Envolvimento dos pais da criança com paralisia cerebral na intervenção terapêutica

Dissertação de mest. em Psicologia da Educação na especialidade Necessidades Educativas Especiais, Faculdade de Ciências Humanas e Sociais, Escola Superior de Educação, Univ. do Algarve, 2002

Discrepância posterior e sua relação com o padrão de crescimento facial hiperdivergente

Poster apresentado na XXVII Reunião Científica Anual da SPODF. Figueira da Foz, 23-25 Abril 2015

Intervenção psicomotora por terras de Moçambique : crianças com paralisia cerebral e jovens com DID, uma realidade escondida

O presente documento, criado no âmbito da Unidade Curricular de Atividade de Aprofundamento de Competências Profissionais, do Mestrado em Reabilitação Psicomotora, apresenta o trabalho desenvolvido no Centro de Reabilitação Psicossocial, das Irmãs Hospitaleiras em Maputo – Moçambique. O processo de intervenção psicomotora foi desenvolvido com jovens/adultos com Dificuldades Intelectuais e Desenvolvimentais e crianças com Paralisia Cerebral ou Atraso Global do Desenvolvimento, durante 8 meses. A intervenção concretizou-se em sessões de grupo e individuais em contexto de atividade motora, terapias expressivas, desenvolvimento pessoal e social com os jovens/adultos e em contexto de promoção do desenvolvimento psicomotor, atividades psicopedagógicas e terapias expressivas com as crianças, com objetivo de promoção de bem-estar, qualidade de vida, funcionalidade e autonomia dos utentes, tendo em conta o contexto cultural, familiar e as potencialidades, dificuldades e interesses. No processo de intervenção estiveram presentes as fases próprias da prática terapêutica, observação, conhecimento e criação de relação empática com os utentes, avaliação inicial, processo de intervenção planeado, avaliação final e comparação dos resultados com avaliação inicial e reflexão sobre o mesmo. É ainda apresentado um projeto de investigação centrado no estudo das atitudes da comunidade do Bairro das Mahotas perante a população com Dificuldade Intelectual e Desenvolvimental.

Cayler Cardio-Facial Syndrome: An Uncommon Condition in Newborns

Introduction: Cayler cardio-facial syndrome is a rare syndrome associated with asymmetric crying faces with congenital heart disease. We report a newborn that was diagnosed as case of Cayler Cardio-facial syndrome based on clinical features and was confirmed with FISH analysis. Case Presentation: A term male baby, born to non-consanguineous couple through normal vaginal delivery was diagnosed to have asymmetric crying faces with deviation of angle of mouth to left side at the time of birth. The baby had normal faces while sleeping or silent. Mother was known case of hypothyroidism and was on treatment. Baby was diagnosed as case of Cayler Cardio-facial Syndrome and was investigated with echocardiogram, brain ultrasound, total body X-ray examination, X-ray of cervico-thoracic vertebral column and fundus examination. Echocardiogram showed muscular VSD, brain ultrasound was normal and fundus examination showed tortuous retinal vessels. Whole body X-ray and lateral X-ray of cervico-thoracic vertebral column were not suggestive of any skeletal abnormalities. The other associated malformation was right ear microtia. Baby FISH karyotype analysis showed deletion of 22q11.2 deletion. Baby was discharged and now on follow-up. Conclusions: Cayler syndrome is a rare syndrome which must be suspected if a baby has asymmetrical cry pattern and normal facies when baby sleeps. Patient must be evaluated with echocardiography to find out associated cardiac malformations. These infants should undergo FISH analysis for 22q11.2 deletion syndrome.

Estandarización de estudios de sangre periférica para reevaluar resultados de biometrías automatizadas y concordancia en dos laboratorios

Implementar las 41 reglas, validadas por el Consenso de la Sociedad Internacional de Hematólogos de Laboratorio, revisando los resultados de biometrías automatizadas con estudio visual de sangre periférica en dos laboratorios de Ecuador; Investigación de tests diagnósticos en 502 sujetos, 395 de primera vez y 107 repeticiones. Las muestras de sangre y los extendidos en placa se obtuvieron y analizaron en Hematología-Laboratorio de Cuenca desde 22 de octubre hasta 12 de noviembre de 2007. El mismo día se envió las respectivas alícuotas y sus frotis a NetL@b en Quito para su revisión y homologación de procedimientos. Se hicieron chequeos delta, combinaciones para definir concordancia, tablas de verdad e indicadores de eficiencia diagnostica. Los deltas porcentuales establecieron datos con un nivel de repetibilidad superior al 90. Kappa dio valores inferiores al 40. Las medianas de los indicadores para los grupos de comparación fueron: sensibilidad, 76; falsos positivos, 17; falsos negativos, 4; valores predictivos positivos, 21; valores predictivos negativos, 81. La implementación de las reglas validadas por el Consenso de la International Society of Laboratory Hematologists fue viable así como las comparaciones entre los laboratorios participantes. La repetibilidad y concordancia fueron aceptables, reconociendo limitaciones tecnológicas y tomando en cuenta la baja prevalencia de enfermedad en los sujetos analizados. Es recomendable que los laboratorios participantes mantengan las reglas validadas en su trabajo diario. Otros laboratorios deberían adoptar las recomendaciones del Consenso

Estudo do comportamento parental face à criança com paralisia cerebral

Dissertação de Mestrado apresentada no Instituto Superior de Psicologia Aplicada para obtenção de grau de Mestre na especialidade de Psicologia Clínica

Unmasking of the trigemino-accessory reflex in accessory facial anastomosis

To evaluate the possible blink reflex responses in facial muscles reinnervated by the accessory nerve. Method: Eleven patients with a complete facial palsy were submitted to a surgical repair by an accessory facial nerve anastomosis (AFA). In this pathological group, blink reflex was studied by means of percutaneous electrical stimulation of the supraorbital nerve and recording from the orbicularis oculi muscle. A control group comprised seven normal people and seven patients with a complete Bell's facial palsy; in this group, responses on the sternocleidomastoideus (SCM) muscles were studied after supraorbital nerve stimulation. Results: All the patients with AFA showed a consistent degree of facial reinnervation. Ten out of the 11 patients with AFA showed reflex responses; in six, responses were configured by a double component pattern, resembling the R1 and R2 components of the blink reflex; three patients had an R1-like response and one patient showed a unique R2 component. Mean values of latencies were 15.2 (SD 4.6) ms for the R1 and 85.3 (SD 9.6) ms for the R2. In the control group, eight out of 14 people had evidence of reflex responses in the SCM muscles; these were almost exclusively configured by a bilateral late component (mean latency 63.5 (SD 15.9) ms) and only one of the subjects showed an early response at 11 ms. Conclusion: The trigemino-accessory reflex response in the pathological group was more complex and of a significantly higher incidence than in the control group. These differences could be tentatively explained by a mechanism of synaptic plasticity induced by the impairment of the efferent portion of the reflex. This could unmask the central linking between the trigeminal and the accessory limbs of the reflex. The findings described could be a demonstration of neurobionomic function in the repairing process of the nervous system.

La retroalimentación facial y su efecto en la evaluación de publicidad de humor

La hipótesis de retroalimentación facial planteada por Tomkins en 1962 sustenta que la activación de algunos músculos faciales envía información sensorial al cerebro y se induce entonces una experiencia emocional en el sujeto. Partiendo de dicha teoría y de investigaciones que la sustentan, el presente estudio se propuso confirmar el efecto de la emoción inducida a través de la retroalimentación facial sobre la evaluación de cinco tipos de humor en publicidad. Para ello se realizó un experimento con 60 hombres y 60 mujeres, que fueron asignados aleatoriamente a una de dos condiciones: estimulación de sonrisa –músculos hacia arriba- o inhibición de sonrisa –músculos hacía abajo-, mientras evaluaban 16 imágenes de publicidad de humor. A partir del análisis de los resultados se encontraron diferencias significativas entre las condiciones; en línea con la hipótesis formulada, los participantes expuestos a la condición estimulación de sonrisa –músculos hacía arriba- evaluaron más positivamente los comerciales. También se encontraron diferencias significativas en función del sexo y los tipos de humor evaluados. El estudio ofrece evidencia empírica de la teoría propuesta hace más de medio siglo y su efecto en el ámbito de la publicidad actual.

Seeing emotions in others: Improving cognitive and neuronal mechanisms of facial expression processing

In the conceptual framework of affective neuroscience, this thesis intends to advance the understanding of the plasticity mechanisms of other’s emotional facial expression representations. Chapter 1 outlines a description of the neurophysiological bases of Hebbian plasticity, reviews influential studies that adopted paired associative stimulation procedures, and introduces new lines of research where the impact of cortico-cortical paired associative stimulation protocols on higher order cognitive functions is investigated. The experiments in Chapter 2 aimed to test the modulatory influence of a perceptual-motor training, based on the execution of emotional expressions, on the subsequent emotion intensity judgements of others’ high (i.e., full visible) and low-intensity (i.e., masked) emotional expressions. As a result of the training-induced learning, participants showed a significant congruence effect, as indicated by relatively higher expression intensity ratings for the same emotion as the one that was previously trained. Interestingly, although judged as overall less emotionally intense, surgical facemasks did not prevent the emotion-specific effects of the training to occur, suggesting that covering the lower part of other’s face do not interact with the training-induced congruence effect. In Chapter 3 it was implemented a transcranial magnetic stimulation study targeting neural pathways involving re-entrant input from higher order brain regions into lower levels of the visual processing hierarchy. We focused on cortical visual networks within the temporo-occipital stream underpinning the processing of emotional faces and susceptible to plastic adaptations. Importantly, we tested the plasticity-induced effects in a state dependent manner, by administering ccPAS while presenting different facial expressions yet afferent to a specific emotion. Results indicated that the discrimination accuracy of emotion-specific expressions is enhanced following the ccPAS treatment, suggesting that a multi-coil TMS intervention might represent a suitable tool to drive brain remodeling at a neural network level, and consequently influence a specific behavior.

Doença arterial periférica: prevenção e recomendações

O material é componente do Curso de Especialização em Saúde da Pessoa Idosa da UNA-SUS/UFMA (Unidade 04, do módulo 03). Trata-se de um recurso educacional interativo que apresenta as formas de prevenção da Doença Arterial Periférica (DAP) e algumas recomendações de uso de medicamentos.

Controle da Pressão Arterial, Débito Cardíaco e RVP (resistência vascular periférica)

Vídeo demonstrativo de esquema fisiopatológico do controle da pressão arterial, débito cardíaco e RVP

Melhora da Atenção ao Controle de Câncer de Colo do Útero e de Mama na ESF Central Periférica Zona Oeste, São Gabriel, RS

COBAS Guerra, Acralys. Melhora a atenção ao controle e prevenção do câncer de colo de útero e de mama na ESF Central Periférica Zona Oeste, São Gabriel/RS. Trabalho de conclusão de Curso (Curso de Especialização em Saúde da Família) - Departamento de Medicina Social, Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, 2015. A Equipe nº5 da ESF Central Periférica Zona Oeste, São Gabriel/RS no período de 12 semanas desenvolveu uma intervenção na comunidade que,fez que o equipe interagiu diretamente com as pessoas da comunidade , com o objetivo de melhorar a atenção ao controle e prevenção do câncer de colo de útero e de mama das mulheres entre 24 e 69 anos da área de abrangência. A intervenção teve ações contempladas em quatro eixos pedagógicos: organização e gestão dos serviços, qualificação da prática clínica, engajamento público e monitoramento e avaliação. Os dados para monitoramento e avaliação foram coletados com ajuda da Planilha de Coleta de Dados e Ficha Espelho elaboradas pela UFPel. Como não tínhamos dados para o preenchimento do CAP tivemos dificuldade para a análise situacional frente a esta ação programática e nisto adotamos para avaliação dos indicadores de cobertura as estimativas da Planilha de coleta de dados que eram de 3820 de mulheres na faxia etária entre 24 e 64 anos e 1535 entre 50 e 69 anos. Ainda assim adotamos como meta ampliação da cobertura de detecção precoce de câncer de colo de útero das mulheres entre 25 e 64 anos para 85%, e do câncer de mama das mulheres entre 50 a 69 anos para 95% da área de abrangência. Durante a intervenção foram acompanhadas 130 mulheres entre 25 e 64 anos, e 31 mulheres entre 50 e 69 anos. As mulheres cadastradas estão com exame clínico em dia de acordo com o protocolo para câncer de mama e útero. Para todas as mulheres na fazia etária entre 24 e 69 anos cadastradas, alcançamos as metas: capacitação de todos os temas de Câncer de colo de útero e Câncer de mama e DST feita para os agentes comunitários e enfermeiros. Mesmo não dispondo de sala reservada para os nossos treinamentos, conseguimos local na unidade que foi utilizado para as reuniões e capacitações. Fizemos atividades com as mulheres na faixa etária compreendida entre os 24 e 69 anos. Na UBS e na comunidade. Realizamos os exames de mamas em todas as mulheres na faixa etária entre50 e 69 anos, durante as consultas. Mediante esta intervenção a comunidade ganhou um atendimento organizado e sistematizado de acordo com o protocolo adotado. A equipe conseguiu um maior vínculo com a comunidade e estas ações e metas priorizadas durante a intervenção estão no cotidiano de trabalho da equipe.

Comparison Of Postoperative Stability Of Three Rigid Internal Fixation Techniques After Sagittal Split Ramus Osteotomy For Mandibular Advancement.

The aim of this investigation was to compare the skeletal stability of three different rigid fixation methods after mandibular advancement. Fifty-five class II malocclusion patients treated with the use of bilateral sagittal split ramus osteotomy and mandibular advancement were selected for this retrospective study. Group 1 (n = 17) had miniplates with monocortical screws, Group 2 (n = 16) had bicortical screws and Group 3 (n = 22) had the osteotomy fixed by means of the hybrid technique. Cephalograms were taken preoperatively, 1 week within the postoperative care period, and 6 months after the orthognathic surgery. Linear and angular changes of the cephalometric landmarks of the chin region were measured at each period, and the changes at each cephalometric landmark were determined for the time gaps. Postoperative changes in the mandibular shape were analyzed to determine the stability of fixation methods. There was minimum difference in the relapse of the mandibular advancement among the three groups. Statistical analysis showed no significant difference in postoperative stability. However, a positive correlation between the amount of advancement and the amount of postoperative relapse was demonstrated by the linear multiple regression test (p < 0.05). It can be concluded that all techniques can be used to obtain stable postoperative results in mandibular advancement after 6 months.

Temporomandibular Dysfunction Post-craniotomy: Evaluation Between Pre- And Post-operative Status.

To identify risk factors associated with post-operative temporomandibular joint dysfunction after craniotomy. The study sample included 24 patients, mean age of 37.3 ± 10 years; eligible for surgery for refractory epilepsy, evaluated according to RDC/TMD before and after surgery. The primary predictor was the time after the surgery. The primary outcome variable was maximal mouth opening. Other outcome variables were: disc displacement, bruxism, TMJ sound, TMJ pain, and pain associated to mandibular movements. Data analyses were performed using bivariate and multiple regression methods. The maximal mouth opening was significantly reduced after surgery in all patients (p = 0.03). In the multiple regression model, time of evaluation and pre-operative bruxism were significantly (p < .05) associated with an increased risk for TMD post-surgery. A significant correlation between surgery follow-up time and maximal opening mouth was found. Pre-operative bruxism was associated with increased risk for temporomandibular joint dysfunction after craniotomy.

Perception Of Oral And Maxillofacial Surgeons, Orthodontists And Laypersons In Relation To The Harmony Of The Smile.

Harmony is one of the main objectives in surgical and orthodontic treatment and this harmony must be present in the smile, as well as in the face. The aim of the present study was to assess the perceptions of professionals and laypersons in relation to the harmony of the smile of patients with or without vertical maxillary alterations. Sixty observers (oral and maxillofacial surgeons, orthodontists and laypersons) reported the degree of harmony of six smiles using an objective questionnaire and the participants indicated if there was a need for corrective surgery or not. The classification of observers was recorded on a Likert scale from 1 to 5. Mixed regression was used to determine differences between the three groups. Statistically significant differences were found only for the harmony of the smile between the oral and maxillofacial surgeons and laypersons, with laypersons being more critical when assessing the smile. There was no statistical difference between the other groups for the harmony of the smile or the indication of corrective surgery. The patterns of greater or lesser harmony determined by observers during the smile were similar to those found in the literature as the ideal standard in relation to vertical maxillary positioning. Laypersons had a tendency to be more critical in relation to facial harmony than surgeons, although no statistical differences were found in the other groups in relation to the harmony of the smile or indication for the corrective surgery. In addition, the patterns of greater or lesser harmony of the smile determined by the participants were similar to those found in the literature as the ideal standard in relation to vertical maxillary positioning. Overall, the present study demonstrates that adequate interaction between surgeons, orthodontists and laypersons is essential in order to achieve facial harmony with orthodontic and/or surgical treatment. Opinion of specialists and laypersons about the smile in relation to the vertical positioning of the maxilla.