Activation timing of soleus and tibialis anterior muscles during sit-to-stand and stand-to-sit in post-stroke vs. healthy subjects.

INTRODUCTION: Sit-to-stand (SitTS) and stand-to-sit (StandTS) are very important functional tasks that become compromised in stroke patients. As in other voluntary movements, they require an adequate postural control (PC) involving the generation of anticipatory postural adjustments (APAs). In order to give clues for more efficient and directed rehabilitation programs, a deeper knowledge about APAs during challenging and daily life movements is essential. PURPOSE: To analyze the activation timing of tibialis anterior (TA) and soleus (SOL) muscles during SitTS and StandTS in healthy subjects and in post-stroke patients. METHODS: Two groups participated in this study: one composed of ten healthy subjects and the other by ten subjects with a history of stroke and increased H-reflex. Electromyographic activity (EMGa) of SOL and TA was analyzed during SitTS and StandTS in the ipsilateral (IPSI) and the contralateral (CONTRA) limb to the side lesion in stroke subjects, and in one limb in healthy subjects. A force plate was used to identify the movement onset. RESULTS: In both sequences, in the stroke group SOL activation timing occurred prior to movement onset, contrary to the pattern observed in the healthy subjects. Statistically significant differences were found in SOL activation timings between each lower limb of the stroke and healthy groups, but no significant differences were found between the IPSI and the CONTRA limb. The TA activation timing seems to be delayed in the CONTRA limb when compared to the healthy subjects and showed a better organization of TA timing activation in StandTS when compared to SitTS. CONCLUSION: Compared to healthy subjects, APAs seem to be altered in both limbs of the post-stroke subjects, with the SOL activation timing being anticipated in both SitTS and StandTS.

Preparo de alta para o cuidado domiciliar de recém-nascidos de baixo risco / Preparing for discharge of low-risk newborns to home care / Preparación de alta para el cuidado domiciliar de neonatos de bajo riesgo

Objetivo: analisar o preparo de alta de famílias no alojamento conjunto quanto aos cuidados domiciliares dos recém-nascidos. Método: pesquisa qualitativa, desenvolvida através de Dinâmicas de Criatividade e Sensibilidade Corpo Saber, do Método Criativo Sensível, junto a 17 participantes, entre puérperas e familiares, em um hospital municipal da baixada litorânea do Rio de Janeiro, entre 2017 e 2018, cujos dados foram submetidos à análise temática. Aprovado por Comitê de Ética em Pesquisa. Resultados: o preparo de alta abarca orientações principalmente sobre aleitamento materno e manejo do coto umbilical, mas incluem conteúdos sobre banho, posições confortáveis e vacinas. Enfermeiras assumem o papel social de educadoras, através de uma prática educativa pontual baseada na transmissão de informações e na demonstração do cuidado do recém-nascido. Conclusão: existem lacunas no preparo de alta quanto às orientações essenciais para o cuidado domiciliar do recém-nascido com segurança e qualidade, ademais, é preciso buscar abordagens pedagógicas dialógicas que partam da realidade das famílias.

Objective: to examine preparations for discharge of families in the rooming-in facility as regards home care for newborns. Method: this qualitative study research, conducted through Body Knowledge Creativity and Sensitivity Dynamics, as part of the Sensitive Creative Method, in 2017 and 2018, at a municipal hospital in the Rio de Janeiro coastal lowlands, with 17 participants, including puerperas and family members The resulting data were treated by thematic analysis. The study was approved by the research ethics committee. Results: preparation for discharge includes guidance mainly on breastfeeding and management of the umbilical stump, but also bathing, comfortable positions and vaccines. Nurses perform the social role of educators by circumstantial educational actions basically to convey information and demonstrate care for the newborn. Conclusion: in the preparation for discharge, there were gaps in essential guidance on safe, quality home care for newborns, and dialogical pedagogical approaches, taking the families' realities as their point of departure, should be encountered.

Objetivo: analizar la preparación de alta de familias en el alojamiento conjunto respecto a los cuidados domiciliarios de los neonatos. Método: investigación cualitativa, desarrollada a través de Dinámicas de Creatividad y Sensibilidad Cuerpo Saber, del Método Creativo Sensible, junto a 17 participantes, entre puérperas y familiares, en un hospital municipal de la costa de Río de Janeiro, entre 2017 y 2018, cuyos datos fueron sometidos al análisis temático. Aprobado por el Comité de Ética en Investigación. Resultados: la preparación de alta abarca orientaciones principalmente sobre lactancia materna y manejo del cordón umbilical, pero incluyen contenidos sobre baño, posiciones confortables y vacunas. Enfermeras asumen el papel social de educadoras, a través de una práctica educativa puntual basada en la transmisión de informaciones y en la demostración del cuidado del neonato. Conclusión: existen deficiencias en la preparación de alta en cuanto a las orientaciones esenciales para el cuidado domiciliar del neonato con seguridad y calidad; además, es necesario buscar enfoques pedagógicos dialógicos que partan de la realidad de las familias.

Perfil de pacientes submetidos à cirurgia geral em um hospital pediátrico: implicações para a enfermagem / Profile of patients who underwent general surgery in a pediatric hospital: implications for nursing

O objetivo da pesquisa foi descrever o perfil demográfico e clínico de pacientes submetidos à cirurgia geral em um hospital pediátrico do município do Rio de Janeiro. Trata-se de um estudo descritivo e retrospectivo com abordagem quantitativa. A fonte de informação foi prontuários de pacientes entre 0-12 anos internados na clínica cirúrgica pediátrica da instituição para realização de cirurgia geral no período de junho-agosto de 2016. Foi utilizado para a coleta de dados um formulário semiestruturado com variáveis demográficas e clínicas. O estudo foi aprovado pelo Comitê de Ética. Foram analisados prontuários de 139 crianças submetidas à cirurgias, sendo a maioria do sexo masculino 107 (77,0%), etnia parda (61,9%), faixa etária pré-escolar (42,4%). A maioria não apresentava comorbidades (90,6%), se tratava de primeira cirurgia (95%), e possuía como acompanhante a mãe 136 (97,8%). Quanto às cirurgias realizadas, prevaleceram as eletivas 137 (98,6%), sendo a hernioplastia 59 (39,07%) a de maior freqüência, seguida pela postectomia 54 (35,76%). A maioria necessitou de medicamento para alívio da dor (65,4%). Conclui-se que o conhecimento desse perfil proporciona subsídios para um cuidado individualizado e qualificado que atenda às reais necessidades das crianças e suas famílias no pré, trans e pós-operatório da clínica cirúrgica

This research aimed to describe the demographic and clinical profile of patients who underwent general surgery in a pediatric hospital in the city of Rio de Janeiro. To that end, we performed a descriptive and retrospective study with a quantitative approach. The information source consisted of medical charts of patients aged 0-12 years old who were admitted to the pediatric surgical clinic of the institution for general surgery in the period of June-August 2016. We used a semi-structured form with demographic and clinical variables to collect data. This study was approved by the Ethics Committee. We analyzed the medical charts of 139 children who underwent surgeries, and mostly were males, 107 (77.0%), brown (61.9%), belonging the pre-school age group (42.4%). Furthermore, most had no comorbidities (90.6%), this was their first surgery (95%), and the mother was the companion, 136 (97.8%). As for the surgeries carried out, the elective took precedent 137 (98.6%), having the hernioplasty 59 (39.07%) as the most frequent, followed by the postectomy (circumcision), 54 (35.76%). Most required pain medication (65.4%). We can conclude that being aware of this profile provides subsidies for an individualized and qualified care that meets the real needs of children and their families in the pre, trans and post-operative period of the surgical clinic