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Heart rate variability as predictor of mortality in sepsis: A systematic review.
2018
Background Autonomic dysregulation is one of the recognized pathophysiological mechanisms in sepsis, generating the hypothesis that heart rate variability (HRV) can be used to predict mortality in sepsis. Methods This was a systematic review of studies evaluating HRV as a predictor of death in patients with sepsis. The search was performed by independent researchers in PubMed, LILACS and Cochrane, including papers in English, Portuguese or Spanish, indexed until August 20th, 2017 with at least 10 patients. Study quality was assessed by Newcastle-Ottawa Scale. To analyze the results, we divided the articles between those who measured HRV for short-term recordings ( 1 hour), and those who did…
Assessment of the Short-Term Effects after High-Inductive Electromagnetic Stimulation of Pelvic Floor Muscles: A Randomized, Sham-Controlled Study
2020
Background: Physiotherapy should be performed by patients with stress or mixed urinary incontinence (SUI and MUI) to increase the strength and endurance of the pelvic floor muscles (PFMs). A method that can positively affect the pelvic floor is stimulation with high-inductive electromagnetic stimulation (HIES). The aim of the study was to evaluate the PFMs after the application of HIES in women with SUI and MUI by using surface electromyography (sEMG). Methods: This was a prospective, randomized, single-blind study with a sham intervention group. The participants were randomly assigned to the HIES group or sham group. The outcomes were features of the bioelectrical PFM activity assessed usi…
Patients with Minimal Hepatic Encephalopathy Show Altered Thermal Sensitivity and Autonomic Function
2021
Cirrhotic patients may experience alterations in the peripheral nervous system and in somatosensory perception. Impairment of the somatosensory system could contribute to cognitive and motor alterations characteristic of minimal hepatic encephalopathy (MHE), which affects up to 40% of cirrhotic patients. We assessed the relationship between MHE and alterations in thermal, vibration, and/or heat pain sensitivity in 58 cirrhotic patients (38 without and 20 with MHE according to Psychometric Hepatic Encephalopathy Score) and 39 controls. All participants underwent attention and coordination tests, a nerve conduction study, autonomic function testing, and evaluation of sensory thresholds (vibra…
A Multimodal Speech-Gesture Training Intervention for Patients With Schizophrenia and Its Neural Underpinnings – the Study Protocol of a Randomized C…
2020
Dysfunctional social communication is one of the most stable characteristics in patients with schizophrenia that also affects quality of life. Interpreting abstract speech and integrating nonverbal modalities is particularly affected. Considering the impact of communication on social life but failure to treat communication dysfunctions with usual treatment, we will investigate the possibility to improve verbal and non-verbal communication in schizophrenia by applying a multimodal speech-gesture training (MSG training). Here we describe the newly developed MSG training program and the study design for the first clinical investigation. The intervention contains perceptive rating (match/mismat…
Impasse in the management of recurrent basal cell carcinoma of the skull with sagittal sinus erosion
2015
Abstract Basal cell carcinoma (BCC) is a non melanocytic skin cancer that arises from basal cells, affecting commonly fair-skinned human beings. Although the tumor is well known for local recurrences, extension into the intracranial space is reported. A case of a giant BCC of the scalp invading the middle and posterior third of the superior sagittal sinus (SSS) is reported. A 70-year-old male with a basal cell carcinoma history presented with a massive bleeding from the SSS invaded by the tumor. Since the patient refused surgery the bleeding was managed through direct compression by applying a thrombin-based hemostatic agents and sterile dressings. This procedure was performed daily in orde…
Oropharyngeal Hairy Polyp: A Case of Respiratory Failure in a Newborn
2020
Hairy polyps, also known as dermoid polyps (DPs), are rare benign cystic lesions of bigerminal origin that may occur in several head and neck regions, including the oropharynx. Despite their benign histopathological nature, DPs may be life threatening, due to their upper airway location, and DPs represent one of the most unusual causes of respiratory distress during the neonatal period. In this paper, we describe a case of respiratory failure in a newborn with an oropharyngeal mass that was accidentally found during difficult intubation. Magnetic resonance imaging (MRI) detected a well-defined soft tissue pedunculated mass, arising from the left oropharynx wall, consistent with an oropharyn…
Recognition of rapid-eye-movement sleep from single-channel EEG data by artificial neural networks: a study in depressive patients with and without a…
1996
An automatic procedure for the online recognition of REM sleep appears to be a necessary tool for selective REM sleep deprivation in depressive patients. To develop such a procedure we applied an artificial neural network to preprocessed single-channel EEG activity. EOG and EMG information was purposely not provided as input to the network. A generalized back-propagation algorithm was used for computer simulation. The sleep profile scored manually according to Rechtschaffen and Kales served as the desired output during the training period and as standard for the judgement of the network output during working mode. Polysomnographic recordings from 5 healthy subjects were pooled to train the …
The association between quality of care and technical efficiency in long-term care
2005
To analyse the association between quality of care and technical (productive) efficiency in institutional long-term care wards for the elderly.One hundred and fourteen public health centre hospitals and residential homes in Finland.Wards were divided into two categories according to their rank in the quality distribution, considering 41 quality variables separately. The technical efficiency scores of the good- and poor-quality groups were compared using cross-sectional data.Data envelopment analysis was used for calculating technical efficiency. The Mann-Whitney test and correlation coefficients were used to explore the association between quality and efficiency.The wards where quality indi…
Innovation in Neurosurgery: The Concept of Cognitive Mapping
2019
In recent years, advances in cortical-subcortical mapping, intraoperative neurophysiology, and neuropsychology have increased the ability to remove intrinsic brain tumors, expanding indications and maximizing the extent of resection. This has provided a significant improvement in progression-free survival, time of malignant transformation (in low-grade gliomas), and overall survival. Although current techniques enable preservation of language and motor functions during surgery, the maintenance of a complex set of functions defined with the term cognition is not always achievable. Cognition is defined as every neural process underlying a high human function and includes motor haptic and visu…
Fertility protection: complications of surgery and results of removal and transplantation of ovarian tissue
2017
Fertility-preserving measures are becoming important for patients receiving oncological treatment. One method involves cryopreservation of ovarian tissue and transplanting it when treatment is completed. We report complications resulting from surgical and fertility medicine, and the results of procedures for the removal and transplantation of ovarian tissue carried out within the FertiProtekt network. A survey using a structured questionnaire was conducted among the FertiProtekt network centres between November 2015 and June 2016. The analysis included surgical techniques used to remove and transplant ovarian tissue, surgical complications and results. Laparoscopic removal and transplantati…