A Rare but Real Necessity: Case Report of Coronary Artery Stenting in an Infant

Percutaneous coronary intervention (PCI) is an extremely common and well-established procedure in adults which is rarely performed in children. We present a case of a successful left main coronary artery stenting in a small infant with a congenital coronary artery anomaly. We highlight the technical challenges of performing a PCI in a small patient, the risks of antithrombotic prophylaxis in this age group, and the importance of the combined work of the adult and pediatric interventional cardiologist.info:eu-repo/semantics/publishedVersio

Optimising mRNA vaccines manufacturing by using Machine learning approaches

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Seroprevalence of Bordetella pertussis in healthcare workers in a Portuguese tertiary referral hospital

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Adaptability and Procedural Content Generation for Educational Escape Rooms

We present a literature review that aims to understand the role of the Educational Escape Room (EER) in improving the teaching, learning, and assessment processes through an EER design framework. The main subject is to identify the recent interventions in this field in the last five years. Our study focuses on understanding how it is possible to create an EER available to all students, namely visually challenged users. As a result of the implementation of new learning strategies that promote autonomous learning, a concern arose in adapting educational activities to each student's individual needs. To study the adaptability of each EER, we found the EER design framework essential to increase the student experience by promoting the consolidation of knowledge through narrative and level design. The results of our study show evidence of progress in students' performance while playing an EER, revealing that students' learning can be effective. Research on Procedural Content Generation (PCG) highlighted how important it is to implement adaptability in future studies of EERs. However, we found some limitations regarding the process of evaluating learning through the EERs, showing how important it is to study and implement learning analytics in future studies in this field

Aneurismas Gigantes do Septo Interauricular Simulando Massas Quísticas. Dois Casos com Opções Terapêuticas Diferentes

With the recent technical improvement in echocardiography imaging (second harmonics) the number of interatrial septum aneurysms (ASA) increased and are easily recognized. We assist to an overdiagnosing number of cases and diagnostic criteria emerged to face this problem. In the great majority of the cases ASA are small and inoffensive, but as ASA is considered a risk factor for cardioembolism when associated with persistence of foramen oval (PFO), an examination by transesophageal echocardiography (TEE) for exclusion of PFO makes the sense and is a common testing in patients with cryptogenic stroke. Besides these frequent ASA, other forms exist; the authors describe two cases of uncommon and huge ASA, one mimicking a right atrial tumor and the other a quistic, hipoechoic mass. The first case was associated with mitral stenosis and was submitted to surgery and the second was closed with an Amplatzer occluder device usually used in atrial septal defect (ASD)

Intermittent Pringle Maneuver and Hepatic Function: Perioperative Monitoring by Noninvasive ICG-Clearance

BACKGROUND: Intermittent Pringle maneuver or selective portal clamping often are used to control inflow during parenchymal liver transection. This study was designed to determinate whether these maneuvers are associated with adverse hepatic function. METHODS: Resection was performed without portal clamping in 17 patients (group 1). Selective continuous portal clamping was performed in 11 patients (group 2) and the remaining 33 patients (group 3) had intermittent nonselective portal clamping (occlusion of the main portal trunk). The centers' protocol for total portal occlusion is 15-min occlusion alternated with 5-min reperfusion in patients with normal liver parenchyma or 10 min alternated with 5 min in patients with abnormal parenchyma. ICG elimination tests were conducted concurrently using a noninvasive monitor that tracks the plasma disappearance rate (PDR-ICG-%/min) and 15-min retention rate after administration (ICG-R15-%). RESULTS: There was no statistically difference between the three studied groups in terms of sequential changes of ICG-PDR (p < 0.625) or ICG-R15 (p < 0.398). CONCLUSIONS: Our study indicates that 15 min of intermittent Pringle maneuver or selective hemihepatic continuous portal clamping are safe methods of vascular control during liver resection, with no adverse effects on hepatocellular function

A Very Rare Case of Coronary Artery Bypass Grafting in a Progeria Child

Hutchinson-Gilford progeria syndrome is a rare genetic disorder, characterized by progressive premature aging and early death in the first or second decade of life, usually secondary to cardiovascular events (myocardial infarction and stroke). We report a case of a 14-year-old boy with progeria syndrome and cardiac arrest due to myocardial infarction, who was submitted to an immediate coronary angiography which revealed left main stem and three-vessel coronary artery disease. A prompt double bypass coronary artery grafting surgery was performed, and, despite successful coronary reperfusion, the patient remained in coma and brain death was declared on fourth day after surgery.info:eu-repo/semantics/publishedVersio

Gait training with partial body weight support during overground walking for individuals with chronic stroke: a pilot study

<p>Abstract</p> <p>Background</p> <p>It is not yet established if the use of body weight support (BWS) systems for gait training is effective <it>per se </it>or if it is the combination of BWS and treadmill that improves the locomotion of individuals with gait impairment. This study investigated the effects of gait training on ground level with partial BWS in individuals with stroke during overground walking with no BWS.</p> <p>Methods</p> <p>Twelve individuals with chronic stroke (53.17 ± 7.52 years old) participated of a gait training program with BWS during overground walking, and were evaluated before and after the gait training period. In both evaluations, individuals were videotaped walking at a self-selected comfortable speed with no BWS. Measurements were obtained for mean walking speed, step length, stride length and speed, toe-clearance, durations of total double stance and single-limb support, and minimum and maximum foot, shank, thigh, and trunk segmental angles.</p> <p>Results</p> <p>After gait training, individuals walked faster, with symmetrical steps, longer and faster strides, and increased toe-clearance. Also, they displayed increased rotation of foot, shank, thigh, and trunk segmental angles on both sides of the body. However, the duration of single-limb support remained asymmetrical between each side of the body after gait training.</p> <p>Conclusions</p> <p>Gait training individuals with chronic stroke with BWS during overground walking improved walking in terms of temporal-spatial parameters and segmental angles. This training strategy might be adopted as a safe, specific and promising strategy for gait rehabilitation after stroke.</p

The use of body weight support on ground level: an alternative strategy for gait training of individuals with stroke

<p>Abstract</p> <p>Background</p> <p>Body weight support (BWS) systems on treadmill have been proposed as a strategy for gait training of subjects with stroke. Considering that ground level is the most common locomotion surface and that there is little information about individuals with stroke walking with BWS on ground level, it is important to investigate the use of BWS on ground level in these individuals as a possible alternative strategy for gait training.</p> <p>Methods</p> <p>Thirteen individuals with chronic stroke (four women and nine men; mean age 54.46 years) were videotaped walking on ground level in three experimental conditions: with no harness, with harness bearing full body weight, and with harness bearing 30% of full body weight. Measurements were recorded for mean walking speed, cadence, stride length, stride speed, durations of initial and terminal double stance, single limb support, swing period, and range of motion of ankle, knee, and hip joints; and foot, shank, thigh, and trunk segments.</p> <p>Results</p> <p>The use of BWS system leads to changes in stride length and speed, but not in stance and swing period duration. Only the hip joint was influenced by the BWS system in the 30% BWS condition. Shank and thigh segments presented less range of motion in the 30% BWS condition than in the other conditions, and the trunk was held straighter in the 30% BWS condition than in the other conditions.</p> <p>Conclusion</p> <p>Individuals with stroke using BWS system on ground level walked slower and with shorter stride length than with no harness. BWS also led to reduction of hip, shank, and thigh range of motion. However, this system did not change walking temporal organization and body side asymmetry of individuals with stroke. On the other hand, the BWS system enabled individuals with chronic stroke to walk safely and without physical assistance. In interventions, the physical therapist can watch and correct gait pattern in patients' performance without the need to provide physical assistance.</p