Physiology and Pathophysiology

  • Analysis of the functional independence of patients with amiotrophic lateral sclerosis

    Introduction: Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative disease characterized by selective degeneration of motoneurons in the cortex, brain stem and spinal cord. Diversity in the clinical condition is a well recognized feature of the disease. Functional Independence (FI) relates to functional activities, identified by the individual as essential for the preservation of their physical and psychological well-being. Patients diagnosed with ALS have direct effects on functionality and well-being. Objective: Analyze the FI index of patients with ALS, living in Aracaju/SE. Methods: This is an analytical, descriptive, cross-sectional study, with sampling for convenience. Data collection was performed in the patients’ homes and Functional Independence Measure (MIF) was used to measure functional independence levels. Results and Discussion: Patients of both sexes were evaluated, being 75% male and 25% female. The mean age was 63.2 years and the time of diagnosis was on average of 4.7 years. Of these, 50% breathed in ambient air and 50% used mechanical ventilation assistants, 75% were assisted with auxiliary devices and 25% were restricted to the bed. All patients receive medical care and 25% of them are assisted by a multidisciplinary team. MIF presented a mean of 65.25 points in total, indicating a dependence between modified and complete in the individuals studied. Chronic diseases such as ALS produce significant repercussions on IF, but with preservation of cognition and these are some of the main problems in the life of patients. Conclusion: Individuals affected by ALS have heterogeneous alterations, with a consequent decrease in their FI. The use of instruments such as MIF is important to assist in more personalized therapeutic action and contribute to the delay of functional dependence.

  • Palliative care: toy therapy benefits of pediatric oncology

    Introduction: Palliative term means “calm ‘’ or” temporarily slow down evil ‘’, according to the World Health Organization (WHO). In this process, palliative care to cancer patients is given from the time of diagnosis, generating preventive actions primarily for the relief of pain of each individual. Pediatric patients often require a different palliative care. Given this, the Law No. 11,104, of March 21, 2005, establishes toy libraries installation in health facilities that offer pediatric care in detention regime. Objective: analyze the benefits of toy in pediatric oncology. Methodology: This is a literature review study, using the following electronic journals in databases: BDENF, LILACS, SciELO and Brazilian law. The descriptors used were Therapeutic Toy, Cancer, Palliative Care, Child oncopediatrica. The search took place 10-20 July 2017. Under the inclusion criteria for articles published between 2012 and 2016, written in Portuguese and in full text. Excluding the items that did not meet the theme. Results and Discussion: identified 98 publications, 12 of these met the inclusion criteria. The discussion of the play as a palliative care to cancer child, demonstrates to be relevant, since it is considered an important element in fighting the disease and treatment. The use of therapeutic play is seen as an essential tool in the treatment because it facilitates the understanding of the procedures and acceptance in the treatment and minimize the anxiety, stress and fear, also contributing to the interaction, the welfare and development of child. Conclusion: Finally, it is noted that the therapy with toys provides a child’s positive response on the procedures and the team itself, making it more collaborative procedures during their treatment, thus making it less painful and traumatic.

  • Case report – human tegumentary leishamaniasis

    Introduction: Leishmaniasis is a serious public health problem in Brazil and in the world. It is considered one of the six most important infectious diseases in the world and is endemic in 88 countries. The objective of this study is an account of the case of a patient attended by Dermatology Department from Clinical Hospital at the Federal University of Pernambuco, which was admitted with clinical suspicion for leishmaniasis in the year 2013 and had your lesion evaluated through histopathological, molecular and also with stress and cellular inflammation markers, Hypoxia-inducible factor, HIF-1α. The patient had a lesion located in the nose, which was initially submitted to biopsy after four months of evolution. Subsequently, the material was submitted to the paraffinization procedure and after to included in the dermatology collection and analysis. Slides with sections of the material were stained with Hematoxylin / Eosin for histopathological analysis performed at the Hospital, and others were not stained for the immunohistochemical study, performed with peroxidase system and HIF-1α detection occurred in the nucleus and / or cytoplasm of macrophages and it was performed by Laboratory of Tropical Disease from Department of Biology at University of Campinas and analysis by molecular biology was done by deparafinisation of fragments and subsequent DNA extraction with Promega® kit followed by PCR performed at the Aggeu Magalhães-Recife research center. Histopathological medical report classified the lesion as differentiated Spinocellular Carcinoma and did not report presence of parasite, while the PCR was positive for Leishmania braziliensis, and the evaluation for HIF-1α was observed by strong marking (3+). Histopathological analysis is the only diagnostic tool used in HC-PE, which may complicate the manipulation and treatment, and cases like this show us the need for methods that corroborate for a more concise and differential diagnosis, when necessary. Using specific and sensitive techniques…

  • The importance of the nutritionist in the multidisciplinary team in the treatment and rehabilitation of the Huntington carriers

    Introduction: Huntington’s disease (DH) is characterized by being triggered by genetic alterations in chromosome 4, being hereditary and autosomal dominant, having as characteristic involuntary movements, intellectual deterioration, change in behavior, difficulty in feeding due to dysphagia, and psychiatric disorders, these are caused by the progressive death of neurological cells. This disease presents difficulties in the nutrition process, causing weight loss and worsening of health, with the development of pneumonia due to bronchoaspiration, resulting from diversions of liquids and other foods to the lungs and frequent suffocations. The role of the dietitian is to help the sufferer achieve the recommended daily intake of vitamins and minerals by providing the necessary dietary planning for DH patients with a view to the rehabilitation of body weight through the adequate intake of all nutrients, which may improve the spasms, the state of attention and interest of the patient, using auxiliary way nutritional supplements. Objective: To demonstrate the importance of the nutritionist and its functions in the multidisciplinary team responsible for monitoring, rehabilitation and quality of life control of patients with Huntington’s disease. Methodology: Qualitative research, through a bibliographic review subsidized in databases such as: Scielo, ABH (Associação Huntington Brasil), scientific journals, case studies and Bireme. Results and Discussion: The study evidenced the need to integrate the nutritionist professional to the multidisciplinary team in Huntington’s disease, seeking to improve the nutritional status of the patient, improving and increasing their energy intake, offering a hyperproteic and hypercaloric diet, using nutritional supplementation, food thickeners will facilitate swallowing and prevent bronchoaspirations. Conclusion: This research had its foundations based on the importance of the integration of the nutritionist in the multidisciplinary team for an assisted nutrient supply, and that the data presented here are of great relevance to the scientific community and subsidize future academic work.

  • Participation of a multidisciplinary team to treat patients with Parkinsons disease

    Introduction: Parkinson’s disease is neurodegenerative, chronic and affects motor and non-motor domains. Its individualized spectrum of symptoms and its slow progression favor the abandonment of treatment. Teams composed of neurologists, physical educators, speech therapists, nutritionists, psychologists and other professionals are increasingly important in the care of this pathology. Objective: To evaluate the importance of a multidisciplinary treatment in Parkinson’s disease. Methodology: An integrative review was performed on the PubMed and BVS databases, using the descriptors “Parkinson’s Disease”, “Patient Care Team” and “Therapeutics” between the years of 2013 and 2017. Review articles and in animals were excluded. Results and discussion: From the 18 studies located, only three were in agreement with the inclusion criteria. Although multidisciplinary intervention is beneficial in the treatment of chronic patients, evidence of its effectiveness in Parkinson’s disease is still limited, due to the lack of standardization in interventions and heterogeneous results. But studies indicate that the insertion of a multidisciplinary team in the care of patients with Parkinson’s disease can bring benefits in the motricity, the emotional state and the quality of life itself. An integrative approach may also have substantial consequences when compared to invasive treatments. It is even recommended that there be prolonged multicenter follow-up to assess the emotional state and the psychic safety of these patients preceding invasive therapies. Conclusion: In multidisciplinary care, there is an interrelationship between different professionals gathering different knowledge, in a more humanized and holistic approach. Allowing more effective care of these patients. Although there is great importance in this subject are still scarce the works that deal with the subject, being necessary more studies in the area.