Ariovaldo Armando da Silva

Amyotrophic lateral sclerosis: combined nutritional, respiratory and functional assessment

OBJECTIVE To establish correlations between nutritional, functional and respiratory indices of patients with amyotrophic lateral sclerosis (ALS). METHOD Twenty patients (13 appendicular-GA and 7 bulbar-GB) were included in the multidisciplinary study at the Neurological Clinic Ambulatory of the University of Campinas Hospital. RESULTS Among the GA type significant correlation was observed between maximal inspiratory (MIP) and expiratory (MEP) pressure (r=-0.76), MEP and pulse oxymetry (r=0.58), MIP and percent weight loss (%WL; r=0.59), and between MIP, total and subscale respiratory scores (ALSFRS-R) with %WL. With regard to the GB, correlation was found between MEP and body mass index (BMI) (r=0.97). In both GA and GB correlations were noticed between the BMI and the variables mass (kg), fat (%), arm and wrist circumference (cm), and tricipital, subscapular and supra-iliac skinfolds (mm), as well as the arm muscle circumference (cm) and fatty arm muscular area (mm2). CONCLUSION It is suggested that the application of simple anthropometric measurements could be useful in routine monitoring of patients with ALS.

Importância da interdisciplinaridade na avaliação das disfagias: avaliação clínica e videofluoroscópica da deglutição

Opaciente disfagico apresenta prejuizos em diversos aspectos, sendo a atuacao interdisciplinar fundamental para definicao do diagnostico e da conduta. A atuacao em conjunto na avaliacao clinica e videoendoscopica e de extrema importância. OBJETIVO: Estudar a correlacao entre a avaliacao clinica (ACD) e videoendoscopica da degluticao (VED) por meio da classificacao do grau de severidade e a analise qualitativo/descritiva dos procedimentos. FORMA DE ESTUDO: Estudo transversal, descritivo, comparativo. MATERIAL E METODO: Realizado no marco a dezembro de 2006 no ambulatorio de Otorrinolaringologia/Disfagia de um hospital do interior de Sao Paulo. Foram avaliados pela ACD e VED 30 pacientes disfagicos com diferentes doencas. Os dados foram classificados por meio de escalas de severidade e analise qualitativa/descritiva. RESULTADOS: A correlacao entre as escalas de severidade de ACD e VED apontou concordância baixa (KAPA = 0,4) de modo estatisticamente significante (p=0,006). A correlacao entre a analise qualitativa/descritiva apontou concordância excelente (KAPA=0.962) estatisticamente significante (p<0.001) para a amostra total. CONCLUSAO: A concordância baixa entre as escalas de severidade aponta a necessidade da realizacao de ambos os procedimentos, reforcando a VED como procedimento factivel. A analise qualitativa descritiva apontou concordância excelente, dado que reforca a necessidade da compreensao da degluticao como um processo.

Características da comunicação em indivíduos com a síndrome do X frágil

The aim of this study was to make a characterization of the communication in a group with fragile X syndrome (FXS), based on normal development scale. The sample has 10 boys, between 6 and 13 years and with FXS. All of them were submitted to language evaluation. The most part of them had the communication in linguistic form (80%), until 3 years old. It was considered that the data confirmed the significant delay in the acquisition and development of the communication, being necessary an early and specialized intervention.

Interdisciplinary evaluation of dysphagia: clinical swallowing evaluation and videoendoscopy of swallowing

UNLABELLED Patients with dysphagia have impairments in many aspects, and an interdisciplinary approach is fundamental to define diagnosis and treatment. A joint approach in the clinical and videoendoscopy evaluation is paramount. AIM To study the correlation between the clinical assessment (ACD) and the videoendoscopic (VED) assessment of swallowing by classifying the degree of severity and the qualitative/descriptive analyses of the procedures. STUDY DESIGN cross-sectional, descriptive and comparative. MATERIALS AND METHODS held from March to December of 2006, at the Otolaryngology/Dysphagia ward of a hospital in the country side of São Paulo. 30 dysphagic patients with different disorders were assessed by ACD and VED. The data was classified by means of severity scales and qualitative/ descriptive analysis. RESULTS the correlation between severity ACD and VED scales pointed to a statistically significant low agreement (KAPA = 0.4) (p=0,006). The correlation between the qualitative/descriptive analysis pointed to an excellent and statistically significant agreement (KAPA=0.962) (p<0.001) concerning the entire sample. CONCLUSION the low agreement between the severity scales point to a need to perform both procedures, reinforcing VED as a doable procedure. The descriptive qualitative analysis pointed to an excellent agreement, and such data reinforces our need to understand swallowing as a process.