Nádia Nara Rolim Lima

Spirituality in childhood cancer care

To deal with the suffering caused by childhood cancer, patients and their families use different coping strategies, among which, spirituality appears a way of minimizing possible damage. In this context, the purpose of the present study was to analyze the influence of spirituality in childhood cancer care, involving biopsychosocial aspects of the child, the family, and the health care team facing the disease. To accomplish this purpose, a nonsystematic review of literature of articles on national and international electronic databases (Scientific Electronic Library Online [SciELO], PubMed, and Latin American and Caribbean Health Sciences Literature [LILACS]) was conducted using the search terms “spirituality,” “child psychology,” “child,” and “cancer,” as well as on other available resources. After the search, 20 articles met the eligibility criteria and were included in the final sample. Our review showed that the relation between spirituality and health has lately become a subject of growing interest among researchers, as a positive influence of spirituality in the people’s welfare was noted. Studies that were retrieved using the mentioned search strategy in electronic databases, independently assessed by the authors according to the systematic review, showed that spirituality emerges as a driving force that helps pediatric patients and their families in coping with cancer. Health care workers have been increasingly attentive to this dimension of care. However, it is necessary to improve their knowledge regarding the subject. The search highlighted that spirituality is considered a source of comfort and hope, contributing to a better acceptance of his/her chronic condition by the child with cancer, as well as by the family. Further up-to-date studies facing the subject are, thus, needed. It is also necessary to better train health care practitioners, so as to provide humanized care to the child with cancer.

Childhood depression: a systematic review.

As an important public health issue, childhood depression deserves special attention, considering the serious and lasting consequences of the disease to child development. Taking this into consideration, the present study was based on the following question: what practical contributions to clinicians and researchers does the current literature on childhood depression have to offer? The objective of the present study was to conduct a systematic review of articles regarding childhood depression. To accomplish this purpose, a systematic review of articles on childhood depression, published from January 1, 2010 to November 24, 2012, on MEDLINE and SciELO databases was carried out. Search terms were “depression” (medical subject headings [MeSH]), “child” (MeSH), and “childhood depression” (keyword). Of the 180 retrieved studies, 25 met the eligibility criteria. Retrieved studies covered a wide range of aspects regarding childhood depression, such as diagnosis, treatment, prevention and prognosis. Recent scientific literature regarding childhood depression converge to, directly or indirectly, highlight the negative impacts of depressive disorders to the children’s quality of life. Unfortunately, the retrieved studies show that childhood depression commonly grows in a background of vulnerability and poverty, where individual and familiar needs concerning childhood depression are not always taken into consideration. In this context, this review demonstrated that childhood-onset depression commonly leads to other psychiatric disorders and co-morbidities. Many of the retrieved studies also confirmed the hypothesis that human resources (eg, health care team in general) are not yet adequately trained to address childhood depression. Thus, further research on the development of programs to prepare health care professionals to deal with childhood depression is needed, as well as complementary studies, with larger and more homogeneous samples, centered on prevention and treatment of childhood depression.

Bipolar disorder incidence between children and adolescents: a brief communication

BACKGROUND Bipolar affective disorder is one of most injurious psychiatric diseases, not, rarely leading patient for suicide, and its prevalence keeps increasing worldwide, notably on low and, middle-income countries. For children living in northeast Brazil, extreme social conditions constitute, an environment of special vulnerability. OBJECTIVE Here we show that bipolar disorder incidence, between children and adolescents in this Brazilian region increased 34.2% from 2005 to 2014 and, in, the same area and age group, deaths provoked by self-caused injuries also became progressively, greater. RESULTS According to DATASUS, the Brazilian national databank for public health, information, in the last five years, we observed an increase of Bipolar Disorder incidence rates under, 19 year-old of about 34.2% in the northeast region of Brazil, while the increase for Brazilian general, population was 12.4%. If considered only patients under 10, this number is even greater, of 47.2%. Content of Table 2 shows this disproportion, while comparing the advance of bipolar disorder, morbidity indices nationwide and worldwide. CONCLUSION Children living in Brazils northeast, region are in a condition of extreme social disadvantage, what can be determinant for the recent and, sequential increase of bipolar disorder prevalence and the mortality in this age-group due to suicide, one of possible reflections of untreated mood disorders. For protecting these children is important to, identify the factors which prevent these illnesses and promote resilience for these young people.

Ultrastructural aspects of cranial and peripheric nerves of cronically diabetic and malnourished rats: a short biochemical panorama

Diabetes Mellitus is one of the most common causes of neuropathies, which can be caused by molecular imbalances that impair metabolic pathways. Studies in rats showed the importance of sirtuins (SIRT), deacetylases that use NAD+ as a cofactor, which have a widespread function in metabolism, and their relation when food deprived or calorie restricted. Additionally, diabetic neuropathy presents different structural biomarkers that cause morphological alterations in fibers that can be partially treated. SIRT1 is the principal sirtuin, which acts on hypothalamus, liver, kidney, among other organs, up regulating or down regulating the expression of some genes or enzymes crucial in the process of glucose absorption.

Factors Associated With Diabetic Neuropathy In Rats: A Systematic Review With Metanalysis

Diabetic neuropathy refers to a group of symptoms associated with the nerve’s damaged ability to perform its functions correctly. Symptoms may vary from paresis to pains that mainly affect sensitive or motor long nerves of feet and hands. Hence, experiments and analysis carried out with rodents, especially rats, allow several clinical interfaces to be known. Therefore, the aim of this study was to analyze the factors associated with diabetic neuropathy in rats. This is a systematic review with metanalysis. Data collection followed some priorelection criteria. The sources of information for the researched data are the databases MEDLINE/PubMed and Scopus. The research was conducted using the keywords found in descriptors/MeSH: rats, diabetic neuropathies, and risk factors with the Boolean operator “AND”. The BioEstat 5.3 was used for statistical analysis, and the Odds Ratio was calculated with a 95% confidence interval (CI). Eighty-three references were found, of which 17 followed the criteria and were then included in the present review. Some factors like nerve morphology, blood hypertension, oxidative stress, diabetes period, hypoglycemic effect, vascular complications, and insulin parameters represent the main risk factors for the development of diabetic neuropathy, as well as diabetes induction in rats by using drugs. Such factors are verysimilar to those from humans, thus requiring a deeper analysis of the theme in a considerable human sample.

The Childhood Depression: Narrative in Familiar Settings

The most mental disorders, including depression, involve the children in a way of great influence in their development processes. Similarly, say the researchers, it is imperative to explore the role of prenatal exposure and develop interventions to reduce the long-term negative impact of low socioeconomic status state in childhood on cognitive ability. On this way, parental practices and communication strategies with the child and the adolescent in the understanding of child depression happen thought the analysis of involvement narratives of disease, affective practices, empathic and linked in describing the itineraries of psychic pain and suffering. It is also important to know that there are “prohibited words” in the family and that these words said and prohibited by relatives appears to make the encounter with the brands and the representations that make up the child depression in search of another character, as a way to associate the words the other access codes, and with this to situate pain and psychic sufferings in the return bedding of voices interpretation, especially in the recognition of what transforms life in mental disease possibilities. Because of that, the discourse have been pointed as one of the steps in the treatment of this disease. In the talk it is important to understand the relationship that requires understanding the child, through contact with the dynamics that seek to explain it by words spoken and prohibited in the face of life reality. In this way, in terms of depression, the word heard with ethics and commitment, combined with the medication and its monitoring can be a powerful icon in the treatment of disease

An Update On Rodent Model Studies In Diabetic Neuropathy: A Brief Communication

The diseases of the peripheral nerves are quite common and diversified, are directly related to several factors, ranging from the imbalance related to good nutrition and adequate needs of nutrients, going to the injuries caused by drugs or mechanisms external to the human organism. Diabetes is a complex syndrome that affects and kills millions of people worldwide. We demonstrated through the experimental model of diabetes using STZ@ in single intraperitoneal dose of 60 mg / kg, that both a purely motor nerve can be directly affected as well as a special afferent nerve (cranial nerve), this comparison showed us that there is a possibility of having a new type of mixed type neuropathy, this may be related to the amount of the dose involved, such as the time of disease progression, but more studies need to be done for definitive confirmation. We can extrapolate the original results to understand the mechanisms of diabetes in humans, although it does not yet have an experimental model of type II diabetes, more related to eating disorders, the STZ application simulates the effects of type I or insulin dependent diabetes, with more serious and deleterious effects mainly the more distal portions of the nerves. Prevention and food control are very important, especially those related to the mechanisms that involve carbohydrate metabolism and its peripheral resistance. The original results commented here are relevant for the continuous study of this serious but old illness, but quite current in the medical and therapeutic clinic. Keywords: Experimental Model of Diabetes; Sensory and Motor Peripheral Nerves; Peripheral Nerve Injuries; Neuropathies; STZ; Rats.

Childhood Depression in Family Narratives

BACKGROUND: The family narratives are true contextual cues in the representation of the experiences of illness of depressive child. The family members use healthcare services in an attempt to understand the disease so that describe the everyday practices in the living with the child. OBJECTIVE: This original article aims to present childhood depression with its various nuances and its many consequences in the family context. METHODS: The universe of this study involved 24 families in the age group ranging from 45 to 70 years who searched the care services at Childrens Psychosocial Care Center (CAPSi). Through the records, a survey of the family members was performed, from case reports, in the course of medical and psychological consultations. This is a purposive sample, which was selected by approximation the inclusion criteria, a sample of 12 family members of both sexes. The attention focused on the use of narrative interview - which is recognized as a genre of sociolinguistic research - fully recorded. RESULTS: The family member has its convivial trajectory with the disease through a specific identity and enunciation with the child. The family narratives show up symbolic portraits to the rescue of the guiding elements of the depressive situation. The family narratives are shown as spaces of reinterpretation of pain and psychological distress. The disorder explained in the narratives of childhood depression inserted in understanding plays a crucial role in exposing the intensity of pain and psychological distress. CONCLUSION: It is fundamental important in clinical care the psychiatric practice inserted into the historical and social context of the family members who have their own living narrative with the disease.

Cancer Treatment and the Fear of Death

INTRODUCTION: The fear of death has significantly appeared in women’s narratives about specific aspects and needs regarding cancer treatment. This study aimed to understand the coping strategies used by female patients with cancer during the illness process, as well as to highlight the psychological factors involved in the fear of death. METHODS: A qualitative study was carried, using narrative interview as instrument to collect data. Information gathering task was accomplished using content analysis technique. Later on, conceptual maps were designed, so as to include the enunciative instances related to the fear of death. RESULTS AND DISCUSSION: The fear of death is reported in the context of situations of suffering experienced by the interviewed women, lying underneath manifested physical and psychological aspects of these patients. The lack of information intensely shows the need of being listened to in issues related to living with cancer. CONCLUSIONS: It is possible to identify/recognize the fear of death in situations of anxiety, especially when dealing with side effects of cancer treatment and its relation with affective and emotional ways of interaction in the treatment process. KEYWORDS: Neoplasms, Cancer, Treatment, Fear, Death