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Biomedical subjects

Gilmar F Prado

Publications and source records attributed to Gilmar F Prado.

8 recordsLinked to original sources

A functional electric orthesis on the paretic leg improves quality of life of stroke patients.

CONTEXT: Hemiparesia changes quality of life of patients with stroke making difficult a normal life. OBJECTIVE: To evaluate the effect of Functional Eletric Orthesis (FEO) applied over the paretic leg in the quality of life of stroke patients. METHOD: The quality of life of 50 stroke patients of Associacao de Assistencia a Crianca Deficiente (AACD) was evaluated with SF-36 questionnaire before and after the treatment with a FEO for rehabilitation of walking. We analyzed data according to gender and affected hemisphere. RESULTS: The average values from all domains of SF-36 improved significantly (p<0.001). Female patients improved more than male in Emotional Domain (p=0.04) and presented a trend to be better regarding Bodily Pain and Social Functioning. Patients with right hemiparesia improved more than those with left hemiparesia (p=0.02). CONCLUSION: FEO over a paretic leg is efficient to improve quality of life of stroke patients, mainly Physical Functioning.

Activities of Daily Living↗

Andersen syndrome: an association of periodic paralysis, cardiac arrhythmia and dysmorphic abnormalities.

Andersen syndrome (AS) is a rare disease characterized by the presence of periodic paralysis (PP), cardiac arrhythmia and dysmorphic abnormalities. We report herein the first Brazilian patient presenting AS who also had obesity, obstructive sleep apnea (OSA) and daytime sleepiness. Clinical and genetic evaluation of six family members demonstrated that four had dysmorphic abnormalities but none had PP or cardiac arrhythmia. Sequencing of KCNJ2 revealed the R218W mutation in the index patient and her 6-year-old daughter, who presented dysmorphic abnormalities (micrognathia, clinodactyly of fourth and fifth fingers, short stature) and OSA. Three relatives had clinodactyly as the only manifestation but the R218W mutation was absent, suggesting that this characteristic may be influenced by another gene. OSA accompanied by dysmorphic features may be related to AS.

Adult↗

Sleep disorders are associated with impulsivity in school children aged 8 to 10 years.

CONTEXT: Sleep has an important function in the physical and emotional development of children. Some studies suggest an association between impulsivity and sleep disorders. However, little is known about this association in schoolchildren aged 8 to 10 years. METHOD: We studied 1180 children, 547 with sleep disorders (SD) and 633 without SD (control group), classified with SD questionnaires. Within the SD group, 53 children with sleep-related respiratory disorders (SRRD) and 521 children with non-respiratory sleep disorders (NRSD) were analyzed. We assessed emotional indicators of impulsivity with Bender test. RESULTS: More SD children presented impulsivity than control group (p<0.05). More NRSD and 10 years old children presented impulsivity than control group of the same age (p=0.001). Impulsivity and SRRD were associated with 8 years old children (p<0.05). CONCLUSION: Children with SD, 8 years old children with SRRD, and 10 years old children with NRSD presented higher proportion of impulsivity than control children.

Age Factors↗

Sleep disorders and starting time to school impair balance in 5-year-old children.

OBJECTIVE: To verify if sleep disorders and different starting time to school have impaired motor skills in 5-year-old children. METHOD: Cross-sectional design consisting of 132 children with sleep disorders and 136 normal controls of the public school in the city of São Paulo. The group with sleep disorders was identified based on a questionnaire, and motor tests for global motor coordination, fine motor coordination, perceptual-motor coordination, and static and dynamic balance were applied in all children. RESULTS: In the static balance test, more specifically in the sharpened Romberg (Tandem) test, 34% of boys from the study group, who studied in the morning, failed the test (p < 0.05). In the single leg stance test, 62% of boys from the study group who studied in the morning failed (p < 0.05). CONCLUSION: This study suggests that sleep disorders may interact with the school period and alter motor performance, especially in boys studying in the morning.

Case-Control Studies↗

[Sleep habits and starting time to school in Brazilian children].

OBJECTIVE: This study investigated the sleep habits in Brazilian children according to age, gender and starting time to school. METHOD: We investigated 2,482 scholars aged 7 to 10 years. We compared sleep habits, gender, and starting time to school (morning and afternoon). RESULTS: Sixty-one per cent of the children presented sleep rituals before sleep. Milk drinking before sleep was more frequent among seven years old children. We found a progressive reduction with age in keeping the lights on. Girls used to leave an object to bed more than boys did. Children that studied in the morning presented reduced total sleep time, sleep earlier, and nap more frequently than children that studied in the afternoon. CONCLUSION: Starting time to school deeply influences sleep habits in Brazilian children from São Paulo City, in whom bed-time rituals are highly prevalent.

Beds↗

Cognitive dysfunction in children with sleep-disordered breathing.

Two daily school periods are mandatory in Brazil owing to a shortage of academic facilities, which can decrease cognitive performance, especially in children with sleep-disordered breathing. This study aimed to verify the influence of starting time to school on cognition, comparing children with sleep disorders and normal children. Cognition was assessed in 79 children with sleep-disordered breathing, 468 children with nonrespiratory sleep disorders, and 633 normal control children. We analyzed total sleep time, starting time to school (morning or afternoon), and grades. First grade morning students with sleep-disordered breathing had 8.04 higher odds for cognitive dysfunction than normal children. For children with sleep-disordered breathing, second and third grade morning students had higher odds for cognitive dysfunction than those who studied in the afternoon (3.69 and 4.07). Fourth grade morning students had 8.27 higher odds for cognitive dysfunction than first grade children. In conclusion, sleep-disordered breathing, grades, and starting time to school interact to affect cognition in Brazilian children.

Age Factors↗

Sleep disruption in systemic sclerosis (scleroderma) patients: clinical and polysomnographic findings.

BACKGROUND: Progressive systemic sclerosis (SSc) is a connective tissue disease characterized by endothelial lesions and fibrosis of the skin and other organs. Patients' quality of life and life expectancy are determined by the intensity of pulmonary, esophageal, cardiac, and renal involvement. Neurological involvement was considered to be rare, but increasing evidence indicates that peripheral and autonomic neuropathies commonly occur. Conditions seen with SSc, such as pulmonary fibrosis and gastro-esophageal reflux, have the potential to affect sleep. No systematic assessment of sleep-related problems associated with this disorder has been performed. MATERIAL AND METHODS: An all-night polysomnogram and a clinical interview blinded to sleep status were obtained for 27 consecutive SSc patients. Sleep data were compared to age adjusted published normative values. Correlations were determined for sleep and clinical data. RESULTS: Patients with SSc had a reduced sleep efficiency (SE) (mean+/-SD: 82+/-12.3%) and rapid eye movement sleep (13.1+/-5.6%) and increased arousal index (26.1+/-13.0) and slow wave sleep (25.7+/-9.7%). The periodic leg movement index (PLMI) exceeded 5/h in 13 patients (48%) and 25/h in seven patients. Six patients had restless legs syndrome (RLS). Significant disordered breathing was absent. The RLS patients showed a greater arousal index than all other patients. PLMI was correlated with SE for RLS but not for non-RLS patients. Esophageal dyskinesia, dyspnea, and RLS were significantly associated with poor sleep. CONCLUSION: Patients with SSc have significant disturbance of their sleep. Esophageal dyskinesia and dyspnea, which are common complications of SSc, were commonly associated with indices of sleep disruption. RLS but not sleep apnea appears to have an increased prevalence in SSc.

Journal Article↗