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Authors: Valeria Azevedo De Almeida, Nancy Sotero, Lilian Lira Lisboa, Rafael Pauletti Gonçalves, Edgard Morya, Lucia Maria Costa Monteiro, Reginaldo Antônio de Oliveira Freitas Júnior
Summary: Children with Congenital Zika Syndrome (CZS) have structural alterations on cortical level which can compromise urinary and digestive systems integrity, becoming them susceptible to develop bowel and bladder dysfunctions. However, although there are already much evidence of bladder dysfunction on this population, still there are not researches that adressess specifically bowel dysfunction on children with CZS. Thus, a research protocol was developed based in our experience on neurogenic bowel treatment in children. After approval by the ethics committee the protocol was tested during bowel function assessment of microcephaly by CZS patients admitted for ambulatory follow-up on Rehabilitation Specialized Center of Anita Garibaldi Center of Education and Research in Health (CEPS) from july to december of 2019. The protocol of bowel function evaluation followed Rome IV Criteria for children and adolescents, applied through clinical anamnesis and physical examination, Bristol Stool Scale of classification based in symptoms for bowel functional disturbs and rectal ampoule ultrasound. So far, neurogenic bowel was confirmed on 90% of assessed patients. Our findings reveal new data about the subject, increasing the need of additional researches that deepen scientific knowledge abou multiple repercussions of CZS.
Proper citation: Valeria Azevedo De Almeida, Nancy Sotero, Lilian Lira Lisboa, Rafael Pauletti Gonçalves, Edgard Morya, Lucia Maria Costa Monteiro, Reginaldo Antônio de Oliveira Freitas Júnior 2020. CRITERIA TO EVALUATE NEUROGENIC BOWEL IN CHILDREN WITH CONGENITAL ZIKA SYNDROME. protocols.io dx.doi.org/10.17504/protocols.io.bd6xi9fn Copy
Authors: Valeria Azevedo De Almeida, Nancy Sotero, Rafael Pauletti Gonçalves, Edgard Morya, Lilian Lira Lisboa, Lucia Maria Costa Monteiro, Reginaldo Antônio de Oliveira Freitas Júnior
Summary: Children with Congenital Zika Syndrome (CZS) present brain abnormalities that include the cortical level (RIBEIRO, 2018) and can compromise the integrity of their conexions with the urinary and digestive systems, making them susceptible to bowel and bladder dysfunctions. Studies have confirmed the presence of neurogenic bladder in children with microcephaly and CZS (COSTA MONTEIRO, 2018; 2019). Considering the frequent association between bladder and bowel dysfunctions (MACHADO, 2016), their common embrionary origin and their similar sympathetic (L1-L3) and parasympathetic (S2-S4) innervation, it would be expected that patients with CZS and neurogenic bladder may also present bowel dysfunction. However, we didn't find published studies that have specifically addressed bowel dysfunction in children with CZS and bladder dysfunction. Therefore, we developed and tested this research protocol, based on accumulated knowledge in the treatment of patients with neurogenic bowel for other causes, and also in the treatment of patients with CZS. This protocol was approved by the institutional ethics committee (CAAE-17583419.7.0000.5537) and has been used as part of the investigation methodology of bowel dysfunction in CZS children admitted for ambulatory follow-up on Anita Garibaldi Center of Education and Research in Health (CEPS). The Bowel Function Assessment Protocol includes extended clinical anamnesis with guiding questions related to signals and symptoms of functionals disturbances, detailed physical examination, Bristol scale and rectal ampoule ultrasound.
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This protocol is part of a research in progress at CEPS. Our preliminary data, under protection to be published, suggest that neurogenic bowel dysfunction can be a sequel of CZS. By making this research protocol public, we hope to encourage the reproduction of this research by other groups and empower scientific knowledge in the field of CZS.
Proper citation: Valeria Azevedo De Almeida, Nancy Sotero, Rafael Pauletti Gonçalves, Edgard Morya, Lilian Lira Lisboa, Lucia Maria Costa Monteiro, Reginaldo Antônio de Oliveira Freitas Júnior 2020. CRITERIA TO EVALUATE NEUROGENIC BOWEL DYSFUNCTION IN CHILDREN WITH CONGENITAL ZIKA SYNDROME. protocols.io dx.doi.org/10.17504/protocols.io.bidika4e Copy
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