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Abstract Aims To evaluate the feasibility of a transthoracic echocardiogram using an apical-subcostal protocol in invasive mechanical ventilation (IMV) and prone position. Methods Prospective study of adults who required a prone position during IMV. A pillow was placed only under the left hemithorax in the prone position to elevate and ease the apical and subcostal windows. A critical care cardiologist (prone group) acquired and evaluated the images using the apical-subcostal protocol. Besides, we used ambulatory echocardiograms performed as a comparative group (supine group). Results 86 patients were included, 43 in the prone and 43 in the supine. In the prone group, the indication to perform an echocardiogram was hemodynamic monitoring. All patients were ventilated with protective parameters, and the mean end-expiratory pressure was 10.6 cmH2O. The protocol was performed entirely in 42 of 43 patients in the prone group because one patient did not have any acoustic window. In the 43 patients in the prone group analyzed and compared to the supine group, global biventricular function was assessed in 97.7% (p = 1.0), severe heart valve disease in 88.4% (p = 0.055), ruled out of the presence of pulmonary hypertension in 76.7% (p = 0.80), pericardial effusion in 93% (p = 0.12), and volume status by inferior vena cava in 93% (p = 0.48). Comparing prone versus supine position, a statistical difference was found when evaluating the left ventricle apical 2-chamber view (65.1 versus 100%, p

The distinct clinical and radiological characteristics of right temporal variant FTD have only been recently recognized. Methods: Eight patients with right temporal variant FTD were prospectively recruited and underwent a standardised neuropsychological assessment, clinical MRI, and quantitative neuroimaging. Results: Our voxelwise grey analyses captured bilateral anterior and mesial temporal grey matter atrophy with a clear right-sided predominance. Bilateral hippocampal involvement was also observed, as well as disease burden in the right insular and opercula regions. White matter integrity alterations were also bilateral in anterior temporal and sub-insular regions with a clear right-hemispheric predominance. Extra-temporal white matter alterations have also been observed in orbitofrontal and parietal regions. Significant bilateral but right-predominant thalamus, putamen, hippocampus, and amygdala atrophy was identified based on subcortical segmentation. The clinical profile of our patients was dominated by progressive indifference, decline in motivation, loss of interest in previously cherished activities, incremental social withdrawal, difficulty recognising people, progressive language deficits, increasingly rigid routines, and repetitive behaviours. Conclusions: Right temporal variant FTD has an insidious onset and may be mistaken for depression at symptom onset. It manifests in a combination of apathy, language, and behavioural features. Quantitative MR imaging captures a characteristic bilateral but right-predominant temporal imaging signature with extra-temporal frontal and parietal involvement.

IntroductionHospitalized children diagnosed with SARS-CoV-2-related conditions are at risk for new or persistent symptoms and functional impairments. Our objective was to analyze post-hospital symptoms, healthcare utilization, and outcomes of children previously hospitalized and diagnosed with acute SARS-CoV-2 infection or Multisystem Inflammatory Syndrome in Children (MIS-C).MethodsProspective, multicenter electronic survey of parents of children

A 70 year old left-handed man presented to his general practitioner with abnormal left arm movements, left hemianopia and loss of balance. He was found to have an isolated brachiocephalic artery aneurysm, measuring 3.5 cm, with associated plaque rupture, contributing to recurrent episodes of transient ischemic attack. He was discussed extensively by a multidisciplinary team. e concurrently had complete occlusion of the right internal carotid artery with distal reconstitution in its supraclinoid segment from collaterals. Stenting of the region would necessitate inappropriately covering the right vertebral artery which would further compromise intracerebral blood. Surgical intervention was deemed the only safe option and he was thus accepted for cardiothoracic surgery. Standard workup revealed left anterior descending artery stenosis. He underwent coronary artery bypass grafting, left atrial appendectomy and brachiocephalic artery resection with replacement with a interposition graft with 10 mm polytetrafluoroethylene graft. He recovered well. This case demonstrates the multi-disciplinary decision making in a rare cause of embolic stroke.

Vitamin D deficiency is prevalent in pediatric patients presenting for hematopoietic stem cell transplantation (HSCT) and has been linked to poor clinical outcomes. Using the data from a randomized control trial, in this paper we explore the effects of vitamin D supplementation on circulating cytokine levels during pediatric HSCT (www.clinicaltrials.gov as NCT03176849). A total of 41 children, 20 received Stoss therapy and 21 children received standard of care vitamin D supplementation. Levels of 25(OH)D and 20 cytokines were assessed at baseline and day +30. Significantly (P < 0.05) higher levels of mostly proinflammatory cytokines, FGF, GCSF, TNFα, IL-2, IL-6, IP10 were detected pre-transplant for patients with low compared to those with normal vitamin D levels. In sex stratified models that compare changes in cytokines between Stoss vs. standard of care, females in the Stoss group show greater changes in mostly pro -inflammatory cytokines- IP-10 (P = 0.0047), MIG (P = 0.009), and RANTES (P = 0.0047), IL-2R (P = 0.07) and IL-6(P = 0.069). Despite a small sample size, these findings suggest vitamin D deficiency affects the pre-transplant cytokine milieu and higher doses of vitamin D (Stoss therapy) appears to influence proinflammatory cytokine responses in a sex specific manner during pediatric HSCT. Larger clinical trials are warranted to validate these results.

Abstract Background Hospitalisation during the last weeks of life when there is no medical need or desire to be there is distressing and expensive. This study sought palliative care initiatives which may avoid or shorten hospital stay at the end of life and analysed their success in terms reducing bed days. Methods Part 1 included a search of literature in PubMed and Google Scholar between 2013 and 2018, an examination of governmental and organisational publications plus discussions with external and co-author experts regarding other sources. This initial sweep sought to identify and categorise relevant palliative care initiatives. In Part 2, we looked for publications providing data on hospital admissions and bed days for each category. Results A total of 1252 abstracts were reviewed, resulting in ten broad classes being identified. Further screening revealed 50 relevant publications describing a range of multi-component initiatives. Studies were generally small and retrospective. Most researchers claim their service delivered benefits. In descending frequency, benefits identified were support in the community, integrated care, out-of-hours telephone advice, care home education and telemedicine. Nurses and hospices were central to many initiatives. Barriers and factors underpinning success were rarely addressed. Conclusions A wide range of initiatives have been introduced to improve end-of-life experiences. Formal evidence supporting their effectiveness in reducing inappropriate/non-beneficial hospital bed days was generally limited or absent. Trial registration N/A

Bioremediation is an active process for the detoxification of polluted ambient media employing the metabolism of microbes, while natural attenuation relies on physical, chemical and biological processes occurring without human intervention. A shallow aquifer (A0) was treated using a bioremediation approach through the amendment of whey to detoxify the most abundant contaminants: 1,1,2,2- tetrachloroethane (1,1,2,2-TeCA), perchloroethene (PCE) and trichloroethene (TCE). A deeper aquifer (A1), showing lower concentration of the contaminants, was left untreated. In A0, a concomitant decrease of more chlorinated molecules 1,1,2,2-TeCA, PCE and TCE and an increase of less halogenated molecules such as trichloroethane (1,1,2-TCA), cis-dichloroethene (cis-DCE) and vinyl chloride (VC) were observed, suggesting that a reductive dechlorination took place. In contrast, the aquifer A1 did not show a significant decrease of contaminants during this period. A metagenomic approach (shot gun and 16S rRNA gene) was then used to investigate the microbial population of the two aquifers. A massive presence of the dehalogenator Dehalococcoides mccartyi (D. mccartyi) and a spectrum of different Geobacter species were detected in A0, after the treatment. The metagenome assembly of shotgun (SG) data further indicated a significant presence of methanogenic archaea, most likely from class Methanomassiliicoccales, at a level comparable to that of D. mccartyi. Instead, A1 was characterized by the species Burkholderia, Curvibacter and Flavobacterium. These results indicate that the autochthonous microbial consortia reflected the geochemistry of the two aquifers, with a dominant population thriving in an anoxic and nutrient rich environment implicated in reductive dehalogenation in A0 and a more diverse population, not able to decompose the pollutants, in A1.

Salmonella spp. is a leading cause of gastrointestinal enteritis in humans where it is largely contracted via contaminated poultry and pork. Phages can be used to control Salmonella infection in the animals, which could break the cycle of infection before the products are accessible for consumption. Here, the potential of 21 myoviruses and a siphovirus to eliminate Salmonella in vitro and in vivo was examined with the aim of developing a biocontrol strategy to curtail the infection in poultry and swine. Together, the phages targeted the twenty-three poultry and ten swine prevalent Salmonella serotype isolates tested. Although individual phages significantly reduced bacterial growth of representative isolates within 6 h post-infection, bacterial regrowth occurred 1 h later, indicating proliferation of resistant strains. To curtail bacteriophage resistance, a novel three-phage cocktail was developed in vitro, and further investigated in an optimized Galleria mellonella larva Salmonella infection model colonized with representative swine, chicken and laboratory strains. For all the strains examined, G. mellonella larvae given phages 2 h prior to bacterial exposure (prophylactic regimen) survived and Salmonella was undetectable 24 h post-phage treatment and throughout the experimental time (72 h). Administering phages with bacteria (co-infection), or 2 h post-bacterial exposure (remedial regimen) also improved survival (73–100% and 15–88%, respectively), but was less effective than prophylaxis application. These pre-livestock data support the future application of this cocktail for further development to effectively treat Salmonella infection in poultry and pigs. Future work will focus on cocktail formulation to ensure stability and incorporation into feeds and used to treat the infection in target animals.

IFMIF-DONES (International Fusion Materials Irradiation Facility - DEMO-oriented Neutron Source) is currently being developed in the frame of the EUROfusion Early Neutron Source work package (WPENS), based on the results achieved in the ongoing IFMIF/EVEDA (Engineering Validation and Engineering Design Activities) project by Japan and Europe in the frame of the Braoder Approach (BA) agreement. The neutron source's limited product of “irradiation volume × neutron fluence” on one hand and the large potential test matrix (defined by number of material grades, test types, irradiation- and test temperature levels and damage dose levels) on the other hand, require a careful selection of test conditions by collaborative effort of the communities of DEMO designers, fusion materials science and the irradiation facility designers. This paper describes achievable irradiation conditions in the High Flux Test Module (HFTM) of IFMIF-DONES, characterized by levels and gradients of irradiation temperatures and nuclear responses (dpa, H and He production). The HFTM development focuses on 9%-Cr Reduced Activation Ferritic Martensitic steel irradiations, but also the possibilities of tungsten and copper alloy irradiations are explored. Possible specimen arrangements and issues of the Small Specimens Test Technique are also discussed.

Abstract Background We present a group of patients affected by a paediatric onset genetic encephalopathy with cerebral calcification of unknown aetiology studied with Next Generation Sequencing (NGS) genetic analyses. Methods We collected all clinical and radiological data. DNA samples were tested by means of a customized gene panel including fifty-nine genes associated with known genetic diseases with cerebral calcification. Results We collected a series of fifty patients. All patients displayed complex and heterogeneous phenotypes mostly including developmental delay and pyramidal signs and less frequently movement disorder and epilepsy. Signs of cerebellar and peripheral nervous system involvement were occasionally present. The most frequent MRI abnormality, beside calcification, was the presence of white matter alterations; calcification was localized in basal ganglia and cerebral white matter in the majority of cases. Sixteen out of fifty patients tested positive for mutations in one of the fifty-nine genes analyzed. In fourteen cases the analyses led to a definite genetic diagnosis while results were controversial in the remaining two. Conclusions Genetic encephalopathies with cerebral calcification are usually associated to complex phenotypes. In our series, a molecular diagnosis was achieved in 32% of cases, suggesting that the molecular bases of a large number of disorders are still to be elucidated. Our results confirm that cerebral calcification is a good criterion to collect homogeneous groups of patients to be studied by exome or whole genome sequencing; only a very close collaboration between clinicians, neuroradiologists and geneticists can provide better results from these new generation molecular techniques.

The mechanism of gender disparity in cutaneous melanoma incidence remains unclear. Steroid hormones including estrogens have long been implicated in the course of melanoma, but the conclusion is controversial. Estrogen receptors (ERs) and insulin-like growth factor 1 receptor (IGF1R) show extensive crosstalk in cancer development, but how the ER/IGF1R network impacts melanoma is currently unclear. Here we studied the melanoma associations of selected SNPs from the ER/IGF1R network. Part of the International Genes, Environment, and Melanoma (GEM) cohort was used as a discovery set, and the Gene Environment Association Studies Initiative (GENEVA) dataset served as a validation set. Based on the associations with other malignant disease conditions, thirteen single nucleotide polymorphism (SNP) variants in ESR1, ESR2, IGF1, and IGF1R were selected for candidate gene association analyses. The rs1520220 in IGF1 and rs2229765 in IGF1R variants were significantly associated with melanoma risk in the GEM dataset after Benjamini-Hochberg multiple comparison correction, although they were not validated in the GENEVA set. The discrepancy may be caused by the multiple melanoma characteristics in the GEM patients. Further analysis of gender disparity was carried out for IGF1 and IGF1R SNPs in the GEM dataset. The GG phenotype in IGF1 rs1520220 (recessive model) presented an increased risk of melanoma (OR = 8.11, 95% CI: 2.20, 52.5, p = 0.006) in men but a significant opposite effect in women (OR = 0.15, 95% CI: 0.018, 0.86, p = 0.045). The AA genotype in IGF1R rs2229765 (recessive model) showed a significant protective effect in men (OR = 0.24, 95% CI: 0.07, 0.64, p = 0.008) and no effect in women. Results from the current study are warranted for further validation.

OBJETIVOS: verificar o desempenho nas habilidades auditivas de atenção seletiva e memória auditiva de idosos protetizados e relacioná-lo com o grau e configuração de perda auditiva, o gênero e a idade. MÉTODO: foram avaliados 29 idosos de 60 a 84 anos, sendo 17 (58,62%) do gênero feminino e 12 (41,38%) do gênero masculino. As avaliações realizadas incluíram meatoscopia, audiometria tonal liminar e aplicação do teste SSW em português. RESULTADOS: a análise dos dados permitiu verificar que, neste grupo de indivíduos, a idade e o grau de perda auditiva influenciaram significantemente nos escores obtidos na avaliação do processamento auditivo, diferentemente das demais variáveis. Os idosos que apresentaram perda auditiva de grau leve com configuração horizontal obtiveram escores significantemente superiores na avaliação do processamento auditivo comparados com os portadores de perda auditiva de grau moderado com configuração horizontal ou grau moderado com configuração descendente. Idosos pertencentes a faixa etária de 60-69 obtiveram desempenho superiormente significante comparado com idosos na faixa etária de 80-89 CONCLUSÃO: concluiu-se que o grau de perda auditiva e a idade influenciam nos resultados da avaliação do processamento auditivo. O gênero e a configuração de perda auditiva não foram fatores determinantes na avaliação do processamento auditivo.

OBJETIVO: avaliar a relação entre o gênero e o nível de desenvolvimento dos sistemas responsáveis pelo equilíbrio postural em crianças de seis a dez anos de idade. MÉTODO: composto por 282 crianças, divididas em três grupos:geral (meninas e meninos), feminino com 146 crianças, e masculino composto por 136 crianças na faixa etária entre os seis e os dez anos de idade. Para avaliação do equilíbrio postural utilizou-se a posturografia dinâmica foam-laser que avalia os sistemas sensoriais por meio de seis testes distintos. Os dados foram submetidos à estatística descritiva e a testes conforme a normalidade dos dados. RESULTADOS: nos Testes de Organização Sensorial, pode-se observar que os valores encontrados para as meninas foram maiores que os valores encontrados para meninos nas variáveis Teste de Organização Sensorial I e na Média destes. Porém, esses valores para os grupos de meninos e meninas foram inferiores aos valores de referência da Foam-Laser Posturography para adultos. Quando foi realizada a comparação entre os gêneros dentro de cada faixa etária, foram observadas diferenças estatisticamente significantes no Teste de Organização Sensorial I aos oito anos de idade, no Teste de Organização Sensorial V aos nove anos e no Teste de Organização Sensorial VI e na Média dos Testes de Organização Sensorial aos oito anos. CONCLUSÃO: o equilíbrio postural de meninas foi melhor que nos meninos, mas ambos os grupos tiveram valores inferiores aos considerados normais em adultos indicando que a maturação neuronal dos sistemas responsáveis pelo equilíbrio postural ainda não está completa.

The objective of this study was to investigate the influence of pain on postural control in women with neck pain and the relationship with possible changes in sensory systems and posture. The neck pain group was composed of women, aged between 20 and 50years, complaining of neck pain for more than three months; the control group was composed of women without complaints of neck pain. For the characterization of the groups, we used anamnesis, neck disability index and Visual Analogue Scale. Postural balance was assessed on force platform. Postural balance with manipulation of the sensory systems was measured by Foam Laser Dynamic Posturography, exposing the individual to six sensory organization tests. Posture was assessed by the Postural Assessment Software. The normality of the variables were verified using Shapiro-Wilk test, Student’s t-test and Mann-Whitney test for comparison between groups, with a significance level of5%. Groups were homogeneous in demographic variables. We observed higher amplitude and displacement velocity of the center of pressure in the neck pain group, showing greater postural balance. There were significant diferences incraniovertebral angle, showing forward head posture in symptomatic women. In dynamics posturography, we observed a difference between the groups: the score obtainedin the six sensory conditions showed that neck pain group presented greater balance impairment. Neck pain and forward head posture have a deleterious effect on postural control in symptomatic women, both in the static posture and dynamic posture.

O objetivo foi verificar a influência da dor no controle postural de mulheres com dor cervicale a relação com as possíveis alterações nos sistemas sensoriais e postura corporal.O grupo dor cervical foi composto por mulheres, entre 20 e 50 anos, com dor cervicalpor mais de três meses e o grupo controle por 20 mulheres sem dor cervical. Para caracterização, utilizaram-se anamnese, índice de incapacidade cervical e Escala Visual Analógica. O equilíbrio postural foi avaliado por uma plataformade força. O equilíbrio com manipulação dos sistemas sensoriais foi avaliado pela posturografia dinâmica Foam-laser, expondo o indivíduo a seis testes de organização sensorial. A postura foi avaliada pelo Software de Avaliação Postural. Normalidade das variáveis verificada pelo teste de Shapiro Wilk etestes t de Student e Mann Whitney para comparação entre grupos, nível de significânciade 5%. Os grupos apresentaram homogeneidade nas variáveis demográficas. No equilíbrio postural, observou-se maior amplitude e velocidade de deslocamento do centro de pressão no grupo dor cervical, demonstrando maior oscilação postural. Houve diferença significativa no ângulo crâniovertebral, mostrando anteriorização da cabeça nas mulheres sintomáticas. Na posturografia dinâmica,observou-se diferença entre os grupos sendo que o escore obtido nas seiscondições sensoriais demonstrou que o grupo dor cervical apresentou maior comprometimento do equilíbrio. Dor cervical e postura anteriorizada da cabeçatêm efeito deletério no controle postural de mulheres sintomáticas, tanto na postura estática quanto na postura dinâmica.

OBJETIVO: destacar possíveis relações entre respiração oral e o sistema auditivo central de crianças em idade escolar, a partir da análise das habilidades auditivas de resolução temporal integração e separação binaural, atenção dividida, memória auditiva e fechamento auditivo. MÉTODOS: estudo em 102 escolares, entre 8 e 12 anos. Grupo I composto por 52 crianças com respiração oral e 50 crianças formaram o grupo II, com respiração nasal. Foram utilizados testes de Fala Filtrada, Teste de Padrões de Freqüência e Dicótico de Dissílabos Alternados (SSW). Os resultados dos testes foram analisados em relação ao tipo de habilidade alterada e sua ocorrência em crianças com respiração oral. Além de uma análise quanto à possível relação entre os testes e as ocorrências de alterações mais freqüentes entre os mesmos. RESULTADOS: indivíduos do grupo I obtiveram maior freqüência de alterações de grau severo e moderado. Comprovou-se diferença estatisticamente significante entre os grupos para as condições de: orelhas esquerda e direita competitiva, alteração relacionada a organização e integração auditiva, fechamento auditivo e padrão temporal. Não ocorreu diferença estatisticamente significante nos resultados da relação entre testes. CONCLUSÃO: crianças com respiração oral apresentam desempenho inferior nas habilidades do processamento auditivo do que crianças com padrão respiratório normal.PURPOSE: to highlight the possible relationships between mouth breathing and central auditory system of school-age children, based on an analysis of the auditory abilities of temporal resolution, binaural separation and integration, divided attention, auditory memory and closure. METHODS: a study of 102 school children, between 8 and 12-year old. Group I was composed of 52 children with mouth breathing and group II was composed of 50 children with nose breathing. The evaluation was carried out using Filtered Speech tests, Pitch Pattern Sequence and Alternating Staggered Spondaic Word. RESULTS: Subjects from Group I had higher frequency of severe and moderate alterations. A statistically significant difference occurred between the groups for the left and right competitive ear, changes related to organization and auditory integration, auditory closure abilities and temporal patterns. There was no statistically significant difference in the relationship among the tests. CONCLUSION: the performance on the tests for auditory processing was associated to the type of breathing.

OBJETIVO: avaliar o equilíbrio corporal de indivíduos expostos a ruído ocupacional em uma indústria gráfica. Trata-se de um estudo descritivo, retrospectivo. MÉTODOS: a medição objetiva do equilíbrio corporal foi realizada pelo método de Posturografia Dinâmica, utilizando-se o protocolo de Testes de Integração Sensorial. Foram avaliadas as respostas de 34 indivíduos do sexo masculino, divididos em dois grupos, sendo 16 trabalhadores expostos ao ruído com idade de 45,81 ± 7,38 anos e 16 indivíduos sem exposição ao ruído ocupacional com idade de 41,31 ± 5,58 anos. O tempo médio de exposição foi de 20,00 ± 8,46 anos. Os resultados foram comparados utilizando-se o teste t, considerando-se como diferença estatística significante o valor de p menor ou igual a 0,05. RESULTADOS: todas as análises mostraram diferenças estatisticamente significantes entre os grupos, com os indivíduos expostos ao ruído ocupacional apresentando valores rebaixados de equilíbrio corporal em relação aos não expostos. CONCLUSÃO: a exposição ao ruído ocupacional está associada a um pior desempenho na avaliação do equilíbrio, em todas as condições testadas pela Posturografia Dinâmica.PURPOSE: to assess the body balance of individuals exposed to occupational noise in a printing industry. This is a descriptive, retrospective study. METHODS: the objective measurement of body balance was performed by the method of Dynamic Posturography, using the protocol of Sensorial Integration Tests. We evaluated the responses of 34 male subjects, divided into two groups, with 16 workers exposed to noise aged 45.81 ± 7.38 years and 16 subjects with no exposure to occupational noise aged 41.31 ± 5.58 years. The average exposure time was 20.00 ± 8.0046 years. The results were compared using the t test, considering statistically significant differences as the p value less than or equal to 0.05. RESULTS: all tests showed statistically significant differences among the groups, with individuals exposed to occupational noise showing demoted values of body balance in relation to non-exposed ones. CONCLUSION: the occupational noise exposure is associated with a worse performance in the assessment of balance in all conditions tested by Dynamic Posturography.

A avaliação otoneurológica consiste em exames para investigação de patologias auditivas e vestibulares, incluindo o potencial evocado de tronco encefálico e a vectoeletronistagmografia. OBJETIVO: Descrever os resultados da avaliação otoneurológica em pacientes com queixas vestibulococleares, normo-ouvintes e com perda auditiva, comparados a grupo-controle. MATERIAL E MÉTODOS: Estudo transversal, retrospectivo, observacional, realizado com 56 pacientes vertiginosos avaliados por audiometria, vectoeletronistagmografia e potencial evocado auditivo de tronco encefálico, divididos em grupo A, 31 pacientes normo-ouvintes, e grupo B, 25 pacientes com perda auditiva, comparados ao grupo-controle constituído por dez voluntários normo-ouvintes assintomáticos. RESULTADOS: Os pacientes dos grupos A e B apresentaram aumento em monobloco das latências absolutas das ondas I, III e V estatisticamente significante, quando comparados ao grupo-controle, embora com valores dentro da normalidade. A ausência da onda I a 80 dBNA foi um achado comum para ambos os grupos e ocorreu em quatro (12,9%) sujeitos bilateralmente e em três (9,6%) unilateralmente no grupo A e em oito (32%) pacientes no grupo B bilateralmente. Nos dois casos em que a vectoeletronistagmografia acusou alteração vestibular central não ocorreram alterações nos parâmetros dos potenciais evocados. CONCLUSÃO: Os pacientes com vertigem, normo-ouvintes e com perda auditiva, apresentaram latências absolutas aumentadas quando comparados a grupo-controleOtoneurological evaluations are based on tests which investigate auditory and vestibular disorders, including brainstem evoked auditory potentials and vecto-electronystagmography. AIM: to describe the results from the otoneurological assessment of patients with vestibulocochlear complaints, normal hearing individuals and patients with hearing loss, and we will compare them to a control group. MATERIALS AND METHODS: Cross-sectional, retrospective, observational study, held with 56 dizzy patients assessed by means of audiometry, vecto-electronystagmography and brainstem evoked auditory potential, broken down into Group A, with 31 normal-hearing individuals and Group B with 25 hearing loss patients, compared to the control group made up of ten normal-hearing asymptomatic individuals. RESULTS: Patients from groups A and B were compared to the Control Group, although with values within the normal range. A common finding for both groups was the lack of wave I at 80 dBHL and it happened bilaterally in four individuals (12.9%) and unilaterally in three (9.6%) for Group A; and bilaterally in eight individuals from Group B (32%). In the two cases in which vecto-electronystagmography showed central vestibular alteration, there were no changes to the evoked potential parameters. CONCLUSION: patients with vertigo, normal-hearing and hearing loss individuals had increased absolute latencies when compared to the Control Group

O alcoolismo é uma doença crônica que consiste em um estado de intoxicação causado pelo consumo de álcool. Os sinais e sintomas frequentemente encontrados são entre outros: instabilidade ao andar, tontura e descoordenação psicomotora. OBJETIVO: Verificar a influência do alcoolismo no equilíbrio postural. MATERIAL E MÉTODOS: Este é um estudo prospectivo; a amostra compreendeu 32 indivíduos para o grupo experimental, frequentadores do grupo de Alcoólicos Anônimos da cidade de Santa Maria-RS e 32 indivíduos não alcoólicos para o grupo controle. Os indivíduos foram submetidos à avaliação otorrinolaringológica, avaliação do equilíbrio estático e dinâmico e provas cerebelares, avaliação vectoeletronistagmográfica e posturografia dinâmica. RESULTADOS: Constatou-se que a vectoeletronistagmografia mostrou-se normal na maioria dos indivíduos do grupo experimental, indicando que o labirinto e as vias vestíbulo-oculomotoras estariam normais e que o distúrbio do equilíbrio por eles apresentado seria decorrente de disfunção em outras áreas do sistema nervoso central ou periférico. Na posturografia dinâmica constatou-se que alcoólicos abstinentes apresentam alterações significantes do equilíbrio postural quando comparados com indivíduos não alcoólicos. CONCLUSÃO: O álcool tem influência deletéria no equilíbrio corporal.Alcoholism is a chronic condition, consisting on a state of intoxication caused by the consumption of alcohol beverages. Frequently found signs and symptoms are: gait instability, dizziness and lack of psychomotor coordination, among others. AIM: to study the influence of alcoholism on postural balance. MATERIALS AND METHODS: this is a prospective study. The sample comprehended 32 individuals in the experimental group, members of the Alcoholic Anonymous Group of the city of Santa Maria-RS and 32 non-alcoholic individuals making up the control group. The individuals were submitted to an otorhinolaryngological evaluation, static and dynamic balance study and cerebellar tests, vecto-electro-nystagmographic evaluation and dynamic posturography. RESULTS: we noticed that the vectoelectronystagmography was normal for most of the individuals in the experimental group, indicating that the labyrinth and the oculomotor-vestibular pathways were normal and that the balance disorder they presented would stem from the dysfunction in other areas of the central or peripheral nervous system. In the dynamic posturography we noticed that alcoholics who were not drinking presented significant alterations in their postural balance when compared to non-alcoholic individuals. CONCLUSION: alcoholic beverages have a deleterious influence on body balance.

As disfunções hormonais presentes na mulher durante a gravidez podem causar desordens vestibulares e/ou cocleares. OBJETIVO: Verificar a ocorrência de queixas auditivas e vestibulares em gestantes. MATERIAL E MÉTODO: Este é um estudo prospectivo no qual participaram 82 gestantes. Para pesquisa das queixas auditivas e vestibulares foi aplicado às gestantes o Protocolo de Anamnese proposto por Castagno (1994). RESULTADOS: Pode-se observar que o zumbido foi a queixa auditiva mais citada (33%), sem diferença entre os trimestres gestacionais. A queixa de tontura esteve presente em 52,44% das gestantes e principalmente no primeiro trimestre gestacional. Quanto aos sintomas relacionados à tontura, no primeiro trimestre o mais frequente foi a vertigem, já no segundo trimestre gestacional foi a instabilidade e o desequilíbrio ao caminhar e no terceiro trimestre gestacional foi a instabilidade seguida da tendência a cair. A náusea é o principal sintoma associado à tontura nas gestantes, sendo mais frequente no primeiro trimestre gestacional. CONCLUSÃO: Mulheres durante a gestação referem queixas auditivas e vestibulares, principalmente tontura e zumbido.Hormonal dysfunctions in women during pregnancy can cause vestibular and/or cochlear disorders. AIM: to study hearing and vestibular complaints in pregnant women. MATERIAL AND METHOD: this is a prospective study. 82 pregnant women participated on this study. For hearing and vestibular complaints, a questionnaire proposed by Castagno (1994) was employed. RESULTS: we could observe that tinnitus was the main auditory complaint (33%), although with no differences between the groups. Tinnitus was present among 52.44% of the pregnant women, mainly in the Group 2. According to symptoms related to dizziness, vertigo was the main auditory complaint in first trimester, whereas instability and gait unbalance were more frequent in the second trimester, and instability and tendency to fall in the third trimester. Nausea was the main symptom associated with dizziness in pregnant women, being more frequent in the first trimester of gestation. CONCLUSIONS: women during gestation have auditory and vestibular complaints, mainly dizziness and tinnitus.

TEMA: processamento auditivo em idosos. OBJETIVO: estudar, através de uma revisão teórica, o processamento auditivo em idosos, as desordens que o envelhecimento auditivo causam, bem como os recursos para reduzir as defasagens nas habilidades auditivas envolvidas no processamento auditivo. CONCLUSÃO: vários são os desajustes ocasionados pela desordem do processamento auditivo em idosos. É necessária a continuidade de estudos científicos nessa área para aplicar adequadas medidas intervencionistas, a fim de garantir a reabilitação do indivíduo a tempo de minimizar os efeitos da desordem auditiva sobre o mesmo.BACKGROUND: auditory processing in elderly. PURPOSE: to promote a theoretical approach on auditory processing in elderly people, the disorders caused by hearing aging, as well as the resources to minimize the auditory aging impairment of the hearing abilities involved in the auditory processing. CONCLUSION: the alterations caused by auditory processing disorder in elderly people are many. It is necessary to continue researching in this field in order to apply adequate interventionist measures, in order to assure the rehabilitation of the individual in time to minimize the effects of the hearing disorder.

RESUMO Com o envelhecimento, o corpo humano passa por um período de transformações que geram declínio de algumas capacidades físicas, tais como o equilíbrio. Este estudo objetivou comparar o equilíbrio corporal de idosos praticantes de hidroginástica e indivíduos adultos sedentários em diferentes bases de apoio, com a manipulação da visão. Foram avaliados 20 idosos praticantes de hidroginástica e 15 adultos sedentários. O equilíbrio foi coletado por meio de uma plataforma de força AMTI. As bases de apoio estudadas foram pés juntos, pés na largura do quadril e pé direito com afastamento anterior. O tempo de aquisição dos dados para cada tentativa foi de 10 segundos, a uma freqüência de 100Hz. Para comparação dos dados, foi utilizado teste t com nível de significância de 5%. Comparando-se os grupos, não houve diferença estatisticamente significativa no equilíbrio nas três posições de bases de apoio, com e sem a utilização da informação visual, com exceção da variável amplitude do deslocamento do centro de pressão na direção médio-lateral, com os pés juntos e com os olhos abertos. Quando a informação visual foi manipulada, indivíduos de ambos os grupos apresentaram diferença estatisticamente significativa para a maioria das variáveis, destacando assim a importância da informação visual para idosos, mesmo estando-se fisicamente ativo. Inferiu-se, com os resultados obtidos, que a hidroginástica é um exercício recomendado para os idosos, uma vez que estes não se mostraram diferentes aos indivíduos mais novos, em relação ao equilíbrio corporal. Mas a hidroginástica não se mostrou favorável para melhorias na utilização do sistema visual.

OBJETIVO: avaliar o processamento auditivo de militares expostos a ruído ocupacional. MÉTODOS: foram avaliados 41 militares, com exposição a ruído superior a 10 anos, subdivididos em Grupo A (n =16), sem perda auditiva e Grupo B (n = 25), com perda auditiva. Foram realizadas avaliação audiológica básica e testes de processamento auditivo (testes de Fala Filtrada, SSW em Português e de Padrão de Freqüência). RESULTADOS: observou-se altas incidências de alteração de processamento auditivo, especialmente no teste de Fala Filtrada (43,75% e 68% nos grupos A e B, respectivamente) e teste de Padrão de Freqüência (68,75% e 48%, nos grupos A e B, respectivamente). O teste SSW não se mostrou eficiente para avaliar as habilidades auditivas centrais de indivíduos expostos a elevados níveis de pressão sonora. CONCLUSÃO: a exposição a ruído ocupacional interfere no processamento auditivo de militares. As alterações na via auditiva central podem ser verificadas independente da presença de alteração auditiva periférica.PURPOSE: to evaluate the auditory processing of military personnel exposed to occupational noise. METHODS: 41 servicemen, exposed to noise for at least 10 years were evaluated, divided into Group A (n= 16), without hearing loss and Group B (n= 25), with hearing loss. The following evaluations were carried through: basic audilogic evaluation and auditory processing tests (low-filtered, SSW and Pitch Pattern Sequence tests). RESULTS: there were high incidences of auditory processing alterations, especially at low-filtered test (43.75% and 68% on groups A e B, respectively) and Pitch Pattern Sequence test (68.75% and 48%, on groups A e B, respectively). The SSW test was not efficient to evaluate the central hearing abilities of people exposed to high levels of sound pressure. CONCLUSION: the occupational noise exposure interferes in the auditory processing of military personnel. The alterations on central auditory pathways can be verified even if there is no any alteration on peripheral hearing.

Plant pathogen attacks are perceived through pathogen-issued compounds or plant-derived molecules that elicit defense reactions. Despite the large variety of elicitors, general schemes for cellular elicitor signaling leading to plant resistance can be drawn. In this article, we review early signaling events that happen after elicitor perception, including reversible protein phosphorylations, changes in the activities of plasma membrane proteins, variations in free calcium concentrations in cytosol and nucleus, and production of nitric oxide and active oxygen species. These events occur within the first minutes to a few hours after elicitor perception. One specific elicitor transduction pathway can use a combination or a partial combination of such events which can differ in kinetics and intensity depending on the stimulus. The links between the signaling events allow amplification of the signal transduction and ensure specificity to get appropriate plant defense reactions. This review first describes the early events induced by cryptogein, an elici-tor of tobacco defense reactions, in order to give a general scheme for signal transduction that will be use as a thread to review signaling events monitored in different elicitor or plant models.

OBJETIVOS: verificar o desempenho nas habilidades auditivas de atenção seletiva e memória auditiva de idosos protetizados e relacioná-lo com o grau e configuração de perda auditiva, o gênero e a idade. MÉTODO: foram avaliados 29 idosos de 60 a 84 anos, sendo 17 (58,62%) do gênero feminino e 12 (41,38%) do gênero masculino. As avaliações realizadas incluíram meatoscopia, audiometria tonal liminar e aplicação do teste SSW em português. RESULTADOS: a análise dos dados permitiu verificar que, neste grupo de indivíduos, a idade e o grau de perda auditiva influenciaram significantemente nos escores obtidos na avaliação do processamento auditivo, diferentemente das demais variáveis. Os idosos que apresentaram perda auditiva de grau leve com configuração horizontal obtiveram escores significantemente superiores na avaliação do processamento auditivo comparados com os portadores de perda auditiva de grau moderado com configuração horizontal ou grau moderado com configuração descendente. Idosos pertencentes a faixa etária de 60-69 obtiveram desempenho superiormente significante comparado com idosos na faixa etária de 80-89 CONCLUSÃO: concluiu-se que o grau de perda auditiva e a idade influenciam nos resultados da avaliação do processamento auditivo. O gênero e a configuração de perda auditiva não foram fatores determinantes na avaliação do processamento auditivo.PURPOSE: to verify the performance in the auditory abilities of selective attention and hearing memory of elderly with prosthesis and relate it to the degree and the configuration of hearing loss, the gender and the age. METHOD: 29 elderly people from 60 to 84 years old were evaluated, 17 of them (58,62%) females and 12 (41,38%) males. The evaluations carried out included meatoscopy, audiometry evaluation and the use of the SSW test in Portuguese. RESULTS: the analysis of the data showed that, in this group of individuals, the age and the degree of auditory loss influenced significantly in the scores obtained in the evaluation of the auditory process, unlike the other variables. The elderly that showed light degree with horizontal configuration obtained scores significantly higher than the ones who had auditory loss in moderate degree with horizontal configuration or moderate degree with descending configuration. Elderly belonging to the age range 60 to 69 years old obtained performance significantly superior when compared with the ones in the age range of 80 to 89 years old. CONCLUSION: it was concluded that the degree of hearing loss and the age influenced the evaluation of the auditory processing. The gender and the configuration of hearing loss were not significant determining factors in the evaluation of the auditory processing.

OBJETIVO: avaliar a relação entre o gênero e o nível de desenvolvimento dos sistemas responsáveis pelo equilíbrio postural em crianças de seis a dez anos de idade. MÉTODO: composto por 282 crianças, divididas em três grupos:geral (meninas e meninos), feminino com 146 crianças, e masculino composto por 136 crianças na faixa etária entre os seis e os dez anos de idade. Para avaliação do equilíbrio postural utilizou-se a posturografia dinâmica foam-laser que avalia os sistemas sensoriais por meio de seis testes distintos. Os dados foram submetidos à estatística descritiva e a testes conforme a normalidade dos dados. RESULTADOS: nos Testes de Organização Sensorial, pode-se observar que os valores encontrados para as meninas foram maiores que os valores encontrados para meninos nas variáveis Teste de Organização Sensorial I e na Média destes. Porém, esses valores para os grupos de meninos e meninas foram inferiores aos valores de referência da Foam-Laser Posturography para adultos. Quando foi realizada a comparação entre os gêneros dentro de cada faixa etária, foram observadas diferenças estatisticamente significantes no Teste de Organização Sensorial I aos oito anos de idade, no Teste de Organização Sensorial V aos nove anos e no Teste de Organização Sensorial VI e na Média dos Testes de Organização Sensorial aos oito anos. CONCLUSÃO: o equilíbrio postural de meninas foi melhor que nos meninos, mas ambos os grupos tiveram valores inferiores aos considerados normais em adultos indicando que a maturação neuronal dos sistemas responsáveis pelo equilíbrio postural ainda não está completa.PURPOSE: to evaluate the relation between gender and level of development of responsible systems for postural balance in children between six and ten years old. METHOD: it was composed of 282 children, divided into three groups: general (girls and boys), female (146 children) and male 136 male (children aged between six and ten years old). For the evaluation of postural balance it was used the dynamic posturography assesses laser-foam sensory systems through six different tests. Data were submitted to descriptive statistics and tests according to the normality of the data. RESULTS: in the Sensory Organization Test, it can be observed that the findings for girls were higher than the values found for boys in the variables Sensory Organization Test I and their average. However, these values for the groups of boys and girls were below the reference values of the Foam-Laser Posturography for adults. When it was done the comparison between genders within each age group it was found statistically significant differences in the Sensory Organization Test I for eight year-old, the Sensory Organization Test V for nine year-old and the Sensory Organization Test and Average VI Sensory Organization Test for eight year-old. CONCLUSION: although postural balance was better for girls than boys, both groups had lower values than those considered normal in adults indicating that the systems responsible for postural balance are not mature.

This critical review of research on platform-mediated work argues that platform work studies are too focused on gig and remote work platforms. We introduce a framework that identifies three perspectives on how platforms reorganize work: narrow, broad, and systemic. This framework is used to examine the impact of platform-mediated work on four different aspects of work: management power, work processes, social protection and labor rights, and skills and career prospects. [ABSTRACT FROM AUTHOR]