In this case study, we hypothesized that sympathetic nerve activity would be higher during conversation with PALRO robot, and that conversation would result in an increase in cerebral blood flow near the Broca’s area...In this case study, we hypothesized that sympathetic nerve activity would be higher during conversation with PALRO robot, and that conversation would result in an increase in cerebral blood flow near the Broca’s area. The facial expressions of a human subject were recorded, and cerebral blood flow and heart rate variability were measured during interactions with the humanoid robot. These multimodal data were time-synchronized to quantitatively verify the change from the resting baseline by testing facial expression analysis, cerebral blood flow, and heart rate variability. In conclusion, this subject indicated that sympathetic nervous activity was dominant, suggesting that the subject may have enjoyed and been excited while talking to the robot (normalized High Frequency < normalized Low Frequency: 0.22 ± 0.16 < 0.78 ± 0.16). Cerebral blood flow values were higher during conversation and in the resting state after the experiment than in the resting state before the experiment. Talking increased cerebral blood flow in the frontal region. As the subject was left-handed, it was confirmed that the right side of the brain, where the Broca’s area is located, was particularly activated (Left < right: 0.15 ± 0.21 < 1.25 ± 0.17). In the sections where a “happy” facial emotion was recognized, the examiner-judged “happy” faces and the MTCNN “happy” results were also generally consistent.展开更多
Atrial fibrillation is a cardiac arrhythmia of high prevalence in the population, especially in the elderly. Its main electrical characteristics are the interval between two successive irregular R waves, absence of P ...Atrial fibrillation is a cardiac arrhythmia of high prevalence in the population, especially in the elderly. Its main electrical characteristics are the interval between two successive irregular R waves, absence of P waves and presence of f waves between QRS complexes. The most common symptoms of atrial fibrillation are irregular palpitations associated with dyspnea, dizziness, feeling tired, fatigue and general malaise, but not all patients have any symptoms. The present report presents the history of an elderly patient who arrived at the hospital’s emergency department with irregular heart rhythm and palpitations. The patient’s symptoms, associated with the electrocardiogram results, indicated paroxysmal atrial fibrillation. Electrical cardioversion was performed, and after, cardiac ablation via the femoral vein at the hospital’s cardiology service. There were no complications during the procedure. As a routine imaging exam after ablation, control esophagogastroduodenoscopy was requested to verify that there was no formation of atrio-esophageal fistula developed by the invasive ablation procedure and electrocardiogram, which showed normal sinus rhythm. The patient remained in the cardiac intensive care unit for observation for 24 hours. After the electrical cardioversion and catheter ablation procedures, the patient improved his clinical picture of atrial fibrillation and was discharged after 24 hours of hospitalization. He received treatment to perform at home, to reduce acid reflux into the esophagus and to prevent thrombosis. He did not present pulmonary thromboembolism after hospital discharge. It is believed, therefore, that this form of treatment and management of paroxysmal atrial fibrillation is effective for the solution of the proposed problem and can also serve as a reference for other professionals within the cardiology service.展开更多
Background: Suicide among physicians is a serious public health issue, with an extremely complex and multifactorial behavior. Aim: The aim of this study was to use the theme “Suicide among Physicians” to exemplify t...Background: Suicide among physicians is a serious public health issue, with an extremely complex and multifactorial behavior. Aim: The aim of this study was to use the theme “Suicide among Physicians” to exemplify the analysis of methodological similarities between the scientific content available at MEDLINE and BVS databases, as scientific research tools. Methods: This is a systematic review with metanalysis. The following combinations of keywords were used for data search in the referred databases: “suicide” AND “physicians” AND “public heath”. Results: Three hundred and thirteen publications were identified, but only 16 studies were chosen. Great association was found between MEDLINE and BVS databases and the Odds Ratio regarding the theme: “Suicide among physicians”. Conclusions: Considering the similarities found in the utilization of the two analyzed databases, it was possible to identify that suicide among physicians is associated with the exercise of an important professional role in the society and in the workplace. With regard to scientific information, the p-value-obtained value (<0.05) seems to be statistically significant for the association between the suggested theme and the methodological similarities of the scientific information available in the analyzed databases. Thus, these open-access research tools are considered scientific reliable tools.展开更多
Intensive care units’ acquired muscle weakness is present in approximately 50% of the patients. Although active muscle training can attenuate weakness, a large proportion of critical patients cannot participate in an...Intensive care units’ acquired muscle weakness is present in approximately 50% of the patients. Although active muscle training can attenuate weakness, a large proportion of critical patients cannot participate in any active mobilization. Neuromuscular electrical stimulation may be an alternative strategy to reverse muscle weakness. The objective of the study was to review the scientific publications on the use of neuromuscular electrical stimulation and its parameters and the main results in patients hospitalized in intensive care units. This is an integrative review surveying studies in online databases. The studies were selected from the following descriptors: neuromuscular electrical stimulation AND parameters AND intensive care units AND muscle weakness. The inclusion criteria included articles that addressed the topic of neuromuscular electrical stimulation and the parameters used in patients admitted to intensive care units, aged 18 years or older. Exclusion criteria were studies involving animals, case reports, letters to the editor and book chapters. The search comprised articles in the Portuguese, English and Spanish languages from January 2013 to March 2019. Of the 185 articles identified, nine met the eligibility criteria. The studies were evaluated assessing the level of evidence, and the relevant information was presented in the table and discussed. The parameters of the neuromuscular electrical stimulation employed in the studies showed positive results for the maintenance of strength and muscle mass. There was evidence of benefits in the local and systemic microcirculation, potentially mobilizing endothelial stem cells, to prevent atrophy, to reduce mechanical ventilation time and stay in intensive care unit;and when incorporated into the usual physiotherapy care, proved to be more effective than usual care. Its use is safe and viable in critically ill patients.展开更多
Parotid gland adenocarcinoma is commonly a tumor of low malignancy and low incidence worldwide. The reported case shows the rapid progression of this tumor in an elderly patient and infrequent effects, such as a prese...Parotid gland adenocarcinoma is commonly a tumor of low malignancy and low incidence worldwide. The reported case shows the rapid progression of this tumor in an elderly patient and infrequent effects, such as a presentation of facial edema not commonly described in the medical literature. Patient was admitted to hospital in November 2019 with secretion and partial hearing loss in the right ear and infiltrative and stone lesion with initial skin ulceration in the right cervical region. After 42 days, he returned and was admitted to the intensive care unit with significant swelling of the face, hardened and hyperemic neck, difficulty in speech and inability to open the eye. He presented changes in the mobility of the speech and hearing organs, reduced laryngeal mobility, vocal changes, speech with altered articulation and severe oropharyngeal dysphagia with risk of bronchoaspiration. The patient was diagnosed in September 2019 with a parotid tumor (salivary gland adenocarcinoma T4). The medical team requested computed tomography, computed tomography angiography of the chest and cervical vessels and computed tomography of the neck, in addition to evaluation by the head and neck surgery service and general surgery. After analyzing the results, the medical team suggested a hypothesis of tumor invasion that could result in obstruction of local lymphatic drainage, something unusual in the evolution of this type of tumor. In addition, it was not possible to adhere to radiotherapy treatment due to the extent of the lesion and there was also no confirmation of metastases. The reported case shows us that parotid gland adenocarcinoma, when diagnosed in an advanced stage, can limit the approach to treatment. It was chosen in agreement with the family to proceed with palliative care without invasive measures. Palliative care may be the best option for cases like this, bringing some comfort to the patient and his family.展开更多
文摘In this case study, we hypothesized that sympathetic nerve activity would be higher during conversation with PALRO robot, and that conversation would result in an increase in cerebral blood flow near the Broca’s area. The facial expressions of a human subject were recorded, and cerebral blood flow and heart rate variability were measured during interactions with the humanoid robot. These multimodal data were time-synchronized to quantitatively verify the change from the resting baseline by testing facial expression analysis, cerebral blood flow, and heart rate variability. In conclusion, this subject indicated that sympathetic nervous activity was dominant, suggesting that the subject may have enjoyed and been excited while talking to the robot (normalized High Frequency < normalized Low Frequency: 0.22 ± 0.16 < 0.78 ± 0.16). Cerebral blood flow values were higher during conversation and in the resting state after the experiment than in the resting state before the experiment. Talking increased cerebral blood flow in the frontal region. As the subject was left-handed, it was confirmed that the right side of the brain, where the Broca’s area is located, was particularly activated (Left < right: 0.15 ± 0.21 < 1.25 ± 0.17). In the sections where a “happy” facial emotion was recognized, the examiner-judged “happy” faces and the MTCNN “happy” results were also generally consistent.
基金funded in part by the Coordination of Improvement of Higher Level Personnel—Brazil(CAPES)—Finance Code 001 by the National Council of Scientific and Technological Development—Brazil(CNPq)—Doctorate GDby Research Foundation of the State of Rio Grande do Sul(FAPERGS).
文摘Atrial fibrillation is a cardiac arrhythmia of high prevalence in the population, especially in the elderly. Its main electrical characteristics are the interval between two successive irregular R waves, absence of P waves and presence of f waves between QRS complexes. The most common symptoms of atrial fibrillation are irregular palpitations associated with dyspnea, dizziness, feeling tired, fatigue and general malaise, but not all patients have any symptoms. The present report presents the history of an elderly patient who arrived at the hospital’s emergency department with irregular heart rhythm and palpitations. The patient’s symptoms, associated with the electrocardiogram results, indicated paroxysmal atrial fibrillation. Electrical cardioversion was performed, and after, cardiac ablation via the femoral vein at the hospital’s cardiology service. There were no complications during the procedure. As a routine imaging exam after ablation, control esophagogastroduodenoscopy was requested to verify that there was no formation of atrio-esophageal fistula developed by the invasive ablation procedure and electrocardiogram, which showed normal sinus rhythm. The patient remained in the cardiac intensive care unit for observation for 24 hours. After the electrical cardioversion and catheter ablation procedures, the patient improved his clinical picture of atrial fibrillation and was discharged after 24 hours of hospitalization. He received treatment to perform at home, to reduce acid reflux into the esophagus and to prevent thrombosis. He did not present pulmonary thromboembolism after hospital discharge. It is believed, therefore, that this form of treatment and management of paroxysmal atrial fibrillation is effective for the solution of the proposed problem and can also serve as a reference for other professionals within the cardiology service.
文摘Background: Suicide among physicians is a serious public health issue, with an extremely complex and multifactorial behavior. Aim: The aim of this study was to use the theme “Suicide among Physicians” to exemplify the analysis of methodological similarities between the scientific content available at MEDLINE and BVS databases, as scientific research tools. Methods: This is a systematic review with metanalysis. The following combinations of keywords were used for data search in the referred databases: “suicide” AND “physicians” AND “public heath”. Results: Three hundred and thirteen publications were identified, but only 16 studies were chosen. Great association was found between MEDLINE and BVS databases and the Odds Ratio regarding the theme: “Suicide among physicians”. Conclusions: Considering the similarities found in the utilization of the two analyzed databases, it was possible to identify that suicide among physicians is associated with the exercise of an important professional role in the society and in the workplace. With regard to scientific information, the p-value-obtained value (<0.05) seems to be statistically significant for the association between the suggested theme and the methodological similarities of the scientific information available in the analyzed databases. Thus, these open-access research tools are considered scientific reliable tools.
基金funded in part by the Coordination of Improvement of Higher Level Personnel—Brazil(CAPES)—Finance Code 001by the National Council of Scientific and Technological Development—Brazil(CNPq)—Doctorate GD
文摘Intensive care units’ acquired muscle weakness is present in approximately 50% of the patients. Although active muscle training can attenuate weakness, a large proportion of critical patients cannot participate in any active mobilization. Neuromuscular electrical stimulation may be an alternative strategy to reverse muscle weakness. The objective of the study was to review the scientific publications on the use of neuromuscular electrical stimulation and its parameters and the main results in patients hospitalized in intensive care units. This is an integrative review surveying studies in online databases. The studies were selected from the following descriptors: neuromuscular electrical stimulation AND parameters AND intensive care units AND muscle weakness. The inclusion criteria included articles that addressed the topic of neuromuscular electrical stimulation and the parameters used in patients admitted to intensive care units, aged 18 years or older. Exclusion criteria were studies involving animals, case reports, letters to the editor and book chapters. The search comprised articles in the Portuguese, English and Spanish languages from January 2013 to March 2019. Of the 185 articles identified, nine met the eligibility criteria. The studies were evaluated assessing the level of evidence, and the relevant information was presented in the table and discussed. The parameters of the neuromuscular electrical stimulation employed in the studies showed positive results for the maintenance of strength and muscle mass. There was evidence of benefits in the local and systemic microcirculation, potentially mobilizing endothelial stem cells, to prevent atrophy, to reduce mechanical ventilation time and stay in intensive care unit;and when incorporated into the usual physiotherapy care, proved to be more effective than usual care. Its use is safe and viable in critically ill patients.
基金funded in part by the Coordination of Improvement of Higher Level Personnel—Brazil(CAPES)—Finance Code 001 by the National Council of Scientific and Technological Development—Brazil(CNPq)—Doctorate GDby Research Foundation of the State of Rio Grande do Sul(FAPERGS).
文摘Parotid gland adenocarcinoma is commonly a tumor of low malignancy and low incidence worldwide. The reported case shows the rapid progression of this tumor in an elderly patient and infrequent effects, such as a presentation of facial edema not commonly described in the medical literature. Patient was admitted to hospital in November 2019 with secretion and partial hearing loss in the right ear and infiltrative and stone lesion with initial skin ulceration in the right cervical region. After 42 days, he returned and was admitted to the intensive care unit with significant swelling of the face, hardened and hyperemic neck, difficulty in speech and inability to open the eye. He presented changes in the mobility of the speech and hearing organs, reduced laryngeal mobility, vocal changes, speech with altered articulation and severe oropharyngeal dysphagia with risk of bronchoaspiration. The patient was diagnosed in September 2019 with a parotid tumor (salivary gland adenocarcinoma T4). The medical team requested computed tomography, computed tomography angiography of the chest and cervical vessels and computed tomography of the neck, in addition to evaluation by the head and neck surgery service and general surgery. After analyzing the results, the medical team suggested a hypothesis of tumor invasion that could result in obstruction of local lymphatic drainage, something unusual in the evolution of this type of tumor. In addition, it was not possible to adhere to radiotherapy treatment due to the extent of the lesion and there was also no confirmation of metastases. The reported case shows us that parotid gland adenocarcinoma, when diagnosed in an advanced stage, can limit the approach to treatment. It was chosen in agreement with the family to proceed with palliative care without invasive measures. Palliative care may be the best option for cases like this, bringing some comfort to the patient and his family.
