Joint attention ability in children with autistic spectrum disorders

BACKGROUND: joint attention in children with autistic spectrum disorders. AIM: to evaluate joint attention ability in subjects with autistic spectrum disorders in different contexts and with different interlocutors. METHOD: twenty subjects with ages between four and twelve years, diagnosed with autism or asperger syndrome (DSM-IV-TR, 2002) by a multidisciplinary team, with no associated disorders, and who were enrolled in language therapy for at least six months were assessed. The Symbolic Maturity Assessment Test was used to evaluate joint attention behaviors. An adaptation that included the Semi-Structured Play situations was carried out for this research. For all of the studied situations (free play; semi-structured play with speech and language therapist and the caregiver; imitation) the following joint attention behaviors were observed: alternate, point, show (by child's initiative or in response to adult's action) and look at adult's action (response behavior). The last included the differentiation of the ways by which the adult drew the child's attention (talking; gesturing; or both). RESULTS: the different situations changed the way these subjects shared attention. The adult's intervention proved to be effective in triggering an increase in the occurrence of joint attention behaviors, mainly in response to the adult. No differences were found between interlocutors (speech therapist and mother) in semi-structured situations, probably because both interlocutors synchronized their behaviors with the children. CONCLUSION: the evaluation of joint attention behaviors in play contexts was effective and the interference of a known adult was reflected in the increase of the occurrence of these behaviors in semi-structured and imitation situations.TEMA: atenção compartilhada em sujeitos do espectro autístico. OBJETIVO: avaliar a habilidade de atenção compartilhada em sujeitos com transtornos do espectro autístico em diferentes contextos e com diferentes interlocutores. MÉTODO: foram avaliados vinte sujeitos com idades entre quatro e doze anos, com autismo infantil ou síndrome de asperger (DSM-IV-TR, 2002) sem outros transtornos, diagnosticados por equipe multidisciplinar, que estavam em terapia fonoaudiológica há pelo menos seis meses. Para avaliação dos comportamentos de atenção compartilhada foram utilizados os materiais e procedimentos da Avaliação da Maturidade Simbólica, além de uma adaptação feita para esta pesquisa que incluiu as situações Semi-Dirigidas com interlocutores familiares. Para as situações estudadas (brincadeira livre; semi-dirigidas com terapeuta e cuidador; imitação), foram observados os comportamentos de atenção compartilhada alternar, apontar, mostrar (por iniciativa ou resposta da criança) e olhar para a ação do adulto (sempre por resposta da criança). Este último incluiu a diferenciação do meio utilizado pelo adulto para chamar a atenção da criança (fala; gestos; ou, ambos). RESULTADOS: as diferentes situações modificaram a forma como estes sujeitos compartilharam a atenção. A intervenção de um adulto aumentou a ocorrência dos comportamentos de atenção compartilhada principalmente em Resposta. Não foram observadas diferenças na intervenção dos diferentes interlocutores (fonoaudiólogo e mãe) nas situações semi-dirigidas, provavelmente porque ambos sincronizaram seus comportamentos com as crianças. CONCLUSÃO: a avaliação da atenção compartilhada em contexto de brincadeira foi eficaz e a intervenção do adulto refletiu no aumento destes comportamentos nas situações semi-dirigidas e de imitação.Universidade Federal de São Paulo (UNIFESP) Departamento de Fonoaudiologia Programa de Pós-Graduação em Distúrbios da Comunicação HumanaUNIFESP, Depto. de Fonoaudiologia Programa de Pós-Graduação em Distúrbios da Comunicação HumanaSciEL

Trichomoniasis : are we giving the deserved attention to the most common non-viral sexually transmitted disease worldwide?

Etiology: Trichomonas vaginalis is the etiologic agent of trichomo-niasis, the most common non-viral sexually transmitted disease (STD) in the world. Transmission: Trichomoniasis is transmitted by sexual intercourse and transmission via fomites is rare. Epidemiology, incidence and prevalence: The WHO estimates an incidence of 276 million new cases each year and preva-lence of 187 million of infected individuals. However, the infection is not noti-fiable. Pathology/Symptomatology: The T. vaginalis infection results in a vari-ety of clinical manifestations - in most cases the patients are asymptomatic, but some may develop signs typically associated to the disease. Importantly, the main issue concerning trichomoniasis is its relationship with serious health consequences such as cancer, adverse pregnancy outcomes, infertility, and HIV acquisition. Molecular mechanisms of infection: To achieve success in parasitism trichomonads develop a complex process against the host cells that includes dependent- and independent-contact mechanisms. This multi-factorial pathogenesis includes molecules such as soluble factors, secreted proteinases, adhesins, lipophosphoglycan that culminate in cytoadherence and cytotoxicity against the host cells. Treatment and curability: The treat-ment with metronidazole or tinidazole is recommended; however, cure fail-ures remain problematic due to noncompliance, reinfection and/or lack of treatment of sexual partners, inaccurate diagnosis, or drug resistance. There-fore, new therapeutic alternatives are urgently needed. Protection: Strategies for protection including sexual behavior, condom usage, and therapy have not contributed to the decrease on disease prevalence, pointing to the need for innovative approaches. Vaccine development has been hampered by the lack of long-lasting humoral immunity associated to the absence of good animal models

Tocar e ser tocado : o design de experiência na editoração de livros impressos

Monografia (graduação)—Universidade de Brasília, Faculdade de Comunicação, Comunicação Social, Habilitação em Publicidade e Propaganda, 2014.Apoiado em leituras de autores como Richard Hendel e Rafael Cardoso, este projeto experimental tem como objetivo a produção de um projeto gráfico para o livro Auto da Compadecida, de Ariano Suassuna, e sua transformação em livro impresso. Para isso, estuda-se os projetos gráficos das versões já existentes do livro, bem como projetos gráficos realizados por editoras brasileiras que trabalham com o design de experiência em livros impressos. ___________________________________________________________________________ ABSTRACTSupported by the reading of authors such as Richard Hendel and Rafael Cardoso, this experimental project intends to create a graphic project for the book Auto da Compadecida, written by Ariano Suassuna, later transforming it in a printed book. For that, it is studied the graphic projects from earlier editions of the book, as well as graphic projects created by Brazilian publishers that work with experience design in printed books

COMPARISON OF PERMANENT STAINING METHODS FOR THE LABORATORY DIAGNOSIS OF TRICHOMONIASIS

Trichomonas vaginalis is the etiologic agent of trichomoniasis, the most common non-viral sexually transmitted disease (STD) in the world. The diagnosis is based on wet mount preparation and direct microscopy on fixed and stained clinical specimens. The aim of this study was to compare the performance of different fixing and staining techniques used in the detection of T. vaginalis in urine. The smears were fixed and submitted to different methods of permanent staining and then, the morphological aspects of the parasites were analyzed and compared. The Papanicolaou staining with ethanol as the fixative solution showed to be the best method of permanent staining. Our data suggest that staining techniques in association with wet mount examination of fresh specimens contribute to increase the sensitivity in the diagnosis of trichomoniasis

Noncoding RNAs in the Cardiovascular System: Exercise Training Effects

Exercise training (ET) represents a non-pharmacological treatment that can attenuate or even reverse the process of cardiovascular diseases (CVD), by stimulating protein synthesis, angiogenesis, mitochondrial biogenesis, anti-inflammatory, and anti-oxidative effects that are involved to enhance the performance and improved quality of life. Despite the benefits of exercise, the intricacies of their underlying molecular mechanisms remain largely unknown. Noncoding RNAs (ncRNAs) have been recognized as a major regulatory network governing gene expression in several physiological processes and appeared as pivotal modulators in a myriad of cardiovascular processes under physiological and pathological conditions. However, little is known about ncRNA expression and role in response to exercise. Here we review the current understanding of the ncRNA role in exercise-induced adaptations focused on the cardiovascular system and address their potential role in clinical applications for cardiovascular diseases

Evaluation of quality of life in patients with type 2 diabetes Mellitus with symptomatic distal symmetric polyneuropathy / Avaliação da qualidade de vida em doentes com diabetes Mellitus tipo 2 com polineuropatia simétrica distal sintomática

INTRO/BACKGROUND The complications of Diabetes Mellitus (DM) are traditionally categorized as micro and macrovascular disorders. Among them, diabetic polyneuropathy (DPN) is one of the most common, presenting with or without associated neuropathic pain, and its morbidity exerts a significant impact on the quality of life (QOL) of these patients. About 50% of individuals with type 2 DM (T2DM) suffer from this condition and the distal symmetric polyneuropathy (DSPN) constitutes its most frequent clinical form.  OBJECTIVE: To demonstrate the effect of symptomatic DSPN on the QOL of T2DM patients in a sample of the Brazilian population, correlating clinical and electrophysiological findings, besides comparing the results obtained by the Medical Outcomes Study Questionaire 36-Item Short Form Health Survey (SF-36) among patients with painful and non-painful diabetic DSPN. METHODS: This study comprised 25 outpatients with DSPN and T2DM submitted to a detailed anamnesis to identify clinical and demographic characteristics, besides comorbidities and complications of DM. Clinical evaluation was performed through neurological physical examination, in addition to specific scales for neuropathy as the Neuropathy Disability Score (NDS). In order to assess the health-related quality of life (HRQoL) of these patients, the SF-36 translated and adapted for the Brazilian population was applied. Nerve conduction study (NCS) was performed for the examined nerves (motor part of peroneal nerve and sensory part of the sural nerve). The following parameters were assessed: motor conduction velocity (MCV), amplitude of the compound muscle action potentials (CMAP) and amplitude of the sensory nerve action potentials (SNAP). RESULTS: Role Physical (RP) domain of SF-36 was significantly related to some of the clinical and electrophysiological factors measured. RP had an inverse and significant relationship with the NDS values (Rho: -0.44), showing the impact of neuropathy severity on these patients’ QOL. The sural nerve SNAP and peroneal nerve MCV showed a significant and positive relationship with RP (Rho: 0,52 and 0,36, respectively). The Mental Health (MH) domain showed a statistically significant difference between those patients with pain and without pain (p = 0.002), and patients without pain had higher mean values, as well as a higher minimum and maximum value. The Role Emotional (RE) domain also showed a significant difference between patients with and without pain, and patients with pain had a lower mean value (p = 0.04). For all other domains, patients with pain showed lower mean values than those without pain, however without statistical difference in the test performed. Between DM complications, only nephropathy presented statistically different RP scores from those without nephropathy (p = 0.02). CONCLUSION: There was a significant inverse relationship between the severity of DSPN and the QOL of the evaluated patients, as evidenced by lower values in the SF-36 specific RP domain, as polyneuropathy becomes more severe. This domain also presented significantly lower values in patients with associated nephropathy. The presence of pain negatively affected the QOL of patients with painful DPN, who presented significantly lower mean values in the MH and RE domains when compared to patients without pain

Patient safety: analysis of the impact of implementation of automated dispensing cabinets on drug return in an university hospital

 Introduction: Patient safety and medication errors have received great attention and interest from health institutions. Drug return is a reverse logistics process that requires further analysis, because the delay or failure to return medications can create an accumulation of drugs in nursing units, favoring deviations and medication errors. The automated dispensing cabinets are a technological innovation that aims to reduce drug-related errors. The present study made an analysis of the amount of returned medications before and after the implantation of automated dispensing cabinets in a university hospitalMethods: This descriptive study presents a retrospective analysis of data on drug return collected from hospital reports published from 2013 to 2016.Results: Before the implantation of automated dispensing cabinets, the mean percentage of returned medications was 27%. In the first year after the implantation of automated dispensing cabinets, the mean percentage of returned medications was reduced to 4%.Conclusion: The implementation of the automated dispensing cabinets led to a reduction in drug return and in its associated risks, generating a positive impact on patient safety.Keywords: Pharmacy service; hospital, automation; patient safetyIntroduction: Patient safety and medication errors have received great attention and interest from health institutions. Drug return is a reverse logistics process that requires further analysis, because the delay or failure to return medications can create an accumulation of drugs in nursing units, favoring deviations and medication errors. The automated dispensing cabinets are a technological innovation that aims to reduce drug-related errors. The present study made an analysis of the amount of returned medications before and after the implantation of automated dispensing cabinets in a university hospitalMethods: This descriptive study presents a retrospective analysis of data on drug return collected from hospital reports published from 2013 to 2016.Results: Before the implantation of automated dispensing cabinets, the mean percentage of returned medications was 27%. In the first year after the implantation of automated dispensing cabinets, the mean percentage of returned medications was reduced to 4%.Conclusion: The implementation of the automated dispensing cabinets led to a reduction in drug return and in its associated risks, generating a positive impact on patient safety.Keywords: Pharmacy service; hospital, automation; patient safet

Patient safety : analysis of the impact of implementation of automated dispensing cabinets on drug return in an university hospital

Patient safety and medication errors have received great attention and interest from health institutions. Drug return is a reverse logistics process that requires further analysis, because the delay or failure to return medications can create an accumulation of drugs in nursing units, favoring deviations and medication errors. The automated dispensing cabinets are a technological innovation that aims to reduce drug-related errors. The present study made an analysis of the amount of returned medications before and after the implantation of automated dispensing cabinets in a university hospita

Surviving cardiac arrest: what happens after admission to the intensive care unit?

Patients successfully resuscitated from cardiac arrest (CA) are admitted to the intensive care unit (ICU) for post-resuscitation care. These patients' prognosis remains dismal, with only a minority surviving to hospital discharge. Understanding the clinical factors involved in the management of these patients is essential to improve their prognosis.Introdução: Doentes ressuscitados de uma paragem cardiorrespiratória (PCR) são admitidos em Unidades de Cuidados Intensivos (UCI) para receber cuidados pós-reanimação, mas apenas uma minoria sobrevive até à alta hospitalar. Compreender os fatores clínicos envolvidos na sua abordagem é essencial para melhorar o prognóstico. Objetivos: Caracterizar a população admitida na UCI após reanimac¸ão bem-sucedida e analisar os fatores associados aos outcomes. Métodos: Realizamos um estudo retrospetivo e descritivo com doentes admitidos após PCR na UCI, de janeiro de 2014 a dezembro de 2018. Analisaram-se os fatores demográficos, caraterísticas da PCR, abordagem precoce e outcomes neurológico e de mortalidade. Resultados: Foram admitidos 187 doentes, com uma mediana de 67 anos; 39% sofreram PCR pré-hospitalar, 87% apresentavam ritmo inicial não desfibrilhável e a etiologia presumida mais frequente foi a cardíaca (31%). A mortalidade intra-hospitalar foi 63%; 31% dos sobreviventes tinha disfunc¸ão neurológica significativa à data da alta hospitalar (CPC 3 ou 4). O atraso no início do suporte básico de vida (SBV), score SAPS II mais elevado e maior durac¸ão indexada de suporte vasopressor foram preditores independentes de mortalidade intra-hospitalar. O ritmo desfibrilhável foi associado a melhoria da sobrevida. Um valor de Escala de Coma de Glasgow mais elevado na alta da UCI e menor durac¸ão de internamento na UCI foram preditores de melhor outcome neurológico. Conclusão: Este estudo salienta o impacto prognóstico do ritmo desfibrilhável e confirma a importância do início imediato de SBV e da rápida desfibrilhação, reforçando a necessidade de capacitar a população intra e extra-hospitalar.info:eu-repo/semantics/publishedVersio

EXTRAÇÃO ÁCIDA DA PECTINA DA CASCA DE MARACUJÁ ASSISTIDA POR ULTRASSOM

A pectina é um polissacarídeo complexo, que atua como agente geleificante, espessante e estabilizante na composição de diversos produtos. A casca do maracujá possui elevado nível de pectina, cujo método convencional de extração é a ebulição utilizando ácidos fortes. O presente estudo objetivou explorar um novo método de extração utilizando ácidos fracos. Buscando esse propósito, a pectina da casca de maracujá foi obtida por meio de extração assistida por ultrassom, utilizando solução de ácido cítrico. Os experimentos foram conduzidos visando avaliar o efeito das variáveis experimentais (razão amostra:solvente, temperatura e tempo) no rendimento de pectina. Os resultados demonstraram que a extração conduzida com razão amostra:solvente de 1:50 (m/v), temperatura de 50 °C e tempo de 90 min proporcionou a obtenção de 26,45% de pectina. Nessas mesmas condições experimentais a pectina foi extraída por método convencional para efeito comparativo, o qual permitiu a obtenção de 21,06% de pectina. Portanto, o uso do ultrassom promoveu a obtenção de melhores resultados, visto que proporcionou o aumento de 25% no rendimento. O grau de esterificação foi determinado apenas para amostras obtidas por ultrassom, as quais foram classificadas com alto grau de metoxilação (81,93%).ABSTRACTPectin is a complex polysaccharide, which acts as a gelling agent, thick and stabilizing in the composition of various products. The passion fruit peel has a high level of pectin, whose conventional method of extraction is boiling using strong acids. The present study aimed to explore a new extraction method with the weak acids. For this purpose, a pectin from the passion fruit peel was obtained by ultrasound-assisted extraction, using citric acid solution. The experiments were conducted with the objective of evaluating the effect of experimental variables (analysis procedure: solvent, temperature and time) on pectin yield. The results demonstrated that the extraction was carried out on the basis of a solvent criterion of 1:50 (m/v) at a temperature of 50 °C and the time of 90 minutes provided a yield of 26.45% pectin. In these same experimental conditions the pectin was extracted by conventional method for comparative effect, which allowed a obtainment of 21.06% pectin. Consequently, the use of the product was promoted to obtain better results, which gave rise to a 25% of increase in yield. The degree of esterification was determined only for samples obtained by ultrasound, which were classified with high degree of methoxylation (81.93%)