Neuropsychomotor development in schoolchildren and its relationship with nutritional status

Abstract

Objective: to determine ASO titer profile by establishing ARF differential diagnoses of other diseases with high levels of ASO antibodies. Methods: we investigated 78 patients with ARF at onset and follow-up, 22 with isolated chorea at onset, 45 with recurrent oropharyngeal tonsillitis, and 23 with recent flare of juvenile idiopathic arthritis. We tested ASO with automated particle-enhanced immunonephelometric assay (Behring ®-Germany). The ASO (IU/ml) titers were assessed at the following time intervals: 0-7 days, 1-2 weeks, 2-4 weeks, 1-2 months, 2-4 months, 4-6 months, 6-12 months, 1-2 years, 2-3 years, 3-4 years, and 4-5 years after onset of ARF. Results: ASO titers in patients diagnosed with ARF had a significant increase up to the 2-4-month time interval (P<0.0001). Baseline levels were observed afterwards in patients under regular penicillin prophylaxis. The levels of ASO in ARF were also significantly higher than in patients with isolated chorea, recurrent oropharyngeal infections or juvenile idiopathic arthritis (P=0.0025), when age-matched samples of these groups were compared. The test's sensitivity was 73.3% and the specificity was 57.6%, and it was calculated taking into account the upper limit of normality at 320 IU/ml, as well as the established diagnosis of ARF. The test's specificity and positive predictive value increased with rising or higher titers, being higher with titers above 960 UI/ml. Conclusion: this reappraisal of ASO profile in ARF patients indicates a remarkable response during the acute phase, and that points to the extent to which ASO levels may differentiate ARF from other diseases with high levels of ASO antibodies, as coincidental but unrelated streptococcal infection or chronic arthritis flareup.

The effect of subclinical infantile thiamine deficiency on motor function in preschool children

“…A previous cross-sectional study reported similar findings among 484 first-grade children in Brazil. The authors of this study found a significant correlation between general chronic malnutrition and psychomotor problems, specifically abnormal static and dynamic balance function (Guardiola, Egewarth, & Rotta, 2001). Brain neuroimaging in symptomatic Israeli infants exposed to the thiamine-deficient formula revealed involvement of the cerebellum and basal ganglia, which are known to play a role in balance control (Fattal-Valevski et al, 2005;Fattal-Valevski et al, 2009b;Hiffler et al, 2016;Kornreich et al, 2007;Leisman, Braun-Benjamin, & Melillo, 2014).…”

“…The authors of this study found a significant correlation between general chronic malnutrition and psychomotor problems, specifically abnormal static and dynamic balance function (Guardiola, Egewarth, & Rotta, 2001). The results were based on two standardized motor assessment tools.…”

“…During this critical period, the developing brain is extremely vulnerable to any kind of disturbance, including nutritional deficits, which may cause developmental disorders (Prado & Dewey, 2014). Motor function is a principal component of neurodevelopmental assessment, especially during the first years of life, as it reflects the level of central nervous system maturity and development (Guardiola, Egewarth, & Rotta, 2001;Rice & Barone, 2000). The preschool age group is known to be a frame of reference age for achievement of complex and adaptive motor skills necessary for the upcoming higher demands in school (Hadders-Algra, 2010;Gerber, Wilks, & Erdie-Lalena, 2010).…”

“…During infancy and early childhood, the developing brain is particularly sensitive to nutritional deficiencies (Dias, de Freitas Silva, de Proença Doyle, & Ribeiro, 2013;Georgieff, 2007;Ivanovic Marincovich et al, 2014;Prado & Dewey, 2014;Rosales & Zeisel, 2008;Walker et al, 2011). Complete or partial deficiency of known micronutrients such as iron, iodine, folic acid, vitamin B12, and choline has proved to have adverse effects on cognitive, physical, and behavioral development (Dias et al, 2013;Grantham-McGregor, Fernald, & Sethuraman, 1999;Guardiola, Egewarth, & Rotta, 2001;Swaminathan, Edward, & Kurpad, 2013;Walker et al, 2011). The present study focuses on infantile thiamine deficiency (ITD) and its long-term effect on motor development.…”

Monitoramento do desenvolvimento infantil realizado no Brasil

“…A study performed in the municipality of Pelotas, Brazil, reinforces development's multifactorial characteristic and the concept of cumulative risk effect. In the studied population, the disadvantaged accumulated factors (social, economic and environmental) that led to a higher chance of delays in children's development (15)(16)(17)(18)(19) . In a study conducted at the Center for Family Health (Núcleo de Saúde da Família) in the municipality of Ribeirão Preto, 33% of children enrolled were at risk of developmental disorder, associated to low paternal education and underweight in the first six months of life (20) .…”