RESUMO
During healthy aging, inhibitory processing is affected at the sensorial, perceptual, and cognitive levels. The assessment of event-related potentials (ERPs) during the Stroop task has been used to study age-related decline in the efficiency of inhibitory processes. Studies using ERPs have found that the P300 amplitude increases and the N500 amplitude is attenuated in healthy elderly adults compared to those in young adults. On the other hand, it has been reported that theta excess in resting EEG with eyes closed is a good predictor of cognitive decline during aging 7 years later, while a normal EEG increases the probability of not developing cognitive decline. The behavioral and ERP responses during a Counting-Stroop task were compared between 22 healthy elderly subjects with normal EEG (Normal-EEG group) and 22 healthy elderly subjects with an excess of EEG theta activity (Theta-EEG group). Behaviorally, the Normal-EEG group showed a higher behavioral interference effect than the Theta-EEG group. ERP patterns were different between the groups, and two facts are highlighted: (a) the P300 amplitude was higher in the Theta-EEG group, with both groups showing a P300 effect in almost all electrodes, and (b) the Theta-EEG group did not show an N500 effect. These results suggest that the diminishment in inhibitory control observed in the Theta-EEG group may be compensated by different processes in earlier stages, which would allow them to perform the task with similar efficiency to that of participants with a normal EEG. This study is the first to show that healthy elderly subjects with an excess of theta EEG activity not only are at risk of developing cognitive decline but already have a cognitive impairment.
RESUMO
We studied the incidence, survival, and risk factors for mortality in a cohort of infants for a period of five years, born in two hospitals, one a second-level General Hospital, the second a tertiary perinatal hospital, both in the City of Toluca. The analysis of survival was performed with the Kaplan-Meier method, and Cox regression was used to estimate the risk of death according to different factors. We found an overall incidence of 7.4 per 1,000 live births; in preterm infants, the rate was 35.6 per 1,000, and in term newborns it was 3.68 per 1,000. The most common heart disease was the ductus arteriosus in the overall group and in preterm infants; in term newborns the most common was the atrial septal defect. The specific mortality was 18.64%, follow-up was 579 days, where we found, according to Kaplan-Meier, survival of an average of 437.92 days, with 95% confidence intervals of 393.25 to 482.6 days, with a standard error of 22.79 days; the cumulative probability of survival was 0.741, with a standard error of 0.44. In Cox regression, two variables had a high hazard ratio (HR): these were the presence or absence of cyanosis and the hospital where they were treated as newborns.
Assuntos
Cardiopatias Congênitas/epidemiologia , Doenças do Prematuro/epidemiologia , Estudos de Coortes , Feminino , Cardiopatias Congênitas/mortalidade , Hospitais , Humanos , Incidência , Recém-Nascido , Recém-Nascido Prematuro , Doenças do Prematuro/mortalidade , Masculino , México , Estudos RetrospectivosRESUMO
UNLABELLED: Within the field of pediatric heart disease, congenital cardiopathology is the most important issue due to the fact that in these patients a delay of neurodevelopment is the most frequent morbidity. The major aim of this work was to determine the impact of severe congenital cardiopathology (SCC) on the central nervous system (CNS) through the study of the electroencephalogram (EEG) and the assessment of neurodevelopment. POPULATION AND METHODS: Children under 3 years old, 41 of them presenting SCC and 15 healthy controls (C) were studied. Conventional EEG recording and assessment of neurodevelopment were performed. RESULTS: In twenty children presenting SCC (48.8%) the EEG was found abnormal (paroxysmal of spikes and sharp waves). Forty of them (97.6%) presented neurodevelopmental alterations, including hypotonia and a delay in gross motor skills. When comparing EEG between SCC and C children, odds ratio was 13.33 (1.602-111) and comparing neurodevelopment delay, it was 35 (3.769-235). Both were statistically significant (p ≤ 0.00039 and p ≤ 0.00038, respectively). CONCLUSIONS: A high percentage of children suffering from SCC exhibited EEG patterns with abnormal epileptic-like activity although without clinical manifestation of seizures. These children also showed delay features in different areas of neurodevelopmental. The assessment of new born carrying some type of severe cardiopathology indicated that they were under high risk of suffering from CNS altered development.
Assuntos
Encefalopatias/etiologia , Encefalopatias/fisiopatologia , Deficiências do Desenvolvimento/etiologia , Deficiências do Desenvolvimento/fisiopatologia , Eletroencefalografia , Cardiopatias Congênitas/complicações , Cardiopatias Congênitas/fisiopatologia , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , Estudos Prospectivos , Índice de Gravidade de DoençaRESUMO
Brain maturation in 1-36 month old children suffering from congenital cardiopathologies was assessed after a study of psychomotor development. The Rogers' test (Rogers et al., Developmental programming for infants and young children. Volume 2. Early intervention developmental profile, Revised edition, ESL/ELT Michigan, Ann Arbor, 1981) was applied to 65 children, of whom 21 presented with simple cardiopathologies (CpS) and 22 with complex cardiopathologies (CpC). All children were matched by age, sex and socioeconomic status to 22 healthy children in a control group (C). Mean differences between the three groups were established by applying the Kruskal-Wallis test, and mean differences between the C and CpS/CpC groups were determined using the Mann-Whitney test. The proportion of cases evaluated as "low" in each group was calculated by applying the Rogers' test, and a test of proportion differences was applied between the C and CpS/CpC groups. CpS children performed similarly to the C, whereas CpC children scored significantly lower than C children on all variables. It is highly likely that the suboptimal psychomotor performance observed in CpC children was due to compromised hemodynamics and related to subclinical immaturity of cerebral development.
Assuntos
Deficiências do Desenvolvimento/diagnóstico , Deficiências do Desenvolvimento/psicologia , Cardiopatias Congênitas/diagnóstico , Cardiopatias Congênitas/psicologia , Testes Neuropsicológicos/estatística & dados numéricos , Transtornos Psicomotores/diagnóstico , Transtornos Psicomotores/psicologia , Encéfalo/fisiopatologia , Pré-Escolar , Deficiências do Desenvolvimento/classificação , Deficiências do Desenvolvimento/fisiopatologia , Feminino , Cardiopatias Congênitas/fisiopatologia , Hemodinâmica/fisiologia , Humanos , Lactente , Masculino , Psicometria , Transtornos Psicomotores/fisiopatologia , Estatísticas não ParamétricasRESUMO
Deficiencies of nutrients such as amino acids, vitamins, lipids, and trace elements during gestation and early infanthood have strong deleterious effects on the development of the limbic system; these effects may be irreversible, even when adequate supplementation is provided at later developmental stages. Recent advances in the neurochemistry of biometals are increasingly establishing the roles of the trace elements iron, copper, zinc, and selenium in a variety of cell functions and are providing insight into the repercussions of deficiencies and excesses of these elements on the development of the central nervous system, especially the limbic system. The limbic system comprises diverse areas with high metabolic demands and differential storage of iron, copper, zinc, and selenium. This review summarizes available evidence suggesting the involvement of these trace elements in pathological disorders of the limbic system.
Assuntos
Encefalopatias/etiologia , Sistema Límbico/efeitos dos fármacos , Sistema Límbico/crescimento & desenvolvimento , Oligoelementos/sangue , Oligoelementos/deficiência , Encefalopatias/sangue , Cobre/sangue , Cobre/deficiência , Cobre/fisiologia , Humanos , Ferro/sangue , Ferro/fisiologia , Deficiências de Ferro , Sistema Límbico/fisiologia , Fenômenos Fisiológicos da Nutrição/efeitos dos fármacos , Fenômenos Fisiológicos da Nutrição/fisiologia , Necessidades Nutricionais , Selênio/sangue , Selênio/deficiência , Selênio/fisiologia , Zinco/sangue , Zinco/deficiência , Zinco/fisiologiaRESUMO
OBJECTIVE: Nursing personnel applied a computerized evaluation instrument, Neuropediatric Development (NPED), and compared the prevalence of deviations from normal neurodevelopment in four communities of two Latin American countries, Mexico and Cuba. At the same time the feasibility of introducing this tool into Mexican local health centers was assessed. DESIGN AND SAMPLE: The NPED screening tool was applied to 400 children 1-60 months old from two suburban and one urban communities of Mexico and one urban community of Cuba. MEASURES: The NPED instrument was developed at the Neurosciences Centre of Cuba (Santos, & Pérez-Ábalo, 2011; Santos, Pérez-Abalo, & Álvarez, 2007), and explores three neurodevelopmental areas: language/communication, psychomotor, and sensory maturation (hearing/vision). RESULTS: Global (21.5%), language (16.5%), psychomotor (5.8%), and sensory (vision/audition; 2.3%/7%) failures were observed. Among Mexican communities, apart from the hearing test in which the urban community showed a significantly higher percentage of failures (p < .001), there were no other significant differences. When compared, the Cuban community showed a significantly higher proportion of audition failures in relation to the Mexican communities. CONCLUSIONS: The prevalence of deviations from normal neurodevelopment was highly similar between both countries, and the NPED system fulfils the necessary requisites for mass screening to be applied by nursing staff at a primary care level.