA) supplementation from a double-blind randomized clinical trial for prevention of orofacial cleft recurrence in Brazil. Methods: Women at risk of recurrence of orofacial clefts in their offspring were randomized into high (4 mg/day) and low (0.4 mg/day) doses of FA supplementation. The women received the study pills before pregnancy, and supplementation continued throughout the first trimester. Miscarriage rates were compared between the two FA groups and with the population rate. Results: A total of 268 pregnancies completed the study protocol, with 141 in the 4.0-mg group and 127 in the 0.4-mg group. The miscarriage rate was 14.2% in the low-dose FA group (0.4 mg/day) and 11.3% for the high-dose group (4 mg/day) (P=0.4877). These miscarriage rates are not significantly different from the miscarriage rate in the Brazilian population, estimated to be around 14% (P=0.311). Conclusions: These results indicate that high-dose FA does not increase miscarriage risk in this population and add further information to the literature on the safety of high FA supplementation for prevention of birth defect recurrence.

Prevalence of newborn bacterial meningitis and sepsis during the pregnancy period for public health care system participants in Salvador, Bahia, Brazil

Bacterial meningitis is still a major public health threat inside developing countries. In Brazil, the Department of Public Health estimates that the prevalence of bacterial meningitis is 22 cases per 100,000 persons. During the neonatal period, the bacterial meningitis develops special characteristics that can result in hearing problems and movement loss due to neurological and psychological damages. This study had the aim to analyze the prevalence of bacterial meningitis and sepsis in newborns during the pregnancy period for those using the public health care system in Salvador-Bahia. One of the goal was to describe the risk factors of bacterial meningitis and sepsis in newborns. A second goal was to identify, based on newborn health records, the difficulties to predict issues with the hearing, neurological and psychological problems. This study has a cross-sectional design. The newborns that were included in this study had bacterial meningitis or sepsis within 0-28 days of life. They were admitted in the maternity wards between June-December 2005 at the newborn intensive unit care. We analyzed 72 reports of newborns and only 11 (17%) were bacterial meningitis or sepsis newborn cases. These cases were associated to high intake of ototoxic drugs that can cause oto and nephrotoxicity, and cause serious sequels on the child development. Nervous system infection is one of the 2 major problems in clinical practice, especially during the first month after birth. During this first month, the nervous system infection develops special characteristics, which are different from regular symptoms and it requires treatment due to the increased risk to develop complications. It is strongly recommended to monitor ototoxic drugs use to prevent effects on the hearing system.

Prognóstico audiológico tardio relacionado à meningite em lactentes

Deficit auditivo tem sido considerado uma das principais manifestacoes tardias dasmeningites, sobretudo quando esta ocorre nos dois primeiros anos de vida. No pais, poucos sao os estudosrelatando a evolucao de criancas acometidas por meningite e a percentagem e gravidade dos transtornosauditivos e sequelas neurologicas apos a alta hospitalar .

Developmental disabilities and socioeconomic outcomes in young adulthood.

Objective. We assessed the associations between developmental disabilities and indicators of socioeconomic outcomes (i.e., educational attainment, employment status, occupation type, subjective perception of socioeconomic status [SES], income, and wage rate) among young U.S. adults aged 24–33 years. Methods. We used data from the National Longitudinal Study of Adolescent Health (n=13,040), a nationally representative study of U.S. adolescents in grades 7–12 during the 1994–1995 school year. Young adult outcomes (i.e., educational attainment, employment status, income, occupation, and subjective SES) were measured in Wave IV (2008 for those aged 24–33 years). Multivariate methods controlled for sociodemographic characteristics and other relevant variables. Results. Nearly 12% of this sample presented with a physical or cognitive disability. Respondents with physical disabilities had lower educational attainment (odds ratio [OR] = 0.69, 95% confidence interval [CI] 0.57, 0.85) and ranked themselves in lower positions on the subjective SES ladder (OR=0.71, 95% CI 0.57, 0.87) than those without a physical disability. Compared with individuals without disabilities, young adults with a cognitive disability also had lower educational attainment (OR=0.41, 95% CI 0.33, 0.52) and, when employed, were less likely to have a professional/managerial occupation (OR=0.50, 95% CI 0.39, 0.64). Young adults with disabilities also earned less annually (–

Etiology of hearing impairment in children and adolescents of a reference center APADA in the city of Salvador, state of Bahia

10,419.05, 95% CI –

Prevalence of behavior problems and associated factors in preschool children from the city of Salvador, state of Bahia, Brazil

4,954.79, –

Patients with Rheumatoid Arthritis and Chronic Pain Display Enhanced Alpha Power Density at Rest

5,883.37) and hourly (–

Tratamento farmacológico da gagueira: evidências e controvérsias

5.38, 95% CI –