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.

Benefits of combined interventions for cognitive enhancement in older adults / Benefícios de intervenções combinadas para aprimoramento cognitivo em idosos

Objective: To investigate the effects of different combined interventions (Stimullus, MEMO, physical activity, and psychoeducation) on the cognitive performance of older adults. Methods: This is a quasi-experimental study with pre- and post-intervention. Thirty-four older adults underwent different combined interventions for a period of 48 weeks and were evaluated at three different points (pre-intervention; post-cognitive intervention; post-physical activity or psychoeducation intervention). Cognitive domains (verbal episodic memory, executive function, general cognitive performance) and depressive symptoms were evaluated. Results: Postintervention gains in global, attentional, and mnemonic cognition were observed, as well as a reduction in depressive symptoms. The MEMO intervention + physical activity or psychoeducation resulted in greater cognitive gains, while Stimullus + psychoeducation showed benefits only in evocation and the free learning index, while Stimullus + physical activity resulted in improvement in the investigated variables. Conclusion: The results of these combined interventions appear promising for healthy older adults and the impact of these interventions should be discussed with individual older patients and evaluated more broadly in the context of public health.

Objetivo: Investigar os efeitos de diferentes intervenções combinadas (Stimullus, MEMO, física e psicoeducacional) no desempenho cognitivo de idosos. Metodologia: Trata-se de um estudo quase experimental com pré e pós-intervenção. Trinta e quatro idosos foram submetidos a diferentes intervenções combinadas pelo período de 48 semanas e avaliados em três tempos diferentes (pré-intervenção; pós-intervenção cognitiva; pós-intervenção física ou psicoeducacional), nos quais foram analisados domínios cognitivos (memória episódica verbal, funções executivas, desempenho cognitivo geral) e sintomas depressivos. Resultados: Após as intervenções, observaram-se ganhos na cognição global, atencional e mnemônica, bem como redução dos sintomas depressivos. A intervenção MEMO (física ou psicoeducacional) resultou em maiores ganhos cognitivos, enquanto Stimullus + psicoeducacional demonstrou benefícios apenas no índice de evocação e aprendizagem livre, e Stimullus + atividades físicas não apresentou melhora em nenhuma das variáveis investigadas. Conclusão: Os achados positivos dessas intervenções combinadas parecem promissores no contexto de idosos saudáveis, e o impacto dessas intervenções deve ser discutido em relação às especificidades de cada indivíduo idoso e avaliado mais amplamente no contexto de saúde pública.

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

Fentanyl attenuates air-puff stimulus-evoked field potential response in the cerebellar molecular layer via inhibiting interneuron activity in mice / 生理学报

Fentanyl as a synthetic opioid works by binding to the mu-opioid receptor (MOR) in brain areas to generate analgesia, sedation and reward related behaviors. As we know, cerebellum is not only involved in sensory perception, motor coordination, motor learning and precise control of autonomous movement, but also important for the mood regulation, cognition, learning and memory. Previous studies have shown that functional MORs are widely distributed in the cerebellum, and the role of MOR activation in cerebellum has not been reported. The aim of the present study was to investigate the effects of fentanyl on air-puff stimulus-evoked field potential response in the cerebellar molecular layer using in vivo electrophysiology in mice. The results showed that perfusion of 5 μmol/L fentanyl on the cerebellar surface significantly inhibited the amplitude, half width and area under the curve (AUC) of sensory stimulation-evoked inhibitory response P1 in the molecular layer. The half-inhibitory concentration (IC

Necessidades do bebê com deficiência física na creche: a percepção de educadoras / Necesidades del bebé con discapacidad física en la guardería: percepción de educadoras / The needs of children with physical disabilities in day care: the perception of educators

RESUMO. Este estudo teve como objetivo investigar a percepção de educadoras frente às necessidades de duas bebês com deficiência física em contexto de inclusão na creche. Realizou-se um estudo de caso múltiplo, com seis educadoras que atendiam a turma de Mariana (24 meses), e quatro educadoras que atendiam a turma de Vitória (18 meses), as quais responderam uma entrevista semiestruturada. Ambas as bebês tinham deficiência física e frequentavam escolas de educação infantil da rede pública de Porto Alegre. Os dados foram analisados através de diversas leituras do material, produzindo um relato clínico. Em relação à Mariana, as educadoras destacaram a necessidade de estímulo e de suporte físico à bebê, bem como a importância do afeto na relação educadora-bebê, presente em um 'olhar a mais', mais sensível. Quanto à Vitória, as educadoras reforçaram a importância da integração entre as áreas da saúde e da educação, assim como de um olhar mais atento às diferentes necessidades da bebê com deficiência. A partir dos resultados, foi possível compreender nesse 'olhar a mais', destacado pelas educadoras como necessário para atender à demanda das bebês com deficiência física, uma exigência de maior disponibilidade corporal e psíquica.

RESUMEN. Este estudio tuvo como objetivo investigar la percepción de educadoras frente a las necesidades del bebé con discapacidad física en el contexto de inclusión en la guardería. Se realizó un estudio de caso múltiple, cuyas participantes fueron seis educadoras que atendían a la clase de Mariana, y cuatro educadoras que atendían a la clase de Vitória, las cuales respondieron una entrevista semiestructurada. Ambas bebés tenían deficiencia física y frecuentaban escuelas de Educación Infantil de la red pública de la ciudad de Porto Alegre/Brasil. Los datos fueron analizados a través de diversas lecturas del material, produciendo un relato clínico. En cuanto a Mariana, 24 meses, las educadoras destacaron la necesidad de estímulo y de soporte físico a la bebé, así como la importancia del afecto en la relación educadora-bebé, que hace presente en una 'mirada a más', más sensible. En cuanto a Vitória, 18 meses, las educadoras reforzaron la importancia de la integración entre las áreas de la salud y la educación, así como de una mirada más atenta a las diferentes necesidades de la bebé con discapacidad. A partir de los resultados, fue posible comprender en esa 'mirada a más', destacada por las educadoras como necesario para atender a la demanda de los bebés con discapacidad física, una exigencia de mayor disponibilidad corporal y psíquica.

ABSTRACT. This study aimed to investigate the perception of educators regarding the needs of two babies with physical disabilities in the context of inclusion in the day care center. A multiple-case study was carried out. The participants were six educators who oversaw Mariana's class, and four educators who oversaw Vitoria's class, and all 10 educators answered a semi-structured interview. Both babies were physically disabled and attended public schools in Porto Alegre/Brazil. The data were analyzed through several readings of the material, which resulted in a clinical report. In relation to Mariana (age 24 months) the educators emphasized the baby's need for stimuli and physical support, as well as the importance of affection in the educator-baby relationship, which was present as a more sensitive 'extra thought'. As for Vitória (age 18 months), educators reinforced the importance of integration between the health and education fields, as well as closer attention to the different needs of the disabled baby. Based on the results, it was possible to observe within that 'extra thought' - highlighted by the educators as necessary to fulfill the needs of babies with physical disabilities - a demand for greater physical and psychic availability.

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.

Influência de estímulos cutâneos plantares sobre a sensibilidade e controle postural em idosos / Influence of plantar cutaneous stimuli on sensitivity and postural control in the elderly / Influencia de los estímulos cutáneos plantares en la sensibilidad y el control postural en ancianos

A diminuição da sensibilidade cutânea plantar pode resultar na redução do controle postural em idosos, tornando-os mais suscetíveis a quedas. O objetivo deste estudo foi verificar a influência de um programa de estimulação cutânea plantar, sobre o limiar de sensibilidade e controle postural em indivíduos idosos. Este foi um estudo clínico prospectivo, randomizado e simples-cego, no qual participaram 36 indivíduos idosos acima de 60 anos de idade de ambos os sexos, submetidos ao teste Timed Up and Go (TUG), para mensurar a mobilidade funcional, teste de apoio unipodal para avaliar o equilíbrio estático, e avaliação da sensibilidade plantar por estesiometria com monofilamentos de nylon. Os idosos foram divididos em dois grupos. O grupo-controle não passou por nenhuma intervenção e foi orientado a não mudar o estilo de vida. Já o grupo-experimental foi orientado a realizar intervenções domiciliares por 3 semanas. Após esse período, todos os participantes foram reavaliados. Os resultados revelaram que ambos os grupos apresentaram maior sensibilidade cutânea plantar após 3 semanas; porém, não foram observadas alterações no controle postural. Ambos os grupos demonstraram melhora em relação à sensibilidade cutânea plantar, e não houve diferença entre eles.

Decreased plantar skin sensitivity may result in reduced postural control in the elderly, making them more susceptible to falls. The objective of this study was to verify the influence of a plantar cutaneous stimulation program on the sensitivity threshold and postural control in elderly individuals. This was a prospective, randomized, single-blind clinical study involving 36 elderly individuals older than 60 years of age of both sexes, submitted to the Timed Up and Go (TUG) test to measure functional mobility, unipedal stance test to evaluate static balance, and evaluation of plantar sensitivity by sensation threshold test with nylon monofilaments. Elderly were divided into two groups. The control group did not undergo any intervention and was instructed not to change their lifestyle. The experimental group was oriented to perform home interventions for 3 weeks. After this period, all participants were reassessed. Results revealed that both groups showed higher plantar skin sensibility after 3 weeks, but no changes were observed in postural control. Both groups showed improvement in plantar cutaneous sensitivity, and there was no difference between them.

La disminución de la sensibilidad cutánea plantar puede resultar en la reducción del control postural en ancianos, haciéndolos más susceptibles a caídas. El objetivo de este estudio fue verificar la influencia de un programa de estimulación cutánea plantar sobre el umbral de sensibilidad y control postural en individuos ancianos. Este fue un estudio clínico prospectivo, aleatorizado y simple ciego en el que participaron 36 individuos mayores de 60 años de ambos sexos, sometidos a la prueba Timed Up and Go (TUG), para medir la movilidad funcional, prueba de apoyo unipodal para evaluar el equilibrio estático, y evaluar la sensibilidad plantar por estosiometría con monofilamentos de nylon. Los ancianos se dividieron en dos grupos. El grupo control no pasó por ninguna intervención y fue orientado a no cambiar el estilo de vida. El grupo experimental fue orientado a realizar intervenciones domiciliares por 3 semanas. Después de ese período, todos los participantes fueron reevaluados. Los resultados revelaron que ambos grupos presentaron mayor sensibilidad cutánea plantar después de 3 semanas, pero no se observaron alteraciones en el control postural. Ambos grupos demostraron una mejora en relación a la sensibilidad cutánea plantar, y no hubo diferencia entre ellos.

La estimulación táctil/kinestésica revierte los efectos del estrés prenatal en la región CA3 del hipocampo en ratas hembras: estudio estereológico / Tactile/kinesthetic stimulation reverses the effects of prenatal stress in the CA3 region of the hippocampus in female rats: a stereological study

Esta investigación fue realizada para saber si la estimulación táctil/kinestésica postnatal es efectiva en revertir el estrés prenatal, en la citoarquitectura de CA3 del hipocampo, en crías hembras. 12 crías de ratas hembras de la cepa Sprague-Dawley, fueron distribuidas en Grupo Control (GC), Grupo con Estrés Prenatal por restricción (EP) y Grupo Estrés prenatal con Estimulación Táctil/Kinestésica postnatal (EP-ETK). El estrés prenatal en crías hembras aumentó la densidad neuronal en las áreas CA3b y CA3c (p<0,001). Cuando se compararon las crías con estrés prenatal con las que recibieron estimulación táctil/kinestésica temprana, disminuyeron las densidades neuronales en las áreas CA3b y CA3c, (p < 0,001). La estimulación táctil/kinestésica postnatal logró revertir los efectos del estrés prenatal, al reducir la densidad neuronal en las áreas CA3b y CA3c del hipocampo.

This investigation was undertaken in order to know whether the postnatal tactile/kinesthetic stimulation is effective in reversing the Prenatal Stress, in the cytoarchitecture of the CA3 region of the hippocampus, in female pups. 12 pups of female rats from the Sprague-Dawley strain were distributed to Control Group (GC), the Prenatal Maternal Stress by restriction group (EP) and Prenatal Maternal Stress with postnatal tactile/ kinesthetic stimulation Group (EP-ETK). The Prenatal Maternal Stress in female pups increased neuronal density in CA3b and CA3c areas (p<0.001). When compared to Prenatal Maternal Stress, pups prenatal stress who received early tactile/kinesthetic stimulation showed a decrease in neuronal density in CA3b and CA3c areas (p < 0,001). Postnatal tactile/kinesthetic stimulation was shown to successfully reverse the Prenatal Maternal Stress effects by decreasing neuronal density in CA3b and CA3c hippocampal areas.

Los padres como promotores del desarrollo de lenguaje de bebés prematuros: propuesta de intervención temprana / Parents as Promoters of Language Development in Premature Babies: a Proposal for Early intervention

Resumen Objetivo: Comparar dos sistemas de puntuación para un test de fluidez verbal con el Modelo de Escalas de Calificación. Método: Se analizaron datos de 289 participantes, de los cuales 92 habían sido diagnosticados con Parkinson. Las puntuaciones se calcularon con dos sistemas de categorización: un procedimiento convencional y otro basado en percentiles. Resultados: Las puntuaciones Rasch procedentes de percentiles dan lugar a categorías adecuadas y medidas fiables; la correlación con las puntuaciones del test Minimental es evidencia de validez concurrente. Tras controlar estadísticamente el efecto de la edad, las medidas Rasch procedentes de percentiles discriminan entre ambos grupos, lo que evidencia validez predictiva. Conclusiones: El análisis de los dos procedimientos permite recomendar el uso de las categorías basadas en percentiles.

Abstract Objective: Two scoring systems for a verbal fluency test were compared using the Rasch Rating Scale Model. Method: The analysis was carried out on 289 participants, 92 of whom had had a Parkinson's disease diagnosis. Scores were calculated with two different category systems: a conventional procedure and a percentile-based one. Results: The percentile-based Rasch scores produce adequate categories and reliable measures, while the correlation with the Mini Mental State Examination evinces concurrent validity. After statistically controlling for age, percentile-based Rasch measures discriminated between both groups, demonstrating predictive validity. Conclusions: The analysis of the two procedures allows for the recommendation of the use of percentile-based categories.

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.

Responses of Patients with Disorders of Consciousness to Habit Stimulation: A Quantitative EEG Study / 神经科学通报·英文版

Whether habit stimulation is effective in DOC patient arousal has not been reported. In this paper, we analyzed the responses of DOC patients to habit stimulation. Nineteen DOC patients with alcohol consumption or smoking habits were recruited and 64-channel EEG signals were acquired both at the resting state and at three stimulation states. Wavelet transformation and nonlinear dynamics were used to extract the features of EEG signals and four brain lobes were selected to investigate the degree of EEG response to habit stimulation. Results showed that the highest degree of EEG response was from the call-name stimulation, followed by habit and music stimulations. Significant differences in EEG wavelet energy and response coefficient were found both between habit and music stimulation, and between habit and call-name stimulation. These findings prove that habit stimulation induces relatively more intense EEG responses in DOC patients than music stimulation, suggesting that it may be a relevant additional method for eliciting patient arousal.

A Context-Based Analgesia Model in Rats: Involvement of Prefrontal Cortex / 神经科学通报·英文版

Cognition and pain share common neural substrates and interact reciprocally: chronic pain compromises cognitive performance, whereas cognitive processes modulate pain perception. In the present study, we established a non-drug-dependent rat model of context-based analgesia, where two different contexts (dark and bright) were matched with a high (52°C) or low (48°C) temperature in the hot-plate test during training. Before and after training, we set the temperature to the high level in both contexts. Rats showed longer paw licking latencies in trials with the context originally matched to a low temperature than those to a high temperature, indicating successful establishment of a context-based analgesic effect in rats. This effect was blocked by intraperitoneal injection of naloxone (an opioid receptor antagonist) before the probe. The context-based analgesic effect also disappeared after optogenetic activation or inhibition of the bilateral infralimbic or prelimbic sub-region of the prefrontal cortex. In brief, we established a context-based, non-drug dependent, placebo-like analgesia model in the rat. This model provides a new and useful tool for investigating the cognitive modulation of pain.

Involvement of NF-κB and the CX3CR1 Signaling Network in Mechanical Allodynia Induced by Tetanic Sciatic Stimulation / 神经科学通报·英文版

Tetanic stimulation of the sciatic nerve (TSS) triggers long-term potentiation in the dorsal horn of the spinal cord and long-lasting pain hypersensitivity. CX3CL1-CX3CR1 signaling is an important pathway in neuronal-microglial activation. Nuclear factor κB (NF-κB) is a key signal transduction molecule that regulates neuroinflammation and neuropathic pain. Here, we set out to determine whether and how NF-κB and CX3CR1 are involved in the mechanism underlying the pathological changes induced by TSS. After unilateral TSS, significant bilateral mechanical allodynia was induced, as assessed by the von Frey test. The expression of phosphorylated NF-κB (pNF-κB) and CX3CR1 was significantly up-regulated in the bilateral dorsal horn. Immunofluorescence staining demonstrated that pNF-κB and NeuN co-existed, implying that the NF-κB pathway is predominantly activated in neurons following TSS. Administration of either the NF-κB inhibitor ammonium pyrrolidine dithiocarbamate or a CX3CR1-neutralizing antibody blocked the development and maintenance of neuropathic pain. In addition, blockade of NF-κB down-regulated the expression of CX3CL1-CX3CR1 signaling, and conversely the CX3CR1-neutralizing antibody also down-regulated pNF-κB. These findings suggest an involvement of NF-κB and the CX3CR1 signaling network in the development and maintenance of TSS-induced mechanical allodynia. Our work suggests the potential clinical application of NF-κB inhibitors or CX3CR1-neutralizing antibodies in treating pathological pain.

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.

Efectos de un programa de estimulación físico-cognitiva sobre la autopercepción de la funcionalidad en adultos mayores / Effects of a physical and cognitive stimulation program on the self-perception of the functional status in older adults

Propósito: determinar el efecto de un programa de 8 semanas de estimulación físico-cognitiva sobre la autopercepción de la funcionalidad en adultos mayores. Metodología: estudio de tipo pre-experi-mental, longitudinal y prospectivo. Participaron 59 mujeres y 15 hombres entre 65 y 80 años de edad quienes realizaron 24 sesiones de estimulación físico-cognitiva con una frecuencia de 3 veces por semana, durante 8 semanas. Se evaluó la autopercepción de la funcionalidad al inicio y al final de la intervención. Se utilizó la prueba t de Student de una cola para muestras relacionadas para comparar la autopercepción de los adultos mayores evaluados antes y después de la intervención. Se consideró un nivel alfa de 0.05. Resultados: la autopercepión de funcionalidad de los adultos mayores intervenidos mejoró luego de ser sometidos a un programa de estimulación físico-cognitiva (p < 0.001; d = 0.28) en hombres (p = 0.010; d = 0.18) y mujeres (p = 0.002; d = 0.33). Conclusiones: los resultados de este estudio señalan que los adultos mayores (mujeres y hombres), mejoran su autopercepción de funcio-nalidad luego de participar en un programa de estimulación físico-cognitiva.

Purpose: To determine the effect of an 8-week physical-cognitive stimulation program on the self-perception of the functional status in older adults. Methodology: Pre-experimental, longitudinal and prospective study. Fifty-nine women and fifteen men between 65 and 80 years old performed 24 ses-sions of physical-cognitive stimulation, 3 times a week for 8 weeks. The self-perception of the adults ́ functional status was evaluated at the beginning and at the end of the intervention. The Student's t-test was used to compare mean scores for the self-perception evaluated in older adults. An alpha level of 0.05 was considered. Results: The self-perception of the functional status in older adults improved after taking part in a physical-cognitive stimulation program (p <0.001; d = 0.28) in men (p = 0.010, d = 0.18) and women (P = 0.002, d = 0.33). Conclusions: The results of this study indicate that older adults (women and men) improve their self-perception of their functional status after participating in a physical-cognitive stimulation program.

Oportunidades de estimulação motora no ambiente domiciliar de crianças / Opportunities for motor stimulation in the home environment of children

INTRODUCTION: The environment in which the child is inserted and motor opportunities offered to this is essential for a good motor development. OBJECTIVE: To analyze the relationship between the motor stimulation opportunities in the family environment and children's motor development of both sex. METHODS: were evaluated 72 children, 33 boys and 39 girls with age of 38 to 42 months. The evaluation was conducted by Affordances in the Home Environment for Motor Development (AHEMD) and the Test of Gross Motor Development-2 (TGMD-2). Were used the tests Chi-square, Fisher exact test, t test for independent samples, Pearson correlation and multiple linear regression. RESULTS: In general, the households have low opportunities for motor stimulation, and for households with boys the score is higher. The girls performed better in locomotor skills, while boys had higher scores on object control skills. It found a significant correlation to motricity materials and thick materials motor for boys and variety of stimulation, fine motor materials, motricity materials and motor stimulation for girls. For the boys the motor performance is explained by the available variables of fine and gross motor skills and for the girls by materials of motor stimulation, stimulation variety and materials of fine and gross motor skills. CONCLUSION: On the presented results we can conclude that the home environment is directly related to the motor development of girls and boys.

INTRODUÇÃO: O ambiente em que a criança está inserida e as oportunidades motoras ofertadas a essa é fundamental para o um bom desenvolvimento motor. OBJETIVO: Analisar a relação entre as oportunidades de estimulação motora no ambiente familiar e o desenvolvimento motor de crianças de ambos os sexos. MÉTODO: Foram avaliadas 72 crianças, sendo 33 meninos e 39 meninas com idade de 38 a 42 meses. A avaliação foi realizada por meio dos instrumentos, Affordances in the Home Environment for Motor Development (AHEMD) e do Test of Gross Motor Development-2 (TGMD-2). Utilizou-se os Testes, Qui-quadrado, Exato de Fisher, Teste t para amostras independentes, correlação de Pearson e regressão linear múltipla. RESULTADOS: De forma geral, os domicílios apresentaram baixas oportunidades de estimulação motora, sendo que para os lares com meninos o escore é maior. As meninas obtiveram melhor desempenho nas habilidades locomotoras, enquanto os meninos apresentaram maiores escores nas habilidades de controle de objetos. Encontrou-se correlação significativa para materiais de motricidade fina e materiais de motricidade grossa para os meninos, e variedade de estimulação, materiais de motricidade fina, materiais de motricidade grossa e estimulação motora para as meninas. Desta forma, no sexo masculino, o desemvolvimento motor é explicado pelas variáveis, disponibilização de materiais de motricidade fina e grossa e para o feminino pela estimulação motora, variedade de estimulação e materiais de motricidade fina e grossa. CONCLUSÃO: Diante dos resultados apresentados pode-se concluir que o ambiente domiciliar está diretamente relacionado com o desenvolvimento motor para as meninas e meninos do contexto analisado.

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.

Standardization of the face-hand test in a Brazilian multicultural population: prevalence of sensory extinction and implications for neurological diagnosis

OBJECTIVE: The face-hand test is a simple, practical, and rapid test to detect neurological syndromes. However, it has not previously been assessed in a Brazilian sample; therefore, the objective of the present study was to standardize the face-hand test for use in the multi-cultural population of Brazil and identify the sociodemographic factors affecting the results. METHODS: This was a cross sectional study of 150 individuals. The sociodemographic variables that were collected included age, gender, race, body mass index and years of education. Standardization of the face-hand test occurred in 2 rounds of 10 sensory stimuli, with the participant seated to support the trunk and their vision obstructed in a sound-controlled environment. The face-hand test was conducted by applying 2 rounds of 10 sensory stimuli that were applied to the face and hand simultaneously. The associations between the face-hand test and sociodemographic variables were analyzed using Mann-Whitney tests and Spearman correlations. Binomial models were adjusted for the number of face-hand test variations, and ROC curves evaluated sensitivity and specificity of sensory extinction. RESULTS: There was no significant relationship between the sociodemographic variables and the number of stimuli perceived for the face-hand test. There was a high relative frequency of detection, 8 out of 10 stimuli, in this population. Sensory extinction was 25.3%, which increased with increasing age (OR=1.4[1:01–1:07]; p=0.006) and decreased significantly with increasing education (OR=0.82[0.71-0.94]; p=0.005). CONCLUSION: In the Brazilian population, a normal face-hand test score ranges between 8–10 stimuli, and the results indicate that sensory extinction is associated with increased age and lower levels of education.

Bebés saludables con estímulos y afecto / Healthy babies with stimuli and affection

El masaje infantil es un arte milenario que además de fortalecer el vínculo entre el bebé y los padres, aporta múltiples beneficios para su desarrollo fisiológico, psicológico y emocional. El masaje al ser algo natural y no precisar de un talento especial hace que sea una opción muy sencilla para lograr el bienestar del recién nacido. La enfermera y la matrona como profesionales sanitarios son capaces con una adecuada formación de enseñar esta técnica a los padres que deseen practicarla. Se realizó un estudio dentro de un enfoque cuantitativo, no experimental de tipo exploratorio, transeccional. La población participante en el estudio, estuvo conformada por enfermeros/as que laboran en las consultas de pediatría de Atención Primaria de Ávila. La variable descriptiva está conformada por los conocimientos, experiencias y opiniones de los enfermeros/as de pediatría en Atención Primaria. Según las profesionales, las mayores ventajas es el fortalecimiento de vínculos entre el bebé y quien le facilita el masaje. De las entrevistadas, 26 opinaron que el masaje facilita la relajación; 10 concluyeron que el mayor aporte es en cuanto al manejo del estrés y 14 afirman que contribuye a aliviar el estreñimiento. Dentro de las conclusiones a las que se llegaron, decir que, el Masaje Infantil es una práctica cada vez más valorada en nuestra sociedad, y por lo tanto, una práctica que las madres demandan, además, a través del masaje el bebe conecta con la persona que lo realiza y así se comunica. Esto tiene su importancia porque los profundos vínculos emocionales creados en la infancia son una base perfecta para toda una vida de confianza, seguridad y amor.

The infant massage is an ancient art that, in addition to strengthening the bond between the baby and the parents, brings multiple benefits for their physiological, psychological and emotional development. The massage being natural and not needing a special talent makes it a very simple option to achieve the well-being of the newborn. The nurse and midwife as health professionals are capable with an adequate training to teach this technique to parents who wish to practice it A study was conducted within a quantitative, non-experimental, exploratory, transectional approach. The population participating in the study was made up of nurses who work in the pediatric consultations of Primary Care in Ávila. The descriptive variable is formed by the knowledge, experiences and opinions of the nurses of pediatrics in Primary Care. According to professionals, the greatest advantages is the strengthening of bonds between the baby and the one who facilitates the massage. Of the interviewees, 26 thought that massage facilitates relaxation; 10 concluded that the greatest contribution is in terms of stress management and 14 say that it contributes to relieve constipation. Within the conclusions reached, say that, Infant Massage is a practice increasingly valued in our society, and therefore, a practice that mothers demand, in addition, through massage the baby connects with the Person who performs it and thus communicates. This is important because the deep emotional bonds created in childhood are a perfect foundation for a lifetime of trust, security and love.