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  1 / 2095 MEDLINE  
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[PMID]:28416565
[Au] Autor:Perez DL; Matin N; Barsky A; Costumero-Ramos V; Makaretz SJ; Young SS; Sepulcre J; LaFrance WC; Keshavan MS; Dickerson BC
[Ad] Endereço:Department of Neurology, Functional Neurology Research Group, Cognitive Behavioral Neurology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
[Ti] Título:Cingulo-insular structural alterations associated with psychogenic symptoms, childhood abuse and PTSD in functional neurological disorders.
[So] Source:J Neurol Neurosurg Psychiatry;88(6):491-497, 2017 Jun.
[Is] ISSN:1468-330X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Adverse early-life events are predisposing factors for functional neurological disorder (FND) and post-traumatic stress disorder (PTSD). Cingulo-insular regions are implicated in the biology of both conditions and are sites of stress-mediated neuroplasticity. We hypothesised that functional neurological symptoms and the magnitude of childhood abuse would be associated with overlapping anterior cingulate cortex (ACC) and insular volumetric reductions, and that FND and PTSD symptoms would map onto distinct cingulo-insular areas. METHODS: This within-group voxel-based morphometry study probes volumetric associations with self-report measures of functional neurological symptoms, adverse life events and PTSD symptoms in 23 mixed-gender FND patients. Separate secondary analyses were also performed in the subset of 18 women with FND to account for gender-specific effects. RESULTS: Across the entire cohort, there were no statistically significant volumetric associations with self-report measures of functional neurological symptom severity or childhood abuse. In women with FND, however, parallel inverse associations were observed between left anterior insular volume and functional neurological symptoms as measured by the Patient Health Questionnaire-15 and the Screening for Somatoform Symptoms Conversion Disorder subscale. Similar inverse relationships were also appreciated between childhood abuse burden and left anterior insular volume. Across all subjects, PTSD symptom severity was inversely associated with dorsal ACC volume, and the magnitude of lifetime adverse events was inversely associated with left hippocampal volume. CONCLUSIONS: This study reveals distinct cingulo-insular alterations for FND and PTSD symptoms and may advance our understanding of FND. Potential biological convergence between stress-related neuroplasticity, functional neurological symptoms and reduced insular volume was identified.
[Mh] Termos MeSH primário: Córtex Cerebral/diagnóstico por imagem
Maus-Tratos Infantis/diagnóstico
Maus-Tratos Infantis/psicologia
Transtorno Conversivo/diagnóstico por imagem
Transtorno Conversivo/psicologia
Giro do Cíngulo/diagnóstico por imagem
Interpretação de Imagem Assistida por Computador
Imagem Tridimensional
Imagem por Ressonância Magnética
Doenças do Sistema Nervoso/diagnóstico por imagem
Doenças do Sistema Nervoso/psicologia
Transtornos Psicofisiológicos/diagnóstico por imagem
Transtornos Psicofisiológicos/psicologia
Transtornos de Estresse Pós-Traumáticos/diagnóstico por imagem
Transtornos de Estresse Pós-Traumáticos/psicologia
[Mh] Termos MeSH secundário: Adulto
Córtex Cerebral/fisiopatologia
Criança
Transtorno Conversivo/fisiopatologia
Dominância Cerebral/fisiologia
Feminino
Substância Cinzenta/diagnóstico por imagem
Giro do Cíngulo/fisiopatologia
Seres Humanos
Acontecimentos que Mudam a Vida
Masculino
Meia-Idade
Doenças do Sistema Nervoso/fisiopatologia
Tamanho do Órgão/fisiologia
Transtornos Psicofisiológicos/fisiopatologia
Estatística como Assunto
Transtornos de Estresse Pós-Traumáticos/diagnóstico
Transtornos de Estresse Pós-Traumáticos/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171114
[Lr] Data última revisão:
171114
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170419
[St] Status:MEDLINE
[do] DOI:10.1136/jnnp-2016-314998


  2 / 2095 MEDLINE  
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[PMID]:28336681
[Au] Autor:Mackay MT; Yock-Corrales A; Churilov L; Monagle P; Donnan GA; Babl FE
[Ad] Endereço:From the Department of Neurology (M.T.M.), Department of Haematology (P.M.), and Emergency Department (F.B.), Royal Children's Hospital Melbourne, Parkville, Victoria, Australia; Murdoch Childrens Research Institute, Parkville, Victoria, Australia (M.T.M., F.B.); Florey Institute of Neurosciences an
[Ti] Título:Accuracy and Reliability of Stroke Diagnosis in the Pediatric Emergency Department.
[So] Source:Stroke;48(5):1198-1202, 2017 May.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: Access to acute stroke interventions in the emergency department (ED) relies on correct clinical diagnosis. Our aims were to determine the accuracy and reliability of pediatric ED physician diagnosis of childhood stroke and other conditions presenting with brain attack symptoms. METHODS: Prospective study of consecutive children aged 1 month to 18 years presenting to the ED from June 2009 to December 2010 with focal neurological deficits. Accuracy (sensitivity, specificity, and receiver operator characteristic curves [ROCs]) and interrater agreement (κ) were determined, between ED physician diagnoses, as recorded in the electronic hospital administrative software system, and final neurological diagnosis, after completion of diagnostic work-up. RESULTS: Two-hundred eighty-seven children with 301 consecutive presentations were recruited. The most common final brain attack diagnoses included migraine in 84 children, first seizure in 48, Bell's palsy in 29, stroke in 21, and conversion disorders in 18 children. Sensitivity of ED physician stroke diagnosis was 62%, and specificity was 98% (ROC, 0.8). Inter-rater agreement for ED physician and final stroke diagnosis was substantial (κ=0.61). ED physician diagnostic accuracy and reliability was highest for Bell's palsy (ROC=0.98; κ=0.96), and lowest for central nervous system demyelination (ROC=0.5; κ=-0.01) and cerebellitis (ROC=0.50; κ=0.50). CONCLUSIONS: ED physician diagnostic accuracy and reliability varies considerably across disorders presenting with brain attack symptoms. Clinical recognition tools are required to assist pediatric ED physicians with diagnosis of stroke and other serious neurological disorders.
[Mh] Termos MeSH primário: Encefalopatias/diagnóstico
Serviço Hospitalar de Emergência/estatística & dados numéricos
Acidente Vascular Cerebral/diagnóstico
[Mh] Termos MeSH secundário: Adolescente
Paralisia de Bell/diagnóstico
Ataxia Cerebelar/diagnóstico
Criança
Pré-Escolar
Transtorno Conversivo/diagnóstico
Doenças Desmielinizantes/diagnóstico
Feminino
Seres Humanos
Lactente
Masculino
Transtornos de Enxaqueca/diagnóstico
Pediatria/estatística & dados numéricos
Reprodutibilidade dos Testes
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170630
[Lr] Data última revisão:
170630
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170325
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.116.015571


  3 / 2095 MEDLINE  
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[PMID]:28235779
[Au] Autor:Kanaan RAA; Duncan R; Goldstein LH; Jankovic J; Cavanna AE
[Ad] Endereço:Department of Psychiatry, Austin Health, University of Melbourne, Heidelberg, Victoria, Australia richard.kanaan@unimelb.edu.au.
[Ti] Título:Are psychogenic non-epileptic seizures just another symptom of conversion disorder?
[So] Source:J Neurol Neurosurg Psychiatry;88(5):425-429, 2017 May.
[Is] ISSN:1468-330X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Psychogenic non-epileptic seizures (PNES) are classified with other functional neurological symptoms as 'Conversion Disorder', but there are reasons to wonder whether this symptomatology constitutes a distinct entity. METHODS: We reviewed the literature comparing PNES with other functional neurological symptoms. RESULTS: We find eight studies that directly examined this question. Though all but one found significant differences-notably in presenting age, trauma history, and dissociation-they were divided on whether these differences represented an important distinction. CONCLUSION: We argue that the aetiological and mechanistic distinctions they support, particularly when bolstered by additional data, give reason to sustain a separation between these conditions.
[Mh] Termos MeSH primário: Transtorno Conversivo/diagnóstico
Convulsões/psicologia
[Mh] Termos MeSH secundário: Transtorno Conversivo/classificação
Transtorno Conversivo/psicologia
Diagnóstico Diferencial
Seres Humanos
Transtornos Psicofisiológicos
Convulsões/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171114
[Lr] Data última revisão:
171114
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170226
[St] Status:MEDLINE
[do] DOI:10.1136/jnnp-2017-315639


  4 / 2095 MEDLINE  
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[PMID]:28093564
[Au] Autor:Nelson EJ; Wu JY
[Ad] Endereço:Anesthesiology, Academic Office One, University of Colorado School of Medicine, Aurora, CO, USA.
[Ti] Título:Postoperative Conversion Disorder Presenting as Inspiratory Stridor and Hemiparesis in a Pediatric Patient.
[So] Source:Am J Case Rep;18:60-63, 2017 Jan 17.
[Is] ISSN:1941-5923
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND Postoperative conversion disorder is rare and has been reported. The diagnosis is usually made after all major organic causes have been ruled out. CASE REPORT We describe a case of a 13-year-old female who presented in the post-anesthesia care unit with acute-onset inspiratory stridor and unresponsiveness to verbal or painful stimuli after receiving a general anesthetic for upper endoscopy. Later in the post-anesthesia care unit, she presented with acute-onset right hemiplegia and sensory loss. She was first evaluated for causes of her stridor and unresponsiveness. The evaluation revealed paradoxical vocal cord movement, and all laboratory test values were normal. For her hemiplegia and sensory loss, she was evaluated for stroke with head MRI and CT scans, which were normal. CONCLUSIONS After extensive workup and consideration of multiple etiologies for her presenting signs and symptoms, the most likely diagnosis was conversion disorder.
[Mh] Termos MeSH primário: Encéfalo/diagnóstico por imagem
Transtorno Conversivo/etiologia
Pancreatectomia/efeitos adversos
Paresia/etiologia
Complicações Pós-Operatórias
Sons Respiratórios/etiologia
[Mh] Termos MeSH secundário: Adolescente
Transtorno Conversivo/diagnóstico
Feminino
Seres Humanos
Imagem por Ressonância Magnética
Pancreatite/congênito
Pancreatite/cirurgia
Paresia/diagnóstico
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170309
[Lr] Data última revisão:
170309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170118
[St] Status:MEDLINE


  5 / 2095 MEDLINE  
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[PMID]:28063373
[Au] Autor:Carlson P; Nicholson Perry K
[Ad] Endereço:Australian College of Applied Psychology, Level 11, 255 Elizabeth Street, Sydney, NSW 2000, Australia. Electronic address: perri@cwnn.com.au.
[Ti] Título:Psychological interventions for psychogenic non-epileptic seizures: A meta-analysis.
[So] Source:Seizure;45:142-150, 2017 Feb.
[Is] ISSN:1532-2688
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The aim of this meta-analysis is to evaluate and synthesize the available evidence from the previous 20 years regarding the utility of psychological interventions in the management of psychogenic non-epileptic seizures (PNES). METHOD: Studies were retrieved from MEDLINE via OvidSP and PsychINFO. Selection criteria included controlled and before-after non-controlled studies including case series, using seizure frequency as an outcome measurement. Studies were required to assess one or more types of psychological intervention for the treatment of PNES in adults. Data from 13 eligible studies was pooled to examine the effectiveness of psychological interventions in treating PNES on two primary outcomes: seizure reduction of 50% or more and seizure freedom. A meta-analysis was conducted with data extracted from 228 participants with PNES. RESULTS: Interventions reviewed in the analysis included CBT, psychodynamic therapy, paradoxical intention therapy, mindfulness and psychoeducation and eclectic interventions. Meta-analysis synthesized data from 13 studies with a total of 228 participants with PNES, of varied gender and age. Results showed 47% of people with PNES are seizure free upon completion of a psychological intervention. Additional meta-analysis synthesized data from 10 studies with a total of 137 participants with PNES. This analysis found 82% of people with PNES who complete psychological treatment experience a reduction in seizures of at least 50%. CONCLUSION: The studies identified for this analysis were diverse in nature and quality. The findings highlight the potential for psychological interventions as a favorable alternative to the current lack of treatment options offered to people with PNES.
[Mh] Termos MeSH primário: Transtorno Conversivo/complicações
Transtornos Psicofisiológicos/complicações
Psicoterapia/métodos
Convulsões
[Mh] Termos MeSH secundário: Eletroencefalografia
Seres Humanos
Escalas de Graduação Psiquiátrica
Convulsões/etiologia
Convulsões/psicologia
Convulsões/reabilitação
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170313
[Lr] Data última revisão:
170313
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170108
[St] Status:MEDLINE


  6 / 2095 MEDLINE  
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[PMID]:27988107
[Au] Autor:Reuber M; Brown RJ
[Ad] Endereço:Academic Neurology Unit, University of Sheffield, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, United Kingdom; Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester M13 9PL, United Kingdom. Electronic address: m.reuber@sheffield.ac.uk.
[Ti] Título:Understanding psychogenic nonepileptic seizures-Phenomenology, semiology and the Integrative Cognitive Model.
[So] Source:Seizure;44:199-205, 2017 Jan.
[Is] ISSN:1532-2688
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Psychogenic Nonepileptic Seizures (PNES) are one of the commonest differential diagnoses of epilepsy. This paper provides a narrative review of what has been learnt in the last 25 years regarding the visible manifestations, physiological features, subjective experiences and interactional aspects of PNES. We then explore how current insights into PNES semiology and phenomenology map onto the Integrative Cognitive Model (ICM), a new account of these phenomena that unifies previous approaches within a single explanatory framework. We discuss to what extent recent psychological and neurophysiological research is consistent with the ICM and indicate how the more detailed analysis of physiological data, connectivity analyses of EEG and functional or structural MRI data may provide greater insights into the biopsychosocial underpinnings of a disabling and under-researched disorder.
[Mh] Termos MeSH primário: Transtorno Conversivo
Epilepsia
Transtornos Psicofisiológicos
[Mh] Termos MeSH secundário: Transtorno Conversivo/complicações
Transtorno Conversivo/etiologia
Transtorno Conversivo/psicologia
Diagnóstico Diferencial
Eletroencefalografia
Epilepsia/diagnóstico
Epilepsia/etiologia
Epilepsia/psicologia
Seres Humanos
Imagem por Ressonância Magnética
Transtornos Somatoformes/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161219
[St] Status:MEDLINE


  7 / 2095 MEDLINE  
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[PMID]:27898362
[Au] Autor:Kanemoto K; Goji H; Tadokoro Y; Kato E; Oshima T
[Ad] Endereço:Neuropsychiatric Department, Aichi Medical University, Japan. Electronic address: fwkh2919@infoweb.ne.jp.
[Ti] Título:Psychogenic non-epileptic seizure in patients with intellectual disability with special focus on choice of therapeutic intervention.
[So] Source:Seizure;45:2-6, 2017 Feb.
[Is] ISSN:1532-2688
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:PURPOSE: There have been a number of studies exploring treatments for psychogenic non-epileptic seizure (PNES) but largely neglecting the sizable subgroup of patients with intellectual disability (ID). In the present study, we attempted to demonstrate effects and preferred modes of therapeutic intervention in PNES patients with ID being treated at a Japanese municipal center with a short referral chain. METHODS: We examined 46 PNES patients with ID (ID group) and 106 PNES patients without ID (non-ID group) retrospectively in case charts. In addition to examining basic demographic and clinical data, effects of different therapeutic intervention were examined as a function of decrease or disappearance of PNES attacks in the ID group. RESULTS: Age at the first visit as well as PNES onset was younger in the ID than in the non-ID group (t=2.651, p=0.009; t=3.528, p=0.001, respectively). PNES-free ratio at the last visit tended to be higher in the non-ID group (chi square=3.455; p=0.063). Psychosis was more often encountered in the ID group (chi square=13.443; p=0.001). Although cognitive therapy and pharmaco-therapeutic approaches were quite similarly distributed in both groups, environmental adjustment was often introduced in the ID group (44%) as compared to the non-ID group (15%) (chi square=14.299; p=0.001). Brief weekly visit service is also more often utilized by the patients with ID (54%) than by those without ID (35%) (chi square=5.021, p=0.025). CONCLUSIONS: Optimal treatment approaches in this sizable patient subgroup should be the subject of future prospective studies.
[Mh] Termos MeSH primário: Anticonvulsivantes/uso terapêutico
Terapia Cognitiva/métodos
Epilepsia
Deficiência Intelectual/complicações
Deficiência Intelectual/terapia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Transtorno Conversivo
Epilepsia/complicações
Epilepsia/psicologia
Epilepsia/terapia
Feminino
Seguimentos
Seres Humanos
Masculino
Transtornos Psicofisiológicos/complicações
Transtornos Psicofisiológicos/terapia
Estudos Retrospectivos
Transtornos Somatoformes
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticonvulsants)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170313
[Lr] Data última revisão:
170313
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161130
[St] Status:MEDLINE


  8 / 2095 MEDLINE  
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[PMID]:27719834
[Au] Autor:Edwards MJ
[Ad] Endereço:Department of Molecular and Clinical Sciences, St George's University of London and Atkinson Morley Regional Neuroscience Centre, St George's University Hospitals NHS Foundation Trust, London, UK. Electronic address: medwards@sgul.ac.uk.
[Ti] Título:Neurobiologic theories of functional neurologic disorders.
[So] Source:Handb Clin Neurol;139:131-137, 2017.
[Is] ISSN:0072-9752
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Although neurobiologic theories to explain functional neurologic symptoms have a long history, a relative lack of interest in the 20th century left them far behind neurobiologic understanding of other illness. Here we review the proposals for neurobiologic mechanisms of functional neurologic symptoms that have been made over time and consider how they might inform our diagnostic and treatment methods, and how they integrate with psychologic formulations of functional symptoms. Modern approaches map on to recent developments in theoretic models of brain function, and suggest a key role for processes affecting attention, beliefs/expectations, and a resultant impairment of sense of agency.
[Mh] Termos MeSH primário: Encéfalo/fisiopatologia
Transtorno Conversivo/fisiopatologia
Doenças do Sistema Nervoso/fisiopatologia
[Mh] Termos MeSH secundário: Seres Humanos
Doenças do Sistema Nervoso/psicologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161011
[St] Status:MEDLINE


  9 / 2095 MEDLINE  
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[PMID]:27694498
[Au] Autor:Nielsen G; Buszewicz M; Stevenson F; Hunter R; Holt K; Dudziec M; Ricciardi L; Marsden J; Joyce E; Edwards MJ
[Ad] Endereço:Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK.
[Ti] Título:Randomised feasibility study of physiotherapy for patients with functional motor symptoms.
[So] Source:J Neurol Neurosurg Psychiatry;88(6):484-490, 2017 Jun.
[Is] ISSN:1468-330X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To determine the feasibility of conducting a randomised controlled trial of a specialist physiotherapy intervention for functional motor symptoms (FMS). METHODS: A randomised feasibility study was conducted recruiting patients with a clinically established diagnosis of FMS from a tertiary neurology clinic in London, UK. Participants were randomised to the intervention or a treatment as usual control. Measures of feasibility and clinical outcome were collected and assessed at 6 months. RESULTS: 60 individuals were recruited over a 9-month period. Three withdrew, leaving 29 intervention and 28 controls participants in the final analysis. 32% of patients with FMS met the inclusion criteria, of which 90% enrolled. Acceptability of the intervention was high and there were no adverse events. At 6 months, 72% of the intervention group rated their symptoms as improved, compared to 18% in the control group. There was a moderate to large treatment effect across a range of outcomes, including three of eight Short Form 36 (SF36) domains (d=0.46-0.79). The SF36 Physical function was found to be a suitable primary outcome measure for a future trial; adjusted mean difference 19.8 (95% CI 10.2 to 29.5). The additional quality adjusted life years (QALY) with intervention was 0.08 (95% CI 0.03 to 0.13), the mean incremental cost per QALY gained was £12 087. CONCLUSIONS: This feasibility study demonstrated high rates of recruitment, retention and acceptability. Clinical effect size was moderate to large with high probability of being cost-effective. A randomised controlled trial is needed. TRIAL REGISTRATION NUMBER: NCT02275000; Results.
[Mh] Termos MeSH primário: Transtorno Conversivo/reabilitação
Transtornos Motores/reabilitação
Modalidades de Fisioterapia
[Mh] Termos MeSH secundário: Adulto
Terapia Cognitiva
Terapia Combinada
Transtorno Conversivo/diagnóstico
Transtorno Conversivo/psicologia
Avaliação da Deficiência
Estudos de Viabilidade
Feminino
Seguimentos
Seres Humanos
Comunicação Interdisciplinar
Colaboração Intersetorial
Masculino
Meia-Idade
Transtornos Motores/diagnóstico
Transtornos Motores/psicologia
Avaliação de Resultados (Cuidados de Saúde)
Aceitação pelo Paciente de Cuidados de Saúde/psicologia
Qualidade de Vida/psicologia
Anos de Vida Ajustados por Qualidade de Vida
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171114
[Lr] Data última revisão:
171114
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161004
[St] Status:MEDLINE
[do] DOI:10.1136/jnnp-2016-314408


  10 / 2095 MEDLINE  
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[PMID]:27640141
[Au] Autor:Järvenpää P; Ilmarinen T; Geneid A; Pietarinen P; Kinnari TJ; Rihkanen H; Ruohoalho J; Markkanen-Leppänen M; Bäck L; Arkkila P; Aaltonen LM
[Ad] Endereço:Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, P.O. Box 263, FI-00029 HUS, Helsinki, Finland. pia.jarvenpaa@fimnet.fi.
[Ti] Título:Work-up of globus: assessing the benefits of neck ultrasound and videofluorography.
[So] Source:Eur Arch Otorhinolaryngol;274(2):931-937, 2017 Feb.
[Is] ISSN:1434-4726
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Globus patients with normal ear, nose, and throat (ENT) status are a diagnostic challenge. The symptom may be long lasting and cause concern about malignancy, leading to possibly unnecessary further investigation. The aim of the study was to assess whether radiological examinations are useful in globus diagnostics, how often patients suffer from persistent globus, and whether globus patients with normal ENT status develop a malignancy during a follow-up. We reviewed medical records of all 76 globus patients referred to Helsinki University Hospital, Department of Otorhinolaryngology-Head and Neck Surgery in 2009. Patient history and findings in physical and radiological examinations were registered. A questionnaire concerning patients' present pharyngeal symptoms was sent 3 and 6 years after their initial visit. Data from the Finnish Cancer Registry revealed whether patients developed malignancies within a 3-year follow-up. Based on medical records, neck ultrasound was performed for 37 (49 %) and videofluorography for 22 patients (29 %), with nonsignificant findings. After a 3- and 6-year follow-up, half patients indicated that they were asymptomatic or had fewer symptoms, whereas the rest had persistent symptoms. The Finnish Cancer Registry data confirmed that globus patients developed no head and neck malignancies during a 3-year follow-up. In the present study, neck ultrasound and videofluorography showed no additional benefit to evaluate the globus etiology in patients whose ENT status was normal. Half the globus patients suffered from persistent symptoms after a 3- and 6-year follow-up, indicating that globus may cause discomfort chronically. However, no patients developed malignancies during a 3-year follow-up.
[Mh] Termos MeSH primário: Transtorno Conversivo/diagnóstico por imagem
Transtornos de Deglutição/diagnóstico por imagem
Transtornos de Deglutição/etiologia
Faringe/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Estudos de Coortes
Feminino
Finlândia
Seres Humanos
Masculino
Meia-Idade
Otolaringologia
Exame Físico
Radiografia
Inquéritos e Questionários
Ultrassonografia
Gravação em Vídeo
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170928
[Lr] Data última revisão:
170928
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160919
[St] Status:MEDLINE
[do] DOI:10.1007/s00405-016-4307-8



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