Tt he most common complication of neck dissection is shoulder dysfunction due to manipulation of spinal accessory nerve, resulting in trapezius muscle atrophy mainly in procedures involving the posterior neck triangle.Aim: This study used electromyography to evaluate the injury to the spinal accessory nerve following neck dissection.Materials and methods: prospective case series of 51 patients submitted to 60 neck dissections followed by physical therapy evaluation of shoulder dysfunction. nerve integrity was evaluated before and after the surgery by means of surface eMG registering the electric activity of the trapezius muscle during voluntary contraction. The patients were grouped according to the type of neck dissection, presence of shoulder pain, impairment during abduction movement and hypotrophy/ atrophy of the trapezius muscle.Results: Action potential had median values of 54.3 microV before surgery and 11.6 microV after it (p<0.001). There was a mean decrease of 70% comparing to preoperative values. The median was 12.5 microV after dissection including level iib, and 8.9 microV after dissection including levels iib and V (p<0.002). Conclusion:Surface eMG is a sensitive and painless method for spinal accessory nerve dysfunction evaluation. The results suggest the usefulness of the trapezius muscle electromyography to confirm diagnosis and early physical therapy intervention in neuropathies of the spinal accessory nerve. Braz J Otorhinolaryngol. 2011;77(2):259-62. ORIgInAL ARTIcLE BJORL
ResumoA relação Educação Infantil e famílias é estudada prioritariamente em contextos urbanos, sendo raras as pesquisas em áreas rurais, fato que influencia os avanços do conhecimento e a elaboração das políticas para infâncias do campo. O artigo apresenta dados de uma pesquisa realizada em uma escola rural (Minas Gerais -Brasil), cujo objetivo foi compreender significações sobre a relação família-escola. Foram feitas observações na escola e entrevistas com seis profissionais de educação e cinco famílias. O material foi analisado qualitativamente e sistematizado nos eixos temáticos: 1) instrumentos da relação escola-família; 2) presença da família na escola; 3) situações problemáticas. A análise dos dados revelou que a concretude do campo investigado, marcada por grandes distâncias geográficas e específicas condições de vida e trabalho, atravessa e configura encontros possíveis entre as instituições escolar e familiar. Os resultados indicam às escolas a necessidade de recriação das formas tradicionais de conceber a relação com a família. Palavras-chave: Educação infantil; família; ambientes rurais. The relationship between early childhood education and countryside families AbstractThe early childhood education and family relationship is studied primarily in urban settings, with few studies in countryside, a fact that influences the progress of knowledge and the development of policies for countryside childhood. The article presents data from a survey in a countryside school (Minas Gerais -Brazil), whose goal was to understand the meanings of family-school relationship. Observations at school and interviews with six education professionals and five families were made. The material was qualitatively analyzed and systematized the themes: 1) instruments of school-family relationship; 2) family presence at school; 3) problematic situations. Data analysis revealed that the concreteness of the investigated field, marked by great geographic distances and specific conditions of life and work, through and sets up possible encounters between the school and family institutions. The results indicate the need for schools to recreate traditional ways of thinking the relationship with the family.Keywords: Early childhood education; family; rural environments. La relación entre la Educación Infantil y las familias del campo ResumenLa relación Educación Infantil y familias son estudiadas prioritariamente en contextos urbanos, siendo raras las investigaciones en áreas rurales, hecho que influencia los avances del conocimiento y la elaboración de las políticas para infancias del campo. El artículo presenta datos de una investigación realizada en una escuela rural (Minas Gerais -Brasil), cuyo objetivo fue comprender significaciones sobre la relación familiaescuela. Se realizaron observaciones en la escuela y encuestas con seis profesionales de educación y cinco familias. El material fue analizado cualitativamente y sistematizado en los ejes temáticos: 1) instrumentos de la relación escuela-familia; 2) presencia de la familia en la e...
In Brazil, despite the existence of a legal apparatus that puts the child in the world of human rights, there is the persistence of violence against children; the family is a major locus for its occurrence. According to the Federal Constitution of 1988 and the Child and Adolescent Statute, responsibility for defending the children's rights should be shared by all segments of society, including educational institutions. In this sense, and considering its purpose of promoting the integral development of children, it is the Child Rearing to contribute to confront the violence against children. This project, in this context, is aimed to investigate how day nursery professionals deal with the issue of domestic violence against children. The target institutions of the search were two kindergartens located in Ribeirão Preto / São Paulo: one which had not reported cases of domestic violence against children in Dial Denounce and/ or Guardianship Councils (day nursery A) and another which had notified some cases to these institutions (day nursery B). For nurseries selection, a survey was conducted along with the Guardianship Councils and the Program of Dial Denounce in Ribeirão Preto of all cases referred and their respective applicants, from October 2005 to September 2006. The instruments used to collect data in the nursery school were: observation (5 months) and interviews (17). In the nursery A, interviews were held with general service employees (2), teachers (5) and director (1). In nursery B, interviews were held with general services employees (2), educators (6) and coordinator (1). We analyzed 10 interviews, five of each kindergarten: 1 (director / coordinator), 1 (general services employee), 3 (educators). The methodology for collecting and analyzing data is anchored on the assumptions of the Meaning Network. Data analysis showed: 1) the existence of the senses network, composed not only by senses of domestic violence against children, which direct / cross / justify the actions of professional Child Rearing in relation to child, the family and the protection institutions; 2) that the senses deployed and the main actions taken by employees in concrete situations of domestic violence targeted at kids (talk to the child, guide the family and not report the cases to the protection institutions), differ from those mobilized senses and actions held in hypothesized situations (talk with the family aiming to find and report the identified cases of violence to the protection institutions); 3) the occurrence of violence against children in day care centers, being the most common practice the punishment, and the scream and threat; 4) the complexity and the ways in which employees deal with children in institutions and in cases of family violence, as well as the phenomena of domestic violence and institutional violence; 5) that actions taken in by nurseries got different positions on a continuum protection / victimization of the child. Thus the considerations made in this study, emphasize that it is of fundamental importance ...
Objective To evaluate through electromyography (EMG) the injury to the 11th cranial nerve following neck dissection. Methods Prospective study with 60 patients submitted to neck dissection as part of treatment of head and neck tumors. All the cases underwent physiotherapic evaluation of shoulder dysfunction. Nerve integrity was evaluated pre- and postoperatively through surface EMG registering the electric activity of descendent fibers of trapezius muscle during maximal isometric voluntary contraction. The patients were grouped according the type of neck dissection, presence of shoulder pain, impairment during abduction movement, and hypotrophy or atrophy of trapezius muscle. Results The action potential had mean and standard deviation of 61,7±31,6mcV in preoperative evaluation and 15,6±12,4mcV in postoperative evaluation (p<0.001). According to the neck dissection extension, there were mean values of 18,8±14,2mcV after dissection includiog level IIb and 18,8±14,2 mcV after dissection including levels IIb and V (p<0.002). Conclusions Surface EMG is a sensitive and painless for 11th cranial nerve disfunction evaluation. In all cases, the superior fibers of trapezius muscle were affected with presence of pain and impairment abduction movement of the arm. The results suggest the benefit of trapezius muscle EMG to confirm the diagnosis and early physiotherapic intervention in neuropathies of the 11th cranial nerve.
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