Combination therapy for patients with a developmental dysphasia: selected approaches based on special education, rehabilitation and psychology in a systematic case study.

OBJECTIVE: The paper deals with the possibilities of the development and the support of individuals with developmental dysphasia with regard to the legislative framework of the Czech Republic in the field of education and presents the results of a systematic case study of a child patient diagnosed with developmental dysphasia (according to ICD-10; F80.1 and F80.2). CASE REPORT: The study aimed to determine the effect of combined therapy using long-term special educational, rehabilitation and psychological intervention, speech therapy and music therapy on the development of the patient's communication skills. The proband was selected by random, stratified sampling based on pre-determined relevant characteristics (age 6 years i.e., before entering primary school, diagnosed with developmental dysphasia). A 6-year-old child patient participated in the research with the consent of the legal representative. The therapy was focused on special educational care, speech therapy, music therapy and psychological intervention (including psychotherapy). During the hospitalization and post-hospitalization care, there was also the presence of a physiotherapist and an occupational therapist. CONCLUSION: The results of the research point out the need for regular and close multidisciplinary cooperation of an occupational therapist, a physiotherapist, a special educator, a speech therapist, a music therapist and a psychologist when working with patients diagnosed with developmental dysphasia. These professions focus specifically on specific areas of support with a focus on cognitive, phatic and motor functions with the support of social adaptability.

Assessment of the Functional Level of Independence in Individuals with Mental Disabilities as Part of Special Education Diagnostics: Case Studies.

In this study we focus on the application of standardized tests aimed at evaluating the functional degree of independence in children (client 1, WeeFIM test; and client 2, FIM test) in special education diagnostics. The target group consisted of two clients with a diagnosis of mental functional diversity (n = 2; client 1: mild mental retardation, according to ICD-10: F70, aged 6.5 years; and client 2: moderate mental retardation, according to ICD-10: F71, aged 13.4 years). Special pedagogical intervention was primarily applied to the clients, focusing on identified deficits in the areas of cognitive, motor, and social skills. The presented results demonstrate the importance of the application of these tests in special pedagogy. An improvement in the observed indicators of the given tests was demonstrated for both probands after the intervention. The aim of this article was to draw attention to the suitability of using functional independence tests in special pedagogical practices. The authors discuss the further implications of this application for future practice.

Nonpharmacological Compensation of Aggressive Behavior of Individuals with Moderate Intellectual Disability and Behavioral Disorders-A Case Study.

The article discusses issues associated with the manifestations of aggressive behavior in an individual diagnosed with moderate intellectual disability and behavioral disorders (according to ICD-10; F7; F711-moderate intellectual disability, significant impairment of behavior requiring attention or treatment). In the research survey, we focused on a client corresponding with relevant features. The research was carried out at the beginning of hospitalization, ongoing hospitalization, and the end of hospitalization, followed by a recommendation to limit the legal capacity of the client and his placement in a residential care home. The case study points out individual approaches to special education and psychology and outlines the key steps in the cooperation of selected helping professions suggesting conclusions and recommendations for practice regarding these selected issues. Upon the termination of our investigation, there was a rapid deterioration of the client being admitted to the intensive care unit with a follow-up treatment in a long-term intensive care unit.

The Effect of Early Applied Robot-Assisted Physiotherapy on Functional Independence Measure Score in Post-Myocardial Infarction Patients.

Robot-assisted training has been widely used in rehabilitation programs, but no significant clinical evidence about its use in productive working-age cardiac patients was demonstrated. Thus, we hypothesized that early applied robot-assisted physiotherapy might provide additional treatment benefits in the rehabilitation of post-myocardial infarction (MI) patients. A total of 92 (50 men, 42 women) hospitalized post-MI patients with the age of 60.9 ± 2.32 participated in the research. An early intensive physiotherapy program (7×/week, 2×/day) was applied for each patient with an average time of 45 min per session. Patients were consecutively assigned to Experimental group (EG) and Control group (CG). Then, 20 min of robot-assisted training by Motomed letto 2 or Thera-Trainer tigo was included in all EG physiotherapy sessions. The Functional Independence Measures (FIM) score at the admission and after 14 days of rehabilitation was used for an assessment. When analyzing time * group effect by repeated-measures ANOVA, we reported that EG showed a higher effect in ADL (p = 0.00), and Motor indicators (p = 0.00). There was no statistically significant effect reported in the Social indicator (p = 0.35). Early rehabilitation programs for post-MI patients might be enhanced by robotic tools, such as THERA-Trainer tigo, and Motomed letto 2. The improvement was particularly noticeable in mobility and ADLs.

The Effect of Combined Therapy on the Support and Development of Social Skills of people with Multiple Sclerosis in Senior Age.

OBJECTIVE: The article contains results of longitudinal research. The aim of the research was to find out how psychomotor therapy with the use of elements of ergotherapy (with the support of cognitive functions; with the support of robotic assisted therapy) on the support and development skills of people with sclerosis multiplex (SM; sclerosis multiplex) in facilities providing social services members of the probands. PROBAND SAMPLE: The research was carried out in 46 probands, with 43.5% of men and 56.5% of women aged 65 - 67 years. The main relevant feature for the selection of probands was the established diagnosis Multiple Sclerosis (according to ICD-10; G35). Another relevant feature for the selection of probands was the length of stay in the facility, which was at least 1 year from the actual start of the facility. The assembled research sample was divided according to other criteria by deliberate selection into the experimental group and the control group. The experimental group participated actively in our intervention and consisted of 23 probands of which 10 were men and 13 were women. The control group only participated in the therapies performed at the facility and did not participate in our intervention. The control group also included 10 men and 13 women. The intervention itself lasted 5 months, three times a week for 40 to 55 minutes. We provided input and output data using a standardized test (FIM test; FIM test; Functional Independence Measure). Subsequent comparison of obtained data between input and output testing was performed by Tuckey HSD test at significance level α = 0.05. RESULTS: The achieved results (at the significance level α = 0.05) show that the experimental group underwent better results in comparison with the initial testing and in comparison with the control group, which rather stagnated in the results, respectively. slightly worsened compared to initial testing.

Combined Therapy for Patients after Ischemic Stroke as a Support of Social Adaptability.

THE OBJECTIVE: The main objective of the research was to find out the effectivity of the combined therapy suitable for patients after ischemic stroke (promoting social adaptability). The therapy itself is then focused on robotic, psychomotor and cognitive therapy. The research indicators were divided into three categories of psychological, social and cognitive indicators. PROBAND SAMPLE: We have a 58 probands diagnosed with a stroke participated on the research (ischemic type I60-I69; ICD-10; the 10th revision of the International Statistical Classification of Diseases and Related Health Problem), out of which 49 were male patients ages between 48-55 and women between the age of 45-51. The data collection was then done during 2018. Indicators were evaluated and tested firstly after the initiation of the combined therapy, then after 10 weeks of intensive therapy, which took place 3 times a week 45 minutes for each patient participating in the research. RESULTS: The results of the research point to the fact, that combined therapy of robotic, psychomotor and cognitive can have positive effect on, and be suitable as a treatment for patients after ischemic stroke, regarding their productive age. Positive results have been therefore overt among all tested areas. CONCLUSION: The results of the research point to the fact, that combined therapy of robotic, psychomotor and cognitive can have positive effect on, and be suitable as a treatment for patients after ischemic stroke, regarding their productive age. Positive results have been therefore overt among all tested areas.

Asymmetric dimethylarginine and progression of chronic kidney disease: a one-year follow-up study.

BACKGROUND/AIMS: Asymmetric dimethylarginine (ADMA) is a prognostic factor in patients with chronic kidney disease (CKD). However, the relationships among factors influencing the metabolism of ADMA and the CKD progression are not fully understood. METHODS: Serum ADMA, and variables related to the metabolism of ADMA were measured in 181 non-dialysis patients (CKD stages 3-5) and in 46 controls. Patients were assessed at baseline, and 6 and 12 months after the initiation of the study. RESULTS: Patients had increased baseline ADMA, advanced glycation end products (AGE), and advanced oxidation protein products (AOPP) compared with controls (P<0.001). In a total of 164 patients who completed a one-year study, the estimated GFR (eGFR) declined from 23.5 (17.7-36) mL/min/1.73m(2) to 21 (14.7-31.5) (P=0.018), AGE rose from 1.58 (1.38-1.90) µmol/L to 1.76 (1.52-2.21) (P<0.001), while ADMA, AOPP, tubular function, and proteinuria remained stable. In a multiple regression model (adjusted R(2) = 0.49, P<0.0001), the interaction of relatively higher baseline eGFR, i.e. > 25 mL/min/1.73m(2), with higher ADMA (P=0.02) and higher AOPP (P=0.04) predicted the severest decrease in eGFR per year. Other predictors of progression were higher baseline AGE (P<0.001), proteinuria (P=0.003), hypertension (P=0.01), and higher baseline eGFR (P=0.03). CONCLUSION: Elevated ADMA and markers of oxidative stress were strong predictors of progression in patients with eGFR between 25-40 mL/min/1.73m(2) , i.e. at the borderline of CKD stages 3-4.

Multiplex Immunoassays: Chips and Beads.

Multiplex analysis is intended to simultaneously look for multiple targets in one sample. This approach has been largely adopted in genomics and progressively expands to various domains of laboratory investigation. In protein analysis, immunoassays are the fundamental methods and their multiplexing and miniaturization is of great applicability to both basic and applied research. Furthermore, the potential of these high-throughput methodologies can be foreseen in the field of clinical diagnostics. The following text describes planar and bead-based arrays, two main strategies of immunoassay multiplexing. Principles, detection methods and strengths of each are shortly discussed. Finally, we mention several challenges linked with the integration of these methods to diagnostics.

Glycation damage targets glutamate dehydrogenase in the rat liver mitochondrial matrix during aging.

Aging is accompanied by gradual cellular dysfunction associated with an accumulation of damaged proteins, particularly via oxidative processes. This cellular dysfunction has been attributed, at least in part, to impairment of mitochondrial function as this organelle is both a major source of oxidants and a target for their damaging effects, which can result in a reduction of energy production, thereby compromising cell function. In the present study, we observed a significant decrease in the respiratory activity of rat liver mitochondria with aging, and an increase in the advanced glycation endproduct-modified protein level in the mitochondrial matrix. Western blot analysis of the glycated protein pattern after 2D electrophoresis revealed that only a restricted set of proteins was modified. Within this set, we identified, by mass spectrometry, proteins connected with the urea cycle, and especially glutamate dehydrogenase, which is markedly modified in older animals. Moreover, mitochondrial matrix extracts exhibited a significant decrease in glutamate dehydrogenase activity and altered allosteric regulation with age. Therefore, the effect of the glycating agent methylglyoxal on glutamate dehydrogenase activity and its allosteric regulation was analyzed. The treated enzyme showed inactivation with time by altering both catalytic properties and allosteric regulation. Altogether, these results showed that advanced glycation endproduct modifications selectively affect mitochondrial matrix proteins, particularly glutamate dehydrogenase, a crucial enzyme at the interface between tricarboxylic acid and urea cycles. Thus, it is proposed that glycated glutamate dehydrogenase could be used as a biomarker of cellular aging. Furthermore, these results suggest a role for such intracellular glycation in age-related dysfunction of mitochondria.