institucionalização de pessoas com paralisia cerebral: a difícil relação sujeito - OUTRO - linguagem

Na Fonoaudiologia há trabalhos que exploram uma gama de questões relativas ao atendimento de pessoas com Paralisia Cerebral. Praticamente todos são orientados por vertentes organicistas ou sócio-cognitivas. A ausência de oralização, muito frequente em casos graves, talvez tenha um papel nesse caso: pesquisadores e profissionais concluem que se não há fala, a pessoa está fora da linguagem. Supõe-se a pessoa, contudo, capacidades perceptuais e cognitivas, mas não linguísticas. Sob esse raciocínio, a linguagem e seus efeitos sobre o sujeito são ignorados. É exceção neste quadro tradicional uma discussão que teorize de modo consistente sobre linguagem e sobre sujeito (Vasconcellos 1999 e 2010; Dudas 2009). Em outras palavras, são raríssimas as pesquisas que se distanciam do discurso organicista e do sujeito epistêmico. O presente artigo toma a direção da exceção mencionada para refletir sobre a institucionalização de pessoas com Paralisa Cerebral e sobre efeitos subjetivos e clínicos

Medición de la profundidad anestésica y memoria durante anestesia general mediante el cerebral state monitor (csm x06)

Este es un ensayo clínico controlado realizado en 327 pacientes ASA II, sometidas a cesárea, distribuidas aleatoriamente en dos grupos iguales para identificar las variaciones hemodinámicas y nivel metamérico, al aplicar Anestesia Intratecal con Lidocaína Isobárica al 2(AILI) comparada con Lidocaína Hiperbárica al 5(AILH), ambas a dosis de 80 mg. Resultados: la AILI, se mantuvo en determinadas metámeras sin sustancial variabilidad, comportamiento totalmente contrario a la AILH. Las diferencias estadísticas en la presión sistólica, diastólica, y frecuencia cardiaca, entre ambos tipos de anestesia no fueron significativas. La hipotensión se presentó en 32,9con AILI, y 54con AILH; siendo tratada con 2,26 mg (ñ 3.65) y 3,93 mg (ñ 4,26) de efedrina respectivamente. (p> 0.05). Con AILI se presentaron 4 casos de bloqueo raquídeo alto más dificultad respiratoria y, con AILH 3 casos, de los cuales solo 2 presentaron dificultad respiratoria. Conclusión: la AILI produce un bloqueo nervioso más predecible que la AILH. Los valores hemodinámicos y la incidencia de complicaciones, entre ambos anestésicos fueron semejantes

An Unusual Case of Cerebral Oedema

Hereditary angioedema (HAE) is a rare genetic disorder transmitted as an autosomal dominant trait, characterized by reduced plasma concentration or by the presence of non-functional C1 esterase inhibitor. Oedema caused by HAE mostly affects the skin and bowel and can induce swelling of genitalia. Oedema can be life threatening if it causes swelling of the larynx with obstruction of the airways. We describe the case of a 52-year-old man who presented a neurological emergency (coma), where the remarkable localization of the clinical manifestation and the unusual symptomatology hindered the correct diagnosis.

El cuidado de niños con parálisis cerebral : experiencias de las enfermeras de una clínica privada del distrito de Chiclayo, 2015

Tesis de pregrado

As respostas sociais para o estudante do ensino superior com paralisia cerebral

Dissertação apresentada à Escola Superior de Educação de Paula Frassinetti para obtenção do grau de mestre em intervenção comunitária, especialização em contextos de risco

Disseminated Cerebral and Intradural Extramedullary Spinal Nocardiosis in an Immunocompetent Patient

Disseminated nocardiosis of the central nervous system (CNS) has been rarely reported, especially in the immunocompetent patient. We report a case of cerebral and cervical intradural extramedullary nocardiosis likely to have been the result of disseminated spread from a pulmonary infective focus. Attempts at tissue biopsy and culture of the initial cerebral and pulmonary lesions both failed to yield the diagnosis. Interval development of a symptomatic intradural extramedullary cervical lesion resulted in open biopsy and an eventual diagnosis of nocardiosis was made. We highlight the diagnostic dilemma and rarity of spinal nocardial dissemination in an immunocompetent individual.

Increased CSF Aβ during the very early phase of cerebral Aβ deposition in mouse models

Abnormalities in brains of Alzheimer's disease (AD) patients are thought to start long before the first clinical symptoms emerge. The identification of affected individuals at this 'preclinical AD' stage relies on biomarkers such as decreased levels of the amyloid-β peptide (Aβ) in the cerebrospinal fluid (CSF) and positive amyloid positron emission tomography scans. However, there is little information on the longitudinal dynamics of CSF biomarkers, especially in the earliest disease stages when therapeutic interventions are likely most effective. To this end, we have studied CSF Aβ changes in three Aβ precursor protein transgenic mouse models, focusing our analysis on the initial Aβ deposition, which differs significantly among the models studied. Remarkably, while we confirmed the CSF Aβ decrease during the extended course of brain Aβ deposition, a 20-30% increase in CSF Aβ40 and Aβ42 was found around the time of the first Aβ plaque appearance in all models. The biphasic nature of this observed biomarker changes stresses the need for longitudinal biomarker studies in the clinical setting and the search for new 'preclinical AD' biomarkers at even earlier disease stages, by using both mice and human samples. Ultimately, our findings may open new perspectives in identifying subjects at risk for AD significantly earlier, and in improving the stratification of patients for preventive treatment strategies.

Amphetamine increases blood pressure and heart rate but has no effect on motor recovery or cerebral haemodynamics in ischaemic stroke: a randomized controlled trial (ISRCTN 36285333)

Amphetamine enhances recovery after experimental ischaemia and has shown promise in small clinical trials when combined with motor or sensory stimulation. Amphetamine, a sympathomimetic, might have haemodynamic effects in stroke patients, although limited data have been published. Subjects were recruited 3-30 days post ischaemic stroke into a phase II randomised (1:1), double blind, placebo-controlled trial. Subjects received dexamphetamine (5mg initially, then 10mg for 10 subsequent doses with 3 or 4 day separations) or placebo in addition to inpatient physiotherapy. Recovery was assessed by motor scales (Fugl-Meyer, FM), and functional scales (Barthel index, BI and modified Rankin score, mRS). Peripheral blood pressure (BP), central haemodynamics and middle cerebral artery blood flow velocity were assessed before, and 90 minutes after, the first 2 doses. 33 subjects were recruited, age 33-88 (mean 71) years, males 52%, 4-30 (median 15) days post stroke to inclusion. 16 patients were randomised to placebo and 17 amphetamine. Amphetamine did not improve motor function at 90 days; mean (standard deviation) FM 37.6 (27.6) vs. control 35.2 (27.8) (p=0.81). Functional outcome (BI, mRS) did not differ between treatment groups. Peripheral and central systolic BP, and heart rate, were 11.2 mmHg (p=0.03), 9.5 mmHg (p=0.04) and 7 beats/minute (p=0.02) higher respectively with amphetamine, compared with control. A non-significant reduction in myocardial perfusion (Buckberg Index) was seen with amphetamine. Other cardiac and cerebral haemodynamics were unaffected. Amphetamine did not improve motor impairment or function after ischaemic stroke but did significantly increase BP and heart rate without altering cerebral haemodynamics.

Sonic hedgehog signaling regulates mode of cell division of early cerebral cortex progenitors and increases

The morphogen Sonic Hedgehog (SHH) plays a critical role in the development of different tissues. In the central nervous system, SHH is well known to contribute to the patterning of the spinal cord and separation of the brain hemispheres. In addition, it has recently been shown that SHH signaling also contributes to the patterning of the telencephalon and establishment of adult neurogenic niches. In this work, we investigated whether SHH signaling influences the behavior of neural progenitors isolated from the dorsal telencephalon, which generate excitatory neurons and macroglial cells in vitro. We observed that SHH increases proliferation of cortical progenitors and generation of astrocytes, whereas blocking SHH signaling with cyclopamine has opposite effects. In both cases, generation of neurons did not seem to be affected. However, cell survival was broadly affected by blockade of SHH signaling. SHH effects were related to three different cell phenomena: mode of cell division, cell cycle length and cell growth. Together, our data in vitro demonstrate that SHH signaling controls cell behaviors that are important for proliferation of cerebral cortex progenitors, as well as differentiation and survival of neurons and astroglial cells.

Sim! Tenho paralisia cerebral - um estudo de caso

Relatório de Investigação apresentado à Escola Superior de Educação de Paula Frassinetti para obtenção do grau de Mestre em Educação Pré-Escolar e Ensino do 1º CEB.

Todos os sentidos no coração: Estudo de caso de intervenção precoce em criança com paralisia cerebral

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