RENATA HYDEE HASUE
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - Docente
LIM/54 - Laboratório de Bacteriologia, Hospital das Clínicas, Faculdade de Medicina
LIM/54 - Laboratório de Bacteriologia, Hospital das Clínicas, Faculdade de Medicina
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- The general movement checklist: A guide to the assessment of general movements during preterm and term age(2021) AIZAWA, Carolina Yuri Panvequio; EINSPIELER, Christa; GENOVESI, Fernanda Francoso; IBIDI, Silvia Maria; HASUE, Renata HydeeObjectives: To develop a checklist describing features of normal and abnormal general movements in order to guide General Movement Assessment novices through the assessment procedure, to provide a quantification of General Movement Assessment; and to demonstrate that normal and abnormal GMs can be distinguished on the basis of a metric checklist score. Methods: Three examiners used General Movement Assessment and the newly developed GM checklist to assess 20 videos of 16 infants (seven males) recorded at 31-45 weeks postmenstrual age (writhing general movements). Inter- and intra-scorer agreement was determined for General Movement Assessment (nominal data; Kappa values) and the checklist score (metric scale ranging from 0 to 26; Intraclass Correlation values). The scorers' satisfaction with the usefulness of the checklist was assessed by means of a short questionnaire (score 10 for maximum satisfaction). Results: The scorers' satisfaction ranged from 8.44 to 9.14, which indicates high satisfaction. The median checklist score of the nine videos showing normal general movements was significantly higher than that of the eleven videos showing abnormal general movements (26 vs. 11, p < 0.001). The checklist score also differentiated between poor-repertoire (median =13) and cramped synchronized general movements (median = 7; p =0.002). Inter- and intra-scorer agreement on (i) normal vs. abnormal general movements was good to excellent (Kappa =0.68-1.00); (ii) the distinction between the four general movement categories was considerable to excellent (Kappa = 0.56-0.93); (iii) the checklist was good to excellent (ICC =0.77-0.96). Conclusion: The general movement checklist proved an important tool for the evaluation of normal and abnormal general movements; its score may potentially document individual trajectories and the effect of therapeutic intervention. (C) 2020 Sociedade Brasileira de Pediatria.
- Neurodevelopment in the third year of life in children with antenatal ZIKV-exposure(2021) AIZAWA, Carolina Yuri Panvequio; CARON, Deyse Mayara Rodrigues; SOUZA, Carolina Barbosa de; KOZIMA, Paula Fernanda Augusto; DAMASCENO, Luana; EINSPIELER, Christa; MARSCHIK, Peter B.; BRASIL, Patricia; SCHMITT, Ana Carolina Basso; NIELSEN-SAINES, Karin; HASUE, Renata HydeeWe report cognitive, language and motor neurodevelopment, assessed by the Bayley-III test, in 31 non-microcephalic children at age 3 with PCR-confirmed maternal Zika virus exposure (Rio de Janeiro, 2015-2016). Most children had average neurodevelopmental scores, however, 8 children (26%) presented delay in some domain. Language was the most affected: 7 children (22.6%) had a delay in this domain (2 presenting severe delay). Moderate delay was detected in the cognitive (3.2%) and motor (10%) domains. Maternal illness in the third trimester of pregnancy and later gestational age at birth were associated with higher Bayley-III scores. Zika-exposed children require long-term follow-up until school age.
- Neurodevelopment in Infants Exposed to Zika Virus In Utero(2018) MOREIRA, M. Elisabeth Lopes; NIELSEN-SAINES, Karin; BRASIL, Patricia; KERIN, Tara; DAMASCENO, Luana; PONE, Marcos; CARVALHO, Liege M. A.; PONE, Sheila M.; VASCONCELOS, Zilton; RIBEIRO, Ieda P.; ZIN, Andrea A.; TSUI, Irena; ADACHI, Kristina; GAW, Stephanie L.; HALAI, Umme-Aiman; SALLES, Tania S.; CUNHA, Denise C. da; BONALDO, Myrna C.; GABAGLIA, Claudia Raja; GUIDA, Leticia; MALACARNE, Jociele; COSTA, Roozemerie P.; GOMES JR., S. Clair; REIS, A. Beatriz; SOARES, Fernanda V. M.; HASUE, Renata H.; AIZAWA, Carolina Y. P.; GENOVESI, Fernanda F.; AIBE, Mitsue; EINSPIELER, Christa; MARSCHIK, Peter B.; PEREIRA JR., J. Paulo; PORTARI, Elyzabeth A.; JANZEN, Carla; CHERRY, James D.
- Zika Virus Infection in Pregnant Women in Rio de Janeiro(2016) BRASIL, P.; PEREIRA JR., J. P.; MOREIRA, M. E.; NOGUEIRA, R. M. Ribeiro; DAMASCENO, L.; WAKIMOTO, M.; RABELLO, R. S.; VALDERRAMOS, S. G.; HALAI, U. -A.; SALLES, T. S.; ZIN, A. A.; HOROVITZ, D.; DALTRO, P.; BOECHAT, M.; GABAGLIA, C. Raja; SEQUEIRA, P. Carvalho de; PILOTTO, J. H.; MEDIALDEA-CARRERA, R.; CUNHA, D. Cotrim da; CARVALHO, L. M. Abreu de; PONE, M.; SIQUEIRA, A. Machado; CALVET, G. A.; BAIAO, A. E. Rodrigues; NEVES, E. S.; CARVALHO, P. R. Nassar de; HASUE, R. H.; MARSCHIK, P. B.; EINSPIELER, C.; JANZEN, C.; CHERRY, J. D.; FILIPPIS, A. M. Bispo de; NIELSEN-SAINES, K.BACKGROUND Zika virus (ZIKV) has been linked to central nervous system malformations in fetuses. To characterize the spectrum of ZIKV disease in pregnant women and infants, we followed patients in Rio de Janeiro to describe clinical manifestations in mothers and repercussions of acute ZIKV infection in infants. METHODS We enrolled pregnant women in whom a rash had developed within the previous 5 days and tested blood and urine specimens for ZIKV by reverse-transcriptase-polymerase-chain-reaction assays. We followed women prospectively to obtain data on pregnancy and infant outcomes. RESULTS A total of 345 women were enrolled from September 2015 through May 2016; of these, 182 women (53%) tested positive for ZIKV in blood, urine, or both. The timing of acute ZIKV infection ranged from 6 to 39 weeks of gestation. Predominant maternal clinical features included a pruritic descending macular or maculopapular rash, arthralgias, conjunctival injection, and headache; 27% had fever (short-term and low-grade). By July 2016, a total of 134 ZIKV-affected pregnancies and 73 ZIKV-unaffected pregnancies had reached completion, with outcomes known for 125 ZIKV-affected and 61 ZIKV-unaffected pregnancies. Infection with chikungunya virus was identified in 42% of women without ZIKV infection versus 3% of women with ZIKV infection (P<0.001). Rates of fetal death were 7% in both groups; overall adverse outcomes were 46% among offspring of ZIKV-positive women versus 11.5% among offspring of ZIKV-negative women (P<0.001). Among 117 live infants born to 116 ZIKV-positive women, 42% were found to have grossly abnormal clinical or brain imaging findings or both, including 4 infants with microcephaly. Adverse outcomes were noted regardless of the trimester during which the women were infected with ZIKV (55% of pregnancies had adverse outcomes after maternal infection in the first trimester, 52% after infection in the second trimester, and 29% after infection in the third trimester). CONCLUSIONS Despite mild clinical symptoms in the mother, ZIKV infection during pregnancy is deleterious to the fetus and is associated with fetal death, fetal growth restriction, and a spectrum of central nervous system abnormalities. (Funded by Ministerio da Saude do Brasil and others.)
- Association of Infants Exposed to Prenatal Zika Virus Infection With Their Clinical, Neurologic, and Developmental Status Evaluated via the General Movement Assessment Tool(2019) EINSPIELER, Christa; UTSCH, Fabiana; BRASIL, Patricia; AIZAWA, Carolina Y. Panvequio; PEYTON, Colleen; HASUE, Renata Hydee; GENOVESI, Fernanda Francoso; DAMASCENO, Luana; MOREIRA, Maria Elisabeth; ADACHI, Kristina; MARSCHIK, Peter B.; NIELSEN-SAINES, Karin; BARTL-POKORNY, Katrin D.; KRIEBER-TOMANTSCHGER, Iris; KRIEBER-TOMANTSCHGER, Magdalena; LANGMANN, Laura; PEHARZ, Robert; POKORNY, Florian B.; ZHANG, Dajie; RAMOS, Cinthia; SILVA, Diniz; REIS, Alberto; ALVES, Elaine; PASSOS, Sandra Alvarenga; VELLOSO FILHO, Roberto; DOBAJA, Felicitas; PANSY, Jasmin; SCHEUCHENEGGER, AnnaIMPORTANCE There is an urgent need to assess neurodevelopment in Zika virus (ZIKV)-exposed infants OBJECTIVES To perform general movement assessment (GMA) at 9 to 20 weeks' postterm age and to evaluate whether the findings are associated with neurodevelopmental outcomes at age 12 months in infants prenatally exposed to acute maternal illness with rash in Brazil during the ZIKV outbreak and in age-matched controls. DESIGN, SETTING, AND PARTICIPANTS In this cohort study, infants prenatally exposed to acute maternal illness with rash were recruited at medical institutions in Rio de Janeiro and Belo Horizonte, Brazil, from February 1, 2016, to April 30, 2017, while infants without any exposure to maternal illness originated from the Graz University Audiovisual Research Database for the Interdisciplinary Analysis of Neurodevelopment. Participants were 444 infants, including 76 infants without congenital microcephaly, 35 infants with microcephaly, and 333 neurotypical children matched for sex, gestational age at birth, and age at GMA. MAIN OUTCOMES AND MEASURES General movement assessment performed at 9 to 20 weeks' postterm age, with negative predictive value, positive predictive value, sensitivity, and specificity generated, as well as clinical, neurologic, and developmental status (Bayley Scales of Infant and Toddler Development, Third Edition [Bayley-III] scores) at age 12 months. Motor Optimality Scores were generated based on the overall quality of the motor repertoire. Adverse outcomes were defined as a Bayley-III score less than 2 SD in at least 1 domain, a score less than 1 SD in at least 2 domains, and/or atypical neurologic findings. RESULTS A total of 444 infants were enrolled, including 111 children prenatally exposed to a maternal illness with rash and 333 children without any prenatal exposure to maternal illness (57.7% male and mean [SD] age, 14 [2] weeks for both groups); 82.1%(46 of 56) of ZIKV-exposed infants without congenital microcephaly were healthy at age 12 months. Forty-four of 46 infants were correctly identified by GMA at 3 months, with a negative predictive value of 94%(95% CI, 85%-97%). Seven of 10 ZIKV-exposed children without microcephaly with adverse neurodevelopmental outcomes were identified by GMA. The GMA positive predictive value was 78% (95% CI, 46%-94%), sensitivity was 70%(95% CI, 35%-93%), specificity was 96%(95% CI, 85%-99%), and accuracy was 91%(95% CI, 80%-97%). Children with microcephaly had bilateral spastic cerebral palsy; none had normal movements. The Motor Optimality Score differentiated outcomes: the median Motor Optimality Score was 23 (interquartile range [IQR], 21-26) in children with normal development, 12 (IQR, 8-19) in children with adverse outcomes, and 5 (IQR, 5-6) in children with microcephaly, a significant difference (P=.001). CONCLUSIONS AND RELEVANCE This study suggests that although a large proportion of ZIKV-exposed infants without microcephaly develop normally, many do not. The GMA should be incorporated into routine infant assessments to enable early entry into targeted treatment programs.
- Delayed childhood neurodevelopment and neurosensory alterations in the second year of life in a prospective cohort of ZIKV-exposed children(2019) NIELSEN-SAINES, Karin; BRASIL, Patricia; KERIN, Tara; VASCONCELOS, Zilton; GABAGLIA, Claudia Raja; DAMASCENO, Luana; PONE, Marcos; CARVALHO, Liege M. Abreu de; PONE, Sheila M.; ZIN, Andrea A.; TSUI, Irena; SALLES, Tania Regina S.; CUNHA, Denise Cotrim da; COSTA, Roozemerie Pereira; MALACARNE, Jociele; REIS, Ana Beatriz; HASUE, Renata Hydee; AIZAWA, Carolina Y. P.; GENOVESI, Fernanda F.; EINSPIELER, Christa; MARSCHIK, Peter B.; PEREIRA, Jose Paulo; GAW, Stephanie L.; ADACHI, Kristina; CHERRY, James D.; XU, Zhiheng; CHENG, Genhong; MOREIRA, Maria ElisabethWe report neurodevelopmental outcomes in 216 infants followed since the time of PCR-confirmed maternal Zika virus (ZIKV) infection in pregnancy during the Rio de Janeiro epidemic of 2015-2016 (refs. (1,2)). Neurodevelopment was assessed by Bayley Scales of Infant and Toddler Development, third edition (Bayley-III; cognitive, language and motor domains) in 146 children and through neurodevelopment questionnaires/neurological examinations in 70 remaining children. Complete eye exams (n = 137) and hearing assessments (n = 114) were also performed. Below-average neurodevelopment and/or abnormal eye or hearing assessments were noted in 31.5% of children between 7 and 32 months of age. Among children assessed by Bayley-III, 12% scored below -2 s.d. (score < 70; a score of 100 +/- 2 s.d. is the range) in at least one domain; and 28% scored between -1 and -2 s.d. in any domain (scores < 85-70). Language function was most affected, with 35% of 146 children below average. Improved neurodevelopmental outcomes were noted in female children, term babies, children with normal eye exams and maternal infection later in pregnancy (P = 0.01). We noted resolution of microcephaly with normal neurodevelopment in two of eight children, development of secondary microcephaly in two other children and autism spectrum disorder in three previously healthy children in the second year of life.