The outbreak of Zika virus in Latin America in the period 2015–2016 has caused a sudden increase in the number of severe manifestations and reports of congenital changes in newborns in Brazil. This is the first study that evaluated and compared the growth and cognitive and motor development of children with microcephaly due to Congenital Zika Virus Syndrome (CZS) in relation to typical children. It was an observational, analytical, cross-sectional study with 8 children with CZS and 16 typical children, with a mean age of 20.5 months (±2.1), in a region of northeastern Brazil. Considering the mean, children with CZS presented extremely low performance in the motor domain and in the cognitive development domain, whereas typical children presented average performance in the cognitive and motor development domains. Children with CZS presented a mean growth rate (head circumference and weight) lower than typical children. Therefore, children with CZS are at risk for growth retardation and development compared to typical children.

Introduction: The increase in the number of cases of microcephaly in Brazil and its association with the Zika virus (ZIKV) is a global public health problem. The International Classification of Functioning Disability and Health (ICF) model is a powerful tool and extremely relevant in managing disability. Objective: Describe the functioning profile of children with microcephaly associated with ZIKV in two states of northeastern Brazil. Methods: This is a descriptive cross-sectional study. The sociodemographic characteristics, head circumference, and other clinical data were collected from medical charts, physical examinations, measuring instruments, and interviews with the children and their parents. The Brazilian Portuguese version of the Brief Common ICF Core Set for cerebral palsy (CP) was used. Each ICF category was assigned a qualifier, which ranged from 0 to 4 (no problem, mild problem, moderate problem, severe problem, complete problem). For environmental factors, 0 represents no barrier and 4 represents complete barrier; +0, no facilitator and +4, complete facilitator. Results: A total of 34 children with microcephaly caused by ZIKV were recruited (18 girls and 16 boys) at four rehabilitation facilities in Rio Grande do Norte and Paraíba states, Brazil. The average age of the participants was 21 months, monthly income was ≈USD 300.00, and head circumference z-scores ranged between 0.92 and −5.51. The functioning profile revealed complete disability in most of the body function categories (b). The activity and participation areas (d) were highly impacted, particularly in mobility-related categories. With respect to environmental factors (e), most of the sample reported a complete facilitator for the immediate family, friends, and health services, systems, and policies, as well as a complete barrier to societal attitudes. Conclusion: This is the first study that describes the functioning profile of children with microcephaly associated with ZIKV, using a tool based on the ICF in Brazil. Our findings reinforce the need to maximize health care and access to information, based on the ICF, for multiprofessional teams, administrators, family members, and children.

BackgroundThe present study aimed to investigate the prevalence of scoliosis and to analyze the factors associated with scoliosis in schoolchildren aged between 7 and 17 years.MethodsThis is a cross-sectional and quantitative study with stratified random selection of public school students in the city of Santa Cruz, Brazil. The presence of scoliosis was examined, as well as the flexibility of the posterior muscle chain, socioeconomic characteristics, anthropometry, lifestyle habits, sexual maturation, and ergonomics of school furniture. In order to identify factors associated with scoliosis, the variables were divided in biological, socioeconomic, lifestyle, and ergonomic factors, and crude and adjusted prevalence ratios (PRs) were estimated by means of Poisson regression analysis.ResultsTwo hundred and twelve pupils participated in this study (mean age 11.61 years, 58% female). The prevalence of scoliosis was 58.1% (n = 123) and associated with female sex (PR 2.54; 95% CI, 1.33–4.86) and age between 13 and 15 years (PR 5.35; 95% CI, 2.17–13.21). Sleeping in a hammock was inversely associated with scoliosis (PR 0.44; 95% CI, 0.23–0.81).ConclusionsScoliosis seems to be positively associated with female sex and age between 13 and 15 years, whereas the habit of sleeping in a hammock is negatively associated with the onset of scoliosis.

Introduction: Previous studies have shown music therapy as a way to improve the clinical status of premature infants, improving vital signs and decreasing crying episodes. Objective: Compare the effects of music on vital signs of premature infants undergoing respiratory physiotherapy. Methods: We performed a randomized clinical trial consisting of 26 premature infants, divided into control group (N=12) and study group (N=14), carried out in a Neonatal Intensive Care Unit. All newborn infants undergone standard practice physiotherapy for 15 minutes: vibration and aspiration. On the study group they were exposed to classical music three minutes before the standard physiotherapy, and finished three minutes after the end of these procedures. A recorder was placed inside the incubator with an intensity of 25 decibels. Measurements of heart and respiratory rate and oxygen saturation were measured before, during and after each sessions of respiratory physiotherapy for two groups. Results: When comparing control and study groups regarding heart rate frequency and oxygen saturation, there was no statistically significant difference, but the inclusion of music determined clinically the variability of these data and 30% of the variation in respiratory rate was due to the inclusion of music during and after the physiotherapy, and the neonatal noninvasive ventilation showed less variation in their respiratory rate when compared to the neonatal on oxygen therapy. Conclusion: The results have showed a beneficial effect of music, showing lower respiratory rate in newborn infants during and after respiratory physiotherapy procedure.

Objective: The aim of the study was to compare the comorbidities and sleep patterns most commonly associated with each gender in obstructive sleep apnea (OSA). Methods: This was a crosssectional study of obese individuals with OSA. The polysomnographies were carried out in a sleep laboratory environment, using a 15-channel polysomnography setup. Airflow was measured using a nasal pressure cannula/thermistor combination. A standard handbook was used for interpretation of PSG findings. Results: A total of 284 subjects were included in the study, (147 females). The mean age, body mass index and neck circumference were similar between females and males (p = 0.9579, p < 0.0001, and p < 0.0001, respectively). On polysomnography, females exhibited longer latency to REM sleep (146.50 ± 85.93 vs. 122.3 ± 68.28, p = 0.0210) and a higher percentage of delta sleep (10.09 ± 7.48 vs. 7.55 ± 6.57, p = 0.0037); males had more frequent microarousals (38.37 ± 27.44 vs. 28.07 ± 21.23, p = 0.0017) and a higher AHI score (30.56 ± 27.52 vs. 17.31 ± 21.23, p < 0.0001). The comorbidities most commonly associated with female gender were diabetes (29% vs. 9.49%, p = 0.0132), hypothyroidism (20% vs. 2.19%, p < 0.0001), and depression (81.63% vs. 51.22%, p < 0.0001). Male gender was associated with myocardial infarction (6.57% vs. 1.38%, p = 0.0245) and alcohol intake (33.88% vs. 11.34%, p < 0.0001). Obese males with OSA have a larger neck circumference and higher AHI and arousal indices than females. Conclusions: There are gender differences both in the sleep patterns and in the comorbidities of patients with OSA. Men had a larger neck circumference, higher apnea and sleep fragmentation scores, were more likely to consume alcohol, and were more likely to have a history of myocardial infarction than women.