Estudar os efeitos da estimulação tátil e cinestésica materna durante a hospitalização de recém-nascidos de muito baixo peso. Métodos: Trata-se de um ensaio clínico randomizado e cego onde foram incluídos recémnascidos pré-termo com peso de nascimento entre 750 g e 1500 g e idade gestacional ≤ 32 semanas. Os critérios de exclusão foram: óbito antes de completar 48 horas de vida, presença de malformações maiores e recusa dos pais em participar do estudo. Os recém-nascidos foram divididos em dois grupos: o grupo intervenção (GI), que recebeu o cuidado padrão e a estimulação tátil e cinestésica, até quatro sessões por dia de 15 minutos de duração cada uma, e o grupo controle (GC), que recebeu exclusivamente o cuidado padrão.Participaram do estudo 104 recém-nascidos, 52 em cada grupo. Os grupos foram similares quanto à idade gestacional (GI: 29,7 1,6 sem.; GC:29,4 1,6 sem.), ao peso de nascimento (GI:1186 194 g; GC:1156 198 g), ao sexo, à incidência de PIG, à mediana do SNAPPE-II e ao número de óbitos. Os ganhos de peso, de comprimento e de perímetro cefálico foram semelhantes nos grupos. A ocorrência de sepse tardia foi significativamente superior no grupo controle (GI: 10,8%, n=5; GC:38,3%, n=18, p=0.005). O grupo intervenção recebeu alta hospitalar 7 dias antes do grupo controle (GI: 42 dias; IC 95%: 38-46 dias; GC: 49 dias; IC 95%: 42-56 dias). Pela regressão de Cox, o grupo intervenção teve a Hazard Rate de 1,85 (IC95%:1,09-3,13; p=0,023) para alta precoce. Conclusão: A estimulação tátil e cinestésica realizada pela mãe diminui o tempo de hospitalização e a freqüência de sepse neonatal tardia em recém-nascidos de muito baixo peso. / Aim: To study the effect of maternal tactile-kinesthetic stimulation on hospital stay and incidence of sepsis in very low birth weight infants. Methods: A masked randomized study was performed including infants of birth weight ≥ 750 and ≤ 1500 grams and gestational age ≤ 32 weeks were included. Exclusion criteria were: death before completing 48 hours after birth, presence of major malformations and parents’ refusing to participate in the study. Neonates were divided into: intervention group (IG) (standard care plus maternal tactile-kinesthetic stimulation, up to four daily sessions of 15 minutes each) and control group (CG). Results: In total, 104 very low birth weight infants were included, 52 in each group. Both groups were similar in gestational age (IG: 29.7 1.6; CG: 29.4 1.6 weeks), birth weight (IG: 1186 194; CG: 1156 198 grams), gender, number of small for gestational age infants, SNAPPE-II median score, and number of deaths. Gains in weight, length and head circumference during hospital stay were similar when comparing both groups. The incidence of late-onset sepsis was significantly lower in the intervention group (IG: 10.8%, n=5; CG: 38.3%, n=18, p=0.005). The intervention group was discharged from hospital 7 days before the control group (GI: 42; CI 95%: 38 – 46; CG: 49; CI 95%: 42 – 56). Using Cox regression model, the intervention group presented 1.85 HR (CI 95%:1.09-3.13; p=0.023) for early discharge. Conclusions: Maternal tactile-kinesthetic stimulation in very low birth weight infants decreases the length of hospital stay and the incidence of late-onset neonatal sepsis.

O principal objetivo deste trabalho foi verificar o efeito do trauma sub-aquático e da estimulação tátil, a longo prazo, no comportamento exploratório de animais submetidos à desnutrição protéica precoce, no teste do labirinto em cruz elevado (LCE). Sabe-se que a desnutrição protéica precoce, além de provocar redução no peso corporal e cerebral, produz alterações estruturais, neuroquímicas e funcionais no Sistema Nervoso Central, levando a alterações no comportamento. Utilizou-se ratos machos provenientes de ninhadas controle (16% de proteína) ou desnutridas (6% de proteína), após o desmame. Os animais receberam ou não estimulação tátil – do nascimento aos 70 dias de idade. No 71º dia, os animais de cada grupo foi submetida ao trauma sub-aquático por 60 segundos, e testada por 5 minutos no LCE. A desnutrição protéica reduziu o peso corporal tanto das ratas-mães quanto dos filhotes. Quando testados no LCE, os animais desnutridos apresentaram-se menos ansiosos e/ou mais impulsivos. A estimulação tátil recuperou parte do peso dos filhotes desnutridos, porém apresentou caráter ansiogênico. O trauma sub-aquático diminuiu a exploração dos braços abertos nos grupos desnutridos. Os dados sugerem que os efeitos da dieta dependem da interação com outros fatores ambientais como a estimulação tátil e o trauma sub-aquático. / Early protein malnutrition, besides reducing body and brain weights, causes structural, neurochemical and functional changes in Central Nervous System, leading to behavioral alterations. The principal aim of the present study was to evaluate the interaction of sub-aquatic trauma and chronic tactile stimulation on the exploratory behavior of malnourished rats, in the elevated plus-maze test (EPM). For this purpose, we used male rats fed by lactating female rats, receiving either 6% (malnourished) or 16% (well-nourished) protein diets. After weaning (21 days), the animals continued to receive the same diets as in the lactating period until 49 days of age, when they all started to receive a regular lab chow diet – period of nutritional recovery for the malnourished rats. Control and malnourished animals were divided in two groups: the first one received tactile stimulation from birth to 70 days of age, while the other group was not stimulated. On day 71st, half of the animals of each group was submitted to the sub-aquatic trauma for 60 seconds and tested for 5 minutes in the EPM, while the others were kept in their cages before the test. Protein malnutrition reduced the body weight of the dams as well as of the pups. When tested in EPM, malnourished animals showed less anxiety and/or more impulsiveness. Tactile stimulation recovered part of the weight of the malnourished animals, although it presented an anxiogenic profile. Sub-aquatic trauma decreased the open arms exploration. These data suggest that the effects of the diet are dependent on the interaction between tactile stimulation and sub-aquatic trauma.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The abusive use of psychostimulant drugs is a common social problem in countries of different cultures, whose incidence is increasing and alarming dimensions taken. Experimentally, some studies have shown the influence of early exposure to stress on changes in patterns of abuse, which may play an important role on the vulnerability to excessive use of psychostimulant drugs in adulthood. On the other hand, procedures such as neonatal tactile stimulation (TS) and neonatal isolation (NI), has been described by interfering with behavioral and neurophysiological parameters, which may persist into adulthood. This study aimed to investigate the conditioned place preference (CPP) and the psychostimulant drugs on anxiety-like symptoms related to abstinence in young rats exposed to TS and NI. In the first experiment, male pups of Wistar rats were subjected daily to TS or NI10 for 10 minutes, or NI60 for 1 hour, from postnatal day 1 (PND1) to PND21. The unhandled (UH) animals remained in the nest without any manipulation. At PND41, animals were subjected to CPP protocol induced by cocaine (20mg/kg, i.p.), for 10 days. At PND53, animals were tested for preference, and at PND55 symptoms of anxiety were evaluated on the elevated plus-maze task (EPM). TS and NI10 groups did not show preference on CPP, however UH and NI60 preferred the chamber associated with drug. In relation to anxiety-like symptoms observed during drug withdrawal, TS and NI10 groups presented higher time spent in the open arms of EPM, showing less anxiety-like behavior. Following the first study, a 2nd experiment was conducted to verify the influence of TS and NI on the CPP induced by amphetamine (AMPH), following the same neonatal handling protocol described in the previous experiment until the PND40, when animals were submitted to a CPP paradigm associated with administration of AMPH (4mg/kg, i.p.) for 8 days. At PND50, following behavioral assessment was observed that NI group had preference for the compartment associated with AMPH, and at PND53 during withdrawal of drug, TS group showed lower preference to compartment associated with drug. The exploratory activity in open field was higher in TS group at PND50, while NI group showed anxiety-like symptoms at PND53. Similarly, animals exposed to TS showed lesser degree of anxiety-like behavior in many different parameters evaluated at EPM and at staircase test, where the exploratory activity also was higher than other handlings. Taken together, these studies showed for the first time that beneficial effects of TS can modify the behavior on CPP paradigm, and influence the anxiety-like symptoms related to withdrawal from cocaine and AMPH. Continuity of studies related to the benefits of TS on reward pathways, neurotransmitter systems and signaling pathways, should be completed in the near future. / O uso abusivo de drogas psicoestimulantes é um problema social comum em países de diferentes culturas, cuja incidência tem tomado dimensões crescentes e alarmantes. Experimentalmente, alguns estudos tem mostrado a influência da exposição precoce ao estresse sobre alterações nos padrões de abuso, a qual pode cumprir um importante papel sobre a vulnerabilidade para o uso excessivo de drogas psicoestimulantes na idade adulta. Por outro lado, procedimentos como estimulação tátil (ET) neonatal e o isolamento neonatal (IN), têm sido descritos por interferir em parâmetros comportamentais e neurofisiológicos, que podem persistir durante a vida adulta. Assim, este estudo objetivou investigar a preferência condicionada de lugar (PCL) a drogas psicoestimulantes e sobre sintomas de ansiedade relacionados à abstinência, em ratos jovens expostos à ET e ao IN. No 1º experimento, filhotes machos de ratos Wistar foram submetidos diariamente à ET ou IN10, por 10 minutos, ou a IN60, por 1 hora, desde o dia pós-natal 1 (DPN1) até o DPN21. Os animais não manuseados (NM) permaneceram no ninho sem qualquer tipo de manipulação. No DPN40, os animais foram submetidos ao protocolo de PCL, induzido por cocaína (20mg/Kg, i.p.), durante 10 dias. No DPN52, os animais foram testados quanto à preferência e no DPN55 foram avaliados sintomas de ansiedade no teste do labirinto em cruz elevado (LCE). Os grupos ET e IN10 não apresentaram PCL, entretanto NM e IN60 preferiram o compartimento associado à droga. Em relação aos sintomas de ansiedade observados durante a abstinência da droga, os grupos ET e IN10, apresentaram maior tempo de permanência nos braços abertos do LCE, mostrando menor grau de ansiedade. Na sequencia do estudo, um 2º experimento foi conduzido, a fim de verificar a influência da ET e do IN sobre a PCL induzida por anfetamina (ANF), seguindo o mesmo protocolo de manuseio descrito no experimento anterior até o DPN40, quando os animais foram submetidos ao protocolo de PCL associado à administração de ANF (4mg/Kg, i.p.), durante 8 dias. No DPN50, após avaliação comportamental, observou-se que o grupo IN apresentou preferência pelo compartimento associado à ANF e no DPN53, durante abstinência da droga, o grupo ET apresentou menor preferência ao compartimento associado à droga. A atividade exploratória em campo aberto foi maior para o grupo ET no DPN50, enquanto o grupo IN apresentou sintomas de ansiedade no DPN53. De forma semelhante, animais expostos à ET mostraram menor grau de ansiedade em diversos parâmetros avaliados no LCE e no teste da escada, onde a atividade exploratória também foi maior do que para outros manuseios. Tomados em conjunto, estes estudos mostraram pela primeira vez que os efeitos benéficos da ET, podem modificar o comportamento frente à PCL, bem como influenciar os sintomas de ansiedade relacionados à abstinência de cocaína e ANF. A continuidade dos estudos relacionados aos benefícios da ET sobre vias de recompensa, sistemas de neurotransmissores e vias de sinalização celular, deverá ser realizada em um futuro breve.

Background: Migraine is characterized by sensory hypersensitivity and habituation deficits. Slow brushing over the skin activates C-tactile nerve fibers, which mediate pleasant touch and analgesic effects in healthy subjects. As this function is altered in painful conditions, we aimed to examine whether the C-tactile processing is disrupted in migraines. Methods: To psychophysically assess C-tactile function, we applied optimal and suboptimal C-tactile stroking stimuli on the dorsal forearm (body reference area) and the trigeminally innervated skin of 52 interictal migraineurs and 52 matched healthy controls. For habituation testing, 60 repeated C-tactile optimal stimuli were presented in both test areas. The participants rated each stimulus on a visual analogue scale by intensity, pleasantness, and painfulness. Results: Regarding C-tactile function, migraineurs showed unphysiological rating patterns but no significantly different pleasantness ratings than controls. During repeated stimulation, controls showed stable pleasantness ratings while migraineurs’ ratings decreased, especially in those experiencing tactile allodynia during headaches. Migraineurs taking triptans responded like controls. Conclusion: The C-tactile function of migraineurs is subclinically altered. Repeated C-tactile stimulation leads to altered habituation but differs from previous work by the direction of the changes. Although the pathophysiology remains unknown, causative mechanisms could include central and peripheral neuronal sensitization, tactile allodynia and hedonic stimulus attributions.

Att köra fastän trötthet upplevs är en erkänd trafikfara. Om en förare idag kör när denne är trött klassas det som vårdslöshet i trafiken. Dock är det nästan omöjligt att vid en olycka påvisa att olyckan skedde för att en förare var trött. Det praktiska resultatet är att det lämnas åt föraren att själv avgöra om denne är för trött för att föra fram fordonet säkert. Hela situationen om att vara en trafikfara eller ej lämnas då åt en subjektiv bedömning.   I denna rapport undersöks olika sömnstadier, och metoder för att avgöra när och hur det är lämpligast att vakna för att vakna i ett mer alert tillstånd. För att sedan använda de metoder som visar sig vara lämpade som indata och parametrar till en algoritm som ska avgöra när det är som lämpligast att vakna för att vakna mer alert. Rapporten gör också en kalkyl som kan användas för att fastställa prototypens utvecklingskostnader.   Arbetet resulterar i en prototyp som föreslår en lösning till problemet med trötthet i trafiken. De kostnader som framkommer i samband med prototyputveckling fastställs och presenteras.   Undersökningen och utvecklandet av den tekniska lösningen har delats upp i två moduler och kommer att göras i samverkan med en extern studentgrupp på skolan för elektroteknik och datavetenskap (EECS) vid Kungliga Tekniska högskolan. / Driving although experiencing fatigue is a recognized traffic hazard. Today, if a driver is driving despite being tired, it is considered to be reckless driving. However, in the event of an accident, it is almost impossible to prove that the accident occurred because the driver was tired. The practical result is that it is left to the driver to decide if one is too tired or not to drive the vehicle safely. The whole situation of being a traffic hazard or not is then subjected to a subjective assessment. This report examines different sleep stages and methods for determining when it’s most appropriate, and how it’s most appropriate to wake up, with the aim on waking up in a more alert state. Further, to use the methods that prove to be suitable as inputs and parameters of an algorithm. The report also examines different calculations that can be used to determine the development cost of the prototype. The result consists of a prototype that is a beginning on addressing the problem with fatigue in traffic. It also consist of a calculation determining the development cost. The research and development of the technical solution has been divided into two modules and will be done in collaboration with an external student group at School of Electrical Engineering and Computer Science (EECS) at KTH Royal Institute of Technology.

In current resuscitation guidelines, tactile stimulation is recommended for infants with insufficient respiratory efforts after birth. No recommendations are made regarding duration, onset, and method of stimulation. Neither is mentioned how tactile stimulation should be applied in relation to the gestational age. The aim was to review the physiological mechanisms of respiratory drive after birth and to identify and structure the current evidence on tactile stimulation during neonatal resuscitation. A systematic review of available data was performed using PubMed, covering the literature up to April 2021. Two independent investigators screened the extracted references and assessed their methodological quality. Six studies were included. Tactile stimulation management, including the onset of stimulation, overall duration, and methods as well as the effect on vital parameters was analyzed and systematically presented. Tactile stimulation varies widely between, as well as within different centers and no consensus exists which stimulation method is most effective. Some evidence shows that repetitive stimulation within the first minutes of resuscitation improves oxygenation. Further studies are warranted to optimize strategies to support spontaneous breathing after birth, assessing the effect of stimulating various body parts respectively within different gestational age groups.

A ingestão de dieta deficiente em ferro pode causar alterações estruturais no Sistema Nervoso Central (SNC) bem como no nervo óptico por prejuízo no processo de mielinização. Essas alterações geradas pela anemia ferropriva pós-natal não são satisfatoriamente revertidas após a reposição de ferro. A estimulação tátil e o enriquecimento ambiental podem reduzir e/ou evitar os efeitos prejudiciais desta desnutrição sobre o SNC. O objetivo deste estudo foi avaliar estrutural e quantitativamente, o nervo óptico de ratos Wistar com anemia ferropriva submetidos à estimulação tátil e recuperação nutricional. Foram utilizados 4 grupos: Controle (C), Anêmico (A), Recuperado Não Estimulado (RN) e Recuperado Estimulado (E), compostos aleatoriamente por 1 rata mãe e 6 filhotes machos. Os grupos foram divididos de acordo com a variável dieta oferecida, pela quantidade de ferro/kg de dieta (com nível adequado em ferro (C), deficiente em ferro (A) e com recuperação do nível adequado de ferro (R)). O grupo C foi alimentado com dieta contendo 35 mg de ferro/kg de dieta, e o grupo A, com 4 mg de ferro/kg de dieta, e os grupos Recuperados (RN e RE), com 4 mg de ferro/kg de dieta do dia 0 ao 21º dia e, 35 mg de ferro/kg de dieta a partir do 22º dia. Os grupos Recuperados foram classificados de acordo com a variável estimulação: Estimulado (E), grupo submetido à estimulação tátil do dia 0 ao 32º dia, e Não Estimulado (N). Durante o período de amamentação, as ratas mães se alimentaram da dieta determinada para cada grupo, e no período pós lactação os filhotes receberam as mesmas dietas de suas respectivas mães. No 21º dia as ratas mães foram eutanasiadas e no 32º dia, todos os filhotes foram anestesiados e perfundidos via transcardíaca com uma solução de salina tamponada (PBS) 0,05M, pH 7,3, tendo seus nervos ópticos dissecados e os fragmentos selecionados refixados em tetróxido de ósmio a 1% em tampão fosfato 0,1 M, pH 7,3 e então processados para inclusão em araldite. Da área total da secção transversal do nervo óptico foram selecionadas 2 áreas que corresponderam aproximadamente 30% do nervo para a realização de análises morfológica e morfométrica. Na análise morfológica os animais do grupo RE mostraram um aspecto muito semelhante às características dos animais do grupo C, e com melhor aspecto em relação aos grupos A e RN, apresentando grande quantidade de fibras nervosas mielínicas, uniformemente distribuídas, bem agrupadas e compactadas, com espaço intersticial reduzido. Na análise morfométrica, em relação ao número de vasos sanguíneos, os fatores dieta, recuperação e estimulação não apresentaram interferência. Em relação ao número de astrócitos, a estimulação não interferiu, e em relação a dieta, o grupo A apresentou maior número que os grupos C e RN. Na avaliação do número de oligodendrócitos, em relação ao fator dieta, o grupo RN apresentou maior número que os grupos C e A, os quais não apresentaram diferença estatisticamente significante entre si. Já para o fator estimulação, o grupo RE apresentou menor número de oligodendrócitos quando comparado ao RN. Podemos concluir que: 1 - a dieta utilizada foi eficaz no desenvolvimento de anemia ferropriva leve nas ratas mães e severa nos filhotes; 2 - a associação das técnicas de estimulação tátil e recuperação nutricional resultou em uma reorganização estrutural do nervo óptico, semelhante ao grupo C e 3 - tal associação não interferiu no número de vasos sanguíneos, entretanto, resultou em uma normalização do número de astrócitos e de oligodendrócitos / Inadequate intake of dietary iron can cause structural changes in the Central Nervous System (CNS) and, thus, in the optic nerve with impaired myelination process. These changes generated by postnatal iron deficiency anemia are not satisfactorily reversed after replacement iron. The tactile stimulation and environmental enrichment can reduce and/or prevent the damaging effects of malnutrition on the CNS. The objective of this study was to evaluate structural and quantitatively the optic nerve of Wistar rats with iron deficiency anaemia submitted to tactile stimulation and nutritional recovery. We used 4 groups: Control (C), Anemic (A), Recovered Not Stimulated (RN) and Recovered Stimulated (R), randomly composed of 1 adult female rat and 6 male newborns. These groups were divided according to the variable diet provided, the amount of iron/kg in the diet (with appropriate levels of iron (C), deficient in iron (A) and with recovery of the appropriate level of iron (R)). The Control (C) group was fed with ration containing 35 mg iron/kg diet and the Anemic (A) group, with 4 mg iron/kg diet, and the Recovered groups (RN and RE) with 4 mg iron/kg diet from day 0 to day 21, and 35 mg iron/kg from day 22. The Recovered groups were classified according variable stimulation: Stimulated (E), group submitted to tactile stimulation from day 0 to day 32, and Not Stimulated (N). During the breastfeeding period, the mother rats fed the diet given to each group, and after lactation period the puppies received the same diets of their mothers. At day 21, the female rats were euthanized and at day 32 all juveniles were anesthetized and perfused transcardially with a buffered saline solution (PBS) 0,05M, pH 7,3, having their optic nerves dissected, and selected fragments were fixed in osmium tetroxide 1% and phosphate buffer 0,1 M, pH 7,3, and then processed for embedding in Araldite. Were selected 2 areas of the total area of optic nerve cross-section which approximately corresponded to 30% of the nerve to perform morphological and morphometric analysis. In the morphological analysis the optic nerve of the animals in RE group showed a very similar structural aspect to the characteristics of the optic nerves in group C, and looking better than in groups A and RN, with lot of myelinated nerve fibers well grouped and compacted and this organization was present uniformly across the nerve, resulting in reduced interstitial space. In the morphometric analysis, the number of blood vessels, dietary factors, recovery and stimulation showed no interference, since all groups showed no statistically significant difference. Regarding to the number of astrocytes, the stimulation did not influence it and, regarding to diet, the group A presented a higher number of cells than groups C and RN. In assessing the number of oligodendrocytes, in relation to diet factor, RN group had a greater number of oligodendrocytes that C and A groups, which showed no significant statistically difference between them. As for the stimulation factor, the RE group had fewer oligodendrocytes than the RN. With the results can be concluded that: 1- the used diet was effective in the development of mild iron deficiency anaemia in mothers and severe in young rats; 2- the association of tactile stimulation and nutritional recovery techniques resulted in a structural reorganization of the optic nerve, similar to C group and 3- this association did not affect the number of blood vessels, however it resulted in a normalization of the number of astrocytes and oligodendrocytes

A ingestão de dieta deficiente em ferro pode causar alterações estruturais no Sistema Nervoso Central (SNC) bem como no nervo óptico por prejuízo no processo de mielinização. Essas alterações geradas pela anemia ferropriva pós-natal não são satisfatoriamente revertidas após a reposição de ferro. A estimulação tátil e o enriquecimento ambiental podem reduzir e/ou evitar os efeitos prejudiciais desta desnutrição sobre o SNC. O objetivo deste estudo foi avaliar estrutural e quantitativamente, o nervo óptico de ratos Wistar com anemia ferropriva submetidos à estimulação tátil e recuperação nutricional. Foram utilizados 4 grupos: Controle (C), Anêmico (A), Recuperado Não Estimulado (RN) e Recuperado Estimulado (E), compostos aleatoriamente por 1 rata mãe e 6 filhotes machos. Os grupos foram divididos de acordo com a variável dieta oferecida, pela quantidade de ferro/kg de dieta (com nível adequado em ferro (C), deficiente em ferro (A) e com recuperação do nível adequado de ferro (R)). O grupo C foi alimentado com dieta contendo 35 mg de ferro/kg de dieta, e o grupo A, com 4 mg de ferro/kg de dieta, e os grupos Recuperados (RN e RE), com 4 mg de ferro/kg de dieta do dia 0 ao 21º dia e, 35 mg de ferro/kg de dieta a partir do 22º dia. Os grupos Recuperados foram classificados de acordo com a variável estimulação: Estimulado (E), grupo submetido à estimulação tátil do dia 0 ao 32º dia, e Não Estimulado (N). Durante o período de amamentação, as ratas mães se alimentaram da dieta determinada para cada grupo, e no período pós lactação os filhotes receberam as mesmas dietas de suas respectivas mães. No 21º dia as ratas mães foram eutanasiadas e no 32º dia, todos os filhotes foram anestesiados e perfundidos via transcardíaca com uma solução de salina tamponada (PBS) 0,05M, pH 7,3, tendo seus nervos ópticos dissecados e os fragmentos selecionados refixados em tetróxido de ósmio a 1% em tampão fosfato 0,1 M, pH 7,3 e então processados para inclusão em araldite. Da área total da secção transversal do nervo óptico foram selecionadas 2 áreas que corresponderam aproximadamente 30% do nervo para a realização de análises morfológica e morfométrica. Na análise morfológica os animais do grupo RE mostraram um aspecto muito semelhante às características dos animais do grupo C, e com melhor aspecto em relação aos grupos A e RN, apresentando grande quantidade de fibras nervosas mielínicas, uniformemente distribuídas, bem agrupadas e compactadas, com espaço intersticial reduzido. Na análise morfométrica, em relação ao número de vasos sanguíneos, os fatores dieta, recuperação e estimulação não apresentaram interferência. Em relação ao número de astrócitos, a estimulação não interferiu, e em relação a dieta, o grupo A apresentou maior número que os grupos C e RN. Na avaliação do número de oligodendrócitos, em relação ao fator dieta, o grupo RN apresentou maior número que os grupos C e A, os quais não apresentaram diferença estatisticamente significante entre si. Já para o fator estimulação, o grupo RE apresentou menor número de oligodendrócitos quando comparado ao RN. Podemos concluir que: 1 - a dieta utilizada foi eficaz no desenvolvimento de anemia ferropriva leve nas ratas mães e severa nos filhotes; 2 - a associação das técnicas de estimulação tátil e recuperação nutricional resultou em uma reorganização estrutural do nervo óptico, semelhante ao grupo C e 3 - tal associação não interferiu no número de vasos sanguíneos, entretanto, resultou em uma normalização do número de astrócitos e de oligodendrócitos / Inadequate intake of dietary iron can cause structural changes in the Central Nervous System (CNS) and, thus, in the optic nerve with impaired myelination process. These changes generated by postnatal iron deficiency anemia are not satisfactorily reversed after replacement iron. The tactile stimulation and environmental enrichment can reduce and/or prevent the damaging effects of malnutrition on the CNS. The objective of this study was to evaluate structural and quantitatively the optic nerve of Wistar rats with iron deficiency anaemia submitted to tactile stimulation and nutritional recovery. We used 4 groups: Control (C), Anemic (A), Recovered Not Stimulated (RN) and Recovered Stimulated (R), randomly composed of 1 adult female rat and 6 male newborns. These groups were divided according to the variable diet provided, the amount of iron/kg in the diet (with appropriate levels of iron (C), deficient in iron (A) and with recovery of the appropriate level of iron (R)). The Control (C) group was fed with ration containing 35 mg iron/kg diet and the Anemic (A) group, with 4 mg iron/kg diet, and the Recovered groups (RN and RE) with 4 mg iron/kg diet from day 0 to day 21, and 35 mg iron/kg from day 22. The Recovered groups were classified according variable stimulation: Stimulated (E), group submitted to tactile stimulation from day 0 to day 32, and Not Stimulated (N). During the breastfeeding period, the mother rats fed the diet given to each group, and after lactation period the puppies received the same diets of their mothers. At day 21, the female rats were euthanized and at day 32 all juveniles were anesthetized and perfused transcardially with a buffered saline solution (PBS) 0,05M, pH 7,3, having their optic nerves dissected, and selected fragments were fixed in osmium tetroxide 1% and phosphate buffer 0,1 M, pH 7,3, and then processed for embedding in Araldite. Were selected 2 areas of the total area of optic nerve cross-section which approximately corresponded to 30% of the nerve to perform morphological and morphometric analysis. In the morphological analysis the optic nerve of the animals in RE group showed a very similar structural aspect to the characteristics of the optic nerves in group C, and looking better than in groups A and RN, with lot of myelinated nerve fibers well grouped and compacted and this organization was present uniformly across the nerve, resulting in reduced interstitial space. In the morphometric analysis, the number of blood vessels, dietary factors, recovery and stimulation showed no interference, since all groups showed no statistically significant difference. Regarding to the number of astrocytes, the stimulation did not influence it and, regarding to diet, the group A presented a higher number of cells than groups C and RN. In assessing the number of oligodendrocytes, in relation to diet factor, RN group had a greater number of oligodendrocytes that C and A groups, which showed no significant statistically difference between them. As for the stimulation factor, the RE group had fewer oligodendrocytes than the RN. With the results can be concluded that: 1- the used diet was effective in the development of mild iron deficiency anaemia in mothers and severe in young rats; 2- the association of tactile stimulation and nutritional recovery techniques resulted in a structural reorganization of the optic nerve, similar to C group and 3- this association did not affect the number of blood vessels, however it resulted in a normalization of the number of astrocytes and oligodendrocytes

Introduction: Les neuropathies focales (NF) peuvent entraîner de l’hypoesthésie tactile et de la douleur neuropathique spontanée (névralgie). La méthode de rééducation sensitive de la douleur décrite par Spicher et collaborateurs (MRSD) propose un traitement innovant des symptômes sensitifs des NF. Objectifs : Chez des patients présentant une hypoesthésie tactile et de la névralgie à la main découlant d’une NF : 1) Décrire l’utilisation de la MRSD, 2) Vérifier son applicabilité, 3) Vérifier s’il y a une corrélation entre la durée requise de traitement et les caractéristiques cliniques initiales (hypoesthésie tactile, intensité douleur) des patients. 4) Décrire les changements dans l’hypoesthésie tactile et la douleur suite à la MRSD, et 5) Vérifier s’il y a une corrélation entre ces changements de sensibilité tactile et de la douleur. Méthodologie: Une étude par série de cas rétrospective a été effectuée à partir des données de patients collectées au Centre de Rééducation Sensitive de Fribourg (Suisse) entre juillet 2004 et Octobre 2018. Résultats: Sur 58 patients inclus dans l’étude, 42 ont complété la MRSD avec une durée requise moyenne de traitement de 124 ±104 jours. Cette durée de traitement était corrélée (rSpearman=.395) avec la sévérité des symptômes sensitifs (hypoesthésie tactile, douleur) avant la thérapie. On observe une diminution importante (p<.001) de l’hypoesthésie tactile et de la douleur entre le début et la fin du traitement. La diminution de l’hypoesthésie était modérément corrélée (rSpearman=.336) avec la diminution de la douleur. Conclusion: La MRSD est applicable au traitement de l’hypoesthésie tactile avec névralgie à la main découlant d’une NF. / Introduction: Focal neuropathies (FN) can lead to tactile hypoesthesia and spontaneous neuropathic pain (neuralgia). The Somatosensory Rehabilitation Method described by Spicher and collaborators (SRM) proposes an innovative approach to treating sensory symptoms in patients with FN. Objectives: In patients with tactile hypoesthesia and hand neuralgia arising from FN: 1) Describe the use of SRM, 2) Verify its applicability, 3) Determine if there is a correlation between the duration of treatment and patients’ clinical characteristics (tactile sensitivity and pain intensity) before therapy. 4) Describe changes in tactile hypoesthesia and pain measures subsequent to treatment with SRM, and 5) Determine if there is a correlation between changes in tactile sensitivity and changes in pain intensity in patients treated with SRM. Methodology: A retrospective case series study was carried out using data from patients admitted to the Somatosensory Rehabilitation Centre of Fribourg (Switzerland) from July 2004 and October 2018. Results: Of 58 patients included in the study, 42 completed SRM until the end of the therapy with an average duration of treatment of 124 ± 104 days. The duration of treatment was moderately correlated (rSpearman= 0.395) with the severity of sensory symptoms (tactile hypoesthesia and pain intensity) before therapy. There was a significant decrease (p <.001) in tactile hypoesthesia and pain intensity between the beginning and the end of treatment. The decrease in tactile hypoesthesia was moderately correlated (rSpearman=0 .336) with the decrease in pain. Conclusion: SRM can be used for treating tactile hypoesthesia and hand neuralgia arising from FN.

Aim: Despite the lack of evidence, current resuscitation guidelines recommend tactile stimulation in apneic infants within the first minutes of life. The aim was to investigate whether timing, duration or intensity of tactile stimulation influences the extent of non-invasive respiratory support in extremely preterm infants during neonatal resuscitation. Methods: In an observational study, we analyzed 47 video recordings and physiological parameters during postnatal transition in preterm infants below 320/7 weeks of gestational age. Infants were divided into three groups according to the intensity of respiratory support. Results: All infants were stimulated at least once during neonatal resuscitation regardless of their respiratory support. Only 51% got stimulated within the first minute. Rubbing the feet was the preferred stimulation method and was followed by rubbing or touching the chest. Almost all very preterm infants were exposed to stimulation and manipulation most of the time within their first 15 min of life. Tactile stimulation lasted significantly longer but stimulation at multiple body areas started later in infants receiving prolonged non-invasive respiratory support. Conclusion: This observational study demonstrated that stimulation of very preterm infants is a commonly used and easy applicable method to stimulate spontaneous breathing during neonatal resuscitation. The concomitant physical stimulation of different body parts and therefore larger surface areas might be beneficial.