Visual dependence after vestibular rehabilitation by virtual reality in individuals with unilateral peripheral vestibular dysfunction – one year of results

Introduction One of the most common approaches in individuals with unilateral peripheral vestibular dysfunction (UPVD) is vestibular rehabilitation (RV). Many factors can negatively affect the result of RV. Virtual reality based treatment may represent an important tool in the solution of these problems. In individuals with UPVD there is a decrease in the reception of vestibular stimuli and there is an adjustment in the reception of visual and proprioceptive stimuli. They use more visual cues to minimise the decrease in vestibular stimuli – visual dependence (VD). Although the importance and results of virtual reality as a tool in improving balance in individuals with UPVD have already been demonstrated, we intend to demonstrate that virtual reality allows significant improvements in the decrease in VD.

Objectives The aim of the study is to compare VD levels in individuals with UPVD after RV program by virtual reality.

Methodology For the evaluation of VD, dynamic posturography was performed with the Balance Rehabilition Unit equipment for 39 people with UPVD, before and after the RV program by virtual reality. Ten conditions were tested, with different visual and propriocetive stimuli. The parameters considered were the oscillation area of the pressure centre and the sway velocity.

Results In the parameter of the oscillation area of the pressure centre, statistically significant results were found in the 10 conditions tested. In the sway velocity parameter, statistically significant results were found in the condition 1, 2, 3, 4, 5 e 10.

Conclusion Virtual reality incorporated in the RV programs presents itself as an important tool in improving VD in individuals with UPVD.

Papilar topografy and morphology of the tongue in the E. sexcinctus

Introduction: The Six-banded armadillo (Euphractussexcintus) belongs to Cigunlata order, has diverse feeding habits and masticatory apparatus developed. The tongue, one of the major components of this equipment, has the mucosa papillae, taste buds and tongue glands. Materials and Methods: Six-banded armadillo were submitted to an anesthetic protocol with Tiletamine and zolazepan (Telazol®, Fortdotge, Brazil) and Sodium Thiopental (Thiopentax®, Cristália, Brazil), we proceeded to euthanasia using Potassium Chloride 19.1%, to then fix them in a 10% formaldehyde solution. The tongues were dissected and identified structures. For microscopic processing, segments from different parts of the tongue were subjected to histological routine and stained with hematoxylin-eosin and Masson. Results: The tongue of the six-banded armadillo presents three types of papillae: filiform, fungiform and vallate, with no conical buds and foliate. Still in the tongue mucosa, was observed mucous glands and various taste corpuscles. Some data differ from those same found in other wild animals that have been studied, but are similar to those of the same phylogenetic. Conclusion: The morphological characteristics of the six-banded armadillo's tongue are adapted to the difficulties faced by him during chewing, requiring the tongue, structures that provide you mobility, strength and sensitivity.

Generalisation of a procedure for computing transcription factor profiles

The limited amount of quantitative experimental data generated from life-science experiments poses a major challenge in systems biology. The reason for this is that many systems approaches, such as parameter estimation, simulation and sensitivity analysis make use of models or analyse quantitative data. However, these techniques are only of limited use if only qualitative or semi-quantitative information is available about a system. Therefore procedures that generate quantitative data from experiments in the life sciences can greatly expand the use of systems approaches to biological problems. This study addresses this issue as it introduces a procedure that computes quantitative transcription factor profiles from fluorescent microscopy data collected from green fluorescent protein (GFP) reporter cells. This technique forms a generalisation of a method that has recently been introduced for monitoring NF-B profiles. The contribution made in this work is that the assumption that the transcription factor profile exhibits damped oscillations is relaxed, as transcription factors, other than the previously investigated NF-B, may exhibit different profiles. This is achieved by investigating a variety of potential profiles and solving the inverse problem for the model describing transcription, translation and activation of GFP for each one. The transcription factor profile that results in the best fit among the potential candidates, for the measured fluorescent intensity data, is then chosen as the most likely concentration profile. The technique is illustrated in two detailed case studies, where one case study involves simulation data whereas the other one uses experimentally derived fluorescent intensity data.

A prospective evaluation of the incidence of bacteremia associated with EUS-guided fine-needle aspiration

BACKGROUND

Endoscopic ultrasound (EUS)--guided fine-needle aspiration (FNA) is frequently performed for diagnostic evaluation of lesions in or near the gastrointestinal (GI) tract. Little data exist concerning possible infectious complications associated with EUS-guided FNA. This prospective evaluation was undertaken to determine the frequency of bacteremia and infectious complications associated with EUS-guided FNA.

METHODS

All patients undergoing EUS-guided FNA for any indication were enrolled in this study. Patients who required antibiotic prophylaxis as per the American Heart Association or American Society for Gastrointestinal Endoscopy guidelines were excluded from the study as were patients with cystic lesions, patients with advanced liver disease/ascites and those with human immunodeficiency virus/acquired immune deficiency syndrome. Blood cultures were obtained 30 and 60 minutes after the EUS-FNA. Patients were monitored for evidence of infection after procedure including telephone follow-up of each subject 1 week after procedure.

RESULTS

One hundred patients underwent EUS-FNA of 108 lesions. All blood cultures were negative except in 6 patients in whom 1 of 2 bottles were positive for coagulase negative Staphylococcus, which was considered a contaminant. There were no complications of acute febrile illness, abscess or other infections.

CONCLUSION

EUS-guided FNA was not associated with bacteremia or infectious complications.

Promoting independent task performance by persons with severe developmental disabilities through a new computer-aided system

This study involved two experiments. In Experiment 1, a computer-aided system for promoting task performance by 6 persons with severe developmental disabilities was compared with a card system. The computer-aided system was portable and presented pictorial task instructions (one instruction per step) and prompts. In Experiment 2, the same system was used, but the number of instruction occasions was reduced. In one condition, the system presented all the instructions used in Experiment 1 but mostly in clusters rather than individually. In another, the system presented part of the Experiment 1 instructions. Three Experiment 1 participants also served in Experiment 2. Experiment 1 results indicated all 6 participants had higher percentages of correct steps with the computer system and preferred it to the card system. Experiment 2 results indicated that the condition in which the instructions were clustered was more effective for maintaining correct task performance. Implications of the findings were discussed.

Results of the surgical treatment of chronic atrial fibrillation

OBJECTIVE

Report clinical experience in surgical treatment of atrial fibrillation (AF) by Cox-maze procedure.

METHODS

61 patients underwent surgical treatment for AF. Two had primary AF and 59 AF secondary to heart disease (2 atrial septal defects, 57 mitral). Ages ranged from 20 to 74 years (mean = 49). There were 44 females (72%). The surgical technique employed was Cox 3 without cryoablation. The patients were follow-up in specific at patient clinics and underwent periodical ECG, exercise tests, echocardiogram and Holter monitoring.

RESULTS

In-hospital mortality was 4.9% and late mortality 1.6%. A temporary pacemaker was used in 28 (46%) and a definitive in 7 patients (11.4%). On hospital discharge, AF remained in 17%; 63.9% had sinus rhythm, 6.9% atrial rhythm, 1.7% junctional rhythm, and 10.3% had pacemaker rhythm. In the last evaluation, AF was present in 19.5%; (70.5% sinus rhythm, 4% atrial rhythm, 2% atrial tachycardia, and 4% pacemaker rhythm). There was no report of thromboembolic episodes. Chronotropic response was considered adequate in 19%, intermediate in 29%, and inadequate in 42%. In Holter monitoring, the mean heart rate was 82 +/- 8 bpm, with a minimum of 57 +/- 7 bpm and maximum of 126 +/- 23 bpm, with supraventricular extrasystoles in 2.3 +/- 5.5% of the total heartbeats and ventricular extrasystoles in 0.8 +/- 0.5%. In the echocardiogram, the A wave was present in the left atrium in 87.5%.

CONCLUSION

Maze procedure is effective and has acceptable surgical risk. Atrial or sinus rhythms remain stable with a small but remarkable frequency of atrial and ventricular arrhythmias. Left atrial contraction is present, although attenuated, as well as the chronotropic response to exercise.

Evaluation of the heart rate and arrhythmias following the maze procedure for chronic atrial fibrillation

PURPOSE

To assess the presence and the prevalence of arrhythmias and the variability of the heart rate in the medium-term postoperative period following the maze procedure for chronic atrial fibrillation (AF).

METHODS

Seventeen patients with a mean age of 51.7 +/- 12.9 years, who previously underwent the maze procedure without cryoablation for chronic atrial fibrillation, were evaluated with the 24 hour electrocardiogram (ECG)--Holter monitoring from the 6th month after the operation. Valvular and coronary procedures were concomitantly performed.

RESULTS

The mean heart rate during Holter monitoring was 82 +/- 8 bpm; the maximal heart rate was 126 +/- 23 bpm and the minimal heart rate 57 +/- 7 bpm. Sinus rhythm was found in 10 (59%) patients and atrial rhythm was found in 7 (41%). Supraventricular extrasystoles had a rate of 2.3 +/- 5.5% of the total number of heartbeats and occurred in 16 (94%) patients. Six (35%) patients showed nonsustained atrial tachycardia. Ventricular extrasystoles, with a rate of 0.8 +/- 0.5% of the total heartbeats, occurred in 14 (82%) patients. The chronotropic competence was normal in 9 (53%) patients and attenuated in 8 (47%). The atrioventricular conduction (AV) was unchanged in 13 (76%) patients and there were 4 (24%) cases of first degree atrioventricular block (AVB).

CONCLUSION

After the maze procedure, the values for the mean heart rate, AV conduction and chronotropic competence approach the normal range, although some cases show attenuation of the chronotropic response, first degree AV block or benign arrhythmias.

Evaluation of a computer-aided system providing pictorial task instructions and prompts to people with severe intellectual disability

The present study extended the evaluation of a computer-aided system providing pictorial instructions and prompts to promote task performance in people with severe intellectual disability. Four people were presented with two sets of tasks. The participants used the computer-aided system for one set and a card (control) system for the other. The results indicate that the computer-aided system was more effective than the card system with all participants. Three of the participants preferred the computer-aided system, while one favoured the card system.

MRI appearance of AIDS subacute encephalopathy

A case of biopsy documented subacute encephalopathy of AIDS was evaluated by CT and MRI. CT scanning revealed ventriculomegaly and ill-defined nonspecific periventricular white matter hypodensities. MRI, however, demonstrated extensive unequivocal diffuse white matter disease as the cause of the ventriculomegaly. MRI findings in this patient support the preliminary suggestion that MRI is more useful than computed tomography (CT) in demonstrating AIDS subacute encephalopathy.