Interrater reliability of the Saint-Anne Dargassies Scale in assessing the neurological patterns of healthy preterm newborns / Confiabilidade inter-observadores da Escala de Saint-Anne Dargassies na avaliação neurológica de recém-nascidos pré-termo sadios

Abstract Objectives: to assess the interrater reliability of the Saint-Anne Dargassies Scale in assessing neurological patterns of healthy preterm newborns. Methods: twenty preterm newborns met the inclusion criteria for participation in this prospective study. The neurologic examination was performed using the Saint-Anne Dargassies Scale, showing normal serial cranial ultrasound examination. In order to test the reliability, the study was structured as follows: group I (rater 1/physiotherapist; rater 2/neonatologist); group II (rater 3/physiotherapist; rater 4/child neurologist) and the gold standard (expert and professor in pediatric neurology). Results: high interrater agreement was observed between groups I - II compared with the gold standard in assessing postural pattern (p<0.01). Regarding the assessment ofprimitive reflexes, greater agreement was observed in the evaluation of palmar grasp reflex and Moro reflex (p< 0.01) for group I compared with the gold standard. An analysis of tone demonstrated heterogeneous agreement, without compromising the reliability of the scale. The probability of equality between measurements of head circumference in the two groups, compared with the gold standard, was observed. Conclusions: the Saint-Anne Dargassies Scale demonstrated high reliability and homogeneity with significant power of reproducibility and may be capable to identify preterm newborns suspected of having neurological deficits.

Resumo Objetivos: avaliar a confiabilidade inter-observadores na avaliação do padrão neurológico de recém-nascidos pré-termo saudáveis pela Escala de Saint-Anne Dargassies. Métodos: vinte recém-nascidos pré-termos foram selecionados com base nos critérios de inclusão para participarem deste estudo prospectivo. O exame neurológico foi realizado utilizando a Escala de Saint-Anne Dargassies e os exames de ultra-som craniano seriados normais. Para testar a confiabilidade da escala o estudo foi estruturado da seguinte forma: grupo I (examinador 1 /fisioterapeuta; examinador 2 / neonatologista); grupo II (avaliador 3 /fisioterapeuta; avaliador 4 / neurologista infantil) e o padrão-ouro (expert e professor em neurologia pediátrica). Resultados: foi observado uma concordância alta inter-observadores entre os grupos I -II em comparação com o padrão ouro na avaliação padrão postural (p<0,01). Em relação à avaliação dos reflexos primitivos, observou-se maior concordância na avaliação do reflexo palmar e do reflexo de Moro (p<0,01) para o grupo I em comparação com o padrão-ouro. Uma análise do tônus demonstrou acordo heterogêneo, sem comprometer a confiabilidade da escala. Observou-se a probabilidade de igualdade entre as medidas do perímetro cefálico nos dois grupos em comparação com o padrão-ouro. Conclusões: a Escala de Saint-Anne Dargassies demonstrou alta confiabilidade e homogeneidade com poder significativo de reprodutibilidade podendo identificar recém-nascidos pré-termo com suspeita de déficit neurológico.

Modulation of the startle response in verbal aggressors: differences among stimuli with distinct affective social content

The emotional response to socially affective stimuli is an important variable to understand aggression. Research is lacking on the psychophysiological basis of verbal aggressiveness that would allow the identification of these emotional responses. The aim of the present study was to investigate modulation of the startle response in verbal aggressors during the presentation of visual stimuli with different affective social content. Acoustic startle probes were administered to 29 verbal aggressors and 28 non-verbal aggressors while viewing slides from the International Affective Picture System, which contains sexual, filial, neutral, unpleasant, and suffering of others pictures. Verbal aggressors showed a low startle response to sexual pictures compared with non-verbal aggressors and a potentiated startle response to neutral pictures compared with unpleasant, filial, and suffering of others pictures. These differences were observed among women. Based on previous studies, the present results may be explained by high testosterone levels, low cortisol levels, and moral disengagement exhibited by verbally aggressive women...

Antipredator and alarm reaction responses of silver catfish (Rhamdia quelen) juveniles exposed to waterborne ammonia

Ammonia has relatively toxic effects on fish and other aquatic organisms. This study examined whether juvenile silver catfish exposed to alarm substances released by conspecifics and predators in water with different ammonia levels modify their behaviour in response to the perceived risk of predation. We used juvenile catfish that were naive to predators. The fish were raised from the larval stage in the laboratory and kept in 40-L aquaria at waterborne NH3 concentrations of 0, 0.05, 0.1, or 0.2 mg L-1 for 10 days. The alarm substances used were predator odour and skin extract from conspecifics. The juveniles were transferred to 2-L aquaria for the antipredator and alarm reaction behavioural tests, which were performed on days 1, 5 and 10 after initial exposure to ammonia. The test aquaria contained a shelter at one end of the tank. The trials consisted of a 10-min prestimulus and a 10-min poststimulus observation period. The results of the study suggest that naive juvenile catfish are able to identify predators and skin extract from conspecifics by odour. In addition, waterborne NH3 levels modify the antipredator response of this species.

Amônia possui efeito relativamente tóxico em peixes e outros organismos aquáticos. Este estudo examinou se juvenis de jundiás modificam seu comportamento em resposta a percepção do risco de predação quando expostos a substâncias de alarme liberadas por conspecíficos e predadores em água com diferentes concentrações de amônia. Foram utilizados juvenis de jundiá nunca expostos a predadores. Os peixes foram criados em laboratório desde a fase larval e mantidos em aquários de 40-L contendo diferentes concentrações de NH3: 0; 0,05; 0,1 e 0,2 mg L-1 por 10 dias. As substâncias de alarme utilizadas foram odor de predador e extrato de pele de conspecíficos. Os juvenis foram transferidos para aquários de 2-L para realização dos testes para comportamento antipredador e resposta à substância de alarme, os quais foram realizados nos dias 1, 5 e 10 a partir do início da exposição à amônia. O aquário teste continha um esconderijo em uma de suas extremidades. Foram feitas observações comportamentais 10-min pré-estímulo e 10-min pós-estímulo. Os resultados do estudo sugerem que juvenis de jundiá nunca expostos a predadores são capazes de identificar predadores e extrato de pele de conspecíficos pelo odor. Além disso, os níveis de NH3 na água alteram a resposta anti-predatória desta espécie.

Habituation of the eyeblink response in humans with stimuli presented in a sequence of incremental intensity

In an experiment we examined whether the repeated presentation of tones of gradually increasing intensities produces greater decrement in the eyeblink reflex response in humans than the repetition of tones of constant intensities. Two groups of participants matched for their initial level of response were exposed to 110 tones of 100-ms duration. For the participants in the incremental group, the tones increased from 60- to 90- dB in 3-dB steps, whereas participants in the constant group received the tones at a fixed 90-dB intensity. The results indicated that the level of response in the last block of 10 trials, in which both groups received 90-dB tones, was significantly lower in the incremental group than in the constant group. These findings support the data presented by Davis and Wagner (7) with the acoustic response in rats, but differ from several reports with autonomic responses in humans, where the advantage of the incremental condition has not been observed unambiguously. The discussion analyzes theoretical approaches to this phenomenon and the possible involvement of separate neural circuits.

Routine post-weaning handling of rats prevents isolation rearing-induced deficit in prepulse inhibition

Rats reared under isolation conditions from weaning present a number of behavioral changes compared to animals reared under social conditions (group housing). These changes include deficits in prepulse inhibition (PPI) of the startle reflex to a loud sound. PPI refers to the reduction of the magnitude of the startle reflex when a relatively weak stimulus (the prepulse) precedes by an appropriate time interval the intense startle-elicing stimulus (the pulse). PPI is useful for studying sensorimotor integration. The present study evaluated the effect of handling on the impairment of PPI induced by isolation-rearing. Male Wistar rats (N = 11-15/group) were housed in groups (5 per cage and handled three times a week) or isolated (housed individually) since weaning (21 days) for 10 weeks when they reach approximately 150 g. The isolated rats were divided into "minimally handled" animals (handled once a week for cleaning purposes only) or "handled" animals (handled three times a week). This handling consisted of grasping the rat by the tail and moving it to a clean cage (approximately 5 s). A statistically significant reduction (52 percent) in the PPI test was found only in the isolated group with minimal handling while no difference was seen between grouped animals and isolated handled animals. These results indicate that isolation rearing causes disruption in the PPI at adult age, which serves as an index of attention deficit. This change in the sensory processing of information induced by post-weaning isolation can be prevented by handling during the development of the animal.

Asma infantil: conducta de los padres y factores coadyuvante / Children asthma: parents' behaviors and coadjutant factors

El presente estudio es derciptivo y transversal, para conocer la relación entre asma infantil y factores coadyuvantes (conflictos familiares, unión paterna, orden de nacimiento, sexo y edad), conductas de los padres, tiempo de evolución, frecuencia de las crisis asmáticas y severidad de la enfermedad. Se utilizó cuestionario debidamente validado, llenado por el investigador y por los padres. La muestra fue no probabilística, intencional y estuvo constituida por 103 niños asmáticos entre 1 y 12 años que asistieron a la emergencia pediátrica del Ambulatorio de Caricuao, entre Febrero y Julio de 2003. Se hizo cruce de variables y se determinó Chi cuadrado, con nivel de significancia de 0.05. Los resultados revelan mayor frecuencia de crisis asmática en niños varones, en familias con padres juntos, sin conflictos familiares; predominó el hijo menor, sin diferencias significativas con respecto a la severidad. Predominaron las crisis moderadas, con frecuencia de 1 a 5 crisis por año. El 53,40 por ciento de los padres tuvo percepción adecuada de las crisis, el 24,27 por ciento percepción aumentada y 22,33 por ciento percepción disminuida y fueron estadísticamente significativas con respecto a la severidad. El 78,64 por ciento de niños no tenía control médico y el 89,32 por ciento de los padres presentaron conductas inadecuadas

Behavioral modulation by mutilation pictures in women

Previous studies have shown that women are more emotionally expressive than men. It is unclear, however, if women are also more susceptible to the emotional modulation of behavior imposed by an affective stimulus. To investigate this issue, we devised a task in which female subjects performed six sequential trials of visual target detection following the presentation of emotional (mutilation and erotic) or neutral pictures (domestic utensils and objects) and compared the data obtained in the present study with those described in a previous study with male subjects. The experiment consisted of three blocks of 24 pictures and each block had an approximate duration of 4 min. Our sample consisted of 36 subjects (age range: 18 to 26 years) and each subject performed all blocks. Trials following the presentation of mutilation pictures (283 ms) had significantly slower reaction times than those following neutral (270 ms) pictures. None of the trials in the "pleasant block" (271 ms) was significantly different from those in the "neutral block". The increase in reaction time observed in the unpleasant block may be related in part to the activation of motivational systems leading to an avoidance behavior. The interference effect observed in this study was similar to the pattern previously described for men. Thus, although women may be more emotionally expressive, they were not more reactive to aversive stimuli than men, as measured by emotional interference in a simple reaction time task.

On the panic reactions of ants to a crushed conspecific: a contribution to a psychoethology of fear

Esmagando-se uma ou mais formigas sobre a trilha da formiga Paratrechina (Nylanderia) fulva Mayr, provocam-se mudanças marcadas no comportamento das outras quando chegam perto da coespecífica morta. Estas "reações de pânico" (desvio, retorno, marcha ondulante, sacolejo e desorientação) representam uma perturbação ou uma desorganização do comportamento que prevalecia na trilha antes da mudança (Cunha, 1967). Na primeira parte do presente trabalho, tentou-se mostrar como a forma e as circunstâncias específicas de cada uma dessas reações são um reflexo da experiência prévia das formigas individuais com a situação posteriormente alterada. Na segunda parte, utilizando-se dados de algumas espécies de formigas de quatro sub-famílias (Myrmicinae, Formicinae, Ponerinae e Dorylinae) sobre a intensidade da reação a coespecíficas esmagadas na trilha, mostrou-se como esta intensidade parece correlacionada, não com a posição taxonômica das espécies consideradas, mas com o grau em que os indivíduos dessas espécies são capazes de atração mútua e de interação num nível propriamente individual. O medo é reinterpretado como um estado motivacional caracterizado por um processo de intensa discriminação sensorial e por duas tendências simultâneas: uma de busca do familiar e outra de fuga do infamiliar

Organizaçäo neural de diferentes tipos de medo e suas implicaçöes na ansiedade / Neural organization of different types of fear: implications for the understanding of anxiety

A natureza das respostas de medo em animais expostos a situaçöes ameaçadoras depende da intensidade e da distância do estímulo aversivo. Esses estímulos podem ser potencialmente perigosos, distais ou proximais ao animal. Esforços têm sido feitos no sentido de identificar os circuitos neurais recrutados na organizaçäo das reaçöes defensivas a estas condiçöes aversivas. Neste artigo, sumarizamos evidências que associam os sistemas cerebrais de defesa ao conceito de medo-stress-ansiedade. Respostas de orientaçäo ao estímulo de perigo, à esquiva e à preparaçäo para o enfrentamento do perigo parecem estar associados à ansiedade. O giro do cíngulo e o córtex pré-frontal de um lado; o núcleo mediano da rafe, septo e o hipocampo de outro fazem parte dos circuitos cerebrais que integram essas respostas emocionais. No outro extremo, estímulos de medo que induzem formas ativas de defesa, mas pouco elaboradas, determinam estados emocionais de natureza diferente e parecem associadas a manifestaçöes elementares de medo. A substância cinzenta periaquedutal dorsal constitui o principal substrato neural para a integraçäo desses estados aversivos no cérebro. Comportamentos defensivos desse tipo säo produzidos pela estimulaçäo elétrica e química desta estrutura. A medida que os estímulos ameaçadores, potenciais e distais däo lugar a estímulos de perigo muito intensos ou säo substituídos por estímulos proximais de medo, ocorre uma comutaçäo (switch) dos circuitos neurais usualmente responsáveis pela produçäo de respostas condicionadas de medo para reaçöes defensivas com baixo nível de regulaçäo e organizaçäo que se assemelham aos ataques de pânico. Portanto, dependendo da natureza do evento estressor ou do estímulo incondicionado, o padräo de respostas defensivas orientadas e organizadas cede lugar a respostas motoras incoordenadas e incompletas. A amígdala e o hipotálamo medial podem funcionar como uma espécie de interface comutando os estímulos para os substratos neurais apropriados para elaboraçäo das respostas defensivas condicionadas ou incondicionadas

Pharmacology of human experimental anxiety

This review covers the effect of drugs affecting anxiety using four psychological procedures for inducing experimental anxiety applied to healthy volunteers and patients with anxiety disorders. The first is aversive conditioning of the skin conductance responses to tones. The second is simulated public speaking, which consists of speaking in front of a video camera, with anxiety being measured with psychometric scales. The third is the Stroop Color-Word test, in which words naming colors are painted in the same or in a different shade, the incongruence generating a cognitive conflict. The last test is a human version of a thoroughly studied animal model of anxiety, fear-potentiated startle, in which the eye-blink reflex to a loud noise is recorded. The evidence reviewed led to the conclusion that the aversive conditioning and potentiated startle tests are based on classical conditioning of anticipatory anxiety. Their sensitivity to benzodiazepine anxiolytics suggests that these models generate an emotional state related to generalized anxiety disorder. On the other hand, the increase in anxiety determined by simulated public speaking is resistant to benzodiazepines and sensitive to drugs affecting serotonergic neurotransmission. This pharmacological profile, together with epidemiological evidence indicating its widespread prevalence, suggests that the emotional state generated by public speaking represents a species-specific response that may be related to social phobia and panic disorder. Because of scant pharmacological data, the status of the Stroop Color-Word test remains uncertain. In spite of ethical and economic constraints, human experimental anxiety constitutes a valuable tool for the study of the pathophysiology of anxiety disorders

Behavioral correlates of the activity of serotonergic and non-serotonergic neurons in caudal raphe nuclei

We investigated the behavioral correlates of the activity of serotonergic and non-serotonergic neurons in the nucleus raphe pallidus (NRP) and nucleus raphe obscurus (NRO) of unanesthetized and unrestrained cats. The animals were implanted with electrodes for recording single unit activity, parietal oscillographic activity, and splenius, digastric and masseter electromyographic activities. They were tested along the waking-sleep cycle, during sensory stimulation and during drinking behavior. The discharge of the serotonergic neurons decreased progressively from quiet waking to slow wave sleep and to fast wave sleep. Ten different patterns of relative discharge across the three states were observed for the non-serotonergic neurons. Several non-serotonergic neurons showed cyclic discharge fluctuations related to respiration during one, two or all three states. While serotonergic neurons were usually unresponsive to the sensory stimuli used, many non-serotonergic neurons responded to these stimuli. Several non-serotonergic neurons showed a phasic relationship with splenius muscle activity during auditory stimulation. One serotonergic neuron showed a tonic relationship with digastric muscle activity during drinking behavior. A few non-serotonergic neurons exhibited a tonic relationship with digastric and/or masseter muscle activity during this behavior. Many non-serotonergic neurons exhibited a phasic relationship with these muscle activities, also during this behavior. These results suggest that the serotonergic neurons in the NRP and NRO constitute a relatively homogeneous population from a functional point of view, while the non-serotonergic neurons form groups with considerable functional specificity. The data support the idea that the NRP and NRO are implicated in the control of somatic motor output

Alarm pheromones and the influence of pupal odor on the aggressiveness of Polybia paulista (Ihering) (Hymenoptera: Vespidae)

Field bioassays were used to demonstrate that aggressive behavior of Polybia paulista (Ihering) workers is elicited by alarm pheromones present in the venom reservoirs of nest defenders and that the brood care pheromone (pupal odor) produced by the young inside the nest also plays an important defensive role. Pupal odor was extracted from the surface of pupa bodies with methanol. When bioassayed alone, the pupal odor elicited onlyu attractiveness of workers towards the odor source, but no stinging attacks were observed. However, in the presence of alarm pheromones, the brood care pheromone potentiated the effect caused by the pupal odors, increasing the number of stinging attacks during an action of colony defense. Thus, the presence of pupae within the nest not only releases brood care but also enhances the aggressiveness of workers in P. paulista colonies.

Evaluacion de la reaccion de alarma inducida por la determinacion de la presion arterial / Evaluation of the alarm reaction induced by blood pressure determination

El objetivo de este trabajo fue evaluar las características de la reacción de alarma que induce un aumento de la PA sobre la "basal" al enfrentarse el paciente con el observador que realizará el procedimiento. Este aumento "suplementario" que se suma a la PA "basal" fue analizado mediante la caída de los niveles de PAZ que se presenta luego de diez tomas consecutivas separadas por intervalos de 3 minutos en 85 individuos con cifras de PA en un amplio rango. 91 por ciento de los pacientes presentaron una disminución en tomas sucesivas y sólo 9 por ciente presentaron ascensos o ningún cambio significativo en los niveles de PAS. El descenso mostró buena correlación con la función exponencial (r = 0,99). La asíntola fue para la PAS de -8,7 + or - ,81 mmHG (P<0,01) con una constante de timpo T (Tau) de 4,7 + or - 1,3 minutos. No hubo correlación entre la magnitud del descenso y los niveles de PA, lo cual no apoya la idea de que esta reacción esté aumentada en hipertensos. El descenso en la PAD fue menor (3,87 + or - 59 mmHG, P<0,01) pero con características similares. Si consideramos las características de la caída exponencial y el hecho de que luego de 4 ó 5 tomas, llegamos a valores cercanos a la asíntola, la PA basal podría determinarse simplesmente por el promedio de 2 ó 3 determinaciones con intervalos de 3 minutos, tomadas luego de desechar las dos o tres primeras tomadas en las mismas condiciones. Esta presión "basal" parece ser de importancia en determinar la repercusión de las cifras tensionales sobre los órganos "blanco" y aunque no lo hallamos comprobado, sus valores serían similares a los obtenidos en el hogar o por monitoreo ambulatorio. Las características exponenciales de la caída de la PA en tomas consecutivas, permite calcular la PA "basal" mediante el cálculo de la asíntota de la ecuación respectiva

Controversias en prótesis mamarias : actualización 1994 / Controversies in mammary implants : update 1994

Debido a diferentes opiniones en varios campos sobre puntos de vista opuestos en el tema de implantes mamarios, hemos decidido escribir este trabajo debido a las sensacionales señales de alarma introducidas principalmente por los medios, entre aquellas mujeres ya implantadas, asistidas quizás inadvertidamente por los profesionales consultados, tal vez confundidos por fuentes de información autollamadas "serias", comenzaron a aparecer soluciones alarmantes tales como reimplantes, remoción, exposición innecesaria a rayos X, además de promesas de remuneración monetaria, por parte de los profesionales legales siempre listos. Nuestra profunda investigación, es la más actualizada información disponible proveniente de bancos de datos científicos, publicaciones médicas y últimas presentaciones en Congresos sobre los principales puntos en controversia como cáncer y enfermedades reumáticas, concluye que es más contundente la "casualidad" que la "causalidad". Nosotros también incluímos algunos hechos sobre contractura capsular, durabilidad y ruptura de las prótesis y lactancia. Para salvar los obstáculos de los estudios radiológicos, mencionamos el uso de técnicas específicas y magnificación, ecografía y resonancia magnética nuclear. Como consecuencias favorables de este controvertido tema, debemos admitir que todo esto ha creado mejores y más seguros procedimientos, los cuales nos impulsan a continuar esta práctica ya probada por la experiencia de muchos años.

Sudden cardiac death caused by coronary ostial compression by an aneurysm of the sinus of valsalva

A 22-year-old man was asymptomatic until he died suddenly after being starled. Post-mortem examination was normal except for aneurysmal dilatation of the left Sinus of Valsalva, the upper margin fo which formed a flap-like ridge, partially occluding the ostium of the left main coronary artery which arose immediately above it. Further compression of this "slit-like" orifice by aneurysmal distention was the proposed cause of myocardial ischaemia and arrhythimic death

Comportamiento de triatominos / Behavior of triatominae

Se hace una revisión bibliográfica sobre el comportamiento de triatominos, enfatizándose en la reacción estímulo-reacción y su base fisiológica. Se describen las manifestaciones de comportamiento más características: estado de repouso (akinesis); estado de alerta y de activación locomotors; estímulos claves relacionados con la búsqueda de alimento; mecanismos de orientación; intensidad motivacional; comunicación química entre los insectos; localización de la fuente de alimentos; reducción de riesgos, programación endógena de umbrales de sensibilidad; y comunicación intraespecífica