O presente estudo observou relatar os avanços em Onco-hematologia, área que cuidam das doenças malignas do sangue, estas doenças exigem tratamento específico, com avançados equipamentos e exames para cuidar de cada uma dessas patologias, que vai de exame de sangue ao Transplante de Medula Óssea. Ao decorrer do trabalho analisaremos perspectivas no tratamento de tais doenças, buscando um melhor entendimento sobre a importância destes estudos. A trajetória da hemoterapia a partir da era científica foi marcada por mudanças de paradigmas, ou seja, ela começa tendo uma importância mínima, com níveis rudimentares de técnica, tendo inclusive uma certa monetização para quem doava. Não havia uma preocupação como existe hoje em relação à detecção de doenças através de exames, era tudo muito precário.

The efficacy of electroconvulsive therapy (ECT) is widely recognized and indications are well defined for acute treatments. Surprisingly, the use of continuation and maintenance ECT (M-ECT) is uncommon after acute remission. This is partly because of the scarcity of scientific evidence. Indications are poorly defined and the practice is based on case reports and small open studies. Recent data suggest that M-ECT is a viable treatment option in severe affective and psychotic illnesses, especially in recurring, drug-resistant or medically compromised patients who suffer toxic effects with psychotropics.Studies regarding the duration and frequency of treatment sessions are laking. The time interval between sessions and duration of treatment vary according to clinical requirements, and should be individualized. The length of treatment and deciding when to stop it are still uncertain. Controversial data about the relation between the frequency of sessions and diagnostic is found. An inverse relation between good prognostic factors for each patient and the frequency of M-ECT was described. During continuation and maintenance ECT, seizure threshold increases until a plateau not being clear when the plateau is reached and if it depends on other treatment variables.The risk of cognitive dysfunction following M-ECT is one major concern. A transient memory and attention dysfunction are described after acute ECT. Recent studies seem to suggest that M-ECT is cognitively safe.

A esquizofrenia faz parte de um grupo de distúrbios mentais graves, que não possui sintomas característicos. O tratamento medicamentoso desta doença consiste no uso de antipsicóticos de primeira geração (típicos), contemplados na atenção básica, e os de segunda geração (atípicos), que são incluídos no Componente Especializado de Assistência Farmacêutica (CEAF). O estudo tem como objetivo analisar os aspectos clínicos e farmacoepidemiológicos de pacientes com esquizofrenia assistidos pelo CEAF em Teresina, Piauí. Trata-se de um estudo descritivo, observacional do tipo transversal com uma abordagem quantitativa sobre o tema. Pesquisas, que reportem os aspectos clínicos relacionados com os transtornos mentais graves tornam-se referência no assunto, fornecem dados epidemiológicos sobre a doença e são úteis para o direcionamento de implantação de serviços de saúde voltados para esses pacientes., os dados foram coletados através de entrevistas utilizando um questionário. Em relação aos primeiros sintomas apresentados pelos pacientes os mais frequentes foram alucinações e agressividade, os homens sofrem mais com o transtorno, fármaco Olanzapina é o mais dispensado, seguido da Quetiapina. Alucinação é geralmente, o primeiro sinal apresentado pelo paciente, os tratamentos convencionais com uso de fármacos antipsicóticos são eficazes, porém passíveis de efeitos adversos graves. Desta forma, os pacientes que têm esta doença têm o convívio social prejudicado, necessitando de cuidados contínuos, uso de fármacos para o controle da doença, e o acompanhamento do profissional farmacêutico, que é crucial para otimizar a farmacoterapia, visando uma melhor qualidade de vida.

IntroductionStudies with electroconvulsive therapy (ECT) in elderly focus mainly on the assessment of possible side effects on the cognitive functioning; there are few studies that evaluate the effectiveness.ObjectiveEvaluate the effectiveness of this treatment in the population over 65 years.AimsPerform a preliminary study to evaluate the response to ECT of ≥ 65 years patients with depression.MethodsWe carry out a descriptive study based on patients treated in the last 10 years in the ECT Unit of Centro Hospitalar Psiquiátrico de Lisboa.ResultsOur initial sample consisted of 457 patients. We select patients aged ≥ 65 years with depression, and with complete data, including electroconvulsive parameters, and initial and final Hamilton Rating Scale for Depression (HRSD) scores (n = 59). Of this, 81.36% (n = 48) had unipolar depression, and 18.64% (n = 11) had bipolar depression. In the first group, the mean variation between the initial and final scores in HRSD was 13.88 points, and 27.10% (n = 13) of the patients ended the treatment in the normal range of HRSD score. In the second group, the mean variation was 12.82, and 63.60% (n = 7) ended the treatment in the normal range of HRSD. Considering the initial and final HRSD scores, it appears that unipolar depression group presents higher values (severe depression) (P < 0.05). When we compare the mean variation between the initial and final HRSD scores, we didn’t observe a statistically significant difference between the two groups. There was a clinical improvement in both.ConclusionsThe acute treatment with ECT appears to improve depressive symptoms in bipolar and unipolar depression, when considering an elderly population.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionElectroconvulsive therapy is widely used for treatment-resistant psychiatric patients, with remission rates close to 50% and response rates between 60–70%. Post ictal suppression index (PISI) has been positively correlated with clinical outcome.ObjectivesCharacterize the treatment results of the electroconvulsive therapy unit of CHPL; find a correlation between improvement on HAM-D, PANSS and PSAS and PISI.MethodsThe patient data was collected and divided according to ICD-10 diagnosis. Evaluation scales were applied at the beginning and end of treatment: depressed patients (F31.3–5; F33; F20.4; F25.1) - HAM-D; schizophrenic/ schizoaffective/ bipolar-manic or mixed patients (F20.X, F25.X, F31.0, F31.6) - PANSS; with any of these diagnosis - PSAS. A correlation between the points of improvement on each scale and PISI was investigated using the Pearson product-moment correlation coefficient.ResultsOf 101 depressed patients, 33,7% showed remission and 49,5% showed response, over 11 sessions (average). The reduction on HAM-D score was significantly greater for patients with initial HAM-D score > 18 versus HAM-D ≤ 18 (52,9% versus 37,75%). Patients with unipolar depression (N = 72) and bipolar depression (N = 22) showed comparable results (response:47,2% versus 52,4%; remission: 30,6% versus 40,1%). Schizophrenic patients (N = 43) had higher response rates: 88%. No correlation was found between PISI and HAM-D, PANSS or PSAS improvement (r = -0,1;-0,01;-0,07).ConclusionResponse and remission rates in depressed patients were inferior to other ECT studies, except in patients with higher severity. Those rates were comparable for schizophrenic patients. PISI did not correlate with clinical outcome.