HB - MFR - Artigos
Permanent URI for this collection
Browse
Recent Submissions
- Neurogenic stuttering: a review of the literaturePublication . Cruz, C; Amorim, H; Beca, G; Nunes, RINTRODUCTION: Neurogenic stuttering is a disorder of neurologic origin in the rhythm of speech during which the patient knows exactly what he wants to say but is unable to because of an involuntary prolongation, cessation or repetition of a sound. AIM: To assemble new insights regarding the epidemiology, pathophysiology, diagnosis, evaluation and treatment of neurogenic stuttering. DEVELOPMENT: A review of all PubMed and Scopus published articles between January 2000 and September 2016 was performed. Thirty-three publications were analyzed. Neurogenic stuttering is a rare entity whose epidemiological incidence is yet not fully established. It is correlated with several neurological diseases and with several possible localizations within the nervous system. Notwithstanding the recent advances in the understanding of the underlying mechanism, it is not yet possible to establish a single pathophysiological mechanism of neurogenic stuttering. The differential diagnosis is complex and requires the detailed knowledge of other language disorders. The treatment is currently based on specific speech language therapy strategies. CONCLUSION: Neurogenic stuttering is a complex disorder which is not fully understood. Additional studies might help to better explain the underlying pathophysiological mechanism and to open doors to novel therapeutic methods.
- Beneficial effects of pulmonary rehabilitation in adult asthmaPublication . Cruz, CM; Lacerda, C; Tizón, S
- Dynamic myelopathy in Hirayama diseasePublication . Pinho, J; Machado, C; Oliveira, TG; Soares, I; Magalhães, Z; Maré, R
- “Quando o Lateral se Torna Central” – Caso ClínicoPublication . Roriz, N; Antunes, FPain control in rheumatological disorders is a true clinical challenge because of its multiple presentations. Unsuccessful pain control attempts, add extra difficulty to its management. Osteoarticular chronic symptoms, especially in an advanced phase, are strongly incapacitating but often undervalued despite its functional impact in patient’s life quality. Treatment options are frequently limited by its side effects, being these one of the major problems when handling different pharmacological groups. We report the case of a patient with an enteropathic arthropathy presenting with difficult persisting pain control. It reflects the importance of a correct and rigorous clinical evaluation leading to therapeutic success.
- Síndrome de Escápula CrepitantePublication . Morgado, S; Antunes, FSnapping Scapula Syndrome is a rare disorder that consists mainly in an audible and/or palpable crepitus of the scapula with movements on the scapulo-thoracic plane. This crepitus is often associated with shoulder or cervicodorsal pain. Patients generally seek medical help for pain relief. This syndrome can have many causes, originating from the various anatomical structures involved in the scapulothoracic movement (bone, muscle, bursa…). The diagnosis is clinical, although imaging studies can be helpful in the identification of the underlying cause. Most patients with Snapping Scapula Syndrome are treated conservatively, with a rehabilitation program and analgesic medication. Surgical approach can be beneficial in patients that do not respond to the nonoperative treatment, although its execution is still not consensual. The authors present the case of a patient with Snapping Scapula Syndrome, its diagnostic and therapeutic approach and a revision of the literature on this pathological entity.
- Fraqueza Muscular Adquirida nos Cuidados Intensivos: Sub ou Sobrediagnosticada?Publication . Morgado, S; Moura, SIntensive care unit-acquired weakness (ICU-AW) is recognized as an important and common clinical problem, associated with an increased morbidity in critical ill patients. This muscle weakness has been described in a wide range of clinical settings and therefore, has many different terminologies such as “critical illness myopathy – CIM”, “critical illness polyneuropathy - CIP”, “acute quadriplegic myopathy”, among others. Nowadays, these designations are considered somewhat restrictive, therefore most authors adopt the more wide range designation of “ICU-Acquired Weakness”.Generally, these patients have a flacid tetraparesis without cranial nerve palsy, normal or diminished osteotendinous reflexes and no sensitive alterations unless on the cases traditionally classified as polyneuropathy. The diagnosis of ICU-AW is often difficult, and should be suspected whenever a critical ill patient has unexplained weakness. Traditionally, the diagnosis of neuromuscular diseases is based in nerve conduction studies and electromyography. Muscle biopsy can be used to confirm or exclude myopathy, but is not a routine exam. Since there is a significant percentage of critical patients that develop muscle weakness it is important to screen all patients in the ICU, avoid potential toxic re-exposures on the identified patients and begin early rehabilitation. However, two questions arise from this screening: if the screening is only clinical are we underestimating these patients? If electrophysiological are we overestimating ICU-AW? There are no specific therapies for ICU-AW. The criterious use of some drugs is one of the possible measures to be taken. On the other hand, the early inclusion of these patients in a rehabilitation program seems to be helpful for a speedy functional recovery. There are few studies regarding ICU-AW, and systematic studies with longer follow-ups and bigger samples are necessary to determine the most effective rehabilitation approach for these patients.
- Qualidade de vida na síndrome de 'cirurgia lombar falhada'Publication . Matias, AC; Antunes, FObjectives: Assessment of self-perceived health status and quality of life in a sample of patients with failed back surgery syndrome (FBSS) and analysis of correlations between the bodily pain dimension of the SF-36, the remaining dimensions of the same instrument and patients clinical data. Methods: Cross-sectional study with convenience sampling that included 40 patients with FBSS observed in PMR consultation between January and October 2010. Clinical data were recorded and the Portuguese version of SF-36 was self-administered. SPSS 17.0 was used for statistical analysis. Results: The mean score in all subscales of the SF-36 was less than 50 points except in social function. There was a significant correlation coefficient between the bodily pain domain and physical functioning, mental health, social functioning and role emotional domains. There was a stronger statistical correlation in the last two cases. There was also a statistically significant correlation between bodily pain and number of surgeries that patients underwent. Conclusion: This sample of patients with FBSS presented SF-36 results that reflect a self-perception of decreased quality of life. Bodily pain, being related to other dimensions, has obvious implications in the quality of life of these patients, which suggests and reinforces the importance of describing the experience of pain as a multifactorial process.
- Dor após cirurgia lombar: imagens e reflexosPublication . Gaspar, AT; Morgado, S; Antunes, FAim: To characterize one population with persistent or recurrent pain after lumbar spinal surgery and evaluate the functional impact of this pathological condition. Methods: The sample consisted of patients with a history of back surgery that kept the pain level and whom had performed imaging examination of the lumbar spine after surgery. The authors made the demographic characterization of the population and the characterization of pain using the DN-4 survey. It was considered the findings in neurological examination and the results of imaging studies. The assessment of quality of life was objectified using the SF-36 survey. Results: The study included 28 patients, mostly female and working age. Most patients had neuropathic pain, changes in neurological examination and for 27 of the 28 patients were found in imaging compression of neurvous structures, mainly by recurrence of initial pathology and scarring. The results obtained in the survey SF- 36 clearly showed the negative impact on patients quality of life. Conclusion: In this sample, most patients presents with documented anatomical lesion that may justify pain complaints. The negative impact on quality of life makes this clinical picture a true challenge for Physical Medicine and Rehabilitation.
- Development, Test and Validation of a Mechatronic Device for Spasticity QuantificationPublication . Ferreira, JF; Moreira, V; Lima, CS; Soares, F; Machado, J; Leão, CP
- Síndrome doloroso regional complexo tipo IPublication . Gaspar, AT; Antunes, FType I complex regional pain syndrome is a neurophatic pain syndrome whose physiopathology is not yet fully understood. It mainly affects limb extremities and often occurs after local trauma. There is no consensus on the treatment, but early intervention seems important, particularly in the context of Physical Medicine and Rehabilitation. The authors review physiopathologic mechanisms and point to importance of an early diagnosis, since failure to recognize this clinical picture and the consequent delay in treatment may cause serious functional impairments.