Tailoring antimicrobials in febrile neutropenia: using faster diagnostic and communication tools to improve treatment in the era of extensively resistant pathogens

Febrile Neutropenia represents a medical emergency and the use of appropriate antimicrobial therapy is essential for a better outcome. Although being time-consuming, conventional cultures and antimicrobial susceptibility tests remain the golden standard practices for microbiology identification. Final reports are typically available within several days. Faster diagnostic tools, such as species identification trough Matrix Assisted Laser Desorption Ionization-Time of Flight (MALDI-TOF) and molecular techniques might help to shorten time to diagnostic and also guide definitive therapy in this scenario. Here we present a case in which the use of a diagnostic molecular workflow combining MALDI-TOF and real-time PCR for relevant genes codifying antibiotic resistant integrated with instant communication report, led to a tailored and more appropriate treatment in a patient presenting with febrile neutropenia.     

Assistive technology for communication of older adults: a systematic review

Objective: Describe the use of assistive technology to enhance communication opportunities for older adults.

Methods: A systematic review was conducted in two databases, PubMed and Web of Science, by using two different searches in each. The search was limited to original articles, in English language, including people aged 60 years and older that used any type of assistive technology for communication. The articles found in the initial search were filtered by title, abstracts and the remaining articles were fully read.

Results: Eighteen studies were included in this review after the reading of full-texts. Most of the studies included apparently healthy participants with communication limitations due to aging related changes and the others included people with some pathology that prevent them from normal communication.

Conclusion: Four categories of assistive technology were identified: assistive technology for people with speech problems; robot or videoconferencing systems; Information and Communication Technologies and, other types of assistive technology for communication, such as hearing aids and scrapbooks. Assistive technology for communication of older adults is not only used by people with disabilities that prevent them from usual communication. They are mostly for older adults without a pathological communication problem.     

Combined effects of auditory and visual cues on the perception of vection

Vection is the illusion of self-motion in the absence of real physical movement. The aim of the present study was to analyze how multisensory inputs (visual and auditory) contribute to the perception of vection. Participants were seated in a stationary position in front of a large, curved projection display and were exposed to a virtual scene that constantly rotated around the yaw-axis, simulating a 360° rotation. The virtual scene contained either only visual, only auditory, or a combination of visual and auditory cues. Additionally, simulated rotation speed (90°/s vs. 60°/s) and the number of sound sources (1 vs. 3) were varied for all three stimulus conditions. All participants were exposed to every condition in a randomized order. Data specific to vection latency, vection strength, the severity of motion sickness (MS), and postural steadiness were collected. Results revealed reduced vection onset latencies and increased vection strength when auditory cues were added to the visual stimuli, whereas MS and postural steadiness were not affected by the presence of auditory cues. Half of the participants reported experiencing auditorily induced vection, although the sensation was rather weak and less robust than visually induced vection. Results demonstrate that the combination of visual and auditory cues can enhance the sensation of vection.     

Validation of the Geriatric Oral Health Assessment Index in complete denture wearers

To perform a validation of the Geriatric Oral Health Assessment Index (GOHAI) for complete denture wearers and present a proposal for estimation of perceived oral health. This is a cross‐sectional study with non‐probabilistic sampling. A total of 211 subjects with a mean age of 62·5 (s.d. = 11·4) years participated, being 169 female. The GOHAI was applied in a personal interview. The construct/convergent/discriminant validity was tested using structural equation modelling. Confirmatory factor analysis was used to verify the fit of three proposals of the GOHAI: three‐factor, one‐factor and second‐order hierarchical models. The stability of the models was evaluated in independent samples. The three‐factor model presented an inadequate fit, and items 3, 4 and 9 were removed. The new structure presented an acceptable fit and strong invariance in independent samples. The convergent, discriminant validity and internal consistency were below adequate. The one‐factor model presented an adequate fit to the sample. Convergent validity was compromised. A strong invariance of the one‐factor model was observed. To calculate the overall scores of the GOHAI factors (three‐factor model) or of the oral health perception (one‐factor model), a matrix of regression weights for each item in the model was presented as a suggestion. We found an adequate fit of the both structures of the GOHAI for denture wearers, but the three‐factor structure was more parsimonious. We suggested considering the weights of the regression model to calculate the overall score of perceived oral health or of its factors in different samples.