Desenvolvimento motor de criança com paralisia cerebral: Avaliação e intervenção

The objective of this study was to analyze the motor development of a ten year old child with ataxic cerebral palsy and the effects of a motor activities program in the swimming pool. Motor development was measured according to the motor assessment and the intervention program of motor activities in the swimming pool conducted at Sesi/Londrina, twice a week, during 45 minute sessions over a 2 month period, with an attendance rate of 87%. Data was analyzed descriptively comparing the results with before and after tests. Generally, the motor quotient regarding all items was classified as very low, characterizing motor deficit, with exception of temporal organization, presented as normal low. After intervention, the only area that showed positive change was balance; this result showed that the child gained 12 months in motor age, without corresponding alterations in the other areas.

Uso de expressões orais durante a implementação do recurso de comunicação suplementar e alternativa

The literature has discussed the importance of early implementation of augmentative and alternative systems with people with various disabilities. This discussion is related to concerns about language acquisition and development within the various expressive possibilities. Researchers advise that starting intervention early through resources and procedures using augmentative and alternative communication does not impede speech acquisition and development. This paper aimed to describe oral expressive abilities during the implementation of augmentative and alternative communication with a student with cerebral palsy. An 11-year-old student with cerebral palsy participated in the augmentative and alternative communication program for two years. Twelve sessions were selected during the first year of the intervention. The sessions were filmed and the augmentative and alternative communication resource procedures were transcribed. The categories of analysis were defined as verbal expression; nonverbal expression and verbal and nonverbal expression associated. The results of this study identified that augmentative and alternative communication resources supported the use of verbal expression such as vocalizations, words and unintelligible oral expressions.

Arranjos configurados pelos nervos do plexo braquial no urubu (Coragyps atratus foetens - Linnaeus, 1758)

The anatomical study of the origin and distribution of brachial plexus in vulture (Coragyps atratus foetens) was performed in 14 animals, adults, males and females, deriving of the region of Araçatuba (SP). After fixed in watery solution of formaldehyde 10,00%, became dissected bilateral of the origin of the brachial plexus, and yours distribution. The analysis allowed verify that brachial plexus of vulture, four root possess, which originate from the ventral branches of cervical spinal nerves eleven (C11), twelve (C12) and thirteen (C13) and of the ventral branches of thoracic spinal nerve one (T1) and (T2) in both sides (100%). The first root part of C11 in the right and left side, and of the edge skull of the dorsal lace the nerves subescapular, subcoracoescapular e supracoracóide in both antímeros (100%). As the root originates from C12 in both sides, giving origin to the dorsal lace, giving the axilar, radial and anconeal nerves (100%). The third root of plexus originates solely from C13 (100%) and the root of T1 in both sides (100%). The roots of C12, C13 and T1 was united the ventral lace originates, which breaks the nerves to medianoulnar that divided in medium and to ulnar and the pectoral nerves (100%). T2 emits filaments that join it root nervous of T1, being one filament (35,55%) and two filaments (64,29%) in side right, while that in the left one filament (42,85%), two filaments (50%) and three filaments (7,15%).

Clinical and microbiological evaluation of the use of toothpaste containing 1% chlorhexidine and the influence of motivation on oral hygiene in patients with motor deficiency

Patients with motor deficiency have variable difficulties with mechanical plaque control, and as a consequence, the incidence of dental caries and periodontal disease can be higher in these patients. The objective of this study was to evaluate the clinical and microbiological efficacy of a toothpaste containing 1% chlorhexidine, which was used by patients with motor deficiency for 14 days. The reduction in plaque and gingival index and the impact on salivary microorganisms was evaluated. We conclude that the motivation of caregivers to carry out oral hygiene for patients with mental and motor deficiency is of great importance and is effective in reducing the formation of plaque as long as it is continuously reinforced. The use of chlorhexidine- containing toothpaste significantly reduced the plaque index and microorganism count between days 0 and 14. A reduction was also observed in the group that used a dentifrice without the chlorhexidine, but this difference was not significant. © 2010 Special Care Dentistry Association and Wiley Periodicals, Inc.

Late-onset sepsis: Epidemiology, evaluation, and outcome

Late-onset neonatal sepsis is a common serious problem in preterm infants in neonatal intensive care units. Diagnosis can be difficult because clinical manifestations are not specific and none of the available laboratory tests can be considered an ideal marker. For this reason, a combination of markers has been proposed. Complete blood count and acute-phase reactants evaluated together help in diagnosis. C-reactive protein is a specific but late marker, and procalcitonin has proven accurate, although it is little studied in newborns. Blood, cerebrospinal fluid, and urine cultures always should be obtained when late-onset sepsis is suspected. Blood culture, the gold standard in diagnosis, is highly sensitive but needs up to 48 hours to detect microbial growth. Various cytokines have been investigated as early markers of infection, but results are not uniform. Other diagnostic tests that offer promise include: neutrophil surface markers, granulocyte colony-stimulating factor, toll-like receptors, and nuclear factor kappa B. The greatest hope for quick and accurate diagnosis lies in molecular biology, using real time polymerase chain reaction combined withDNAmicroarray. Sepsis and meningitis may affect both the short- and long-term prognosis for newborns. Mortality in neonatal meningitis has been reduced in recent years, but short-term complications and later neurocognitive sequelae remain. Late-onset sepsis significantly increases preterm infant mortality and the risk of cerebral lesions and neurosensory sequelae, including developmental difficulties and cerebral palsy. Early diagnosis of late-onset sepsis contributes to improved neonatal prognosis, but the outcome remains far from satisfactory. © 2010 by the American Academy of Pediatrics.

Assistência Odontológica em Crianças com Paralisia Cerebral e Perspectivas Tecnológicas de Reabilitação

The improvement of oral health and quality of life is closely related to transdisciplinary dialogue, technological development and social responsibility. In patients with cerebral palsy, the lesion of motor areas of the brain compromises the development and function of the craniofacial complex. Considering all the ethiopathogenic conditions, the treatment of such patients involves great difficulties. The dentist and other professionals related to their rehabilitation need to deal with difficulty in chewing, respiration, phonation, besides the poor oral hygiene resulted from abnormal involuntary movements of facial and masticatory musculature, tongue, and upper limb. It is also relevant the lack of understanding about the importance of oral health care due to mental deficits of these individuals. This study aims to review some aspects of oral health in patients with cerebral palsy proposing rehabilitation associated to technology. Few studies concerned about the effectiveness of therapies for oral rehabilitation in patients with cerebral palsy. Laser therapy, electromyography, electrostimulation and LED therapy should be analyzed as options for treatment of patients with cerebral palsy. Following research projects should focus more attention on the dynamic and oral function of these patients to achieve positive repercussions in their overall health. © ArquiMed, 2010.

Estudio sobre la amplitud del movimiento articular de la rodilla en el proceso de marcha de niños con parálisis cerebral espástica

Introduction: To analyze the contribution of knee range of motion in walking of hemiplegic and diplegic children, considering their asymmetries. Material and method: Twelve children, 6 hemiplegics and 6 diplegics, from 7 to 12 years of age (9.5 ± 1.93) participated. Spasticity was assessed with the Ashworth's Modified Scale and the passive knee range of motion using an electrogoniometer. The task was to walk on an 8 m long walkway, using their preferred speed. Six attempts were made, three of which were on the right and three on the left sagittal planes. Results: The Mann-Whitney's U test found differences in the type of cerebral palsy for knee extension/hyperextension, for the relative angle of the knee at the load acceptance phase and for the knee range of motion during stride. The Wilcoxon's test revealed differences in hemibody for hemiplegics in the relative angle of the knee in acceptance of the load. Conclusions: Children with spastic cerebral palsy use compensation strategies between the lower limbs during walking. These strategies differed according to the type of cerebral palsy. The knee joint has an important function in those strategies, especially in the load acceptance and propulsion phases. © 2010 Elsevier España, S.L. y SERMEF. Todos los derechos reservados.

Preeclampsia: Early and late neonatal outcomes

Newborn infants exposed to preeclampsia (PE) present increased short-term morbidity, mainly respiratory diseases such as respiratory distress syndrome and bronchopulmonary dysplasia. Gastrointestinal problems are also frequent, although a higher risk of necrotizing enterocolitis has not been confirmed. These problems could be related not just to PE itself but also to prematurity or intrauterine growth restriction, which frequently occur in this maternal disease. Other findings, however, seem to be due to the direct effect of the maternal disease; these findings include an increased frequency of neutropenia and thrombocytopenia and a lower incidence of cerebral disorders, such as periventricularintraventricular hemorrhage and cerebral palsy. The evaluation of long-term outcome shows increasing evidence that PE has important implications for the future health of the mother and her child, suggesting that PE is not a simple gestational disorder but a clinical syndrome with an unclear etiology, a genetic component, and a complex pathophysiology. This syndrome involves important maternal and fetal vascular alterations that can persist and cause diseases in later life. The divergence in results on outcomes for children exposed to PE could, in part, be due to methodological differences in the studies, most of which are retrospective case-control studies. Better evidence on prognosis is obtained from cohort studies. Even in the cohort studies, differences in patient characteristics and severity of maternal disease, as well as sample size, follow-up time, and main outcome measures certainly contribute to the variability in results reported in the literature. © 2012 by the American Academy of Pediatrics. All rights reserved.

Interação de um aluno com paralisia cerebral com colegas de classe durante atividades ludicas

The study aimed to examine the quality of interpersonal relationships developed between a child with cerebral palsy (CP) and his classmates during group play activities carried out in the classroom and during recess. The participants of the study were a boy with clinical diagnosis of quadriplegic CP, his teacher and classmates. Data collection was carried out by means of a structured interview with the teacher and of video recording the child with CP interacting with his classmates in play activities. The interview data analysis was carried out using qualitative procedures and the video recording was analyzed using a category system. The results showed that the teacher perceived the child with CP to be interested; he participated in play activities and interacted successfully both with familiar partners and with all classmates in general. On the other hand, the analysis of the video recorded activities showed that even though interaction did in fact occur positively, the child with CP remained mostly an observer of the activities rather than an active participant, possibly due to the gap between the child's possibilities and the requirements imposed by the activities underway in the school setting.

Myenteric denervation in gastric carcinogenesis: Differential modulation of nitric oxide and annexin-A1

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Desempenho motor de aluno com paralisia cerebral discinética frente à adaptação das propriedades físicas de recurso pedagógico

The main purpose of this study was to analyze the modified physical properties of an educational resource for facilitating the handling of a child with dyskinetic cerebral palsy. The participant of the study was a six year old child with dyskinetic cerebral palsy enrolled in a regular early childhood education classroom. The educational resource that was selected was a brick game, in which the physical properties of weight, size and texture had been modified. The analysis was made regarding the quality of upper limb movement to the variables: righting index, scalar displacement (s), average speed (As) and time (t). The results showed that combined large size and heavy weight did not have a satisfactory outcome, affecting both grasping the educational resource and fitting. There was also inconsistency in children with cerebral palsy's responses. There is variation in the results, though a standard cannot be established. Thus, this study contributed to understanding the motor responses of a child with dyskinetic cerebral palsy when participating in a fitting activity with educational resources in which the physical properties had been modified.

Alterations in the duodenum myenteric neurons of Wistar rats after ingesting of 2,4 dichlorophenoxyacetic acid

The 2,4 dichlorophenoxyacetic acid (2,4-D) is a systemic herbicide whose effects in animal organic systems have been examined in previous studies, being the neurotoxicity considered the predominant effect. However, the studies that detect the 2,4-D neurotoxicity have merely focused in the central nervous system, and therefore, little is known about the effect of this herbicide in the enteric nervous system. This study aimed to verifying the 2,4-D effects on the myenteric neurons in duodenum of Wistar rats. Ten 60-day-old male Wistar rats (Rattus norvegicus) were divided in two groups: control group (C) that did not receive 2,4-D and experimental group (E) that received 5.0 mg of 2,4-D/kg for 15 days. At the end of experimental period, the animal were euthanized, the duodenum was collected and processed for NADPH-diaphorase histochemical analysis in order to expose the nitrergic myenteric neurons (NADPH-dp). In the light microscopy analysis, the whole-mount preparation obtained from duodenum of each animal were image-captured in 120 and 40 fields, for quantitative and morphometric analyses of myenteric neurons, respectively. The neuronal density was not affected when comparing the two groups, but an increase (p > 0.05) of 8.5% was observed in the cell body area of neurons in the E group. In conclusion, the ingestion of 2,4-D at a dosage of 5.0 mg/kg body weight for 15 days does not change the neuronal density, but promotes the hypertrophy of NADPH-dp myenteric neurons in duodenum of the rats of this study.

Visceral colouration of Eupemphix nattereri (Anura: Leiuperidae): effects of NDP-α-melanocyte stimulating hormone

Amphibians have melanin-containing cells in visceral organs that are similar to pigmentary cells from the epidermis. Both of them are derived from the ectodermal neural crest. Epidermal cells respond to α-melanocyte stimulating hormone (α-MSH), which is associated to the dispersion of melanin granules within melanocytes. Therefore, our aim was to test whether a non-degradable analogue of the α-MSH changes the superficial colouration of organs of Eupemphix nattereri. The hormone rapidly increases (within 12 hours) the colouration on the surface of the pericardium, heart, testes, nerves of the lumbar plexus, and lumbosacral parietal peritoneum. Colouration increased late (after 24 hours) in the kidneys and mesentery following hormone administration. However, this hormone did not change colouration of intestine, rectum and lungs. Our findings could be explained by the similarities between epidermal and visceral melanocytes, since both cells have a common embryonic origin. Furthermore, the increase in visceral colouration may be related to the dispersion of melanosomes within melanocytes, which causes the darkening of organs. Our results demonstrate for the first time that the visceral colouration is responsive, thereby altering the internal pattern of organs' colouration in anurans. © 2013 Copyright 2013 Unione Zoologica Italiana.

Mobilidade funcional em indivíduos com paralisia cerebral espástica

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Assento adaptável para pessoas com paralisia cerebral e seqüela de escoliose: aplicando ergonomia por meio do design - num estudo de caso

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)