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Spreading depression (SD) is an interesting and important phenomenon due to its role in mammalian pathologies such as migraine, seizures, and stroke. Until recently investigations of the mechanisms involved in SD have mostly utilized mammalian cortical tissue, however in my thesis I demonstrated that SD-like events occur in the CNS of an invertebrate model, Locusta migratoria. Locusts enter comas in response to stress during which neural and muscular systems shut down until the stress is removed, and this is believed to be an adaptive strategy to survive extreme environmental conditions. Using the ventilatory central pattern generator (vCPG) as a model circuit I was able to show that stress-induced arrest of vCPG function is associated with SD-like events in the locust metathoracic ganglion (MTG) that closely resemble cortical SD (CSD) in many respects, including mechanism of induction, extracellular potassium ion ([K+]o) changes, and propagation in areas equivalent to mammalian grey matter. SD-like events in the locust were characterized as abrupt [K+]o increases associated with electrical activity silence in the locust CNS that propagate to other areas within the MTG. In this thesis I described the generation of comas by several cellular stressors (hyperthermia, metabolic stressors, Na+/K+-ATPase inhibition, and KCl) and the associated SD-like events in the locust, provide a description of the similarities to CSD, and show how they can be manipulated both by stress preconditioning and pharmacologically. I showed that hyperthermic vCPG arrest can be preconditioned by prior heat shock (HS) treatment and induced-thermotolerance was associated with an increased rate of [K+]o clearance associated with vCPG recovery that was not linked to changes in ATP levels or total Na+/K+-ATPase activity. I also provided evidence for the involvement of the stress-sensor AMP-activated protein kinase (AMPK) in stress-induced comas in the locust. AMPK activation was linked to a switch in motor pattern behavior following recovery from anoxia-induced vCPG arrest and exacerbated repetitive SD-like events induced by ouabain (Na+/K+-ATPase inhibitor). I suggested that locust SD-like events are adaptive by conserving energy and preventing cellular damage, and I provided a model for the mechanism of SD onset and recovery in the locust nervous system. / Thesis (Ph.D, Biology) -- Queen's University, 2010-08-05 16:08:19.905

Animated color film with images of water, birds, winged humans, a man in a hooded sweatshirt, doors, the sea, a woman on a stool wearing a red scarf, marching soldiers, a gun, a knife, blood on hands, a dancing couple, a crowd of dancers, a seed, plants growing, clouds, a flying winged person, a figure playing an instrument. The images transform into each other in ever-changing sequences.

O traumatismo craniano é uma das principais causas de morte em países industrializados e é responsável por mais de 50% dos 100.000 óbitos por trauma nos Estados Unidos a cada ano; isto tem causado crescente interesse em cuidados neuro-intensivos. O estudo de medidas indiretas do metabolismo cerebral, como pressão de perfusão cerebral (PPC), pressão intracraniana (PIC), pressão parcial de CO2 (PaCO2) e pressão arterial média (PAM), é necessário para guiar o tratamento e prevenir a ocorrência de dano isquêmico secundário. O objetivo deste estudo foi analisar a associação entre os parâmetros hemometabólicos e a ocorrência de isquemia cerebral traumática. Trinta e um pacientes foram prospectivamente seguidos nas Unidades de Tratamento Intensivo Pediátrico e do Trauma do Hospital de Pronto Socorro de Porto Alegre de abril a dezembro de 2003. Os pacientes eram 23 adultos (17 a 56 anos de idade) e 8 crianças (3 a 13 anos de idade) com traumatismo craniano grave. A idade média dos pacientes foi de 29 anos. Os critérios de inclusão foram escore inferior a oito na Escala de Coma de Glasgow e Tomografia Computadorizada (TC) de crânio alterada. Foram monitorizadas a pressão intracraniana, a pressão arterial média, a pressão arterial de CO2 e a pressão de perfusão cerebral. Isquemia cerebral foi identificada em 13 (56,5%) adultos e 7 (87,5%) crianças. Elevação da PAM foi associada com mortalidade (P<=0,005) em crianças. A elevação da PIC (P= 0,03) e a queda da PPC (P=0,007) em adultos foram associadas com isquemia cerebral. Pacientes adultos com baixa PPC apresentaram pior prognóstico, com elevação dos índices de mortalidade (P=0,045). Dos 14 pacientes (45,2%) que morreram, 13 (56,5%) eram adultos e 1(12,5%) era criança. Concluímos que a elevação da pressão intracraniana e da pressão arterial média e a queda da pressão de perfusão cerebral estão associadas com isquemia cerebral traumática e mortalidade nestes pacientes. / Head injury is one of the leading causes of death in the industrialized world and is responsible for more than 50% of the 100.000 deaths from trauma in the United States each year. The past decade has seen a resurgence of the interest in the critical care. The indirect measurements study of brain metabolism, like cerebral perfusion pressure (CPP), intracranial pressure (ICP), arterial pressure CO2 (PaCO2) and mean arterial blood pressure (MABP) is necessary to guide treatment and prevent secondary cerebral ischemia. The aim of the present study was to analyse association between cerebral hemodynamic and metabolic parameters and traumatic brain ischemia occurrence. Thirty one patients were prospectively assessed in the Paediatric or Adult Intensive Care Unit at Pronto Socorro Hospital (HPS) from April at December, 2003. The patients were 23 adults (17 to 56 years old) and 8 children (3 to 13 years old) with severe traumatic brain injury. Mean age was 29 years old. Inclusion criteria were Glasgow coma scale (GCS) score below eight and abnormalities in computadorized tomography (CT) of the skull. The monitoring of intracranial pressure, mean arterial blood pressure, arterial pressure CO2 and cerebral perfusion pressure were recorded. Brain ischemia was identificated in 13 (56. 5%) adults and 7 (87. 5%) children. High MABP was associated with mortality (P<=0.005) in children. The high ICP (P= 0.03) and the low CPP (P=0.007) in adults were associated with brain ischemia. Fourteen patients (45. 2%) died, 13(56. 5%) were adults and 1(12. 5%) patient was child. Adults patients with low CPP had worse outcome with high rate mortality (P=0.045). In conclusion, high intracranial pressure, high mean arterial blood pressure and low cerebral perfusion pressure were associated with traumatic brain ischemia and mortality in these patients.

O traumatismo craniano é uma das principais causas de morte em países industrializados e é responsável por mais de 50% dos 100.000 óbitos por trauma nos Estados Unidos a cada ano; isto tem causado crescente interesse em cuidados neuro-intensivos. O estudo de medidas indiretas do metabolismo cerebral, como pressão de perfusão cerebral (PPC), pressão intracraniana (PIC), pressão parcial de CO2 (PaCO2) e pressão arterial média (PAM), é necessário para guiar o tratamento e prevenir a ocorrência de dano isquêmico secundário. O objetivo deste estudo foi analisar a associação entre os parâmetros hemometabólicos e a ocorrência de isquemia cerebral traumática. Trinta e um pacientes foram prospectivamente seguidos nas Unidades de Tratamento Intensivo Pediátrico e do Trauma do Hospital de Pronto Socorro de Porto Alegre de abril a dezembro de 2003. Os pacientes eram 23 adultos (17 a 56 anos de idade) e 8 crianças (3 a 13 anos de idade) com traumatismo craniano grave. A idade média dos pacientes foi de 29 anos. Os critérios de inclusão foram escore inferior a oito na Escala de Coma de Glasgow e Tomografia Computadorizada (TC) de crânio alterada. Foram monitorizadas a pressão intracraniana, a pressão arterial média, a pressão arterial de CO2 e a pressão de perfusão cerebral. Isquemia cerebral foi identificada em 13 (56,5%) adultos e 7 (87,5%) crianças. Elevação da PAM foi associada com mortalidade (P<=0,005) em crianças. A elevação da PIC (P= 0,03) e a queda da PPC (P=0,007) em adultos foram associadas com isquemia cerebral. Pacientes adultos com baixa PPC apresentaram pior prognóstico, com elevação dos índices de mortalidade (P=0,045). Dos 14 pacientes (45,2%) que morreram, 13 (56,5%) eram adultos e 1(12,5%) era criança. Concluímos que a elevação da pressão intracraniana e da pressão arterial média e a queda da pressão de perfusão cerebral estão associadas com isquemia cerebral traumática e mortalidade nestes pacientes. / Head injury is one of the leading causes of death in the industrialized world and is responsible for more than 50% of the 100.000 deaths from trauma in the United States each year. The past decade has seen a resurgence of the interest in the critical care. The indirect measurements study of brain metabolism, like cerebral perfusion pressure (CPP), intracranial pressure (ICP), arterial pressure CO2 (PaCO2) and mean arterial blood pressure (MABP) is necessary to guide treatment and prevent secondary cerebral ischemia. The aim of the present study was to analyse association between cerebral hemodynamic and metabolic parameters and traumatic brain ischemia occurrence. Thirty one patients were prospectively assessed in the Paediatric or Adult Intensive Care Unit at Pronto Socorro Hospital (HPS) from April at December, 2003. The patients were 23 adults (17 to 56 years old) and 8 children (3 to 13 years old) with severe traumatic brain injury. Mean age was 29 years old. Inclusion criteria were Glasgow coma scale (GCS) score below eight and abnormalities in computadorized tomography (CT) of the skull. The monitoring of intracranial pressure, mean arterial blood pressure, arterial pressure CO2 and cerebral perfusion pressure were recorded. Brain ischemia was identificated in 13 (56. 5%) adults and 7 (87. 5%) children. High MABP was associated with mortality (P<=0.005) in children. The high ICP (P= 0.03) and the low CPP (P=0.007) in adults were associated with brain ischemia. Fourteen patients (45. 2%) died, 13(56. 5%) were adults and 1(12. 5%) patient was child. Adults patients with low CPP had worse outcome with high rate mortality (P=0.045). In conclusion, high intracranial pressure, high mean arterial blood pressure and low cerebral perfusion pressure were associated with traumatic brain ischemia and mortality in these patients.

O traumatismo craniano é uma das principais causas de morte em países industrializados e é responsável por mais de 50% dos 100.000 óbitos por trauma nos Estados Unidos a cada ano; isto tem causado crescente interesse em cuidados neuro-intensivos. O estudo de medidas indiretas do metabolismo cerebral, como pressão de perfusão cerebral (PPC), pressão intracraniana (PIC), pressão parcial de CO2 (PaCO2) e pressão arterial média (PAM), é necessário para guiar o tratamento e prevenir a ocorrência de dano isquêmico secundário. O objetivo deste estudo foi analisar a associação entre os parâmetros hemometabólicos e a ocorrência de isquemia cerebral traumática. Trinta e um pacientes foram prospectivamente seguidos nas Unidades de Tratamento Intensivo Pediátrico e do Trauma do Hospital de Pronto Socorro de Porto Alegre de abril a dezembro de 2003. Os pacientes eram 23 adultos (17 a 56 anos de idade) e 8 crianças (3 a 13 anos de idade) com traumatismo craniano grave. A idade média dos pacientes foi de 29 anos. Os critérios de inclusão foram escore inferior a oito na Escala de Coma de Glasgow e Tomografia Computadorizada (TC) de crânio alterada. Foram monitorizadas a pressão intracraniana, a pressão arterial média, a pressão arterial de CO2 e a pressão de perfusão cerebral. Isquemia cerebral foi identificada em 13 (56,5%) adultos e 7 (87,5%) crianças. Elevação da PAM foi associada com mortalidade (P<=0,005) em crianças. A elevação da PIC (P= 0,03) e a queda da PPC (P=0,007) em adultos foram associadas com isquemia cerebral. Pacientes adultos com baixa PPC apresentaram pior prognóstico, com elevação dos índices de mortalidade (P=0,045). Dos 14 pacientes (45,2%) que morreram, 13 (56,5%) eram adultos e 1(12,5%) era criança. Concluímos que a elevação da pressão intracraniana e da pressão arterial média e a queda da pressão de perfusão cerebral estão associadas com isquemia cerebral traumática e mortalidade nestes pacientes. / Head injury is one of the leading causes of death in the industrialized world and is responsible for more than 50% of the 100.000 deaths from trauma in the United States each year. The past decade has seen a resurgence of the interest in the critical care. The indirect measurements study of brain metabolism, like cerebral perfusion pressure (CPP), intracranial pressure (ICP), arterial pressure CO2 (PaCO2) and mean arterial blood pressure (MABP) is necessary to guide treatment and prevent secondary cerebral ischemia. The aim of the present study was to analyse association between cerebral hemodynamic and metabolic parameters and traumatic brain ischemia occurrence. Thirty one patients were prospectively assessed in the Paediatric or Adult Intensive Care Unit at Pronto Socorro Hospital (HPS) from April at December, 2003. The patients were 23 adults (17 to 56 years old) and 8 children (3 to 13 years old) with severe traumatic brain injury. Mean age was 29 years old. Inclusion criteria were Glasgow coma scale (GCS) score below eight and abnormalities in computadorized tomography (CT) of the skull. The monitoring of intracranial pressure, mean arterial blood pressure, arterial pressure CO2 and cerebral perfusion pressure were recorded. Brain ischemia was identificated in 13 (56. 5%) adults and 7 (87. 5%) children. High MABP was associated with mortality (P<=0.005) in children. The high ICP (P= 0.03) and the low CPP (P=0.007) in adults were associated with brain ischemia. Fourteen patients (45. 2%) died, 13(56. 5%) were adults and 1(12. 5%) patient was child. Adults patients with low CPP had worse outcome with high rate mortality (P=0.045). In conclusion, high intracranial pressure, high mean arterial blood pressure and low cerebral perfusion pressure were associated with traumatic brain ischemia and mortality in these patients.

Orientador: Jose Jorge Facure / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-07-28T15:23:09Z (GMT). No. of bitstreams: 1 DantasFilho_VenancioPereira_D.pdf: 3702111 bytes, checksum: 6ee6b0450e7a5f619f3deef2347458d5 (MD5) Previous issue date: 1999 / Resumo: Foram analisados 206 pacientes com TCE grave (ECGI menor ou igual a 8 pontos após manobras de reanimação no atendimento inicial), internados para tratamento na UTI-HC-UNICAMP. Todos os pacientes foram avaliados por TC, sendo que 72 receberam tratamento neurocirúrgico. Todos os pacientes foram submetidos à monitorização contínua da PIC pelo método subaracnóideo, sendo 11 com parafuso metálico e 195 com cateter plástico de PVC. Os níveis de PIC foram observados continuamente na tela do monitor de pressão, sendo os seus valores sistólicos de final de hora registrados pela equipe de enfermagem em ficha padronizada da UTI. Todos os pacientes foram tratados segundo um protocolo orientado pelos níveis da PIe. Pacientes com PIC menor ou igual a 20 mm Hg foram mantidos em decúbito elevado a 30°, sedação e ventilação mêcanica por no mínimo 48 horas. Nos pacientes com níveis de PIC acima de 20 mm Hg foi iniciada hiperventilação, seguida de manitol em bolo endovenoso e aumento progressivo da sedação, conforme confirmada a refratariedade da PIC à manobra precedente. Metade dos pacientes tinham entre 19 e J6 anos de idade, 43,69% apresentavam pontuação na ECGI menor ou igual a 5 após as manobras de reanimação no atendimento inicial, 23,79% apresentavam pelo menos dois sítios de lesões extracranianas além do TCE e 83,50% evoluíram com complicações sistêmicas, as quais foram identificadas como a causa princip~l do óbito em 10 pacientes. O resultado final, medido na alta hospitalar, mostrou 54,85% de maus resultados (36,40% de óbitos e 18,45% de pacientes com ECGI entre 3-8 pontos) e 45,15% de bons resultados (21,85% com ECGI entre 9-12 e 23,30% entre 13-15 pontos). Conclusões: o método subaracnóideo para a monitorização contínua da PI~ foi considerado aplicável, seguro, simples e de baixo custo, sendo útil na orientação do tratamento dos pacientes, principalmente até o nono dia pós- TCE. O cateter plástico apresentou vantagens com relação ao parafuso metálico. A metodologia de registro da PIC foi considerada prática e útil. A mc foi considerada uma complicação precoce e freqüente com uma forte influência negativa sobre os resultados. A gravidade clínico-neurológica, medida através da ECGI após a reanimação inicial, influenciou significativamente o resultado. O tipo de lesão intracraniana influenciou significativamente o resultado e a incidência de me. A presença de hipóxia, hipotensão arterial sistêmica e a associação desses eventos influenciou negativamente os resultados. Os politraumatismos somente influenciaram os resultados quando associados à hipóxia, hipotensão arterial e sua associação. A idade não influenciou significativamente o resultado final desta casuística / Abstract: Two hundred and six patients with severe head injury (GCS of 8 points or less, after nonsurgical resuscitation on admission, who were managed at lCU - HC UNICAMP) were analysed. AlI patients were assessed by CT scan and seventy two required neurosurgical intervention. All patients were continuously monitored to evaluate lCP levels by a subarachnoid device (11 with subarachnoid metallic bolts and 195 with subarachnoid polyvinyl catheters). The lCP levels were continuously observed in the bedside pressure monitor display and their sistolic 'end-hour' values were recorded by the nursing staff in a standard lCU chart. The patients were managed according to a standard protocol guided by the lCP levels. Patients with lCP lower than 20 mm Hg were left with 30° head position, sedation and mechanical ventilation. Patients with lCP over 20 mm Hg were submited to hyperventilation, following mannitol and increasing sedation. Each step of the protocol was started only after the failure of the preceding step. Half of the patients were 19 to 36 years-old, 43,69% were 5 points or less in GCS after nonsurgical resuscitation, 23,79% had at least two sites of extracraniallesions and 83,50% had systemic complications that were the main cause of death in 10 patients. The final results measured at hospital discharge were 54,85% of poor results (36,40% of deaths and 18,45% of patients with 3 - 8 points in GCS) and 45,15% ofgood results (21,85% of9 - 12 and 23,30% of 13 ¬15 poi~ts in GCS). Conclusions: the subarachnoid method to continuously assess the lCP levels was considered aplicable, safe, simple, low cost and useful to advise the management ofthe patients, mainly until the nineth day. The plastic catheter had more advantages than the metallic bolt. The lCP record methodology was considered practical and useful. lntracranial hypertension (lCP over 20 mm Hg) was considered an early and frequent complication with a strong negative influence in the results. The initial seriousness, by GCS, had a negative influence in the results. The type of intracraniallesion influenced the results and the intracranial hypertension incidence. The presence of hypoxia, systemic arterial hypotension or both also influenced the results. The presence of multiple traumas only influenced the results when associated with hypoxia, arterial hypotension or both. The age did not influence the results in this series / Doutorado / Neurologia / Doutor em Ciências Médicas

Posterior reversible encephalopathy syndrome (PRES) is associated with seizures, visual disturbances, headache, and altered mental status. Given its presentation, the diagnosis can be mistaken for other severe conditions. Palliative medicine consultants should be aware of PRES and be prepared to counsel families on the treatment and prognosis of this syndrome.

The main idea of this thesis is to present the novel concept of localized feature selection (LFS) for data classification and its application for coma outcome prediction. Typical feature selection methods choose an optimal global feature subset that is applied over all regions of the sample space. In contrast, in this study we propose a novel localized feature selection approach whereby each region of the sample space is associated with its own distinct optimized feature set, which may vary both in membership and size across the sample space. This allows the feature set to optimally adapt to local variations in the sample space. An associated localized classification method is also proposed. The proposed LFS method selects a feature subset such that, within a localized region, within-class and between-class distances are respectively minimized and maximized. We first determine the localized region using an iterative procedure based on the distances in the original feature space. This results in a linear programming optimization problem. Then, the second method is formulated as a non-linear joint convex/increasing quasi-convex optimization problem where a logistic function is applied to focus the optimization process on the localized region within the unknown co-ordinate system. This results in a more accurate classification performance at the expense of some sacrifice in computational time. Experimental results on synthetic and real-world data sets demonstrate the effectiveness of the proposed localized approach. Using the LFS idea, we propose a practical machine learning approach for automatic and continuous assessment of event related potentials for detecting the presence of the mismatch negativity component, whose existence has a high correlation with coma awakening. This process enables us to determine prognosis of a coma patient. Experimental results on normal and comatose subjects demonstrate the effectiveness of the proposed method. / Dissertation / Doctor of Philosophy (PhD) / This study proposes a novel form of pattern classification method, which is formulated in a way so that it is easily executable on a computer. Two different versions of the method are developed. These are the LFS (localized feature selection) and lLFS (logistic LFS) methods. Both versions are appropriate for analysis of data with complex distributions, such as datasets that occur in biological signal processing problems. We have shown that the performance of the proposed methods is significantly improved over that of previous methods, on the datasets that were considered in this thesis. The proposed method is applied to the specific problem of determining the prognosis of a coma patient. The viability of the formulation and the effectiveness of the proposed algorithm are demonstrated on several synthetic and real world datasets, including comatose subjects.

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2018-08-01T11:34:26Z No. of bitstreams: 1 Verusk Arruda Mimura.pdf: 4908287 bytes, checksum: 6e6d3694f80bb455a6f750aaea622f91 (MD5) / Made available in DSpace on 2018-08-01T11:34:26Z (GMT). No. of bitstreams: 1 Verusk Arruda Mimura.pdf: 4908287 bytes, checksum: 6e6d3694f80bb455a6f750aaea622f91 (MD5) Previous issue date: 2018-06-15 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / This present thesis is an analysis on communication of the body in coma in intensive care units. The communication process between those patients and the health staff demands constant evaluation on their perception. Recent studies have indicated possibilities of flaws in classifying patients in coma and they have questioned the excessive faith that has been placed on technological devices. Therefore, we propose here the investigation of the primary communication of patients in coma through olfaction, making use of an interdisciplinary study involving communication and health sciences. This study is in accordance with the studies of Semiotics of Culture as well as with the advances in the field of medical research which suggest changes of the established paradigm for the diagnose of those patients. The objective of this study is identifying from olfaction stimulation any probable evidence of communication of patients in coma, by reading and interpreting any possible physiological alterations such as electroencephalographic recording, blood pressure, heart rate and oxygen blood saturation, associated to the observation of subjective signs emitted by the body, from face and body expressions, searching for a possible triggering of the olfactory memory. The physiological responses of patients in coma were compared to those of outpatients. As to face the lack of meaningful statistic alterations on patients in coma, the outpatients were called to take a central role on this present study. Yet, the qualitative analysis makes it possible to imply that the primary responses delivered by the body of the patients in coma might be considered as communication when submitted to olfactory stimulation carried by the combination of other stimuli sensitive to the senses. This interdisciplinary study points to the need of creating between the fields of communication and health an essential link toward the studies of the human body. The theoretical framework was built around the following authors: A. R. Luria (1966, 1979, 1982, 1991), Oliver Sacks (1988, 2013), Edgar Morin (1973, 1996), Gerald M. Edelman (1992), Norval Baitello Jr. (1997, 2005, 2012), F. S. Machado (2006), Hawkes and Doty (2009), Jox et al. (2012), E. Delamonica (1984) among others / A presente tese é uma reflexão sobre a comunicação do corpo em coma em uma unidade de terapia intensiva. O processo de comunicação dessespacientes com a equipe de saúde requer avaliações constantes de sua percepção. Estudos recentes apontam possibilidades de falhas na classificação dos pacientes em coma e questionam a confiança demasiada que se deposita em aparelhos tecnológicos. Dessa forma, propõe-se a investigação da comunicação primária desses pacientes, através do sentido do olfato, por meio de um estudo de caráter interdisciplinar, envolvendo comunicação e as ciências da saúde. Este trabalho está em consonância com os estudos da Semiótica da Cultura e com os avanços na área da pesquisa médica, que sugerem mudanças no paradigma estabelecido para o diagnóstico desses pacientes.O objetivo deste estudo foi identificar, a partir do estímulo olfativo, indícios do processo de comunicação do paciente em coma, através da leitura e da interpretação de possíveis alterações fisiológicas, como registro eletroencefalográfico, pressão arterial, frequência cardíaca e percentual de saturação de oxigênio no sangue, associados à observação de sinais subjetivos emitidos pelo corpo, por meio de expressões faciais e corporais, buscando-se uma possível ativação da memória olfativa. As respostas fisiológicas dos pacientes em coma foram comparadas com as repostas fisiológicas dos pacientes ambulatoriais. A ausência de alterações estatísticas significativas nos pacientes em coma fez com que os pacientes do grupo ambulatorial assumissem um papel central no desenrolar deste estudo. Já a análise qualitativa permite inferir que as respostas primárias apresentadas pelo corpo do paciente em coma, submetido ao estímulo olfativo, podem ser interpretadas como comunicação quando carregadas pela combinação de outros estímulos sensíveis aos órgãos do sentido. Este estudo interdisciplinar aponta para a necessidade de se estabelecer, entre as áreas de comunicação e de saúde, um elo essencial para os estudos sobre o corpo. O quadro teórico assenta-se nos autores: A. R. Luria (1966, 1979, 1982, 1991), Oliver Sacks (1988, 2013), Edgar Morin (1973, 1996), Gerald M. Edelman (1992), Norval Baitello Jr. (1997, 2005, 2012), F. S. Machado (2006), Hawkes e Doty (2009), Jox et al. (2012), E. Delamonica (1984) entre outros