Background
Subtle cognitive impairments have been described in children with congenital hypothyroidism (CH) detected by neonatal screening (NS), even with early and adequate treatment. Patients with CH may present brain cortical thickness (CT) abnormalities, which may be associated with neurocognitive impairments.
Aims
To evaluate the CT in adolescents with CH detected by the NS Program (Paraná, Brazil), and to correlate possible abnormalities with cognitive level and variables of neurocognitive prognosis.
Methods
Review of medical records followed by psychometric evaluation of adolescents with CH. Brain magnetic resonance imaging with analysis of 33 brain areas of each hemisphere was performed in 41 patients (29 females) and in a control group of 20 healthy adolescents. CT values were correlated with Full-scale Intelligence Quotient (FSIQ) scores, age at start of treatment, pretreatment thyroxine levels and maternal schooling.
Results
No significant difference in CT between patients and controls. However, there was a trend toward thinning in the right lateral orbitofrontal cortex among patients and in the right postcentral gyrus cortex among controls. CT correlated significantly with FSIQ scores and with age at start of treatment in one area, and with hypothyroidism severity in five brain areas. Maternal schooling level did not correlate with CT but was significantly correlated with FSIQ. Cognitive level was within average in 44.7% of patients (13.2% had intellectual deficiency).
Conclusions
There was a trend toward morphometric alterations in the cerebral cortex of adolescents with CH compared with healthy controls. The correlations between CT and variables of neurocognitive prognosis emphasize the influence of hypothyroidism on cortical development. Socioeconomic status exerts a limiting factor on cognitive outcome.
RESUMO – A apendicite aguda é uma das emergências cirúrgicas mais comuns em todo o mundo. O objetivo deste estudo foi avaliar o perfil epidemiológico de pacientes submetido à apendicectomia. Foi realizada análise retrospectiva de prontuários de pacientes com diagnóstico de apendicectomia. Foram considerados 154 pacientes, destes 143 apresentaram dados suficientes para serem incluídos no estudo. Em conclusão, as características epidemiológicas dos pacientes seguiram padrões internacionais, ou seja, maior acometimento de homens, jovens, em fase ainda não avançada, idosos com prognóstico menos favorável, mortalidade compatível com países em desenvolvimento, com tempo médio de internação e perfil de complicações semelhantes aos relatados na literatura
RESUMO – Responsáveis por 89% de lesões neurológicas, as fraturas de coluna vertebral torácica e lombar, quando analisadas perante os fatores de risco para déficit neurológico, apresentam associação controversa. Apesar da relação contestável, estudos apontam que as características morfológicas dessas lesões estão associadas ao grau de déficit neurológico e funcionam como guia para a estratégia terapêutica. O objetivo deste estudo foi identificar quais os fatores de risco para déficit neurológico nas fraturas da coluna vertebral torácica e lombar. É estudo transversal, observacional e individuado, no qual foram analisados 150 pacientes. Em conclusão, demonstrou-se que os subtipos de fratura A são fatores de risco para déficit neurológico e determinantes da conduta terapêutica aplicada. Além disso, indicou relação entre a classificação do déficit neurológico e energia do trauma com a necessidade de tratamento invasivo
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