Background. We compare the incidence of delirium before and after extubation and identify the risk factors and possible predictors for the occurrence of delirium in this group of patients. Methods. Patients weaned from mechanical ventilation (MV) and extubated were included. The assessment of delirium was conducted using the confusion assessment method for the ICU and completed twice per day until discharge from the intensive care unit. Results. Sixty-four patients were included in the study, 53.1% of whom presented with delirium. The risk factors of delirium were age (P = 0.01), SOFA score (P = 0.03), APACHE score (P = 0.01), and a neurological cause of admission (P = 0.01). The majority of the patients began with delirium before or on the day of extubation. Hypoactive delirium was the most common form. Conclusion. Acute (traumatic or medical) neurological injuries were important risk factors in the development of delirium. During the weaning process, delirium developed predominantly before or on the same day of extubation and was generally hypoactive (more difficult to detect). Therefore, while planning early prevention strategies, attention must be focused on neurological patients who are receiving MV and possibly even on patients who are still under sedation.

A síndrome de Moebius é caracterizada por apresentar paralisia, geralmente bilateral, do nervo facial, sendo possível o acometimento de outras estruturas faciais. A etiologia não é claramente definida, a SM pode ocorrer devido a uma alteração vascular durante o desenvolvimento embrionário que produz uma isquemia ao nível dos núcleos dos nervos cranianos com subsequente hipoplasia, além disso, pode estar relacionada com o uso de medicações, infecções ou agentes externos, causadores de danos neurológicos nos núcleos dos nervos cranianos. O tratamento cirúrgico muitas vezes é fundamental, para corrigir adversidades oriundas da SM. No tratamento fisioterapêutico é necessário um bom prognóstico, conhecimento detalhado da história clínica, análise dos exames de imagens, exame e inspeção física, testes de sensibilidade, e coordenação. O objetivo deste estudo é relatar o caso de uma paciente com síndrome de Moebius, bem como a importância do acompanhamento fisioterapêutico no tratamento, prevenção, melhora e manutenção da qualidade de vida. O presente estudo trata-se de um relato de caso realizado em um Centro Especializado em Anomalias Craniofaciais, localizado no oeste do Paraná, a partir de anamnese, exame clínico e físico, atendimentos semanais e entrevista com responsável. Paciente sexo feminino, em acompanhamento na clínica de reabilitação de uma Universidade Estadual, desde os 23 dias de vida, e atendimento no referido centro em 2018.  A resposta do plano de tratamento fisioterapêutico foi positiva, auxiliando para que a paciente pudesse se adaptar e superar suas dificuldades, favorecendo adaptações nas atividades de vida diária, prevenindo possíveis complicações, melhorando e mantendo a força muscular.ss

AIMS: To evaluate the effectiveness of photodynamic therapy with Brilliant Blue G in the treatment of an experimental model of arthritis by Paracoccidioides brasiliensis (P. brasiliensis). METHODS: After the induction of experimental arthritis with isolated from P. brasiliensis of lineage Pb18 in the knees of Wistar rats, the animals were divided into groups and submitted to photodynamic therapy with intra-articular Brilliant Blue G photosensitizer and laser therapy only, without Brilliant Blue G. All groups received their respective treatments from the seventh to the 11th day. For edema analysis, the knee lateral-lateral diameter of each animal was measured daily and after the treatment period the animals were sacrificed for experimental knee dissection and blood collection for analysis by ELISA, in order to quantify levels of anti-P. brasiliensis antibodies. RESULTS: The results showed that the application of photodynamic therapy was able to prevent the formation of edema when compared to the control (p>0.005), as well as the production of anti-Gp-43 antibodies from P. brasiliensis (p=0.001). In the anatomopathological examination it was possible to observe a higher degree of synovitis and a greater presence of granulomas with the fungus inside the group that did not receive treatment when compared to the groups that received the photodynamic therapy. CONCLUSIONS: Photodynamic therapy was effective in attenuating the experimental arthritis induced by P. brasiliensis in the proposed joint model.

The antifungals used in the treatment of vulvovaginal candidiasis, although effective, can have side effects and high cost, which may not occur with the medicinal use of ozone. The study aimed to evaluate the effects of medicinal home ozone therapy on C. albicans. The experiment was carried out in vitro, cultivating C. albicans in 10mm Petri dishes, containing solid Agar Sabour and Dextrose (Oxoid). The in vivo experiment used 45-day-old female C57/BL6 mice and after suppression of ovarian activity, 20 µL of C. albicans suspension in sterile PBS, at a concentration of 105 yeast cells, were inoculated in a single dose under anesthesia. Distribution occurred in 4 groups: (i) Absolute Control Group (GCA): Not subjected to infection by the pathogen. (ii) Control Group (CG): Submitted to C. albicans infection, but not treated. (iii) Ozone Therapy Group (GO): Subjected to infection and treated with medicinal ozone therapy. (iv) Lavage Group (GL): Subjected to infection and subsequently treated with vaginal lavage. It was found that GC had a higher amount of CFU when compared to GO. Exposure for 600s was able to reduce the number of CFUs by 98.89% when compared to GC. The study concludes that ozone gas showed great efficacy in the proliferation of C. albicans in vitro. The best results were observed with application in liquid medium, however, ozone therapy was able to significantly reduce infection in the experimental model used. In in vivo experiments, the number of CFU/ml found was lower in the ozone-treated group.

Introduction: Paracoccidioidomycosis (PCM) is the most prevalent systemic mycosis in Latin America. This study aimed to evaluate the natural history of Paracoccidioides brasiliensis-induced experimental arthritis of the knee joints in Wistar rats. Methods: Rats were randomly allocated to either an absolute control group, or 15-day, 45-day, or 90-day experimental (fungusinoculated) groups. Results: Experimental groups developed classic signs of articular PCM. Titers of anti-gp43 were observed to increase during the interval from 15 to 45 days post-inoculation. Conclusions: Articular arthritic lesions were induced and progressed during the study period in all experimental groups.