The influence of the quality in daycare environments on children's motor development between six to 15 months old / Influência da qualidade do ambiente das creches no desenvolvimento motor de crianças entre seis e 15 meses

Abstract Objectives: to analyze the influence of the quality in the environment on children's motor development between six to 15 months old attending early childhood education centers. Methods: a cross-sectional and analytical study addressing children's motor development between six to 15 months old, both sexes, enrolled in nursery (0-12 months) and preschoolers (12-24 months). The Affordances in the Home Environment for Motor Development-Infant Scale and Alberta Infant Motor Scale were used in the Brazilian versions Results: the sample was comprised of 104 children and 30 early childhood education centers: presenting a mean age of 9.15 months, 88% attended full-time and 12% part-time schooling (mornings or afternoons). One center was classified with a low Affordances, 26 were considered Sufficient, and three were Adequate. Of the participating children, 40% presented typical motor development. The higher levels of Affordances suggest better motor development, and lower levels of suspected delayed motor development. Conclusion: the environments of early childhood education centers influence children's motor performance, especially daily activities and the use of toys. The lower the Affordances level, more likely children are suspected of delayed motor development.

Resumo Objetivos: analisar a influência da qualidade do ambiente no desenvolvimento motor de crianças na faixa etária entre seis e 15 meses que frequentam centros de educação infantil. Métodos estudo de delineamento transversal e analítico sobre o desenvolvimento motor de crianças entre seis e 15 meses de idade, de ambos os sexos, matriculadas em turmas de berçário (0-12 meses) e maternal I (12-24 meses), com utilização das escalas validadas Affordances in the Home Environment for Motor Development-Infant Scale e Alberta Infant Motor Scale. Resultados: a amostra de 104 crianças e 30 centros de educação infantil apresentou idade média de 9,15 meses, 88% permanecia em período integral e 12% meio período (manhã ou tarde), um centro foi classificado como Affordance Fraca, 26 Suficiente e três Adequada. Das crianças participantes, 40% apresentaram desenvolvimento motor normal. Os maiores níveis de Affordance indicam melhor desenvolvimento motor e níveis menores de Affordance sinalizam suspeita de atraso motor. Conclusão: o ambiente de centros de educação infantil em que a criança está inserida exerce influência no desempenho motor, principalmente ligado às atividades diárias e uso de brinquedos. Quanto menor o nível de Affordance mais possibilidades de suspeita de atraso motor infantil.

Profile of patients with Fournier's gangrene and their clinical evolution.

OBJECTIVE: to analyze the profile of patients with Fournier's gangrene treated in a public tertiary hospital in western Paraná State. METHODS: we conducted a cross-sectional, retrospective and descriptive study of patients with Fournier's gangrene treated between January 2012 and November 2016. RESULTS: there were 40 patients with Fournier's gangrene treated in the period, 29 (72.5%) men and 11 (27.5%) women. The mean age was 51.7±16.3 years. The mean time of disease progression, from the initial symptom to hospitalization, was 10.5±1.2 days. All patients had clinical signs such as pain, bulging, erythema, among others, and 38 (95%) had associated comorbidities, the most common being type 2 diabetes mellitus and systemic arterial hypertension. The majority (30 patients - 75%) had perianal abscess as the probable etiology. All patients were submitted to antibiotic therapy and surgical treatment, with a mean of 1.8±1.1 surgeries per patient. Nine (22.5%) patients died. There was a strong correlation between the presence of sepsis on admission and mortality. CONCLUSION: Fournier's gangrene patients in this series had a long disease duration and a high prevalence of comorbidities, with a high mortality rate.

Profile of patients with Fournier's gangrene and their clinical evolution / Perfil dos pacientes com gangrena de Fournier e sua evolução clínica

ABSTRACT Objective: to analyze the profile of patients with Fournier's gangrene treated in a public tertiary hospital in western Paraná State. Methods: we conducted a cross-sectional, retrospective and descriptive study of patients with Fournier's gangrene treated between January 2012 and November 2016. Results: there were 40 patients with Fournier's gangrene treated in the period, 29 (72.5%) men and 11 (27.5%) women. The mean age was 51.7±16.3 years. The mean time of disease progression, from the initial symptom to hospitalization, was 10.5±1.2 days. All patients had clinical signs such as pain, bulging, erythema, among others, and 38 (95%) had associated comorbidities, the most common being type 2 diabetes mellitus and systemic arterial hypertension. The majority (30 patients - 75%) had perianal abscess as the probable etiology. All patients were submitted to antibiotic therapy and surgical treatment, with a mean of 1.8±1.1 surgeries per patient. Nine (22.5%) patients died. There was a strong correlation between the presence of sepsis on admission and mortality. Conclusion: Fournier's gangrene patients in this series had a long disease duration and a high prevalence of comorbidities, with a high mortality rate.

ABSTRACT Objetivo: analisar o perfil dos pacientes com gangrena de Fournier tratados em um hospital público terciário do oeste do Paraná. Métodos: estudo transversal, retrospectivo e descritivo de pacientes portadores de gangrena de Fournier atendidos no período de janeiro de 2012 a novembro de 2016. Resultados: foram tratados 40 pacientes com gangrena de Fournier no período: 29 (72,5%) homens e 11 (27,5%) mulheres. A média de idade foi de 51,7±16,3 anos. A média de tempo de evolução da doença, do sintoma inicial até a internação, foi de 10,5±1,2 dias. Todos os pacientes apresentaram algum sinal clínico como dor, abaulamento, eritema, entre outros, e 38 (95%) tinham comorbidades associadas, sendo as mais comuns diabetes mellitus tipo 2 e hipertensão arterial sistêmica. A maioria (30 pacientes -75%) apresentava como etiologia provável abscesso perianal. Todos os pacientes foram submetidos à antibioticoterapia e tratamento cirúrgico com média de 1,8±1,1 cirurgias por paciente. Nove (22,5%) pacientes morreram. Houve forte correlação entre a presença de sepse na admissão e mortalidade. Conclusão: pacientes portadores de gangrena de Fournier, nesta casuística, apresentavam longo tempo de doença e elevada prevalência de comorbidades com alto índice de mortalidade.

Action of vanillin (Vanilla planifolia) on the morphology of tibialis anterior and soleus muscles after nerve injury.

OBJECTIVE: To evaluate the action of vanillin (Vanilla planifolia) on the morphology of tibialis anterior and soleus muscles after peripheral nerve injury. METHODS: Wistar rats were divided into four groups, with seven animals each: Control Group, Vanillin Group, Injury Group, and Injury + Vanillin Group. The Injury Group and the Injury + Vanillin Group animals were submitted to nerve injury by compression of the sciatic nerve; the Vanillin Group and Injury + Vanillin Group, were treated daily with oral doses of vanillin (150mg/kg) from the 3rd to the 21st day after induction of nerve injury. At the end of the experiment, the tibialis anterior and soleus muscles were dissected and processed for light microscopy and submitted to morphological analysis. RESULTS: The nerve compression promoted morphological changes, typical of denervation, and the treatment with vanillin was responsible for different responses in the studied muscles. For the tibialis anterior, there was an increase in the number of satellite cells, central nuclei and fiber atrophy, as well as fascicular disorganization. In the soleus, only increased vascularization was observed, with no exacerbation of the morphological alterations in the fibers. CONCLUSION: The treatment with vanillin promoted increase in intramuscular vascularization for the muscles studied, with pro-inflammatory potential for tibialis anterior, but not for soleus muscle. OBJETIVO: Avaliar a ação da vanilina (Vanilla planifolia) sobre a morfologia dos músculos tibial anterior e sóleo após lesão nervosa periférica. MÉTODOS: Ratos Wistar foram divididos em quatro grupos, com sete animais cada, sendo Grupo Controle, Grupo Vanilina, Grupo Lesão e Grupo Lesão + Vanilina. Os animais dos Grupos Lesão e Grupo Lesão + Vanilina foram submetidos à lesão nervosa por meio da compressão do nervo isquiático, e os Grupos Vanilina e Grupo Lesão + Vanilina foram tratados diariamente com doses orais de vanilina (150mg/kg) do 3o ao 21o dia após a indução da lesão nervosa. Ao término do experimento, os músculos tibial anterior e sóleo foram dissecados e seguiram o processamento de rotina em microscopia de luz, para posterior análise morfológica. RESULTADOS: A compressão nervosa promoveu alterações morfológicas características de denervação, sendo que o tratamento com vanilina foi responsável por respostas distintas nos músculos estudados. Para o tibial anterior, houve aumento do número de células satélites, núcleos centrais e atrofia das fibras, bem como desorganização fascicular. Já no sóleo, houve apenas aumento da vascularização, sem exacerbação das alterações morfológicas nas fibras. CONCLUSÃO: O tratamento com vanilina promoveu o aumento da vascularização intramuscular para os músculos estudados, com potencial pró-inflamatório para o tibial anterior, o que não ocorreu no músculo sóleo.

Action of vanillin (Vanilla planifolia) on the morphology of tibialis anterior and soleus muscles after nerve injury / Ação da vanilina (Vanilla planifolia) sobre a morfologia dos músculos tibial anterior e sóleo após lesão nervosa

ABSTRACT Objective To evaluate the action of vanillin (Vanilla planifolia) on the morphology of tibialis anterior and soleus muscles after peripheral nerve injury. Methods Wistar rats were divided into four groups, with seven animals each: Control Group, Vanillin Group, Injury Group, and Injury + Vanillin Group. The Injury Group and the Injury + Vanillin Group animals were submitted to nerve injury by compression of the sciatic nerve; the Vanillin Group and Injury + Vanillin Group, were treated daily with oral doses of vanillin (150mg/kg) from the 3rd to the 21st day after induction of nerve injury. At the end of the experiment, the tibialis anterior and soleus muscles were dissected and processed for light microscopy and submitted to morphological analysis. Results The nerve compression promoted morphological changes, typical of denervation, and the treatment with vanillin was responsible for different responses in the studied muscles. For the tibialis anterior, there was an increase in the number of satellite cells, central nuclei and fiber atrophy, as well as fascicular disorganization. In the soleus, only increased vascularization was observed, with no exacerbation of the morphological alterations in the fibers. Conclusion The treatment with vanillin promoted increase in intramuscular vascularization for the muscles studied, with pro-inflammatory potential for tibialis anterior, but not for soleus muscle.

RESUMO Objetivo Avaliar a ação da vanilina (Vanilla planifolia) sobre a morfologia dos músculos tibial anterior e sóleo após lesão nervosa periférica. Métodos Ratos Wistar foram divididos em quatro grupos, com sete animais cada, sendo Grupo Controle, Grupo Vanilina, Grupo Lesão e Grupo Lesão + Vanilina. Os animais dos Grupos Lesão e Grupo Lesão + Vanilina foram submetidos à lesão nervosa por meio da compressão do nervo isquiático, e os Grupos Vanilina e Grupo Lesão + Vanilina foram tratados diariamente com doses orais de vanilina (150mg/kg) do 3o ao 21o dia após a indução da lesão nervosa. Ao término do experimento, os músculos tibial anterior e sóleo foram dissecados e seguiram o processamento de rotina em microscopia de luz, para posterior análise morfológica. Resultados A compressão nervosa promoveu alterações morfológicas características de denervação, sendo que o tratamento com vanilina foi responsável por respostas distintas nos músculos estudados. Para o tibial anterior, houve aumento do número de células satélites, núcleos centrais e atrofia das fibras, bem como desorganização fascicular. Já no sóleo, houve apenas aumento da vascularização, sem exacerbação das alterações morfológicas nas fibras. Conclusão O tratamento com vanilina promoveu o aumento da vascularização intramuscular para os músculos estudados, com potencial pró-inflamatório para o tibial anterior, o que não ocorreu no músculo sóleo.

Ação do exercício de subida em escada com sobrecarga na morfologia do músculo tibial anterior de ratos Wistars após axonotmese / Action of the climbing ladder exercise with overload in the morphology of the anterior tibial muscle of wistars rats after axonotmesis

Objetivo: avaliar histomorfometrica e morfologicamente o músculo tibial anterior de ratos submetidos à axonotmese e tratados com exercício. Métodos: foram randomizados 28 ratos Wistar nos grupos controle (GC), exercício (GE), lesão (GL) e lesão+exercício (GLE). No terceiro dia após compressão, GE e GLE realizaram exercício de subida em escada, com duas séries de dez repetições. Após 21 dias, o músculo tibial anterior foi processado para microscopia de luz. Resultados: Na análise morfológica GC apresentou morfologia com aspecto característico, GE hipertrofia muscular, GL alterações morfológicas, como fibras polimórficas e núcleos centrais, e GLE aspecto semelhante ao controle, porém com algumas alterações. Na área de secção transversa e menor diâmetro das fibras GC e GE apresentaram valores maiores, o inverso da análise de vasos sanguíneos. Para o tecido conjuntivo, GE apresentou-se menor que o GL. Conclusão: O protocolo de exercício promoveu melhora nos aspectos histomorfológicos, mas não reverteu totalmente os efeitos deletérios. (AU)

Objective: to evaluate morphologically the tibialis anterior muscle of rats submitted to axonotmosis and treated with exercise. Methods: 28 Wistar rats were used in groups control (CG), exercise (GE), injury (GL) and injury + exercise (GLE). On the third day after compression, GE and GLE performed climb exercise staircase, with two sets of ten repetitions. After 21 days, the muscle was processed for light microscopy. Results: In the morphological analysis GC presented with morphology characteristic appearance, GE muscle hypertrophy, GL morphological changes like polymorphic fibers and central nucleo, and GLE look similar to the control, but with some changes morphological. In the cross-sectional area and smaller diameter of the GC and GE fiber showed higher values, inversed analysis of blood vessels. For the connective tissue, GE was lower than the GL. Conclusion: Summing up, the exercise promoted improvement in morphological aspects, but not totally reversed the deleterious effects of denervation. (AU)

Resistance exercise recovers the structure of cartilage and synovial membrane of the ankle joint of rats after sciatic compression

Aim: to determine the effects of sciatic compression and treatment with resistance exercise on the morphology of the ankle joint of Wistar rats. Methods: 32 male rats, aged 10 ± 1 week, weighing 376±22 grams were divided into the following four groups (n=8/group): CG (control), LG (lesion), EG (exercise) and LEG (lesion and exercise). Three days after sciatic compression, the animals in the EG and LEG were submitted to resistance exercise by climbing stairs (five days/week) for three weeks and a load of 100 grams was added. The exercise was carried out in two sets of ten consecutive ascents of the steps. The ankle joint tissues were analyzed for their morphometry and morphology using light microscopy. Results: Regarding the number of chondrocytes, the LG and EG had more cells in the anterior articular cartilage in the tibia (62 and 43%) and in the talus (57 and 45%) when compared to the CG. In the LEG there was a 25% and 26% reduction of chondrocytes in the anterior cartilage in the tibia and talus when compared to the LG. Changes were observed in the tibia and talus in the LG, with the presence of flocculation, invagination of the subchondral bone, discontinuity of tidemark and pannus covering the subchondral bone in the talus, as well as changes in the synovial membrane. These alterations were minimized in the articular cartilage and synovial membrane in the LEG. Conclusions exercise restores the tissue morphology of ankle joint in Wistar rats after sciatic compression.(AU)

Nociceptive and Neuronal Evaluation of the Sciatic Nerve of Wistar Rats Subjected to Compression Injury and Treated with Resistive Exercise.

Background. To investigate the climb stairs resistance exercise on nociception and axonal regeneration in the sciatic nerve of rats. Methods. 24 Wistar rats were divided: control group (CG-no injury), exercise group (EG-no injury with physical exercise), lesion group (LG-injury, but without exercise), and treated group (LEG-injury and physical exercise). LG and LEG were subjected to sciatic nerve compression with hemostat. From the 3rd day after injury began treatment with exercise, and after 22 days occurs the removal of a nerve fragment for morphological analysis. Results. Regarding allodynia, CG obtained values less than EG (p = 0.012) and larger than LG and LEG (p < 0.001). Histological results showed that CG and EG had normal appearance, as LG and LEG showed up with large amounts of inflammatory infiltration, degeneration and disruption of nerve fibers, and reduction of the myelin sheath; however LEG presented some regenerated fibers. From the morphometric data there were significant differences, for nerve fiber diameter, comparing CG with LG and LEG and comparing axon diameter and the thickness of the myelin of the CG to others. Conclusion. Climb stairs resistance exercise was not effective to speed up the regenerative process of axons.

Efeito do exercício resistido na redução do edema, nocicepção e regeneração nervosa em um modelo de compressão do nervo isquiático / Effect of resistance training on the reduction of edema, nociception, and nerve regeneration in a sciatic nerve compression model

OBJETIVOS: Analisar os efeitos do exercício físico resistido de subida em escada, sobre o edema, nocicepção e regeneração nervosa de ratos Wistar, submetidos à compressão do nervo isquiático. MÉTODOS: Foram estudados 24 ratos Wistar, divididos igualmente entre quatro grupos: Grupo Controle, Grupo Exercício, Grupo Lesão e Grupo Tratado ­ Lesão e Exercício. O Grupo Lesão e o Grupo Tratado foram submetidos à compressão do nervo isquiático com pinça hemostática por 30 segundos. A partir do terceiro dia após a lesão, iniciou-se o tratamento com exercício resistido de subida em escada para o Grupo Exercício e o Grupo Tratado. O tratamento consistiu em realizar duas séries de 10 subidas na escada, com sobrecarga de 100 gramas e intervalo de um minuto entre uma série e outra. O estudo foi conduzido por 22 dias e nesse tempo os animais foram avaliados quanto ao edema e à nocicepção. No 22º dia de pós-operatório, os animais foram anestesiados para retirada de um fragmento do nervo isquiático para análise do número de axônios e da densidade de fibras. Em seguida, ainda sob efeito da anestesia, os animais foram eutanasiados. Os nervos coletados seguiram protocolo de processamento histológico de rotina. As expressões do Fator de Crescimento Neural e do Fator de Crescimento Derivado do Cérebro foram avaliadas por Western blotting. RESULTADOS: Não houve diferença significativa entre os grupos no tamanho do edema. O Grupo Controle apresentou maior limiar nociceptivo comparado aos demais grupos. A análise morfométrica não revelou diferença significativa entre os grupos, quanto à quantidade de axônios e à densidade de fibras. A expressão do Fator de Crescimento Derivado do Cérebro foi maior no Grupo Lesão e no Grupo Tratado quando comparados ao Grupo Controle. CONCLUSÕES: O exercício físico resistido de subida em escada, nos parâmetros propostos, não foi eficaz para reduzir o edema, a nocicepção ou aumentar o número de axônios e a densidade de fibras nervosas após lesão do nervo isquiático.

AIMS: To analyze the effects of ladder-climbing resistance training exercise on edema, nociception, and regeneration of the sciatic nerve in Wistar rats subjected to sciatic nerve compression. METHODS: Twenty-four Wistar rats were divided into four groups: Control Group, Exercise Group, Injury Group, and Treated Group (injury and exercise). Injury Group and Treated Group were subjected to sciatic nerve compression with a hemostat for 30 seconds. On the third day after injury, Exercise Group and Treated Group began treatment with ladder-climbing resistance exercise. The treatment consisted in performing two series of 10 ladder climbs with a 100-gram overload and a one-minute interval between the series. The study was conducted for 22 days, during which time the animals were evaluated for edema and nociception. Twenty-two days after surgery, the animals were anesthetized for removal of a sciatic nerve fragment and analysis of the number of axons and fiber density. Thereafter, still under anesthesia, the animals were euthanized. Nerve sampling followed the routine histological processing protocol. Expressions of Neural Growth Factor and Brain-derived Neurotrophic Factor were evaluated by Western blotting. RESULTS: There was no significant difference in edema size between groups. Control Group showed the highest nociceptive threshold compared to the other groups. The morphometric analysis showed no significant difference in number of axons and fiber density between groups. The expression of Brain-derived Neurotrophic Factor was greater in the Injury Group and the Treated Group compared to the Control Group. CONCLUSIONS: The proposed ladder-climbing resistance training was not effective in reducing edema and nociception or in increasing the number of axons and fiber density after sciatic nerve injury.