Rehabilitation of the afasic patient in speech therapy

Aphasias are considered to be neurological linguistic disorders in which the comprehension and/or expression of oral and/or written language is compromised, thus having a significant potential impact on the quality of life of an individual and his / her family. Although much studied in its neurophysiological mechanism, aphasia is not always discussed in terms of rehabilitation. Therefore, this article aims to discuss the scientific production in speech therapy on the rehabilitation of aphasia. For this purpose, an Integrative Review of Literature was carried out, covering the period from 2000 to 2021 on the Scielo and BVS data platforms of articles available in full and in the Portuguese language, using as a descriptor the unitermo "aphasia", in which the articles found were submitted to the relevance tests I and II, in which the final sample made only those that passed the established criteria. A total of 236 articles were found on the Scielo platform, with only 29 discussing rehabilitation and only 5 on speech therapy. In the BVS platform, 98.901 articles were found, but only 86 were discussing deaf aphasia and were available, none of which addressed speech therapy rehabilitation. The electronic search reached a total of 5 relevant articles that included the theme of speech and hearing rehabilitation to the aphasic patient, all of them being from the Scielo platform. Thus, scientific scarcity on the subject of aphasia becomes evident, and it is necessary to invest in production that encapsulate the therapeutic behavior of the speech-language pathologist. As afasias são consideradas distúrbios linguísticos de cunho neurológico em que a compreensão e/ou expressão da linguagem oral e/ou escrita encontra-se comprometida, tendo desta maneira um potencial significativo de impacto na qualidade de vida de um indivíduo e sua família. Embora muito estudada em seu mecanismo neurofisiológico, as afasias nem sempre são discutidas sob o aspecto de reabilitação. Diante disso, este artigo objetiva discutir sobre a produção cientifica em fonoaudiologia sobre a reabilitação da afasia. Para tanto, foi realizada uma Revisão Integrativa da Literatura, contemplando o período de 2000 a 2021 nas plataformas de dados Scielo e BVS de artigos disponíveis na íntegra e no idioma em português, utilizando como descritor o unitermo “afasia”, em que os artigos encontrados foram submetidos aos testes de relevância I e II, em que fizeram a amostra final apenas aqueles que passaram pelos critérios estabelecidos. Foram encontrados na plataforma Scielo o total de 236 artigos, sendo que apenas 29 discutiam sobre reabilitação e apenas 5 sobre terapia fonoaudiológica. Na plataforma BVS foram encontrados 98.901 artigos, porém apenas 86 discutiam sobre afasia de fato e estavam disponíveis, sendo que nenhum abordava a reabilitação fonoaudiológica. A busca eletrônica alcançou o total de 5 artigos relevantes que contemplassem a temática de reabilitação fonoaudiológica ao paciente afásico, sendo todos da plataforma Scielo. Assim, torna-se evidente a escassez científica sobre o tema de afasia, sendo necessário investimentos para produção que embase a conduta terapêutica do profissional fonoaudiólogo.

A Girl from Qatar with Post-Infantile Acquired Cerebral Palsy Caused By Submersion Injury: A Rare Etiology and a Therapeutic-Challenge.

Background: Cerebral palsy is a heterogeneous disorder that can cause a lifelong disability that is associated with a non-progressive damage in the brain. It is commonly caused by antenatal, perinatal, early postnatal and neonatal conditions. However, post-neonatal cases of acquired cerebral palsy have also been reported, and were commonly caused by infection. Patients and Methods: The family of a girl from Qatar, who developed severe cerebral palsy caused by submersion injury, consulted us about the possible therapies for her condition. Clinical picture and brain imaging abnormalities are described, and the relevant literatures were reviewed with the aim of suggesting possible evidence-based therapies. Results: At the age of 23 months, a previously healthy girl developed anoxic encephalopathy after experiencing submersion injury. MRI showed evidence of significant hypoxic ischemic injury primarily affecting the deep grey matter, hippocami, mid-brain and the posterior cortex. EEG showed diffuse slowness of cerebral activity and diffuse attenuation of the background without no epileptic abnormalities suggesting diffuse encephalopathy resulting from diffuse cortical injury. At the about age of three and half years, her family consulted us about her condition as she was still showing no awareness to the environment, showing no significant spontaneous movements. She had poor head control. Unable to sit or stand alone, and had a flexed posture. She was on levetiracetam (Keppra), diazepam, and baclofen 30 mg daily. She was still having tracheotomy, and was fed through gastrostomy tube. Conclusion: In this paper, the rare occurrence of severe post-infantile cerebral palsy is described. Emphasis is made on the possibility of using evidence-based multi-factorial therapies in cerebral palsy.

Functional signaling test identifies HER2 negative breast cancer patients who may benefit from c-Met and pan-HER combination therapy

Background Research is revealing the complex coordination between cell signaling systems as they adapt to genetic and epigenetic changes. Tools to uncover these highly complex functional linkages will play an important role in advancing more efficacious disease treatments. Current tumor cell signal transduction research is identifying coordination between receptor types, receptor families, and transduction pathways to maintain tumor cell viability despite challenging tumor microenvironment conditions. Methods In this report, coactivated abnormal levels of signaling activity for c-Met and HER family receptors in live tumor cells were measured by a new clinical test to identify a subpopulation of breast cancer patients that could be responsive to combined targeted therapies. The CELsignia Multi-Pathway Signaling Function (CELsignia) Test uses an impedance biosensor to quantify an individual patient’s ex vivo live tumor cell signaling response in real-time to specific HER family and c-Met co-stimulation and targeted therapies. Results The test identified breast tumors with hyperactive HER1, HER2, HER3/4, and c-Met coordinated signaling that express otherwise normal amounts of these receptors. The supporting data of the pre-clinical verification of this test included analyses of 79 breast cancer patients’ cell response to HER and c-Met agonists. The signaling results were confirmed using clinically approved matching targeted drugs, and combinations of targeted drugs in addition to correlative mouse xenograft tumor response to HER and c-Met targeted therapies. Conclusions The results of this study demonstrated the potential benefit of a functional test for identifying a subpopulation of breast cancer patients with coordinated abnormal HER and c-Met signaling for a clinical trial testing combination targeted therapy.

A Girl from Qatar with Post-Infantile Acquired Cerebral Palsy Caused By Submersion Injury: A Rare Etiology and a Therapeutic Challenge

Background: Cerebral palsy is a heterogeneous disorder that can cause a lifelong disability that is associated with a non-progressive damage in the brain. It is commonly caused by antenatal, perinatal, early postnatal and neonatal conditions. However, post-neonatal cases of acquired cerebral palsy have also been reported, and were commonly caused by infection. Patients and methods: The family of a girl from Qatar, who developed severe cerebral palsy caused by submersion injury, consulted us about the possible therapies for her condition. Clinical picture and brain imaging abnormalities are described, and the relevant literatures were reviewed with the aim of suggesting possible evidence-based therapies. Results: At the age of 23 months, a previously healthy girl developed anoxic encephalopathy after experiencing submersion injury. MRI showed evidence of significant hypoxic ischemic injury primarily affecting the deep grey matter, hippocami, mid-brain and the posterior cortex. EEG showed diffuse slowness of cerebral activity and diffuse attenuation of the background without no epileptic abnormalities suggesting diffuse encephalopathy resulting from diffuse cortical injury. At the about age of three and half years, her family consulted us about her condition as she was still showing no awareness to the environment, showing no significant spontaneous movements. She had poor head control. Unable to sit or stand alone, and had a flexed posture. She was on levetiracetam (Keppra), diazepam, and baclofen 30 mg daily. She was still having tracheotomy, and was fed through gastrostomy tube. Conclusion: In this paper, the rare occurrence of severe post-infantile cerebral palsy is described. Emphasis is made on the possibility of using evidence-based multi-factorial therapies in cerebral palsy.

Death and the Maiden in Philostratus, About Apollonius of Tyana 4.45

The Vita Apollonii leaves much open to interpretation. In 4.45 Philostratus tells us about a young woman who was thought dead by her family and the whole of Rome. Apollonius whispers something in her ear and the maiden starts talking again. The narrator comments it was impossible for the bystanders and still is impossible for him to say whether the girl was really dead or not: whether it was a case of Scheintod which proved Apollonius’s extraordinary powers of observation or whether it was a resurrection-miracle which would signal a special ontological status for ‘the man’ from Tyana. In his suspension of judgment, Philostratus uses the words arrhêtos hê katalêpsis combining a technical term from Stoic epistemology (katalêpsis) with a concept related to the Mysteries (arrhêtos). We discuss the Philostratean interpretative strategies, link them to the Pythagorean tradition of selective communication, and read the reference in this chapter to the story of Alcestis to the epistemological debates between Stoics and Skeptics about the limits of human wisdom.

Solitary skin-colored nodule on a child’s face

Sir, A healthy, six-year-old boy presented with a slowly grown dome-shaped nodule on the mandibular angle region present for two years. The patient’s past medical and family history were unremarkable. A physical examination revealed a solitary, 1.3 × 1 cm, firm, painless, flesh-colored tumor (Fig. 1). Dermoscopy showed branching, serpentine vessels on a pink background (Fig. 2a). These features disappeared when slight pressure was exerted on the dermoscope and the tumor exhibited a central, white, structureless area (Fig. 2b). An excisional biopsy was performed. A microscopic examination showed a well-circumscribed, paucicellular dermal tumor composed of eosinophilic collagen bundles separated by clefts and forming a storiform pattern. Scattered fibroblasts were found among the collagen bundles. The overlying epidermis was slightly flattened (Fig. 3). The diagnosis of solitary sclerotic fibroma was established. Sclerotic fibroma (SF), also known as storiform collagenoma, is a rare benign skin tumor. It usually manifests itself as an asymptomatic, slowly growing, white-to-skin-colored papule or nodule [1]. It was first described in patients with Cowden’s disease, yet may also occur sporadically [2]. There were no mucocutaneous features of Cowden’s disease (tricholemmomas, oral fibromas, acral keratoses, palmar pits, and gingival and palatal papules) in the patient and her family members. Dermatofibroma, the main differential diagnosis of SF, usually exhibits hyperplastic changes of the epidermis instead of atrophy, and the boundaries of the lesion are unclear [2]. Only two papers have been published describing the dermoscopic findings of SF, consisting of a white background with peripheral arborizing vessels [3]. A white background may be related to an increased dermal collagen density. It is also described in dermatofibroma, typically with a peripheral pigmentation network. Although dermoscopy may improve the clinical diagnosis of SF, histopathological analysis is required.

Dimension feminine in The Respectful Prostitute’s Jean- Paul Sartre and The Blind Prostitute’s Badr Shaker al-Sayyabe La dimension féminine dans La P….respectueuse de Jean-Paul Sartre et La Prostituée Aveugle de Badr Shaker al-Sayyabe

Jean-Paul Sartre and Badr Shakir al-Sayyabe are among the most prominent writers that critiqued the destructive role of capitalism and the patriarchal power system in the period of the Post-World War II crisis. Divided into three chapters, the present study examines two of the most eminent literary works in the history of the Western and Eastern societies in the fifties of the last decade: Jean Paul Sartre’s play : The Respectful Prostitute and Badr Shaker al-Sayyabe’s poem: The Blind Prostitute. Chapter one discusses the position of the prostitute in a patriarchal societies. Chapter two linguistically analyzes the prostitute’s behavior with men and evaluates the nature of a relationship when based on profit and loss. Such a relationship exposes the male dominance system on this social level through stigmatizing, marginalizing and depriving of her family establishing rights. Chapter Three sheds light on the prostitute’s ego and the other. In the two works, the society double standard is presented in dealing with status of a woman, rather than a man, as a prostitute, something that leads to uncover the individuality of such a character. Thus, and in addition to justly picturing prostitution as a human setback in all the western and Eastern societies, Sartre and al – Sayyab succeed in visualizing humanity decay within the perspective of the preceding decades. Résumé Jean-Paul Sartre et Badr Shakir al-Sayyabe font partie des écrivains qui ont contribué à travers leurs œuvres à critiquer le système capitaliste et la société masculine dans la période de l'après-guerre. En lisant les deux ouvrages, nous avons choisi comme sujet commun de cette étude d'analyser le statut de prostituée dans les sociétés orientale et occidentale au cours des années 1950 du siècle dernier. L'étude est divisée en trois chapitres : Le premier chapitre est basé sur la présentation du statut de la prostituée dans les communautés masculines des deux auteurs. Le deuxième chapitre analyse linguistiquement le comportement de la prostituée envers les hommes et la nature de la relation basée sur le principe du profit ou de la perte. Cette relation met d'abord en évidence la domination du système masculin sur cette partie social, le problème de la stigmatisation sociale, de la marginalisation et de la privation de son droit d'avoir et de fonder une famille. Le troisième chapitre traite la position de la prostituée entre le moi et l'autre. Dans les deux œuvres, le point de vue de la société semble être un double standard dans la condamnation de la femme comme prostituée plutôt que comme homme. Ce mécanisme nous amène à retrouver l'identité de la prostituée. Nous arrivons à conclure que le succès de Sartre et d'al-Sayyabe en présentant cette profession comme un échec humain pour les sociétés orientales et occidentales et la décadence de l'homme ou de la femme et en les dépeignant avec une perspective qui correspond aux crises du siècle dernier.

Applying Salutogenesis in Midwifery Practice

This chapter presents midwifery as unique amongst the healthcare professions because it mostly focuses on physiological processes and a period of transition in the life of a woman and her family. Thus, midwives work across a childbearing continuum and the health-ease dis-ease continuum. The “midwifery model of care” and its approach to childbearing focuses on wellness rather than illness and works closely with women to help them mobilize their own resources to move towards greater health. But the contrasting pathogenic approach to maternity care is still ubiquitous in contemporary healthcare provision with over-medicalization of childbirth and overuse of interventions, which can also cause more harm than good.While there is resonance between midwifery practice and salutogenesis, research examining the relationship is still in its infancy. Few researchers explicitly draw on salutogenic theory. Of these, few studies and scoping reviews are described in more detail. They suggest that there is an alignment between salutogenesis and midwifery practice.The chapter concludes by stressing that salutogenesis, with its focus on health rather than pathology, offers a promising way forward to underline that much of midwifery work is health promotion and must be operationalized accordingly in midwifery practice.

Reminiscences of Lafcadio Hearn

Setsuko Koizumi (1868–1932) was the daughter of a Japanese samurai family in Matsué. In 1891 she married a foreigner — Lafcadio Hearn (1850–1904) — and their union lasted 13 years and produced three children. Hearn adopted her family name, becoming Koizumi Yakumo 小泉八雲,and spent those years in Japan writing, teaching, and achieving international recognition. Setsuko’s Reminiscences tells something of the couple’s moves and travels, but focuses mostly on the character, habits, and eccentricities of her husband. The book is a heartfelt and intimate portrait of a marriage that brought Lafcadio the home and family he had never before enjoyed. This book shares a charming story of domestic happiness, told by his closest companion, collaborator, and interpreter of life, death, and afterlife in Meiji Japan.

Living With Intellectual Disability

The need to understand the quality of life of people with intellectual disability is crucial as this mental disability is considered to be a major setback for any individual and his/her family. Current researches focus on creating an equal platform to understand intellectual disability in order to gain more acceptances from the masses, especially for the families who have a member suffering from intellectual disability. The age of the family member and available care taking measures are also of critical value. Models of therapy/interventions drawn from previous evidence-based practices give a bright picture.