To investigate the effect of intensive physiotherapy training on the motor function of children with congenital Zika syndrome (CZS).
A retrospective cohort study.
A support center for children with ...microcephaly.
Children (N=7) aged 14 to 18 months old who were diagnosed with CZS and previously monitored more than 1 year.
A 2-stage protocol repeated uninterruptedly for 1 year. In the first stage, the children were submitted to 1 hour of conventional physiotherapy and 1 hour of suit therapy 5 times a week for 4 weeks. The second stage consisted of 1 hour of suit therapy 3 times a week for 2 weeks.
Gross motor function measure (GMFM) and body weight.
Six evaluations were conducted approximately 3 months apart. An increase in the overall GMFM score was observed between the first and second (P=.046), first and third (P=.018), first and fourth (P=.018), first and fifth (P=.043), and first and sixth evaluations (P=.018). Differences in the scores of the individual GMFM dimensions were found only for dimension A (lying and rolling) between the first and fourth evaluations (P=.027) and for dimension B (sitting) between the first and third (P=.018), first and fourth (P=.046), and first and sixth evaluations (P=.027). No difference was found in body weight between the first and sixth evaluations (P=.009). During follow-up, only 1 child required hospitalization, and another had increased irritability.
Children with CZS were able to perform 2 hours of motor physiotherapy daily with no serious complications, resulting in an increase or stabilization in GMFM scores.
To provide a detailed description of the development of the first case of congenital Zika syndrome (CZS) to be reported in the literature worldwide.
This report describes the case of a child with CZS ...monitored from pregnancy until four years of age, with periodic evaluations of head circumference, weight, height, motor function according to the Gross Motor Function Measure (GMFM-88), and the occurrence of comorbidities.
The child's birth weight and length were normal (z-score = 1.1 and -1.95, respectively), while head circumference was below the expected value (z-score = -3.15). At 48 months, head circumference reached 43 cm (z-score = -4.48). During daily home physiotherapy sessions, the child achieved developmental milestones, standing unsupported at 17 months, with a GMFM-88x score of 137. With specialist therapy, the child walked independently at 36 months and a total GMFM-66 score of 214 was achieved by 42 months. In the four years of follow-up, the child was hospitalized four times for different reasons. No convulsive seizures occurred.
Despite severe neurological impairment, the child's weight and height are adequate for age, with motor and cognitive function improving over the first four years of life.
To use the International Classification of Functioning, Disability and Health (ICF) to investigate whether children with congenital Zika Syndrome (CZS) show changes in their functioning and ...disability profile after nine months. This study included children with CZS recruited from a support centre for children with microcephaly in Brazil. The children's functional abilities and limitations were classified using ICF Core Set for children with cerebral palsy. Each ICF category was quantified in two moments with a mean interval of nine months. The study included 81children (mean age = 38.4 ± 3.3mo). Most children showed changes between assessments. Categories that presented improvements were in body functions (five categories), environmental factors (two categories), and activity and participation (one category) sections. Most children with CZS evaluated improved their functioning and disability profile over time, mainly in body functions. These changes can be related to the course of the disease or to the health programmes that children had access.
To describe and analyze the changes in anthropometric parameters in children with congenital Zika syndrome (CZS) from birth to four years of age. This prospective study evaluated 117 children ...diagnosed with CZS. Anthropometric indices evaluated annually were classified with respect to presence of microcephaly and adequacy of weight-for-age, length/height for-age and body mass index-for-age (BMI-for-age). At birth, 69.6% of the children had microcephaly, 90.2% had adequate weight and 72.1% had adequate length. The following year, an increase occurred in the proportion of children with microcephaly, with a reduction of those with adequate weight. In the second year, the proportion of children with microcephaly increased again, while those with adequate BMI decreased. In the third to fourth years of life, a reduction was found in the proportion of children with adequate height. Anthropometric indices are affected in children with CZS over the first four years of life and appear to be potentiated over time.
Objective
To describe obstetric and perinatal outcomes in cases of congenital Zika syndrome (CZS).
Methods
A dual prospective and retrospective cohort study involving 102 pairs of mothers and ...fetuses/children with CZS whose infection was confirmed by testing for the Zika virus in amniotic fluid, umbilical cord blood, and fragments from the placenta of the newborn infant (confirmed CZS), or by intrauterine imaging tests (neurosonography), and/or postnatal computed tomography (presumed CZS).
Results
Suspicion of CZS was investigated by ultrasonography during pregnancy in 52.9% of cases. The principal prenatal imaging findings were ventriculomegaly (43.1%) and microcephaly (42.2%). Median gestational age at delivery was 39 weeks, with 15.7% being premature. Mean head circumference at birth was 30.0 ± 2.3 cm, with 66% of cases being classified as having microcephaly. Arthrogryposis was found in 10 cases (9.8%). There were no fetal deaths; however, nine neonatal deaths were recorded, and three autopsies were performed.
Conclusion
Neonatal mortality was high, almost 10%. Regarding the abnormalities of CZS, microcephaly, although common, was not present in all cases and intracranial findings need to be taken into consideration for diagnosis. Therefore, ultrasound screening during pregnancy should be systematized and expanded in endemic zones.
Abstract Objectives: to evaluate burden, frequency of anxiety and signs and symptoms of depression in mothers of children with congenital Zika syndrome (CZS) during the COVID-19 pandemic and the ...social isolation period. Methods: this is a cross-sectional study conducted with mothers who care for their children with CZS. The data were collected by an online form with questions regarding mother's socioeconomic conditions and questions related with Zarit burden scale and Beck's inventories on depression and anxiety. Spearman’s correlation tests and multiple regression analyzes were performed to assess factors related to mothers' burden and mental health. Results: 41 mothers were evaluated, 51.2% had mild burden, 39% had minimal anxiety and 73.2% did not have signs and symptoms of depression. Negative correlations were observed between levels of burden and maternal schooling (p=0.01), presence of signs and symptoms of anxiety and receiving financial aid (p<0.04) as well as the presence of signs and symptoms of anxiety and having children with seizures history (p=0.03). Conclusion: despite the risk of their children again being victims of an epidemic virus, mothers who care for their children with CZS did not present serious mental health impairments.
Resumo Objetivos: avaliar a sobre carga e frequência de sinais e sintomas de ansiedade e depressão em mães de crianças com síndrome congênita do Zika (SCZ) durante pandemia de COVID-19. e o período de isolamento social. Métodos: trata-se de um estudo transversal realizado com mães que cuidam de seus filhos com SCZ. Os dados foram coletados por meio de um formulário online contendo questões referentes as condições socioeconômicas da mãe além da escala de sobrecarga de Zarite dos inventários de Beck de depressão e ansiedade. Para avaliação de fatores relacionados a sobrecarga e saúde mental das mães foram realizados testes de correlação de Spearman e análises de regressão múltipla. Resultados: ao todo foram avaliadas 41 mães das quais 51,2% apresentaram sobrecarga leve, 39% apresentaram ansiedade mínima e 73,2% não apresentaram sinais e sintomas de depressão. Correlações negativas foram observadas entre níveis de sobrecarga e a escolaridade materna (p=0,01), presença de sinais e sintomas de ansiedade e recebimento de auxílio financeiro (p<0,04) assim como da presença de sinais e sintomas de ansiedade e ter filhos com histórico de crises convulsivas (p=0,03). Conclusão: apesar do risco iminente de seus filhos serem novamente vítimas de um vírus epidêmico, mães que cuidam de seus filhos com SCZ não apresentaram comprometimento graves na saúde mental.
Aim: To identify abnormalities in muscle tone and motor function associated with congenital Zika syndrome (CZS).
Method: A cross-sectional observational study involving 96 children (55 males) with ...CZS at a mean (SD) age 35.2 ± 2.9 months. Children's muscle tone was investigated using the pull to sit, scarf sign, shoulder suspension and ventral suspension tests and the modified Ashworth scale (MAS). Motor impairment was determined using the Gross Motor Function Classification System (GMFCS) and body segments most affected with motor impairment.
Results: 58 (60,5%) children tested positive for ≥1 maneuver used to evaluate muscle tone, while 38 (39.5%) tested negative in all the tests. MAS score was >0 for at least one of the appendicular muscles in 91 children (94.8%). In 88 children (91.7%), all four limbs were affected.
Conclusion: Findings suggestive of axial hypotonia and appendicular hypertonia associated with severe motor impairment were prevalent in children with CZS.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
This article describes the impact of social distancing during the COVID-19 pandemic on the motor function and growth of children with congenital Zika syndrome (CZS). Children's motor function, ...weight, height and joint range of movement (ROM) were evaluated before the onset of the pandemic and soon after their return to face-to-face activities at a rehabilitation center. Fifty-two children (Mean 46.07 months, SD 3.76 months) were assessed. Results showed a reduction in proportion of children with adequate body mass index (p = .04), an increase in proportion with adequate height (p < 0.001), deterioration in gross motor function in children with severe motor impairment (p < .01), and a reduction in the maximum ROM for shoulder (p < .01) and wrist flexion (p = .046), elbow (p = .01), knee (p = .03) and ankle extension (p < .01), and an increase in hip flexion (p = .04). The social distancing period appears to have contributed to important losses in motor function and joint mobility of children with CZS; however, this period of time appeared to have less impact on their growth.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
INTRODUCTION:This study was conducted to compare the pulmonary function and the body composition between trimesters of pregnancy and, to determine the variables correlated to the peak expiratory flow ...(PEF) and the expiratory flow between 25% and 75% of vital capacity (FEF25%75%).
METHODS:A cross-sectional study examined 120 healthy low-risk pregnant women in the three trimesters of pregnancy, measured by spirometry and multisegmental electrical impedance. Women between the fifth and 40th gestational week, ages between 18-35 years, singletons, and sedentary were included. Smokers, individuals with cardio-respiratory diseases, neurological and chest deformities were excluded.
RESULTS:The vital capacity, the expiratory volume in one second, the peak expiratory flow and expiratory flow between 25% and 75% of vital capacity decreased with the progression of pregnancy, the multiple linear regression analysis showed that height and maternal age were associated with PEF, being responsible for explaining 14.7% of its variability. The prepregnancy weight explained 6.5% of the variability of the FEF25%75%. The multiple linear regression analysis showed that height and maternal age were associated with PEF, explaining 14.7% of its variability.
CONCLUSION:This study showed that the volumes and lung capacity in healthy pregnant women do not seem to change with the progress of pregnancy. The pre-pregnancy weight was related to the FEF25%75%. Height and maternal age had greater influence on PEF changes, while the body composition and obstetric variables did not influence it.
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