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  • THE IMPORTANCE OF THE MULTIPROFESSIONAL APPROACH IN SOTOS SYNDROME

    Introduction: Sotos syndrome or cerebral gigantism is a rare genetic disorder characterized by excessive physical growth in early childhood, being associated with the NSD1 gene, located on chromosome 5. The Individuals show as physical changes macrocephaly, neuropsychomotor retardation, stomatoglossognathic system alteration, delay in language acquisition and development, and cognitive deficit. Objectives: To report the importance of the approach of Occupational Therapy, Speech Therapy, Physiotherapy and Psychology professional regarding intervention in a patient with Sotos syndrome. Local: Unit of Neuropsychomotor rehabilitation of the Specialized Center for Rehabilitation of a region of the Alagoas backwood. Methodology: Patient attended the aforementioned institution with medical diagnosis of Sotos Syndrome and with complaints of motor deficit, delay in acquisition, development and use of oral language, difficulty in oral control, and cognitive and behavioral changes. Initially, the basic script for multiprofessional institutional evaluation was applied, as a way to gather more information about the general complaint of the patient, made the anamneses and specific evaluations of occupational therapy, phonoaudiology physiotherapy and psychology, looking to promote the rescue of specific complaints. Was also performed the application of the UTP- Unique Therapeutic Project, seeking to list the CIF of the patient and the objectives to be drawn in the short, medium and long term. The multiprofessional rehabilitation regarding of this patient was performed from preselected play resources, where she also had guidelines regarding early stimulation. Results: After 1 year in the unit of neuropsychomotor rehabilitation, it was observed that there was significant improvement in all aspects evaluated. With regard physiotherapeutic rehabilitation and occupational therapy, the patient shows improvement in gait resulting from lower limb strengthening and balance development. Regarding the speech-language complaints, the patient improved communicative intention, social interaction, linguistic structuring and oral control. It also presented a linear change in the psychological patterns of cognitive and behavioral…

  • THE USE OF ELASTIC BANDAGE IN TREATMENT OF SPEECH THERAPY IN PATIENTS POST ORTHOGNATHIC SURGERY

    Introduction: The orthognathic surgery is realized for the correction of maxillo-mandibular disproportions, providing improvement in aesthetics and setting a harmony between anatomical structures. As it is a readjustment of these structures, these patients may present a demand for speech therapists interventions, either in pre or post-operative with the objective of set a new functional pattern suitable to the new form. Objectives: To describe the experience regarding the effectiveness of patients post orthognathic surgery with the use of elastic bandage associated with speech therapy. Local: Specialized Center in Rehabilitation of the municipality of Maceió. Methods: A descriptive study of the experience in patients submitted to the orthognathic surgery. Interventions and lectures were realized in order to solve the doubts regarding speech therapy. The purpose of the action is to realize anamnesis, evaluation and speech-language intervention, focused on the area of orofacial motricity, in patients who entered the rehabilitation center and looked for phonoaudiological demand after orthognathic surgery. Results: Five patients who had realize orthognathic surgery to correct maxillo-mandibular disproportion were observed. Initially, a anamnesis speech-language pathology was realized, with the objective of knowing the clinical history and demand of each patient. Then, evaluations were carried out based on validated protocols, in order to analyze how was the structures and functions related to orofacial motricity, in order to draw up the therapeutic plan of these patients. Of the five patients initially mentioned, four presented a demand to apply for elastic bandage associated with the performance of speech therapy. The sessions were performed once a week, where orofacial myofunctional exercises were performed during therapy and finished with the application of elastic bandage. At the end of one year of observation, it was possible to verify that patients who used elastic bandage presented a faster rehabilitation process, when compared to those who did not,…

  • POSSIBLE ETIOLOGICAL FACTORS REPORTED BY PARENTS OF CHILDREN WITH PHONOLOGICAL DISORDER

    Introduction: Most four-year-old children present a well-developed phonological system, thus producing speech sounds properly. However, this does not always occur and some children end up developing speech disorders that remain beyond this age, which is known as phonological disorder. This is partially characterized by the speaker’s difficulty in mentally representing the phonological rule and, consequently, inefficient production of sounds. It is worth noting that this change has no well-defined cause, therefore, its etiology is still quite unknown. Objective: To investigate the possible etiological factors of phonological disorders in children, according to what was reported by their parents. Methodology: This study was carried out on eight children who are in therapy for phonological disorder at the Centro Universitário de João Pessoa in October 2018. The data collection took place upon an interview with the parents, which was guided towards the probable cause of the phonological disorder. Regarding ethical considerations, this study is part of a larger project approved under the number 2.117.018. Results: Based on the quantitative analysis of the responses of the parents who participated in the study, 3 reported that they believed that the cause was linked to the genetic factor, 2 reported that the cause may be linked to overprotection, 2 linked to the emotional factors and 1 to lack of motivation. Conclusion: It is suggested that there might be more in-depth studies aimed at investigating and defining the etiological factors of phonological disorders.

  • PROFESSIONAL SENSITIZATION IN A NEONATAL INTENSIVE THERAPY UNIT AS A HUMANIZATION STRATEGY IN THE CARE

    Introduction: Humanization in the Neonatal Intensive Care Unit depends on the encounter involving the caregiver and the care. Moments of awareness and reflection on the work process are fundamental in order to review the assistance. Objective: To promote the sensitization and reflection of the professionals regarding the humanized care of the newborn through simulated life activity. Method: The activity happens individually in four moments (stress management, appropriate / humanized management, kangaroo positioning and qualified listening), conducted by nursing, occupational therapists and psychology residents. At this moment all the professionals involved directly and indirectly in the care of the newborn of the Neonatal Intensive Care Unit of a Maternity School take part. The action was developed weekly in the internal space of the sector itself during the period of July and August of 2018. Results: 72 professionals were involved in the sensitization activity, bringing feelings and emotions after the simulated experiences. As for the first moment of the intervention (stress management), the participants report anguish, fear and impotence. On the following moments, which relate to the appropriate / humanized handling and kangaroo positioning, their reports revolve around the reception, protection and care. In addition, after the intervention, a significant number of professionals refer to reflect on their daily practice. Conclusion: The simulated experience generated a change in attitudes in the practice of the NICU professionals regarding the care of the newborn in order to generate more comfort and well-being and thus provide a better growth, development and recovery of the baby, with reduced effects and sequelae caused by hospitalization. With this, it is indispensable to invest in the work process so that humanized action becomes more and more accomplished with quality, uniqueness and completeness, and above all with respect to life. However, even with the efforts made to humanize care in…

  • FAMILY AND DEAF: HOW DO YOU COMMUNICATE?

    INTRODUCTION: Human hearing is part of a very specialized system, only in humans this system allows the processing of acoustic events, such as speech (FRAZZA et al, 2000). Hearing loss occurs when there is some type of alteration in the structures that make up the auditory system and this loss can be of different degrees and types depending on the affected location (CORMEDI, 2012). In most cases of children who have been diagnosed with deafness, it is necessary to stimulate speech therapy because this is the beginning of the process to acquire language in these individuals, since communication between family members and deaf people often becomes difficult (BOSCOLO , SANTOS, 2005). OBJECTIVES: To analyze the conception of family members about how to communicate with the deaf, identifying the means they use to communicate. METHODOLOGY: This research is a descriptive, field study, with quantitative and qualitative nature. Data collection was of a systematic nature, using as a selection criterion 10 (ten) family members, determined by convenience, who attend the Educational Audiology sector of the Clinic School of Speech-Language Pathology and Audiology at UNIPÊ-PB. The instrument used was a structured questionnaire with 7 (seven) objective and 1 (one) subjective questions. As a requirement for the start of data collection, the research project was forwarded for analysis and opinion of the Ethics Committee of the University Center of João Pessoa – UNIPÊ, fulfilling the requirements of resolution 466 \ 12 of the National Health Council (NHC). Only after the approval of the Ethics Committee, CAAE: 54711216.6.0000.5176, was the questionnaire applied. RESULTS: With the 10 interviewees, it was observed that 70% used oral language to communicate; 60% of the patients are not users of LIBRAS (Brazilian Sign Language), but they answered that it helps in the socialization of the deaf and presents no disadvantages;…

  • Compositional analysis of genetically modified soybeans placed on Taiwan market

    Soybean is an important protein source for consumers in Taiwan. Soybean production in Taiwan is not self-sufficient. Taiwan imports 2.5 million tons of soybeans annually. More than 90% of the imported soybeans are genetically modified (GM). To provide an objective assessment on safety of GM soybean and for post-market monitoring, we conducted a comparative assessment on key component compositions between imported GM soybean and local non-GM soybean from Taiwan. All the soybean samples were purchased from the local market to simulate the status of Taiwanese consumers in purchasing soybeans. The GM soybean samples were herbicide-tolerant soybeans. The content of the proximate, the amino acid composition, the fatty acid composition, vitamins, minerals, antinutritional factors, and isoflavones of soybean samples were analyzed. Most contents of the key components of the GM soybean had no significant difference with those of the non-GM soybean. However, the contents of ash, crude protein, amino acids, myristic acid, behenic acid, phosphorus, iron and phytic acid were significantly lower in the GM soybean samples, and the contents of crude fat, margaric acid, and stearic acid were significantly higher in the GM soybean samples. But they were all within the range of reference values. A total of 314 pesticide residues in each of the samples were analyzed. Glyphosate residue was detected only in GM soybean samples, but it is well below the threshold prescribed by the government. In summary, the GM soybean samples purchased from Taiwan market were shown to be substantially equivalent to non-GM soybeans.

  • Factors associated with morbidity in ICU

    The beginnings of caring for critically ill patients date back to Florence Nightingale’s work during the Crimean War in 1854, but the subspecialty of critical care medicine is relatively young. Many factors are hypothesized to contribute to the relatively high incidence and associated morbidity of medication errors in the ICU. The patients themselves are the most complex and critically ill in the hospital setting [1]. Critical care areas present a particular challenge with regard to medication errors. They are a dynamic environment with critically ill patients who often require rapid adaptation of ongoing management. ICUs can be error-prone settings, where even otherwise minor adverse events can lead to serious disability. By virtue of being sicker, older, and having more comorbidities, these patients are less resilient to errors. Because they require a higher intensity of care provision and may receive more medications, they may be at greater risk of iatrogenic harm. Pharmacokinetics of medications can also be altered in critically ill patients, principally through changes in volume of distribution and drug clearance. Large volume resuscitations, positive pressure ventilation, surgical procedures, systemic inflammatory response, and changes in protein binding, all common in ICU patients, affect the pharmacokinetics of many drugs. In addition, these patients are usually unable to help facilitate their own care, a problem aggravated by the volume of transfers to and from ICUs. Medication safety in ICUs might also be compromised because of the risks associated with the use of multiple medications per patient and the use of high-risk drugs associated with potentially severe adverse events [2]. Drugs used in the ICU are more likely to be potent, require dose calculations, have medication interactions, and be continuous infusions (which have a greater potential for error). Many medications may be used for off-label indications in the ICU setting, similar to the…

  • Alternative Measures to Chronic Pain Management

    “No pain no gain” still is one of the most widely used inspiring quote. With that spirit, chronic pain sufferers should find heaven on earth at some point of life. However, chronic pain is a widespread and complex set of conditions that are often difficult and expensive to treat. The Institute of Medicine (US) estimated that chronic pain affects over 100 million Americans [1] and is associated with $874 billion in healthcare costs annually [2]. Of this, close to 10% ($78 billion) is associated with the economic burden of prescription opioid overdose, abuse and dependency [3]. Pain increases depression 3-5-fold [4-6] and 50–90% of chronic pain patients report insomnia that warrants clinical attention [7-10]. Conventional pain killers are usually associated with a variety of adverse side effects, such as constipation, urinary retention, nausea, sedation, respiratory depression, low platelet count, sexual dysfunction and hyperalgesia [11-14]. Pain affects more than 65% cancer patients [15], distressing or intolerable in more than one‐third of patients [16]. Although, WHO described opioids as essential medicines for pain control but distribution shows substantial inequity, 10% of the world’s population consuming more than 90% of the world’s supply [17], 80% opioids consumed by US alone [18-23]. Famous celebrities like Bruce Lee, Chris Penn, Elvis Presley, Heath Ledger, Anna Nicole Smith died from opioid overdose. Also, some 85% of primary care physicians perceived their training in pain management to be inadequate in a Pan-European survey [24,25]. Along with these, fear of dependence, prescription diversion, regulatory scrutiny, withdrawal symptoms, opioid-related adverse events and deaths limit its use. Although, abuse and availability of medical cannabis are big issues, several studies support use of cannabis/marijuana in cancer pain management [26-36]. Its social acceptability is gradually increasing around the world [37], but many studies oppose it’s use or at least demand further investigation…

  • Lifestyle Issues and Prevention of Recurrent UTIs

    UTI is one of the most prevalent diseases with diverse etiological agents annually affecting 250 million and causes death of 150 million people worldwide [1,2]. Adult women are 30 times more likely than men to develop a UTI [3]. Although the estimated mortality rate is generally lower than with RTIs, it may rise up to 26% if complicated with bacteremia or septic shock [4]. Financial burden of UTIs exceeds $3.5 billion in US alone [5] whereas more than 50% of the antibiotics prescribed for a suspected UTI in older adults being considered unnecessary [6]. More interestingly, nosocomial UTIs account for nearly 40% of all hospital acquired infections [7] and around 50% of UTI in children are missed [8]. Recurrent UTIs (RUTIs) are mostly caused by frequent sexual intercourse, heterosexual lack of circumcision receptive anal intercourse (without a condom), multiple sexual partners (each sex partner shares his/her UGT microbiota with the other), use of spermicide and a new sexual partner, sexual intercourse with addicted partners, sexual intercourse with sex workers, sexual intercourse with online dating friends, sexual intercourse with a new sex partner within less than 2 months [9-20]. Traditional lifestyle factors such as fluid intake and diet are not considered independent risk factors now [15]. UTIs account for nearly 25% of all infections [16]. Sexual intercourse ≥3 times/week was associated with greater frequency of UTI [21]. Close proximity of the urethral meatus to the anus and shorter urethra, is a likely factor [22-26]. Many other factors have been thought to predispose women to RUTIs, such as voiding patterns pre- and post-coitus, wiping technique, wearing tight undergarments, deferred voiding habits and vaginal douching; nevertheless, there has been no proven association [16]. Although, genital hygiene practices such as frequency of coitus, urinating after coitus, washing genitals precoitus, male partner washing genitals precoitus,…

  • Dengue Protection and Cure: Bangladesh Perspective

    Up to 50-100 million infections are now estimated to occur annually in over 100 endemic countries, putting almost half of the world’s population at risk. Bangladesh is one of the countries that are affected by dengue viruses. Dengue is a viral infection caused by four types of viruses (DENV-1, DENV-2, DENV-3, DENV-4) belonging to the Flaviviridae family. These mosquitoes thrive in areas with standing water, including puddles, water tanks, containers and old tires. Lack of reliable sanitation and regular garbage collection also contribute to the spread of the mosquitoes. The disease has probably been known since the Chinese described it in 420 AD. Outbreaks are increasing although there is no human-to-human transfer, only mosquito-to-human viral transfer. Africans described “ka dinga pepo” as cramp-like seizure caused by an evil spirit. The Spanish may have changed “dinga” to dengue since it means fastidious or careful in Spanish, which describes the gait of people trying to reduce the pain of walking. With the number of patients rising, hospitals outside Dhaka are facing huge challenges to cope with the pressure, mostly due to lack of diagnosis chemicals, kits and other medical support.