Cortical deafness of following bilateral temporal lobe stroke

Cortical deafness is an extremely rare clinical manifestation that originates mainly from bilateral cortical lesions in the primary auditory cortex. Its main clinical manifestation is the bilateral sudden loss of hearing. Diagnosis is difficulty due to its rarity and similarity with other language and communication disorders, such as Wernicke's aphasia, auditory agnosia or verbal deafness. Herein, we present a case report of a young woman with a sudden bilateral loss of auditory comprehension. Initially, a psychiatric nature of the disorder was considered, but the persistence of the symptoms, lead to the diagnosis of cortical deafness secondary to bilateral ischemic lesions in both temporal lobes. Progressive improvement occurred and three months after the initial manifestations she manifested pure verbal deafness. Cortical deafness usually has a poor functional prognosis, with limited therapeutic options. Rehabilitation and speech therapy is recommended to improve the chance of patients achieving communication skills.info:eu-repo/semantics/publishedVersio

Prevalence, predictors and treatment of insomnia in palliative care : systematic review of literature

Introdução: a função primordial dos cuidados paliativos é melhorar a qualidade de vida. O reconhecimento e tratamento dos sintomas que causam sofrimento é central para a concretização desse objetivo. A insónia pode causar desconforto e acarretar um peso acrescido de sofrimento aos doentes e famílias em cuidados paliativos. O conhecimento sobre a prevalência, fatores associados e tratamento da insónia nos cuidados paliativos é escasso. Metodologia: revisão da literatura com o objetivo de sistematizar o conhecimento sobre a prevalência, os preditores, e as opções de tratamento da insónia em doentes em cuidados paliativos. As fontes primárias de investigação foram identificadas e selecionadas através das bases de dados Pubmed e Scopus. A pesquisa foi complementada pela pesquisa de referências nos artigos identificados e em revisões selecionadas. A OpenGrey e o Google Scholar foram usadas para pesquisa de literatura cinzenta. A análise da qualidade dos estudos foi com base na Newcastle-Ottawa Scale. Resultados: foram incluídos 65 estudos na revisão. A maior parte dos estudos teve qualidade aceitável/boa. A prevalência da insónia nos estudos incluídos variou entre 2.1 a 100%, com prevalência mediana global de 49.5%. Fatores sociodemográficos como a idade; características clínicas como o estado funcional, estadio da doença, dor, uso de fármacos específicos, incluído os opióides; fatores psicológicos como a ansiedade/depressão, e espirituais como a sensação de bem-estar foram identificados como preditores. As opções de tratamento identificadas foram biológicas (farmacológicos e não farmacológicos), psicológicas (visualização, relaxamento) e espirituais (oração). Conclusões: a revisão sistemática demonstrou que a prevalência da insónia é alta, com pelo menos um em cada 3 doentes acometidos na maior parte dos estudos. A insónia nos cuidados paliativos está associada, tanto no seu risco como no seu tratamento, a fatores físicos, psicológicos, sociais e espirituais, refletindo a sua verdadeira natureza holística.Introduction: The primary function of palliative care is to improve quality of life. The recognition and treatment of symptoms that cause suffering is central to the achievement of this goal. Insomnia can cause discomfort and increase suffering of patients and families in palliative care. Knowledge about prevalence, associated factors and treatment of insomnia in palliative care is scarce. Methodology: literature review aimed at systematizing knowledge about the prevalence, predictors, and treatment options of insomnia in palliative care patients. Primary sources of investigation were identified and selected through Pubmed and Scopus databases. The research was complemented by reference search in identified articles and selected reviews. OpenGrey and Google Scholar were used for searching grey literature. Study quality analysis was based on the Newcastle-Ottawa Scale. Results: 65 studies were included in the review. Most studies had acceptable / good quality. The prevalence of insomnia in the included studies ranged from 2.1 to 100%, with a median overall prevalence of 49.5%. Sociodemographic factors such as age; clinical characteristics such as functional status, disease stage, pain and use of specific drugs, including opioids; psychological factors such as anxiety / depression, and spiritual factors such as feelings of well-being were identified as predictors. The treatment options identified were biological (pharmacological and non-pharmacological), psychological (visualization, relaxation) and spiritual (prayer). Conclusions: the systematic review showed that the prevalence of insomnia is high, with at least one in three patients affected in most studies. Insomnia’s risk factors and treatment in palliative care, are both associated to physical, psychological, social and spiritual factors, reflecting its true holistic nature

Systematic review of the prevalence, predictors, and treatment of insomnia in palliative care

Introduction: The primary function of palliative care is to improve quality of life. The recognition and treatment of symptoms causing suffering is central to the achievement of this goal. Insomnia reduces quality of life of patients under palliative care. Knowledge about prevalence, associated factors, and treatment of insomnia in palliative care is scarce. Methodology: Literature review about the prevalence, predictors, and treatment options of insomnia in palliative care patients. Primary sources of investigation were identified and selected through Pubmed and Scopus databases. The research was complemented by reference search in identified articles and selected reviews. OpenGrey and Google Scholar were used for searching grey literature. Study quality analysis was based on the Newcastle-Ottawa Scale. Results: A total of 65 studies were included in the review. Most studies had acceptable /good quality. The prevalence of insomnia in the included studies ranged from 2.1% to 100%, with a median overall prevalence of 49.5%. Sociodemographic factors such as age; clinical characteristics such as functional status, disease stage, pain, and use of specific drugs, including opioids; psychological factors such as anxiety/depression; and spiritual factors such as feelings of well-being were identified as predictors. The treatment options identified were biological (pharmacological and nonpharmacological), psychological (visualization, relaxation), and spiritual (prayer). Conclusions: The systematic review showed that the prevalence of insomnia is high, with at least one in 3 patients affected in most studies. Insomnia's risk factors and treatment in palliative care are both associated to physical, psychological, social, and spiritual factors, reflecting its true holistic nature