RESUMO Objetivo Elaborar e validar um protocolo multiprofissional para identificação do risco de disfagia em pessoas com HIV no momento da internação hospitalar. Método Após revisão bibliográfica, o protocolo de rastreio de disfagia criado foi submetido a análise de juízes especialistas em HIV/Aids e público-alvo na aplicação deste instrumento para realização da validação de face/conteúdo. Esses avaliadores poderiam sugerir mudanças no protocolo, julgando os quesitos como clareza, pertinência e abrangência. Para avaliar o grau de concordância do instrumento, foi utilizado o Índice de Validade de Conteúdo (IVC) mínimo de 0,78. Resultados O protocolo foi elaborado com 16 itens, incluindo aspectos relacionados à fase oral e faríngea da deglutição, e a pontuação final foi calculada baseada nos diferentes riscos para complicações clínicas. O instrumento apresentou IVC acima de 0,78 para todos os itens nas duas fases da validação, bem como IVC total de 0,92. Conclusão A partir dos dados obtidos, foi possível a construção e validação do protocolo de rastreio do ponto de vista de aparência e conteúdo, uma vez que apresentou IVC total acima do valor mínimo estipulado na validação dos juízes especialistas e do público-alvo, constatando-se assim IVC adequado para o protocolo como um todo.
Studies have shown that working memory tasks minimize the cognitive disabilities associated with old age. In this context, the present study examined the bavioral changes of working memory in elders during a cognitive training through DVDs. The results show that there significance in MMSE tests (p=0.001), self-evaluation (p=0.002) and verbal fluency test in the semantic category (p=0.022). However, verbal fluency tests of spelling criterion and free evocation did not present significant differences (p ≥ 0.05). Based on the findings, we suggest that recurring training with working memory tasks through DVDs promotes neural adaptations compared to retaining and recalling the memory, promoting a compensatory effect in the performance and maintenance of cognitive skills. In addition, the training of working memory through DVDs offers a non-invasive, non-pharmacological and low-cost alternative for rehabilitation.
Objective: To describe the profile of patients undergoing a gastrostomy, the recommendations and outcome of this insertion in a Pediatric Teaching Hospital. Method: This was a retrospective, quantitative, and descriptive study that researched the records of patients who underwent a gastrostomy between January 2010 and December 2012. Results: The diseases and conditions most frequent were chronic infantile encephalopathy (77.5%), pneumonia (67.5%), seizures (57.5%), and malnutrition (42.5%). Although most patients presented a history of dysphagia (62.5%), oral feeding was observed most frequently as the most common form of nutrition, before the gastrostomy insertion (42.5%), followed by nasoenteric tube (40%). The introduction of nutrition by gastrostomy was successful and occurred an average of 2.82 (± 1.19) days after insertion. Six months after their gastrostomy, 80% of patients continued feeding only through this access tube and only 2.5% had removed the gastrostomy; 45% of the participants had gastrostomy complications, with extravasation of gastric material (15%) and local inflammation (15%) being the most frequent. Conclusion: The profile of patients undergoing gastrostomy is mostly of individuals with neurological and respiratory diseases, without respiratory support, of the male gender, and feeding by oral cavity or nasoenteric tube for a prolonged period. The main recommendation criteria were dysphagia and neurological diseases. Regarding the outcome, the introduction of nutrition by gastrostomy was successful; most individuals remained with this long-term nutritional support and the most common complications were gastric material extravasation and local inflammations. Acta Fisiatr. 2015;22(3):123-129 Soutinho LAR, Fontes DA, Carvalho YSV, Brendim MP, Marques CHD Profile, recommendation criteria, and outcome of gastrostomy tube insertions in a pediatric teaching hospital Acta Fisiatr. 2015;22(3):123-129 Soutinho LAR, Fontes DA, Carvalho YSV, Brendim MP, Marques CHD Profile, recommendation criteria, and outcome of gastrostomy tube insertions in a pediatric teaching hospital Acta Fisiatr. 2015;22(3):123-129 Soutinho LAR, Fontes DA, Carvalho YSV, Brendim MP, Marques CHD Profile, recommendation criteria, and outcome of gastrostomy tube insertions in a pediatric teaching hospital Acta Fisiatr. 2015;22(3):123-129 Soutinho LAR, Fontes DA, Carvalho YSV, Brendim MP, Marques CHD Profile, recommendation criteria, and outcome of gastrostomy tube insertions in a pediatric teaching hospital 129
Objective: To describe the profile of patients undergoing a gastrostomy, the recommendations and outcome of this insertion in a Pediatric Teaching Hospital. Method: This was a retrospective, quantitative, and descriptive study that researched the records of patients who underwent a gastrostomy between January 2010 and December 2012. Results: The diseases and conditions most frequent were chronic infantile encephalopathy (77.5%), pneumonia (67.5%), seizures (57.5%), and malnutrition (42.5%). Although most patients presented a history of dysphagia (62.5%), oral feeding was observed most frequently as the most common form of nutrition, before the gastrostomy insertion (42.5%), followed by nasoenteric tube (40%). The introduction of nutrition by gastrostomy was successful and occurred an average of 2.82 (± 1.19) days after insertion. Six months after their gastrostomy, 80% of patients continued feeding only through this access tube and only 2.5% had removed the gastrostomy; 45% of the participants had gastrostomy complications, with extravasation of gastric material (15%) and local inflammation (15%) being the most frequent. Conclusion: The profile of patients undergoing gastrostomy is mostly of individuals with neurological and respiratory diseases, without respiratory support, of the male gender, and feeding by oral cavity or nasoenteric tube for a prolonged period. The main recommendation criteria were dysphagia and neurological diseases. Regarding the outcome, the introduction of nutrition by gastrostomy was successful; most individuals remained with this long-term nutritional support and the most common complications were gastric material extravasation and local inflammations
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