Objective: to investigate protocols used by Speech Therapists to evaluate breastfeeding. Methods: this is an integrative literature review that aims to synthesize available evidence on the evaluation of breastfeeding, from 2002 to 2015. The inclusion criteria were scientific articles that approached breastfeeding evaluation performed by Speech Therapists, published in English and Portuguese. Papers that did not present summaries in their entirety were discarded. Results: a total of 140 studies were found, 134 being excluded. The remaining six publications evaluated breastfeeding and were included in the study with four instruments. The articles selected aimed at evaluating the mothers' knowledge about breastfeeding and its relation to language, the first feeding of the premature baby, describing the initial conditions of breastfeeding, relating breastfeeding to the cup/bottle supply and evaluating orofacial characteristics and breastfeeding. The protocols evaluated aspects of the infant's state of consciousness, behavior and positioning, mother's breastfeeding behavior, breast characteristics, latching and milking, and conditions after breastfeeding. Conclusion: there are few studies in Speech Therapy that use standardized and validated protocols for breastfeeding evaluation. The major focus is on the evaluation of preterm infants. It is suggested that new studies be performed, especially with a focus on validating instruments.
Introduction Chloroquine and hydroxychloroquine are antimalarial drugs widely used in the treatment of rheumatic diseases. With the global pandemic caused by the new coronavirus, there was an increase in the prescription of these drugs, which led to a major concern regarding their ototoxic effects. Objectives The objective of the present study was to assess existing scientific evidence about the toxic effects of chloroquine and hydroxychloroquine on the peripheral and/or central auditory system. Data Synthesis A systematic literature review was performed by searching the PubMed (Medline), Scopus, Web of Science, LILACS, and SciELO electronic databases, in a search of articles that fullfiled the predefined inclusion and exclusion criteria. The review was conducted in three phases and, in all of them, analyses were performed by two independent researchers. Disagreements were discussed with a third researcher until a consensus was reached. A total of 437 articles were found and 8 were included in this review. Seven of the included studies reported hearing loss in their samples and presented a diagnostic hypothesis of ototoxicity induced by chloroquine or hydroxychloroquine. The most common type of hearing loss was sensorineural, with varying laterality and degrees of severity. The most frequently used audiological test was pure tone audiometry, and only two studies assessed brainstem evoked responses. Conclusion The scientific evidence compiled in this research showed that chloroquine and hydroxychloroquine have an ototoxic effect in the peripheral auditory system. These drugs can cause cochlear damage, including changes in the stria vascularis and lesions in sensory hair cells.
A incontinência urinária, de etiologia multifatorial, pode ocorrer em diferentes idades e sexo, afetando de maneira adversa a qualidade de vida das pessoas que são acometidas. Dessa forma, o presente estudo teve como objetivo identificar a prevalência e os fatores de risco associados à incontinência urinária em acadêmicas do curso de Fisioterapia de uma Instituição de Ensino Superior, em Maringá - PR. Para isso, realizou-se uma pesquisa do tipo exploratória, de caráter transversal, quantitativa e descritiva, que teve como base a aplicação de questionários nas dependências da instituição. As acadêmicas receberam a Ficha para Identificação dos Fatores de Risco e o questionário International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF), para preenchimento. Os dados obtidos foram analisados estatisticamente, sendo apresentados em: médias, desvio-padrão, frequências e porcentagens. Para avaliar a associação entre variáveis foi utilizado o teste de Qui-quadrado. A amostra foi composta por 79 participantes, destas apenas 16 (20,3%) apresentaram incontinência e somente a infecção urinária (p=0,020) foi o fator de risco identificado neste estudo. Concluiu-se que apenas uma parcela das acadêmicas apresentou incontinência urinária e, entre os fatores de risco avaliados, somente a infecção urinária evidenciou associação com a perda involuntária de urina.
| To evaluate the effects of oral supplementation of L-carnitine associated with physical and respiratory muscles training in chronic obstructive pulmonary disease (COPD). Participated 14 COPD volunteers (65±10.4 years), divided in group training mat (GTM) and respiratory muscle training group (RMTG). Passed by the six minute walk test (6MWT) and shuttle walk test (SWT), nutritional assessment of body mass index (BMI), dose recommended daily L-carnitine and evaluation of the inspiratory muscle training (IMT) and expiratory muscle training (EMT). They made 30 min walk on a treadmill 3 times/week for 10 weeks, and the RMTG also carried out 10 min with inspiratory muscle training (Threshold® IMT) and 10 min with expiratory muscle training (Threshold® PEP) with 50% of the MIP and MEP adjusted weekly. After 10 weeks, the volunteers were reevaluated. In 6MWT pre and post physical training programs, the variables changed were distance travelled (DT), final cardiac frequency (FCF), final systolic blood pressure (FSBP), diastolic blood pressure (DBP) and final Borg in RMTG. At GTM the variables changed were initial CF, final CF, SBP final, initial Borg and DT. Comparing the groups, we showed that in 6MWT, GTM presented final CF, final DBP and final Borg higher than RMTG in reevaluation. In shuttle walk test, the final SBP and final Borg were higher in GTM, and DT was higher in RMTG. In respiratory evaluation, the MEP was higher in RMTG in reevaluation. The aerobic training and L-carnitine supplementation in COPD patients presented performance optimization, improvement in physical capacity and greater exercise tolerance.
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