ABSTRACT
OBJECTIVE: To test the intra- and interrater reliability of the Brazilian Portuguese version of the 66-item Gross Motor Function Measure (GMFM-66). METHOD: The sample included 48 children with cerebral palsy (CP), ranging from 2-17 years old, classified at levels I to IV of the Gross Motor Function Classification System (GMFCS) and four child rehabilitation examiners. A main examiner evaluated all children using the GMFM-66 and video-recorded the assessments. The other examiners watched the video recordings and scored them independently for the assessment of interrater reliability. For the intrarater reliability evaluation, the main examiner watched the video recordings one month after the evaluation and re-scored each child. We calculated reliability by using intraclass correlation coefficients (ICC) with their respective 95% confidence intervals. RESULTS: Excellent test reliability was documented. The intrarater reliability of the total sample was ICC=0.99 (95% CI 0.98-0.99), and the interrater reliability was ICC=0.97 (95% CI 0.95-0.98). The reliability across GMFCS levels ranged from ICC=0.92 (95% CI 0.72-0.98) to ICC=0.99 (95% CI 0.99-0.99); the lowest value was the interrater reliability for the GMFCS IV group. Reliability in the five GMFM dimensions varied from ICC=0.95 (95% CI 0.93-0.97) to ICC=0.99 (95% CI 0.99-0.99). CONCLUSION: The Brazilian Portuguese version of the GMFM-66 showed excellent intra- and interrater reliability when used in Brazilian children with CP levels GMFCS I to IV.
Subject(s)
Humans , Child , Adolescent , Cerebral Palsy/physiopathology , Motor Skills , Brazil , Reproducibility of Results , Disability Evaluation , Motor Skills/classificationABSTRACT
Introdução: As bactérias são os micro-organismos com maior potencial patogênico para o ser humano. As infecções causadas por elas são na sua maioria graves e devem ser tratadas com drogas antibacterianas. Uma dessas bactérias patogênicas é Streptococcus pyogenes, causadora de diversas infecções, incluindo amigdalite, erisipela e ndocardite, sendo que em alguns pacientes ocorre febre reumática como complicação pós-infecção. Diversos trabalhos na literatura demonstram efeitos biológicos em bactérias após contato com soluções ultra-diluídas. Embasados nessas informações, propusemos avaliar o efeito dos medicamentos homeopáticos Belladonna (Bell), Mercurius solubillis (Merc), Gelsemium sempervirens (Gels) e nosódio de S. pyogenes no crescimento in vitro da bactéria S. pyogenes. Arnica montana (Arn) foi usado no presente trabalho como controle, por não ser, aparentemente, indicada no tratamento de infecções bacterianas. Materiais e métodos: Os medicamentos foram utilizados nas diluições de 12cH e 30cH, nas concentrações de 2, 4 e 6 gotas em 3 mL de meio BHI (Brain Heart Infusion) com 100µL da bactérias na concentração 0,5 da escala de McFarland. A solução foi incubada a 37ºC por 20 horas e submetida à leitura em espectrofotômetro a 600nm. Resultados: Os medicamentos nosódio e Bell nas diluições 12cH e 30cH com 2, 4 ou 6 gotas inibiram significativamente o crescimento in vitro de S. pyogenes, enquanto Arn 30cH na concentração de 6 gotas estimulou esse crescimento. Conclusão: Medicamentos homeopáticos podem ter ação sobre o crescimento in vitro de bactérias, sendo que essa ação pode estar relacionada a sua aplicação clínica.
Introduction: Bacteria are the microorganisms with greatest pathogenic potential for human beings. The infections caused by bacteria are usually serious and require treatment with antibacterial drugs. One of such pathogenic bacteria is Streptococcus pyogenes, which is associated with several infections diseases, including tonsillitis, erysipela and endocarditis, being that rheumatic fever might occur as a post-infection complication. There are records in the literature of biological effects in bacteria subjected to ultra-diluted solutions. On those grounds, we sought to test the effects of homeopathic medicines Belladonna (Bell), Mercurius solubillis (Merc), Gelsemium sempervirens (Gels) and S. pyogenes nosode on the in vitro growth of S. pyogenes. Arnica montana (Arn) was used as control, as it is believed not to have any effect in the treatment of infections. Materials and methods: The homeopathic medicines were used in dilutions 12cH and 30cH in concentration 2, 4 and 6 drops/3 mL of BHI (Brain Heart Infusion) with 100 µL of bacteria in concentration 0.5 McFarland scale. The solution was incubated at 37 ºC for 20 hours and read in spectrophotometer at 600 nm. Results: Medicines nosode and Bell in dilution 12cH and 30cH and concentration 2, 4 and 6 drops induced significant inhibition of the in vitro growth of S. pyogenes; Arn30cH in concentration 6 drops promoted bacterial growth. Conclusion: Homeopathic medicines might have an action on the in vitro growth of bacteria, which might be related with their clinical applications.
Subject(s)
Mechanisms of Action of Homeopathic Remedies , Atropa belladonna , /analysis , Gelsemium sempervirens/analysis , Isotherapy , Mercurius Solubilis/analysis , Streptococcus pyogenes/growth & developmentABSTRACT
OBJETIVOS: Conhecer o perfil de colonização fúngica e os fatores de risco associados em recém-nascidos prematuros. MÉTODOS: Coorte prospectiva, de 01/04/10 a 31/04/11, com 44 pacientes admitidos na unidade de terapia intensiva neonatal, nascidos na maternidade do hospital, com peso menor que 1.500 g. Na admissão, coletaram-se dados sobre pré-natal e parto. Informações clínico-laboratoriais, swabs nasal, retal e hemocultura periférica foram coletados nos dias 1, 7, 10 e 14 de permanência na unidade de terapia intensiva neonatal e, então, a cada 7 dias até alta ou óbito. Para análise estatística, utilizou-se teste qui-quadrado, exato de Fisher, curva de Kaplan-Meier e modelo de regressão logística. RESULTADOS: A incidência de colonização foi de 13,5/1.000 pacientes/dia. A de candidemia foi de 0,9/1.000 paciente/dia. A média de internamento foi de 30,5 dias (±20,27), sendo o início da colonização, em média, aos 11,13 dias (±8,82). O parto vaginal foi um fator de risco independente para desenvolvimento de colonização fúngica ao longo da internação [p = 0,042; odds ratio = 4,38; intervalo de confiança de 95% (IC95%) = 1,13-16,99]. Da mesma forma, a leucocitose (> 30.000/mm3) na admissão foi um sinalizador para a presença concomitante de colonização (p = 0,048). A presença de displasia broncopulmonar tende a ser um fator de maior chance para desenvolvimento de colonização (p = 0,067). O sítio de colonização mais acometido foi a mucosa retal: 89,09 versus 10,9% da nasal. CONCLUSÃO: Parto vaginal e leucocitose acima de 30.000/mm3 na admissão foram fatores de risco para colonização fúngica no decorrer da hospitalização.
OBJECTIVES: To learn about the profile of fungal colonization and related risk factors in premature newborns. METHODS: Prospective cohort, from 04/01/2010 to 04/31/2011, with 44 patients admitted to the neonatal intensive care unit, born at the hospital maternity, weighing less than 1,500 g. On admission, data were collected on pre-natal care and childbirth. Clinical and laboratory information, nasal and rectal swabs, and peripheral blood cultures were collected on days 1,7,10 and 14 of stay in neonatal intensive care unit and then, every 7 days until discharge or death. For statistical analysis, we used chi-square test, Fisher exact test, Kaplan-Meier and logistic regression model. RESULTS: The incidence of colonization was 13.5/1,000 patients/day. The incidence of candidemia was 0.9/1,000 patients/day. The average hospitalization time was 30.5 days (± 20.27), and the onset of colonization occurred, in average, at 11.13 days (±8.82). Vaginal delivery was found to be an independent risk factor for the development of fungal colonization during hospitalization (p = 0.042, odds ratio = 4.38, 95% confidence interval [95%CI] = 1,13-16,99). Likewise, leukocytosis (> 30,000/mm3) on admission was an indicator for the simultaneous presence of fungal colonization (p = 0.048). The presence of bronchopulmonary dysplasia tends to be a factor of higher probability for the development of colonization (p = 0.067). The most affected colonization site was the rectal mucosa: 89.09 versus 10.9% of the nasal mucosa. CONCLUSION: Vaginal delivery and leukocytosis over 30,000/mm3 on admission were found to be risk factors for fungal colonization during hospitalization.