Promotion effect of TGF-β-Zfp423-ApoD pathway on lip sensory recovery after nerve sacrifice caused by nerve collateral compensation / 国际口腔科学杂志·英文版

Resection of oral and maxillofacial tumors is often accompanied by the inferior alveolar nerve neurectomy, resulting in abnormal sensation in lower lip. It is generally believed that spontaneous sensory recovery in this nerve injury is difficult. However, during our follow-up, patients with inferior alveolar nerve sacrifice showed different degrees of lower lip sensory recovery. In this study, a prospective cohort study was conducted to demonstrate this phenomenon and analyze the factors influencing sensory recovery. A mental nerve transection model of Thy1-YFP mice and tissue clearing technique were used to explore possible mechanisms in this process. Gene silencing and overexpression experiments were then conducted to detect the changes in cell morphology and molecular markers. In our follow-up, 75% of patients with unilateral inferior alveolar nerve neurectomy had complete sensory recovery of the lower lip 12 months postoperatively. Patients with younger age, malignant tumors, and preservation of ipsilateral buccal and lingual nerves had a shorter recovery time. The buccal nerve collateral sprouting compensation was observed in the lower lip tissue of Thy1-YFP mice. ApoD was demonstrated to be involved in axon growth and peripheral nerve sensory recovery in the animal model. TGF-β inhibited the expression of STAT3 and the transcription of ApoD in Schwann cells through Zfp423. Overall, after sacrificing the inferior alveolar nerve, the collateral compensation of the ipsilateral buccal nerve could innervate the sensation. And this process was regulated by TGF-β-Zfp423-ApoD pathway.

Sensory assessment of balance regulation of physically active women, 60-79 years old / Avaliação sensorial da regulação do equilíbrio de mulheres fisicamente ativas, 60-79 anos

OBJECTIVE: To evaluate the performance of sensory regulation of static and dynamic balance in older women, and to verify the sensitivity and specificity levels of the Body Balance Test (Teste de Equilíbrio Corporal, TEC) in relation to its reference standard, determining the best cutoff point for identifying risk of falling. METHODS: 74 women (age 67.59 ± 5.26 years) participated in the study, divided into fallers (n = 18) and non-fallers (n = 56). RESULTS: Comparatively, non-fallers had higher performance scores on static balance exteroceptive regulation (SBER), dynamic balance exteroceptive regulation (DBER), and dynamic balance interoceptive regulation (DBIR). Statistically significant differences were found in DBER (p = ≤0.001) and DBIR (p = 0.031). The area under the ROC curve was 0.73 (95%CI 0.58 ­ 0.88; p = 0.003), with a sensitivity level of 42.30% and specificity of 84.80%. CONCLUSIONS: The greatest chance of falling was found for dynamic balance in situations of exteroceptive and interoceptive regulation for older women with and without a history of falls. Deficits in sensory regulation of body balance are common in older women, both fallers and non-fallers

OBJETIVO: Avaliar o desempenho da regulação sensorial do equilíbrio estático e dinâmico de mulheres idosas e verificar os níveis de sensibilidade e especificidade do Teste de Equilíbrio Corporal (TEC) em relação ao seu padrão de referência, determinando o melhor ponto de corte para a identificação do risco de queda. METODOLOGIA: participaram do estudo 74 mulheres (67,59 ± 5,26 anos), divididas em caidoras (n = 18) e não-caidoras (n = 56). RESULTADOS: Comparativamente, não-caidoras indicaram escores de desempenho mais elevados para equilíbrio estático regulação exteroceptiva (EERE), equilíbrio dinâmico regulação exteroceptiva (EDRE) e equilíbrio dinâmico regulação interoceptiva (EDRI). Diferenças estatisticamente significativas foram encontradas na regulação EDRE (p = ≤0,001) e EDRI (p = 0,031). A área verificada sob a curva ROC foi de 0,73 (IC95% 0,58 ­ 0,88; p = 0,003) e nível de sensibilidade de 42,30% e especificidade de 84,80%. CONCLUSÕES: A maior chance de queda foi encontrada para o equilíbrio dinâmico em situação de regulação exteroceptivo e interoceptivo para mulheres idosas com e sem histórico de queda. Déficits na regulação sensorial do equilíbrio corporal são comuns em mulheres idosas caidoras e não-caidoras

Autoconcepto, autoeficacia y percepción de calidad de vida en niños y niñas con y sin déficit de procesamiento sensorial / Self-concept, self-efficacy and quality of life in boys and girls with and without sensory processing deficit

Objetivo. El Autoconcepto, la autoeficacia y la calidad de vida son variables que pueden verse afectadas en los niños/as por la presencia de un déficit de procesamiento sensorial (DPS). Este déficit se caracteriza por fallas en el procesamiento de las sensaciones que pueden ocasionar dificultades en el desempeño cotidiano. La presente investigación tuvo por objetivo determinar si existe diferencia en el autoconcepto, la autoeficacia y la calidad de vida de niños/as venezolanos/as entre 7 y 13 años con y sin DPS.Metodología. El presente es un estudio transversal, con diseño estadístico no experimental de comparación de medias mediante el estadístico t de Student. La muestra estuvo constituida por 98 niños/as de 7 a 13 años, de los cuales 38 (38,8%) estaban diagnosticados con déficit de procesamiento sensorial y 60 (61,2%) sin déficit. Resultados. Se evidenció que existen diferencias significativas en la autoeficacia académica, donde los niños/as con DPS mostraron puntajes medios menores; así como en el autoconcepto físico, donde los puntajes fueron menores en niños/as sin déficit. No se encontraron diferencias significativas en la calidad de vida de las dos muestras. Esta investigación permitió abrir una línea de investigación en el área de variables psicológicas que han sido poco estudiadas en niños/as con DPS, demostrando que esta condición impacta principalmente su percepción de autoeficacia.

Objective. Self-concept, self-efficacy and quality of life are variables that can be affected in children by the presence of a sensory processing deficit (DPS). This deficit is characterized by failures in the processing of sensations that can cause difficulties in daily performance. The objective of this study is to determine whether or not there is a significant difference in the self-concept, self-efficacy and quality of life of Venezuelan children between 7 and 13 years old with and without Sensory Processing Difficulties (SPD). Methodology. This is a cross-sectional study, with a non-experimental statistical design of comparison of means using the student's t-statistic. The sample consisted of 98 children from 7 to 13 years old, of whom 38 (38.8%) were diagnosed with sensory integration deficit and 60 (61.2%) without deficit. Results. There was evidence of significant differences in academic self-efficacy, where children with SPD showed lower mean scores; as well as in physical self-concept, where children without SPD attained lower scores. No significant differences were found in the quality of life of the samples. This study contributes to a line research in psychological variables that have been little studied in children with sensorial integration deficit, demonstrating that this condition mainly impacts their perception of self-efficacy.

Desarrollo de un procedimiento estructurado de observación clínica de la modulación táctil y desempeño de dos muestras clínicas de niños con y sin defensividad táctil / Development of an estructured procedure of clinical observations of the sensory modulation and the performance of two clinical samples of children with and without tactile defensiveness

La defensividad táctil es una de las disfunciones de integración sensorial que fueron tempranamente descritas por Jean Ayres (Lane, 2020). Sin embargo, para su diagnóstico se carece de instrumentos de evaluación basados en la observación del desempeño del niño, y en cambio, se suele utilizar casi exclusivamente el reporte de los padres por medio de cuestionarios sensoriales. Basado en diversos fundamentos teóricos se diseñó un procedimiento estructurado de observación clínica de la modulación táctil, compuesto por dos juegos con exposición a estímulos táctiles, el cual fue aplicado en contexto de práctica clínica privada, registrándose sus observaciones textualmente en fichas clínicas. El objetivo de esta investigación es describir los signos de defensividad táctil que pueden ser detectados con este procedimiento. Por medio de una pauta de análisis de 29 ítems de respuesta dicotómica, se examinaron retrospectivamente 83 fichas, de una población clínica de niños con y sin defensividad táctil, de 2 a 11 años de edad. Se comparó los resultados de una muestra de niños con defensividad táctil con otra de niños sin defensividad táctil, por medio de estadística descriptiva y pruebas no paramétricas. El desempeño de niños con defensividad táctil estadísticamente difiere de manera significativa del de niños sin defensividad táctil en el procedimiento de observación estudiado. Además, este instrumento puede contribuir con el proceso diagnóstico de defensividad táctil, por medio de la contabilización de indicadores para sugerir el diagnóstico, o de la identificación específica de algunos de ellos que serían más relevantes.

Tactile defensiveness is one of the first sensory integration dysfunctions described by Jean Ayres. However, for the diagnosis, evaluation procedures based on the observation of the child's performance are lacking, and instead, parents' reports are usually used almost exclusively. Based on several theoretical foundations, a structured procedure of clinical observations of tactile modulation was designed, consisting of two games that expose children to tactile stimuli. The observation was applied in a private clinic, using recording used for the purpose of documentation in clinical records. The objective of this research is to describe the tactile defensiveness signs that may be detected with this procedure. Through a guideline with 29 items of dichotomous response, 83 clinical records were retrospectively examined, from a clinical population of children with and without tactile defensiveness, aged 2 to 11 years. The results of a sample of children with tactile defensiveness were compared with another one of children without tactile defensiveness, through descriptive statistics and non-parametric tests. The performance of children with tactile defensiveness are significantly different from children without tactile defensiveness. In addition, this instrument can contribute to the diagnostic process of tactile defensiveness, through the analysis of indicators that suggest the diagnosis, or the specific identification of relevant signs of tactile defensiveness.

Alterações sensoriais em respiradores orais: revisão sistemática baseada no método prisma / Sensory changes in mouth breathers: systematic review based on the prisma method

RESUMO Objetivo: Revisar, na literatura, estudos que abordem alterações nos sistemas sensoriais apresentadas por respiradores orais. Fonte de dados: A busca foi realizada nas bases de dados PubMed, BIREME, LILACS, Web of Science e Scopus. A busca foi realizada independentemente por dois pesquisadores, seguindo os critérios de seleção. Foram selecionados artigos originais que abordaram a respiração oral e as alterações nos sistemas sensoriais publicados nos idiomas português, inglês e espanhol. Os artigos de revisão da literatura, as dissertações, os capítulos de livros, os estudos de caso e os editoriais foram excluídos. Síntese dos dados: Foram encontrados 719 artigos, dos quais 663 foram excluídos pelo título e 22 pelo resumo. Trinta e quatro manuscritos foram analisados, dos quais 23 estavam repetidos e 8 foram excluídos pelo texto lido na íntegra. Assim, três artigos foram selecionados para esta revisão. Conclusões: A maioria dos estudos apresenta a ocorrência de alterações dos sistemas sensoriais em crianças respiradoras orais. Contudo, observa-se maior preocupação na avaliação da recepção sensorial. Além disso, a avaliação dos sistemas sensoriais foi realizada de forma não padronizada, o que pode ter acarretado resultados menos precisos na população estudada.

ABSTRACT Objective: To review, in the literature, information regarding changes in the sensory systems of mouth breathers. Data sources: The search was conducted in the following databases PubMed, BIREME, LILACS, Web of Science and Scopus. The search was independently carried out by two researchers, following the selection criteria. Original articles that approached mouth breathing and changes in sensory systems published in Portuguese, English and Spanish were published. Literature review of articles, dissertations, book chapters, case studies and editorials were excluded. Data synthesis: We found 719 articles. Among them, 663 were excluded by the title and 22 by the summary. Among the 34 analyzed manuscripts, 23 were repeated and 8 were excluded by reading the full text. Thus, 3 articles were selected for this review. Conclusions: Most studies presents the occurrence of changes in sensory systems in mouth breathing children. However, sensory reception is a matter of more concern. Besides, the evaluation of sensory systems was not standardized, which may have led to less precise results in the studied population.

Desórdenes neurosensoriales posextracción de terceros molares inferiores retenidos / Neurosensory disorders after removal of retained lower third molars

Introducción: Los desórdenes neurosensoriales aparecen vinculados a la exéresis de terceros molares inferiores; su mal diagnóstico y tratamiento acarrean una larga permanencia de los mismos. Objetivo: Caracterizar desde el punto de vista clínico y terapéutico los desórdenes neurosensoriales asociados a la extracción quirúrgica de terceros molares inferiores retenidos. Material y Método: Se realizó un estudio cuasi-experimental en 136 pacientes sometidos a exéresis quirúrgica de terceros molares inferiores retenidos con criterios específicos de inclusión en la Facultad de Estomatología de La Habana, período 2016-2017. Los pacientes fueron intervenidos y examinados a los 3 y 10 días tras la intervención para identificar desórdenes neurosensoriales. Se emplearon 3 test diagnósticos para definir el nivel de función neurológica; se utilizó escala VAS para evaluar el nivel de sensibilidad del paciente, y el interrogatorio estandarizado para categorizar los tipos de desórdenes sensoriales. Se registraron las variables: edad, sexo, clase de retención, modificación de técnica quirúrgica y hallazgos neurosensoriales. Resultados: Presentó desórdenes neurosensoriales 3,5 por ciento de los pacientes; 2,1 por ciento del sexo femenino. La clase III, posición C, mesioangular fue la retención más vinculada con 2,1 por ciento. El nervio dentario inferior fue el más involucrado (2,1 por ciento) y la parestesia fue el hallazgo más frecuente (60 por ciento). El 60 por ciento de los desórdenes involucionaron a los 180 días. Conclusiones: Los desórdenes neurosensoriales vinculados a la exéresis de terceros molares inferiores registran una baja frecuencia en la población estudiada, predomina en el nervio dentario inferior, en retenciones clase III, posición B, mesioangular y se asocia más a técnicas con ostectomías y odontosecciones. La disestesia es la entidad más refractaria al tratamiento(AU)

Introduction: Neurosensory disorders are linked to the removal of retained lower third molars; its misdiagnosis and poor treatment can lead to their long persistence. Objective: To characterize neurosensory disorders associated with the removal of retained lower third molars from the clinical and therapeutic point of view. Material and Method: A quasi-experimental study was conducted in 136 patients with specific inclusion criteria who underwent surgical removal of retained lower third molars in the Dental Faculty of the University of Havana, between 2016-2017. The patients were operated on and examined 3 and 10 days after surgery to identify the presence of neurosensory disorders. Three types of diagnostic tests were used to define the level of neurological function. VAS Scale was used to evaluate the sensitivity level in the patient, and the standardized interview was made to categorize the type of neurosensory disorders. Variables such as age, sex, kind of retention, modification of surgical techniques, and neurosensory findings were recorded. Results: 3,5 percent of patients had neurosensory disorders, 2,1 percent were female. Class III, position C, mesioangular was the most linked retention (2,1 percent). The inferior dental nerve was the most involved (2,1 percent), and paresthesia was the most frequent finding (60 percent). The 60 percent of disorders recovered their normal function after 180 days. Conclusions: The appearance of neurosensory disorders linked to the removal of lower third molars presented a low frequency in the population studied, predominating in the inferior dental nerve, in class III retentions, Position B, mesioangular position; and they are more linked to the surgical techniques of ostectomies and odontosections. Dysesthesia is the most refractory to treatment(AU)

Tumarkin-like phenomenon as a sign of therapeutic success in benign paroxysmal positional vertigo / Fenômeno Tumarkin-like como sinal de sucesso terapêutico na vertigem posicional paroxística benigna

ABSTRACT Objective: To describe an unusual patient reaction to maneuvers used in the treatment of posterior canal benign paroxysmal positional vertigo (PC-BPPV) that we termed the "Tumarkin-like phenomenon". Methods: At a private practice, 221 outpatients were diagnosed and treated for PC-BPPV. The treatment consisted of performing the Epley or Semont maneuvers. At the end of these maneuvers, when assuming the sitting position, the patients' reactions were recorded. Results: Thirty-three patients showed a Tumarkin-like phenomenon described by a self-reported sensation of suddenly being thrown to the ground. In the follow-up, this group of patients remained without PC-BPPV symptoms up to at least 72 hours after the maneuvers. Conclusion: The occurrence of a Tumarkin-like phenomenon at the end of Epley and Semont maneuvers for PC-BPPV may be linked with treatment success.

RESUMO Objetivo: Descrever uma reação incomum dos pacientes às manobras utilizadas no tratamento da vertigem posicional paroxística benigna do canal posterior (VPPB-CP), a qual denominamos de fenômeno Tumarkin-like. Métodos: Em uma clínica privada, 221 pacientes ambulatoriais foram diagnosticados e tratados para VPPB-CP. O tratamento consistiu em realizar as manobras de Epley ou de Semont. Ao término da manobra, ao serem colocados na posição sentado, as reações dos pacientes foram filmadas. Resultados: Trinta e três pacientes apresentaram o fenômeno de Tumarkin-like, descrito como uma sensação súbita de ser jogado no chão. O acompanhamento mostrou que todos eles permaneceram sem sintomas de VPPB até pelo menos 72 horas após as manobras. Conclusão: A ocorrência do fenômeno Tumarkin-like no final das manobras de Epley e Semont para VPPB-CP pode estar associado ao sucesso terapêutico.

Microscopic aspects of electrosensory system on the partially euryhaline lesser guitarfish

ABSTRACT The electrosensory system on elasmobranchs consists of subcutaneous electroreceptor organs known as ampullae of Lorenzini. The present study investigated the ampullae of Lorenzini morphology of the lesser guitarfish Zapteryx brevirostris, using light microscopy and scanning electron microscopy. The pore number found in the ventral skin surface is much higher than that found in the dorsal portion, characteristic of species that inhabit the euphotic zone. Under light microscopy it was possible to observe that the wall canal consists of a single layer of squamous epithelial cells. The canal features distal expansion, where the ampullae are located with up to six alveoli. The sensory epithelium of ampullae is composed by cubic cells, with oval nucleus, restricted to the interior of the alveoli. With analysis the clusters under scanning electron microscopy, it was possible to observe the structure and the random arrangement of individual ampullae, canals and nerves. The distribution of dorsal and ventral pores and ampullae in Z. brevirostris resembled those of the same family. The number of alveoli per ampullae was similar to that found in euryhaline elasmobranchs species, suggesting that the morphological organization in Z. brevirostris is linked to its possible evolutionary transitory position among batoids.

Saciación vs saciedad: reguladores del consumo alimentario / Satiation and satiety in the regulation of energy intake

The study of the factors that regulate high energy food intake is especially relevant nowadays due to the high prevalence of overweight and obesity. Food intake regulation can be divided in two basic processes, namely satiation and satiety. Satiation is the process that determines the moment in which feeding stops and regulates the amount of ingested food during a single meal. Satiety is the interval between meals and regulates the time elapsed between two meals. The longer the interval, the lower energy intake. Each of these processes are regulated by different factors, which are here reviewed.

Two-point discrimination values vary depending on test site, sex and test modality in the orofacial region: a preliminary study

Abstract The two-point discrimination (TPD) test is one of the most commonly used neurosensory tests to assess mechanoperception in the clinical settings. While there have been numerous studies of functional sensibility of the hand using TPD test, there have been relatively not enough reports on TPD in the orofacial region. Objective The aims of the present study were to determine the normal values of TPD in the six trigeminal sites (the forehead, cheek, mentum, upper lip, lower lip, and the tongue tip) and to investigate the effect of the site, sex, and test modality on the TPD perception. Material and Methods Forty healthy volunteers consisting of age-matched men (20) and women (20) with a mean age of 27.1 years were recruited. One examiner performed the TPD test using a simple hand-operated device, i.e., by drawing compass with a blunt or sharp-pointed tip. The static TPD with a blunt-pointed tip (STPDB), moving TPD with a blunt-pointed tip (MTPDB), and static TPD with a sharp-pointed tip (STPDS) were measured. The predictors were the site, sex, and test modality, and the outcome variable was the TPD value. Three-way ANOVA was used for statistics. Results The analysis showed a significant effect of the site, sex and test modality on the TPD values. Significant differences between the test sites were observed with the descending order from the forehead and cheek>mentum>upper lip and lower lip>tongue tip and index finger. Women showed lower TPD values than those of men. The STPDS measurements were consistently lower than those of the STPDB and MTPDB. Conclusions The normal values of TPD in this study suggest that the cheek and forehead were less sensitive than other regions evaluated and women were more sensitive than men. The STPDS was the most sensitive test modality.

Sensory processing patterns, coping strategies, and quality of life among patients with unipolar and bipolar disorders

Objective: To compare sensory processing, coping strategies, and quality of life (QoL) in unipolar and bipolar patients; to examine correlations between sensory processing and QoL; and to investigate the relative contribution of sociodemographic characteristics, sensory processing, and coping strategies to the prediction of QoL. Methods: Two hundred sixty-seven participants, aged 16-85 years (53.6±15.7), of whom 157 had a diagnosis of unipolar major depressive disorder and 110 had bipolar disorder type I and type II, completed the Adolescent/Adult Sensory Profile, Coping Orientations to Problems Experienced, and 12-item Short-Form Health Survey version 2. The two groups were compared with multivariate analyses. Results: The unipolar and bipolar groups did not differ concerning sensory processing, coping strategies, or QoL. Sensory processing patterns correlated with QoL independently of mediation by coping strategies. Correlations between low registration, sensory sensitivity, sensation avoidance, and reduced QoL were found more frequently in unipolar patients than bipolar patients. Higher physical QoL was mainly predicted by lower age and lower sensory sensitivity, whereas higher mental QoL was mainly predicted by coping strategies. Conclusion: While age may predict physical QoL, coping strategies predict mental QoL. Future studies should further investigate the impact of sensory processing and coping strategies on patients’ QoL in order to enhance adaptive and functional behaviors related to affective disturbances.

Videofluoroscopic evaluation of swallows in anorexia nervosa / Avaliação videofluoroscopica da deglutição na anorexia nervosa

ABSTRACT Background There are some studies in the literature about the feeding behavior and masticatory process in patients with feeding disorders; however, it is not very well known if there are alterations in oral-pharyngeal swallowing dynamics in subjects with anorexia nervosa. Objective To evaluate the oral and pharyngeal bolus transit in patients with anorexia nervosa. Methods The study was conducted with 8 individuals clinically diagnosed and in treatment for restricting-type anorexia nervosa (seven women and one man), and 14 healthy individuals with no digestive or neurological symptoms (10 women, 4 men). Swallows were evaluated by videofluoroscopy with three swallows of 5 mL liquid bolus and three swallows of 5 mL paste bolus consistency, given in a random sequence. The participants were asked after each swallow about the sensation of the bolus passage. Results In the analysis of oral-pharyngeal transit duration, the mean duration of pharyngeal transit with paste bolus in patients with anorexia was shorter than in healthy volunteers (P=0.02). In the duration of movement of the hyoid bone, longer movement was observed in anorexia than in healthy volunteers with liquid bolus (P=0.01). With liquid bolus, five (62.5%) patients and one (7.1%) control had sensation of the bolus passage (P<0.05). Conclusion There seems to be no important alterations of swallowing in subjects with anorexia nervosa, although the results suggest that pharyngeal transit has shorter duration than that seen in healthy volunteers and the hyoid movement duration is longer in patients than in healthy volunteers. Fast pharyngeal transit may be the cause of bolus transit perception in patients with anorexia nervosa.

RESUMO Contexto Existem alguns estudos na literatura sobre o comportamento alimentar e da mastigação em pacientes com distúrbios da alimentação, no entanto não é conhecido se há alterações na dinâmica da deglutição em indivíduos com anorexia nervosa. Objetivo Avaliar o trânsito oral e faríngeo em pacientes com anorexia nervosa. Métodos O estudo foi realizado em 8 indivíduos com diagnóstico e em tratamento para anorexia nervosa do tipo restritivo (sete mulheres e um homem), e 14 indivíduos saudáveis, sem sintomas digestivos ou neurológicos (10 mulheres e 4 homens). Os trânsitos oral e faríngeo foram avaliados por videofluoroscopia, com três deglutições de 5 mL de bolo líquido e três deglutições de 5 mL de bolo na consistência pastosa, ingeridos em sequência aleatória. Os participantes foram arguidos, após cada deglutição, sobre a sensação da passagem do bolo. Resultados A duração do trânsito faríngeo com o bolo pastoso, em pacientes com anorexia, foi mais curta do que em voluntários saudáveis (P=0,02). Com bolo líquido a duração do movimento do osso hióide foi mais longa na anorexia do que em voluntários saudáveis (P=0,01). Com bolo líquido, cinco (62,5%) pacientes e um controle (7,1%) tiveram sensação da passagem de bolus (P<0,05). Conclusão Não parece haver importantes alterações da deglutição em pacientes com anorexia nervosa, embora os resultados indiquem que o trânsito faríngeo tem duração mais curta do que a observada em voluntários saudáveis e a duração do movimento do hióide é maior em pacientes do que em voluntários saudáveis. O trânsito faríngeo rápido pode ser a causa da percepção da passagem do bolo em pacientes com anorexia nervosa.

Funciones sensoriales en niños menores de 3 años diagnosticados con trastorno del espectro autista (TEA) / Sensory processing in toddlers diagnosed with autism spectrum disorder (ASD)

Las dificultades de procesamiento sensorial en niños con Trastorno del Espectro Autista (TEA) están ampliamente descritos en la literatura principalmente mediante el uso de encuestas a padres y observaciones. Con menor frecuencia se han descrito las dificultades de procesamiento sensorial en niños menores de 3 años de edad que han sido posteriormente diagnosticados con TEA. Este estudio retrospectivo está basado en 84 niños (28 diagnosticados con TEA, 28 con retraso en el desarrollo, y 28 niños con desarrollo típico) entre 18 y 36 meses de edad que asistieron a un programa de intervención temprana y cuyos padres completaron el cuestionario Infant Toddler Sensory Profile (Dunn & Daniels, 2002). Los resultados obtenidos en esta encuesta revelan que los niños menores de edad con TEA muestran un patrón específico de procesamiento sensorial en comparación con niños con otros retrasos en el desarrollo.

Sensory processing difficulties of children with Autism Spectrum Disorder (ASD) are extensively described in the literature using parent surveys and observations. The sensory processing difficulties of children under 3 years of age who are later diagnosed with ASD have seldom been described. This retrospective study is based on 84 children (28 diagnosed with ASD, 28 with developmental disabilities, and 28 typically developing children) between 18 and 36 months of age attending an early intervention program and whose parents completed the Infant Toddler Sensory Profile questionnaire (Dunn & Daniels, 2002). The results obtained in this survey reveals that toddlers with ASD exhibit a distinct pattern of sensory processing as compared to children with other developmental delays.

Quality of life evaluation of frail elderly in Campinas, São Paulo / Avaliação de qualidade de vida em idosos frágeis em Campinas, SP

Summary Objective: describe the quality of life of frail elderly assisted by the Centro de Referência à Saúde do Idoso (CRI), Campinas, São Paulo, Brazil. Methods: the convenience sample included 122 frail elderly being treated from January 2010 to July 2011, out of a total of 668 frail elderly who were referred to the CRI after application of the brief evaluation form of the elderly, recommended by Ministry of Health, which identifies the elderly with some degree of frailty. Descriptive observational study collected data through sociodemographic questionnaire and quality of life questionnaires: WHOQOL-BREF, WHOQOLOLD and SF-36. Results: the study included 122 frail elderly. Of these, 74.6% (91) were female, mean age 73 years, 46.7% (57) were married, 51.6% (63) had less than 3 years of schooling and 87.7% (107) reported income of one to four minimum wages. The mean total score of the WHOQOL-BREF was 56.6, the WHOQOL-OLD 57.6 and SF-36 Physical Component Summary 34.5 and Mental Component Summary 43.6. Conclusion: knowledge of the impairment profile of quality of life among frail elderly is, therefore, essential for planning health care to this population.

Resumo Objetivo: descrever a qualidade de vida dos idosos frágeis atendidos pelo Centro de Referência à Saúde do Idoso (CRI), de Campinas, São Paulo. Métodos: a amostra de conveniência incluiu 122 idosos frágeis, que iniciaram tratamento a partir de janeiro de 2010 até julho de 2011, de um universo de 668 idosos frágeis encaminhados ao CRI após aplicação da ficha de avaliação breve do idoso, preconizada pelo Ministério da Saúde, que identifica o idoso com algum grau de fragilidade. Estudo observacional descritivo coletou dados por meio de questionário sociodemográfico e questionários de qualidade de vida: WHOQOL-BREF, WHOQOL- -OLD e SF-36. Resultados: participaram do estudo 122 idosos frágeis. Desses, 74,6% (91) eram do sexo feminino, com média de idade de 73 anos, 46,7% (57) eram casados, 51,6% (63) apresentaram até 3 anos de escolaridade e 87,7% (107) informaram renda de um a quatro salários mínimos. O escore total médio do WHOQOL-BREF foi 56,6, o do WHOQOL- OLD, 57,6; e no SF-36 o Componente Físico Sumarizado foi 34,5, enquanto o Componente Mental Sumarizado foi de 43,6. Conclusão: o conhecimento do perfil de comprometimento de qualidade de vida de idosos frágeis é, portanto, fundamental para o planejamento da atenção à saúde dessa população.

O papel do professor no desenvolvimento da sensopercepção em nadadores / Felt sense development in swimmers: work model and results / Desarrolo de la pecepción sensorial en nadadores: modelo de trabajo y resultados

A sensopercepção é a percepção das sensações internas que são geradas por meio da experiência corporal. Frente a esta realidade o papel do profissional de educação física também se torna fundamental uma vez que conduz essas práticas corporais. O objetivo do presente estudo foi mostrar a importância do professor de natação no processo de desenvolvimento da sensopercepção do aluno. A valorização do processo de sensopercepção contribuiu não só para o aprimoramento técnico nas práticas de atividade física, como promoveu nos alunos um aprendizado de melhor cuidar, valorizar e respeitar o próprio corpo. O projeto mostrou uma boa aderência pelos participantes.

The felt sense is the perception of internal sensations that are generated through the body experience. Due to this reality, the Physical Education professional role becomes fundamental, once they conduct the bodily practices. The main objective of this study was to show the importance of swimming teacher in the development process of the felt sense. The appreciation of the felt sense can contribute not only for the technical development on the physical activities, but also promote on the students a better knowledge of taking care, respect and valorize their own body. The project showed to have a good adherence of the ones involved.

La percepción sensorial es la percepción de sensaciones internas que se generan a través de la experiencia del cuerpo. Frente a esta realidad, el papel de la educación física también es crucial, ya que conduce a estas prácticas corporales. El objetivo de este estudio era demostrar la importancia del profesor de natación en el proceso de desarrollo de la percepción sensorial del estudiante. La apreciación del proceso de la percepción sensorial no sólo ha contribuido para ala mejora técnica en la práctica de la actividad física, y promovieran en los estudiantes/clientes un aprendizaje para mejor cuidar, valorar y respetar su propio cuerpo. El proyecto mostró una buena adherencia de los participantes.

Sintomas mentais em homeopatia versus neurociência em medicina veterinária / Mental symptoms in homeopathy versus neuroscience in veterinary medicine

O objetivo deste estudo foi o de conhecer a devida correspondência entre os sintomas mentais considerados na homeopatia e as várias regiões e estruturas identificáveis no encéfalo dos animais. Os resultados obtidos mostraram que as sensações e emoções muito primitivas, como medos e fobias, interagem pontualmente com regiões evolutivamente também muito primitivas do cérebro (como amígdala e núcleos septais), enquanto sentimentos “nobres” como afeto e lealdade interagem holisticamente com várias estruturas cerebrais evolutivamente mais recentes, tais como as áreas neocorticais terciárias associativas (área pré-frontal e temporal). No primeiro caso, as manifestações orgânicas são mediadas pelo sistema nervoso autônomo com sinais fisiológicos de taquicardia, elevação da pressão arterial, vasoconstrição periférica, eriçamento de pelos, midríase e secreção de hormônios como adrenalina e cortisol (disfluência comportamental), enquanto na outra situação apontada, eventuais manifestações orgânicas são harmoniosas e serenas (fluência comportamental). O conteúdo de todo o texto do trabalho é indicativo do interesse prático dos dados obtidos para o clínico veterinário homeopata, ressaltando-se nesse contexto a validação do uso de repertórios homeopáticos humanos na clínica veterinária, evidentemente com as devidas precauções sempre balizadas pelo bom senso do profissional.

This study was motivated by the need to determine the relationship between mental symptoms considered in homeopathy and several regions and structures identified in animal’s brain. Obtained results showed that very primitive sensations (what “it feels like”) and emotions (what is “put out” in behavioral terms), such as fears and phobias, interact punctually with also very primitive brain regions (from the evolutionary point of view, such as amygdala and septal nuclei), while “noble” feelings, such as affection and loyalty, interact holistically with newer brain structures (also from the evolutionary point of view), such as the tertiary associative neocortical areas (prefrontal and temporal). In the first case, the symptoms are expressed in organic manifestations, mediated by the autonomic nervous system, with physiological signs of tachycardia, elevated blood pressure, peripheral vasoconstriction, bristling hair, mydriasis and secretion of hormones, such as adrenaline and cortisol (behavioral disfluency), while, in the second case, eventual organic manifestations are harmonious and serene (behavioral fluency). Overall results are highly suggestive about the influence of mental conditions over health and disease of the physical body, through the process of somatization. The overall content of this work is indicative of the practical interest in the results by homeopathic veterinary practitioners, and in this context emphasizes the validity of using human homeopathic repertories in veterinary clinics, obviously with suitable precaution and, always directed by good professional judgment.

The comparison of urodynamic findings ?n women with various types of urinary ?ncontinence

PurposeWe aimed to determine the differences of the urodynamic findings of mix urinary incontinence (MUI), urge urinary incontinence (UUI), and stress urinary incontinence (SUI), and to evaluate the urodynamic findings in different groups by using bladder sensitivity index (BSI).Materials and MethodsThe data of 99 patients who underwent urodynamic testing related to the suspicion of SUI, UUI or MUI were analysed. This analysis included a retrospective evaluation of patients’ cards, voiding diaries, and urodynamic reports. At filling cystometry, the parameters of first sensation of bladder filling (FSBF), first desire to void (FDV), strong desire to void (SDV), and bladder capacity (Vmax), which were related to the bladder sensation, were determined. Subsequently, uroflowmetric findings were recorded during bladder emptying. BSI was defined as the ratio of Vmax/FDV. These results were statistically compared among the goups.ResultsThe sample included 35(35.5%) MUI, 33(33.3%) UUI and 31 (31.1%) SUI. The mean ages were similar in all groups (P = 0.868). The mean FSBF, FDV, SDV and Vmax values were significantly different among groups (p = 0.004, p < 0.001, p < 0.001, p < 0.001 respectively). Nevertheless, there was no statistically significant difference among the mean daily voiding accounts (P = 0.005). Although the mean maximum flow rate (Qmax) values were similar (P = 0.428), the mean maximum detrusor pressure (Pdetmax) values were significantly different (P = 0.021). The mean BSI values showed no significant differences (P = 0.097).ConclusionsIt was concluded that while the use of urodynamic testing could contribute to the management of urinary incontinence, the indexes including BSI requere more detailed and comprehensive studies.

Esophageal contractions, bolus transit and perception of transit after swallows of liquid and solid boluses in normal subjects / Contrações esofágicas, trânsito do bolo e percepção do trânsito após deglutições de bolos líquido e sólido em voluntários normais

CONTEXT: Esophageal dysphagia is the sensation that the ingested material has a slow transit or blockage in its normal passage to the stomach. It is not always associated with motility or transit alterations. OBJECTIVES: To evaluate in normal volunteers the possibility of perception of bolus transit through the esophagus after swallows of liquid and solid boluses, the differences in esophageal contraction and transit with these boluses, and the association of transit perception with alteration of esophageal contraction and/or transit. METHODS: The investigation included 11 asymptomatic volunteers, 4 men and 7 women aged 19-58 years. The subjects were evaluated in the sitting position. They performed swallows of the same volume of liquid (isotonic drink) and solid (macaroni) boluses in a random order and in duplicate. After each swallow they were asked about the sensation of bolus passage through the esophagus. Contractions and transit were evaluated simultaneously by solid state manometry and impedance. RESULTS: Perception of bolus transit occurred only with the solid bolus. The amplitude and area under the curve of contractions were higher with swallows of the solid bolus than with swallows of the liquid bolus. The difference was more evident in swallows with no perception of transit (n = 12) than in swallows with perception (n = 10). The total bolus transit time was longer for the solid bolus than for the liquid bolus only with swallows followed by no perception of transit. CONCLUSION: The results suggest that the perception of esophageal transit may be the consequence of inadequate adaptation of esophageal transit and contraction to the characteristics of the swallowed bolus.

CONTEXTO: Disfagia esofágica é a sensação de que o alimento ingerido tem trânsito lento ou é bloqueado em sua passagem para o estômago. Nem sempre o sintoma é associado com alterações em trânsito ou motilidade. OBJETIVOS: Avaliar, em voluntários normais, a possibilidade de percepção do trânsito através do esôfago de bolo sólido e líquido, as diferenças nas contrações esofágicas e no trânsito pelo esôfago com estes bolos, e a associação entre percepção do trânsito com alterações nas contrações e/ou trânsito. MÉTODOS: Foram estudados 11 voluntários assintomáticos, 4 homens e 7 mulheres com idades entre 19 e 58 anos. Os voluntários foram avaliados na posição sentada. Eles deglutiram, em duplicata, o mesmo volume de bolo sólido (macarrão) e líquido (bebida isotônica). Após cada deglutição foi perguntado sobre sensação da passagem do bolo pelo esôfago. Contrações e trânsito foram avaliados simultaneamente por manometria de estado sólido e impedância. RESULTADOS: Percepção do trânsito ocorreu apenas com o bolo sólido. A amplitude e área sob a curva das contrações foram maiores com a deglutição do bolo sólido do que com a deglutição de bolo líquido. A diferença foi mais evidente nas deglutições em que não houve percepção do trânsito (n = 12) do que nas deglutições com percepção (n = 10). O tempo total de trânsito foi mais longo para o bolo sólido do que para o bolo líquido somente com as deglutições seguidas pela não percepção do trânsito. CONCLUSÃO: Os resultados sugerem que a percepção da passagem do bolo pelo esôfago deve estar relacionada à adaptação inadequada das contrações esofágicas e do trânsito às características do bolo deglutido.

A existência de alterações neurofisiológicas pode auxiliar na compreensão do papel da hipotonia no desenvolvimento motor dos indivíduos com síndrome de Down? / Existence of neurophysiologic changes can assist in understanding the role of hypotonia in motor development of subjects with Down syndrome?

A proposta deste estudo foi analisar e verificar a existência de alterações neurofisiológicas nos indivíduos com síndrome de Down, como a hiporreflexia, estática e dinâmica, que, se presente, pode ocasionar prejuízo no controle sensório-motor dos músculos, e consequentemente a hipotonia, contribuindo para alterações no desenvolvimento motor. O sinal eletromiográfico (EMG), início e término do sinal eletromiográfico, foi coletado de 24 voluntários com diagnóstico de síndrome de Down e 25 voluntários como grupo controle, durante 2 situações distintas: período de latência dinâmico e teste de reflexo monossináptico (estático) patelar e aquileu. Em relação aos aspectos neurofisiológicos, observou-se que, para todas as variáveis analisadas, houve diferença estatisticamente significante (p<0,05) entre os grupos. A existência de alterações neurofisiológicas (retardo do período de latência) comprovadas neste estudo, oriundas de um prejuízo no controle sensório-motor, as quais podem ser responsáveis pela hipotonia muscular, mostrou-se como um dos vários possíveis fatores determinantes pelas alterações no desenvolvimento motor dessas crianças, tornando-se importante devido às alterações neuromusculares que podem interferir nas atividades funcionais.

The purpose of this study was to analyze and verify the existence of neurophysiological changes in individuals with Down syndrome, such as hyporeflexia, static and dynamic, which, if present, may cause impairment in sensory-motor control of muscles, and consequently hypotonia, contributing to changes in motor development. The electromyographic signal (EMG), start and termination electromyographic signal, was collected from 24 volunteers with a diagnosis of Down syndrome and 25 volunteers as controls for 2 different situations: the dynamic latency period and monosynaptic reflex (static) patellar and Achilles. For neurophysiological aspects, it was observed that for all variables analyzed, statistical difference (p<0.05) between groups. The existence of neurophysiological changes (delay of the latency period) demonstrated in this study originated from an impairment in sensory-motor control, which may account for the decreased muscle tone, presents as one of several possible factors for the changes in motor development of children, which shows important due to neuromuscular disorders that can interfere in functional activities.

Correlations between motor and sensory functions in upper limb chronic hemiparetics after stroke / Correlações entre função motora e sensorial do membro superior de hemiparéticos crônicos pós-acidente vascular encefálico

OBJECTIVE: Describe the somatosensory function of the affected upper limb of hemiparetic stroke patients and investigate the correlations between measurements of motor and sensory functions in tasks with and without visual deprivation. METHOD: We applied the Fugl-Meyer Assessment (FMA), Nottingham Sensory Assessment (NSA), and several motor and sensory tests: Paper manipulation (PM), Motor Sequences (MS), Reaching and grasping (RG) Tests Functional (TF), Tactile Discrimination (TD), Weight Discrimination (WD) and Tactile Recognition of Objects (RO). RESULTS: We found moderate correlations between the FMA motor subscale and the tactile sensation score of the NSA. Additionally, the FMA sensitivity was correlated with the NSA total; and performance on the WD test items correlated with the NSA. CONCLUSION: There was a correlation between the sensory and motor functions of the upper limb in chronic hemiparetic stroke patients. Additionally, there was a greater reliance on visual information to compensate for lost sensory-motor skills.

OBJETIVO: Descrever a função somatossensorial do membro superior afetado de hemiparéticos crônicos após acidente vascular encefálico (AVE) e verificar as correlações entre instrumentos de medida da função motora e sensorial em tarefas com e sem privação visual. MÉTODO: Aplicados o Protocolo de Desempenho Físico de Fugl-Meyer (FMA), Avaliação Sensorial de Nottingham (ASN), e os testes de: Manipulação de Papel (MP), Sequência Motora (SM), Alcance e Preensão (AP), Testes Funcionais (TF), Discriminação Tátil (DT), Discriminação de Peso (DP) e Reconhecimento Tátil de Objetos (RO). RESULTADOS: Foram encontradas correlações moderadas entre a FMA motora e itens da subescala sensação tátil da ASN; a FMA sensibilidade correlacionou-se a ASN total; e o teste DP se correlacionou com itens da ANS. CONCLUSÃO: Houve correlação entre a função sensorial e motora do membro superior em pacientes hemiparéticos crônicos pós- AVE; e maior dependência das informações visuais para compensar a perda sensório-motora.