Case report: Guillain-Barre syndrome - language development delay

The aim of the study was to describe the Guillain-Barré syndrome development and speech and language pathology manifestations. It describes the clinical picture of a speech and language pathology, and the revaluation 7 months after the symptoms beginning, through formal and informal tests application and auditory evaluation. In the revaluation, the results showed intentional communication, primary functions, restricted participation in dialogic activity, isolated words productions, orders understanding linked to the context, alimentary abilities return. Peripheral audition normality. Hospitalization, family conducts front to the disease and absence of school activities influenced in the communicative acting. The Guillain-Barré syndrome emergence, as well as the family answer to the child’s condition, influenced in a negative way the language development.O objetivo deste estudo foi descrever o desenvolvimento da síndrome de Guillain-Barré e manifestações fonoaudiológicas. É relatado breve histórico do quadro clínico e reavaliação fonoaudiológica 7 meses após o início dos sintomas, por meio de aplicação de testes formais, informais e avaliação audiológica. Na reavaliação, os resultados indicaram comunicação intencional, funções primárias, restrita participação em atividade dialógica, produções de palavras isoladas, compreensão de ordens ligadas ao contexto, retorno das habilidades alimentares. Foi constatada normalidade da audição periférica. Hospitalização, condutas familiares frente à doença e ausência de atividades escolares influenciaram no desempenho comunicativo. O aparecimento da Síndrome de Guillain-Barré influenciou de forma negativa no desenvolvimento da linguagem, assim como a resposta familiar à condição da criança

IMPORTANCIA DA PRODUÇÃO CIENTIFICA PARA O DESENVOLVIMENTO INTELECTUAL E FORMAÇÃO PROFISSIONAL NO BRASIL

Abstract: The demand of the labor market for qualified professionals is an increasingly present reality. Higher education centers act as an important agent of social transformation through the training of future professionals. Added to the teaching offered by the curriculum of the institutions, there is scientific research as an addition to the generation of knowledge, an important tool in the training of students for their personal and professional development. The purpose of this article is to discuss the concept of research and its importance in professional practice and training in Brazil. In the present study, an integrative literature review was carried out, which enables the synthesis and analysis of the knowledge already produced on the topic investigated to originate the construction of thoughts and concepts. Search is a tool to facilitate understanding in the most diverse areas of knowledge; through it, one can understand problems and increase public awareness, develop skills in business management, discard or accept hypotheses, arouse interests and motivations; learn to work in a group.A exigência do mercado de trabalho por profissionais capacitados é uma realidade cada vez mais presente. Os centros de ensino superior atuam como importante agente de transformação social através da formação de futuros profissionais. Agregada ao ensino ofertado pela grade curricular das instituições, a pesquisa científica representa acréscimo na geração de conhecimento, importante ferramenta na capacitação de discentes para seu desenvolvimento pessoal e profissional. O objetivo deste artigo é discutir o conceito de pesquisa e sua importância na prática e na formação profissional no Brasil. No presente estudo, foi realizada a revisão integrativa da literatura, a qual possibilita a síntese e a análise do conhecimento científico já produzido sobre o tema investigado a fim de originar a construção de pensamentos e conceitos. A pesquisa é uma ferramenta para facilitar o entendimento nas mais diversas áreas do conhecimento; através dela pode se compreender os problemas e aumentar a consciência pública, desenvolver habilidades na gestão de negócios, descartar ou aceitar hipóteses, despertar interesses e motivações, aprender a trabalhar em grupo

Avaliação da resposta inicial de desenvolvimento de ensaios clínicos para COVID-19 no Brasil

Objective: To describe the methodological characteristics and good research practices of the intervention studies for COVID-19 developed in Brazil in the first months of the pandemic. Method: A review in the CONEP-COVID bulletin (05/28/2020) and the International Clinical Trials Registry Platform, ClinicalTrials.gov, ReBEC was conducted to identify drug-type, biological therapy or vaccine intervention studies registered in Brazil. The studies were evaluated for methodological characteristics and power for different magnitudes of effect. Results: 62 studies were included, 55 identified on the CONEP website and seven on a registration database. Several interventions are being tested: chloroquine/hydroxychloroquine, azithromycin, plasma convalescent, tocilizumab, sarilumab, eculizumab, vaccine, corticoids, anticoagulants, n-acetylcysteine, nitazoxanide, ivermectin, lopinavir/ritonavir, etc. By May 2020, 22 research protocols were published in a protocol registry database, 82% were randomized clinical trials and 59% had adequate control group. However, 59% were not masked and only 24% included patients with positive test with diagnostic accuracy. Most of the studies would have power >80% just to identify large effect sizes. In a prospective follow-up, until July 21st/2020, 60% of the studies available at CONEP were not registered in the ICTRP/ReBEC/ClinicalTrials platforms. Conclusion: The interventions evaluated during the Brazilian research response reflect international initiatives, but with a different distribution, a larger proportion of studies asseessed hydroxychloroquine/chloroquine. Limitations in methodological design and sample planning represent challenges that could affect the research outreach.Objetivo: Descrever as características metodológicas e de boas práticas em pesquisa dos estudos de intervenção para COVID-19 desenvolvidos no Brasil nos primeiros meses da pandemia. Método: Revisamos o boletim da CONEP-COVID (28/05/2020) e as bases International Clinical Trials Registry Platform, ClinicalTrials.gov e ReBEC para identificar estudos registrados no Brasil, avaliando intervenções de tipo medicamento, terapia biológica ou vacinas. Descrevemos as características metodológicas e calculamos o poder para diferentes magnitudes de efeito. Resultados: Foram incluídos 62 estudos, 55 identificados no site da CONEP e mais sete nas bases de registro. As intervenções medicamentosas mais frequentemente testadas nesses estudos foram: cloroquina/hidroxicloroquina, azitromicina, plasma convalescente, tocilizumabe, sarilumabe, eculizumabe, vacina, corticoides, anticoagulantes, n-acetilcisteína, nitazoxanida, ivermectina e lopinavir/ritonavir. De 22 protocolos, publicados até maio de 2020 nas bases de registro, 18 (82%) eram ensaios clínicos randomizados e 13 (59%) tinham grupo controle adequado. Entretanto, nove (41%) eram mascarados e somente cinco (24%) incluía pacientes diagnosticados com teste de laboratório específico (e.g. RT-PCR). A maioria desses trabalhos teria poder >80% apenas para identificar grandes tamanhos de efeito. Em seguimento prospectivo, observamos que 60% dos estudos, disponíveis na CONEP até maio de 2020, não estava em nenhuma das plataformas de registro (ICTRP/ReBEC/ClinicalTrials) até o dia 21/07/2020.Conclusão: As intervenções avaliadas durante a resposta brasileira em pesquisa refletem iniciativas internacionais, porém com uma distribuição diferente, tendo um número elevado de estudos avaliando hidroxicloroquina/ cloroquina. Limitações no delineamento metodológico e planejamento amostral representam desafios que poderiam afetar o alcance dos trabalhos

Heart rate variability under resting conditions in postmenopausal and young women

The aim of the present study was to compare the modulation of heart rate in a group of postmenopausal women to that of a group of young women under resting conditions on the basis of R-R interval variability. Ten healthy postmenopausal women (mean ± SD, 58.3 ± 6.8 years) and 10 healthy young women (mean ± SD, 21.6 ± 0.82 years) were submitted to a control resting electrocardiogram (ECG) in the supine and sitting positions over a period of 6 min. The ECG was obtained from a one-channel heart monitor at the CM5 lead and processed and stored using an analog to digital converter connected to a microcomputer. R-R intervals were calculated on a beat-to-beat basis from the ECG recording in real time using a signal-processing software. Heart rate variability (HRV) was expressed as standard deviation (RMSM) and mean square root (RMSSD). In the supine position, the postmenopausal group showed significantly lower (P<0.05) median values of RMSM (34.9) and RMSSD (22.32) than the young group (RMSM: 62.11 and RMSSD: 49.1). The same occurred in the sitting position (RMSM: 33.0 and RMSSD: 18.9 compared to RMSM: 57.6 and RMSSD: 42.8 for the young group). These results indicate a decrease in parasympathetic modulation in postmenopausal women compared to young women which was possibly due both to the influence of age and hormonal factors. Thus, time domain HRV proved to be a noninvasive and sensitive method for the identification of changes in autonomic modulation of the sinus node in postmenopausal women

State of the art of blue light effects on hidradenitis suppurativa: a concise systematic review

Introduction: In the setting of inflammatory diseases, hidradenitis suppurativa (HS), or acne inversa, is an immune-mediated skin disease with a prevalence of 0.1-1% and characterized by nodules and abscesses in the armpits, groin, and inframammary areas, which may evolve for fistulas and scars. Still, an update is needed on the recent understanding of the pathogenesis of HS, including the central role of inflammatory cytokines and other contributing factors such as genetics, hormones, and pathogenic microorganisms. As an innovative approach, antimicrobial blue light in the 400-470 nm spectrum has demonstrated its intrinsic antimicrobial properties resulting from the presence of endogenous photosensitizing chromophores in pathogenic microorganisms. Objective: To carry out a narrative and systematic review of the literature to explore the main clinical and experimental results of the use of photobiomodulation with blue light for the treatment of hidradenitis suppurativa by antibacterial action. Methods: The present study followed a model of narrative and systematic review, according to PRISMA rules, to gather the main information about the efficiency and safety of blue light in the treatment of HS. The research was carried out from January 2018 to May 2019 and developed based on Google Scholar, Scopus, PubMed, Scielo, and Cochrane Library. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: Microorganisms are less able to develop resistance to antimicrobial blue light than to traditional antibiotics, due to the multi-targeting characteristics of antimicrobial blue light. Furthermore, it is well accepted that antimicrobial blue light is much less harmful to host cells than UV irradiation. Clinical studies have presented scientific evidence of treatment for HS with light-based therapy, showing efficacy and safety through articles published in quality journals in scientific evidence. A meta-analysis published in 2019, based on the quality of the evidence, showed that the most recommended treatments for HS include adalimumab and laser (blue light) therapy. For intense pulsed light with blue light, two RCTs reported improvements in HS-LASI scores and the Dermatology Quality of Life Index. Conclusion: The use of blue light for dermal treatments, particularly for HS, is finding an increasing role in dermatology. However, more robust and consistent studies are still needed to better demonstrate the antibacterial effects of blue light on HS

VÍTIMAS DE VIOLÊNCIA SEXUAL ATENDIDAS EM UM SERVIÇO DE REFERÊNCIA

Objetivou-se conhecer aspectos da violência sexual e adesão das vítimas ao seguimento ambulatorial.Estudo transversal, com coleta retrospectiva de dados em um serviço de referência no estado do Paraná. Acoleta foi realizada de fevereiro a maio de 2014 mediante fichas de notificação de 2009 a 2013. Foram atendidos1272 agredidos sexualmente, sendo 53,46% deles com idade entre 12 e 18 anos e 94,65%, mulheres. Em maisda metade dos casos, o agressor era desconhecido (53,38%), a agressão ocorreu nas residências (39,30%)e vias públicas (35%), à noite (50,33%) e, em 96,67% dos casos, houve penetração vaginal. A indicação daProfilaxia Pós-Exposição às vítimas ocorreu em 76,4% e a contracepção de emergência foi administrada em64,77% das mulheres. Apenas 19,54% completaram o seguimento ambulatorial. As evidências indicam anecessidade de estratégias de atendimento que motivem a vítima de violência sexual a finalizar o tratamento.El objetivo del estudio fue conocer aspectosde la violencia sexual y adhesión de las víctimas alprocedimiento ambulatorial. Estudio transversal cuyosdatos fueron obtenidos de modo retrospectivo en unservicio de referencia en el estado de Paraná. Los datosfueron recogidos de febrero a mayo de 2014 por medio defichas de notificación de 2009 a 2013. Fueron atendidos1272 agredidos sexualmente, siendo la edad de 53,46% deellos entre 12 y 18 años y 94,65%, mujeres. En más de lamitad de los casos, el agresor era desconocido (53,38%),la agresión ocurrió en las residencias (39,30%) y localespúblicos (35%), por la noche (50,33%) y, en 96,67% delos casos, hubo penetración vaginal. La indicación de laProfilaxia Pos Exposicón a las víctimas ocurrió en 76,4%y la contracepción de emergencia fue administrada en64,77% de las mujeres. Solamente 19,54% completaronel procedimiento ambulatorial. Las evidencias apuntan lanecesidad de estrategias de atendimiento que ayuden lavíctima de violencia sexual a finalizar el tratamiento.The aim was to investigate aspects of sexualviolence and the victims’ adherence to outpatient follow-up. This transversal study involved retrospective datacollection in a specialized service in the Brazilian state ofParaná. The collection was undertaken between Februaryand May 2014 from the notification files of 2009 – 2013.A total of 1,272 persons who had been the victims ofsexual assault was attended; 53.46% of them were agedbetween 12 and 18 years old, and 94.65% were female. Inmore than half of the cases, the aggressor was unknown(53.38%), the aggression took place in homes (39.30%) andon public highways (35%), at night (50.33%) and, in 96.67%of cases, there was vaginal penetration. Indication of Post-Exposure Prophylaxis to the victims took place in 76.4%of cases and emergency contraception was administeredto 64.77% of the women. Only 19.54% completed theoutpatient follow-up. The evidence indicates the need forattendance strategies which motivate the victim of sexualviolence to complete treatment

The Schistosoma mansoni cyclophilin A epitope 107-121 induces a protective immune response against schistosomiasis

Great efforts have been made to identify promising antigens and vaccine formulations against schistosomiasis. Among the previously described Schistosoma vaccine candidates, cyclophilins comprise an interesting antigen that could be used for vaccine formulations. Cyclophilin A is the target for the cyclosporine A, a drug with schistosomicide activity, and its orthologue from Schistosoma japonicum induces a protective immune response in mice. Although Schistosoma mansoni cyclophilin A also represents a promising target for anti-schistosome vaccines, its potential to induce protection has not been evaluated. In this study, we characterized the cyclophilin A (SmCyp), initially described as Smp17.7, analyzed its allergenic potential using in vitro functional assays, and evaluated its ability to induce protection in mice when administered as an antigen using different vaccine formulations and strategies. Results indicated that SmCyp could be successfully expressed by mammalian cells and bacteria. The recombinant protein did not promote IgE-reporter system activation in vitro, demonstrating its probable safety for use in vaccine formulations. T and B-cell epitopes were predicted in the SmCyp sequence, with two of them located within the active isomerase site. The most immunogenic antigen, SmCyp (107–121), was then used for immunization protocols. Immunization with the SmCyp gene or protein failed to reduce parasite burden but induced an immune response that modulated the granuloma area. In contrast, immunization with the synthetic peptide SmCyp (107–121) significantly reduced worm burden (48–50%) in comparison to control group, but did not regulate liver pathology. Moreover, the protection observed in mice immunized with the synthetic peptide was associated with the significant production of antibodies against the SmCyp (107–121) epitope. Therefore, in this study, we identified an epitope within the SmCyp sequence that induces a protective immune response against the parasite, thus representing a promising antigen that could be used for vaccine formulation against schistosomiasis

Effect of combined therapy of virtual reality and transcranial direct current stimulation in children and adolescents with cerebral palsy: A study protocol for a triple-blinded randomized controlled crossover trial

Background: Transcranial direct current stimulation (tDCS) and therapy-based virtual reality (VR) have been investigated separately. They have shown promise as efficient and engaging new tools in the neurological rehabilitation of individuals with cerebral palsy (CP). However, the recent literature encourages investigation of the combination of therapy tools in order to potentiate clinic effects and its mechanisms. Methods: A triple-blinded randomised sham-controlled crossover trial will be performed. Thirty-six individuals with gross motor function of levels I to IV (aged 4–14 years old) will be recruited. Individuals will be randomly assigned to Group A (active first) or S (sham first): Group A will start with ten sessions of active tDSC combined with VR tasks. After a 1-month washout, this group will be reallocated to another ten sessions with sham tDCS combined with VR tasks. In contrast, Group S will carry out the opposite protocol, starting with sham tDCS. For the active tDCS the protocol will use low frequency tDCS [intensity of 1 milliampere (mA)] over the primary cortex (M1) area on the dominant side of the brain. Clinical evaluations (reaction times and coincident timing through VR, functional scales: Abilhand-Kids, ACTIVLIM-CP, Paediatric Evaluation of Disability Inventory-PEDI- and heart rate variability-HRV) will be performed at baseline, during, and after active and sham tDCS. Conclusion: tDCS has produced positive results in treating individuals with CP; thus, its combination with new technologies shows promise as a potential mechanism for improving neurological functioning. The results of this study may provide new insights into motor rehabilitation, thereby contributing to the better use of combined tDCS and VR in people with CP