Descripción de la experiencia en RM cerebral fetal en Cali - Colombia / Experience description in fetal magnetic resonance in Cali - Colombia

Resumen: Objetivo: Describir la experiencia en la implementación de resonancia magnética fetal en alteraciones del sistema nervioso en un centro de alto nivel en Cali - Colombia. Materiales y métodos: Estudio descriptivo observacional retrospectivo. Se analizaron los casos de resonancia magnética fetal (RMF) entre septiembre del 2011 y abril del 2017. Se registró y analizó la información demográfica, clínica e imagenológica disponible en los informes radiológicos e historia clínica. Resultados: Se analizaron 36 estudios de RMF cerebral, la edad promedio de las pacientes fue 29.7 ± 5.2 años, la edad gestacional promedio fue 31.8 ± 3.5 semanas. El hallazgo más frecuente fue ventriculomegalia en 47.2% de casos (n= 17), patologías adquiridas n=6 (16.7%), alteraciones del tubo neural n=5 (13.9%), y anormalidades del cuerpo calloso n=3 (8.3%). Cuatro pacientes tuvieron estudio postnatal. Conclusión: La frecuencia de anomalías cerebrales encontradas en esta revisión es congruente con lo reportado en la literatura.

Abstract: Objective: To describe the experience with the use of fetal magnetic resonance in alterations of the nervous system, in a high level center in Cali - Colombia. Methods: A retrospective observational descriptive study was made. We analyzed all cases of fetal MRI between September 2011 and April 2017. Demographic, clinical and imagenological information were reviewed. Including age, gestational age, type of gestation, study indication and imagenological fidings. Results: 36 fetal brain MRI were analyzed. The average age of cases was 29.7 ± 5.2 years-old with an average of 31.8 ± 3.5 weeks of gestation. All cases were single gestation. The most frequent result was ventriculomegaly n=17(47.2%), acquired pathologies n=6 (16.7%), neural tube anormalities n=5(13.9%), and corpus callosum anomalies n=3(8.3%). Conclusions: The frequencies of fetal cerebral anomalies found in this study were congruent with literature.

Efecto de la frecuencia e intensidad de intervenciones terapéuticas basadas en neurodesarrollo en niños con parálisis cerebral: una revisión sistemática / Effects of frequency and intensity of neurodevelopmentaltreatment interventions in children with cerebral palsy. a systematic review

Introduction: Cerebral palsy (CP) is a health condition causing very different levels of function limitation in children. Neurodevelopmental treatment is used with different frequencies and intensities, however there is no consensus regarding optimal dose. Objective: To perform a systematic assessment of the effectiveness of different intensities and/or frequencies of neurodevelopmental intervention in gross motor function, spasticity and range of joint motion, in children diagnosed with cerebral palsy. Materials and Methods: The systematic review was carried out following Cochrane Collaboration recommendations. Randomized and quasi-randomized clinical studies were considered, including > 14 year-old CP diagnosed children as subjects, classified using GMFCS I-V. The search was run in the following databases: PubMed, PEDro, CENTRAL, CINAHL Plus, EMBASE, OpenGrey, LILACS and SciELO. Two independent researchers were responsible for the selection of the studies. Disagreements were resolved by means of a consensus. A descriptive analysis was carried out on the selected studies. The Cochrane Collaboration’s tool for assessing risk of bias was used. Results: Only two of the 484 studies met all eligibility criteria. None of the selected studies showed significant differences between the high intensity or high frequency groups compared to the control groups. Conclusions: There is not enough evidence to conclude if a type of therapeutic frequency or intensity will determine the therapeutic results of neurodevelopmental treatment that are expected in children with CP.

Introducción: La parálisis cerebral es una condición de salud que determina grados muy variables de limitación en la función de niños y niñas. El neurodesarrollo, como intervención terapéutica, se utiliza con variadas frecuencias e intensidades no existiendo consenso respecto de la mejor dosificación. Objetivo: Evaluar sistemáticamente la efectividad de distintas intensidades y/o frecuencias de la intervención de neurodesarrollo en niños diagnosticados con parálisis cerebral en la función motora gruesa, espasticidad y rango articular. Material y Método: La revisión sistemática se realizó siguiendo las recomendaciones de la Colaboración Cochrane. Se incluyeron ensayos clínicos aleatorizados o cuasi aleatorizados, que contuvieran como población niños con PC menores de 14 años, clasificados según GMFCS I-V. La búsqueda se llevó a cabo en las bases de datos PubMed, PEDro, CENTRAL, CINAHL Plus, EMBASE, OpenGrey, LILACS y SciELO. La selección de los estudios la realizaron dos investigadores independientes. Los desacuerdos se resolvieron mediante consenso. Se realizó un análisis descriptivo de los estudios seleccionados. La evaluación del riesgo de sesgo se realizó con la herramienta de Colaboración Cochrane. Resultados: De los 484 trabajos, sólo dos reunían todos los criterios de elegibilidad. Ninguno de los trabajos seleccionados demostró diferencias significativas entre los grupos de alta intensidad o frecuencia en comparación con el control. Conclusiones: No existe evidencia suficiente para concluir si un tipo de frecuencia o intensidad de intervención terapéutica basada en neurodesarrollo determinará los resultados clínicos esperados en niños con parálisis cerebral.

Evaluation of neuromotor development by means of the Harris Infant Neuromotor Test / Evaluación del desarrollo neuromotor del niño a través del harris infant neuromotor test / Avaliação do desenvolvimento neuromotor da criança por meio do Harris Infant Neuromotor Test

Objective: To investigate the neuromotor development of at-risk children between three and 12 months of life, administering the Brazilian version of the Harris Infant Neuromotor Test (HINT).Method: A longitudinal study, with 78 children and 76 parents/guardians discharged from a neonatal intensive care unit in Fortaleza-CE/Brazil. Two instruments were administered: HINT and a socioeconomic questionnaire, between July/2009 to August/2010. Data from 55 preterm and 23 term children were analyzed. Results: The final mean scores ranged from 14.6 to 25.2 and from 11.2 to 24.7, for preterm and term, respectively, showing that 91% of children demonstrated good neuromotor performance; seven premature infants showed alterations which led to the referral of three children to a specialized clinic for examination and diagnostics.Conclusion: The test allowed nurses to assess infant development, identify deviations early, and plan interventions.

Objetivo: Investigar el desarrollo neuromotor de los niños en riesgo entre tres y 12 meses de vida, por medio de la versión brasileña del Harris Infant Neuromotor Test (HINT). Método: Estudio longitudinal con 78 niños y 76 padres egresados ​​de una Unidad de Cuidados Intensivos Neonatales en Fortaleza-CE, Brasil. Se aplicaron dos instrumentos: HINT y un cuestionario socioeconómico, entre los meses de julio de 2009 a agosto de 2010. Se analizaron 55 niños prematuros y 23 niños nacidos de término. Resultados: Las puntuaciones medias finales oscilaron entre 14,6 a 25,2 y 11,2 a 24,7 para los recién nacidos prematuros y de término respectivamente. El 91% de los niños mostraron un buen desempeño neuromotor y siete recién nacidos prematuros mostraron alteraciones, lo que implicó la derivación de tres niños a un servicio especializado para exámenes y diagnósticos. Conclusión: El test permitió a los enfermeros evaluar el desarrollo infantil, identificar precozmente la presencia de desviaciones y planificar intervenciones.
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Objetivo: Investigar o desenvolvimento neuromotor das crianças de risco, entre três e 12 meses de vida, aplicando o Harris Infant Neuromotor Test (HINT), na versão brasileira.Método: Estudo longitudinal, com 78 crianças e 76 pais/responsáveis egressos de Unidade de Terapia Intensiva Neonatal, em Fortaleza-CE/Brasil. Aplicaram-se dois instrumentos: HINT e questionário socioeconômico, de julho/2009 a agosto/2010. Analisaram-se 55 crianças nascidas prematuras e 23 a termo. Resultados: A média final dos escores variou de 14,6 a 25,2 e 11,2 a 24,7, para os prematuros e a termo, respectivamente, mostrando que 91% das crianças evidenciaram bom desempenho neuromotor e sete, nascidas prematuras, apresentaram alterações, o que implicou encaminhamento de três crianças ao serviço especializado para exames e diagnósticos. Conclusão: O teste possibilitou aos enfermeiros avaliar o desenvolvimento infantil, identificar desvios precoces e planejar intervenções.
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RIC-8B, uma GEF de sistema olfatório, é essencial para o desenvolvimento do sistema nervoso / RIC-8B, an olfactory GEF, is essential for the development of the nervous system

RIC-8B é um fator trocador de nucleotídeo de guanina (GEF) predominantemente expresso em neurônios olfatórios maduros de camundongos adultos. Trabalhos desenvolvidos em nosso laboratório mostraram que RIC-8B interage com Gαolf e Gγ13, duas subunidades de proteína G que estão enriquecidas nos cílios dos neurônios olfatórios, onde participam da transdução do sinal de odorantes. In vitro, RIC-8B é capaz de amplificar a sinalização de receptores olfatórios através de Gαolf, no entanto, seu papel fisiológico ainda é desconhecido. Para determinar a função desempenhada por essa proteína in vivo, nós utilizamos a tecnologia de Gene Trap com o objetivo de produzir um camundongo knockout para Ric-8B. Apesar de a expressão de Ric-8B ser restrita a poucos tecidos no camundongo adulto, descobrimos que homozigotos para a mutação em Ric-8B são inviáveis e morrem por volta do dia embrionário E10,5. Além disso, são menores e apresentam evidente falha no fechamento do tubo neural na região cranial (exencefalia). Utilizamos o gene repórter ß-galactosidase expresso pelo alelo mutado para determinar o padrão de expressão de Ric-8B em embriões durante o desenvolvimento. Observamos que, no estágio E8,5, Ric-8B é expresso nas pregas neurais da região cefálica e na notocorda. De E9,5 a E12,5, a expressão de Ric-8B é detectada predominante no assoalho da placa. Esse padrão de expressão se assemelha ao de outro gene importante para a embriogênese, Sonic hedgehog (Shh). SHH é um morfógeno diretamente responsável pela padronização dorsoventral do sistema nervoso central e sua sinalização depende de cílio primário. Cílio primário é uma organela baseada em microtúbulos que se projeta da superfície da maioria das células de mamíferos e funciona como um centro de sinalização intracelular. Nossos dados mostram que fibroblastos embrionários Ric-8B-/- formam cílios primários, assim como alguns tecidos do embrião. Além disso, não encontramos alterações na sinalização de Shh em embriões homozigotos mutantes. No entanto, observamos que esses embriões apresentam apoptose aumentada em células migratórias da crista neural cranial. Shh é importante para a sobrevivência de células da crista neural migratória, sugerindo um possível papel para Ric-8B a downstream da sinalização de SHH

Ric-8B is a guanine nucleotide exchange factor (GEF) which is predominantly expressed in mature olfactory sensory neurons in adult mice. We have previously shown that RIC-8B interacts with both Gαolf and Gγ13, two G protein subunits, which are enriched in olfactory cilia and are required for odorant signal transduction. In vitro, RIC-8B is able to amplify odorant receptor signaling through Gαolf, however, its physiological role remains unknown. To determine the role played by RIC-8B in vivo we used the Gene trap technology to generate a Ric-8B knockout mouse. We found that, despite the limited distribution of Ric-8B gene expression in adult mice, Ric-8B homozygous mutants are not viable and die around the E10,5 stage. Mutant embryos are also smaller and fail to close the neural tube at the cranial region (exencephaly). We used the activity of the ß-galactosidase reporter gene to determine the pattern of expression of the Ric-8B gene in heterozygous embryos. At E8,5 the Ric-8B gene is expressed in the notochord and neural folds of the cephalic regions. From E9,5 to E12,5 Ric-8B is predominantly expressed in the floor plate, in a pattern that strongly resembles the one shown by Sonic hedgehog (Shh). SHH is a morphogen directly responsible for the dorsoventral patterning of the central nervous system and its signaling depends on primary cilia. Primary cilia are microtubule-based organelles that protrude from the surface of mammalian cells and act as a signaling center. We show that Ric-8B-/- embryonic fibroblasts and some embryonic tissues grow primary cilia normally. In addition, we did not find alterations in the SHH signaling of homozygous mutants. Instead, we found an increased apopotosis in migratory cells of the cranial neural crest in these embryos. Shh is an important factor to survival of neural crest cells, suggesting a role for RIC-8B downstream of the SHH signaling

Neonatal seizures; types, etiology and long term neurodevelopmental outcome at a tertiary care hospital

To study the types, etiology and long term neurodevelopmental outcome in neonates with seizures.A descriptive cross-sectional study. PNS Shifa Naval hospital Karachi from Jan 2011 to Feb 2014.Population: Ninety six neonates of either gender presented with seizures at NICU PNS Shifa Naval hospital Karachi were studied. Method: All neonates with seizures were evaluated. The seizures were classified according to the simiology. They were investigated according to NICU protocol to confirm the underlying diagnosis and timely management. The patients after discharge were regularly followed up for one year to assess the long term neurodevelopmental outcome. A total of 96 neonates with seizures were studied and it was observed that 60 [62.5%] were male babies and 56 [58.33%] were term with a male to female ratio of 1.6:1. Majority of the neonatal seizures were seen in 1stweek of life [85%]. The most common type of seizures was clonic 40 [41.67%] followed by subtle 20 [20.84%], mixed 16 [16.67%], tonic 10 [10.41%], myoclonic 5 [5.20%] and unclassified 5 [5.20%]. Antiepileptics were used in 82 [85.41%] patients. Phenobarbitone 49 [59.76%] was most commonly prescribed drug. The most common cause of seizures was birth asphyxia 48 [50%] followed by metabolic 16 [16.68%], sepsis 10 [10.41%], intracranial hemorrhage 6 [6.25%], bilirubin encephalopathy 4 [4.16%], inborn errors of metabolism 2 [2.08%], birth trauma 2 [2.08%] and unknown etiology 5 [5.20%]. 25 [26.04%] patients develop adverse neurodevelopmental outcome i.e. cerebral palsy with epilepsy 10 [40%] and cerebral palsy without epilepsy 05 [20%], developmental delay 10 [40%]. Mortality in the study was 12 [12.5%]. Clonic seizures are commonest in neonates apart from infants and children who have GTCS. The most common etiology of seizures in neonates is birth asphyxia. Phenobarbitone is still the most commonly prescribed antiepileptic. Quick assessment, timely diagnosis and aggressive management according to the etiology are necessary to prevent the morbidity and mortality associated with neonatal seizures. Long term neurodevelopmental outcome is worse in patients with birth asphyxia especially with low Apgar score at 5 minutes. Normal delivery and birth asphyxia were the major risk factors for cerebral palsy

Desarrollo de la médula espinal de salmón (Salmo salar) durante el período post-eclosional / Development of spinal cord of the salmon (Salmo salar) during the period post eclosional

En este estudio se describe el desarrollo post-eclosional de la médula espinal del salmón. Salmo salar. Se utilizaron 200 alevines recién eclosionados, los que fueron cultivados en el Centro de Estudios Acuícolas de la Universidad de Chile. Las condiciones ambientales de cultivo fueron de un 90% de saturación de oxigeno. La temperatura ambiental se mantuvo en 7°C. A los días 1, 3, 5 7 ds post-eclosión, 50 alevines por grupo etario fueron anestesiados y sacrificados por exposición a 5% Benzocaina diluida en agua (Kalmagin 20®, Farquímica). Posteriormente fueron fijados en formalina tamponada al 10% y procesados mediante técnica histológica. Para cada alevín se tomaron a nivel de la aleta dorsal un total de 40 cortes coronales seriados de 5µm de grosor, los que fueron procesados de acuerdo a las técnicas Cresil violeta. La cuantificación neuronal se realizó sobre imágenes microscópicas mediante el método del disector. Los resultados obtenidos se sometieron a una prueba de Coeficiente de Kurtosis con el propósito de analizar el grado de concentración que presentan los valores alrededor de la zona central de la distribución. La médula espinal de los alevines de 1 día es poco diferenciada. En los alevines de 3, 5 y 7 días se diferencian gradualmente las neuronas de la sustancia gris, pero no presenta la distribución característica en forma de "Y" invertida del salmón adulto. El número de neuronas aumenta desde 67+1.7 en el día 1 hasta 88+2.1 en el día 7. Esta observación se puede relacionar con la ausencia de movimientos natatorios de los peces durante los primeros días ya que estos caen sobre la gravilla al fondo de las bateas. Un factor determinante en la adquisición de la morfología de la médula espinal es el inicio de los movimientos natatorios, lo que ocurre aproximadamente al quinto día post-eclosión. La actividad motriz activa permite que las neuronas de la médula espinal sean reclutadas y se formen y activen las redes neurales, permaneciendo finalmente los circuitos más eficientes. El aumento del número de neuronas se puede explicar por neurogénesis post-eclosión, como ocurre en otros teleósteos. Este estudio indica que al momento de la eclosión, el sistema nervioso está muy indiferenciando, y que durante las primeras semanas de vida del alevín ocurre la diferenciación de las neuronas y neurogénesis. Este conocimiento es muy importante debido a que en las pisciculturas se cuidan las ovas, y se descuida la fase del alevinaje en la creencia que los tejidos están constituidos.

We describe the development of the spinal cord during the post eclosion period of the salmon (Salmo salar).We used a total of 200 newly hatched fry grown in the Aquaculture Research Center of the Universidad de Chile. Environmental conditions were of 90% oxygen saturation. Ambient temperature was maintained at 7° C. At days, 1, 3, 5 and 7, post-hatching, 50 fry were anesthetized and sacrificed by exposure to 5% benzocaine diluted in water, (Kalmagin 20 ®, Farquímica). They were then fixed in 10% buffered formalin and processed by histological technique. For each juvenile a total of 40 serial coronal sections of 5µm were taken at the level of the dorsal fin, which were then processed according to cresyl violet techniques.Neuronal quantitation was performed on microscopic images by dissector method. The results obtained were subjected to coefficient Kurtosis test in order to analyze the degree of concentration of values around the central distribution area.The spinal cord of the one-day fry is poorly differentiated. In fry of 3, 5 and 7 days neurons are gradually differentiated, they do not however present the characteristic neuronal distribution inverted "Y" of the adult salmon. The number of neurons increases from 67±1.7 on day one, to 88±2.1 on day 7.This observation may be related to the absence of fish swimming movements during days one and three as these fall on the gravel at the bottom of the trays. A determining factor in the acquisition of the morphology of the spinal cord is the start of swimming movements, which occur at around the fifth day post-hatching.Active motor activity allows spinal cord neurons to be recruited and form to activate neural networks, to remain finally in the most efficient circuits. Increasing the number of neurons can be explained by post-hatching neurogenesis as in other teleosts.This study indicates that at the time of hatching, the nervous system is very undifferentiated and that neuron differentiation and neurogenesis occur during the first weeks of life. This knowledge is very important as fish farms take care of eggs, neglecting the nursery stage in the belief that tissues are formed.

Origen y Migración de Células Troncales / Stem Cells Origin and Migration

La generación de progenitores celulares, su migración y distribución a través del organismo, es determinante en la generación de divergencia morfológica y evolución de las distintas especies de vertebrados. Las células progenitoras transitan por diferentes compartimentos durante el desarrollo embrionario y su exposición a diferentes medioambientes tisulares estimula la activación de programas específicos de diferenciación. En este capítulo discutiremos el origen de diferentes poblaciones de células migratorias, tales como las células madre embrionarias, las células germinales primordiales y las células de la cresta neural, con un enfoque en los distintos factores moleculares activados durante la migración hacia distintos compartimientos embrionarios.

Generation, migration and distribution of stem cells throughout the body are a major process in the generation of morphological divergence and evolution in different species of vertebrates. Progenitor cells pass through different compartments during embryonic development and the exposition to different tissue environments stimulates the activation of specific differentiation programs. In this chapter we discuss the origin of different migratory cell populations, such as embryonic stem cells, primordial germ cells and neural crest cells, with focus on the different molecular factors activated during migration to different embryonic compartments.

Educação em saúde: repercussões no crescimento e desenvolvimento neuropsicomotor do recém-nascido / Health education: repercussions in the neuropsychomotor growth and development of the newborn / Educación en salud: repercusiones en el crecimiento y el desarrollo neurológico y psicomotor del recién nacido

O período pós-parto caracteriza-se por grandes transformações físicas e emocionais, em que puérperas e familiares muitas vezes experimentam sentimentos e emoções ambivalentes e conflitantes, gerando necessidade de orientação e apoio profissional. Assim, buscou-se avaliar as evidências disponíveis na literatura sobre educação em saúde por parte da equipe de enfermagem para puérpera e familiares sobre cuidados com o recém-nascido, que reflita em seu adequado crescimento e desenvolvimento neuropsicomotor. Realizou-se revisão integrativa da literatura que resultou na análise de sete artigos. Ficou evidente a necessidade de incentivo à participação do núcleo familiar na construção do cuidado à criança potencializando o sucesso dos resultados das ações em saúde, uma vez que proporciona a este núcleo autonomia e confiança em seus atos.

The postpartum period is characterized by great physical and emotional changes, when parturients and families experience ambivalent and conflicting feelings and emotions, especially with the arrival of the baby, requiring the need of professional orientation and support. Having it in mind, it was searched the available literature evidence about health education, coming from a nursing team and directed to parturients and families, dealing with the newly born care and regarding its appropriate neuropsychomotor growth and development. It is clear the need of motivating the mother and the family to participate in the development of child care, increasing the success of health action results, once it provides autonomy and trust to this nucleus towards its acts, especially to the maternal role.

El período posparto se caracteriza por grandes transformaciones físicas y emocionales, donde las madres y miembros de la familia a menudo experimentan sentimientos y emociones ambivalentes y contradictorias, creando la necesidad de orientación profesional y de apoyo. Hemos tratado de evaluar la evidencia disponible en la literatura sobre educación para la salud por el personal de enfermería para la atención post-parto y la familia sobre el bebé que se refleja en su crecimiento y desarrollo psicomotor, lo que resultó en el análisis de siete artículos. Es evidente la necesidad de fomentar la participación de la familia en el cuidado infantil aprovechando el éxito de los resultados de las intervenciones de salud, ya que proporciona la autonomía central y la confianza.

Using systematic reviews and meta-analyses to support regulatory decision making for neurotoxicants: lessons learned from a case study of PCBs / Utilizando revisões sistemáticas e meta-análise de apoio às decisões regulatórias para neurotóxicos: lições de um estudo de caso dos PCBs

We examined prospective cohort studies evaluating the relation between prenatal and neonatal exposure to polychlorinated biphenyls (PCBs) and neurodevelopment in children to assess the feasibility of conducting a meta-analysis to support decision making. We described studies in terms of exposure and end point categorization, statistical analysis, and reporting of results. We used this evaluation to assess the feasibility of grouping studies into reasonably uniform categories. The most consistently used tests included Brazelton's Neonatal Behavioral Assessment Scale, the neurologic optimality score in the neonatal period, the Bayley Scales of Infant Development at 5-8months of age, and the McCarthy Scales of Children's Abilities in 5-year-olds. Despite administering the same tests at similar ages, the studies were too dissimilar to allow a meaningful quantitative examination of outcomes across cohorts. These analyses indicate that our ability to conduct weight-of-evidence assessments of the epidemiologic literature on neurotoxicants may be limited, even in the presence of multiple studies, if the available study methods, data analysis, and reporting lack comparability.

Foram examinados estudos de grupo que avaliaram a relação entre a exposição pré-natal e neonatal aos bifenilos policlorados (PCB) e o desenvolvimento neuropsicomotor em crianças a fim de avaliar a viabilidade da realização de uma meta-análise para suporte à tomada de decisão. Nós descrevemos os estudos em termos de exposição, categorizações, análise estatística e elaboração de relatórios de resultados. Nós utilizamos esta avaliação para verificar a viabilidade de agrupar os estudos em categorias razoavelmente uniformes. Os testes mais utilizados foram Brazelton Neonatal Behavioral Assessment Scale, a pontuação de otimalidade neurológica no período neonatal, as Escalas Bayley de Desenvolvimento Infantil de 5 a 8 meses de idade, e as Escalas McCarthy de habilidades das crianças em 5 anos de idade. Apesar de administrar os mesmos testes com idades semelhantes, os estudos foram muito diferentes para permitir uma análise quantitativa significativa dos resultados entre grupos. Estas análises indicam que a nossa capacidade de realizar avaliações da literatura epidemiológica sobre neurotóxicos pode ser limitada - mesmo na presença de vários estudos - se não existe nenhuma forma de comparação com os métodos de estudo disponíveis e análise dos dados.

Bases neurales del desarrollo de las funciones ejecutivas durante la infancia y adolescencia: una revisión / Neural basis of executive function development during childhood and adolescence: a review

Las funciones ejecutivas constituyen un controvertido constructo, bajo el cual se han agrupado diferentes procesos cognitivos asociadas al control consciente del pensamiento, comportamiento y afectividad. Gran parte de los mismos, comienzan su desarrollo en la infancia, culminando dicho proceso a fines de la adolescencia. A nivel anatómico, el funcionamiento ejecutivo (FE) ha sido vinculado a la actividad de la corteza prefrontal y la corteza cingulada, entre otras regiones cerebrales. El objetivo del presente artículo, es realizar una revisión de los cambios en la actividad cortical que han sido asociados a las mejoras en el FE durante la infancia y adolescencia. Para tal fin, se realizará una recopilación de diversos estudios con fMRI comparativos de la performance y actividad neuronal de infantes, adolescentes y adultos; durante la ejecución de tareas de FE. Se concluirá resaltando la necesidad de ampliar el número de estudios comparativos con tales características. Dichas investigaciones, podrían facilitar el diseño de estrategias preventivas y terapéuticas más específicas para el abordaje de las diferentes patologías asociadas al FE.

Executive functions is a controversial construct, under which are grouped different cognitive processes associated with conscious control of thought, behavior and emotion. Much of them, begin their development in childhood, finishing it in late adolescence. In the anatomical level, executive function (EF) has been linked to the activity of the prefrontal cortex and the cingulate cortex, among other brain regions. The purpose of this article is to review the changes in cortical activity that has been associated with improvements in EF during childhood and adolescence. To this goal, there will be a compilation of several fMRI studies that compare the performance and neuronal activity between infants, adolescents and adults during the performance of EF tasks. It will conclude by stressing the need to expand the number of comparative studies with such characteristics. Such research may facilitate the design of preventive and therapeutic strategies for addressing numerous pathologies associated with the FE.

Papel da proteína prion celular e seus ligantes no desenvolvimento do sistema nervoso / Gene expression characterization of WNT signaling pathway and epithelial-mesenchymal transition during kidney embryogenesis and their implications in Wilms tumors

A proteína prion celular (PrPC) é altamente expressa no sistema nervoso e sua. modificação estrutural está relacionada as encefalopatias espongiformes transmissíveis.. PrPC associa-se com proteínas de matriz extracelular, como a laminina (Ln) e. vitronectina (Vn) e também com a co-chaperonina stress inducible protein 1 (STI1).. Estes complexos estão envolvidos em diferentes processos relacionados ao. desenvolvimento do sistema nervoso. No desenvolvimento embrionário de camundongo. a distribuição de PrPC, Vn e STI1 é espaço-temporalmente relacionada, iniciando-se a. partir do oitavo dia embrionário para STI1 e Vn e no décimo para PrPC. As três proteínas. apresentam um padrão de expressão na medula espinhal em forma de gradiente, com. maior expressão na região ventral do tubo neural e notocorda e diminuindo na porção. dorsal, o que sugere o seu envolvimento na organização do sistema nervoso. A STI1. assim como o peptídeo da cadeia γ1 laminina (Ln-γ1), correspondente ao domínio de. ligação de PrPC, são capazes de promover axonogênese em neurônios de gânglios da raiz. dorsal. Quando combinados, Ln-γ1 e STI1 apresentam um efeito sinérgico sobre a. axonogênese através da mobilização intracelular de cálcio e pela ativação de Erk1/2. O. aumento na concentração intracelular de cálcio pela ligação de STI1 a PrPC é mediado. pela abertura de canais presentes na membrana. Por outro lado, o complexo PrPC-Ln-γ1. mobiliza cálcio a partir de estoques intracelulares. A interação PrPC-STI1 também é. importante na biologia de células tronco neurais. Precursores neurais (neuroesferas). derivados de animais deficientes para PrPC apresentam comprometimento de autorenovação. quando comparados aqueles provenientes animais tipo-selvagem. A ligação. de STI1 a PrPC promove um aumento na proliferação de precursores neurais,. desempenhado um papel chave nos mecanismos de auto-renovação destas. Portanto,. PrPC é capaz de se associar a diferentes ligantes desempenhando um papel relevante no desenvolvimento do sistema nervoso central e periférico.

The cellular prion protein (PrPC) is highly expressed in thenervous system and its structural modification is associated to transmissible espongiform encephalopathies. PrPC associates with extracellular matrix proteins, such as laminin (Ln) and vitronectin (Vn) and also to the co-chaperonin stress inducible protein 1 (STI1).These PrPC complexes are involved in to the development of the nervous system. During the mouse embryo development, PrPC , Vn and STI1 distribution is spatiotemporally related. STI1 and Vn expression became evident at embrionary day 8 (E8), while PrPC is initialy detected at E10. These three proteins present a gradient of expression in spinal cord, more abundant in the notochord and floor plate, suggesting that they can have a role in brain patterning. STI1 as well as the peptide from laminin γ1 chain (Ln-γ1), which corresponds to PrPC binding site, are able to promote axonogenesis in dorsal root ganglia neurons. When combined, STI1 and Ln-γ1 shown a synergic effect upon axonogenesis through intracellular Ca2+ mobilization and Erk1/2 activation. The increment of intracellular Ca2+ promoted by STI1 binding to PrPC is mediated by Ca2+ channels at the plasma membrane. On the other hand, the complex Ln-γ1-PrPC mobilizes Ca2+ from intracellular stores. The interaction between PrPC and STI1 is also important in neural stem cells biology. Neural precursors (neurospheres) derived from PrPC -null mice present impairment of selfrenewal compared to wild-type neuronal precursors. In addition, STI1 binding to PrPC promotes the proliferation of neural precursors, performing a key role in the self-renewal of stem cells. Thus, PrPC is able to associate with different ligands and presents a relevant role in the development of central and peripheric nervous system.

A importância dos ácidos graxos poliinsaturados de cadeia longa na gestação e lactação / The significance of long chain polyunsaturated fatty acids in pregnancy and lactation

Os ácidos graxos poliinsaturados de cadeia longa (AGPICL), ácido docosahexaenóico (DHA) e ácido araquidônico (AA) são componentes essenciais não só para o desenvolvimento neurológico quanto para a função visual da criança. O objetivo desta revisão foi buscar estudos recentes sobre a importância desses nutrientes no período gestacional e neonatal. A maior necessidade dos AGPICL ocorre durante a vida intra-uterina e nos primeiros meses de vida. A mãe é um fator determinante na oferta desses ácidos graxos para a criança. O leite materno contém todos os nutrientes necessários para o crescimento e desenvolvimento da criança. O bebê não tem capacidade de elongação e dessaturação dos ácidos graxos e dessa maneira as fórmulas infantis devem conter AGPICL pré-formados.

Long chain polyunsaturated fatty acids (LC-PUFAS), docosahexaenoic acid (DHA) and arachinodonic acid (AA) are essential components for both neurological development and visual function of the child. This review focused on recent studies concerning the value of these nutrients during gestational and neonatal periods. The need for (LC-PUFAS) is enhanced during intra-uterine and first months of life. The mother is the principal source of fatty acids to the child. Maternal milk contains all required nutrients for infant's growth and development. Babies do not have the ability to elong and desaturate fatty acids therefore; feeding formulas should contain preformed LC-PUFAS.

Long term outcome of birth asphyxiated infants.

Fifty eight neonates who survived birth asphyxia were prospectively studied in the department of Paediatrics, Dhaka Medical College Hospital, to see the incidence of long term neurodevelopmental sequelae among them and also to identify possible risk factors. All of them had been admitted in the Neonatal Unit of this hospital and were born between July 1997 & December 1999. After discharge from the hospital, the study infants were followed up at the Child Neurology Clinic of this hospital. They were seen at 6 weeks. at 3 months & then every 3 months upto 2 years of age for evaluation of growth and development (age corrected for prematurity for preterm babies) 69% of them were boys and 31% were girls. 74% of the babies were inborn in the same hospital & the rest were out born. Prolonged labour (24%) and PET (18.96%) were the most common obstetric factors & respiratory distress (38%) and neonatal convulsion (35%) were the important neonatal complications. Of the 58 enlisted study cases, 30 (51.7%) responded to complete 2 years follow up and the rest were lost. Normal growth and developments were observed in 12 (40%) cases, 7 (23.33%) had mild handicap, 6 (20%) moderate & 5 (16.6%) were left with severe neurodevelopmental handicaps at 2 years of age. 61% of the handicapped children had suffered from neonatal seizure for varying periods. It may be concluded that the response to follow up unsatisfactory, the number of severe handicap was alarmingly high and post asphyxiated seizure was associated with poor outcome. So prevention of perinatal asphyxia should be targeted. Further long term follow up study is required.

Escalas de avaliação neuromotora em pré-escolares: revisão bibliográfica / Neuromotor scales for preschool childrren assessment: a review

O sistema nervoso da criança esta em constante transformação e a combinação entre fatores genéticos e ambientais e o que determina o seu desenvolvimento neuropsicomotor. O use de avaliações padronizadas permite identificar se a criança esta apresentando ou não problemas no seudesenvolvimento. O presente estudo tem por finalidade realizar uma revisão bibliográfica sobre as escalas de avaliação do desenvolvimento neuromotor aplicáveis a pré-escolares. Observa-se que as escalas variam quanto ao item analisado, quanto a idade, quanto a forma de interpretação dos resultados entre outros; portanto, o avaliador deve ter em mente o que deseja avaliar para fazer a escolha da escala adequada.

The child's nervous system is in constant transformation that determines its neurodevelopment and it appears to result from a combination of genetic and environmental factors. The use of standardized scales allows the identification of the neurodevelopmental disorders. This paper aims at establishing a bibliographic review on the neuromotor scales for the neurodevelopment assessment of preschool students. We observed that the scales vary according to the analysed item, the age, the way of interpreting the results, among other factors; therefore, the evaluator must keep in mind what he/she wishes to evaluate to choose the adequate scale.

Desenvolvimento neurológico: avaliação evolutiva / Neurologic development: evolutional assessment

Esse artigo se propõe a revisar a avaliação do desenvolvimento neuropsicológico das crianças no seu período pós-natal, com o objetivo de fornecer aos profissionais de saúde envolvidos na assistência infantil subsídios teóricos para vigilância do desenvolvimento normal e da intervenção precoce, que pode minimizar as repercussões funcionais e lesionais do sistema nervoso submetido a eventos potencialmente patológicos, melhorando a qualidade de vida da criança, da família e com menor custo social na reabilitação (AU)

This article intend to review the assessment of the children's neuropsicologic development in the postnatal period, with the aim to give theoric information to heath professionals envolved in the children's care in terms of vigilance of the normal development and precocious intervention, wich can minimise the functional and lesional central nervous system repercutions, submitted to potencially pathological events, making better the child and family quality of live, with lower social costs in the rehabilitation (AU)

Realidad actual del bocio endémico y su repercusión en el desarrollo del sistema nervioso / Endemic goiter: present situation and consequences on central nervous system development

Se presentan los requerimientos de yodo del ser humano, la etiología del bocio endémico, la evolución de la prevalencia de esta enfermedad nutricional colectiva en Chile y las consecuencias del bocio endémico, especialmente sobre el desarrollo del sistema nervioso central. Se discuten las diferentes posibilidades preventivas de esta enfermedad que debería estar erradicada en nuestros países al finalizar este siglo

Hyperbilirubinemia in preterm infants and neurodevelopmental outcome at 2 years of age

This survey generating the hypothesis that mild to moderate hyperbilirubinemia is causally related to impaired neurodevelopmental outcome. The data demonstrated that mild to moderate hyperbilirubinemia in preterm infants is associated with impaired neurodevelopmental outcome specially cerebral palsy. A linear increase of serum total bilirubin concentration will increase the risk of handicap in preterm infants. Increase of serum total bilirubin concentration in preterm infants will increase the risk of impaired cerebral electrical activity and change in electroencephalographic patterns