Breat hing is responsible for facial and cranial morphology development. Aim: investigate in order to see if there is any relationship between oral breathing and facial type. Material and Methods: 119 male and female teenagers, with ages ranging between 15 and 18 years. The sample was separated in two groups: A-50 teenage oral breathers, 28 males and 22 females; and group B-69 teenage nasal breathers, 37 males and 32 females. The sample was collected at the Centro de Atendimento e Apoio ao Adolescente do Departamento de Pediatria da UNIFESP/ EPM. We evaluated breathing and facial measures. Results: by means of anthropometric indexes we classified facial types and associated them with the person's breathing type, Hypereuriprosopic (Total=0; oral breathers 0%; nasal breathers 0%; Euriprosopic (Total=14; oral breathers 2.52%, nasal breathers 9.24%;Mesoprosope (Total=20; oral breathers 19.32%; nasal breathers 21.01%, Leptoprosopic (Total=37; oral breathers 14.29%; nasal breathers 16.81%; Hyperleptoprosopic (Total =48; oral breathers 5.89% nasal breathers 10.92%). The mesoprosopic facial type was found in 48 teenagers (40.33%) of whom 25 (21.01%) were oral breathers and 23 (19.32%) were nasal breathers. Conclusion: it was not possible to prove the existence of an association between oral breathing and facial type.
BACKGROUND: Cerebral palsy may be associated with comorbidities such as undernutrition, impaired growth and gastrointestinal symptoms. Children with cerebral palsy exhibit eating problems due to the effect on the anatomical and functional structures involved in the eating function resulting in malnutrition. OBJECTIVE: The aim of this study was to investigate the association between food intake, nutritional status and gastrointestinal symptoms in children with cerebral palsy. METHODS: Cross-sectional study that included 40 children with cerebral palsy (35 with spastic tetraparetic form and 5 with non-spastic choreoathetoid form of cerebral palsy, all requiring wheelchairs or bedridden) aged from 4 to 10 years. The dietary assessment with the parents was performed using the usual household food intake inquiry. Anthropometric data were collected. Gastrointestinal symptoms associated with deglutition disorders, gastroesophageal reflux and chronic constipation were also recorded. RESULTS: The median of height-for-age Z-score (-4.05) was lower (P<0.05) than the median of weight-for-age (-3.29) and weight-for-height (-0.94). There was no statistical difference between weight-for-age and weight-for-height Z-scores. Three patients with cerebral palsy (7.5%) exhibited mild anemia, with normal ferritin levels in two. Symptoms of dysphagia, gastroesophageal reflux, and constipation were found in 82.5% (n=33), 40.0% (n=16), and 60.0% (n=24) of the sample, respectively. The patients with symptoms of dysphagia exhibited lower daily energy (1280.2±454.8 Kcal vs 1890.3±847.1 Kcal, P=0.009), carbohydrate (median: 170.9 g vs 234.5 g, P=0.023) and fluid intake (483.1±294.9 mL vs 992.9±292.2 mL, P=0.001). The patients with symptoms of gastrointestinal reflux exhibited greater daily fluid intake (720.0±362.9 mL) than the patients without symptoms of gastroesophageal reflux (483.7±320.0 mL, P=0.042) and a greater height-for-age deficit (Z-score: -4.9±1.7 vs 3.7±1.5, P=0.033). The patients with symptoms of constipation exhibited lower daily dietary fiber (9.2±4.3 g vs 12.3±4.3 g, P=0.031) and fluid (456.5±283.1 mL vs 741.1±379.2 mL, P=0.013) intake. CONCLUSION: Children with cerebral palsy exhibited wide variability in food intake which may partially account for their severe impaired growth and malnutrition. Symptoms of dysphagia, gastroesophageal reflux, and constipation are associated with different food intake patterns. Therefore, nutritional intervention should be tailored considering the gastrointestinal symptoms and nutritional status.
OBJETIVOS: comparar o processo de sucção em recém-nascidos prematuros incluídos no método Mãe-Canguru com recém-nascidos submetidos aos cuidados tradicionais. MÉTODOS: foram selecionados 30 recém-nascidos prematuros com idade gestacional entre 30 e 35 semanas. A amostra foi constituída de dois grupos: Grupo 1, composto por 16 recém-nascidos inseridos no Alojamento Mãe-Canguru da Maternidade Escola Assis Chateaubriand e Grupo 2, constituído por 14 recém-nascidos submetidos aos cuidados tradicionais, ou seja, Berçário de Médio Risco do Hospital Geral de Fortaleza. Todos os recém-nascidos foram avaliados, submetidos à intervenção fonoaudiológica e reavaliados durante a alta hospitalar. RESULTADOS: no Grupo 1 houve uma melhora significativa em relação ao estado comportamental, sinais de estresse, coordenação e ritmo de sucção. O tempo de permanência hospitalar foi consideravelmente menor. No Grupo 2 foi verificada uma melhora significativa em relação à coordenação entre sucção, deglutição e respiração. CONCLUSÕES: os recém-nascidos de ambos os grupos foram beneficiados com a intervenção fonoaudiológica, no entanto, os melhores resultados foram referentes ao método Mãe-Canguru. Verificou-se que esse método constitui uma ótima alternativa para países em desenvolvimento, pois contribui para a efetividade da amamentação, diminuindo o tempo de permanência hospitalar, acarretando menores custos para a saúde pública.
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