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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.
- Accuracy of acoustic evaluation of swallowing as a diagnostic method of dysphagia in individuals affected by stroke: preliminary analysisPublication . Enz, Vivian; Vaz, Amanda; Nunes, Maria Cristina; Rosa, Marcelo; Nunes, Janaína; Marques, Jair; Santos, Rosane SampaioAfter a stroke, more than half of the patients have some kind of disability, and dysphagia is frequently found. Cervical auscultation by Doppler sonar is an innovative technique with gain of credibility in the clinical evaluation of swallowing. To verify the diagnostic accuracy of Doppler sonar along with the DeglutiSom® software as an auxiliary method in the evaluation of oropharyngeal dysphagia in patients after stroke. The research is a cross-sectional, uncontrolled, blind, quantitative study with systematic random sampling. Patients from inpatient and outpatient units of a reference hospital with a stroke care unit were concomitantly submitted to both Doppler sonar and Fiberoptic Endoscopic Evaluation of Swallowing (FEES®). Seventy-three audio files collected from 26 patients through Doppler sonar were analyzed using DeglutiSom® software and confronted with the FEES® report, regarding three food consistencies offered to them during the exam. The study showed that the Doppler sonar correctly identified, among all the analyzed files, those that actually presented tracheal aspiration as well as it effectively identified patients who did not aspirate. The Youden index of 0.91 corroborates this information, showing a promising accuracy in detecting tracheal aspiration in the studied sample. The study evaluates the diagnostic accuracy of Doppler sonar, showing that it can be used as a valuable tool in the diagnosis of tracheal aspiration in patients after stroke. It is important to emphasize that the identification of residue by this method requires further studies. Also, larger sample size and more than one blind evaluator should be considered in future researches to increase the reliability of the proposed method.
- Psychosocial changes in patients submitted to orthodontic surgery treatment: a systematic review and meta‑analysisPublication . Basso, Isabela; Gonçalves, Flavio; Martins, Agnes; Schroder, Angela; Taveira, Karinna; Neto, José; Santos, Rosane Sampaio; Guariza‑Filho, Odilon; Araujo, CristianoObjective: This systematic review aims to answer the following question: What is the psychological impact of orthognathic surgery on patients with dentofacial deformities undergoing orthodontic-surgical treatment? Material and methods: The search was adapted for each of the following databases: American and Caribbean Center on Health Sciences (LILACS), Cochrane Library, Embase, Psychinfo, PubMed/Medline, Scopus and Web of Science, and gray literature using Google Scholar, OpenGrey, and ProQuest. The risk of bias was assessed using the Joanna Briggs Institute Critical Assessment Checklist. This study performed estimates of interest, random-effects meta-analyses, and calculated heterogeneity using Higgins inconsistency index (I2). Results: A total of 6751 references were found in all searches. After applying the eligibility criteria after full-text reading, 37 studies comprised the final qualitative synthesis. Thirteen studies were included in quantitative synthesis, and it was possible to meta-analyze data from the following questionnaires: GHQ-28, MMPI, RSES, and SCL-90-R. There was an improvement in psychological aspects related to depression, hysteria, self-esteem, anxiety, obsessive-compulsiveness, interpersonal sensitivity, paranoid ideas, and psychoticism (p < 0.05). Conclusions: Correction of dentofacial deformity through orthodontic-surgical treatment is associated with improvements observed in several psychological domains, especially in relation to depressive states. Clinical relevance: This result highlights the importance of surgeons and orthodontists in promoting adequate control of patients’ expectations and treatment goals taking into account the individual's psychological aspects.
- Acoustic analysis of swallowing sounds with the use of Sonar Doppler in premature babies during food transitionPublication . Vieira Cunha, Talita; Figueiredo, Ana Clara; Guidotti Lemos, Raquel; Pereira, Karina; Zeigelboim, Bianca Simone; Stechman-Neto, José; Sampaio Santos, RosaneObjective: To define the acoustic parameters and the feasibility of using swallowing acoustic analysis as an auxiliary method for the transition from nasogastric or orogastric tube feeding to oral breastfeeding. Methodology: A cross-sectional study, which consisted of the following steps: 1. Data collection: Thirty-two newborns participated in this study (16 preterm and 16 full-term); 2. Clinical speech-language pathology evaluation: Clinical data were collected using Sonar Doppler used to assess the readiness of preterm infants to start oral feeding and swallowing sounds. Swallowing sounds were captured during breastfeeding and analyzed according to the frequency, intensity, and time of swallowing, as well as the pause time between swallows and the number of swallows. Results: The control and study groups presented significant differences in the mean wave time and swallowing per minute variables. Conclusion: Sonar Doppler, as an instrument used to capture sounds, is a viable auxiliary resource to evaluate the transition from nasogastric or orogastric tube to oral breastfeeding.
- O impacto intrafamiliar do diagnóstico da síndrome de Down: uma revisão integrativaPublication . Lima Filho, João; Guarinello, Ana Cristina; Ribas, Tânia; Paisca, Adriele Barbosa; Gonçalves, Flávio; Santos, Rosane SampaioO objetivo deste estudo é analisar, por meio de uma revisão de literatura, o que tem sido abordado acerca do impacto do diagnóstico de SD em famílias, por pesquisadores da área da saúde. Trata-se de um estudo de revisão integrativa de artigos publicados em periódicos, que apresentaram como conteúdo principal o impacto do diagnóstico de Síndrome de Down em famílias. Foram incluídos artigos publicados entre janeiro de 2000 e novembro de 2020, em inglês, português e espanhol nos bancos de dados eletrônicos pesquisados: Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), PubMed, Psycoinfo. Além dessas três bases de dados, também foi realizada busca de artigos na área cinzenta, por meio do Google Scholar. Foram incluídos oito estudos para análise, os quais relatavam sobre os impactos do diagnóstico da SD na família ou em integrantes desta família, sobretudo, pais e mães. Pôde-se constatar que, pesquisas que discorrem sobre o impacto da Síndrome de Down em famílias, de acordo com bases eletrônicas consultadas ainda são poucos, tendo como abordagem em sua maioria, os aspectos orgânicos resultantes da síndrome, distanciando-se das questões singulares de cada um que possui SD. Nota-se, além disso, um restrito número de trabalhos vinculados à uma perspectiva sócio-histórica, que considera a dialogia como fundamental para o processo de apropriação da linguagem de cada sujeito. Este trabalho de revisão de literatura, também, aponta que grande parte dos participantes dos estudos, ou seja, familiares de crianças com SD, sofrem impactos intrafamiliares intensos a partir do diagnóstico, derivados de um forte estigma social repleto de discursos enraizados sobre a SD, que interferem negativamente na relação que estabelecem com suas crianças.
- Front lines of the COVID-19 pandemic: what is the effectiveness of using personal protective equipment in health service environments?: a systematic reviewPublication . Araujo, Cristiano; Guariza‑Filho, Odilon; Gonçalves, Flavio; Basso, Isabela; Schroder, Angela; Cavalcante‑Leão, Bianca; Ravazzi, Glória; Zeigelboim, Bianca; Neto, José; Sampaio Santos, RosanePurpose: This systematic review aimed to evaluate the effectiveness of the use of personal protective equipment (PPE) in closed environments, similar to waiting or exam rooms of healthcare facilities, in the face of exposure to a bioaerosol. Methods: Combinations of words were selected for six electronic databases and for the gray literature. To consider the eligibility of the studies to be included/excluded, the acronym “PECOS” was used: humans and/or experimental models that simulate aerosol (Population); aerosol exposure and the use of masks/respirators (exposition/intervention); controlled or not controlled (comparison); effectiveness of PPE and the receiver exposure (outcomes); and randomized clinical studies or not, observational or laboratory simulation studies (Studies design). Results: A total of 4820 references were retrieved by the search strategy. Thirty-five articles were selected for complete reading, of which 13 articles were included for qualitative synthesis. A surgical mask or N95 respirator reduced the risk of transmission, even over short distances. The use of masks, even those with less filtering power, when used by all individuals in the same environment is more effective in reducing risk than the use of respirators with high filtering power for only some of the individuals present. Conclusion: The use of mask in closed environments is effective in reducing the risk of transmission and contagion of a contaminated bioaerosol, with greater effectiveness when these devices are used by the source and receiver, regardless of the equipment’s filtering power.
- Multiprofessional instrument for tracheal decannulation in adults: content validityPublication . Coltro, Paulo Henrique; Zanata, Isabel; Boumer, Tatiane Caroline; Sartori, Ana Paula; Sampaio Santos, RosaneIntroduction: Tracheal decannulation needs multiprofessional evaluation observing success predictor criteria. A validated instrument can increase the safety of the procedure, reduce the length of stay and ensure better quality of life. Objective: To develop and perform the content validity of a multiprofessional instrument for tracheal decannulation in adults. Method: Cross-sectional descriptive study, with 24 judges: doctors, physiotherapists, speech therapists and nurses. The instrument was developed and presented through an electronic form where the judges took their notes. The Content Validity Index by item (CVI-I) and total (CVI-T) were calculated to verify evidence of validation. In unverified items, adjustments were made pointed out by the judges and submitted to the new evaluation phase in order to obtain complete validation of the instrument. Results: First evaluation phase, the items: Identification, Ventilatory History, Vital Signs, Consciousness/Collaboration, Ventilatory Data, Opinion and Legend obtained CVI-I > 0.78, were considered validity. The items Muscular Performance and Speech and Swallowing did not obtain adequate validity CVI-I 0.67 and 0.17, respectively. Therefore, they were submitted to the second phase of evaluation. In this phase, these items were validated obtaining CVI-I=0.83 in the item Muscular Performance and CVI-I=1.0 in the item Speech and Swallowing. From the mean of CVI-I, the value CVI-T=0.9 was obtained, validity all the instrument. Conclusion: Multiprofessional instrument that can help in the process of tracheal decannulation in adults was developed and validity in content post two phases of evaluation by a group of expert judges in the area.
- Risk factors associated with the stability of mini-implants and mini-plates: systematic review and meta-analysisPublication . Mattos, Paola; Gonçalves, Flavio; Basso, Isabela; Zeigelboim, Bianca; Niwa, Marcio; Neto, José; Santos, Rosane Sampaio; Araujo, Cristiano; Guariza‑Filho, OdilonObjective: The objective of this systematic review is to assess the risk factors associated with the stability of mini-implants and mini-plates in patients undergoing orthodontic treatment using temporary anchorage devices. Material and Methods: Search strategies were developed for each electronic database (PubMed/Medline, LILACS, Scopus, Web of Science, Embase, and Cochrane Library) and gray literature (Google Scholar, Proquest, and Open Grey). The risk of bias was assessed using the Cochrane Collaboration tool for assessing the risk of bias and Meta-Analysis of Statistics Assessment and Review Instrument. The certainty of the evidence was assessed using the GRADE tool. Meta-analyses and meta-regressions of random effects were performed for the outcomes of interest. Results: A total of 1517 articles were found, of which seven were selected for quantitative synthesis. When comparing the risk of failure between mini-implants and mini-plates, the risk values approached the threshold of statistical significance (p = 0.07) (RR = 1.83; 95% CI = 0.96–3.50; I2 = 69%), showing significance after sensitivity analysis (p < 0.05) and a greater risk for mini-implants. Mandible installation presented a higher risk of failure (RR = 1.85; 95% CI = 1.17–2.91). Conclusions: The evidence found indicates that failure in the stability is related to the type of device and that there is a greater risk by using isolated mini-implants, especially when positioned in the mandible. Clinical relevance: These findings help the orthodontist and/or the surgeon to stipulate risks, learn about the predictability of techniques, and communicate with the patient in an easier way.
- Validação de um instrumento multiprofissional para rastreio do risco de broncoaspiração em ambiente hospitalarPublication . Sartori, Ana Paula; Coltro, Paulo; Boumer, Tatiane; Zanata, Isabel; Sampaio Santos, RosaneObjetivo: Desenvolver e validar em conteúdo um instrumento multiprofissional para rastreio do risco de broncoaspiração. Método: Trata-se de um estudo transversal, quantitativo de validação de conteúdo que seguiu as seguintes etapas: elaboração de um instrumento de rastreio do risco de broncoaspiração com base em uma revisão bibliográfica e validação desse instrumento de acordo com concordância e relavância entre juízes. Para esta fase, 6 profissionais especialistas na area foram convidados (1 médico, 1 fisioterapeuta, 1 fonoaudiólogo, e 3 enfermeiros) a avaliar o instrumento e informar concordância baseadas em um questionário do tipo Likert. Para análise de concordância entre os juízes foi utilizado o Indice de Validade de Conteúdo para cada item (IVC-I) e total (IVC-T). Resultados: O instrumento foi composto por 10 itens: idade (≥60 anos); doença pregressa; Escala de Glasgow <13; intubação orotraqueal; tempo de intubação orotraqueal (≥24h); traqueostomia; sensação de dispneia, higiêne oral inadequada; via alternativa de alimentação e tosse/engasgo. Há concordância entre juízes com relação a cada item (IVC-I 1,0) e também na totalidade (IVC-T 1,0) do instrumento. Conclusão: O instrumento multiprofissional para rastreio do risco de broncoaspiração em ambiente hospitalar foi desenvolvido e apresenta validade de conteúdo, assegurado por uma equipe de profissionais experientes na área.
- Efficacy of disinfecting inanimate surfaces against coronavirus: a systematic reviewPublication . Basso, Isabela; Schroder, Angela Graciela Deliga; Sampaio Santos, Rosane; Ravazzi, Gloria; Gonçalves, Flávio Magno; Stechman-Neto, José; Zeigelboim, Bianca Simone; Guariza Filho, Odilon; Araujo, CristianoHuman coronaviruses tend to persist on dry surfaces for 2 to 9 days, necessitating infection control and prevention protocols using biocidal agents. This systematic review aimed to answer the following focused question: What is the effectiveness of disinfectants on inanimate surfaces against the coronavirus? The acronym “PICOS” was used to represent the eligibility of studies: P = population (inanimate surfaces contaminated with coronavirus); I = intervention (disinfectants); C = comparison (studies with any type of control or studies that used a control group); O = outcomes (coronavirus inactivation on different types of inanimate surfaces); and S = study design (in vitro studies). The seven databases used were PubMed/Medline, EMBASE, Latin American and Caribbean Literature on Health Sciences (LILACS), Web of Science, Scopus, LIVIVO, and Cochrane Library. The gray literature was also used as an information source through Google Scholar, ProQuest, and Open Gray. The search resulted in 6639 references, and 21 articles were used in the qualitative analysis. The results showed that all studied biocidal solutions provided some degree of decontamination and inactivation of the coronavirus, depending on the concentration of the disinfectant solution, the time of exposure of the product to the pathogen and the type of surface.