Intraventricular hemorrhage (IVH) is a severe complication in very low birth weight (VLBW) newborns (NB). With the purpose of studying the incidence of IVH, the associated risk factors, and the outcomes for these neonates, we studied all the VLBW infants born in our neonatal unit. Birth weight, gestational age, presence of perinatal asphyxia, mechanical ventilation, length of hospitalization, apnea crisis, hydrocephalus, and periventricular leukomalacia were analyzed. The diagnosis of IVH was based on ultrasound scan studies (Papile's classification) performed until the tenth day of life and repeated weekly in the presence of abnormalities. Sixty-seven/101 neonates were studied. The mortality rate was 30.6% (31/101) and the incidence of IVH was 29.8% (20/67) : 70% grade I, 20% grade III and 10% grade IV. The incidence of IVH in NB <1,000 g was 53.8% (p = 0. 035) and for gestational age <30 weeks was 47.3% (p = 0.04), both considered risk factors for IVH. The length of hospitalization (p = 0.00015) and mechanical ventilation (p = 0.038) were longer in IHV NB. The IVH NB had a relative risk of 2.3 of developing apnea (p = 0. 02), 3.7 of hydrocephalus (p = 0.0007), and 7.7 of periventricular leukomalacia (p < 0.00001). The authors emphasize the importance of knowing the risk factors related to IVH so as to introduce prevention schemes to reduce IVH and to improve outcomes of affected newborns.
It is common belief that the use of high-heeled shoes is deleterious to venous return, by impairing the efficiency of the muscular calf pump. Ambulatory venous pressure obtained with dorsal foot venipuncture is the gold standard in the evaluation of venous pressure during walking, but it is not routinely used in clinical practice. The objective of the present study was to determine the variations in leg venous pressure obtained with a new noninvasive method, in individuals without venous disease, walking without shoes and wearing high-heeled shoes. A new method of evaluation of the venous pressure by means of air plethysmography was applied to 10 volunteers (20 limbs). The patients were evaluated while standing, with orthostatic flexion and extension foot movements, and while walking on a treadmill barefooted and wearing high-heeled shoes. It was found that the variation on the cuff pressure during walking with high-heeled shoes was higher than the variation on the cuff pressure walking barefooted (52.2 +/- 8.89 X 26.65 +/- 6.7 mm Hg, p < 0.0001), and the final hydrostatic venous pressure was lower (51.5 +/- 12.78 X 61.5 +/- 8.44 mm Hg). The use of high-heeled shoes increases muscular effort during walking and diminishes the leg venous pressure compared with barefooted.
O objetivo do estudo foi investigar o efeito das dicas verbais na aquisição da habilidade rebater na Educação Física Escolar (EFE), com foco de atenção no seu aspecto perceptivo e motor. Participaram do estudo 84 alunos de três turmas de uma escola (faixa etária entre seis a oito anos). Cada turma correspondeu a um grupo: sem dicas, com dica perceptiva e com dica motora. O experimento teve três fases: pré-teste, aulas de EFE e pós-teste. O grupo com dica perceptiva apresentou melhores resultados. Portanto, verificou-se o efeito das dicas relacionado com a especificidade da tarefa no que se refere às suas demandas de processamento. Assim concluiu-se que a dica de aprendizagem relacionada à especificidade da tarefa mostrou o seu potencial como um conhecimento que orienta os alunos em direção à melhoria da qualidade do movimento, confirmando a possibilidade de sua inclusão como conteúdo de ensino da EFE.
O objetivo desse artigo foi discutir o papel da prática na preparação profissional em educação física e esporte. Inicialmente, refletiu-se sobre o papel que a prática ocupou e pode ocupar ao longo do curso de graduação. Em sequência, refletiu-se sobre a prática como práxis, favorecendo a aproximação entre a formação inicial e o campo de trabalho. Depois, buscou-se analisar a possibilidade da utilização de projetos temáticos compráticas de intervenção, com a possibilidade de o aluno seguir por diferentes itinerários de aprendizagem ao longo da graduação. Todavia, levantou-se o fato que a operacionalização desses projetos pode esbarrar em empecilhos oriundos da falta de uma identidade claramente definida para a educação física e o esporte. Assim, concluiu-se que apesar das dificuldades, novas reflexões a respeito do tema podem surgir a partir de experiências bem-sucedidas com a prática de intervenção na área.
Although deep vein thrombosis (DVT) recurrence is a common late complication of the disease, there are few predictive markers to risk-stratify patients long-term after the thrombotic event. The accuracy of residual vein thrombosis (RVT) in this context is controversial, possibly due to a lack of a standardized methodology. The objective of the study was to evaluate the accuracy of RVT echogenicity as a predictive marker of late DVT recurrence. To evaluate the accuracy of RVT echogenicity as a predictive marker of late DVT recurrence. This prospective study included patients with history of DVT in the past 33 months. Ultrasound examination was performed to detect the presence of RVT, and its echogenicity was determined by calculating the grayscale median (GSM) of the images. Blood samplings were taken for plasma D-dimer levels. Patients were followed-up for 28 months and the primary end point was DVT recurrence. Deep vein thrombosis recurrence was confirmed or excluded by ultrasound during the follow-up. Fifty-six patients were included, of which 10 presented DVT recurrence during the follow-up. D-dimer levels above 630 ng/mL conferred higher risk for recurrence with a negative predictive value of 94%. The absence of RVT was a protective marker for recurrence with a negative predictive value of 100%. Also, the presence of hypoechoic RVT, determined by GSM values below 24, positively predicted 75% of DVT recurrences. Our results suggest that the persistence of RVT and, particularly, the presence of hypoechoic thrombi (GSM < 24) are predictive markers of the risk of DVT recurrence. Residual vein thrombosis echogenicity, by GSM analysis, could represent a new strategy for the evaluation of recurrence risk in patients with DVT.
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