Zika virus, an arbovirus transmitted by mosquitoes of the Aedes species, is now rapidly disseminating throughout the Americas and the ongoing Brazilian outbreak is the largest Zika virus epidemic so far described. In addition to being associated with a non-specific acute febrile illness, a number of neurological manifestations, mainly microcephaly and Guillain-Barré syndrome, have been associated with infection. These with other rarer neurological conditions suggest that Zika virus, similar to other flaviviruses, is neuropathogenic. The surge of Zika virus-related microcephaly cases in Brazil has received much attention and the role of the virus in this and in other neurological manifestations is growing. Zika virus has been shown to be transmitted perinatally and the virus can be detected in amniotic fluid, placenta and foetus brain tissue. A significant increase in Guillain-Barré syndrome incidence has also been reported during this, as well as in previous outbreaks. More recently, meningoencephalitis and myelitis have also been reported following Zika virus infection. In summary, while preliminary studies have suggested a clear relationship between Zika virus infection and certain neurological conditions, only longitudinal studies in this epidemic, as well as experimental studies either in animal models or in vitro, will help to better understand the role of the virus and the pathogenesis of these disorders.

This 48-week, randomized, placebo-controlled phase 3 study (DMD114044; NCT01254019) evaluated efficacy and safety of subcutaneous drisapersen 6 mg/kg/week in 186 ambulant boys aged ≥5 years, with Duchenne muscular dystrophy (DMD) resulting from an exon 51 skipping amenable mutation. Drisapersen was generally well tolerated, with injection-site reactions and renal events as most commonly reported adverse events. A nonsignificant treatment difference (P = 0.415) in the change from baseline in six-minute walk distance (6MWD; primary efficacy endpoint) of 10.3 meters in favor of drisapersen was observed at week 48. Key secondary efficacy endpoints (North Star Ambulatory Assessment, 4-stair climb ascent velocity, and 10-meter walk/run velocity) gave consistent findings. Lack of statistical significance was thought to be largely due to greater data variability and subgroup heterogeneity. The increased standard deviation alone, due to less stringent inclusion/exclusion criteria, reduced the statistical power from pre-specified 90% to actual 53%. Therefore, a post-hoc analysis was performed in 80 subjects with a baseline 6MWD 300-400 meters and ability to rise from floor. A statistically significant improvement in 6MWD of 35.4 meters (P = 0.039) in favor of drisapersen was observed in this subpopulation. Results suggest that drisapersen could have benefit in a less impaired population of DMD subjects.

ResumoObjetivo: Revisar criticamente os instrumentos de avaliação mais utilizados na atualidade na literatura para triagem e identificação precoce de anormalidades no desenvolvimento em crianças. Fontes dos dados:Foi realizado um levantamento bibliográfico nas bases de dados no SciELO, plataforma CAPES, PubMed e Google Scholar, com os unitermos "prematuridade", "atraso no desenvolvimento", "paralisia cerebral", "diagnóstico precoce" e "testes de avaliação". Síntese dos dados:Foram listados 455 títulos, sendo selecionados para esta revisão 174 artigos com base em título, relevância temática e resumo. Apenas artigos originais, disponíveis em meio eletrônico, a partir de 1985, com informação sobre a construção, aplicabilidade e propriedades psicométricas dos testes foram usados. Sources: A search on SciELO, PubMed and Google Scholar was performed using the terms "prematurity," "developmental delay," "cerebral palsy," "early diagnosis" and "evaluation tests." Conclusões Summary of the findings:A total of 455 references were listed, and 174 studies were selected for this review based on title,

We report the cases of 5 adolescents with human T lymphotropic virus type 1-associated myelopathy/tropical spastic paraparesis, acquired in all but 1 case from the mother. The first symptom in all patients was difficulty in running, which was present for many years before the final diagnosis was made. Follow-up showed an indolent progression, regardless of treatment strategy.

No abstract

Objective: To review the literature regarding screening psychomotor tests for the early identification of developmental problems. Sources:A search on SciELO, PubMed and Google Scholar was performed using the terms "prematurity," "developmental delay," "cerebral palsy," "early diagnosis" and "evaluation tests." Summary of the findings:A total of 455 references were listed, and 174 studies were selected for this review based on title, relevance, and abstract. Only original and electronically available material, from 1985 forward, with information on design, applicability, and psychometric properties of those tests was included. Conclusions:Screening tests are important to speed the beginning of treatment measures in order to allow for better developmental outcome. Among the many tests that can be employed for this purpose, the DENVER II and the Alberta Infant Motor Scale are the most often used in Brazilian studies. The Movement Assessment of Infants is starting to be used in our country. Two other tests are recommended in the literature due to their high sensibility and specificity:the Test of Infant Motor Performance and the General Movements.J Pediatr (Rio J). 2008;84(4):289-299: Prematurity, motor delay, early diagnostic, screening tests.

ResumoObjetivo: esta revisão visa fornecer aos pediatras, neurologistas infantis e psiquiatras infantis noções atualizadas sobre a relação entre desempenho escolar e transtorno do déficit de atenção e hiperatividade (TDAH). Fonte de dados: revisão abrangente não-sistemática da literatura médica sobre a relação entre desempenho escolar e TDAH. Síntese de dados: os dados da literatura demonstram que o TDAH, principalmente o tipo desatento está relacionado a mau desempenho escolar. Conclusões: crianças com TDAH estão sob risco de mau-desempenho escolar e devem receber cuidados especiais.Palavras-chave: Transtorno do déficit de atenção e hiperatividade, baixo rendimento escolar, criança, adolescente. AbstractObjective: This review aims at providing Pediatricians, Pediatric Neurologists and Psychiatrists an update on the relationship between scholar achievement and Attention Deficit Hyperactivity Disorder. Sources: Data was obtained by a comprehensive, non-systematic review of medical literature. Summary of the findings: Data obtained from literature shows that Attention Deficit Hyperactivity Disorder, specially inattentive subtype, is related to underachievement. Conclusions: Children with Attention Deficit Hyperactivity Disorder are at risk for underachievement and must receive special care. Key-words: Attention deficit hyperactivity disorder, underachievement, child, adolescent. School Achievement and Attention Deficit Hyperactivity DisorderIntrodução O transtorno do déficit de atenção e hiperatividade (TDAH) repercute na vida da criança e do adolescente levando a prejuízos em múltiplas áreas, como a adaptação ao ambiente acadêmico, relações interpessoais e desempenho escolar (Arnold e Jensen, 1995;Barkley, 1996). Estes são denominados sintomas não-cardinais do TDAH, ou seja, embora não imprescindíveis para o diagnóstico, freqüentemente, fazem parte das queixas do portador (Mercugliano 1999). As repercussões do mau desempenho escolar (MDE) na vida do aluno com TDAH,

Significant advances in the understanding and management of Duchenne muscular dystrophy (DMD) have occurred since the publication of international guidelines for DMD care in 2010. Our objective was to provide an evidence-based national consensus statement for multidisciplinary care of DMD in Brazil. A combination of the Delphi technique with a systematic review of studies from 2010 to 2016 was employed to classify evidence levels and grade of recommendations for the guideline. Our recommendations were divided in two parts. Guideline methodology and overall disease concept descriptions are found in Part 1. Here we present Part 2, where we provide the results and recommendations on rehabilitation and systemic care for DMD.