Expectativas prévias ao implante coclear e avaliação pós implante em adolescentes

This work aimed to verify tendencies of relation between previous expectations (P.E.), anxieties and fears of patients applying to Cochlear Implant (C.I.) and their later evaluation concerning the gains obtained with the implant. The subjects were 6 patients of both sexes, between 13 and 19 years of age, with C.I. accomplished from 7 to 44 months. The data previous to the surgery were collected from the patients registers and compared with the ones collected through the semi-structured interview conducted during the later rehabilitation stage. The results indicated similarity between two kinds of P.E. and evaluation post C.I.. The aesthetic aspect revealed itself as an important factor among the patients concerns. The pre-surgery guidance made the P.E. more adequate as well as the evaluation of the gains post C.I.. The necessity of psychological attendance pre and post C.I. is indicated in order to minimize the difficulties of adaptation related to the self-image of adolescent patients and the development of proper expectations.O trabalho objetivou verificar tendências de relação entre expectativas prévias (E.P.), ansiedades e temores de pacientes candidatos a Implante Coclear (I.C.) e suas avaliações posteriores quanto a ganhos obtidos com o implante. Os sujeitos foram 6 pacientes, de ambos os sexos, entre 13 a 19 anos de idade com I.C. realizado de 7 a 44 meses. Dados anteriores à cirurgia foram coletados dos prontuários e comparados aos coletados via entrevista semi-estruturada na fase de reabilitação posterior. Resultados indicaram similaridade entre tipos de E.P. e avaliações subseqüentes ao I.C.. O aspecto estético mostrou-se importante fator de preocupação. A orientação pré-cirúrgica facilitou adequação de E.P. e avaliações de ganhos pós implante. Indica-se a necessidade de acompanhamento psicológico pré e pós I.C. para minimizar dificuldades de adaptação relacionadas à auto-imagem de pacientes adolescentes e adequação de expectativas.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)USP Hospital de Reabilitação de Anomalias Craniofaciais - HRACUniversidade Estadual PaulistaUSP HRACHospital Reabilitação de Anomalias CraniofaciaisUSP Fac. Odontologia de BauruUSP HRAC CPAPUC-SPUniversidade Estadual Paulist

Slow-growing craniopharyngioma masquarading as early-onset eating disorder: Two cases

Udgivelsesdato: JulyBACKGROUND:: Craniopharyngiomas are slow-growing tumors, which can either be asymptomatic or present themselves with visual, neuropsychiatric or endocrine disturbances. Eating disorders (EDs) are syndromes with unknown etiology, associated with multiple endocrine abnormalities. In pediatric cases the presentation of EDs may differ markedly from those of adults. OBJECTIVE:: We report on two pediatric patients with craniopharyngioma misinterpreted as ED. METHOD:: Available patient records, psychiatric examinations, neuro-radiographic imaging, and biochemical data were evaluated. CONCLUSION:: The reported cases illustrate the importance to consider slow-growing craniopharyngioma in ED. Especially in atypical ED, neuro-radiographic, ophthalmologic and endocrine examination should be carried out. Furthermore, structural hypothalamic lesions in these cases mimicking features of ED, suggesting the possibility of an as yet unidentified structural hypothalamic disorder to be implicated in the etiopathogeny of ED. (c) 2008 by Wiley Periodicals, Inc. Int J Eat Disord, 2009

Pineal germinoma presenting as anorexia nervosa: Case report and review of the literature

Objective: Tumors of the hypothalamicpineal region may present with a wide variety of symptoms, including disturbed eating. We present a case where such a tumor was misdiagnosed as anorexia nervosa. Method: We describe a case of pineal germinoma invading the hypothalamus, which was initially diagnosed as anorexia nervosa. Results: Clinical features included weight loss, vomiting, pyrexia, hypernatraemia, and visual disturbance and the typical psychopathology of anorexia nervosa was absent. Conclusion: Organic disorder should always be considered before making a diagnosis of anorexia nervosa, particularly if the presentation is atypical. (c) 2006 by Wiley Periodicals, Inc