Características do contato pele a pele em unidades neonatais brasileiras: estudo multicêntrico / Características del contacto piel con piel en unidades neonatales brasileñas: estudio multicéntrico / Characteristics of skin-to-skin contact in Brazilian neonatal units: a multicenter study

Resumo Objetivo Descrever o início, duração, local e quem realiza o contato pele a pele em unidades neonatais brasileiras. Métodos Estudo multicêntrico descritivo, longitudinal, realizado de maio de 2018 a março de 2020, em cinco unidades neonatais referência para o Método Canguru no Brasil, que incluiu recém-nascidos com peso até 1800g. As características maternas e dos recém-nascidos foram coletadas em prontuários e entrevistas. A prática do contato pele a pele era registrada em cartões anexados ao leito, preenchidos pela equipe e pelos pais. A análise ocorreu por meio de estatística descritiva. Resultados Foram incluídos 405 recém-nascidos, 51,4% do sexo masculino, mediana de idade gestacional de 31,4 semanas e de peso ao nascimento de 1.412g. Em relação ao tempo de realização do contato pele a pele, a mediana da frequência do contato diário foi de 1,5 vezes (IIQ: 1,2 - 2,4), o tempo/dia de 147 min/dia (IIQ: 106,7 - 263,0) e a realização do primeiro contato aos cinco dias de vida (IIQ:4,0-8,0). O maior tempo de contato/dia foi realizado pelas mães, com mediana de 137,8 min/dia (IIQ:95,6-232,1) e a segunda etapa do Método Canguru, Unidade de Cuidados Intermediários Canguru, foi o local onde se realizou por maior tempo o contato, com mediana de 184,4 min/dia (IIQ:124,7-455,4). Conclusão Nas unidades avaliadas, o contato pele a pele é praticado de forma intermitente, poucas vezes por dia, predominantemente pelas mães e com maior tempo de exposição na segunda etapa. É necessário buscar meios que possibilitem mais encontros entre mãe/pai-filho e que dê condições de maior permanência dos genitores no hospital.

Resumen Objetivo Describir el inicio, duración, lugar y quién realiza el contacto piel con piel en unidades neonatales brasileñas. Métodos Estudio multicéntrico descriptivo, longitudinal, realizado de mayo de 2018 a marzo de 2020, en cinco unidades neonatales de referencia del Método Canguro en Brasil, que incluyó recién nacidos de hasta 1800 g de peso. Las características maternas y de los recién nacidos fueron recopiladas en historias clínicas y entrevistas. La práctica del contacto piel con piel fue registrada en tarjetas anexadas a la cama, completadas por el equipo y por los padres. El análisis se realizó mediante estadística descriptiva. Resultados Se incluyeron 405 recién nacidos, 51,4 % de sexo masculino, mediana de 31,4 semanas de edad gestacional y de 1412 g de peso al nacer. Con relación al tiempo de realización del contacto piel con piel, la mediana de la frecuencia del contacto diario fue 1,5 veces (IIQ: 1,2 - 2,4), el tiempo/día fue de 147 min/día (IIQ: 106,7 - 263,0) y la realización del primer contacto a los cinco días de vida (IIQ:4,0-8,0). El mayor tiempo de contacto/día fue realizado por las madres, con una mediana de 137,8 min/día (IIQ:95,6-232,1) y la segunda etapa del Método Canguro, la Unidad de Cuidados Intermedios Canguro, fue el lugar donde se realizó el contacto por mayor tiempo, con una mediana de 184,4 min/día (IIQ:124,7-455,4). Conclusión En las unidades analizadas, el contacto piel con piel se practica de forma intermitente, pocas veces por día, predominantemente por las madres y con mayor tiempo de exposición en la segunda etapa. Es necesario buscar medios que permitan más encuentros entre madre/padre-hijo y que ofrezcan condiciones de mayor permanencia de los progenitores en el hospital.

Abstract Objective To describe the beginning, duration, location and who makes skin-to-skin contact in Brazilian neonatal units. Methods This is a descriptive, longitudinal multicenter study, carried out from May 2018 to March 2020, in five reference neonatal units for Kangaroo Mother Care in Brazil, which included newborns weighing up to 1,800 grams. Maternal and newborn characteristics were collected from medical records and interviews. Skin-to-skin contact was recorded on cards attached to the bed, filled in by the team and fathers. Analysis occurred through descriptive statistics. Results We included 405 newborns, 51.4% male, median gestational age of 31.4 weeks and birth weight of 1,412 grams. Regarding skin-to-skin contact time, the median daily contact frequency was 1.5 times (IQR: 1.2 - 2.4), the time/day was 147 min/day (IQR: 106.7 - 263.0) and the first contact at five days of life (IQR:4.0-8.0). The longest contact time/day was performed by mothers, with a median of 137.8 minutes per day (IQR:95.6-232.1), and the second stage of kangaroo Mother Care, kangaroo Intermediate Care Unit, was the place where contact was performed for the longest time, with a median of 184.4 minutes per day (IQR:124.7-455.4). Conclusion In the units assessed, skin-to-skin contact is practiced intermittently, a few times a day, predominantly by mothers and with longer exposure time in the second stage. It is necessary to seek ways that allow more encounters between mother/father-child and that gives conditions of greater permanence of fathers in the hospital.

The role of skin-to-skin contact in exclusive breastfeeding: a cohort study.

OBJETIVE: To understand the role of exposure to skin-to-skin contact and its minimum duration in determining exclusive breastfeeding at hospital discharge in infants weighing up to 1,800g at birth. METHODS: A multicenter cohort study was carried out in five Brazilian neonatal units. Infants weighing ≤ 1,800g at birth were eligible. Skin-to-skin contact time was recorded by the health care team and parents on an individual chart. Maternal and infant data was obtained from maternal questionnaires and medical records. The Classification Tree, a machine learning method, was used for data analysis; the tree growth algorithm, using statistical tests, partitions the dataset into mutually exclusive subsets that best describe the response variable and calculates appropriate cut-off points for continuous variables, thus generating an efficient explanatory model for the outcome under study. RESULTS: A total of 388 infants participated in the study, with a median of 31.6 (IQR = 29-31.8) weeks of gestation age and birth weight of 1,429g (IQR = 1,202-1,610). The exclusive breastfeeding rate at discharge was 61.6%. For infant's weighting between 1,125g and 1,655g, exposed to skin-to-skin contact was strongly associated with exclusive breastfeeding. Moreover, infants who made an average > 149.6 min/day of skin-to-skin contact had higher chances in this outcome (74% versus 46%). In this group, those who received a severity score (SNAPPE-II) equal to zero increased their chances of breastfeeding (83% versus 63%). CONCLUSION: Skin-to-skin contact proved to be of great relevance in maintaining exclusive breastfeeding at hospital discharge for preterm infants weighing 1,125g-1,655g at birth, especially in those with lower severity scores.

Effect of Kangaroo Position on microcirculation of preterm newborns: a controlled randomized clinical trial

Abstract Objective: The objective of this study was to evaluate the effect of Kangaroo Position (KP) in microcirculation (MC) of the flexor muscles of preterm newborns. Method: A controlled clinical trial was conducted in the city of Recife, Brazil, with 26 preterm children randomized in the Kangaroo Group (13) and in the Control Group (13). Assessments of blood flow, temperature, and tissue oxygen saturation (SO2) were made at two different times and in the biceps brachii muscle and hamstrings muscle group: before the KP and after 24 h of KP. In the Control Group, the registrations were performed at the times corresponding to those of the Kangaroo Group. The mean values among the times were analyzed by paired t-test for repeated measures. The clinical trial was recorded in Clinical Trials (NCT03611088). Results: In the Kangaroo Group there was an increase in tissue temperature and blood flow at the time evaluation periods (p < 0.05). In the control group, there was no statistical difference between the recording moments hamstring muscles group, but in the biceps brachii, there was a reduction in mean blood flow (p = 0.023). Conclusion: In conclusion, the KP has effects on the microcirculation of the flexor muscles of preterm newborns.

Effect of Kangaroo Position on microcirculation of preterm newborns: a controlled randomized clinical trial.

OBJECTIVE: The objective of this study was to evaluate the effect of Kangaroo Position (KP) in microcirculation (MC) of the flexor muscles of preterm newborns. METHOD: A controlled clinical trial was conducted in the city of Recife, Brazil, with 26 preterm children randomized in the Kangaroo Group (13) and in the Control Group (13). Assessments of blood flow, temperature, and tissue oxygen saturation (SO2) were made at two different times and in the biceps brachii muscle and hamstrings muscle group: before the KP and after 24 h of KP. In the Control Group, the registrations were performed at the times corresponding to those of the Kangaroo Group. The mean values among the times were analyzed by paired t-test for repeated measures. The clinical trial was recorded in Clinical Trials (NCT03611088). RESULTS: In the Kangaroo Group there was an increase in tissue temperature and blood flow at the time evaluation periods (p < 0.05). In the control group, there was no statistical difference between the recording moments hamstring muscles group, but in the biceps brachii, there was a reduction in mean blood flow (p = 0.023). CONCLUSION: In conclusion, the KP has effects on the microcirculation of the flexor muscles of preterm newborns.

The role of skin-to-skin contact in exclusive breastfeeding: a cohort study

ABSTRACT OBJETIVE To understand the role of exposure to skin-to-skin contact and its minimum duration in determining exclusive breastfeeding at hospital discharge in infants weighing up to 1,800g at birth. METHODS A multicenter cohort study was carried out in five Brazilian neonatal units. Infants weighing ≤ 1,800g at birth were eligible. Skin-to-skin contact time was recorded by the health care team and parents on an individual chart. Maternal and infant data was obtained from maternal questionnaires and medical records. The Classification Tree, a machine learning method, was used for data analysis; the tree growth algorithm, using statistical tests, partitions the dataset into mutually exclusive subsets that best describe the response variable and calculates appropriate cut-off points for continuous variables, thus generating an efficient explanatory model for the outcome under study. RESULTS A total of 388 infants participated in the study, with a median of 31.6 (IQR = 29-31.8) weeks of gestation age and birth weight of 1,429g (IQR = 1,202-1,610). The exclusive breastfeeding rate at discharge was 61.6%. For infant's weighting between 1,125g and 1,655g, exposed to skin-to-skin contact was strongly associated with exclusive breastfeeding. Moreover, infants who made an average > 149.6 min/day of skin-to-skin contact had higher chances in this outcome (74% versus 46%). In this group, those who received a severity score (SNAPPE-II) equal to zero increased their chances of breastfeeding (83% versus 63%). CONCLUSION Skin-to-skin contact proved to be of great relevance in maintaining exclusive breastfeeding at hospital discharge for preterm infants weighing 1,125g-1,655g at birth, especially in those with lower severity scores.

The effect of kangaroo care on modulate chronic stress response in preterm infants and mothers.

To assess stress experienced during Neonatal Intensive Care Unit (NICU) stay, we analyzed fingernail Cortisol (CORT) and Dehydroepiandrosterone (DHEA) levels and ratios in mothers and preterm infants (PI); compared hormones levels/ratio (CORT and DHEA) in kangaroo care (KC) versus standard care (SC) groups and examined relationships between PI hormone levels total days spent in the NICU. Mothers and their infants were recruited in the NICU, included levels I-IV and kangaroo care unit, within one week of infant birth in hospitals in Brazil. At 3 months after birth, mothers provided 3-month growth clippings from all ten digits of their own and their infants' fingernails. CORT and DHEA were measured using enzyme immunoassays (mothers) and high-performance-liquid-chromatography-with-mass-spectrometry (infants). Sample: n = 59 mothers (KC = 30/SC = 29) and 63 infants (KC = 32/SC = 31). Data were analyzed using non-parametric/parametric comparative statistics. NICU stay ranged from 3-103 days. For mothers in Kangaroo and Standard Care the CORT, DHEA levels and DHEA:CORT ratio (DC) ratio did not differ. Infants in KC had higher DHEA (p = 0.003) and a higher DC ratio (p = 0.011) than SC infants. Even though KC infants stayed in the NICU for a greater number of days than infants in SC, they had higher mean level of DHEA, and DC ratio, suggesting that KC played a role in promoting their stress regulatory capacities and may mitigate toxic effects of chronic hypercortisolemia. However, for mothers, KC did not reduce chronic stress compared to that in women in the SC condition. Further research warranted.

Effect of a Copaiba Oil-Based Dental Biomodifier on the Inhibition of Metalloproteinase in Adhesive Restoration.

AIM: This study sets out to evaluate the antiproteolytic activity of copaiba oil-based emulsion at the resin/dentin adhesive interface union formed with conventional and self-etching adhesives systems. METHODS: At in situ zymography, 30 teeth were sectioned 2 mm below the enamel-dentin junction; a smear layer was standardized and subdivided into four groups. Gelatin conjugated with fluorescein was used and taken to the fluorescence microscope for evaluation. In cytotoxicity, the Trypan Blue method was used at four different time points. The tested groups were (G1) control with distilled water; (G2) 2% chlorhexidine (CLX); (G3) emulsion based on copaiba oil (EC) 10% + X; (G4) 10% EC + Y; and (G5) EC 10% alkaline. The zymographic assay used the same groups described, but in 30 seconds and 10 and 20 minutes. HT1080 cells were incubated and submitted to electrophoresis. The gel was analyzed using ImageJ software. Mann-Whitney and Kruskal-Wallis tests were used in the statistical analysis (p < 0.05). RESULTS: ECs showed higher cell viability in the cytotoxicity test and showed a significant difference in 10 and 20 minutes. In the zymographic assay, alkaline EC reduced 67% of MMP-2 activity and 44% of MMP-9 compared to 2% chlorhexidine. At in situ zymography in qualitative evaluation, all groups tested showed inhibition of activity in metalloproteinases. CONCLUSION: EC showed activity in the inhibition of metalloproteinases in vitro and in situ, especially the alkaline one. The survey shows the possibility of using ECs, a product from Amazonian biodiversity, as a biomodifier in dentistry.

Evaluation of the lingual frenulum in newborns using two protocols and its association with breastfeeding / Avaliação do frênulo lingual em recém-nascidos com dois protocolos e sua relação com o aleitamento materno

Abstract Objective: To characterize the lingual frenulum of full-term newborns using two different protocols and to assess the association of the lingual frenulum with breastfeeding. Methods: This non-probabilistic sample consisted of 449 mother/baby binomials. For the anatomo-functional evaluation of the frenulum, the Neonatal Tongue Screening Test and the Bristol Tongue Assessment Tool were used for the evaluation of the lingual frenulum. Breastfeeding was evaluated using the protocol proposed by UNICEF. Scores were created (good, fair, poor) to evaluate every aspect of the breastfeeding to be observed. The results were analyzed through descriptive and inferential statistics and association tests (Pearson's chi-squared and Fisher's exact test). Results: The study showed that 14 babies had a lingual frenulum alteration, of whom three had difficulties during suction, requiring frenotomy in the first week of life, whereas 11 had no difficulties during breastfeeding. Regarding the breastfeeding evaluation, 410 mother/baby binomials had good, 36 regular, and three had bad scores. There was a statistically significant association between the tongue-tie test protocol and breastfeeding (p = 0.028) and between the Bristol Tongue Assessment Tool protocol and breastfeeding (p = 0.028). Conclusion: Alterations in the lingual frenulum are associated with interferences in the quality of breastfeeding and thus, evaluation of the lingual frenulum in newborns is important.

Resumo Objetivo: Caracterizar o frênulo lingual de recém-nascidos a termo, utilizando dois protocolos diferentes e verificar a relação do frênulo lingual com o aleitamento materno. Método: A amostra não probabilística foi constituída por 449 binômios mãe/bebê. Para a avaliação anatomofuncional do frênulo, utilizou-se o protocolo de avaliação do frênulo lingual para bebês "Teste da Linguinha" e o Bristol Tongue Assessment Tool. A mamada foi avaliada com o protocolo proposto pelo UNICEF. Foram criados escores (bom, regular, ruim) para avaliar cada aspecto da mamada a ser observada. Os resultados foram analisados através de estatísticas descritivas e inferenciais e testes de associação (Qui-quadrado de Pearson e Exato de Fisher). Resultados: O estudo mostrou que 14 bebês apresentaram alteração de frênulo lingual, nos quais três com dificuldade durante a sucção, necessitando de frenotomia na primeira semana de vida e 11 sem dificuldades durante a amamentação. Quanto à avaliação da mamada, 410 binômios mãe/bebê apresentaram o escore bom, 36 regular e 3 ruim. Houve associação estatisticamente significativa entre o protocolo "Teste da Linguinha" e amamentação (p = 0,028) e entre o protocolo Bristol Tongue Assessment Tool e amamentação (p = 0,028). Conclusão: Alterações no frênulo lingual estão associadas a interferências na qualidade da amamentação, sendo importante a avaliação do frênulo lingual em recém-nascidos.

Short-time effect of the kangaroo position on electromyographic activity of premature infants: a randomized clinical trial / Efeito de curto prazo da posic¸ão canguru sobre a atividade eletromiográfica do prematuro: um ensaio clínico randomizado

Abstract Objective: To verify the short-term influence of the kangaroo position (KP) on the electromyography activity of preterm newborns. Method: A clinical study was conducted in a kangaroo unit sector (secondary and tertiary care) in the city of Recife, Brazil, with 44 preterm infants randomized to intervention (n = 21) and control (n = 23) groups. The KP was performed through a band that supports the newborn against the adult's thorax, in a prone and vertical position, and infants were dressed with few pieces of clothes, thus keeping skin-to-skin contact with the mother. Surface electromyography was used to investigate the muscle activity of the biceps brachii and hamstrings. The randomization of the groups was performed by the program R® (v. 3.3.1). The electromyography registrations were made at three different times: before the KP and after one and two hours of KP. In the control group, the registrations were performed at the times corresponding to those of the intervention group. The mean values of the electromyography activity among the times were analyzed by ANOVA for repeated measures and the Kruskal-Wallis test. The clinical trial was recorded in ClinicalTrials.gov (NCT02849665 - 07/28/2016). Results: In the intervention group (n = 21), there was a variation of the electromyography activity values between the three recording moments for both the biceps brachii and hamstrings. In the control group (n = 23), there was no statistical difference between the recording moments for both. Conclusions: The KP increases the short-term electromyographic activity of the biceps brachii and hamstrings.

Resumo Objetivo: Verificar a influência de curto prazo da Posição Canguru (PC) sobre a atividade eletromiográfica de recém-nascidos prematuros. Método: Foi feito um estudo clínico em um setor da Unidade do Método Mãe Canguru (cuidado secundário e terciário) na cidade de Recife, com 44 neonatos prematuros randomizados em grupos de Intervenção (n = 21) e Controle (n = 23). A Posição Canguru foi feita por meio de uma faixa que apoia o recém-nascido de bruços contra o tórax do adulto, na posição vertical e vestido com poucas peças de roupa, mantém o contato pele a pele com a mãe. Foi usada a Eletromiografia Superficial para investigar a atividade muscular dos bíceps braquiais e músculos isquitobiais. A randomização dos grupos foi feita com o software R (versão 3.3.1)®. Os registros da eletromiografia foram feitos em três momentos: antes da PC e após uma e duas horas da Posição Canguru. No Grupo de Controle, os registros foram feitos nos momentos correspondentes àqueles do Grupo do Método Mãe Canguru. Os valores médios da atividade eletromiográfica entre esses momentos foram analisados pela análise de variância (Anova) de medidas repetidas e por um teste de Kruskal-Wallis. O ensaio clínico foi registrado no Clinical Trials (NCT02849665 - 28/07/2016). Resultados: No Grupo do Método Mãe Canguru (n = 21), houve variação dos valores da atividade eletromiográfica entre os três momentos de registro de atividade dos bíceps braquiais e dos músculos isquitobiais. No Grupo de Controle (n = 23), não houve diferença estatística entre os momentos de registro. Conclusões: A PC aumenta a atividade eletromiográfica de curto prazo dos músculos bíceps braquiais e isquitobiais.

Fat Distribution among Children Born Extremely Low Birth Weight and Very Low Birth Weight: A Cohort Study.

Background: Fat distribution is associated with chronic diseases and birth weight may influence fat distribution throughout life. Our aim was to compare fat distribution in children born extremely low birth weight (ELBW) and very low birth weight (VLBW). Methods: This retrospective cohort study evaluated children born ELBW and VLBW around the 7th year of life. Fat distribution was assessed by ultrasonography measurements of abdominal subcutaneous and visceral fat thickness. Multiple linear regression analysis was performed. Results: We studied 63 children. Visceral fat thickness but not subcutaneous fat thickness was significantly increased in children born ELBW compared with children born VLBW, respectively, 3.13 (±1.08) versus 1.86 (±0.76) mm. This result remained after adjustment for age, gender, and BMI; adjusted coefficient 0.118, 95% confidence interval 0.009-0.227, p = 0.034. Conclusion: Children born ELBW seem to have increased visceral fat thickness compared with children born VLBW.

Evaluation of the lingual frenulum in newborns using two protocols and its association with breastfeeding.

OBJECTIVE: To characterize the lingual frenulum of full-term newborns using two different protocols and to assess the association of the lingual frenulum with breastfeeding. METHODS: This non-probabilistic sample consisted of 449 mother/baby binomials. For the anatomo-functional evaluation of the frenulum, the Neonatal Tongue Screening Test and the Bristol Tongue Assessment Tool were used for the evaluation of the lingual frenulum. Breastfeeding was evaluated using the protocol proposed by UNICEF. Scores were created (good, fair, poor) to evaluate every aspect of the breastfeeding to be observed. The results were analyzed through descriptive and inferential statistics and association tests (Pearson's chi-squared and Fisher's exact test). RESULTS: The study showed that 14 babies had a lingual frenulum alteration, of whom three had difficulties during suction, requiring frenotomy in the first week of life, whereas 11 had no difficulties during breastfeeding. Regarding the breastfeeding evaluation, 410mother/baby binomials had good, 36 regular, and three had bad scores. There was a statistically significant association between the tongue-tie test protocol and breastfeeding (p=0.028) and between the Bristol Tongue Assessment Tool protocol and breastfeeding (p=0.028). CONCLUSION: Alterations in the lingual frenulum are associated with interferences in the quality of breastfeeding and thus, evaluation of the lingual frenulum in newborns is important.

Short-time effect of the kangaroo position on electromyographic activity of premature infants: a randomized clinical trial.

OBJECTIVE: To verify the short-term influence of the kangaroo position (KP) on the electromyography activity of preterm newborns. METHOD: A clinical study was conducted in a kangaroo unit sector (secondary and tertiary care) in the city of Recife, Brazil, with 44 preterm infants randomized to intervention (n=21) and control (n=23) groups. The KP was performed through a band that supports the newborn against the adult's thorax, in a prone and vertical position, and infants were dressed with few pieces of clothes, thus keeping skin-to-skin contact with the mother. Surface electromyography was used to investigate the muscle activity of the biceps brachii and hamstrings. The randomization of the groups was performed by the program R® (v. 3.3.1). The electromyography registrations were made at three different times: before the KP and after one and two hours of KP. In the control group, the registrations were performed at the times corresponding to those of the intervention group. The mean values of the electromyography activity among the times were analyzed by ANOVA for repeated measures and the Kruskal-Wallis test. The clinical trial was recorded in ClinicalTrials.gov (NCT02849665 - 07/28/2016). RESULTS: In the intervention group (n=21), there was a variation of the electromyography activity values between the three recording moments for both the biceps brachii and hamstrings. In the control group (n=23), there was no statistical difference between the recording moments for both. CONCLUSIONS: The KP increases the short-term electromyographic activity of the biceps brachii and hamstrings.

WITHDRAWN: Short-time effect of the kangaroo position on electromyographic activity of premature infants: a randomized clinical trial.

The Publisher regrets that this article is an accidental duplication of an article that has already been published, https://doi.org/. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.

Dentin Cleaning Ability of an Amazon Bioactive: Evaluation by Scanning Electron Microscopy.

UNLABELLED: The role of dentin cleaning is to remove debris that may impair adaptation and marginal sealing, quantitatively reducing microorganisms. The aim of this study was to investigate through scanning electron microscopy (SEM) the morphology of the dentin surface, cut and treated with copaiba oil emulsions (CO) and suspension of ethanol extract of propolis (EP). Twenty four upper pre-molars teeth, divided into eight groups (n=3), were used: G1: no cleaning, G2: air/water spray, G3: 10% CO, G4: 10% CO + A, G5: 30% CO, G6: 30% CO + A, G7: 1% EP, G8: 2% Chlorhexidine. The specimens were dentin discs (1 mm Ø). The SEM photomicrographs were classified and the results were: G1 - Debris dentin on the entire image / countless microorganisms, G2 and G7 - 50-100 debris / countless microorganisms and G3, G4, G5, G6 and G8 - 0-50 debris / countable microorganisms (50-100 colonies). CONCLUSION: The present results suggest that copaiba oil emulsions (CO) and suspension of ethanol extract of propolis (EP) have feasibility to be used as bioactive dental cleaning agents.

Electromyographic activity of preterm newborns in the kangaroo position: a cohort study.

OBJECTIVE: To compare the electromyographic activity of preterm newborns placed in the kangaroo position with the activity of newborns not placed in this position. DESIGN: A cohort study. SETTING: A Kangaroo Unit sector and a Nursery sector in a secondary and tertiary care at a mother-child hospital in Recife, Brazil. PARTICIPANTS: Preterm infants of gestational age 27-34 weeks (n=38) and term infants (n=39). PRIMARY AND SECONDARY OUTCOME MEASURES: Surface electromyography was used to investigate muscle activity in the brachial biceps at rest. 3 groups were designed: (1) preterm newborns in the kangaroo position (PT-KAN), where the newborn remains in a vertical position, lying face down, with limbs flexed, dressed in light clothes, maintaining skin-to-skin contact with the adult's thorax. Her electromyographic activity was recorded at 0 h (immediately before starting this position), and then at 48 h after the beginning of the position (but newborns were kept in the kangaroo position for 8-12 h per day) and at term equivalent age (40±1 weeks); (2) preterm newborns not in the kangaroo position (PT-NKAN), in which measurements were made at 0 h and 48 h; and (3) term newborns (T), in which measurements were made at 24 h of chronological age. RESULTS: The Root Mean Square (RMS) values showed significant differences among groups (F(5,108)=56.69; p<0.001). The multiple comparisons showed that RMS was greater at 48 h compared to 0 h in the preterm group in the kangaroo position, but not in the group not submitted in the kangaroo position. The RMS in the term equivalent aged group in the kangaroo position was also greater when compared with those in the term group. CONCLUSIONS: The kangaroo position increases electromyographic activity in the brachial biceps of preterm newborns and those who have reached the age equivalent to term.

Effect of the kangaroo position on the electromyographic activity of preterm children: a follow-up study.

BACKGROUND: One of the components of the Kangaroo Method (KM) is the adoption of the Kangaroo Position. The skin-to-skin contact and the vertical position the child adopts when in this position may provide sensorial, vestibular and postural stimuli for the newborn. The Kangaroo Position may encourage vestibular stimuli and a flexed posture of the limbs, suggesting the hypothesis that the Kangaroo Position may have an impact on flexor muscle tone. The effect of these stimuli on the motor features of the newborn has not been the subject of much investigation. No study has yet been conducted to determine whether the Kangaroo Position may progressively increase electromyographic activity or whether this increase persists until term-equivalent age. The aim of this study was to evaluate the effect of the Kangaroo Position on the electromyographic activity of preterm children. METHOD: A follow-up study was carried out between July and November 2011 at the Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife-Brazil, using a sample of 30 preterm children. Surface Eletromyography (SEMG) was used to investigate the muscle activity of biceps brachii. The electromyographic readings were taken immediately before (0 h) and after 24 h, 48 h, 72 h, 96 h of application of the Kangaroo Position as well as at the term equivalent age in each baby. Electromyographic activity was analyzed using the Root Mean Square (RMS) and the mean values of the times were analyzed by way of analysis of variance for repeated measures and the Tukey test. RESULTS: Electromyographic activity of the biceps brachii varied and increased over the whole 96h period (RMS:0 h = 36.5 and 96 h = 52.9) (F(5.174) = 27.56; p < 0.001) and remained constant thereafter (RMS: term-equivalent age = 54.2). The correlations between the corrected age and the values for electromyographic activity did not show any statistical significance. CONCLUSION: The Kangaroo Position leads to a growing increase in the electromyographic activity of preterm children's biceps brachii after up to 96 h of stimulation and this response persists until at least the 21st day after this period.

Motor development evaluated by Test of Infant Motor Performance: comparison between preterm and full-term infants.

OBJECTIVES: To compare the motor development of preterm infants whose gestational age had been corrected to 38-40 weeks with full term newborns using the Test of Infant Motor Performance (TIMP). METHODS: The cross-sectional study compared preterm infants (PT group), with a gestational age at birth of 28-33 weeks, at an equivalent age to full term newborns (FT group), who were assessed up to 48 hours after birth. The assessments were performed between December 2008 and April 2009 in a hospital nationally recognized for premature infant care in the city of Recife, PE, Brazil. The sample consisted of 92 infants, 46 in each group. The test was administered at age 38-40 weeks (or equivalent age in the PT group). RESULTS: In the 46 preterm infants studied, 26.1% were classified as atypical, while in the FT group 100% were classified as typical (p<0.001). Moreover, there was a significant difference in average raw TIMP score between the two groups, with the PT group being lower (p<0.001). CONCLUSION: According to TIMP performance, prematurity seems to be associated with impaired motor development.

Motor development evaluated by Test of Infant Motor Performance: comparison between preterm and full-term infants / Desenvolvimento motor avaliado pelo Test of Infant Motor Performance: comparação entre lactentes pré-termo e a termo

OBJECTIVES: To compare the motor development of preterm infants whose gestational age had been corrected to 38-40 weeks with full term newborns using the Test of Infant Motor Performance (TIMP). METHODS: The cross-sectional study compared preterm infants (PT group), with a gestational age at birth of 28-33 weeks, at an equivalent age to full term newborns (FT group), who were assessed up to 48 hours after birth. The assessments were performed between December 2008 and April 2009 in a hospital nationally recognized for premature infant care in the city of Recife, PE, Brazil. The sample consisted of 92 infants, 46 in each group. The test was administered at age 38-40 weeks (or equivalent age in the PT group). RESULTS: In the 46 preterm infants studied, 26.1 percent were classified as atypical, while in the FT group 100 percent were classified as typical (p<0.001). Moreover, there was a significant difference in average raw TIMP score between the two groups, with the PT group being lower (p<0.001). CONCLUSION: According to TIMP performance, prematurity seems to be associated with impaired motor development.

OBJETIVOS: Comparar, por meio do Test of Infant Motor Performance (TIMP), o desenvolvimento motor de lactentes nascidos pré-termo que estavam com idade gestacional corrigida de 38 a 40 semanas com o de recém-nascidos a termo. MÉTODOS: Estudo de desenho transversal em que se comparou o desempenho motor de lactentes pré-termo (grupo RNPT), com idade gestacional no parto de 28 a 33 semanas, avaliados na idade equivalente ao termo, com o de recém-nascidos a termo (grupo RNT), avaliados em até 48 horas de vida, por meio do TIMP. A coleta dos dados foi realizada no período de dezembro de 2008 a abril de 2009, num hospital de referência para assistência a prematuros na cidade de Recife, PE, Brasil. A amostra foi constituída de 92 lactentes, 46 para cada grupo. O teste foi aplicado na idade de 38 a 40 semanas de idade gestacional (corrigida, no caso dos lactentes nascidos pré-termo). RESULTADOS:Dos 46 lactentes pré-termo avaliados, 26,1 por cento foram classificados como atípicos, enquanto 100 por cento dos recém-nascidos a termo foram classificados como típicos (p<0,001). Além disso, houve diferença significativa na média do escore bruto do teste nos dois grupos, sendo a média do grupo RNPT menor (p<0,001). CONCLUSÕES: A prematuridade parece estar associada a prejuízo no desenvolvimento motor, avaliado pelo TIMP.

Psicodinâmica interativa mãe-criança e desmame / Mother-child interactive psychodynamics and weaning

A amamentação representa uma das principais intervenções na redução da morbimortalidade infantil, processo privilegiado à subjetivação, desenvolvimento infantil e prevenção de perturbações no vínculo mãe-filho, quando bem vivenciada pela díade. O estudo analisou a psicodinâmica envolvida no desmame precoce e no desmame tardio, baseado na interação de duas díades mãe-criança com desnutrição grave primária, com bebês entre seis e 15 meses de idade, internadas num hospital escola. Foi utilizado o método qualitativo referenciado na psicanálise, com entrevistas semi-estruturadas e observações. O desmame precoce pareceu associado à dificuldade de construção da maternidade e vínculo; o desmame tardio refletiu o excesso psicoafetivo materno/dificuldade na entrada do pai.(AU)

Breastfeeding is one of the main interventions in reducing child morbimortality, a privileged process to subjectivation, to child development and to prevention of disturbances in child-mother bond, when it is well experienced by the dyad. The study analyzed the psychodynamics involved in early weaning and late weaning, based on the interaction of two mother-child dyads with severe malnutrition, involving babies aged six and 15 months, hospitalized in a teaching institution. Qualitative methods based on psychoanalysis were used, with semi-structured interviews and observations. Early weaning seemed related to difficulties constructing motherhood and bonding; late weaning appeared to reflect an excess of maternal affection or difficulty in accepting the father figure.(AU)

Psicodinâmica interativa mãe-criança e desmame / Mother-child interactive psychodynamics and weaning

A amamentação representa uma das principais intervenções na redução da morbimortalidade infantil, processo privilegiado à subjetivação, desenvolvimento infantil e prevenção de perturbações no vínculo mãe-filho, quando bem vivenciada pela díade. O estudo analisou a psicodinâmica envolvida no desmame precoce e no desmame tardio, baseado na interação de duas díades mãe-criança com desnutrição grave primária, com bebês entre seis e 15 meses de idade, internadas num hospital escola. Foi utilizado o método qualitativo referenciado na psicanálise, com entrevistas semi-estruturadas e observações. O desmame precoce pareceu associado à dificuldade de construção da maternidade e vínculo; o desmame tardio refletiu o excesso psicoafetivo materno/dificuldade na entrada do pai.

Breastfeeding is one of the main interventions in reducing child morbimortality, a privileged process to subjectivation, to child development and to prevention of disturbances in child-mother bond, when it is well experienced by the dyad. The study analyzed the psychodynamics involved in early weaning and late weaning, based on the interaction of two mother-child dyads with severe malnutrition, involving babies aged six and 15 months, hospitalized in a teaching institution. Qualitative methods based on psychoanalysis were used, with semi-structured interviews and observations. Early weaning seemed related to difficulties constructing motherhood and bonding; late weaning appeared to reflect an excess of maternal affection or difficulty in accepting the father figure.