Objective: To report cases of children and adolescents diagnosed with pseudotumor cerebri associated or not with rheumatic disease. Methods: This was a retrospective study based on medical reports of 29 patients, up to 18 years of age and diagnosed with pseudotumor cerebri, followed up in the Pediatric Rheumatology and Neurology outpatient clinics of a tertiary hospital, until December 2016. Results: Among the 29 patients diagnosed with pseudotumor cerebri, 51.7% were girls and the mean age at the disease onset was 12.3 years. In 18 patients (62%) where an etiology was found, four were associated with a rheumatic disease. The most common symptom was headache (69%) and acetazolamide was the most used medication (69%). Two patients developed blindness and 10 are still being followed up. Conclusion: Although rare, pseudotumor cerebri should be considered in children with headaches, especially in patients with rheumatic disease.
Objetivos: Revisão da literatura na busca de evidências da efetividade da fisioterapia aquática em pacientes com doença neurológica e análise crítica dos ensaios clínicos aleatórios (ECA). Método: Localização dos ensaios clínicos aleatórios através da busca em bases eletrônicas e análise crítica dos ECA utilizando a lista Delphi. Resultados: Dos 207 trabalhos localizados 157 foram recuperados. Destes, 22 foram utilizados, sendo apenas 6 ECA. Um trabalho apresentou o método de aleatorização, mostrando que este não é um método utilizado regularmente em estudos clínicos sobre este assunto, devendo estudos futuros utilizar-se deste método para a alocação dos pacientes. A maioria dos estudos apresentou grupos similares com relação aos indicadores prognósticos mais importantes dos pacientes e, todos os estudos apresentaram critérios de elegibilidade especificados, intenção de tratar e foram relatadas estimativas das medidas de tendência central e variabilidade nas medidas de desfecho primário propiciando, assim estudos de melhor qualidade. Conclusão: existem fracas evidências na literatura dos benefícios da fisioterapia aquática quando aplicada à pacientes com doenças neurológicas, sendo fundamental a elaboração de um ensaio clínico aleatório de grande amostra para avaliar o efeito da fisioterapia aquática em pacientes com doença neurológica específica
O Acidente Vascular Cerebral (AVC) é uma doença que pode ocasionar incapacidade funcional e levar ao óbito. Sendo assim, é necessária a intervenção de uma equipe multidisciplinar, com formação especializada, para o manuseio desses pacientes. O objetivo desse estudo foi realizar pesquisa de campo, com profissionais da área da saúde, (enfermeiro, fisioterapeuta, assistente social, médico, fonoaudiólogo, terapeuta-ocupacional, nutricionista e psicólogo), sobre as dificuldades, dúvidas e importância de orientações sobre os cuidados de pacientes com AVC. Foi aplicado questionário a 146 profissionais da saúde, que possuem experiência no atendimento desses pacientes, nas cidades de São Paulo, Santo André, São Bernardo do Campo e São Caetano do Sul. Observou-se, nesse estudo, que a maioria dos profissionais da área da saúde apresentam dificuldades (85%), dúvidas (58%), e consideram importante receber orientações (91%), em relação aos cuidados de pacientes com AVC, através de materiais didáticos eletrônicos ou impressos, e cursos de extensão. A análise da pesquisa de campo realizada mostrou a importância e necessidade de informação/formação especializada para a maioria dos profissionais da saúde, da amostra estudada, que atendem pacientes com AVC.Unitermos: Acidente vascular cerebral, Educação continuada, Profissionais da saúde, Cuidados especializados. SUMMARYStroke can generate functional disability and death. It is necessary an intervention of a multidisciplinary team with specialized formation to handle those patients. The objective of this study was to accomplish field research with professionals of health area (nursing, physiotherapy, social work, physician, speech therapy, occupational therapy, nutritionist and psychologist) on the difficulties, doubts, and importance of orientations on caring of patients with stroke. 146 questionnaires were applied to health professionals, Artigo OriginalProfissionais da saúde, que assistem pacientes com Acidente Vascular Cerebral, necessitam de informação especializada Health Professionals who treat stroke patients need specialized information.
Purpose. To correlate optical coherence tomography (OCT) measurements with clinical parameters in idiopathic intracranial hypertension (IIH). Methods. A cross-sectional study was conducted with 22 patients with IIH and 11 controls. All participants underwent comprehensive ophthalmological examination followed by spectral-domain OCT (SD-OCT) and standard automated perimetry using the 30–2 program of the Humphrey visual field analyzer. Correlations between ganglion cell complex (GCC) thickness and retinal nerve fiber layer (RNFL) thickness, as measured by SD-OCT, and clinical parameters were assessed using generalized estimating equations. Result. The mean age of the participants was 35.0 ± 10.83 years. The groups were similar regarding age, but were significantly different regarding sex and visual acuity ( p = 0.001 and p = 0.038 , respectively). The GCC was significantly thinner in the IIH group, with a mean of 90.535 ± 9.766 μm compared to 98.119 ± 6.988 μm for the controls ( p = 0.023 ). There was a significant association between GCC thickness and optic disc pallor ( p = 0.016 ) and between edema and visual acuity ( p = 0.037 ). No significant difference was found in RNFL thickness between patients and controls. Conclusion. The GCC was thinner in the patients with IIH compared to the controls, and there was an association between GCC and optic disc pallor. This might suggest a role for OCT parameters when the structural changes that occur in IIH are investigated, possibly guiding clinical decision making.
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