Browsing by Issue Date, starting with "2021-12-01"
Now showing 1 - 2 of 2
Results Per Page
Sort Options
- Effects of respiratory training on obstructive sleep apnea: systematic review and meta-analysisPublication . Cavalcante-Leão, Bianca; Araujo, Cristiano; Ravazzi, Glória; Basso, Isabela; Guariza‑Filho, Odilon; Taveira, Karinna; Santos, Rosane Sampaio; Neto, José; Zeigelboim, BiancaPurpose: This systematic review sought to answer the following focused question: “What are the effects of respiratory training devices on obstructive sleep apnea (OSA) outcomes in adults?” Methods: The acronym “PICOS” was used to determine eligibility criteria, which consists of (P population) = adults with mild to moderate OSA, (I intervention) = spirometry devices or breathing exercises, (C comparison) = compared to no breathing exercises in adults (> 18 years) with mild to moderate OSA, (O outcomes) = improved sleep quality (sleep quality indexes) and improved apnea-hypopnea indexes (AHI), (S study types) = randomized, pseudo-randomized, and nonrandomized clinical trials. The search was performed in the following databases: PubMed/Medline, LILACS, Scopus, Web of Science, Scopus, and Cochrane Library, in addition to gray literature through Google Scholar, Proquest, and Open Grey. The risk of bias was assessed using the Cochrane Collaboration tool. The certainty of the evidence was assessed using the GRADE tool. Meta-analyses of random effects were performed for the outcomes of interest. Results: A total of 1171 references were found. Applying the eligibility criteria, six studies were included in qualitative synthesis. Expiratory exercises showed a decrease in the apnea–hypopnea index (AHI) when compared to baseline (MD = − 8.4; 95% CI = − 12.4 to − 4.4; I2 = 19%). There was a decrease in values compared to baseline (MD = − 4.4; 95% CI = − 8.2 to − 0.6; I2 = 0%) for the Epworth Sleepiness Scale (ESS), when considering the inspiratory exercises. Both groups of breathing exercises showed a significant decrease in the mean index assessed by the Pittsburgh Sleep Quality Index (PSQI). Conclusion: Results of this meta-analysis suggests that breathing exercises lead to a measurable improvement in AHI for patients with mild to moderate OSA, as well as an improvement in sleep quality and daytime sleepiness.
- Unilateral temporomandibular joint discectomy without interposal material in patients with disc perforation or fragmentation: a prospective studyPublication . Ângelo, David Faustino; Sanz, David; Cardoso, Henrique JoséObjective: Temporomandibular joint (TMJ) discectomy is one of the most popular surgical techniques for patients with an unsalvageable disc. Previous studies have demonstrated predictable results of dis-cectomy with optimal results in pain reduction and maximum mouth opening (MMO) improvement.However, those studies had most of the times wide-ranging inclusion criteria. This study was thereforeconducted to assess the role of unilateral TMJ discectomy in a well defined diagnosis.Methods: A 6-year prospective study was designed including patients treated with unilateral TMJ dis-cectomy without interposal material, preserving condyle and temporal fibrocartilage, for two specificintra-articular diagnosis: disc perforation and disc fragmentation.Results: A total of 19 patients were enrolled, with a mean age of 51.05 ± 13.71 (mean ± SD) years.Preoperative pain was 7.63 ± 1.89 (mean ± SD), MMO was 25.95 ± 10.27 mm (mean ± SD) and muscletenderness (MT) was 2.53 ± 0.77 (mean ± SD). The most common diagnosis was disc perforation. Afteran average of 37.9 months of follow-up time (range from 10 to 71 months), a statistically significant improvement of pain (P < 0.0001), MMO (P < 0.0001) and MT (P = 0.00011) was observed. Postoperatively,16 of 18 patients (89 %) showed a reduction in pain and improvement in MMO, fulfilling the criteria fora successful outcome of TMJ surgery. No second surgery was necessary. Conclusion: Unilateral TMJ discectomy without interposal material in patients with disc perforation or fragmentation seems to be an adequate technique. However, we encourage rigorous long-term studiesand new preclinical trials to pursuit a disc substitute, as relevant preclinical trials have demonstrated significant degenerative changes after TMJ discectomy.