USE OF MUSIC DURING PHYSICAL THERAPY INTERVENTION IN A NEONATAL INTENSIVE CARE UNIT: A RANDOMIZED CONTROLLED TRIAL

Introduction: Previous studies have shown music therapy as a way to improve the clinical status of premature infants, improving vital signs and decreasing crying episodes. Objective: Compare the effects of music on vital signs of premature infants undergoing respiratory physiotherapy. Methods: We performed a randomized clinical trial consisting of 26 premature infants, divided into control group (N=12) and study group (N=14), carried out in a Neonatal Intensive Care Unit. All newborn infants undergone standard practice physiotherapy for 15 minutes: vibration and aspiration. On the study group they were exposed to classical music three minutes before the standard physiotherapy, and finished three minutes after the end of these procedures. A recorder was placed inside the incubator with an intensity of 25 decibels. Measurements of heart and respiratory rate and oxygen saturation were measured before, during and after each sessions of respiratory physiotherapy for two groups. Results: When comparing control and study groups regarding heart rate frequency and oxygen saturation, there was no statistically significant difference, but the inclusion of music determined clinically the variability of these data and 30% of the variation in respiratory rate was due to the inclusion of music during and after the physiotherapy, and the neonatal noninvasive ventilation showed less variation in their respiratory rate when compared to the neonatal on oxygen therapy. Conclusion: The results have showed a beneficial effect of music, showing lower respiratory rate in newborn infants during and after respiratory physiotherapy procedure

Thermal and cardiorespiratory newborn adaptations during hot tub bath

Objective: To evaluate thermal and cardiorespiratory adaptation during hot tub bath and shower in healthy newborns in the first hours of life. Study design: This is a randomized blind controlled trial, registered in ReBEC (No. RBR-4z26f3) with 184 newborns divided into hot tub group (n=84) and shower (n=100). Newborns from intervention group were immersed in a hot tub with warm water up to the neck, without exposure to air flow, and control group received traditional shower. Heart rate, respiratory rate and temperature were measured before and immediately after bath by an investigator blinded to the type of bath. Results: Groups were similar in gender, gestational age, birth weight, Apgar score at 5th minute and hours of life, p => 0.05. To analyze thermal and cardiorespiratory adjustments, difference between post-bath variables and pre-bath was calculated. In this analysis, it was found statistically significant difference between two types of bath regarding heart rate, respiratory rate and temperature. Hot tub bath decreases heart and respiratory rates and increases temperature, whereas shower provides the opposite effect (0.0001). Conclusion: This study demonstrates that hot tub baths and shower, in healthy newborns, promote thermal and cardiorespiratory adaptations, reflecting thermal, cardiac and respiratory positive reactions after hot tub bath

Síndrome de Torsades de Pointes: análise de casos: Torsades de Pointes Syndrome: case analysis

A Síndrome de Torsades de Pointes (TdP) é uma taquiarritmia ventricular polimórfica de pacientes com um intervalo QT longo congênito ou induzido por fármacos, cujo eletrocardiograma possui aspecto de “torção das pontas” e os sinais e sintomas característicos são síncope, palpitação ou mesmo evolução para fibrilação ventricular e morte súbita. O sexo mais frequentemente acometido é o feminino, o diagnóstico se baseia no eletrocardiograma e o tratamento preconizado é o sulfato de magnésio (MgSO4) intravenoso, a correção dos distúrbios eletrolíticos, principalmente a hipocalemia e o tratamento da causa base, na TdP farmacoinduzida. O objetivo do estudo é analisar os casos de Síndrome de Torsades de Pointes em pacientes com alterações do intervalo QT no eletrocardiograma. Trata-se de uma revisão bibliográfica integrativa, do tipo quantitativa, que utilizou as plataformas do PubMed, SciELO e Cochrane Library como bases de dados para seleção dos artigos, todos na língua inglesa. Foram utilizadas literaturas publicadas com recorte temporal de 2017 a 2022. De acordo com as literaturas analisadas, conclui-se que a TdP é uma taquiarritmia ventricular polimórfica com um mau prognóstico se não tratada precocemente com o MgSO4 intravenoso e, por ter diversas etiologias, é primordial que o diagnóstico preciso seja estabelecido de forma rápida, devido ao alto índice de mortalidade. Pacientes portadores da síndrome do QT longo congênita, bradicardia sinusal e bloqueio atrioventricular de 1º grau possuem predisposição para o desenvolvimento de TdP. Observa-se escassez na literatura a respeito das formas adequadas de prevenção da TdP, já que muitos pacientes que participam das triagens, muitas das vezes inefetivas, adquirem a síndrome após o uso de drogas que a predispõem, com prolongamento do intervalo QT, ou não sabem que possuem uma SQTL pré-existente, obrigatória para o desenvolvimento da TdP

DESEMPENHO MOTOR DE RECÉM-NASCIDOS A TERMO PELA TIMP E AIMS: VARIÁVEIS MATERNAS E NEONATAIS

Objetivos: comparar o desempenho motor de recém-nascidos a termo saudáveis, avaliados pelo Test of Infant Motor Performance (TIMP) e Alberta Infant Motor Scale (AIMS) com variáveis clinicas e maternas. Métodos: estudo transversal, realizado com 50 recém-nascidos termo (RNT), saudáveis, de baixo risco para lesões neurológicas, avaliados entre as primeiras 72 horas de vida. Foram coletados dados maternos e infantis a partir dos prontuários e realizadas avaliações de desempenho motor de acordo com o TIMP e a AIMS, através de filmagem para posterior pontuação. Resultados: Dos 50 recém-nascidos avaliados, 58% (N=29) eram do sexo feminino. Pela avaliação da AIMS todos apresentaram desempenho motor adequado para a idade, enquanto pelo TIMP, seis foram classificados com atraso no desempenho motor. Na análise de correlação entre variáveis maternas e neonatais com os escores brutos das escalas, apenas a idade gestacional (IG) apresentou correlação significativa com os escores da AIMS indicando que a menor idade gestacional se relacionou com atraso no desenvolvimento. Conclusões: O TIMP representou um instrumento mais seguro na administração de recém-nascidos a termo saudáveis em relação à AIMS quando aplicados nas primeiras horas de vida, pois não sofreu interferências de fatores, como a idade gestacional

mHealth strategies for monitoring child development in low- and middle-income countries: a systematic scoping review protocol

A systematic scoping review protocol. this review aims to address the following questions: What mHealth strategies are used for monitoring child development in low- and middle-income countries? What are the purposes of using these strategies? What are the main features of mHealth strategies? What are the effects of mHealth strategies? For whom are mHealth strategies directed

Screening for Autism Spectrum Disorder in Premature Subjects Hospitalized in a Neonatal Intensive Care Unit

Considering that the average age for diagnosis of autism spectrum disorder (ASD) is 4-5 years, testing screening methods for ASD risk in early infancy is a public health priority. This study aims to identify the risks for development of ASD in children born prematurely and hospitalized in a neonatal intensive care unit (NICU) and explore the association with pre-, peri- and postnatal factors. Methods: The children's families were contacted by telephone when their child was between 18 and 24 months of age, to apply the Modified Checklist for Autism in Toddlers (M-CHAT). The sample consisted of 40 children (57.5% boys). M-CHAT screening revealed that 50% of the sample showed early signs of ASD. Although the frequency of delayed development was higher in boys, this difference was not statistically significant between the sexes (p = 0.11). Assessment of the association between perinatal conditions and early signs of autism in children hospitalized in an NICU exhibited no correlation between the factors analyzed (birth weight and type of delivery). The findings indicate a high risk of ASD in premature children, demonstrating no associations with gestational and neonatal variables or the hospitalization conditions of the NICUs investigated