Cognitive impairment is frequent in cerebral palsy (CP) and there is a lack of multiprofessional screening instruments.OBJECTIVE:The aim of this study was to investigate the utility of the Mini-Mental State Examination for Children (MMC), an adapted version of the Mini-Mental State Examination, in screening for cognitive impairments in children with CP.METHODS:We assessed 397 Brazilian children, 310 with typical development and 87 with CP (hemiplegic and quadriplegic forms), aged 5-16 years. Association between the MMC and general intelligence was assessed by the Colored Progressive Matrices instrument.RESULTS:Psychometric indexes for the MMC were adequate. ROC analyses revealed effective diagnostic accuracy in all ages assessed. Cut-off values are reported. Major difficulties on the MMC were observed in children with CP, particularly individuals with the quadriplegic form. Moreover, the MMC showed moderate correlation with the intelligence test, and was reliable in discriminating, among clinical cases, those with poorer cognitive abilities.CONCLUSION:The MMC could be useful as a multiprofessional screening instrument for cognitive impairment in children with hemiplegic CP. Results of the MMC in quadriplegic CP children should be interpreted with caution. Diagnosis should be confirmed by further psychological testing.
Dental anxiety scores were reduced over the course of six appointments. Children with toothache had higher levels of dental anxiety than those that had never experienced toothache.
Objective
The present study's objective was to investigate the pandemic's impact on mental health and identify variables that can increase or decrease the chances of stress, anxiety, and depression, in both a sample with and one without self-reported mental health issues, in a Brazilian population.
Design
a cross-sectional quantitative study. Data were collected online in May and June of 2020. Participated 1130 adults between 18–78 years old (mean = 37.46 years, SD = 12.18), from 20 Brazilian states, with an average of 58.61 days (SD = 23.2) of social distancing.
Main Outcome Measures
Depression, anxiety and stress symptoms, characterization of social distancing, and Coping strategies.
Results
A significantly higher prevalence of severe depression was found in those who practiced social distancing. Multinomial logistic regressions identified the explanatory model with risk and protection variables to mental health. For the group without a previous mental health diagnosis, using confrontation (
OR
= 1.39,
CI95%
1.23–1.58) and escape strategies (
OR
= 1.48,
CI95%
1.19–1.84) increases the odds of presenting severe depression, while positive reappraisal (
OR
= 0.85,
IC95%
0.78–0.93) and problem-solving (
OR
= 0.75,
CI95%
0.63-–0.88) were protective factors. In the group with mental disorders, using confrontation (
OR
= 1.33,
CI95%
1.10–1.60) and escape strategies (
OR
= 1.49,
CI95%
1.12–1.98) were also risk factors for severe depression and no coping protective factors were found.
Conclusions
Problem-solving and positive reappraisal were protective strategies that potentially reduced the odds of presenting depression and anxiety, but only in people without a previous mental health diagnosis. Public policies must offer psychological support to the most vulnerable, as well as orientation based on scientific evidence, aiming at improving quality of life.
Aims/Methods: We investigated the expression of CCL2 by immunohistochemistry in samples of oral cavity squamous cell carcinoma (OCSCC), lip squamous cell carcinoma (LSCC) and metastatic and nonmetastatic lymph nodes. The relationship of CCL2 with survival data was also evaluated. Results: The percentage of CCL2+ cells in tumor parenchyma was similar in OCSCC and LSCC. In stroma, OCSCC showed a higher number of CCL2+ cells when compared with LSCC. In contrast, higher CD68+ macrophage counts were observed in LSCC. Low macrophage counts were significantly related to a greater proliferative index in tumoral cells. The density of CCL2+ nodal cells was significantly higher in metastatic lymph nodes when compared with nonmetastatic lymph nodes. When considering CCL2 in the parenchyma, the mean survival time for the patients with high CCL2+ cell counts was lower than that for patients with low CCL2+ cell counts. In contrast, in stroma, the mean survival time for the patients with high CCL2+ cell percentages was higher than for those with low CCL2+ cell percentages. Conclusion: Our findings suggest a role for CCL2 in the spreading of tumoral cells to the lymph node in OCSCC. Furthermore, the CCL2-independent macrophage infiltration may play a role in determining less aggressive behavior.
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