RESUMO: O estudo objetivou traduzir e adaptar a versão do PrematureInfant Pain Proile para a língua portuguesa adotada no Brasil. Trata-se de estudo transversal de caráter metodológico para validação de tradução de instrumento. O processo foi conduzido em quatro etapas: tradução inicial, síntese, retrotraduçãoe análise por juízes. Foram elaboradas quatro versões independentes do instrumento traduzido para o português. Posteriormente, uma versão síntese foi produzida com base nas traduções anteriores. A seguir, duas retrotraduções foram elaboradas independentemente e nenhuma destas apresentou discrepâncias importantes em relação ao instrumento original. Um comitê de juízes analisou a versão síntese e as retrotraduções com relação à equivalência semântica e idiomática e julgou adequada a versão do instrumento em língua portuguesa. Assim, o Peril de Dor no Recém-Nascido Pré-termo foi considerado adaptado à língua portuguesa do Brasil, para aplicação em pesquisa e na prática clínica, o contribuirá, especialmente, para a internacionalização de pesquisas brasileiras.
While the overall community structure and balance between pathogenic and commensal bacteria within the intestinal microbiome is very likely to influence the development of NEC, to what extent the microbiome drives the etiology of NEC is not clear. As in many other dis- eases, where the disease evolves as a result of the interaction between the pathogen and the host, we think that there is a greater need to understand the prematureinfant inflammatory re- sponse to intestinal bacteria, as this response is likely playing a significant role in the etiology of NEC. This area of inquiry is especially important given recent findings, which have shown that the immune system of the infant born at term is “turned-down” for a period of time early in life, presumably to allow for the rapid intestinal colonization that occurs following birth . How the immature immune system is programmed to facilitate early intestinal coloniza- tion of the prematureinfant is unknown. Future research on the immature immune response, in tandem with early intestinal colonization, may help develop interventions that attenuate the inappropriate inflammatory response that characterizes NEC in premature infants.
Despite several studies that have demonstrated the importance and benefits of exclusive breastfeeding up to six months of age in premature infants, the strong marketing of the food industry still shows great impact worldwide on it through advertisements on TV and internet, free distribution of infant formulas, financing of scientific events, among others. Thus, investments in supervising and monitoring adherence to the standard are required, besides to the professionals working in the field of neonatology to encourage the EBF since the presence of the prematureinfant in a neonatal intensive care unit (NICU) (30) .
Objetivo: identificar as evidências científicas acerca das habilidades de recém-nascidos prematuros, em Unidade de Terapia Intensiva Neonatal, para início da alimentação oral. Métodos: revisão integrativa, realizada nas bases de dados Scopus, Cinahl, Medline, Lilacs, Science Direct e Web of Science, de forma não controlada e sem recorte temporal, utilizando os descritores: Recém-Nascido Prematuro/Premature, Infant; Comportamento Alimentar/ Feeding Behavior e Aleitamento Materno/Breast Feeding, cruzando-os com o operador AND. Critérios de inclusão: disponíveis na íntegra, em português, inglês e espanhol, sem limitação de ano; e os de exclusão: artigos que não responderam à questão de pesquisa, repetidos e provenientes de outras fontes científicas. Resultados: as produções científicas revelaram que a estimulação sensório-motora-oral, sucção não nutritiva e avaliação de parâmetros hemodinâmicos favorecem a transição sonda-oral para o aleitamento materno. Conclusão: foram identificadas evidências que comprovam que o uso da estimulação e o desenvolvimento das habilidades facilitam, em menor tempo, o in ício da alimentação oral.
Objective: To measure pain in neonates during placement of central line catheter via peripheral insertion by comparing pain at the moment of the introduction of the catheter and pain at the progression of the catheter. Methods: This was a descriptive exploratory study with 28 neonates from a large teaching hospital in Sao Paulo city. Data were collected with the PrematureInfant Pain Profile (PIPP) 15 seconds prior the initial introduction of the catheter, during the initial introduction of the catheter (30 seconds), and during the progression of the catheter (30 seconds). Results: The majority of neonates (59.1%) had a score e” 7 on the PIPP, moderate to high pain intensity, during the initial introduction of the catheter. A greater number of neonates (45.5%) who did not receive analgesic or sedative medication had score e” 7 on the PIPP, moderate to high pain intensity, during the progression of the catheter. Conclusion: There is a need for adoption of use of analgesic medication in the neonatal unit, since neonates often undergo invasive and painful procedures.
The prematureinfant readiness protocol for oral administration is divided into the following categories: corrected age, state of behavioral organization, oral posture, relexes and oral non-nutritive sucking. Each category consists of items with performance variations between scores of 0 (zero) and 2 (two), with the total score of 0 to 36. Infant alertness, state of behavioral organization regarding global posture and overall tone were observed, while oral posture (lip and tongue posture) and oral relexes (rooting relex, sucking relex, biting relex and the gag relex) were tested. To conclude, non-nutritive sucking was evaluated for one minute using a gloved little inger. This evaluation assessed tongue and jaw movement, tongue cupping, sucking strength, number of sucks per pause, sucking rhythm and ability to maintain alertness. During testing of non-nutritive sucking, the presence or absence of the following signs of stress was noted: accumulation of saliva, beating of nasal wings, change in skin color, apnea, tone variation, posture change, labored breathing, tongue or jaw tremors, hiccups or crying 8.15 . After the application
RESUMO | Os objetivos deste estudo foram veriicar a diferença do comportamento motor entre lactentes prematuros de baixo peso (BP) e muito baixo peso (MBP) nos primeiros 8 meses de vida e avaliar o comportamento motor em diferentes faixas etárias desses lactentes. Avaliou- se 41 lactentes nascidos com BP (2.499 a 1.500g) e 22 com MBP (1.499 a 1.000g). Dividiu-se os grupos nas faixas de RN-1 mês, 2-4 meses e 5-8 meses, e seu comportamento motor foi analisado pelo escore e percentil da Alberta Infant Motor Scale (AIMS). Foi utilizado o teste Kruskall- Wallis para veriicar a diferença do comportamento motor entre as faixas etárias (RN a 1 mês, 2-4 meses e 5-8 meses) em cada grupo independentemente. Para veriicar a diferença entre os grupos (BP e MBP) em cada faixa etária utilizou-se o teste Mann-Whitney (p≤0,05). Observou-se diferença signiicativa entre os grupos BP e MBP, tanto no escore (p=0,011) quanto nos percentis (p=0,010), nas faixas etárias de 2-4 e 5-8 meses (p=0,017; p=0,013, respectivamente). Na comparação entre 0-1 mês e 2-4 meses foram observados maiores escores nos grupos BP (p=0,000) e MBP (p=0,001) e menores percentis (p=0,003) no grupo MBP aos 2-4 meses. Entre 0-1 mês e 5-8 meses, observamos maiores escores (p=0,000; p=0,000) e menores percentis (p=0,005; p=0,000) aos 5-8 meses, bem como, entre 2-4 e 5-8 meses apresentaram maior escore (p=0,000; p=0,000) e menor
The worries with infant food and the problems caused by its wrong conduction have lead to a series of harmful consequences to future generations health. The impelling from advertising respecting to utilization of maternal milk substitutes has been motive of discomfort from many international organizations, which have en- gaged themselves in alert several countries authorities to look for legal mechanisms to defend children’s health, as is the case of International Code or Marketing of Breast Milk Substitutes and Law # 11265/2006, here in Brazil.
The brain is particularly vulnerable to oxidative stress due to its high metabolic rate, high lipid content and limited antioxidant defenses [18,19,20]. Therefore, we propose that absence of Bmi-1 causes brain oxidative stress, which may be a primary mechanism for premature neurodegeneration. In addition, it is known that astrocytes are responsible for modulation of neurotransmitter release and synchronization of neuronal firing [21,22]. Reactive astrocytes accompanied with alterations in glutamate transporters and glutamine synthetase have been observed in the brains of patients with temporal lobe epilepsy and animal models of epilepsy [23,24]. Thus, an additional aim of the present study is to
Data provided in the study of Padma Kumari and in that of Lin, in cases of loss of the temporary irst mandibular molar, showed a statistically signiicant loss of space on the extraction side and insigniicant reduction in the control . The loss rate was higher in the irst 4 months. This study certiies the use of space maintainers in the circumstances of premature loss of temporary mandibular molars in order to preserve space. Yet, the authors found no signiicant arch differences in width, length and perimeter between the initial and the inal examination, so that they concluded that the change in space after premature loss of the irst temporary molar in the mandible is caused mainly by a distal movement of the temporary canine during the irst stage of the premature loss of the irst temporary molars.
The IMR decreased from 29.5 in 2001 to 17.7 deaths per thousand LB in 2010 (Figure 2). The average IMR decreased in all the living condition strata between the two ive-year periods. The strata “very low” and “high” were the ones with the highest reduction percentages (34.7% and 33.8%, respectively). Average infant mortality rates differed between the two periods in all the living condi- tion strata, except for the “intermediate” strata (Table 1). The main causes of death in 2001-2005 were perinatal problems, with an average IMR of 18.1 deaths per thou- sand LB, which signiicantly reduced during 2006-2010 to 12.3. Deaths from diarrheal causes and from other infectious and parasitic diseases have ceased to exist in the “high” strata. This did not occur in the other strata, despite the signiicant reduction (Table 3).
The index case (Fig 1A, Ⅲ5) in the family was a 28-year-old woman of Han Chinese descent who presented with secondary amenorrhea at 23 years of age, with serum follicle stimulating hormone (FSH) concentrations exceeding 40 IU/L on two occasions. In her family there were 3 other females with POF. Ⅱ3 andⅡ11, currently in their 60s or 50s, were childless and presented with secondary amenorrhea at the age of 18 years and 27 years, respectively. Ⅲ2 experienced oligomenorrhea from the age of menarche at age 14 years, gave birth at age 30 years to a nor- mal infant after attempting, unsuccessfully, for the previous 6 years. She developed amenorrhea at the age of 37 years. Chromosomal abnormalities, FMR1 premutation, previous ovarian sur- gery, or exposure to chemotherapy or radiotherapy were not present in any family member.
Conclusions: Screening tests are important to speed the beginning of treatment measures in order to allow for better developmental outcome. Among the many tests that can be employed for this purpose, the DENVER II and the Alberta Infant Motor Scale are the most often used in Brazilian studies. The Movement Assessment of Infants is starting to be used in our country. Two other tests are recommended in the literature due to their high sensibility and specificity: the Test of Infant Motor Performance and the General Movements.
and the excessive number of deliveries at home, without assistance of a qualiied professional. As shown in this study, these facts have increased the chance of infant deaths and require the implementation of timely and safe transport systems for pregnant women or the building of homes for pregnant women and recent mothers next to hospitals. Another recommendation is the greater compliance of health professionals to the healthcare protocols of the Ministry of Health, with risk classiication and appropriate referral of pregnant women according to their needs 8 .
To date, one study has attempted to link observed maternal behaviour with fMRI activation to own infant visuals . Mothers were classified as either synchronous (N = 13) or intrusive (N = 10) to test the hypothesis of the differential recruitment of the nucleus accumbens and the amygdala in response to viewing videos of own versus an unknown infant, which they found support for. This forms the first evidence supporting the notion that sensitive (or synchronous) mothers show a different neural pathway in response to viewing own infant than less sensitive (and specifically, intrusive) mothers. However, mothers did not view their infant versus an unknown infant per se, Rather, they viewed 2-mins solitary infant play and 2-mins of themselves interacting with their infant, of which the latter was used as a basis for group assignment (synchronous or intrusive), as well as for the correlational measure. The ‘unknown infant’ comparison stimuli (viewed in typical and ‘pathological’ interactions) were consistent across participants, irrespective of the quality of the index mother’s own interaction. Thus, the own infant and other infant stimuli differed in many ways beyond familiarity; subsequently, the degree of difference varied between participants. Since evidence suggests that it is the degree of maternal sensitivity which plays an important role in the child’s long-term psychological development [19–21], directly linking the extent of neural responses to sensitivity of maternal behavioural response may provide more developmen- tally meaningful data than constraining maternal behaviour within two classifications .
These cases presented to a part-time general practitioner in a 5-doctor general practice. Cases 1 and 2 lived in different towns 40 km apart. Case 3 had been diagnosed elsewhere but her case had not been notified to the TGA. Her presentation, while holidaying, was stimulated by her awareness of case 1 in medical literature and by identification of the township of the author. The third case had passed unnoticed in the context of preceding HPV vaccination. The number of girls in the population who may have a similar unnotified diagnosis is not knowable. The pattern of ovarian demise here is not clear, but a gradual process is apparent. Lack of diagnosis in cases 1 and 2 prompted investigation in preference to further issuing of oral contraceptive prescriptions. OCP prescribing would delay appropriate diagnosis and management as well as notification of a possible adverse event. Therapeutic man- agement was commenced with a more appropriate level of hormone replacement, attention to calcium, vitamin D, exer- cise, bone mineral density, and subsequent monitoring for autoimmune conditions that may be associated. Psychological health will also be monitored given the physiological and emotional effects of this diagnosis. Depressive symptoms were not found in these patients. Anxiety symptoms have been found in premature ovarian failure and psychosocial stress has scored higher during the year before cessation of menses. 63