Infant stimulation reduces weight loss and increases breastfeeding: a randomized controlled trial / La estimulación del neonato reduce la pérdida de peso y aumenta la lactancia materna: un ensayo controlado aleatorio / A estimulação do neonato reduz a perda de peso e aumenta a lactância materna: um ensaio controlado aleatório

Objective. The study aimed to measure the effect of auditory, tactile, visual, and vestibular (ATVV) stimulation therapy on sucking effectiveness (SE), infant-feeding mode, weight, height, and head circumference (HC) of full-term infants. Methods. A single-blinded randomized trial with a sample of 107 mother-child dyads. Inclusion criteria were healthy first-time mothers and full-term infants with no known pathological conditions, weighing between 2500 and 4000 grams, and recommendation of exclusive or predominant breastfeeding. The mothers in the experimental group (EG) received training in ATVV stimulation therapy and provided it from birth (first 24 hours of life) until the end of the follow-ups at week 5. The control group (CG) received only standard care that included education on warning signs and basic guidance on breastfeeding. SE, infant-feeding mode, and neonatal growth were measured at weeks 2 and 5. Results. In contrast to CG infants, the EG infants drank 2.02 cc more human milk in one minute of effective breastfeeding (p=0.002) at week 2 and 5.51 cc more at week 5 (p<0.0001). They showed greater adherence to breastfeeding at week 5 (p=0.025) and gained more weight: 8.35 grams/day (p=0.009) and 4.19 grams/day (p=0.008). HC did not differ between groups, and height difference was statistically significant at week 5 (p=0.025). Conclusion: ATVV stimulation therapy has a positive effect on neonatal health as it promotes effective sucking and exclusive breastfeeding, reduces weight loss, and improves neonatal growth.

Objetivos. Medir el efecto de la terapia de estimulación auditiva, táctil, visual y vestibular en la succión eficaz, el modo de alimentación, el peso, talla y perímetro cefálico de los neonatos a término. Métodos. Ensayo aleatorizado ciego, con una muestra de 107 díadas madre-hijo. Los criterios de inclusión fueron madres primerizas sanas y bebés a término sin condiciones patológicas conocidas, con peso entre 2500 y 4000 gramos e indicación de lactancia materna exclusiva o predominante. En el grupo experimental las madres recibieron entrenamiento en la terapia de estimulación auditiva, táctil, visual y vestibular y lo aplicaron desde el nacimiento (primeras 24 horas de vida) hasta el final del seguimiento. El grupo control recibió solamente la atención estándar que incluyó la educación sobre los signos de alarma y las indicaciones básicas sobre la lactancia materna. Se midió la eficacia de la succión, el tipo de alimentación y el crecimiento neonatal en la semana 2 y la semana 5. Resultados. Los bebés del grupo experimental comparados con el grupo control bebieron 2.02 cc más leche humana en un minuto de lactancia efectiva (p=0.002) en la segunda semana y 5.51 cc más en la quinta semana (p<0.0001); las madres registraron una mayor adherencia a la lactancia a las 5 semanas (p=0.025) y los bebés ganaron más peso: 8.35 gramos/día (p=0.009) y 4.19 gramos/día (p=0.008). El perímetro cefálico no presentó diferencias entre grupos, mientras que la diferencia en la talla fue estadísticamente significativa en la semana 5 (p=0.025). Conclusión. La terapia de estimulación auditiva, táctil, visual y vestibular tiene un efecto positivo en la salud neonatal, promueve la succión eficaz, la lactancia materna exclusiva, atenúa la pérdida de peso y mejora el crecimiento neonatal.

Objetivos. Medir o efeito da terapia de estimulação auditiva, táctil, visual e vestibular na sucção eficaz, o modo de alimentação, o peso, tamanho e perímetro cefálico dos neonatos a término. Métodos. Ensaio aleatório cego, com uma mostra de 107 díade mãe-filho. Os critérios de inclusão foram mães de primeira viagem saudáveis e bebês a término sem condições patológicas conhecidas, com peso entre 2500 e 4000 gramas e indicação de lactância materna exclusiva ou predominante. No grupo experimental as mães receberam treinamento na terapia de estimulação auditiva, táctil, visual e vestibular e a aplicaram desde o nascimento (primeiras 24 horas de vida) até o final do seguimento; o grupo de controle recebeu somente a atenção padrão que incluiu a educação sobre os sinais de alarme e as indicações básicas sobre a lactância materna. Se mediu a eficácia da sucção, o tipo de alimentação e o crescimento neonatal na 2ª semana e na 5ª semana. Resultados. Os bebês do grupo experimental comparados com o grupo de controle beberam 2.02 cc mais leite humana num minuto de lactância efetiva (p=0.002) na segunda semana e 5.51 cc mais na quinta semana (p<0.0001); as mães registraram uma maior aderência à lactância às 5 semanas (p=0.025) e os bebês ganharam mais peso: 8.35 gramas/dia (p=0.009) e 4.19 gramas/dia (p=0.008). O perímetro cefálico não apresentou diferenças entre grupos, enquanto a diferença no tamanho foi estatisticamente significativa na 5ª semana (p=0.025). Conclusão. A terapia de estimulação auditiva, táctil, visual e vestibular tem um efeito positivo na saúde neonatal, promove a sucção eficaz, a lactância materna exclusiva, atenua a perda de peso e melhora o crescimento neonatal.

Antenatal breastmilk expression in late pregnancy to improve lactation for women with gestational hyperglycemia: a review / 中华围产医学杂志

Women with gestational hyperglycemia tend to encounter breastfeeding difficulties, which may lead to breastfeeding failure or short duration of breastfeeding. Antenatal breastmilk expression, stimulating or massaging the breasts during pregnancy to produce milk and to collect and store colostrum, is beneficial to lactogenesis, thereby reducing formula feeding, promoting the transition to exclusive breastfeeding and increasing the exclusive breastfeeding rate. This review summarizes the safety and feasibility of antenatal breastmilk expression for women with gestational hyperglycemia, aiming to provide breastfeeding guidance for this population.

Estrategias de intervención en la UCI neonatal: un enfoque fisioterapéutico / Intervention strategies in the neonatal ICU: a physiotherapeutic approach

Resumen El fisioterapeuta a lo largo de su profesión ha ampliado el espectro de intervenciones y escenarios de desempeño, siendo uno de los más recientes el abordaje en la unidad de cuidado intensivo neonatal. Recientemente se han reportado en la literatura diferentes estrategias de intervención con el objetivo de lograr un desarrollo adecuado del neonato, tales como masaje, estimulación kinestésica, educación en el programa madre canguro, y maniobras de tórax. El objetivo del artículo fue revisar la información actual proveniente de la evidencia científica disponible sobre estas diferentes estrategias de intervención aplicadas en la unidad de cuidado intensivo neonatal, por lo que se realizó una revisión bibliográfica de los artículos encontrados entre febrero y agosto del 2019 en las bases de datos PUBMED y SCOPUS. Se obtuvieron 40 artículos que cumplieron los criterios de selección y que se incluyeron en la revisión. Finalmente, se concluye que estas estrategias de intervención fisioterapéutica contribuyen al logro de un desarrollo integral adecuado en el neonato. MÉD.UIS.2021;34(1): 63-72

Abstract The physiotherapist throughout his profession has broadened the spectrum of interventions and performance scenarios, one of the most recent being the approach in the neonatal intensive care unit. Recently, different intervention strategies have been reported in the literature with the aim of achieving adequate development of the newborn, such as massage, kinesthetic stimulation, education in the kangaroo mother program, and chest maneuvers. This article aimed to review the current information from the scientific evidence available on these different intervention strategies in the neonatal intensive care unit, so a bibliographic review of the articles found between February and August 2019 in PUBMED and SCOPUS databases was carried out. 40 articles which met the eligibility criteria were obtained and included in the review. Finally, it is concluded that these physiotherapeutic intervention strategies contribute to the achievement of an adequate integral development in the neonate. MÉD.UIS.2021;34(1): 63-72

Effect of infant stimulation on the adaptation to birth: a randomized trial / Efeito da estimulação infantil na adaptação ao nascimento: um estudo randomizado / Efecto de la estimulación infantil en la adaptación al nacimiento: un ensayo aleatorizado

Objective: to measure the effect of an infant stimulation therapy (auditory, tactile, visual and vestibular) on the adaptation to postnatal life of the mother-child dyad. Method: an experimental and blind study composed of 120 dyads of first-time mothers and full-term newborns, who practiced breastfeeding. The follow-up was conducted during the first five weeks of life and the evaluation was carried at two different times. Results: the adaptive capacity was measured in two modes. The physiological adaptive mode (activity and exercise and neonatal nutrition) and the interdependence adaptive mode (appropriate affection and proper development); and statistically significant differences were found in favor of the experimental group. Regression models that show the collaborative relationship between mother and child, and their reciprocity in the process of adaptation were proposed. Conclusion: the early stimulation is a therapy with bidirectional effect, because it has favorable effects on the person who administers it; promotes health and prevents illness in the process of adaptation to birth; especially in contexts of vulnerability. It is recommended its teaching to mothers and its application in the home environment. This study was registered in the Australian New Zealand Clinical Trial Registry (ANZCTR) under protocol number: ACTRN12617000449336.

Objetivo: medir o efeito de uma terapia de estimulação infantil (auditiva, tátil, visual e vestibular) na adaptação à vida pós-natal da díade mãe e filho. Método: estudo experimental, cego, que incluiu 120 díades formadas por mãe de primeiro parto e recém-nascido a termo, que praticavam amamentação materna. O acompanhamento foi realizado durante as primeiras cinco semanas de vida e a avaliação foi feita em dois momentos distintos. Resultados: a capacidade de adaptação foi medida de dois modos. O modo adaptativo fisiológico (atividade e exercício e nutrição neonatal) e o modo adaptativo de interdependência (afeto e desenvolvimento adequados); sendo encontradas diferenças estatisticamente significativas a favor do grupo experimental. Foram propostos modelos de regressão que mostram a relação de colaboração entre mãe e filho, e sua reciprocidade no processo de adaptação. Conclusão: a estimulação precoce é uma terapia com efeito bidirecional, pois tem efeitos favoráveis em quem a administra; promove a saúde e previne doenças no processo de adaptação ao nascimento; especialmente em contextos de vulnerabilidade. Recomenda-se seu ensino às mães e sua aplicação no ambiente doméstico. Este estudo foi registrado no Australian New Zealand Clinical Trial Registry (ANZCTR), sob protocolo de número: ACTRN12617000449336.

Objetivo: medir el efecto de una terapia de estimulación infantil (auditiva, táctil, visual y vestibular) en la adaptación a la vida postnatal de la diada madre e hijo. Método: estudio experimental, ciego que vinculó 120 díadas madre primeriza y neonato nacido a término que practicaban lactancia materna. El seguimiento se realizó durante las primeras cinco semanas de vida y se evaluó en dos momentos distintos. Resultados: se midió la capacidad de adaptación en dos modos. El modo adaptativo fisiológico (actividad y ejercicio y nutrición neonatal) y el modo adaptativo interdependencia (afecto y desarrollo adecuados); encontrando diferencias estadísticamente significativas a favor del grupo experimental. Se plantearon modelos de regresión que evidencian la relación colaborativa entre madre e hijo, y su reciprocidad en el proceso de adaptación. Conclusión: la estimulación temprana es una terapia con efecto bidireccional, pues tiene efectos favorables en quien la administra; que promueve la salud y previene la enfermedad en el proceso de adaptarse al nacimiento, especialmente en contextos de vulnerabilidad. Se recomienda su enseñanza a las madres y su aplicación en el entorno domiciliario. Este estudio se registró en Australian New Zealand Clinical Trial Registry (ANZCTR), con número: ACTRN12617000449336.

Segurança no uso da eletroestimulação neuromuscular em pacientes graves: revisão sistemática / Safety of neuromuscular electrical stimulation among critically ill patients: systematic review

RESUMO Objetivo: Revisar as evidências sobre segurança da eletroestimulação neuromuscular quando utilizada em unidade de terapia intensiva. Métodos: Revisão sistemática, sendo a busca realizada nas bases de dados MEDLINE (acessado via PubMed), PEDro, Cochrane CENTRAL e EMBASE, além de busca manual de referências em estudos randomizados. Foram incluídos ensaios clínicos randomizados que comparassem aplicação da eletroestimulação neuromuscular com grupo controle ou placebo em unidades de terapia intensiva, e que contivessem informações sobre segurança da técnica nos desfechos, sendo considerado como segurança dados de variáveis hemodinâmicas e informações sobre efeitos adversos. Resultados: Os artigos foram analisados por dois revisores independentes, e a análise dos dados foi descritiva. A busca inicial encontrou 1.533 artigos; destes, foram incluídos somente 4 ensaios clínicos randomizados. Dois estudos avaliaram segurança por meio das variáveis hemodinâmicas, e somente um deles mostrou aumento nas frequências cardíacas, respiratória e lactato, porém sem relevância clínica. Os outros dois estudos avaliaram a segurança por meio do relato de efeitos adversos; um expôs que 15% dos pacientes apresentaram sensação de picada, sem alteração clinicamente relevante; o outro relatou apenas que um paciente sofreu queimadura superficial por configuração incorreta dos parâmetros. Conclusão: A eletroestimulação neuromuscular é uma técnica segura para ser aplicada em pacientes graves, porém deve ser aplicada por profissional treinado e utilizando parâmetros corretos, baseados em evidências.

ABSTRACT Objective: To review the evidence on the safety of neuromuscular electrical stimulation when used in the intensive care unit. Methods: A systematic review was conducted; a literature search was performed of the MEDLINE (via PubMed), PEDro, Cochrane CENTRAL and EMBASE databases, and a further manual search was performed among the references cited in randomized studies. Randomized clinical trials that compared neuromuscular electrical stimulation to a control or placebo group in the intensive care unit and reporting on the technique safety in the outcomes were included. Hemodynamic variables and information on adverse effects were considered safety parameters. Articles were independently analyzed by two reviewers, and the data analysis was descriptive. Results: The initial search located 1,533 articles, from which only four randomized clinical trials were included. Two studies assessed safety based on hemodynamic variables, and only one study reported an increase in heart rate, respiratory rate and blood lactate, without clinical relevance. The other two studies assessed safety based on reported adverse effects. In one, 15% of patients described a prickling sensation, without any clinically relevant abnormalities. In the other, one patient suffered a superficial burn due to improper parameter configuration. Conclusion: Neuromuscular electrical stimulation is safe for critically ill patients; however, it should be applied by duly trained professionals and with proper evidence-based parameters.

Physics behind the implants used for high strain fractures: literature review / A física por trás dos implantes utilizados para fraturas de alto strain: revisão de literatura

Whenever bone fractures occur, external forces produce continuous interfragmentary motion and a stabilization method is necessary. It is known that the mechanical conditions at the fracture site influence bone callus formation during healing process. To achieve primary (direct) bone healing, absolute stability at the fracture site is necessary. Perren's concept of strain determines that relative deformation at the fracture gap depends on the original gap's conformation. Simple fractures (without comminution) are considered high strain fractures since a small force applied to the fracture site results in great movement with deleterious effects on the healing process. The purpose of this study is to review the available literature regarding factors that influence the mechanics of high strain fractures in veterinary medicine, its treatment methods and implants available. Each fracture configuration requires special attention and critical care in choosing the osteosynthesis method and the type of stability required for consolidation to occur within the expected time. One must know the strain theory to become an orthopedic surgeon.(AU)

Quando fraturas ósseas ocorrem, forças externas produzem movimentação interfragmentária continuamente e um método de estabilização se faz necessário. É sabido que as condições mecânicas no local de fratura influenciam a formação de calo durante o processo de cicatrização óssea e para que cicatrização óssea primária seja obtida é necessária estabilidade absoluta no foco de fratura. O conceito de strain de Perren determina que a deformação relativa no foco de fratura estabilizado depende do tamanho da lacuna de fratura original. Fraturas redutíveis (sem cominuição) são consideradas de alto strain, pois uma pequena força aplicada a linha de fratura resulta em grande movimentação com efeito deletério ao processo de consolidação. O presente trabalho revisa a literatura disponível a respeito de fatores que influenciam a mecânica de fraturas de alto strain em medicina veterinária, seus métodos de tratamento e a física por trás dos implantes disponíveis. Cada configuração de fratura requer atenção especial e cuidado crítico na escolha do método de osteossíntese e no tipo de estabilidade necessária para que a consolidação ocorra no tempo esperado. Conhecimento da teoria do strain é mandatório para a formação de cirurgiões ortopédicos.(AU)

Influência da intervenção sensório-motora no sistema respiratório de recém-nascidos prematuros / Influence of sensorimotor intervention on the respiratory system of preterm infants

Introdução: A intervenção sensório-motora é utilizada para prevenir ou minimizar alterações no desenvolvimento de recém-nascido pré-termo (RNPT). Entretanto, mais estudos sobre sua influência em RNPT hospitalizados são necessários. Objetivos: Verificar a influência da intervenção sensório-motora sobre parâmetros fisiológicos e peso corporal em RNPT hospitalizados. Métodos: Avaliaram-se 30 RNPT estáveis, submetidos a uma intervenção sensório-motora durante 10 minutos diários por 3 dias consecutivos. Análises comparativas foram realizadas considerando as variáveis frequência respiratória (FR), frequência cardíaca (FC), saturação de oxigênio (SaO2), Boletim Silverman-Andersen (BSA) e peso corporal, mensuradas imediatamente antes da intervenção, imediatamente após, e no 15º minuto após término da intervenção. Resultados: A FR foi maior no 15º minuto após a intervenção do que antes (p<0,05). A SaO2 aumentou logo após a intervenção (p<0,05). O peso corporal aumentou ao longo dos três dias (p<0,001). A FC e o BSA permaneceram constantes. Conclusão: A intervenção sensório-motora pode ter contribuído para melhor frequência respiratória e saturação de oxigênio e demonstrou-se segura aos RNPT.

Introduction: Sensorimotor intervention is frequently used to prevent or minimize dysfunction in the development of preterm newborns (PTNB). However, further studies on its influence in hospitalized PTNB are needed. Objective: To verify the influence of a sensorimotor intervention on physiological parameters and body weight in hospitalized PTNB. Methods: Thirty stable PTNB underwent a sensorimotor intervention during 10 minutes daily for 3 consecutive days. Comparative analyzes were performed considering the variables respiratory rate (RF), cardiac frequency (CF), oxygen saturation (SaO2), Silverman-Andersen Score (SAS), and body weight, measured immediately before the intervention, immediately after, and at 15 minutes after the intervention. Results: RF was higher in the 15th minute after the intervention than before (p<0.05). SaO2 increased immediately after the intervention (p<0.05). Body weight increased over the three days (p<0.001). CF and SAS remained constant. Conclusion: The sensorimotor intervention may have contributed to better respiratory rate and oxygen saturation and was shown to be safe for PTNB.

Effect of sensory stimulation on swallowing functional recovery in patients with cerebrovascular accident / 中国基层医药

Objective To observe the effect of sensory stimulation on swallowing functional recovery in patients with cerebrovascular disease .Methods 60 cerebrovascular accident patients with swallowing dysfunction were randomly divided into research group ( 30 cases ) and control group ( 30 cases ) .The control group was given conventional swallowing function training ,the research group was given sensory stimulation training on this basis of the control group .Before treatment and 1 month after treatment , kubota drinking water test and feeding -swallowing function rating were used to evaluate the swallowing ability of the two groups .Results There were no statistically significant differences between the two groups in terms of sex ,age and course of disease (all P >0.05).Before treatment,the ability of swallowing between the two groups had no statistically significant difference [( 3.27 ± 1.14)points vs.(2.97 ±1.43)points,t=0.646,P>0.05].After 1 month of treatment,the swallowing ability score of the two groups[(7.10 ±1.16)points vs.(5.07 ±1.55)points;t=8.046,P<0.01]and swallowing function grade (90.0％vs.63.3％,χ2 =7.638,P<0.05) were significantly higher than those before treatment .which of the study group were more significant , and the differences between the two groups were statistically significant .Conclusion Various sensory stimulation for patients with dyspraxia after cerebrovascular accident is obviously better than monotherapy ,which can effectively improve the swallowing function of patients with cerebrovascular disease .

Effect of auditory-motor training on auditory processing of school children / Efeito do treinamento auditivo-motor no processamento auditivo de escolares

ABSTRACT Objective To compare performance in Avaliação Simplificada do Processamento Auditivo Central and Scale of Auditory Behaviors scores before and after auditory and motor training. Methods Sample comprising 162 children aged 9 to 11 years and attending public schools in the city of São Paulo (SP), Brazil; 122 out of 162 children were allocated to one of three experimental groups: Multisensory; Auditory/Motor and Motor/Auditory. Experimental groups were submitted to 8 hours of auditory, visuospatial and motor stimulation over the course of 8 weeks. The remaining 40 children formed the Control Group and received no stimulation. Results Relation between child behavior as perceived by school teachers and auditory test responses revealed that the better the performance in auditory processing assessment, the higher the Scale of Auditory Behaviors scores. Conclusion Auditory and motor training led to improvements in auditory processing skills as rated by Avaliação Simplificada do Processamento Auditivo Central and Scale of Auditory Behaviors; this intervention model proved to be a good tool for use in school settings.

RESUMO Objetivo Comparar as respostas da Avaliação Simplificada do Processamento Auditivo Central às da Scale of Auditory Behaviors antes e depois de um treinamento auditivo e de habilidades motoras. Métodos Participaram 162 escolares de 9 a 11 anos de escola pública municipal da cidade de São Paulo (SP), sendo 122 deles divididos em três grupos experimentais: Multissensorial; Auditivo/Motor e Motor/Auditivo. Eles receberam estimulação auditiva, visuoespacial e motora durante 8 semanas (8 horas). O Grupo Controle, que não recebeu estimulação, foi formado por 40 escolares. Resultados A relação entre a percepção dos professores sobre o comportamento dos alunos e suas respostas em testes auditivos mostrou que quanto melhor o resultado na avaliação do processamento auditivo, melhores os escores da Scale of Auditory Behaviors. Conclusão Após treinamento auditivo e motor, ocorreu melhora significativa das habilidades do processamento auditivo demonstradas pela Avaliação Simplificada do Processamento Auditivo Central e na Scale of Auditory Behaviors, e este modelo de intervenção consistiu em boa ferramenta para uso na escola.

Resultados de la estimulación (ATVV) en la adaptación al nacimiento de la díada madre e hijo / Results of the stimulation (ATVV) in the adaptation to the birth of the mother-child dyad

Las madres y los recién nacidos no pasan la mejor época de sus vidas una vez sucede el nacimiento. Atraviesan por un periodo de ajustes fisiológicos, emocionales y comportamentales, que afectan su bienestar físico y emocional. Esta adaptación, se ve influida por factores contextuales propios de un país en desarrollo como la pobreza y pueden generar consecuencias como la depresión postparto y el retraso en el crecimiento y desarrollo infantil. En Colombia, no se dispone de estrategias de soporte o seguimiento durante este periodo sensible. La estimulación (ATVV) se ha estudiado desde 1980 y se sabe que favorece en el recién nacido prematuro y a término su crecimiento; disminuye el estrés; favorece la organización de la conducta neonatal y mejora la interacción madre e hijo. Objetivo: Determinar el efecto de la estimulación multisensorial ATVV realizada por la madre a su neonato, en la adaptación al nacimiento de la díada madre e hijo Método: Estudio cuasi-experimental, ciego, con mediciones post prueba repetidas. Vinculó 220 díadas atendidas en un hospital de Bogotá, Colombia que ofrece servicios de salud a población de bajos recursos. El seguimiento se realizó durante las primeras 4-5 semanas de vida postnatal Resultados: Se valoró la adaptación en dos modos según el modelo de Calista Roy: 1. El modo adaptativo fisiológico y 2. El modo adaptativo interdependencia. En el primero se encontraron diferencias estadísticamente significativas a favor del grupo experimental en las medidas de crecimiento infantil y la capacidad de succión eficaz; así como en la cantidad de sueño neonatal. En el segundo modo se observaron diferencias favorables en la sincronía de mutualidad diádica, el riesgo de estrés por el rol materno y el riesgo de depresión postparto.

Mothers and newborns do not have the best time of their lives once birth occurs. They go through a period of physiological, emotional and behavioral adjustments that affect physical and emotional well-being. This adaptation is influenced by contextual factors typical of a developing country such as poverty and can generate consequences such as postpartum depression and retarded child growth and development. In Colombia, no support or followup strategies are available during this sensitive period. Stimulation (ATVV) has been studied since 1980 and is known to favor the newborn and newborns premature their growth; decreases stress; favors the organization of neonatal behavior and improves interaction. Objective: to determine the effect of the multisensory stimulation ATVV performed by the mother to her neonate, in the adaptation to the birth of the mother and child dyad. Method: Quasi-experimental, blind study, with repeated post-test measurements. He linked 220 diates treated at a hospital in Bogotá, Colombia, which provides health services to low-income populations. Follow-up was performed during the first 4-5 weeks of postnatal life. Results: Adaptation was assessed in two ways according to the Calista Roy model: 1. Physiological adaptive mode and 2. Adaptive mode interdependence. In the first, we found statistically significant differences in favor of the experimental group in the measures of infant growth and the capacity of effective suction; as well as in the amount of neonatal sleep. In the second mode, there were favorable differences in the synchrony of dyadic mutuality, the risk of stress due to the maternal role and the risk of postpartum depression.

Estado de desarrollo psicomotor en niños sanos que asisten a un centro infantil en Santo Domingo, Ecuador / Psychomotor development status in healthy children attending a child center in Santo Domingo, Ecuador / Estado do desenvolvimento psicomotor em crianças saudáveis que participam a um centro da SAUDÁVEIS QUE PARTICIPAM A UM centro da infância em Santo Domingo, Equador

Resumen: El objetivo de este artículo es describir los puntajes de desarrollo psicomotor en niños y niñas que acuden un centro infantil, mediante el formulario 028 que corresponde al Test de Denver II, estandarizado internacionalmente. Se trata de un estudio con un enfoque cuantitativo de carácter descriptivo-transversal. Se reclutaron 42 niños de 18-36 meses, que acuden al centro infantil en Santo Domingo de los Tsáchilas, Ecuador, para la aplicación del test de Denver II. Se excluyeron los niños con patologías graves con impedimento para contestar el instrumento por déficit en su capacidad física y mental. Mediante los puntajes obtenidos por la aplicación del test de Denver se observó que el déficit en el Área Personal-Social se da más en los niños (20%) que en las niñas (5%). En el Área Motriz Fino-Adaptativo el déficit se presenta tanto en los niños (10%) como en las niñas (9%). En el Área de Lenguaje se observó que existe un retardo muy marcado, se presentó más en los niños (35%) que en las niñas (18%). Al igual se observó que el déficit en el Área Motriz Grande se da más en los niños (15%) que en las niñas (5%). Destaca la alta frecuencia de déficit en el desarrollo psicomotor en la población evaluada, especialmente en los niños, donde el área más significativa fue la de Lenguaje. Se recomienda la estimulación temprana y los patrones de crianza para mejorar el desarrollo del lenguaje y el desempeño de los niños en las demás áreas.

Abstract: The goal of this article is to describe psychomotor development scores in children who attend the children's center through Form 028, corresponding to the Internationally Standardized Denver II Test. This is a study with a quantitative approach of descriptive-transversal character. A total of 42 children aged 18-36 months were recruited to attend the Denver II test in Santo Domingo de los Tsáchilas Children's Center in Ecuador. Children with severe pathologies with impediment to answer the form due to deficiency in their physical and mental capacity were excluded. Through the scores obtained by the application of the Denver test, it was observed that the deficit in the Personal-Social Area occurs more in boys (20%) than in girls (5%). In the Fine Motor Skill Area, the deficit occurs in both boys (10%) and girls (9%). In the Language Area it was observed that there is a significant retardation: it was more present in boys (35%) than in girls (18%). It was also observed that the deficit in the Gross Motor Area is higher in boys (15%) than in girls (5%). It is significant the high frequency of deficits shown in psychomotor development in the population evaluated, especially in the language area. Early stimulation and parenting patterns are recommended to improve language development and the performance of children in other areas.

Resumo: O presente estudo buscou descrever escores de desenvolvimento psicomotor em crianças que frequentam o Centro das Crianças usando o formulário de 028 correspondente ao Teste de Denver II, padronizado internacionalmente. Pesquisa quantitativa com abordagem transversal descritivo. 42 crianças com idades entre 18-36 meses que frequentam o centro infantil em Santo Domingo de los Tsáchilas, Ecuador, para a implementação do teste de Denver II foram recrutados. Crianças com doenças graves foram excluídos devido a um impedimento para atender o déficit de instrumento em sua capacidade física e mental. Usando os escores obtidos pela aplicação do teste de Denver foi observado que o déficit na área pessoal-social é mais comum em crianças (20%) e mulheres (5%). Na Área Motriz fina o déficit ocorre em crianças (10%) e mulheres (9%). Na área da linguagem foi observado que há um atraso acentuado, parecia mais filhos (35%) do que em meninas (18%). Como observou-se que o déficit na área Motriz Grande é mais comum em crianças (15%) do que meninas (5%). Destaca a alta freqüência de déficits no desenvolvimento neuropsicomotor na população estudada, especialmente em crianças. Onde a área mais significativa foi Idioma. estimulação precoce e padrões parentais é recomendado para melhorar o desenvolvimento da linguagem e desempenho das crianças em outras áreas.

The effects of Pannexin1 in the osteogenic differentiation of the bone marrow mesenchymal stem cells with mechanical stimulation / 中华骨科杂志

Objective To explore the effects of Pannexin1 (Px1) channel protein on osteogenic differentiation of mesen?chymal stem cells (MSCs) under mechanical stress stimulation. Methods Bone marrow was extracted from Sprague Dawley (SD) rats (3 weeks, weighing 100-120 g) and cultured following 1st generation cellular technology. The safe dose of CBX (an inhibitor of Px1 channel protein) on MSCs was determined by CCK8 method and 100 μmol/L was used. The MSCs were cultured by the whole marrow culture method. When the cell was passaged to 3-4 generation, high purity of the MSCs were harvested. MSCs were divided into three groups:control group, stress?stimuli group (4 000μstrain) and stress stimuli+CBX group. The duration of stress was 15 min and CBX pre?treatment time point was 3 h, 6 h, 12 h, and 24 h, respectively. The alkaline phosphatase (ALP) activity, type I collagen expression, intracellular calcium ion (Ca2+) concentration, and Px1 channel protein, p?p38MAPK and p?ERK ex?pression were determined. Results ALP activities were highest in the stress group, and it was reduced by pretreatment of CBX. Similarly, stress increased the expression of type I collagen, concentration of Ca2+, and expressions of Px1 channel protein and p?p38MAPK was reduced by CBX. p?ERK was down?regulated by stress but not affected by CBX treatment. Conclusion Mechani?cal stress could promote osteogenic differentiation of MSCs and this promotion was inhibited by pretreatment of CBX, which might result in regulation of p?p38MAPK.

A Systematic Review and Meta-Analysis on the Effects of Oral Stimulation Interventions on the Transition from Tube to Oral Feeding in Premature Infants / 임상간호연구

PURPOSE: The purpose of this study was to evaluate the effects of oral stimulation interventions on the transition from tube to oral feeding in preterm infants through systematic review. METHODS: The randomized clinical trials published between 1980 and 2015 were searched using domestic and international databases, and five randomized studies were selected for this study. The quality of study was assessed by assessment tool from the SIGN and meta-analysis was performed using the Cochrane Review Manager software Version 5.3 (RevMan). RESULTS: Oral stimulation intervention in preterm infants decreased the transition time from tube to oral feeding (Post Menstrual Age, Day of life). Especially, a significant medium effect size was found in the number of days needed on the transition (ES=-4.95, p=.02). The oral stimulation intervention also had a significant large effect on the length of stay at hospital (ES=-8.33, p < .001). CONCLUSION: Based on the findings, oral stimulation interventions could be useful to facilitate the transition from tube to oral feeding in preterm infants in terms of reducing the length of stay at hospital and the number of days needed on transition.

Effects of N-acetylcysteine on behavior and monoamine neurotransmitters in rats with chronic unpredictable stress / 天津医药

Objective To investigate effects of N-acetylcysteine (NAC) on changes of the behavior and the monoamine neurotransmitters in prefrontal cortex (PFC), striatum (ST), amygdala (AM) and hippocampus (HIP) in rat model of chronic unpredictable stress (CUS), and to explore the possible mechanisms related to the NAC. Methods Thirty-two male Sprague-Dawle (SD) rats were divided into CUS group, fluoxetine group (FLX), NAC group and control group (n=8 for each group). Rats in CUS group, NAC group and FLX group were all fed alone and received CUS for 6 weeks to establish CUS model. Rats in NAC group and FLX group were given NAC and FLX by daily intragastric administration respectively during the last 3 weeks, while rats in CUS group and control group were given the same volume of solvent. Behavioral assessment including weight measurement, sucrose water consumption test, and opened field test were used for evaluation before and after CUS, and before and after intervention. The concentrations of the monoamine neurotransmitters (NE, DA, 5-HT) in PFC, ST, AM and HIP were measured with Coul array HPLC. Results (1) There were more increases in weight gain, sucrose consumption, and distance of horizontal moving and number of up-right, while the number of feces was less, after intervention in control group, NAC group and FLX group than those of CUS group (P<0.05). (2) Neurotransmitters including NE, DA and 5-HT were significantly decreased in PFC, ST, AM and HIP in CUS group compared with that of control group (P<0.05). The monoamine neurotransmitter (NE, DA and 5-HT) were significantly increased in the brain region (PFC, ST, AM and HIP) in NAC group and FLX group than those of CUS group (P < 0.05). Conclusion NAC and fluoxetine can effectively improve the depressive behavior of the CUS rats, increase the contents of monoamine neurotransmitters including NE, DA and 5-HT in PFC, AM, ST and HIP brain regions.

Nivel de conocimiento y actitudes de las madres puérperas sobre estimulación temprana en niños menores de un año en el Hospital Nacional Docente Madre-Niño San Bartolomé / Level of knowledge and attitudes postpartum mothers about earlystimulation in children below one year, Hospital Nacional Docente Madre-Niño San Bartolomé

Objetivo: medir el nivel de conocimientos y actitudes de las madres puérperas acerca de la estimulación temprana. Material y métodos: investigación descriptiva, cuantitativa y de corte transversal. La muestra estuvo conformada por 65 madres del Hospital San Bartolomé Madre-Niño. Se construyó dos tipos de cuestionario: el primero, para evaluar el nivel de conocimientos, y estuvo constituido por 15 preguntas; y el segundo, para evaluar el nivel de actitudes, constituido por 10 preguntas. Resultado: el nivel de conocimiento de las madres puérperas es alto en 24 (36,9%); medio en 29 (44,6%); y bajo en 12 (18,5%) de ellas. La actitud hacia la estimulación temprana es favorable en 23 (35%); indiferente en 28 (43%) y desfavorable en 14 (22%). Conclusiones: la mayoría de las madres presentan una actitud indiferente hacia la estimulación temprana, a pesar que tiene un conocimiento de nivel medio. Esa información debe llamar la atención de las enfermeras/os para su intervención oportuna.

Objective: To know the level of knowledge and attitudes of postpartum mothers abput early stimulation. Material and methods: Quantitative, descriptive and cross-sectional.With a sample formed by 65 mothers from Hospital San Bartolome Madre-Niño. It was used two types of questionnaires: one to assess the level of knowledge, which was composed of 15 questions and the other to assess the level of attitudes, consisting of 10 questions. Results: The knowledge's level of postpartum mothers is high with 24 (36.9%) medium 29 (44.6%) and low 12 (18.5%). The attitude toward early stimulation is favorable 23 (35%), indifferent 28 (43%) and unfavorable 14 (22%). conclusions: The most of the mothers have indifferent attitude toward early stimulation despiet of they have regular knowledge. This information must call attention of nurses in order to intervene.

Contribuição da aplicação do ultrassom de baixa potência na prevenção de osteopenia em tíbias de ratos sob ausência de carga / The contribution of the application of low power ultrasound to the prevention of rat tibial osteopenia under the absence of load

Este trabalho objetivou verificar se o ultrassom de baixa potência (US) previne a ocorrência de osteopenia em tíbias de ratos sob ausência de carga. Foram utilizados 45 Rattus novergicus albinus, Wistar adultos, machos, distribuídos em cinco grupos iguais: C - animais-controle livres em gaiolas por 21 dias; S - animais suspensos pela cauda por 21 dias; ST - suspensos pela cauda por 21 dias e concomitantemente tratados com US; S→C - suspensos por 21 dias e depois permanecendo livres em gaiolas por mais 21 dias; S→CT - suspensos por 21 dias e depois permanecendo livres em gaiolas por mais 21 dias e concomitantemente tratados com US. O tratamento foi realizado com US de 1,5MHz, ciclo de trabalho 1:4, 30mW/cm², na tíbia direita, por 15 sessões de 20 minutos cada, cinco sessões por semana. Ainda vivos, os animais foram submetidos a exame de densitometria óssea para verificação da densidade mineral óssea (DMO) e do conteúdo mineral ósseo (CMO). Após a eutanásia dos animais, as tíbias foram desarticuladas, dissecadas e submetidas a ensaio mecânico destrutivo para análise da força máxima (Fmáx) e da rigidez (R). Foram avaliados também o comprimento (L) e o diâmetro (D) no ponto médio da tíbia. O grupo S apresentou valores de DMO, CMO, Fmáx, R, L e D menores em relação ao grupo C, demonstrando que a suspensão pela cauda é prejudicial a estas variáveis. O tratamento dos animais suspensos com o US, grupo ST, elevou os valores de CMO e DMO em relação aos do grupo S, igualando-os aos do grupo C...

This work intended to verify if the low power ultrasound (US) prevents the occurrence of osteopenia on the tibia of rats under the absence of load. 45 adult male Wistar Rattus novergicus albinus were used, separated in five equal groups: C - control free animals in cages for 21 days; S - animals suspended by the tail for 21 days; ST - animals suspended by the tail for 21 days and concurrently treated with US; S→C - animals suspended for 21 days and then free in cages for another 21 days; S→CT - animals suspended for 21 days and then free in cages for another 21 days and concurrently treated with US. The treatment was performed with US with 1.5 MHz, work cycle 1:4, 30 mW/cm², on tibia, for 15 sessions of 20 minutes each, 5 sessions per week. While still alive, the animals underwent bone densitometry examination to verify the Bone Mineral Density (BMD) and the Bone Mineral Content (BMC). After the euthanasia of the animals, the tibias were disjointed, dissected and underwent destructive mechanical testing for the analysis of the maximum force (Fmax) and Rigidity (R). The length (L) and the diameter (D) of the middle point of the tibia were also measured. In group S, BMD, BMC, Fmax, R, L and D were smaller than in group C, demonstrating that the suspension by the tail is detrimental to these variables. The treatment of the suspended animals with the US, in group ST, increased the BMD and BMC compared to group S, leveling them to group C...

03-2 The physical stimulations promote the resilience and the homeostasis of our body and two mechanisms of them / 日本温泉気候物理医学会雑誌

Objective: We investigated the effects and the mechanism of the acupuncture. Methods: Nishijo/Mori and colleagues studied the function of the autonomic nervous system (ANS) with the instantaneous heart rate (IHR) as indicator. With the ANS blockers we also revealed the response of ANS when we insert needles to human body. For example, in our study of 1991, we conducted an experimental study on humans and elucidated that the physical stimulation promoted the resilience and the homeostasis of our body. Our recent study (2013) showed the physical stimulation (not acupuncture) on the lower thighs (mainly the bottom of the feet) also enhanced the above mentioned effects. Results and Discussion: 1.　The subjects sat on the chairs and they were given the acupuncture stimulation on their wrists (the skin and subcutaneous tissues) at the expiration. The stimulation for the duration of 15 consecutive breaths increased the function of the parasympathetic nerve (PN). At the same time that of the sympathetic nerve (SN) also enhanced. In short, firstly that of PN enhanced and secondly that of SN followed. Thus, it was observed that the physical stimulations promoted the resilience and the homeostasis of our body and we may regard that this is the first mechanisms. 2.　In our recent study (2013) the subjects sat on the chairs and there were given the stimulation (50 times of fist-strikes) on the sole of the feet. Immediately after the stimulation the result of Floor Finger Distance test （FFD) was improved. At the same time IHR, the indicator of the function of ANS, showed that those of SN (adrenaline β stimulus) and PN were simultaneously increased as soon as the stimulation started. The same result was obtained from the study of the body vibration (the SOUND healing). This process of 2013 was different from that of 1991, however, both of them provided the effect; the promotion of the resilience and the homeostasis of our body. Therefore, we could regard it as the second mechanism of the physical stimulations which promotes the resilience and the homeostasis of our body. Conclusion: In this way, there are two mechanisms of the physical stimulation in promoting the resilience and the homeostasis of our body.

Clinical value of nerve stimulator-versus ultrasound-guided continuous femoral nerve block for analgesia after laparoscopic surgery / 中华麻醉学杂志

Objective To compare the clinical value of nerve stimulator-versus ultrasound-guided continuous femoral nerve block for analgesia after laparoscopic surgery.Methods Forty patients,aged 18-60 yr,with body mass index of 18-30 kg/m2,of ASA physical status Ⅰ or Ⅱ,scheduled for elective laparoscopic surgery,were randomly assigned into 2 groups (n =20 each) using a random number table:nerve stimulator group (group S) and ultrasound group (group U).Epidural anesthesia was performed with 1.73 ％ carbonated lidocaine in both groups.0.2％ ropivacaine 5 ml/h was infused continuously after surgery to perform femoral nerve block for analgesia.VAS score at rest was assessed at 2,6,24 and 48 h after surgery.At 24 and 48 h after surgery,VAS scores during active and passive movement were assessed.The time for catheter placement near the femoral nerve and development of subcutaneous hematoma at the puncture site,local anesthetic intoxication and nausea and vomiting were recorded.The postoperative requirement for analgesics was also recorded.Results There was no significant difference in the VAS scores and puncture for femoral nerve block-and local anesthetics-related adverse events between the two groups.The time for catheter placement near the femoral nerve was 8.0 ± 1.4 and (6.7 ± 0.9) min in S and U groups,respectively,and the time was significantly longer in group S than in group U.No patients required rescue analgesic after surgery in both groups.Conclusion Nerve stimulator-guided continuous femoral nerve block provides higher clinical value than ultrasound-guided continuous femoral nerve block for analgesia after laparoscopic surgery and it is more suitable for clinical application.

03-2The physical stimulations promote the resilience and the homeostasis of our body and two mechanisms of them / 日本温泉気候物理医学会雑誌

<b>Objective:</b> We investigated the effects and the mechanism of the acupuncture.<BR><b>Methods:</b> Nishijo/Mori and colleagues studied the function of the autonomic nervous system (ANS) with the instantaneous heart rate (IHR) as indicator. With the ANS blockers we also revealed the response of ANS when we insert needles to human body. For example, in our study of 1991, we conducted an experimental study on humans and elucidated that the physical stimulation promoted the resilience and the homeostasis of our body. Our recent study (2013) showed the physical stimulation (not acupuncture) on the lower thighs (mainly the bottom of the feet) also enhanced the above mentioned effects.<BR><b>Results and Discussion:</b> <BR>1.　The subjects sat on the chairs and they were given the acupuncture stimulation on their wrists (the skin and subcutaneous tissues) at the expiration. The stimulation for the duration of 15 consecutive breaths increased the function of the parasympathetic nerve (PN). At the same time that of the sympathetic nerve (SN) also enhanced. In short, firstly that of PN enhanced and secondly that of SN followed. Thus, it was observed that the physical stimulations promoted the resilience and the homeostasis of our body and we may regard that this is the first mechanisms.<BR>2.　In our recent study (2013) the subjects sat on the chairs and there were given the stimulation (50 times of fist-strikes) on the sole of the feet. Immediately after the stimulation the result of Floor Finger Distance test （FFD) was improved. At the same time IHR, the indicator of the function of ANS, showed that those of SN (adrenaline β stimulus) and PN were simultaneously increased as soon as the stimulation started. The same result was obtained from the study of the body vibration (the SOUND healing). This process of 2013 was different from that of 1991, however, both of them provided the effect; the promotion of the resilience and the homeostasis of our body. Therefore, we could regard it as the second mechanism of the physical stimulations which promotes the resilience and the homeostasis of our body.<BR><b>Conclusion:</b> In this way, there are two mechanisms of the physical stimulation in promoting the resilience and the homeostasis of our body.

A estimulação russa no fortalecimento da musculatura abdominal / Russian stimulation in strengthening abdominal muscle

INTRODUÇÃO - A flacidez muscular surge com maior frequência nas mulheres, o que causa fator ruim para a estética corporal. OBJETIVO - Analisar os resultados da corrente russa no fortalecimento da musculatura abdominal. MÉTODOS - Revisão bibliográfica com base nas publicações acessíveis pelas seguintes bases de dados: Medline/Pubmed, Scielo, Lilacs com cruzamento dos descritores corrente russa, flacidez, abdômen. O uso da eletroestimulação age tanto sobre as fibras brancas, que respondem pela velocidade, como também sobre as fibras vermelhas dado à sua sustentação, e ainda sobre as fibras intermediárias. CONCLUSÃO - Os dados publicados mostram a satisfação e êxito do tratamento, enfatizando que a corrente russa favorece o aumento da hipertrofia e força muscular.

INTRODUCTION - Muscle weakness appears most often in women, the factor that causes bad esthetics. OBJECTIVE - To analyze the results of the Russian current strengthening the abdominal muscles. METHODS - Literature review based on publications available in the following databases: Medline / Pubmed, Scielo, Lilacs with crossing headings Russian current, sagging, abdomen. The use of electrical stimulation acts both on the white fibers, which account for the speed, but also on the red fibers given their support, and on intermediate fibers. CONCLUSION - The data published show the satisfaction and success of treatment, emphasizing that the Russian current promotes increase of muscle strength and hypertrophy.