Technical Innovation for Visual Assessment of Preterm Newborns in a Neonatal Intensive Care Unit: Exploratory Study.

OBJECTIVE: The present study is aimed at assessing heart rate variability (HRV) and its correlation with visual acuity (VA) assessment of preterm newborns (PTNB) in neonatal intensive care units. METHOD: Cross-sectional study analyzing HRV during assessment of VA with the aid of a Polar RS800CX heart rate monitor (Polar Electro Oy, Finland). HRV was analyzed according to time and frequency domains and the chaos domain used the autocorrelation coefficient and entropy. The sample consisted of hospitalized PTNB, and static analysis included simple regression diagnosis. RESULTS: A total of 14 PTNB were included in the sample. VA varied between 0.23 and 1.60 cpd, and only five PTNB obtained below-expected values for age. Statistical analysis demonstrated a negative correlation between VA and time domain (SDDN and SD2) and a positive correlation between frequency domain (heart rate and hertz), but in simple linear regression analysis, these variables did not influence VA. CONCLUSION: The results of the study demonstrate that visual acuity was inversely correlated with SDNN and SD2 and during stimulation, showing that the higher the visual performance, the lower the autonomic modulation response.

Long-term impact of pre-operative physical rehabilitation protocol on the 6-min walk test of patients with adolescent idiopathic scoliosis: A randomized clinical trial.

BACKGROUND: Monitored physical activities in patients with adolescent idiopathic scoliosis (AIS) have been shown to improve physical performance, endurance and cardiopulmonary function and may be assessed by the 6-min walk test (6MWT). We aimed to evaluate the long-term results of the 6MWT after a rehabilitation protocol employed before surgical correction for AIS. METHODS: This prospective randomized clinical trial studied the impact of a 4-month pre-operative physical rehabilitation protocol on post-operative cardiopulmonary function and physical endurance, by using the 6MWT, in patients with AIS submitted to surgical correction, comparing them to matched controls without physical rehabilitation. Studied variables were heart and respiratory rate, systolic and diastolic blood pressure, peripheral blood oxygen saturation, Borg score, and distance walked. Patients were assessed at baseline, after 4 months of rehabilitation, and 3, 6 and 12 months post-operatively. RESULTS: A total of 50 patients with AIS were included in the study and allocated blindly, by simple randomization, into either one of the two groups, with 25 patients each: study group (pre-operative physical rehabilitation) and control group. The physical rehabilitation protocol promoted significant progressive improvement in heart and respiratory rate, peripheral blood oxygen saturation, distance walked, and level of effort assessed by the Borg scale after surgery. CONCLUSIONS: Post-surgical recovery, evaluated by 6MWT, was significantly better in patients who underwent a 4-month pre-operative physical rehabilitation protocol.

Extracellular mutations of protease-activated receptor-1 result in differential activation by thrombin and thrombin receptor agonist peptide.

The protease-activated thrombin receptor-1 (PAR-1) can be activated by both the tethered ligand exposed by thrombin cleavage and a synthetic peptide having the tethered ligand sequence (thrombin receptor agonist peptide or TRAP). We conducted a mutational analysis of extracellular residues of the receptor potentially involved in interaction with both the tethered ligand and the soluble peptide agonist. Agonist-stimulated calcium efflux in X. laevis oocytes or inositol phosphate accumulation in COS-7 cells was used to assess receptor activation. We have also examined the binding of a radiolabeled TRAP for the wild-type and mutant PAR-1 receptors. Our results indicated that most of the mutations strongly affected TRAP-induced responses without significantly altering thrombin-induced responses or TRAP binding. Several point mutations and deletion of extracellular domains (DeltaEC3, DeltaNH3) drastically altered the ability of mutant receptors to respond to TRAP, but not to thrombin, and did not affect the affinity for the radiolabeled TRAP by these mutant receptors. Only mutations that disrupted the putative disulfide bond or substitution of multiple acidic residues in the second extracellular loop by alanine had a significant effect on both ligand binding and thrombin activation. These results suggest that although both agonists can activate PAR-1, there are profound differences in the ability of thrombin and TRAP to activate PAR-1. In addition, we have found PAR-1 mutants with the ability to dissociate receptor-specific binding from functional activity.

Atendimento de casais: descrevendo processos

Descreve e analisa o processo da psicoterapia conjugal, realizada segundo os princípios da Abordagem Centrada na Pessoa e discorre sobre a viabilidade do instrumento utilizado. São participantes da pesquisa: a terapeuta e quatro casais de Sentido (VSs). Utiliza um instrumento de acesso ao processo denominado Versão de Sentido (VS), que permite aos participantes expressar o sentido vivido. As VSs são analisadas qualitativamente cada uma e na série, concluindo que: 1- oferece-se a estes casais um espaço que se torna terapêutico porque Ihes permite rever suas relações conjugais; 2- o caminho que trilham no processo é coerente com o que objetivam; 3 - dois casais se centralizam nas relações com os filhos, e dois focalizam a relação conjugal; 4 - os casais partem de relações rigidamente estabelecidas e chegam a relações mais fluidas; 5 - processos (a) partem de um desnudar-se diante da terapeuta e do cônjuge, o que Ihes permite entrar em contato com relações que mantém; 6 - os casais mais centrados nas relações com os filhos obtêm uma mudança de percepção na relação com estes b) integrando-os mais com c) o que Ihes possibilita também explorar questões conjugais e chegar a d) relações mais fluidas. Os casais mais centrados nas relações conjugais passam de b) uma exploração de aspectos individuais, c) confrontando-se com os medos que, em sendo superados, Ihes permite chegar a d) uma relação mais tranqüila e ao, contrário, uma separação; 7 - constata que estes casais são representativos de famílias pós-modernas; 8 - conclui que o instrumento utilizado é facilitador do acesso ao processo psicoterápico (AU)