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https://consultqd.clevelandclinic.org/common-skin-signs-of-covid-19-in-adults-an-update/ + https://twitter.com/duducompanheiro/status/1537601401920098305 Researchers provide an update on the 5 most common skin abnormalities associated with COVID-19 in adult patients:
- Morbilliform rash (containing macules and papules, resembling measles);
- Urticaria (itchy red welts);
- Vesicles (small blisters);
- Pseudo-chilblains (also known as “COVID toes,” painful inflammation of the digits in response to cold);
- Vaso-occlusive lesions (due to thrombosis and occlusion of small arteries, with subsequent ischemia).
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https://www.linkedin.com/pulse/what-dreams-mean-still-scientific-mystery-heres-we-do-compagnoni What dreams mean is still a scientific mystery, but here’s what we do know about nightmares, sleep disorders and why we dream. https://health-clevelandclinic-org.cdn.ampproject.org/c/s/health.clevelandclinic.org/dreams-and-dreaming/amp/ What Do Dreams Mean?
https://twitter.com/duducompanheiro/status/1537816131494465538 June 15, 2022 / Brain & Spine https://health.clevelandclinic.org/topics/health-a-z/brain-spine-health/
Imagine this. You’re enjoying a deep, restful snooze when suddenly you startle awake. However, it’s not from noise outside, but a vivid dream.
That’s not necessarily out of the ordinary. But you might wonder why your dreams are so realistic. And what does it mean when you dream about someone? What do falling dreams mean? What about recurring dreams?
Psychologists such as Sigmund Freud and Carl Jung developed theories to explain what dreams mean. “Freud thought dreams are repressed content, ideas or themes,” https://my.clevelandclinic.org/staff/8553-michelle-drerup says behavioral sleep medicine expert Michelle Drerup, PsyD, DBSM. “And Jungian theory came out of Freud’s ideas and has this idea of collective unconscious. It’s something that you’re carrying from your ancestors.”
But from a medical perspective, dream interpretation is still a mystery. “There’s no real consistent, scientifically proven theory linking specific content back to what a dream means,” Dr. Drerup notes.
What are dreams?
Dreams themselves are a little less mysterious. “Dreams are mental imagery or activity that occur when you sleep,” explains Dr. Drerup. You can dream at any stage of sleep, but your most vivid dreams typically occur in rapid eye movement sleep, https://my.clevelandclinic.org/health/articles/12148-sleep-basics or REM sleep. That’s the period of sleep when your brain is highly active, your eyes move rapidly behind your closed eyes and you have temporary loss of muscle tone.
“In REM sleep, we have less autonomic stability,” says Dr. Drerup. “Our heart rate increases. We don’t have the kind of steady, calm respiration that we do during other stages of non-REM sleep.”
Researchers find it challenging to analyze dreams because we often don’t remember them. “Even if you’re having a sleep study, it’s not like we can look in your brain and see what’s happening during a dream,” says Dr. Drerup. “That’s part of the reason why they’re still kind of mysterious — they’re difficult to study.”
Why do we dream?
https://health.clevelandclinic.org/why-do-we-dream-a-sleep-expert-answers-5-questions/ Doctors have several working theories as to why we dream. For starters, Dr. Drerup says you also tend to dream more in REM sleep. Additionally, dreaming during this stage is associated with “consolidation of memories,” she adds.
“That dreaming may represent important cognitive functioning. Brain activity that occurs when we’re dreaming is similar to the memory processing brain activity we experience when we’re awake.”
When you’re experiencing more stress or anxiety, you tend to dream more, too. The types of dreams you have also change. Dr. Drerup says that nightmares or stressful dreams — for example, about being chased or being in a frightening situation — are also common when you’re stressed. “That’s one of the theories of why we dream,” she says. “Our dreams might help us process and manage our emotions.”
Interestingly enough, Dr. Drerup notes that researchers have found that people living in certain places might have similar nighttime visions, although they aren’t quite sure why. “There seems to be some cultural influence on dreams,” she explains. “For example, the same type of dream might be more common in Germany.”
What do dreams mean?
Determining what dreams mean is a big question, one that doctors, researchers and scientists are still trying to answer. But Dr. Drerup stresses that dream interpretation is subjective. “That’s always what I tell people — the meaning that you ascribe to the dream is going to be much more meaningful than anything I ascribe to the dream,” she says. “Because it’s probably something from your life that’s represented in that dream.”
As an example, Dr. Drerup notes that you might have the same dream as someone else, but yours will be more representative of what you’re personally experiencing. “For example, if someone recently lost their job, a certain dream about not being able to find their shoes might mean something very different to them versus someone who recently went through a divorce.”
Dreaming that you’re pregnant — in other words, involved with a new life — is also subjective. This could occur maybe when you’re trying to get pregnant or if you were pregnant and had a miscarriage. Or maybe not. “It’s much more of what this dream means to you. Your dream of pregnancy could be much more about, ‘I’m starting a new career.’ A new life, in a sense. The dream could mean a whole lot of different things.”
Although experiences you have in a dream might be based on real-life events, that doesn’t mean your dreams are always realistic. “A person might be distorted in the dream, or in a situation or place where they wouldn’t normally be,” notes Dr. Drerup. “What does that mean? Your guess is as good as mine.”
However, sometimes even the strangest dreams have logical explanations. Dreams about your teeth falling out could be happening because you’re grinding your teeth in your sleep, https://my.clevelandclinic.org/health/diseases/10955-teeth-grinding-bruxism a condition called bruxism. “This dream is more a sign of psychological stress,” says Dr. Drerup.
What causes nightmares?
Nightmares can be terrifying and have lingering effects even when you’re awake. “With nightmares, especially recurring nightmares, it can feel like you’re playing out a story,” says Dr. Drerup. “People often say it’s like the same movie’s playing.”
Talking about a nightmare like you would a movie you’ve seen can bring about unexpected consequences. “If you have a nightmare, you’ll tell everybody about it because it was so weird, right?” ventures Dr. Drerup. “But rehearsing that nightmare over and over again means your neural pathways are getting reinforced. It’s like you’re developing a memory of that nightmare. Then, it’s more likely the dream will reoccur.”
Dr. Drerup says nightmares are commonly associated with a variety of other conditions and events as well, such as:
PTSD
For someone living with post-traumatic stress disorder (PTSD), nightmares are often a component of re-experiencing or re-living their trauma.
Alcohol
Overindulging a bit too much can exacerbate nightmares.
Stress
High stress levels can lead to more dreams and nightmares. According to Dr. Drerup, this is likely because the stress is kicking the emotional processing that occurs during dreaming into overdrive.
Psychological disorders
Dr. Drerup says psychological disorders such as depression and anxiety are associated more frequently with nightmares.
Medication withdrawal
Withdrawing from certain medications can also cause more nightmares. “Antidepressants suppress REM sleep, and decrease the amount of REM sleep that we have,” explains Dr. Drerup. “When you go off of an antidepressant, you tend to have REM rebound.”
In other words, you experience more REM sleep, which then makes it more likely that you’re spending time where dreaming happens. “People will often have an increase in dreams or nightmares when they discontinue antidepressants,” she adds.
Addressing untreated sleep apnea
https://my.clevelandclinic.org/health/diseases/8718-sleep-apnea People who get help for untreated sleep apnea often have “a high level of dream recall and potentially nightmares as well,” says Dr. Drerup. “If you have sleep apnea, you’re having fragmented disrupted sleep.” Getting better quality sleep means you’re going into REM sleep — and staying there, “instead of having these brief arousals that are keeping you out of that stage of sleep,” she notes. “You’ll have that REM rebound as well.”
Can sleep disorders affect dreaming?
Sleep disorders can affect all aspects of slumber, including dreaming.
Nightmare disorder
For some people, nightmares are more than just a temporary scare. https://my.clevelandclinic.org/health/diseases/12133-parasomnias--disruptive-sleep-disorders They have a sleep disorder called nightmare disorder.
“With nightmare disorder, you have these really distressing nightmares that are repetitive,” says Dr. Drerup. “They occur frequently. They wake you from sleep. You can’t get back to sleep afterwards. You have a panicked feeling upon awakening and take a while to reorient.”
https://health.clevelandclinic.org/what-is-lucid-dreaming-and-how-to-do-it/ This disorder can be debilitating, as you’re often very tired during the day. But Dr. Drerup says treating nightmare disorder is possible using what’s called imagery rehearsal therapy.
“This treatment has some really significant research backing behind it,” https://pubmed.ncbi.nlm.nih.gov/7677723/ says Dr. Drerup. “You work with your therapist to rewrite the nightmare to contain less disturbing content, and then practice the new dream imagery during the daytime.”
“It’s like guided imagery of that new content to make the dream less distressing,” https://health.clevelandclinic.org/guided-imagery/ she continues. “The image you’re practicing can replace or decrease the frequency of that disruptive nightmare, or completely eliminate it altogether.”
REM sleep behavior disorder
A sleep disorder called REM sleep behavior disorder can also cause abnormal dreaming. “During REM sleep, your muscles are typically paralyzed, so you don’t act out dreams,” says Dr. Drerup. “From an evolutionary standpoint, it happened because it was more protective for us to not be able to move when dreaming.”
People living with REM sleep behavior disorder, however, actually aren’t paralyzed — meaning they can move in their sleep while dreaming. Dr. Drerup says it’s not always an issue, but can be in certain situations.
“It’s often not as disruptive to you unless you’re punching someone in your dream, and then punch your spouse or the nightstand and injure yourself,” she says. “There are safety concerns with this.”
REM sleep behavior disorder can also foreshadow bigger health problems. “When someone is diagnosed with REM sleep behavior disorder really early in life, https://my.clevelandclinic.org/health/diseases/17815-lewy-body-dementia that’s linked to a really high conversion rate of someone eventually developing Parkinson’s disease or Lewy body dementia.”
Is it normal not to dream?
Dr. Drerup says there is a rare condition called Charcot-Wilbrand syndrome where people don’t dream at all. This dream loss occurs following focal brain damage (typically a stroke) https://my.clevelandclinic.org/health/diseases/5601-stroke-understanding-stroke that’s specifically characterized by you losing the ability to mentally recall (or “revisualize”) images.
Most people do dream, though — you just don’t recall them. “People will say, ‘I don’t dream at all, because I don’t sleep well.’ And that’s not necessarily the case,” explains Dr. Drerup. “Just because you don’t have dream content doesn’t mean that you’re not dreaming. We usually don’t remember our dreams unless we’re awoken from them.”
At the end of the day, however, dream interpretation is still a big mystery yet to be solved. But if you’re trying to puzzle out what your subconscious is trying to tell you, look to your day-to-day life for clues.
“We can have really good recall of a dream when we wake up, and then it’ll fade away,” says Dr. Drerup. “And then you think back, ‘I know I had a weird dream, but I don’t remember it.’ So, if you want to have more awareness, jot details down as soon as you wake up — what was the dream, identify if there’s patterns.”
“Once again, it’s much more what meaning you ascribe to dreams,” she adds. “That’s key. That’s more relevant than dream interpretation books that list specific interpretations.”
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Twitter.com/DuduCompanheiro —Briga comercial, pois dipirona é alemã, e os EUA desejavam impor seu TYLENOL® no mercado mundial, então proibiram dipirona em solo ianque= pro mundo ficar com medo.
Metamizol: medicamento principalmente analgésico e antipirético —disponível em balcão de um modo geral mundialmente, menos em alguns países como os EUA, onde sua venda é proibida, pelo suposto risco de agranulocitose= redução de leucócitos granulócitos (neutrófilos, basófilos e eosinófilos). A quantidade de granulócitos por volume de sangue abaixo da qual se considera como Agranulocitose é de 500 células por milímetro cúbico de sangue. https://pt.wikipedia.org/wiki/Agranulocitose
TYLENOL® foi criado em 1955 pelo laboratório norte-americano McNeil e lançado como um analgésico e antitérmico para o público infantil. Desde o início de sua comercialização foi amplamente recomendado pelos médicos, principalmente por possuir o paracetamol como princípio ativo. Em 1959, a Johnson & Johnson adquiriu o laboratório McNeil e ampliou o poder de eficácia do medicamento, diversificando suas aplicações. O TYLENOL® tem presença global em mais de 100 países, estando presente no Brasil desde 1974. https://www.jnjbrasil.com.br/tylenolboxhistoria
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https://consultqd-clevelandclinic-org.cdn.ampproject.org/c/s/consultqd.clevelandclinic.org/convergent-plus-optimizes-hybrid-strategy-for-persistent-atrial-fibrillation/amp/‘Convergent Plus’ Optimizes Hybrid Strategy for Persistent Atrial Fibrillation
https://www.linkedin.com/pulse/convergent-plus-optimizes-hybrid-strategy-persistent-oct-compagnoni Oct. 15, 2021. https://twitter.com/_10000feet/status/1533592268199837696
Convergent, the hybrid epicardial/endocardial approach to atrial fibrillation (AF) ablation, is increasingly used to provide a more durable and reliable posterior wall isolation with significantly reduced risk of esophageal injury. “Convergent Plus” adds ablation of the ligament of Marshall and a left atrial appendage (LAA) clip to further reduce stroke risk and AF burden. This more complete strategy has been pioneered at Cleveland Clinic and is now offered at its Complex AF Clinic.
“Surgeons and electrophysiologists each bring unique capabilities to the table to optimize strategies for persistent AF,” https://my.clevelandclinic.org/staff/21286-ayman-hussein says Ayman Hussein, MD, Medical Co-Director of Cleveland Clinic’s.https://my.clevelandclinic.org/departments/heart/depts/atrial-fibrillation-center Atrial Fibrillation Center. “The collaborative hybrid approaches are improving outcomes while reducing risks.”
Persistent AF involves substrate abnormalities
While excellent outcomes can typically be achieved with endocardial catheter ablation alone in patients with paroxysmal AF, success rates for a first-time procedure for persistent AF tend to be only around 65%.
Dr. Hussein explains that AF is mainly paroxysmal early in its course, with triggers from the pulmonary veins being the main culprit. As time goes on, the role of the substrate becomes increasingly important as the left atrium changes: mechanical stress due to pericardial tethers and cardiac motion causes stress-induced inflammation, leading to fibrosis and increased susceptibility to fibrillation, especially along the posterior wall.
“Many strategies have been tried to improve the outcomes of ablation in patients with persistent AF with only modest success,” https://my.clevelandclinic.org/staff/3456-walid-saliba says Walid Saliba, MD, Director of Cleveland Clinic’s Electrophysiology Lab and Medical Co-Director of the Atrial Fibrillation Center. He identifies several likely explanations:
- Pulmonary vein conduction recovers. The created lesions might not be transmural or may have gaps, which can be invisible during the procedure because of edema.
- Ablation is incomplete due to fear of injury. The electrophysiologist may limit energy delivery to the posterior wall of the left atrium to avoid causing an atrioesophageal fistula.
- Non-pulmonary vein triggers exist. Areas beyond the pulmonary veins may trigger AF, including the ligament of Marshall, the superior vena cava, the LAA and the coronary sinus. These areas are not routinely ablated; it is best to wait for evidence that triggers come from within these areas to do so.
CONVERGE establishes superiority of hybrid approach
The multicenter CONVERGE (Convergence of Epicardial and Endocardial Ablation for the Treatment of Symptomatic Persistent AF) trial compared efficacy and safety of adding epicardial left atrial posterior wall ablation (conducted by a cardiac surgeon) to endocardial catheter ablation to isolate the pulmonary veins (conducted by an electrophysiologist). https://www.ahajournals.org/doi/10.1161/CIRCEP.120.009288 Results were published in late 2020 in Circulation: Arrhythmia and Electrophysiology.
Freedom from atrial arrhythmia absent new or increased medications was reached at 12 months in 67.7% of patients who underwent the hybrid approach versus 50.0% of those who received endocardial catheter ablation alone (risk ratio = 1.35; P = 0.036). Off-antiarrhythmic drug success was achieved in 53.5% versus 32.0%, respectively (risk ratio = 1.67; P = 0.013). No deaths, cardiac perforations or atrioesophageal fistulas occurred.
“The hybrid Convergent procedure needs no cardiopulmonary bypass, and it spares the sternum and protects the esophagus,” https://my.clevelandclinic.org/staff/8050-edward-soltesz says Cleveland Clinic cardiothoracic surgeon Edward Soltesz, MD, MPH, Surgical Co-Director of the Atrial Fibrillation Center. “By targeting triggers and substrate, it provides a viable treatment option for complex atrial fibrillation.”
Cleveland Clinic’s approach to the hybrid procedure
Cleveland Clinic’s Complex AF Clinic offers state-of-the-art mapping and ablation techniques for patients with challenging AF cases, especially those who failed prior ablation procedures.
The epicardial ablation of the posterior wall is conducted first by a cardiothoracic surgeon via subxiphoid or transdiaphragmatic access to the pericardium. The posterior left atrium contributes minimally to left atrial ejection, Dr. Soltesz explains, with multiple studies demonstrating little ill effect of complete ablation.
Next, the endocardial procedure is conducted by an electrophysiologist in standard fashion.
The “plus” indicates additional management with a thoracoscopic LAA clip and ligament of Marshall ablation.
“Applying a left atrial appendage clip may have benefits in terms of both stroke prevention and arrhythmia control,” https://my.clevelandclinic.org/staff/7336-oussama-wazni says Oussama Wazni, MD, Section Head of Cardiac Electrophysiology and Pacing at Cleveland Clinic.
He notes that LAA clipping is one of the main advantages of Convergent Plus, citing the recently published Left Atrial Appendage Occlusion Study (N Engl J Med. 2021;384:2081-2091). https://pubmed.ncbi.nlm.nih.gov/33999547/ In patients who underwent surgery for AF, closing the appendage led to reduced incidence of stroke or systemic embolism after a mean follow-up of 3.8 years relative to those who did not have LAA closure (4.8% vs. 7.0%, respectively; hazard ratio = 0.67; 95% CI, 0.53-0.85; P = 0.001).
“We also target the ligament of Marshall because that has been shown to contribute to atrial fibrillation physiology in many cases,” Dr. Wazni adds.
A map of the left atrium showing electrical isolation (red) of the pulmonary veins and the posterior wall that is characteristic of results with the Convergent Plus procedure.
Candidates for Convergent Plus
Patients with any of the following should be considered for a hybrid procedure:
- Persistent AF and failure of one or multiple antiarrhythmic drugs
- Failure of multiple ablations
- Severely dilated atria
- Inability to undergo posterior wall ablation due to proximity to the esophagus
Absolute contraindications are either a documented LAA thrombus or significant valvular or coronary heart disease. These findings should prompt an open surgical approach and a concomitant Cox-Maze IV lesion set.
Staged vs. single-day approach
Hybrid procedures can be performed staged or in a single day. “At Cleveland Clinic, we prefer a staged approach, which allows resolution of postsurgical acute edema before the endocardial procedure is started,” Dr. Soltesz notes. “It also enables the epicardial lesions to mature.”
Moreover, he adds, staging allows time to determine whether a patient actually needs a second procedure, which can be helpful for patients who have had prior catheter ablations with good control of the pulmonary veins.
More questions to be answered
Cleveland Clinic’s Complex AF Clinic also has a research component: prospective data on patient characteristics and outcomes are collected, with the goal of assessing new technologies.
Dr. Saliba identifies several issues that deserve further research:
- Candidacy for the procedure: Might the hybrid approach also benefit patients with paroxysmal AF?
- Staged vs. simultaneous timing: Which produces the best outcomes?
- Anticoagulation: What are optimal strategies?
“Our Complex AF Clinic presents a great opportunity to move science forward,” Dr. Hussein concludes. “We anticipate that we’ll soon have longitudinal data on patient outcomes to share.”
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Até austríacos sabem! https://twitter.com/_10000feet/status/1533632830403760128
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Meritocracia! https://twitter.com/_10000feet/status/1533641096785547264
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Sobre 3ª Via! https://twitter.com/_10000feet/status/1533646873394917376
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Coach Reverso! https://twitter.com/_10000feet/status/1533669926766010369
🦀
https://twitter.com/_10000feet/status/1533682726792052737 Documentos do Wikileaks mostram como os EUA usam redes sociais de Marcelo Tas para propaganda!
⛓
https://twitter.com/_10000feet/status/1533692693397876738 Sempre alguém mete o “Nariz de fumar na chuva”= dando pitacos sem ser chamado!
Pitaco pi.ta.co pi'taku - nome masculino - coloquial: opinião pouco refletida ou pouco fundamentada; bitaite, palpite. De origem obscura; bitaite bi.tai.te bi'tajt(ə) - nome masculino - popular: opinião pouco refletida ou palpite geralmente sem fundamento. Corruptela de bitate.
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Pobre desconfie de quem nunca passou “Fome”! https://twitter.com/_10000feet/status/1533827734903857152
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Fico abismado com tantos defendendo apresentador de TV aqui, todos são educados pelo televisor, por isto o brasileiro é dócil/dominado/conformado!
No Xvideos vi várias transas com o televisor ligado na Globo, o brasileiro faz sexo ouvindo Bonner= sem saber o significado de boner em inglês! Boner= ereção em inglês!https://twitter.com/_10000feet/status/1533835502792712195
🦀
CorrupSOM Universitário! https://twitter.com/_10000feet/status/1533851442536235010
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Picanha do Guedes! https://twitter.com/_10000feet/status/1533866412636311553
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SertaNOJO Universitário= CorrupSOM! https://twitter.com/_10000feet/status/1533879758878134274
🦀
Va-ga-bun-do! https://twitter.com/duducompanheiro/status/1533890182977560577
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https://twitter.com/duducompanheiro/status/1533892999041654788 Fui agredido por um agente penitenciário, após quebrar meu rosto dito agente simulou golpes com um pedaço de madeira no próprio corpo pra dizer que fui eu, motivo da agressão? Reclamei que meu lanche veio sem batatas fritas, pois havia pago por elas, o agente fazia bico na lanchonete.
⛓
Reverso Coach! https://twitter.com/duducompanheiro/status/1533918767629074432Gangorra - Dom Manel https://vm.tiktok.com/ZMNdTrn2D/
🦀
https://twitter.com/duducompanheiro/status/1533941928269697024 Uma máquina de xerox o cérebro 🧠 repetindo algo que viu em algum momento com palavras diferentes, pergunte algo numa fila= o primeiro e o último darão respostas similares com palavras diferentes, então é preciso tirar o brilho do artista excluído há tempos= ao invés de incluí-lo: https://twitter.com/duducompanheiro/status/1533928438112960514 Repetimos aquilo que escrevem aqui, sempre manipulados pelo opressor, não é você, somos assim.https://youtu.be/ItVY5xs3_VM Este era militar e foi cancelado pelo opressor também! https://youtu.be/z_qknpPA5JA Acontece, e o dono da bola quer que o oprimido seja lembrado como “cancelado” e nunca como um artista “espetacular”! Uma máquina de xerox o cérebro 🧠 repetindo algo que viu em algum momento com palavras diferentes… Identitarismo! https://vm.tiktok.com/ZMNdKSVgQ
🦀
Dá zero pra eles! https://twitter.com/duducompanheiro/status/1533958591874584577
⛓
Bento Carneiro= coach brasileiro. https://twitter.com/duducompanheiro/status/1533977315000320000
⛓
Bento Carneiro= coach brasileiro. https://twitter.com/duducompanheiro/status/1533977315000320000
🦀
Revolução do Mito! https://twitter.com/duducompanheiro/status/1533994841520099330
⛓
https://twitter.com/duducompanheiro/status/1534004267941609474 Agora guerra também é responsável pela impressão desenfreada de dólares?
🦀
Rosebud! https://twitter.com/duducompanheiro/status/1534009168151121920
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13 Champions League! https://twitter.com/duducompanheiro/status/1534012452605665280
🦀
https://twitter.com/duducompanheiro/status/1534163880603271173 Teorias gringas pro júri sem noção tupiniquim:
a) TEORIA DOMÍNIO DO FATO;
b) delação inventada;
c) Teoria da Cegueira Deliberada, ou Instruções de Avestruz (Ostrich Instructions).
A DIVINA TRINDADE E SEU MÉTODO LAVAJATISTA —QUÉC!
⛓
#L! https://twitter.com/duducompanheiro/status/1534172080530415617
🦀
https://twitter.com/duducompanheiro/status/1534245791631556608 ¡Lo sabía Collor de Mello y también la policía!
⛓
Juiz Gatuno! https://twitter.com/duducompanheiro/status/1534309689487413248
⛓
https://twitter.com/duducompanheiro/status/1534396765973118976 Morou? Falta pouco demais pro Sergio Moro ser confirmado na “A Fazenda”! https://twitter.com/duducompanheiro/status/1534380005161041921
🦀
Inflado pela TV Goblo! https://twitter.com/duducompanheiro/status/1534402087450181633
⛓
Teu nariz tá branco! https://twitter.com/duducompanheiro/status/1534446451333419008
⛓
Efeito Guedes! https://twitter.com/duducompanheiro/status/1534454975941730306
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https://twitter.com/duducompanheiro/status/1534558909641498624 Maioria pensa que o STF não podia impedir o Moro, bastou o Temer colocar o dedo indicando 1 juiz nesta história= pro povo esquecer que o PT foi perseguido.
🦀
https://twitter.com/duducompanheiro/status/1534559829183832067 Aquela história de que presidente não pode ser preso= é tão fantasiosa quanto o STF virar polícia virtual.
⛓
Tiago volume raso! https://twitter.com/duducompanheiro/status/1534575441511579651
⛓
Marcelo Tas é outro panaca= estilo Vera laranja da TV Cultura Maluf! 🍊https://twitter.com/duducompanheiro/status/1534585835798073344
⛓
https://twitter.com/duducompanheiro/status/1534621229977681925 Ó Josué eu nunca vi tamanha desgraça!
"Metade da humanidade não come; e a outra metade não dorme, com medo da que não come". Josué de Castro & Chico musicou! 🦀
🦀 Da Lama ao Caos!
⛓
Me leva daqui! https://twitter.com/duducompanheiro/status/1534629487555534849
⛓
Moro 171! https://twitter.com/duducompanheiro/status/1534636261331324935
⛓
https://twitter.com/duducompanheiro/status/1534644638824415233 Y al pasar por tu calle allí estabas tú; Esperando en la parada del autobús; Comiéndote con gracia aquel chupachup; ¡Qué vicio, qué vicio!
🦀
Coach Reverso! https://twitter.com/duducompanheiro/status/1534653044616568832
⛓
Reverse Coach! https://twitter.com/duducompanheiro/status/1534658831472644096
⛓
Pantanar do Jumentino 17/22! https://twitter.com/duducompanheiro/status/1534679863734435844
⛓
🐂 Ivomec®! https://twitter.com/duducompanheiro/status/1534683670170288128
⛓
https://twitter.com/duducompanheiro/status/1534687229653794817 Francamente! Assino Globo Pay= paga e tenho que ver comercial o tempo todo, agora tem um quadro “Pense Fora da Bolha” com aquele escroto que mandou um afro-brasileiro ficar quieto na UNB devido cotas raciais: https://youtu.be/fCcyxahMDBk Raça Humana: bastidores das cotas raciais na UnB.
🦀
https://twitter.com/duducompanheiro/status/1534691678682075137 Como se estuda um espírito? Quando o pobre trabalhava por sopa de osso na França= surgiu o espiritismo dizendo que dita vida sofrida era consequência duma encarnação anterior de muitos pecados e riquezas. Morou? Então o pobre trabalhava por sopa pagando os pecados reencarnado.
⛓
Lula-Lula-Leila —Silvio Francesco! https://twitter.com/duducompanheiro/status/1534710985403125760
🦀
🦑🧔🏻♂️⭐️ Be-Bop-A-Lula é um rock de 1956, por Gene Vincent and His Blue Caps.https://twitter.com/duducompanheiro/status/1534720599636987906
🦀
Frentista de Maringá! https://twitter.com/duducompanheiro/status/1534731912639651840
⛓
Lu Lu La Lu —Hongga Hongga! https://twitter.com/duducompanheiro/status/1534743003381870593
🦀
Entre religiosos ruins o brasileiro padece.https://twitter.com/duducompanheiro/status/1534751903183249411
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Cabocla Maringá! https://twitter.com/duducompanheiro/status/1534762147103793158
⛓
Saravá! https://twitter.com/duducompanheiro/status/1534766814693101570
🦀
Gado Real! https://twitter.com/duducompanheiro/status/1534806278802968576
⛓
TikTok= é um Museu de Bocós! https://twitter.com/duducompanheiro/status/1534823755624722432
⛓
Big Cabra Da Peste! https://twitter.com/duducompanheiro/status/1534835754110750722
🦀
Um sulista nada sudestino! https://twitter.com/duducompanheiro/status/1534951784992620545
⛓
Já esteve na Bambinera?https://twitter.com/duducompanheiro/status/1534959961217847296 O Time do domicílio eleitoral fake do Serjo Moro!
🦀
https://twitter.com/duducompanheiro/status/1534968471280308238 Coach sincero! Loco —Andrés Calamaro. https://youtu.be/D8GP_LsGKcM
⛓
Cuidado! ⚠️ Todos já sabem:https://twitter.com/duducompanheiro/status/1534980187061903365
⛓
Existe um fungo no solo do nordeste que provoca coccidioidomicose e leva 6 meses para tratar. Os indivíduos geralmente adquirem a infecção pela inalação (entrada) do fungo, decorrente do manuseio do solo contaminado, relacionado às atividades laborais ou caça a tatus. https://www.gov.br/saude/pt-br/assuntos/saude-de-a-a-z/c/coccidioidomicose
⛓
The Brad and Caboclo “Ugly”! https://twitter.com/duducompanheiro/status/1534998144022372365
⛓
Coach pro ensino básico! https://twitter.com/duducompanheiro/status/1535006263200866325
⛓
Marreco Depenado! https://twitter.com/duducompanheiro/status/1535010187454603275
⛓
Observe o caminhãozinho! https://twitter.com/duducompanheiro/status/1535035039511203850 Note mãe e filha pedindo esmola= graças ao Moro + Guede$ & Bolsonaro!
⛓
Criança Feliz? Infeliz. https://twitter.com/duducompanheiro/status/1535046001840607235
⛓
QUÉC! https://twitter.com/duducompanheiro/status/1535088280819179522
⛓
https://twitter.com/duducompanheiro/status/1535093739911356419 Ladislas Dowbor ou Ladislau Dowbor [economista] de origem polonesa —catedrático titular na Pontifícia Universidade Católica de São Paulo (Wikipédia) —1941 [81 anos] Banyuls-sur-Mer, França.
🦀
Vida de Patrão —por Luxúria! https://twitter.com/duducompanheiro/status/1535101971362942986
⛓
Neymar= Velho Batuta! https://twitter.com/duducompanheiro/status/1535139261221064706
⛓
Vida Lixo! https://twitter.com/duducompanheiro/status/1535141264877932545
⛓
ADeus Eletrobras! https://twitter.com/duducompanheiro/status/1535266160190578688
⛓
Why Bill Gates is the largest private farmland owner in the United States https://twitter.com/duducompanheiro/status/1535282552763609088
⛓
Vadio! https://twitter.com/duducompanheiro/status/1535289037384208385
⛓
Aristinder! https://twitter.com/passaroserosas/status/1535290953648439296
⛓
50 Tons de Escuridão! https://twitter.com/duducompanheiro/status/1535316104335196163
⛓
Lula de novo! https://twitter.com/duducompanheiro/status/1535328734026276866
🦀
Luiz Inácio do Brasil! https://twitter.com/duducompanheiro/status/1535338145893556227
🦀
Prelude And Rooftop —Alfred Hitchcock! https://twitter.com/duducompanheiro/status/1535345000090853379
⛓
2019: The Ecstasy Of Gold! https://twitter.com/duducompanheiro/status/1535351541925830657
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https://twitter.com/duducompanheiro/status/1535371043002413056 Hoje vou
Ficar perto do candeeiro
De olho aberto no candeeiro
Pra ninguém soprar
Não vou ficar
Feito a ano passado
Naquele escurão danado
Bebo em pé e sem mulher
Lá eu fiquei, fiquei
Chupando o dedo
Santo Antonio, São João, São Pedro
E o resto do ano
Mas hoje dane-se…
🦀
1971/2022: https://twitter.com/duducompanheiro/status/1535410820645101568
⛓
🔎💯🍌 100 Banana 🍼!https://twitter.com/duducompanheiro/status/1535419670676787200
⛓
Tiago Barbie! https://twitter.com/duducompanheiro/status/1535430997671542784
⛓
¡Saludos Almagro! #OEA. https://twitter.com/duducompanheiro/status/1535436025874587648
🦀
https://twitter.com/duducompanheiro/status/1535448198591963136 "Última flor do Lácio, inculta e bela" 1º verso dum famoso poema de Olavo Bilac, poeta brasileiro que viveu no período de 1865 a 1918; dito verso designa o nosso idioma: a última flor é a língua portuguesa, considerada a última das filhas do latim. http://www.linguisticaelinguagem.cepad.net.br/EDICOES/02/arquivos/20%20Poesia.pdf
⛓
Quem qué Lula? https://twitter.com/duducompanheiro/status/1535456374645219332
🦀
Voto impresso! https://twitter.com/duducompanheiro/status/1535482429993099266
⛓
https://twitter.com/duducompanheiro/status/1535488432344006656 Rata de dos patas
Canção de Paquita la del Barrio https://youtu.be/VuyvT9inAf8
⛓
Tem Luiz no fim do túnel! https://twitter.com/duducompanheiro/status/1535643939197304832
🦀
Aqui os golpistas curitibanos ainda estão livres, por isto é preciso votar 13 em cada opção, pois assim o Centrão será aniquilado, então os juristas terão que seguir nossas leis e prender o cupinzeiro sulista chamado TRF4.
⛓
É mentira da Barata! https://twitter.com/duducompanheiro/status/1535731461638201344
⛓
Bactéria FDP! https://twitter.com/duducompanheiro/status/1535801724673396736
⛓
Trisal excitado! https://twitter.com/duducompanheiro/status/1535818149781815297 +https://twitter.com/duducompanheiro/status/1535822005374697472
⛓
Aquecimento do São Paulo! https://twitter.com/duducompanheiro/status/1535827193821114369
⛓
Coach Realista: “Você nunca valerá nada”! https://twitter.com/duducompanheiro/status/1535833366494420994
🦀
LinkedIn versus Tinder!https://twitter.com/duducompanheiro/status/1535863223806722048
⛓
Ricaços querem que você desconfie dos políticos e nunca desconfie da elite, além disto ricos difamam líderes sindicais de origem pobre, estes burgueses farão você pensar que o candidato pobre é presidiário e alcoólatra= enquanto desviam riquezas nacionais pra pequena burguesia.
Escravo da tua fé —Grilo. https://twitter.com/duducompanheiro/status/1535889520004149249
🦀
Cristão… Fala sério! Você realmente pensa que alguém não pode se livrar da sina de acreditar num Deus que te promete um paraíso em troca da tua exploração em vida?
Killer Queen! https://twitter.com/duducompanheiro/status/1535900369150267392
🦀
Bozo Jacu! https://twitter.com/duducompanheiro/status/1535996040108724232
⛓
Bozo Flozô! https://twitter.com/duducompanheiro/status/1536001234263588864
⛓
I got my red dress on tonight! https://twitter.com/duducompanheiro/status/1536014467561054208
🦀
Pipa alça voo em apoio a Bolsonaro e cai no pátio do presídio Papuda https://twitter.com/duducompanheiro/status/1536051592541179906
⛓
Pessoa Anta em Fortaleza! https://twitter.com/duducompanheiro/status/1536090784235134976
⛓
O Sul do ozônio retal sempre nos envergonha! Rio Grande do Sul/Cidade Capim —oops Gramado. https://twitter.com/duducompanheiro/status/1536097625904226305
⛓
Estrela Guia —PT! https://twitter.com/duducompanheiro/status/1536121603335012353
🦀
Peruca Americana —Horizonte! https://twitter.com/duducompanheiro/status/1536162800430632960
⛓
É Disso Que O Velho Gosta —Gaúcho da Fronteira! https://twitter.com/duducompanheiro/status/1536169897058779136
🦀
Bozo continua fumando tudo até… + https://twitter.com/duducompanheiro/status/1536177968631906304
⛓
Sabão 🧼 Limão! 🍋 https://twitter.com/duducompanheiro/status/1536180648616071168
🦀
Comunismo Made in Japan!🇯🇵https://twitter.com/duducompanheiro/status/1536195008432316416
⛓
Oh o Golpe… Plim! PLIM! https://twitter.com/duducompanheiro/status/1536212868886142977
⛓
Vivir Sin Ti, No Puedo —Pimpinela. https://twitter.com/duducompanheiro/status/1536225915646136322
🦀
Dane-se! Não sou albergue. https://twitter.com/duducompanheiro/status/1536231729383489537
⛓
Quero o meio-fio pintado! ⛓https://twitter.com/duducompanheiro/status/1536380240494215168 Por nosso meio-fio pintado —sem soldado privilegiado!
🦀
Deu merda! https://twitter.com/duducompanheiro/status/1536434414640680960
⛓
Cadê? https://twitter.com/duducompanheiro/status/1536438139610451970
⛓
Pelo fim das bancadas da Bíblia/bala/agro & para aniquilar o Centrão… Vote 13 em cada opção! https://twitter.com/duducompanheiro/status/1536456156402565123
🦀
Capitão da Encruzilhada! https://twitter.com/duducompanheiro/status/1536491350262177792
⛓
Atrás da orelha: Arruda —planta que benze! https://twitter.com/duducompanheiro/status/1536540501712769025
🦀
Jornalistas capturam o exato momento em que Bolsonaro caga nas calças. Entenda:https://twitter.com/duducompanheiro/status/1536721434034200577
⛓
Milico Anaeróbio! https://twitter.com/duducompanheiro/status/1536726659298205697
⛓
https://twitter.com/duducompanheiro/status/1536758268344909824 Livres & Anaeróbicos!https://vm.tiktok.com/ZMNNasrGM/
⛓
https://twitter.com/duducompanheiro/status/1536759392682508288 Tudo aquilo sobre Moro + Lava Jato + Tanque Russo na Ucrânia esmagando carro erra real? Se toca cara! Vai defender o carrasco agora? Tenha um bom dia, votarei 13 em cada opção= bye Centrão.
🦀
Mansão inFlávio/inflável! https://twitter.com/duducompanheiro/status/1536766566540488712
⛓
https://twitter.com/duducompanheiro/status/1536846158231912448 Guedes nos fez viver sem Lockdown e com liberdade pra pegar Coronavírus= vivendo doentes sem oxigênio.
Pet Mito… Aristides, deixamos seu cão= um gato!
🦀
Lua 🌝🌑🌜 Lula! 🦑🧔🏻♂️⭐️https://twitter.com/duducompanheiro/status/1536857675069267973
⛓
Chega de Globo= que o povo tá bobo! https://twitter.com/duducompanheiro/status/1537066979382775808
🦀
https://twitter.com/duducompanheiro/status/1537142789200388098 Yes I'm let loose from the noose;
That's kept me hangin' about
I been livin like a star 'cause it's gettin' me high;
Forget the hearse, 'cause I never die…
⛓
Treze! https://twitter.com/duducompanheiro/status/1537195690689953793
🦀
Piolho Chato! https://twitter.com/duducompanheiro/status/1537200212153970690
⛓
Pai Guedes= tira seu salário em um só dia! https://twitter.com/duducompanheiro/status/1537233796772544512
⛓
https://twitter.com/duducompanheiro/status/1537238260057264128 Morra sabendo= que o rei também morre prometendo paraísos pros vivos= explorados que oferecem seu trabalho= pro paraíso terrestre do rei mentiroso!
⛓
Fartura Guedes= Farta Tudo= menos Plim! PLIM! https://twitter.com/duducompanheiro/status/1537241219478466560
⛓
Tabagismo de extrema-direita: https://twitter.com/duducompanheiro/status/1537245094843191297
⛓
Extrema-direita! https://twitter.com/duducompanheiro/status/1537253373434597376
⛓
https://twitter.com/duducompanheiro/status/1537257767282565120 Inclua os líderes sociais= que morrem aos montes= principalmente no Brasil & Colômbia= ambos países com governantes homicidas!
⛓
Jumentoboy! https://twitter.com/duducompanheiro/status/1537261593121136640
⛓
Extrema-direita brasileira, bancada boi/bala/Bíblia! https://twitter.com/duducompanheiro/status/1537266860693114882
⛓
Rolaentrando! https://twitter.com/duducompanheiro/status/1537271532703076357
⛓
Gimme Tha Power! Canção de Molotov. https://twitter.com/duducompanheiro/status/1537293533643685888
🦀
50 Tons de Indecisão! https://twitter.com/duducompanheiro/status/1537302194491473921
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https://www.terra.com.br/amp/vida-e-estilo/saude/saude-bucal/atualidades/mais-bonito-lingua-no-lugar-certo-pode-mudar-a-fisionomia,e385395116f4902cc17aad99915de6568rxss7df.html Só o otorrino sabe se respiração oral é caso de tratamento medicamentoso ou de cirurgia das amidalas e ou da adenoide/carne esponjosa… https://twitter.com/duducompanheiro/status/1537444216938213378 Normalmente, ao manter os lábios fechados e a respiração pelo nariz, a língua fica naturalmente no lugar certo. Causas: Oclusão (mordida) incorreta, a alimentação sem mastigação com papinhas líquidas e mamadeira ou chupeta por muito tempo. Língua saudável tem tônus e fica em contato com o palato duro (isso só é possível se a boca fica fechada) e se o frênulo/freio da língua é normal (pele que liga a parte de baixo da língua com o assoalho da boca). Se não há razão problema com a respiração a causa pode ser mecânica ou viciosa”. Fonoaudiologia: Quando a causa foi solucionada, o tempo para fechar a boca e a língua ir para seu melhor local em adultos é de 2 a 3 meses de terapia. Em crianças, o tempo é maior, podendo chegar até 8 meses, mas a média costuma ser de seis meses. “Quando a língua não está bem colocada contra o palato duro significa que está baixa na cavidade oral e isso faz com que a boca fique aberta ou entreaberta. O tônus da língua diminui e, dependendo do tempo que a boca fica aberta, a pessoa pode ficar com bochechas mais caídas e lábios também alterados, sendo que o inferior fica evertido (virado para baixo) e o superior, sem contato com o inferior fica mais curto”, diz a fonoaudióloga, Irene Marchesan, presidente da Associação Brasileira de Fonoaudiologia. https://www.linkedin.com/posts/activity-6943204431282737153-YmOL
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https://my.clevelandclinic.org/podcasts/health-essentials/babies-and-bedtime-with-dr-heidi-szugye So, the American Academy of Pediatrics (AAP) recommends about 12 to 16 hours of sleep for infants less than a year of age. https://twitter.com/duducompanheiro/status/1537448177913110528 That sleep amount really decreases a little bit over that first year. So, in the first three months, that's when babies are going to need the most sleep, typically 14 to up to 16 hours a day. Once they hit three to four months, they require a little bit less sleep, but still a good chunk of sleep compared to you and I. So, 12 to 15 hours per day. I find it easier in those first three months, and even sometimes up to six months, to think about sleep more in, how long should the baby be awake? So, you're not sitting there adding up. I mean, 16 hours is a long amount of time, so you don't want to be sitting there adding up the hours, could be tedious and daunting. So, really up until six months they say.
Sometimes it helps to figure out, how long should my baby actually be awake? So, typically in the first six weeks of life, babies can stay awake for about 30 to 45 minutes, before they start to get sleepy and need a bit of a nap. As they approach 10 weeks, it gets closer to 60 minutes or an hour. Then by five months, they usually can stay awake for two hours. Then by five to seven months, it's usually two and a half to three hours. Then we can start changing that lingo around sleep and start using things like nap time and bedtime. But sometimes it's not even until six months when we can start saying that my baby takes a certain amount of naps a day, or has a distinct bedtime. By three to six months, babies are usually taking three naps a day. By six to nine months, it's usually about two naps a day. Then somewhere between 13 and 18 months is when we say kids will often drop down to one nap a day.
So, no. Up until the age of 12 months, stuffed animals, loose blankets and pillows should all be kept out of the crib. So, all you should have in the crib is a flat fitted sheet, nothing loose that could potentially get in the way of the child's breathing. That's the biggest concern we have, is that something will obstruct their airway. Instead of breathing in fresh oxygen, they actually re-breathe their own CO2, and that's what we think can cause Sudden Infant Death Syndrome. So, anything at all. Even hats is another thing. Babies might be wearing hats in the crib, and then if it falls off it could get in their airway. So, flat sheet is all we should have in the crib. https://www.linkedin.com/posts/duvar-compagnoni-8858bb215_babies-and-bedtime-with-dr-heidi-szugye-activity-6943208439678410752-yMRa
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https://twitter.com/duducompanheiro/status/1537454888518557696 Lute no Luto!
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Tutorial do Carluxo! https://twitter.com/duducompanheiro/status/1537466141047762945
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#Carofour.com.br! https://twitter.com/duducompanheiro/status/1537512630755155969
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Ensine o óbvio pra um bolsonarista! https://twitter.com/duducompanheiro/status/1537517661252460545
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https://twitter.com/duducompanheiro/status/1538595903136747520 COVID-19 Vaccine Update: Everyone 6 months and older should get vaccinated against COVID-19. Getting vaccinated can help protect you from severe disease, hospitalization, and death from COVID-19. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/children-teens.html
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https://twitter.com/duducompanheiro/status/1538599132998270981 Com sangue 🩸 nas mãos: https://twitter.com/duducompanheiro/status/1538604783367602176 Caetano Veloso narra jantar com Dallagnol e explica por que apoia, em seu “íntimo”, a Lava-Jato https://www.diariodocentrodomundo.com.br/essencial/caetano-veloso-narra-jantar-com-dallagnol-e-explica-por-que-apoia-em-seu-intimo-a-lava-jato/
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https://twitter.com/duducompanheiro/status/1538615868254470145 Ema, ema, ema: cada um com seus problemas —Rica Soares! https://vm.tiktok.com/ZMNY3JUw5/
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Mentira Manda & Momanda!https://twitter.com/duducompanheiro/status/1538628777881788418
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Earned it! https://twitter.com/duducompanheiro/status/1538636245156364295
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https://twitter.com/duducompanheiro/status/1538674870770335746 Ianque —Ara Va De Bo https://vm.tiktok.com/ZMN21etSB/
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https://twitter.com/duducompanheiro/status/1538695672584671233 O Twitter está cheio de malucos fingindo ensinar os seguidores de esquerda, porém ensinam errado, estes supostos defensores de esquerda passam uma mensagem sublimar pro ignorante virtual aprender errado.
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https://twitter.com/duducompanheiro/status/1538700631963222018 Vote 13 em qualquer uma das opções para cargos políticos, só assim o Centrão será aniquilado!
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Ouviram do Ipiranga da Globo!
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