Os procedimentos são realizados usando a prótese Zimmer Trabecular Metal Total do tornozelo (Zimmer, Varsóvia, IN).

Todos os métodos descritos foram aprovados pelo nosso Conselho de revisão institucional e o Comitê de ética local e eles têm sido realizados em conformidade com os padrões éticos constantes da declaração de Helsinque de 1964 e suas alterações posteriores.
1. pré avaliação radiográfica
<ol><li>Realize radiografias do tornozelo e do pé com vistas para o alinhamento com antero-posterior, lateral e retropé (modo de exibição30) do Saltzman do rolamento de peso.</li>
	<li>Executar uma convencional tomografia computadorizada (CT) do tornozelo e solicitar quaisquer outro exames de diagnóstico (por exemplo, ressonância magnética), se necessário, para melhor esclarecer o diagnóstico.</li>
	<li>Medir os parâmetros a seguir sobre os pré-operatório do peso-rolamento radiografias.<ol>
<li>Medir o ângulo da tíbia distal anterior (ADTA, valor normal 83.0 ± 3,6 °) na vista lateral do tornozelo: medir o ângulo entre o eixo anatômico da tíbia e a linha que conecta os pontos distais na borda anterior e posterior do (superfície articular tibial A Figura 1) 30 , 31.</li>
		<li>Medir o ângulo da tíbia distal lateral (Ltda, o valor normal 89,0 ± 3,0 °) na vista antero-posterior do tornozelo: medir o ângulo de abertura entre o eixo anatômico da tíbia e a linha que conecta os pontos distais na borda medial e lateral do tibial articular superfície (Figura 2)32,33,34.</li>
		<li>Medir a tibio-talar ratio (proporção de TT, o valor normal 34,8 ± 3,8%): medir esse parâmetro na vista lateral do tornozelo; é a proporção entre o comprimento do talo longitudinal posterior (o comprimento entre a borda posterior do tálus e a interceptação da anatômica eixo da tíbia) e o comprimento do talo completo longitudinal (Figura 1)33,35,36.</li>
		<li>Medir o ângulo tibio-talar de superfície (valor normal 89,0 ± 2,6 °) na vista antero-posterior do tornozelo: medir o ângulo entre o eixo anatômico da tíbia e a linha que conecta o ponto proximal medial e lateral do talo superfície articular (Figura 2 )37.</li>
	</ol>
</li>
	<li>Use o CT para avaliar o estoque disponível de osso e para avaliar a gravidade da necrose avascular do tálus, se presente.</li>
</ol>2. cirúrgica técnica17
Nota: Este procedimento é realizado sob anestesia geral ou regional (raquianestesia).
<ol><li>Coloca o paciente em posição supina com uma placa rígida sob a perna para sustentar a posição de alinhamento. Coloque uma almofada grossa sob o quadril ipsilateral. Não utilize um torniquete.</li>
	<li>Faça uma incisão longitudinal com um bisturi sobre o maléolo lateral que curvas sob sua ponta em direção ao seio társico (Figura 3). Disse a fíbula e o lado anterior da tíbia subperiosteally com o bisturi e o elevador periosteal para obter uma visão completa dos osteófitos e articulação.</li>
	<li>Lançamento da cápsula posterior da tíbia e a fíbula usando um elevador periosteal.</li>
	<li>Fazer uma osteotomia oblíqua maléolo lateral com uma lâmina de serra sagital: começam a partir da borda posterior da fíbula, 6-7 cm proximal à linha comum; terminar no lado anterior da fíbula, 2 cm proximal à linha comum. Girar o maléolo fibular distalmente e usar um fio de Kirschner de 1,6 mm para corrigi-lo ao calcâneo.</li>
	<li>Remova os osteófitos anteriores com a lâmina de serra sagital e um rongeur até o tornozelo pode ser facilmente colocado em uma posição neutra. Nota: O lançamento de sarjeta medial pode ser executado mais tarde durante a preparação da tíbia.</li>
	<li>Medir a largura do talo medial/lateral do medidor do fabricante, escolher o maior tamanho possível, evitando a saliência.</li>
	<li>Coloque a perna no stand alinhamento que é montado no início do procedimento.</li>
	<li>Internamente girar o pé e usar o pino trans-calcâneo para corrigi-lo para a placa de pé. Use o pino de 4,0 mm para corrigir o talo para o estribo: colocar o pino tão distal quanto possível no pescoço do talo, facilitando ainda mais a correção da inclinação do talo.</li>
	<li>Verifique o alinhamento tibial com fluoroscopia usando uma barra que é paralela ao eixo mecânico da tíbia. Usar fluoroscopia com os seguintes parâmetros: 55 quilovolts, miliampère-3 segundos.</li>
	<li>Inserir dois pinos de 5,0 mm na borda medial da tíbia enquanto assistente empurra a tíbia anteriormente, se um anterior sagital do talo de movimento está presente. Para aumentar a rigidez da construção, uma barra de fibra de carbono adjuvante pode ser colocada na posição vertical.</li>
	<li>Verifique se o nível da linha comum desejado com o ponteiro localizado no buraco ' posição ' do guia de corte do tamanho selecionado. Verifique a quantidade de ressecção óssea com o ponteiro colocada no ' talo ' e ' Tibia #1 ' buraco.</li>
	<li>Use a broca 4,0 mm através do guia de pré-corte de pré-perfurar as superfícies de tíbia e o tálus. Montar a rebarba de osso para o pneumático handpieces e colocar o julgamento do talo contralateral do tamanho selecionado entre as rebarbas do osso e o guia de corte para avaliar a profundidade medial do osso corte. Em seguida, use a rebarba de osso para fazer os cortes de osso definitivo através do 'talo ' e os furos do ' Tibia #1 ' do guia. Use o buraco do ' Tibia #2 ' para alcançar o corte tibial inteira no lado medial e liberar osteófitos da calha medial</li>
	<li>Posição do trilho guias de broca. Utilize a fluoroscopia antero-posterior para verificar se que eles estão devidamente posicionados para evitar folga lateral. Os trilhos da broca e posicionar o implante provisório e, em seguida, escolher o tamanho de inserção.</li>
	<li>Inserir os implantes definitivos, usando o dispositivo de inserção do tálus e da tíbia.</li>
	<li>Usar fluoroscopia para verificar o posicionamento e usar dois ou três parafusos de retardação de 3,5 mm para corrigir a fíbula; Como alternativa, use uma placa-fixação do maléolo lateral, se a deformidade requer um maleolares alongamento ou encurtamento que não deixa contato suficiente para fixação do parafuso.</li>
	<li>Verificar a estabilidade da sindesmose com um hookapplied de osso para o maléolo lateral. Puxe delicadamente a fíbula lateralmente para avaliar qualquer instabilidade residual tibiofibular. Se houver um movimento lateral do maléolo lateral, estabilizá-la com uma fixação do parafuso da sindesmose em quatro córtices. Teste o alcance do tornozelo de movimento.</li>
	<li>Reparação do ligamento talofibular anterior com suturas absorvíveis antes a rotina de fechamento de ferida.</li>
</ol>3. pós-operatório cuidados
<ol><li>Coloque a perna em um molde e livre do peso-rolamento, durante quatro semanas. Então permita do peso-rolamento com um arranque walker durante duas semanas.</li>
	<li>Permitem que o bezerro reforço, treinamento proprioceptivo e alongamento do tríceps sural, seis semanas após a cirurgia.</li>
</ol>4. clínico e radiográfico de acompanhamento
<ol><li>Radiograficamente e clinicamente avalie pacientes em um, dois, seis e doze meses após o procedimento e, depois, a cada doze meses. O protocolo de acompanhamento consiste de avaliação de função e dor com SF-12, pontuação de dor VAS e AOFAS tornozelo e retropé partituras coletadas em cada ponto de tempo.</li>
	<li>Realizar exame radiográfico: solicitar radiografias do peso-rolamento do tornozelo e do pé com antero-posterior, lateral e exibição do Saltzman em cada ponto de extremidade.</li>
	<li>Medir os seguintes parâmetros sobre as radiografias pós-operatórias em cada ponto de extremidade.<ol>
<li>Medir o ângulo alfa (α-ângulo) na vista antero-posterior do tornozelo: medir o ângulo formado lateralmente pelo eixo anatômico da tíbia e a superfície articular da componente tibial (Figura 4)38.</li>
		<li>Medir o ângulo beta (β-ângulo) na vista lateral do tornozelo: medir o ângulo de abertura anteriormente pelo eixo anatômico da tíbia e a superfície articular da componente tibial (Figura 5)18,38.</li>
		<li>Medir o ângulo de gama (γ-ângulo) na vista lateral do tornozelo: medir o ângulo entre uma linha através o anterior e a borda posterior do componente do talo e uma linha ao longo do centro do pescoço do talo (Figura 5)39.</li>
		<li>Medir a relação Tibio-talar.</li>
		<li>Medir o ângulo Tibio-talar de superfície.</li>
	</ol>
</li>
</ol>

Dr. Usuelli recebe subsídios e taxas pessoais de Zimmer. Dr. D'Ambrosi, Dr. Maccario, Dr. Manzi e Dr. Indino não têm nada para divulgar.

Informamos que os métodos e o protocolo que usamos o TAR realizando com abordagem lateral transfibular. As contra-indicações absolutas para o alcatrão são necrose avascular do tálus, envolvendo mais a 50% da infecção óssea-estoque, aguda ou ativa com ou sem osteomielite, síndrome diabética com polineuropatia, riscos elevados de anesthesiologic, neuromusculares transtornos, doença vascular periférica e de19,neurartropatia (artropatia de Charcot do médio pé ou retropé)<sup...

A etiologia mais frequente da artrose do tornozelo é a origem pós-traumática. Na verdade, muitas vezes é secundária a lesões traumáticas que normalmente afetam pacientes jovens1,2. Artrose do tornozelo influencia a qualidade de vida dos pacientes com o mesmo grau como osteoartrite do quadril e até mesmo mais do que de osteoartrite do joelho3. Fusão do tornozelo tem sido considerada o padrão-ouro para o tratamento da artrose do tornozelo, mas alguns estudos mostram que confira tensão aumentada e aumento do risco de artrose das articulações adjacentes4,5,6 ,7; Além disso, ainda existem uma série de complicações associadas à fusão do tornozelo, como o equinismo ou deformidade talipes e doloroso não-União8,9. Com a evolução das técnicas cirúrgicas e dos projetos de implante, a substituição total do tornozelo (TAR) tornou-se uma excelente alternativa para fusão do tornozelo por um cirurgião com uma boa curva de aprendizagem10,11,12.
TAR permite a preservação da escala do tornozelo do movimento e protege contra degeneração articular adjacente13. A abordagem anterior permite uma visualização ideal do alinhamento coronal; ao mesmo tempo, esta abordagem é inclinada a cicatrização de feridas complicações14,15. Recentemente, um implante TAR a novela foi projetado para ser executado através da abordagem lateral transfibular que resulta em uma visualização ideal do centro de rotação e ressecções curvas que permitem poupar o osso cortes16; Além disso, esta abordagem permite a implantação de componentes perpendicular as trabéculas ósseas, limitando assim a distorcer as forças a nível do interface osso-implante16. Esta prótese é composto por um implante de rolamento fixo; um sistema de coordenadas de alinhamento orienta as ressecções ósseas e facilita abordar ambas as deformidades coronal e sagital17. Os primeiros resultados de tornozelo artroplastia usando este implante de alcatrão foram publicaram 12,16,17,18. O objetivo do presente trabalho é apresentar nossos protocolos de pré-operatório, operatório e pós-operatório para o tratamento da artrose do tornozelo com TAR através da abordagem lateral.
Seleção dos pacientes começa com um cuidadoso exame clínico e história. Uma história médica de doença inflamatória ou vascular, neuropatia ou doença neurológica e diabetes complicada pode modificar a indicação. Envelope pobre de partes moles do tornozelo deve ser avaliada com cuidado porque isso pode comprometer a cicatrização de feridas: pele e tecido subcutâneo mole podem já ter sido comprometidas de lesão ou cirurgia anterior. Deve considerar-se o uso de medicamentos que podem influenciar a cicatrização. Função de músculos e tendões, alinhamento do tornozelo e retropé e tornozelo intervalo de movimento devem ser avaliados: um exame detalhado pode indicar se o acessórios procedimentos são necessárias no momento da cirurgia,19.
Sugerimos que sempre discutindo as expectativas do paciente sobre os resultados do procedimento e a necessidade de cumprimento de cuidados pós-operatórios. ALCATRÃO é indicado para pacientes com uma doença articular do tornozelo devido à artrite pós-traumática, artrite reumatoide ou primário não responsivo às opções conservadoras que incluem a terapia física, modificação de atividade e não-esteroides anti-inflamatórios19 . Também, a instabilidade lateral do tornozelo pode representar uma causa da degeneração articular, definida como ligamentar tornozelo pós-traumático osteoartrose20. Além disso, a osteoartrite secundária pode ser associada com doenças sistêmicas: necrose avascular do tálus, gota, hemofilia, artrite pós-infecciosa e hemocromatose hereditária21,22,23, 24.
Durante a consulta pré-operatória, gravamos rotineiramente os resultados clínicos e funcionais seguintes: American Orthopaedic pé & tornozelo Society (AOFAS) tornozelo e retropé marcar25,26,27, 12-Item Short Inquérito de saúde de forma27,28e Visual analógica escala de Pontuação de dor (VAS)29.

<table border="0" cellpadding="0" cellspacing="0" width="880">
	<tbody>
		<tr height="22">
			<td height="22" style="height:22px;width:172px;">Zimmer Total Ankle</td>
			<td style="width:204px;">Zimmer, Inc.</td>
			<td style="width:179px;">82-0175-162-00</td>
			<td style="width:327px;">Total Ankle Replacement</td>
		</tr>
		<tr height="22">
			<td height="22" style="height:22px;width:172px;">Calcaneus pin</td>
			<td style="width:204px;">Zimmer, Inc.</td>
			<td style="width:179px;">00-4501-040-00</td>
			<td>Trans-calcaneal pin</td>
		</tr>
		<tr height="22">
			<td height="22" style="height:22px;width:172px;">4.0 mm Pin</td>
			<td style="width:204px;">Zimmer, Inc.</td>
			<td style="width:179px;">00-4501-040-04</td>
			<td>Talar pin</td>
		</tr>
		<tr height="22">
			<td height="22" style="height:22px;width:172px;">5.0 mm Pin</td>
			<td style="width:204px;">Zimmer, Inc.</td>
			<td style="width:179px;">00-4501-040-05</td>
			<td>Tibial pins</td>
		</tr>
		<tr height="22">
			<td height="22" style="height:22px;width:172px;">1.6 mm k-wire</td>
			<td style="width:204px;">Zimmer, Inc.</td>
			<td style="width:179px;">00-4501-040-01</td>
			<td>1.6 mm Kirschner wire</td>
		</tr>
		<tr height="22">
			<td height="22" style="height:22px;width:172px;">Moonray BlueLIne Dual</td>
			<td style="width:204px;">SIMAD</td>
			<td style="width:179px;"></td>
			<td>Mobile C-arm</td>
		</tr>
		<tr height="22">
			<td height="22" style="height:22px;width:172px;">Pre-Cut Guide Drill</td>
			<td style="width:204px;">Zimmer, Inc.</td>
			<td style="width:179px;">00-4501-059-00</td>
			<td>Precutting bone drill</td>
		</tr>
		<tr height="22">
			<td height="22" style="height:22px;width:172px;">Bur</td>
			<td style="width:204px;">Zimmer, Inc.</td>
			<td style="width:179px;">00-4501-076-00</td>
			<td>Bone resection burr</td>
		</tr>
		<tr height="22">
			<td height="22" style="height:22px;width:172px;">Micro 100 Drill</td>
			<td style="width:204px;">Conmed Corporation</td>
			<td style="width:179px;">5053-009</td>
			<td>Pneumatic handpieces</td>
		</tr>
		<tr height="22">
			<td height="22" style="height:22px;width:172px;">3.5 mm ULS screws</td>
			<td style="width:204px;">Zimmer, Inc.</td>
			<td style="width:179px;"></td>
			<td>Fibular fixation screws</td>
		</tr>
		<tr height="22">
			<td height="22" style="height:22px;width:172px;">Matlab version 2008</td>
			<td style="width:204px;">The MathWorks Inc.</td>
			<td style="width:179px;"></td>
			<td>Statistical software</td>
		</tr>
	</tbody>
</table>

treatment of ankle osteoarthritis with total ankle replacement through a lateral transfibular approach

Substituição total do tornozelo (TAR) é uma opção válida para o tratamento da artrose do tornozelo. A tradicional abordagem cirúrgica para o alcatrão é a abordagem anterior. Recentemente, a abordagem transfibular lateral do tornozelo ganhou popularidade como um novo implante de alcatrão foi projetado para ser executada através desta abordagem que resulta em uma visualização ideal do centro de rotação do tornozelo e ressecções curvas que permitem a poupadores de osso cortes. O objetivo do presente trabalho é apresentar nossos protocolos de pré-operatório, operatório e pós-operatório para o tratamento da artrose do tornozelo com alcatrão através de abordagem lateral. Apresentamos o nosso protocolo clínico e radiográfico pré-operatório. Além disso, descrevemos a nossa técnica cirúrgica com algumas dicas técnicas. Finalmente, nós relatamos nossa agenda de acompanhamento que inclui a coleta de dados clínicos, funcionais e radiográficos. Os resultados deste procedimento são animadores: TAR através de uma abordagem lateral transfibular proporciona alívio da dor confiável e melhorias nos resultados funcionais em pacientes com osteoartrite de tornozelo.

Foram coletados os resultados de uma série consecutiva de 114 pacientes (114 tornozelos) submetidos à TAR através de abordagem lateral transfibular entre maio de 2013 e julho de 2016. Todos os procedimentos operacionais foram realizados pelo autor sênior.
Os dados foram analisados com um software estatístico (ver Tabela de materiais). Os testes ANOVA e kappa foram realizadas40,<...

Watch this Scientific Journal Video about Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach at JoVE.com

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach

Tratamento da artrose do tornozelo com substituição Total do tornozelo através de uma abordagem Transfibular Lateral

Apresentamos nossos protocolos de pré-operatório, operatório e pós-operatório para o tratamento da artrose do tornozelo com substituição total do tornozelo através de abordagem lateral transfibular.

Total ankle replacement (TAR) is a valid option for the treatment of ankle osteoarthritis. The traditional surgical approach for TAR is the anterior ...

treatment-ankle-osteoarthritis-with-total-ankle-replacement-through

Research

JoVE Journal

Behavior

11.7K visualizações.  Galeazzi Orthopedic Institute for Research and Care. Apresentamos nossos protocolos de pré-operatório, operatório e pós-operatório para o tratamento da artrose do tornozelo com substituição total do tornozelo através de abordagem lateral transfibular.

Vídeo: Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach

Measuring Sensitivity to Viewpoint Change with and without Stereoscopic Cues

The speed and accuracy of object recognition is compromised by a change in viewpoint; demonstrating that human observers are sensitive to this transformation. Here we discuss a novel method for simulating the appearance of an object that has undergone a rotation-in-depth, and include an exposition of the differences between perspective and orthographic projections. Next we describe a method by which human sensitivity to rotation-in-depth can be measured. Finally we discuss an apparatus for creating a vivid percept of a 3-dimensional rotation-in-depth; the Wheatstone Eight Mirror Stereoscope. By doing so, we reveal a means by which to evaluate the role of stereoscopic cues in the discrimination of viewpoint rotated shapes and objects.

We discuss a novel method forviewpoint-rotation of visual stimuli, and demonstrate using a mirror stereoscopethe three-dimensional percept of rotation-in-depth. The technique can be used to investigate the role of stereoscopic cues in encoding viewpoint-rotated figures.

Medição Sensibilidade à Mudança Viewpoint com e sem Stereoscopic Sugestões

The speed and accuracy of object recognition is compromised by a change in viewpoint; demonstrating that human observers are sensitive to this ...

Comportamento

Assessment of Age-related Changes in Cognitive Functions Using EmoCogMeter, a Novel Tablet-computer Based Approach

The main goal of this study was to assess the usability of a tablet-computer-based application (EmoCogMeter) in investigating the effects of age on cognitive functions across the lifespan in a sample of 378 healthy subjects (age range 18-89 years). Consistent with previous findings we found an age-related cognitive decline across a wide range of neuropsychological domains (memory, attention, executive functions), thereby proving the usability of our tablet-based application. Regardless of prior computer experience, subjects of all age groups were able to perform the tasks without instruction or feedback from an experimenter. Increased motivation and compliance proved to be beneficial for task performance, thereby potentially increasing the validity of the results. Our promising findings underline the great clinical and practical potential of a tablet-based application for detection and monitoring of cognitive dysfunction.

We tested the usability of a tablet-computer-based application (EmoCogMeter) in investigating the effects of age on cognition. Results show an age-related cognitive decline, thereby proving the usability of our application. Findings underline the great clinical and practical potential of a tablet-based application for detection and monitoring of cognitive dysfunction.

Avaliação das Alterações relacionadas à idade em Funções Cognitivas Usando EmoCogMeter, uma nova abordagem Tablet computador baseado

The main goal of this study was to assess the usability of a tablet-computer-based application (EmoCogMeter) in investigating the effects of age on ...

Experimental Assessment of Mouse Sociability Using an Automated Image Processing Approach

Mouse is the preferred model organism for testing drugs designed to increase sociability. We present a method to quantify mouse sociability in which the test mouse is placed in a standardized apparatus and relevant behaviors are assessed in three different sessions (called session I, II, and III).
The apparatus has three compartments (see Figure 1), the left and right compartments contain an inverted cup which can house a mouse (called &#34;stimulus mouse&#34;).
In session I, the test mouse is placed in the cage and its mobility is characterized by the number of transitions made between compartments. In session II, a stimulus mouse is placed under one of the inverted cups and the sociability of the test mouse is quantified by the amounts of time it spends near the cup containing the enclosed stimulus mouse vs. the empty inverted cup. In session III, the inverted cups are removed and both mice interact freely. The sociability of the test mouse in session III is quantified by the number of social approaches it makes toward the stimulus mouse and by the number of times it avoids a social approach by the stimulus mouse.
The automated evaluation of the movie detects the nose of the test mouse, which allows the determination of all described sociability measures in session I and II (in session III, approaches are identified automatically but classified manually). To find the nose, the image of an empty cage is digitally subtracted from each frame of the movie and the resulting image is binarized to identify the mouse pixels. The mouse tail is automatically removed and the two most distant points of the remaining mouse are determined; these are close to nose and base of tail. By analyzing the motion of the mouse and using continuity arguments, the nose is identified.
<img alt="Figure 1" src="/files/ftp_upload/52508/52508fig1.jpg" /> 
Figure 1. Assessment of Sociability During 3 sessions. Session I (top): Acclimation of test mouse to the cage. Session II (middle): Test mouse moving freely in the cage while the stimulus mouse is enclosed in an inverted cup. Session III (bottom): Both test mouse and stimulus mouse are allowed to move freely and interact with each other.

This protocol describes a method to quantify mouse sociability. Mice are videotaped as they move and interact in a special cage. Movie processing allows for the automated quantification of sociability with excellent accuracy and reliability.

Avaliação experimental de rato Sociabilidade utilizando uma abordagem de processamento de imagem automatizado

Mouse is the preferred model organism for testing drugs designed to increase sociability. We present a method to quantify mouse sociability in which the ...

A Treatment Package without Escape Extinction to Address Food Selectivity

Feeding difficulties and feeding disorders are a commonly occurring problem for young children, particularly children with developmental delays including autism. Behavior analytic interventions for the treatment of feeding difficulties oftentimes include escape extinction as a primary component of treatment. The use of escape extinction, while effective, may be problematic as it is also associated with the emergence of challenging behavior (e.g., extinction burst). Such challenging behavior may be an acceptable side effect in treatment cases where feeding problems are severe and chronic (e.g., failure to thrive). However, in more acute cases (e.g., selective eating), the negative side effect may be unwarranted and undesired. More recent research on the behavioral treatment of food selectivity has begun to evaluate treatments for feeding difficulties that do not include escape extinction (e.g., demand fading, behavioral momentum), with some success. However, research to date reveals individual differences in responsiveness to such treatments and no clear preferable treatment has emerged. This manuscript describes a multi-component treatment package that includes shaping, sequential presentation and simultaneous presentation, for the treatment of food selectivity in four young children with developmental delays. This treatment package extends the literature on the behavioral treatment for food selectivity and offers a multi-component treatment protocol that may be clinically applicable across a range of treatment scenarios and settings.

Feeding difficulties are a common problem for children with developmental disorders, including autism, and behavioral interventions often include escape extinction. Recent research has begun to evaluate treatments that do not include escape extinction. This manuscript describes a multicomponent treatment package that does not use escape extinction to treat feeding difficulties.

Um pacote de tratamento, sem escapar da extinção a Morada Food Seletividade

Feeding difficulties and feeding disorders are a commonly occurring problem for young children, particularly children with developmental delays including ...

Experimental Research Examining How People Can Cope with Uncertainty Through Soft Haptic Sensations

Human beings are constantly surrounded by uncertainty and change. The question arises how people cope with such uncertainty. To date, most research has focused on the cognitive strategies people adopt to deal with uncertainty. However, especially when uncertainty is due to unpredictable societal events (e.g., economical crises, political revolutions, terrorism threats) of which one is unable to judge the impact on one&#8217;s future live, cognitive strategies (like seeking additional information) is likely to fail to combat uncertainty. Instead, the current paper discusses a method demonstrating that people might deal with uncertainty experientially through soft haptic sensations. More specifically, because touching something soft creates a feeling of comfort and security, people prefer objects with softer as compared to harder properties when feeling uncertain. Seeking for softness is a highly efficient and effective tool to deal with uncertainty as our hands are available at all times. This protocol describes a set of methods demonstrating 1) how environmental (un)certainty can be situationally activated with an experiential priming procedure, 2) that the quality of the softness experience (what type of softness and how it is experienced) matters and 3) how uncertainty can be reduced using different methods.

To date research has focused on cognitive strategies people adopt to cope with uncertainty. This research examines instead an experiential way of dealing with uncertainty and introduces a set of experimental methods showing how the experience of haptic softness can serve as a tool to deal with uncertainty.

Pesquisa Experimental examinando como as pessoas podem lidar com a incerteza Através macios Haptic Sensations

Human beings are constantly surrounded by uncertainty and change. The question arises how people cope with such uncertainty. To date, most research has ...

Pavlovian Conditioned Approach Training in Rats

Cues that are contingently paired with unconditioned, rewarding stimuli can acquire rewarding properties themselves through a process known as the attribution of incentive salience, or the transformation of neutral stimuli into attractive, &#34;wanted&#39; stimuli capable of motivating behavior. Pavlovian conditioned approach (PCA) develops after the response-independent presentation of a conditioned stimulus (CS; e.g., a lever) that predicts the delivery of an unconditioned stimulus (US; e.g., a food pellet) and can be used to measure incentive salience. During training, three patterns of conditioned responses (CRs) can develop: sign-tracking behavior (CS-directed CR), goal-tracking behavior (US-directed CR), and an intermediate response (both CRs). Sign-trackers attribute incentive salience to reward-related cues and are more vulnerable to cue-induced reinstatement of drug-seeking as well as other addiction-related behaviors, making PCA a potentially valuable procedure for studying addiction vulnerability. Here, we describe materials and methods used to elicit PCA behavior from rats as well as analyze and interpret PCA behavior in individual experiments.

Here, we present a protocol to elicit Pavlovian conditioned approach behavior in rats. This procedure can be used to measure individual differences in the tendency to approach and attribute incentive salience to reward-related cues and investigate addiction vulnerability.

Formação Abordagem Condicionada pavloviano em Ratos

Cues that are contingently paired with unconditioned, rewarding stimuli can acquire rewarding properties themselves through a process known as the ...

Eye-Tracking Control to Assess Cognitive Functions in Patients with Amyotrophic Lateral Sclerosis

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder with pathological involvement of upper and lower motoneurons, subsequently leading to progressive loss of motor and speech abilities. In addition, cognitive functions are impaired in a subset of patients. To evaluate these potential deficits in severely physically impaired ALS patients, eye-tracking is a promising means to conduct cognitive tests. The present article focuses on how eye movements, an indirect means of communication for physically disabled patients, can be utilized to allow for detailed neuropsychological assessment. The requirements, in terms of oculomotor parameters that have to be met for sufficient eye-tracking in ALS patients are presented. The properties of stimuli, including type of neuropsychological tests and style of presentation, best suited to successfully assess cognitive functioning, are also described. Furthermore, recommendations regarding procedural requirements are provided. Overall, this methodology provides a reliable, easy to administer and fast approach for assessing cognitive deficits in patients who are unable to speak or write such as patients with severe ALS. The only confounding factor might be deficits in voluntary eye movement control in a subset of ALS patients.

Cognitive deficits are common in about one third of patients with amyotrophic lateral sclerosis, a neurological condition leading to progressive impairments in speech and movement abilities. To conduct cognitive tests in patients unable to speak or write a reliable and easy to administer eye-tracking paradigm was developed.

Eye-Tracking de controle para avaliar a função cognitiva em pacientes com Esclerose Lateral Amiotrófica

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder with pathological involvement of upper and lower motoneurons, subsequently leading to ...

Behavioral Disturbances: An Innovative Approach to Monitor the Modulatory Effects of a Nutraceutical Diet

In dogs, diets are often used to modulate behavioral disturbances related to chronic anxiety and stress caused by intense and restless activity. However, the traditional ways to monitor behavioral changes in dogs are complicated and not efficient. In the current clinical evaluation, a new, simple monitoring system was used to assess the effectiveness of a specific diet in positively modulating the intense and restless activity of 24 dogs of different ages and breeds. This protocol describes how to easily and rapidly evaluate improvement in a set of symptoms related to generalized anxiety by using a specific sensor, a mobile phone app, a wireless router, and a computer. The results showed that dogs treated with specific diets showed significant improvement in the times spent active and at rest after 10 days (p &lt; 0.01 and p &lt; 0.05, respectively). These dogs also showed an overall significant improvement in clinical and behavioral symptoms. A specific sensor, along with its related hardware, was demonstrated to successfully monitor behavioral changes relating to movement in dogs.

We report a simple approach to evaluate the effectiveness of a specific diet in positively modulating the daily activity and clinical and behavioral symptoms of dogs with evident behavioral disturbances.

Distúrbios de comportamento: uma abordagem inovadora para monitorizar os efeitos moduladores de uma dieta Nutraceutical

In dogs, diets are often used to modulate behavioral disturbances related to chronic anxiety and stress caused by intense and restless activity. However, ...

Enactive Phenomenological Approach to the Trier Social Stress Test: A Mixed Methods Point of View

The single Trier Social Stress Test (TSST) and the TSST for groups (TSST-G) are the most used protocols to experimentally induce psychosocial stress. These tests are based on uncontrollability and social-evaluative threat, inducing psychological and physiological consequences (e.g., anxiety, emotional states, salivary cortisol increases). Many quantitative experimental studies have investigated these stress inducers and these consequences. But, as far as we know, this study is the first to provide a qualitative analysis to access the participants' voices so as to understand the dynamics of their experience throughout the TSST and the TSST-G. This paper outlines a mixed methods approach to the TSST. This approach can help to maximize the information that can be gained from the TSST, which researchers often use without looking more closely at what is qualitatively happening psychologically for participants during the stressor itself. In this way, this protocol is an example of mixed methods, showing the added value of using the enactive phenomenological approach to analyze experimental protocols more deeply. This kind of mixed methods is helpful to access the experience, to understand the actor's point of view, and to analyze in-depth the dynamics of cognitive processes like intentions, perceptions, enacted knowledge, and emotion. The discussion section shows the different uses of a mixed methods protocol, exploiting the enactive phenomenological approach to analyze a protocol or to give a cross vision of the same research subject. This section deals with different existing applications, pointing out some critical steps in this mixed methods approach.

Here, we present an original mixed method combining a quantitative and a qualitative approach to examine accurately participants&#39; experiences during the Trier Social Stress Test and the Trier Social Stress Test for groups.

Enactive abordagem fenomenológica para o teste de Stress Social Trier: ponto de vista métodos mistos

The single Trier Social Stress Test (TSST) and the TSST for groups (TSST-G) are the most used protocols to experimentally induce psychosocial stress. ...

Use of a Wireless Video-EEG System to Monitor Epileptiform Discharges Following Lateral Fluid-Percussion Induced Traumatic Brain Injury

The lateral fluid percussion injury (FPI) model is well established and has been used to study TBI and post-traumatic epilepsy (PTE). However, considerable variability has been reported for the specific parameters used in different studies that have employed this model, making it difficult to harmonize and interpret the results between laboratories. For example, variability has been reported regarding the size and location of the craniectomy, how the Luer lock hub is placed relative to the craniectomy, the atmospheric pressure applied to the dura and the duration of the pressure pulse. Each of these parameters can impact injury severity, which directly correlates with the incidence of PTE. This has been manifested as a wide range of mortality rates, righting reflex times and incidence of convulsive seizures reported. Here we provide a detailed protocol for the method we have used to help facilitate harmonization between studies. We used FPI in combination with a wireless EEG telemetry system to continuously monitor for electrographic changes and detect seizure activity.&#160; FPI is induced by creating a 5 mm craniectomy over the left hemisphere, between the Bregma and Lambda and adjacent to the lateral ridge. A Luer lock hub is secured onto the skull over the craniectomy. This hub is connected to the FPI device, and a 20-millisecond pressure pulse is delivered directly to the intact dura through pressure tubing connected to the hub via a twist lock connector. Following recovery, rats are re-anesthetized to remove the hub. Five 0.5 mm, stainless steel EEG electrode screws are placed in contact with the dura through the skull and serve as four recording electrodes and one reference electrode. The electrode wires are collected into a pedestal connector which is secured into place with bone cement. Continuous video/EEG recordings are collected for up to 4 weeks post TBI.

Here we present a protocol to induce severe TBI with the lateral fluid percussion injury (FPI) model in adult, male Wistar rats. We also demonstrate the use of a wireless telemetry system to collect continuous video-EEG recordings and monitor for epileptiform discharges consistent with post-traumatic epileptogenesis.&#160;