Sleep disorders and starting time to school impair balance in 5-year-old children

Objective: To verify if sleep disorders and differents starting time to school have impaired motor skills in 5-year-old children.Method: Cross-sectional design consisting of 132 children with sleep disorders and 136 normal controls of the public school in the city of São Paulo. the group with sleep disorders was identified based on a questionnaire, and motor tests for global motor coordination, fine motor coordination, perceptual-motor coordination, and static and dynamic balance were applied in all children.Results: in the static balance test, more specifically in the sharpened Romberg (Tandem) test, 34% of boys from the study group, who studied in the morning, failed the test (p < 0.05). in the single leg stance test, 62% of boys from the study group who studied in the morning failed (p < 0.05).Conclusion: This study suggests that sleep disorders may interact with the school period and alter motor performance, especially in boys studying in the morning.Universidade Federal de São Paulo, Dept Internal Med, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Neurol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Internal Med, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Neurol, São Paulo, BrazilWeb of Scienc

Opções terapêuticas para as hemartroses em pacientes hemofílicos graves

the coagulation factors VIII (FVIII) or IX (FIX), respectively. The primary therapeutic approach is to replace the deficient coagulation factor, which can be achieved with factors derived from human plasma or recombinants. However, despite having a therapeutic approach, most severe cases are symptomatic and may have complications, mainly in the muscles and joints. One example of such disorder is hemarthrosis. This manifestation tends to affect mainly the knee, ankle, or elbow joints in about 80% of cases. Objective: to describe the primary forms of treatment for joint bleeding in patients with severe hemophilia. Methods: This is a qualitative research of the integrative review type meant to identify productions on topics associated with hemarthrosis and severe hemophilia. The articles were searched through the databases PubMed, Scientific Electronic Library Online (Scielo) and Virtual Health Library (BVS) with the following search descriptors: “hemarthrosis andhemophilia”; “joint diseases and Hemophilia” and corresponding terms in Portuguese. The inclusion criteria were as follows:a) scientific articles b) available in full-text c) studies available in Portuguese, English, or Spanish d) randomized clinical trials e) articles published between 2016 and 2021 f) articles containing hemarthrosis caused by severe hemophilia. As exclusion criteria, texts that had no relation to the theme, did not answer the guiding question, other types of articles that did not include randomized clinical trials and/or presented duplicates were discarded. Results: In total, 42 articles were found in the selected databases; eight were duplicated, and 25 were excluded for not being randomized clinical trials or because they did not contemplate the theme. After careful reading, nine articles that met the inclusion and exclusion criteria were identified. Of the eligible studies, one reported factor replacement, and eight reported physiotherapeutic treatment. Conclusion: Factor replacement for hemophilic patients is essential and, based on the information obtained, early replacement is beneficial for the patient to avoid joint complications. Prophylaxis is indicated in severe hemophilia and its main objective is to prevent recurrent hemarthrosis, which can cause permanent functional deformities. Some physiotherapeutic interventions are indicated to prevent joint damage in severe hemophilic patients. The findings show diversity in the physical therapy modalities employed. The complete prevention of joint damage is still a challenge. A combination of treatments and a multidisciplinary team follow-up is necessary to ensure health and quality of life of patients.Introdução: As hemofilias A e B são doenças congênitas raras, recessivas ligadas ao X, causadas por falta ou deficiência de fator de coagulação VIII (FVIII) ou IX (FIX), respectivamente. A terapêutica tem como conduta principal a reposição do fator de coagulação deficiente, podendo ser feita com fatores derivados de plasma humano ou recombinantes. Porém, apesar de possuir uma terapêutica, grande parte dos casos graves são sintomáticos e podem ter complicações, na sua maioria, nos músculos e nas articulações. Uma dessas desordens é a hemartrose. Essa manifestação tende a acometer principalmentearticulações do joelho, tornozelo ou cotovelo em cerca de 80% dos casos. Objetivo: descrever as principais formas de tratamento para sangramento articular em pacientes com hemofilia grave. Método: Trata-se de uma pesquisa qualitativa do tipo revisão integrativa para identificação de produções sobre temas associados a hemartrose e hemofilia grave. A busca dos artigos foi através das bases de dados PubMed, Scientific Electronic Library Online (SciELO) e Biblioteca Virtual em Saúde (BVS) com os seguintes descritores de busca: “hemarthrosis and hemophilia”; “joint diseases and hemophilia” e termoscorrespondentes no português. Os critérios de inclusão foram os seguintes: a) artigos b) estar disponível em texto completo c) estudos disponíveis nos idiomas português, inglês ou espanhol d) ensaios clínicos randomizados e) artigos publicadosentre 2016 e 2021 f) artigos que contemplem hemartrose por hemofilia grave. Resultados: No total, foram encontrados 42 artigos nas bases de dados selecionadas; oito estavam duplicados e 25 foram excluídos por não serem ensaios clínicosrandomizados ou por não contemplarem a temática. Após leitura cuidadosa, foram identificados 9 artigos que atenderam aos critérios de inclusão e exclusão. Dos trabalhos elegíveis, um relatou sobre reposição de fator e oito artigos relataram sobre tratamento fisioterapêutico. Conclusão: A reposição de fatores para pacientes hemofílicos é essencial e, com basenas informações obtidas, a reposição precoce é benéfica para o paciente, evitando complicações articulares. A profilaxia está indicada na hemofilia grave e seu principal objetivo é prevenir a hemartrose recorrente, que pode causar deformidades funcionais permanentes. Algumas intervenções fisioterapêuticas são indicadas para prevenir danos articulares em pacientes hemofílicos graves. Os achados mostram diversidade nas modalidades de fisioterapia empregadas. A prevenção total dos danos articulares ainda é um desafio. É necessária uma combinação de tratamentos e acompanhamento por equipe multidisciplinar de forma a garantir a saúde e qualidade de vida dos pacientes

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

A IMPORTÂNCIA DO CONHECIMENTO DA COMUNIDADE SOBRE PRIMEIROS SOCORROS NA INFÂNCIA

Os acidentes que acontecem com as crianças são geralmente causados por fatores externos, sendo que a maioria poderia ser evitada pela elaboração de medidas preventivas e conhecimento de primeiros socorros. Tem-se como importantes pontos de informação a promoção e prevenção em saúde, que quando aplicados proporcionam uma melhor qualidade e aumento da expectativa de vida. Entende-se então como necessária a implementação de ações que informem a população sobre os fatores de risco na infância e sobre medidas que podem ser realizadas em situações de emergência. O objetivo é promover conhecimento a comunidade, sobre medidas de primeiros socorros na infância. Trata-se de um estudo experimental de intervenção que foi realizado na ação social do município de Araranguá-SC, em duas etapas. Primeiramente, a população era abordada e os alunos realizavam um questionário rápido de cinco perguntas sobre os conhecimentos prévios e adquiridos. Logo após, explicavam as manobras de Heimlich e de Ressuscitação Cardiopulmonar e quando utilizá-las. A análise de resultados foi dada pelas 64 pessoas que participaram e responderam o questionário, podendo ser sim, não, ou prefiro não responder. A realização de ações em conjunto com a comunidade, promove a disseminação do conhecimento, podendo diminuir o número de acidentes e morbimortalidade infantil, melhorando o desenvolvimento e a qualidade de vida das crianças

Therapeutic options for hemarthrosis in severe hemophilic patients

the coagulation factors VIII (FVIII) or IX (FIX), respectively. The primary therapeutic approach is to replace the deficient coagulation factor, which can be achieved with factors derived from human plasma or recombinants. However, despite having a therapeutic approach, most severe cases are symptomatic and may have complications, mainly in the muscles and joints. One example of such disorder is hemarthrosis. This manifestation tends to affect mainly the knee, ankle, or elbow joints in about 80% of cases. Objective: to describe the primary forms of treatment for joint bleeding in patients with severe hemophilia. Methods: This is a qualitative research of the integrative review type meant to identify productions on topics associated with hemarthrosis and severe hemophilia. The articles were searched through the databases PubMed, Scientific Electronic Library Online (Scielo) and Virtual Health Library (BVS) with the following search descriptors: “hemarthrosis and hemophilia”; “joint diseases and Hemophilia” and corresponding terms in Portuguese. The inclusion criteria were as follows: a) scientific articles b) available in full-text c) studies available in Portuguese, English, or Spanish d) randomized clinical trials e) articles published between 2016 and 2021 f) articles containing hemarthrosis caused by severe hemophilia. As exclusion criteria, texts that had no relation to the theme, did not answer the guiding question, other types of articles that did not include randomized clinical trials and/or presented duplicates were discarded. Results: In total, 42 articles were found in the selected databases; eight were duplicated, and 25 were excluded for not being randomized clinical trials or because they did not contemplate the theme. After careful reading, nine articles that met the inclusion and exclusion criteria were identified. Of the eligible studies, one reported factor replacement, and eight reported physiotherapeutic treatment. Conclusion: Factor replacement for hemophilic patients is essential and, based on the information obtained, early replacement is beneficial for the patient to avoid joint complications. Prophylaxis is indicated in severe hemophilia and its main objective is to prevent recurrent hemarthrosis, which can cause permanent functional deformities. Some physiotherapeutic interventions are indicated to prevent joint damage in severe hemophilic patients. The findings show diversity in the physical therapy modalities employed. The complete prevention of joint damage is still a challenge. A combination of treatments and a multidisciplinary team follow-up is necessary to ensure health and quality of life of patients

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 =&gt; 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

Impacto do tipo de parto sobre a mobilidade Toracoabdominal de recém-nascidos

Introduction: In newborns delivered by cesarean section, there is less chest compression and little amount of fluid is drained by gravity, which temporarily reduces thoracoabdominal mobility. Objetive: The objective of this study is to evaluate the impact of the type of delivery on newborns Thoracoabdominal Mobility. Methods: This is a cross-sectional study with newborns of gestational age between 37 and 41 weeks, of both sexes, with up to 72 hours of life, breathing in ambient air and born by normal delivery or cesarean section. The Thoracoabdominal Mobility was evaluated by videogrammetry using MATLAB Software and considered, in metric units (cm2), as the difference between the highest and lowest thoracoabdominal expansibility for each respiratory cycle. Results: Twenty-six infants were included, 11 were male and 50% were born by cesarean section. The mean gestational age was 39 ± 0,9 and 28 ± 18 hours of life. The mobility, difference between greater and lesser expansion, of the thoracic area in vaginal and cesarean delivery was 6 ± 3 cm2 and 7 ± 5 cm2 and the abdominal area was 29 ± 22 cm2 and 21 ± 14 cm2, respectively. This difference was not statistically significant between the two types of delivery for the thoracic area, but was statistically different for the abdominal area (p= 0.01). And the higher the respiratory rate, the lower the abdominal mobility (r= -0.57, p= 0.02). Conclusion: The data indicate that the type of delivery seems to influence abdominal mobility and respiratory rate. In the studied sample, newborns with cesarean section presented lower abdominal mobility.Introdução: Nos recém-nascidos de parto cesáreo, ocorre menor compressão torácica e pouca quantidade de líquido é drenada por ação da gravidade, o que diminui, transitoriamente, a mobilidade toracoabdominal. Objetivo: O objetivo do estudo é avaliar o impacto do tipo de parto na mobilidade torácica e abdominal em recém-nascidos. Método: Trata-se de um estudo transversal com recém-nascidos de idade gestacional entre 37 a 41 semanas, de ambos os sexos, com até 72 horas de vida, respirando em ar ambiente e nascidos de parto normal ou parto cesáreo. A mobilidade torácica e abdominal foram avaliadas pela videogrametria por meio do Software MATLAB e considerada, em unidades métricas (cm2), como a diferença da maior e menor expansibilidade toracoabdominal para cada ciclo respiratório.Resultados: Foram inclusos 26 recém-nascidos 11 do sexo masculino e 50% nascidos de parto cesáreo. A idade gestacional média foi de 39 ± 0,9 sem e tinham 28 ± 18 horas de vida. A mobilidade, diferença entre a maior e menor expansibilidade, da área torácica no parto vaginal e cesáreo foi 6 ± 3 cm2 e 7 ± 5 cm2 e da área abdominal foi de 29±22 cm2 e 21± 14 cm2, respectivamente. Esta diferença não foi estatisticamente significante entre os dois tipos de parto para a área torácica, mas mostrou-se diferente estatisticamente para a área abdominal (p = 0,01). E para os recém-nascidos de parto cesáreo, quanto maior a frequência respiratória, menor a mobilidade abdominal (r= -0,57; p = 0,02). Conclusão: Os dados indicam que o tipo de parto parece influenciar a mobilidade abdominal e a frequência respiratória. Na amostra estudada os recém-nascidos de parto cesáreo apresentaram menor mobilidade abdominal