Rehabilitation of a Child with Neonatal Brachial Plexus Palsy: Case Report Described by Parents

This paper presents a case report of a child with Neonatal Brachial Plexus Palsy on the right arm, with C5, C6, and C7 nerve injuries. The symptoms presented at birth and at the time of diagnosis were absence of movement in the right arm but with mobility of the fingers; internal rotation of the injured limb with elbow extension; active flexion of the wrist and fingers; and ulnar deviation of the hand. The rehabilitation plan followed the conservative approach and included different intervention strategies (passive and active mobilisation, kinesio tape, use of splints, bimanual stimulation, etc.) carried out by the occupational therapist and the physical therapist. The rehabilitation allowed the child to have a functional limb for daily activities, with bimanual motor integration and coordination; passive and active range of motion in the different joints except for pronation, sensibility, and maintained strength. In conclusion, it can be said that this case report describes a set of rehabilitation strategies that were used in the conservative treatment of a child with NBPP and the functional gains they allowed. Early intervention, parental involvement in the rehabilitation process, and continuous follow-up of the child favoured the prognosis and allowed the prevention of functional sequelae of the limb.info:eu-repo/semantics/publishedVersio

Rehabilitation of Neonatal Brachial Plexus Palsy: Integrative Literature Review

This integrative literature review has been carried out with the aim of analyzing the scientific literature aimed at identifying and describing existing rehabilitation treatments/therapies for neonatal brachial plexus palsy (NBPP). NBPP is a frequent consequence of difficult birthing, and it impairs the function of the brachial plexus in newborns. This is why knowledge on rehabilitation strategies deserves special attention. The data collection was carried out in January 2019, in the EBSCOhost and BVS (Biblioteca Virtual em Saúde) platforms, in the CINAHL Complete, MEDLINE Complete, LILACS and PubMed databases. Thirteen articles were included in this integrative literature review, based on a literature search spanning title, abstract and full text, and considering the inclusion criteria. Two main treatments/therapies for NBPP rehabilitation were identified: conservative treatment and surgical treatment. Conservative treatment includes teamwork done by physiatrists, physiotherapists and occupational therapists. These professionals use rehabilitation techniques and resources in a complementary way, such as electrostimulation, botulinum toxin injection, immobilizing splints, and constraint induced movement therapy of the non-injured limb. Professionals and family members work jointly. Surgical treatment includes primary surgeries, indicated for children who do not present any type of spontaneous rehabilitation in the first three months of life; and secondary surgeries, recommended in children who after primary surgery have some limitation of injured limb function, or in children who have had some spontaneous recovery, yet still have significant functional deficits. Treatment options for NBPP are defined by clinical evaluation/type of injury, but regardless of the type of injury, it is unanimous that conservative treatment is always started as early as possible. It should be noted that there was no evidence in the literature of other types of rehabilitation and techniques used in clinical practice, such as preventive positioning of contractures and deformities, hydrotherapy/aquatic therapy, among others, so we consider there is a need for further studies at this level in this area.info:eu-repo/semantics/publishedVersio

Perceptions in Living Kidney Donation: What ProtagonistsThink and Feel

Abstract Background Although donor perceptions of donation have been evaluated in several programs, evaluation of associated recipients has not been as frequent. Purpose Our aim was to evaluate and compare after transplantation, donor and recipient perceptions of donation. Methods After transplantation 35 recipients and 45 donors completed a sociodemographic and a donation perception questionnaire. We applied the Fisher test to descriptive (absolute and relative frequency) data. Results 57.8% of donors were female and 62.9% of recipients male. 53.3% of donors were siblings, 44.5% parents, and 2.2% a daughter. Most recipients (71.9%) thought that the donation was the donors' initiative and 21.9% that it was suggested by medical team. 96.4% responded that it was the donor's wish that determined their decision; 51.4% had serious or some doubts about accepting the option, but for 48.6% it was an easy decision. Among the donors, 88.9% decided by themselves and 8.9% were asked for donation. For 91.1%, their wish was the main reason of the decision, but 8.9% felt a moral obligation; 77.8% thought it was an easy decision, and 17.8% hesitated a little 84.4% were not worried about their future health. Conclusions Altruistic motivations were predominant in both groups. Most recipients thought that the motivation for donation was self-determined, a finding that agreed with donor perceptions. Perceptions about the quality of and changes in emotional relationship were the same in both groups. Donors and recipients referred to the donation process as positive, but there were some negative emotions and perceptions

Depression and anxiety in living kidney donation: evaluation of donors and recipients.

Transplant Proc. 2011 Jan-Feb;43(1):131-6. Depression and anxiety in living kidney donation: evaluation of donors and recipients. Lopes A, Frade IC, Teixeira L, Oliveira C, Almeida M, Dias L, Henriques AC. SourceLyaison-Psychiatry and Health Psychology Unit, Oporto Hospital Centre, Oporto, Portugal. [email protected] Abstract BACKGROUND: Psychosocial status of donors before and after living kidney donor transplantation has been an important concern. Investigations of psychosocial issues in related recipients are not frequent. AIM: The aims of this study were to evaluate and compare psychopathologic dimensions in donors and recipients before and after transplantation. METHODS: Thirty-five recipients and 45 donors completed a psychosocial evaluation before and after transplantation. We applied Pearson chi-square, McNemar, Fisher, Wilcoxon, and Mann-Whitney tests as well as linear and logistic regression statistical methods. RESULTS: Before transplantation 100% of the recipients presented total anxiety, compared with 64.4% of donors, with higher anxiety levels in all dimensions (P < .001). Also, 38.7% of recipients and 16.3% of donors had moderate/serious depression (P = .029). Men showed higher levels of cognitive anxiety before transplantation (odds ratio [OR] = 4.3; P = .008). After versus before transplantation central nervous system and cognitive anxiety had diminished in recipients (P = .031; P = .035, respectively); there were higher levels of cognitive anxiety than among the donors (P = .007). Depression showed no significant changes in recipients or donors; the differences were no longer significant. There were less severely depressed recipients but an increase among severely depressed donors. Male recipients and donors showed greater cognitive anxiety (P = .02; P = .04, respectively) at both times. Female recipients presented with more severe depression (P = .036). CONCLUSIONS: Anxiety is an important symptom. Surgery had a positive impact to lower anxiety in recipients. Most protagonists displayed little or no depression; it was more prevalent among recipients. Donors and recipients maintained some psychopathologic symptoms after surgery. We defined vulnerable groups among these cohorts. Copyright © 2011 Elsevier Inc. All rights reserved

Adult-onset autoimmune diabetes: comparative analysis of classical and latent presentation

Introduction: Adult-onset autoimmune diabetes (AID) has two different phenotypes: classic type 1 diabetes mellitus (T1DM), with insulin requirement just after diagnosis, and latent autoimmune diabetes in adults (LADA). The purpose of this study is to characterize patients with AID followed on a tertiary centre, comparing classic T1DM and LADA. Methods: We collected data from patients with diabetes and positive islet autoantibodies, aged 30 years old and over at diagnosis. Patients who started insulin in the first 6 months were classified as T1DM and patients with no insulin requirements in the first 6 months were classified as LADA. Data regarding clinical presentation, autoantibodies, A1C and C-peptide at diagnosis, pharmacologic treatment and complications were analysed. Results: We included 92 patients, 46 with classic T1DM and 46 with LADA. The percentage of females was 50% in T1DM group and 52.1% in LADA group. The median age at diagnosis was 38 years (IQR–15) for T1DM and 42 years (IQR–15) for LADA (p = 0.057). The median time between diagnosis of diabetes and diagnosis of autoimmune aetiology was 0 months in T1DM group and 60 months in LADA group (p < 0.001). The mean BMI at diagnosis was 24.1 kg/m2 in T1DM group and 26.1 kg/m2 in LADA group (p = 0.042). In T1DM group, 67.4% of the patients had more than one positive autoantibody, comparing to 41.3% of LADA patients (p = 0.012). There was no statistical difference in what concerns to title of GAD autoantibodies, A1C and C-peptide at diagnosis of autoimmune aetiology. The presence of symptoms at diagnosis was associated with T1DM group (p < 0.001). The median daily insulin dose was 40 IU for T1DM (0.58 IU/kg) and 33.5 IU for LADA (0.57 IU/kg), with no statistical difference. LADA patients were more often under non-insulin antidiabetic drugs (p = 0.001). At 10 years follow up, 21.1% of T1DM patients and 63.3% of LADA patients had microvascular complications (p = 0.004). Diabetic nephropathy was present in 23.5% of T1DM patients and 53.3% of LADA patients (p = 0.047). At the last evaluation, 55.6% of T1DM and 82.6% of LADA patients had metabolic syndrome and this difference was independent of diabetes duration. Conclusion: Patients with classic T1DM presented more often with symptoms, lower BMI and higher number of autoantibodies, which may be related to a more aggressive autoimmune process. Patients with LADA developed more frequently microvascular complications for the same disease duration, namely diabetic nephropathy, and had more often metabolic syndrome

Social theory and the politics of big data and method

This article is an intervention in the debate on big data. It seeks to show, firstly, that behind the wager to make sociology more relevant to the digital there lies a coherent if essentially unstated vision and a whole stance which are more a symptom of the current world than a resolute endeavour to think that world through; hence the conclusion that the perspective prevailing in the debate lacks both the theoretical grip and the practical impulse to initiate a much needed renewal of social theory and sociology. Secondly, and more importantly, the article expounds an alternative view and shows by thus doing that other possibilities of engaging the digital can be pursued. The article is thus an invitation to widen the debate on big data and the digital and a call for a more combative social theory

N-doped sponge-like biochar: a promising CO2 sorbent for CO₂/CH₄ and CO2/N₂ gas separation

Sponge-like biochar sorbents were prepared from the dissolution of chitosan followed by freeze-drying methodology and pyrolysis at three different temperatures (400, 600, and 800 °C) to produce sustainable N-enriched carbon materials with enhanced CO2 uptake from CO2/CH4 and CO2/N2 gas mixtures. The pyrolysis process was reproduced by operando TGA-IR to study the gas evolved from the pyrolysis process. It was found that the pyrolysis temperature highly influences the textural properties of the chitosan sponge-like biochar materials, impacting mainly the amount and type of the N-species on the sample but also at the microporosity. XPS revealed the transformation of the amino groups from chitosan into pyridinic-N, pyrrolic-N, graphitic center-N, and graphitic valley-N or pyridine-N oxide species during the pyrolysis process. Increasing the pyrolysis temperature enhanced the quantity of the latter two N-type species. All sponge-like biochars adsorbed higher amounts of CO2 compared with CH4 and N2 gases, with maximum CO2 uptake (∼1.6 mmol⋅g−1) at 100 kPa and 25 °C for the sample pyrolyzed at 600 °C (named CTO_P600). Biochar produced at 800 °C showed no longer adsorption capacity for CH4 and N2, having the highest selectivity value for CO2/N2 separation under continuous flux conditions among all prepared biochar sorbents. Isobaric CO2 adsorption measurements on the CTO_P600 sorbent revealed that physisorption phenomena predominantly governed the CO2 adsorption process, which was confirmed by its consistent adsorption capacity after 10 consecutive adsorption–desorption cycles. Moreover, the biochar exhibited tolerance to water vapor adsorption, indicating its suitability to work under moisture-rich conditions.publishe

In situ photobiology of corals over large depth ranges: A multivariate analysis on the roles of environment, host, and algal symbiont

We applied a multivariate analysis to investigate the roles of host and symbiont on the in situ physiological response of genus Madracis holobionts towards light. Across a large depth gradient (5–40 m) and for four Madracis species and three symbiont genotypes, we assessed several variables by measuring chlorophyll a fluorescence, photosynthetic pigment composition, or symbiont population descriptors. Most of the variation is explained by two major photobiological components: light-use efficiency and symbiont cell densities. Two other minor components emphasize photoprotective pathways and light-harvesting properties such as secondary pigments. Statistics highlight the role of irradiance on coral physiology and reveal mechanisms that are either genetically constrained, such as symbiont cell sizes, or environmentally dependent, such as photochemical efficiencies. Other parameters, such as cellular light-harvesting and photoprotective pigment concentrations, are regulated by host, symbiont, and environment. The interaction between host and environment stresses the role of host properties in adjusting the internal environment available for the endosymbionts. Different holobiont strategies, relating to symbiont cell density, vary in their physiological optimization of light-harvesting or photoprotective mechanisms and link to host-species distribution and dominance over the reef slope. Symbiont functional diversity appears to have a significant role but does not explain host vertical distribution patterns per se, highlighting the importance of species-specific morphological and physiological properties of the coral host

Candidemia Surveillance in Brazil: Evidence for a Geographical Boundary Defining an Area Exhibiting an Abatement of Infections by Candida albicans Group 2 Strains

Prospective population surveillance has been conducted for candidemia in Brazil (A. L. Colombo, M. Nucci, B. J. Park, et al., J. Clin. Microbiol. 44:2816-2823, 2006). in the present study, a total of 63 isolates from 61 patients, representing 11 medical centers from nine geographic regions, were characterized by multilocus sequence typing (MLST). A total of 48 unique profiles or diploid sequence types (DSTs) were observed, with nine new sequence types (STs) and 32 new DSTs. There were no apparent correlations between center/region and DST patterns. Subtypes were compared to those in a known characterized reference set, including a large database of strains obtained worldwide. Significantly, only one C. albicans group 2 isolate was found in our collection, although isolates from this particular group are commonly found worldwide. These data, combined with information from other previously reported studies, establish a statistically significant diminishment of group 2 strains in Central and South America, including Mexico and portions of the Southwestern United States.Centers for Disease Control and Prevention (CDC)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Ctr Dis Control & Prevent, Mycot Dis Branch, Atlanta, GA 30333 USAUniversidade Federal de São Paulo, Div Infect Dis, São Paulo, BrazilUniversidade Federal de São Paulo, Div Infect Dis, São Paulo, BrazilWeb of Scienc