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ABSTRACT Purpose: to investigate the association of symptoms of inattention and hyperactivity with language development and cognitive, environmental, socioeconomic, and quality of life aspects in children with attention-deficit/hyperactivity disorder. Methods: an observational, analytical, cross-sectional study with a sex-stratified sample of 38 children 7 to 12 years old, diagnosed with attention-deficit/hyperactivity disorder. The assessments approached sociodemographic and environmental aspects, the quality of life, language comprehension, rapid automatic naming, phonological working memory, vocabulary, reading and writing processes and metalinguistic skills. Descriptive and bivariate analyses were conducted at the 5% significance level. Results: there was a statistically significant association between the profile of attention-deficit/hyperactivity disorder and behavioral aspects. There was no significant association of the forms of manifestation of attention-deficit/hyperactivity disorder with the quality of life, oral language, written language and phonological processing skills. Conclusion: children with hyperactive profiles had a better performance, whereas children with combined and predominantly inattentive profiles had similar performances. Although no statistically significant associations were found between attention-deficit/hyperactivity disorder and most of the variables analyzed in this research, it contributes to the discussion of the speech-language-hearing diagnosis.

RESUMO Objetivo: investigar a associação de sintomas de desatenção e hiperatividade com o desenvolvimento de linguagem, aspectos cognitivos, ambientais, socioeconômicos e de qualidade de vida, em crianças com Transtorno do Déficit de Atenção e Hiperatividade. Métodos: estudo observacional, analítico, transversal, com amostra estratificada por sexo e composta por 38 crianças de sete a doze anos de idade, com diagnóstico de Transtorno do Déficit de Atenção e Hiperatividade. Foram avaliados aspectos sociodemográficos e ambientais, qualidade de vida, compreensão da linguagem, nomeação automática rápida, memória de trabalho fonológica, vocabulário, processos de leitura, escrita e habilidades metalinguísticas. Foram realizadas análises descritiva e bivariada, adotando nível de significância de 5%. Resultados: houve associação com significância estatística entre perfil do Transtorno do Déficit de Atenção e Hiperatividade e aspectos comportamentais. Não houve associação significante das formas de apresentação do Transtorno do Déficit de Atenção e Hiperatividade com qualidade de vida, linguagem oral, linguagem escrita e habilidades de processamento fonológico. Conclusão: verificou-se melhor desempenho das crianças com perfil hiperativo e desempenho semelhante entre os perfis combinado e predominantemente desatento. Embora não tenham sido encontradas associações estatisticamente significantes entre Transtorno do Déficit de Atenção e Hiperatividade e a maioria das variáveis analisadas nesta pesquisa, ela contribui para a discussão do diagnóstico fonoaudiológico.

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Abstract Introduction: Chronic Kidney Disease (CKD) may cause great impacts on areas of occupational performance of children and adolescents on hemodialysis. The identification of these occupations can guide the practice of occupational therapy, enabling specific interventions as well as the creation of policies and guidelines in the field. Objective: To identify the impact of CKD on the occupational performance of children and adolescents on hemodialysis. Method: Twenty-one children and adolescents with CKD undergoing hemodialysis treatment participated in the study. The tools applied were the profile identification questionnaire and the semi-structured interview Canadian Measurement of Occupational Performance (COPM). Numerical variables were described as measures of central tendency and dispersion, and for categorical variables were calculated the frequencies. Results: 13 impacted occupations were identified, in which 9 are related to play/leisure , 1 to productivity/ school, 3 to self-care. In addition, 57% of the sample dropped out of school and 23% repeated one school year or more. Conclusion: Impacts on different areas of occupational performance, mainly related to play and leisure, have been identified. Children and adolescents present specific demands related to their age ranges. Therefore, the occupational therapist, considering this specificity, can enable these clients to improve their performance in occupations and resume significant roles in their lives.

Resumo Introdução: O acometimento pela Doença Renal Crônica (DRC) pode trazer impactos importantes em áreas de desempenho ocupacional de crianças e adolescentes em tratamento hemodialítico. A identificação dessas áreas de desempenho prejudicadas pode direcionar a atuação da terapia ocupacional, possibilitando intervenções específicas e criação de políticas e diretrizes na área. Objetivo: Identificar o impacto da DRC no desempenho ocupacional de crianças e adolescentes em hemodiálise. Método: Participaram do estudo 21 crianças e adolescentes com DRC em tratamento via hemodiálise. Os instrumentos utilizados foram o questionário de identificação do perfil da amostra e a entrevista semiestruturada Medida Canadense de Desempenho Ocupacional (COPM). Os dados da pesquisa foram analisados por meio do programa estatístico SSPS 22.0. As variáveis numéricas foram descritas como medidas de tendência central e dispersão, e para variáveis categóricas foram calculadas as frequências. Resultados: Foram identificadas 13 ocupações impactadas, das quais, 9 são relacionadas à área do brincar/lazer , 1 produtividade/escola e 3 ocupações da área de autocuidado. Além disso, 57% da amostra abandonaram a escola e 23% repetiram um ano escolar ou mais. Conclusão: Foram identificados prejuízos em diferentes áreas do desempenho ocupacional, principalmente relacionadas ao brincar e lazer. As crianças e adolescentes apresentam demandas específicas dessa faixa etária e o terapeuta ocupacional, considerando essa especificidade, pode possibilitar a esses clientes a melhoria de desempenho em ocupações e a retomada de papéis significativos em suas vidas.

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BACKGROUND: In adult chronic kidney disease (CKD) patients, there is a positive association between inflammation and progressive renal dysfunction. Higher levels of soluble receptors of tumor necrosis factor (sTNFR) have been related to worst prognosis of adult CKD patients. Therefore, the present study aimed to evaluate soluble TNF receptors in children and adolescents with CKD and to search for an association with clinical and laboratory features. METHODS: Demographic, clinical, anthropometric, and laboratory data were evaluated in 34 pediatric patients with CKD and in 34 healthy sex- and age-matched controls. Blood samples were collected in both groups to measure sTNFR by enzyme-linked immunosorbent assay. The modified Schwartz formula was used to estimate glomerular filtration rate (GFR). RESULTS: Pediatric patients with CKD had significantly higher plasma concentrations of soluble TNF receptors types 1 and 2 (sTNFR1 and sTNFR2) in comparison to sex- and age-matched healthy controls. Plasma levels of sTNFR1 and sTNFR2 increased progressively as renal function worsened, being inversely and significantly correlated with GFR (r = - 0.853 for sTNFR1 and GFR, r = - 0.729 for sTNFR2 and GFR). CONCLUSIONS: Children and adolescents with CKD exhibited higher plasma levels of sTNFR1 and sTNFR2 than healthy controls, which increased in relation to renal function deterioration. Plasma levels of sTNFR1 and sTNFR2 emerge as markers of progressive CKD in pediatric patients.

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BACKGROUND: Chronic kidney disease (CKD) is a risk factor for psychosocial impairment and psychiatric symptoms. Children and adolescents on dialysis frequently have compromised daily life activities and a worse quality of life (QoL) compared with healthy peers. However, few studies have investigated these aspects of CKD in pediatric pre-dialysis CKD patients. Therefore, we have analyzed resilience, QoL and anxiety and depressive symptoms in children and adolescents with pre-dialysis CKD and compared these to the values of healthy controls. METHODS: Demographic and clinical data were collected from 28 children and adolescents with pre-dialysis CKD and 28 healthy sex- and age-matched controls. Psychological assessment of the participants was performed using the Wagnild and Young Resilience Scale, Pediatric Quality of Life (QoL) Inventory 4.0 , Child Depression Inventory and Self-report for Childhood Anxiety Related Disorders scales. RESULTS: Of the 56 children enrolled in our study, the CKD patients were referred to mental health professionals more frequently than the controls. Patients exhibited higher scores for separation anxiety and a higher frequency of clinically significant depressive symptoms. They also had lower overall QoL scores, as well as poorer scores for the psychological, educational and psychosocial subdomains of QoL instruments. There was a negative correlation between anxiety and depressive symptoms and all domains of QoL. Resilience was similar in both groups, but lower in patients with significant depressive symptoms. No significant association was found between clinical or laboratory findings and psychological variables in CKD patients. CONCLUSION: Although patients and controls exhibited similar scores of resilience, CKD negatively impacted the QoL of pediatric patients, contributing to a higher frequency of depression and separation anxiety.

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Impairment of cognitive functions occurs frequently in chronic kidney disease (CKD). The conditions most associated with this decline are depression, delirium, mild cognitive impairment and dementia. The mechanisms involved have not been established yet, but some factors, as neuronal damage by uremic toxins, cerebrovascular ischemic lesions, oxidative stress, chronic inflammation, anemia, hyperhomocysteinemia, the endothelial dysfunction may play a critical role. The neuropsychological performance improves with the initiation of dialysis, although some cognitive dysfunctions remain even after treatment, especially in the areas of attention, cognitive flexibility, memory and learning. Kidney transplantation may improve and even reverse some cognitive deficits detected in the dialysis period, despite some compromise in verbal memory and executive functions remain after transplantation. The diagnosis of cognitive decline in patients with CKD may have an important impact on the management and prognosis. This paper presents an update on the decline of cognitive function in patients with CKD.

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PURPOSE: Integrative review of the scientific literature about the behavioral characteristics of dysphonic children discussing profiled and their etiologic relationship with the voice disorder, seeking to define recommendations on the importance of analyzing the behavior of children in voice assessment. RESEARCH STRATEGY: Integrative review of articles published in the last 12 years, the Virtual Health Library. SELECTION CRITERIA: Set up the theme of "behavioral characteristics of dysphonic children" was selected the databases LILACS, IBECS, MEDLINE, Cochrane Library, SciELO and ISI Web of Science and the following inclusion criteria: original articles, publication year from 2000 and 2012, Portuguese, English and Spanish. DATA ANALYSIS: Among the 528 articles published childish voice and dysphonia, seven covered the topic researched and were included in the results. RESULTS: Observed that four papers studied the behavior of children with vocal nodules, one addressed the behavioral characteristics of children with various types of dysphonic vocal fold lesion and three correlated Attention Deficit Disorder / Hyperactivity and dysphonia. CONCLUSION: Not established a behavioral profile of children with vocal disorders, but the results were consistent recommendation for the importance of this analysis in the evaluation of dysphonia in children.

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Prejuízos das funções cognitivas ocorrem com frequência na doença renal crônica (DRC). As condições mais associadas a esses prejuízos são depressão, delirium, comprometimento cognitivo leve e demência. Os mecanismos envolvidos ainda não estão estabelecidos, mas alguns fatores, como dano neuronal induzido pelas toxinas urêmicas, lesões cerebrovasculares isquêmicas, estresse oxidativo, inflamação crônica, anemia, hiper-homocisteinemia e disfunção endotelial, podem ser importantes. O desempenho neuropsicológico tende a melhorar com o início da diálise, apesar de algumas disfunções cognitivas permanecerem alteradas mesmo após a instituição do tratamento, principalmente nos domínios de atenção, flexibilidade cognitiva, memória e aprendizagem. O transplante renal pode melhorar e, inclusive, reverter alguns déficits cognitivos, apesar de prejuízos na memória verbal e nas funções executivas poderem permanecer. O diagnóstico do declínio cognitivo nos pacientes renais crônicos pode ter impacto no manejo e no prognóstico. Este artigo apresenta uma atualização sobre declínio das funções cognitivas nos pacientes com DRC.

Impairment of cognitive functions occurs frequently in chronic kidney disease (CKD). The conditions most associated with this decline are depression, delirium, mild cognitive impairment and dementia. The mechanisms involved have not been established yet, but some factors, as neuronal damage by uremic toxins, cerebrovascular ischemic lesions, oxidative stress, chronic inflammation, anemia, hyperhomocysteinemia, the endothelial dysfunction may play a critical role. The neuropsychological performance improves with the initiation of dialysis, although some cognitive dysfunctions remain even after treatment, especially in the areas of attention, cognitive flexibility, memory and learning. Kidney transplantation may improve and even reverse some cognitive deficits detected in the dialysis period, despite some compromise in verbal memory and executive functions remain after transplantation. The diagnosis of cognitive decline in patients with CKD may have an important impact on the management and prognosis. This paper presents an update on the decline of cognitive function in patients with CKD.

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PURPOSE: Integrative review of the scientific literature about the behavioral characteristics of dysphonic children discussing profiled and their etiologic relationship with the voice disorder, seeking to define recommendations on the importance of analyzing the behavior of children in voice assessment. RESEARCH STRATEGY: Integrative review of articles published in the last 12 years, the Virtual Health Library. SELECTION CRITERIA: Set up the theme of "behavioral characteristics of dysphonic children" was selected the databases LILACS, IBECS, MEDLINE, Cochrane Library, SciELO and ISI Web of Science and the following inclusion criteria: original articles, publication year from 2000 and 2012, Portuguese, English and Spanish. DATA ANALYSIS: Among the 528 articles published childish voice and dysphonia, seven covered the topic researched and were included in the results. RESULTS: Observed that four papers studied the behavior of children with vocal nodules, one addressed the behavioral characteristics of children with various types of dysphonic vocal fold lesion and three correlated Attention Deficit Disorder / Hyperactivity and dysphonia. CONCLUSION: Not established a behavioral profile of children with vocal disorders, but the results were consistent recommendation for the importance of this analysis in the evaluation of dysphonia in children. .

OBJETIVO: Revisar de forma integrativa a literatura científica a respeito das características comportamentais de crianças disfônicas, discutindo o perfil traçado e sua relação etiológica com o distúrbio vocal, procurando definir recomendações sobre a importância da análise do comportamento infantil na avaliação vocal. ESTRATÉGIA DE PESQUISA: Revisão integrativa de artigos publicados nos últimos 12 anos na Biblioteca Virtual em Saúde. CRITÉRIOS DE SELEÇÃO: Definiram-se o tema "características comportamentais de crianças disfônicas", selecionaram-se as bases de dados LILACS, IBECS, MEDLINE, Biblioteca Cochrane, SciELO e Web of Science ISI, e os seguintes critérios de inclusão: artigos originais, ano de publicação entre 2000 e 2012 e idiomas português, inglês e espanhol. ANÁLISE DOS DADOS: Entre os 528 artigos sobre voz e disfonia infantil publicados, sete abrangeram o tema pesquisado e foram incluídos nos resultados. RESULTADOS: Observou-se que quatro artigos estudaram o comportamento de crianças com nódulos vocais, um abordou as características comportamentais de crianças disfônicas com vários tipos de lesão de prega vocal e três correlacionaram o Transtorno do Déficit de Atenção/Hiperatividade à disfonia. CONCLUSÃO: Não se estabeleceu um perfil comportamental de crianças com distúrbio vocal, mas os resultados foram consistentes na recomendação sobre a importância desta análise na avaliação da disfonia em crianças. .

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