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- 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.
- Effect and longevity of botulinum toxin in the treatment of gummy smile: a meta-analysis and meta-regressionPublication . Zengiski, Aline; Basso, Isabela; Cavalcante-Leão, Bianca; Neto, José; Santos, Rosane Sampaio; Guariza‑Filho, Odilon; Zeigelboim, Bianca; Taveira, Karinna; Araujo, CristianoObjective: The aim of this systematic review is to synthesize the evidence on the effectiveness and longevity of the botulinum toxin in the treatment of individuals with excessive gingival exposure. Methods: The search was adapted to six electronic databases and gray literature. The risk of bias was assessed using the Cochrane Risk of Bias Assessment Tool for Non-Randomized and Randomized Studies of Interventions. Meta-analyses and meta-regression were performed using random effects models. Results: A total of 5247 articles were collected during the final search in the database, resulting in 17 articles included. There was a mean decrease of 3.42 mm [95% CI = −4.50 to −2.34; I2 = 97%] in the level of gingival exposure 2 weeks after the application of botulinum toxin. The application time explained 29.58% of the observed variance (p < 0.001), with a tendency for the effect size to decrease from the second week of application onwards, with values returning close to baseline levels in 24 weeks. Conclusion: Botulinum toxin is an alternative technique considered effective for reducing gummy smile, especially for gummy smiles up to 4 mm, with a longevity of at least 12 weeks, returning close to initial values within 24 weeks after application. Clinical relevance: The knowledge about the longevity and effectiveness of botulinum toxin in the treatment of gummy smile allows for a more adequate clinical planning for these cases, as well as for clinical decisions, as for prognostic factors.
- Coronavirus survival time on inanimate surfaces: a systematic reviewPublication . Schroder, Angela Graciela Deliga; Stechman-Neto, José; Basso, Isabela; Gonçalves, Flávio Magno; Cavalcante-Leão, Bianca; Ravazzi, Gloria; Zeigelboim, Bianca Simone; Povh, Bruna; Guariza Filho, Odilon; Sampaio Santos, Rosane; Araujo, CristianoThis systematic review aimed to study the survival time of the virus from the coronavidae family on various materials and surfaces, thus enabling the adoption of preventive measures mainly in public environments. The electronic databases selected as a source of information were PubMed/Medline, Excerpta Medica database (EMBASE), Latin American and Caribbean Literature in Health Sciences (LILACS), Web of Science, Scopus, and LIVIVO; grey literature (Google Scholar, ProQuest, and OpenGrey) was also examined. The last electronic search of the six databases retrieved 4287 references. After removing the duplicate references, the titles and abstracts (phase 1) were read, and 37 articles were selected for complete reading (phase 2), which resulted in 13 included studies. All the studies evaluated coronavirus survival on the following surfaces and objects: stainless steel, glass, plastic, wood, metal, cloth, paper, cotton, latex, polystyrene petri dish, aluminium, copper, cardboard, Teflon, polyvinyl chloride (PVC), silicone rubber and disposable fabric. On surfaces such as glass, plastic, and steel, the virus has greater stability than it does on copper, fabric, paper, and cardboard. The conditions of temperature, relative humidity, absorption power, and texture were also considered important factors in the survival of the virus.
- Balance rehabilitation with a virtual reality protocol for patients with hereditary spastic paraplegia: protocol for a clinical trialPublication . Zeigelboim, Bianca; José, Maria Renata; Santos, Geslaine; Severiano, Maria Izabel; Teive, Hélio; Neto, José; Santos, Rosane Sampaio; Araujo, Cristiano; Cavalcante-Leão, Bianca
- Is there scientific evidence of the mouthwashes effectiveness in reducing viral load in Covid-19?: a systematic reviewPublication . Cavalcante-Leão, Bianca; Araujo, Cristiano; Basso, Isabela; Schroder, Angela; Guariza-Filho, Odilon; Ravazzi, Glória; Gonçalves, Flavio; Zeigelboim, Bianca; Sampaio Santos, Rosane; Neto, José StechmanBackground: The aim of this research is to verify whether there is evidence in the literature regarding the decrease in viral load present in saliva after using three types of mouthwashes. Material and Methods: Clinical and/or in vitro experimental studies that have used mouthwashes as a form of intervention to reduce the viral load in saliva were included. Combinations of words and appropriate truncations were adapted for each of the seven selected electronic bases including grey literature. Results: The selection of articles was carried out in two phases by two independent reviewers. After removing duplicate articles, 1245 references were maintained, and 2 articles were included in the Systematic Review. Both studies were performed in vitro and tested the virucidal action of the PVP-I solution for mouthwash at two different concentrations, 1% without dilution and 7% with 1:30 dilution, on the SARS-CoV and MERS-CoV viruses. Both showed a viral reduction of ≥ 99.99% with 15 s exposure. Conclusions: Based on the evidence currently available in the literature, PVP-I, at concentrations of 1 and 7%, appears to be the most effective mouthwash for reducing the viral load of COVID-19 present in human saliva. However, the guidelines for dental care refer to the use of hydrogen peroxide but there is insufficient scientific evidence to support this recommendation.