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Análise comparativa da sobrevida entre pacientes submetidos à cirurgia exclusiva ou associada à quimioterapia para o tratamento de metástases hepáticas de câncer colorretal: revisão sistemática e meta-análise; Chemotherapy for patients with colorectal liver metastases who underwent curative resection improves long-term outcomes: a systematic review and meta-analysis

Araujo, Raphael Leonardo Cunha de
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 23/01/2015 PT
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Introdução: A ressecão hepática é considerada um tratamento potencialmente curativo para metástases hepáticas de câncer colorretal (MHCCR), mas os benefícios a longo prazo oferecidos pela complementação do tratamento com quimioterapia sistêmica não foram completamente comprovados. Existe ganho já bem estabelecido para sobrevida livre de doença com o uso de quimioterapia perioperatória, mas não existe ganho de sobrevida global demonstrado em ensaios clínicos randomizados (ECR). Objetivo: Comparar sobrevida global e livre de doença em pacientes com MHCCR submetidos apenas ao tratamento cirúrgico com intenção curativa com aqueles que além da cirurgia também receberam tratamento complementar com quimioterapia sistêmica, independentemente do regime utilizado. Métodos: Construção de revisão sistemática com meta-análise avaliando estudos publicados entre 1991 e 2013 e que compararam o tratamento cirúrgico isolado ao associado à quimioterapia sistêmica para o tratamento de MHCCR ressecáveis. Os ECR foram avaliados através da ferramenta Cochrane para detecção de viéses, e os estudos observacionais comparativos (EOC) de boa qualidade foram incluídos no processo meta-analítico após terem sido selecionados seguindo a metodologia MINORS (índice metodológico para análise de ensaios clinicos não randomizados). Sobrevidas global e livre de doença foram comparadas utilizando modelos fixos e randômicos de efeitos de tratamento e razão de riscos (RR). Resultados: Na avaliação de sobrevida global foram incluídos 5 estudos (3 ECR e 2 EOC)...

Nursing interventions to prevent falls in older people : a systematic review

Lage, Isabel; Araújo, Odete; Vilaça, Simão
Fonte: Universidade de São Paulo. Faculdade de Saúde Pública Publicador: Universidade de São Paulo. Faculdade de Saúde Pública
Tipo: Conferência ou Objeto de Conferência
Publicado em /05/2014 ENG
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Publicado em "Revista de saúde pública, vol. 48, n.º especial (2014)"; Introduction: Falls are common and become a serious problem among older people who have the highest risk of falling, with 30% of people older than 65 and 50% of people older than 80 falling at least once a year. Several consequences can result as fractures, loss of Independence and hasten death. Objective: To synthesize the effectiveness of nursing interventions to prevent falls in older people (≥75). Methods: Systematic review of RCT’s. We searched the SCOPUS database without date restriction. Inclusion and exclusion criteria were defined, the search expression used was: older people AND falls prevention AND nurs* AND randomized controlled trials. Full manuscripts were obtained and screened independently by two reviewers using a screening form with clearly defined criteria. Results: From twelve studies met the inclusion criteria. Four were related with exercise programs; four involved devices to prevent falls (hip protectors); two included health promotional sessions (multidisciplinary team); and two studies involved a software to evaluate the risk of falling. Conclusions: Twelve interventions found in this study, nine had positive effect on preventing falls. Studies showed that physical exercise promotes strength...

Avaliação crítica e implementação prática de ensaios clínicos aleatorizados

Azevedo, L.; Pereira, A.
Fonte: Nascer e Crescer Publicador: Nascer e Crescer
Tipo: Artigo de Revista Científica
Publicado em /06/2009 POR
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A Medicina Baseada na Evidência (MBE) é genericamente definida como a aplicação consciente, explícita e criteriosa da melhor evidência científica disponível na tomada de decisões sobre o cuidado individual dos doentes. Nesta rubrica de Pediatria Baseada na Evidência têm vindo a ser abordados os aspectos conceptuais, metodológicos e operacionais relativos à prática da MBE no âmbito específico da Pediatria. Neste artigo é apresentado um exemplo prático de aplicação dos conceitos, métodos e competências abordados nos artigos anteriores, debruçando-se especificamente sobre a avaliação crítica e aplicação prática de ensaios clínicos aleatorizados (ECA’s). É apresentado um cenário clínico em que surge a necessidade de encontrar e avaliar a evidência científica existente sobre a eficácia da utilização de antibióticos no tratamento da otite média aguda em crianças com menos de 2 anos. São discutidos os métodos de pesquisa da evidência mais actual e mais apropriada à questão; e é sugerida uma metodologia sistemática para a avaliação crítica de ECA’s incluindo três fases distintas: (1) avaliação da validade ou qualidade metodológica do ECA; (2) avaliação da importância científica e prática dos seus resultados e (3) avaliação da aplicabilidade prática dos mesmos. ABSTRACT Evidence Based Medicine (EBM) is generally defined as the conscientious...

Efectividade de programas de intervenção na prevenção de quedas em idosos com osteoporose: revisão sistemática

Correia, Maria Goretti; Moniz, Rubina; Roque, Ana; Santos, Cátia; Robalo, Lina
Fonte: Repositório Comum de Portugal Publicador: Repositório Comum de Portugal
Tipo: Artigo de Revista Científica
Publicado em /06/2010 POR
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Background: Falls are the third cause of chronic incapacity among elders. Among others, elders with osteoporosis are more vulnerable to negative consequences such as fractures. Recent research evidence suggests that some interventions are effective in preventing elderly falls but there is limited information concerning the effectiveness of fall prevention programmes for elders with osteoporosis. Objectives: To identify the most effective programmes in falls prevention in elders with osteoporosis, living in the community and compare the results with prevention for a non-specific condition. Search Strategy: We searched RCT’s published in the last 5 years conducted on PubMed, PEdro, CENTRAL, Web of Knowledge and CINAHL (January, 2009). Selection criteria: RCT’s, published in English in the last 5 years that addressed interventions to prevent falls for community-dwelling elders with osteoporosis. Results: Eight RCT’s were included in this review. For falls reduction, different approaches were evaluated, but only the intervention with hip protectors and the intervention with an exercise program to promote balance had significant statistical results. However the confidant intervals are unknown. For fractures reduction, only two interventions had significant statistical results – annual intramuscular Vitamin D2 over 3 years (HR- 1...

Efectividade de exercícios de estabilidade em adultos com dor cervical crónica: Revisão sistemática

Freitas, Tiago Valente; Serpa, Rui Alexandre; Simão, Daniel Filipe; Jardim, Marco
Fonte: Repositório Comum de Portugal Publicador: Repositório Comum de Portugal
Tipo: Artigo de Revista Científica
Publicado em /06/2010 POR
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Introduction: Chronic Neck Pain is described as the second most frequent musculoskeletal pathology. The dynamic stability theory as a fundamental concept in these dysfunctions has increased its scientific support in the last years. Objective: To analyze and evaluate the effectiveness of the stability exercises and its influence in the outcomes: pain and/or function. Data Base: Pubmed (Medline), Cochrane Library and PEDro until February 2009. Review Methods: The inclusion criteria were Randomized Control Trials (RCT’s), in English language, published in the last 10 years, with PEDro Scores ≥ 6, non athlete adults, (≥19 years), the intervention must had stabilization exercises applied to the cervical spine and must had as outcomes pain and/or function. After the systematic search the articles that weren’t classified were evaluated by PEDro score. Results: 7 articles were selected for this review; only 5 had as outcome both pain and function simultaneously. It seems to exist some evidence that the specific training of the craneo-flexors muscles immediately reduces neck pain. However there isn’t evidence of significative differences between stabilization exercises and progressive resistance training, proprioceptive training...

Annotated bibliography of the biomedical literature pertaining to chiropractic, pediatrics and manipulation in relation to the treatment of health conditions

Gotlib, Allan C; Beingessner, Melanie
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /09/1995 EN
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Biomedical literature retrieval, both indexed and non-indexed, with respect to the application of manipulative therapy with therapeutic intent and pediatric health conditions (ages 0 to 17 years) yielded 66 discrete documents which met specified inclusion and exclusion criteria. There was one experimental study (RCT’s), 3 observational (cohort, case control) studies and 62 descriptive studies (case series, case reports, surveys, literature reviews). An independent rating panel determined consistency with a modified quality of evidence scale adopted from procedure ratings system 1 of Clinical Guidelines for Chiropractic Practice in Canada. Results indicate minimal Class 1 and Class 2 and some Class 3 evidence for a variety of pediatric conditions utilizing the application of manipulation with therapeutic intent.

Randomized Clinical Stroke Trials in 2007

Rabadi, Meheroz H; Blass, John P
Fonte: Bentham Open Publicador: Bentham Open
Tipo: Artigo de Revista Científica
Publicado em 31/10/2008 EN
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This article reviews the randomized control trials (RCT’s) that were published in 2007 of emerging pharmacotherapies in patients with acute (≤ 2 weeks), sub-acute (2 to 12 weeks) and chronic (≥ 12 weeks) stroke. A Medline search generated 22 RCT’s in stroke in the year 2007 in the English language. These trials were primarily efficacy studies. These included the role of statins (an anti-lipid agent) in reducing post-stroke morbidity and mortality, and decreasing the carotid atherosclerotic plaque in middle aged patients at increased risk of cardiovascular disease; glucose-potassium-insulin infusion in hyperglyceamic acute stroke patients; pioglitazone (an anti-diabetic medication) to reduce recurrence of stroke in Type 2 diabetic patients; administration of intra-arterial urokinase (a thrombolytic agent) and the role of laser therapy in clot dissolution given that at present there is only one FDA approved thrombolytic agent (r TPA); benefit of warfarin (an anticoagulant) in elderly patients with atrial fibrillation in the community; NXY (a free radical trapping agent) and minocycline both tested as neuroprotectants; and zoledronate (an intravenous bisphosphonate) to prevent loss of bone mineral density of the affected extremity...

Manualization of Occupational Therapy Interventions: Illustrations from the Pressure Ulcer Prevention Research Program

Blanche, Erna Imperatore; Fogelberg, Donald; Diaz, Jesus; Carlson, Mike; Clark, Florence
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em //2011 EN
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The manualization of a complex occupational therapy intervention is a crucial step in ensuring treatment fidelity for both clinical application and research purposes. Towards this latter end, intervention manuals are essential for assuring trustworthiness and replicability of randomized controlled trials (RCT’s) that aim to provide evidence of the effectiveness of occupational therapy. In this paper, literature on the process of intervention manualization is reviewed. The prescribed steps are then illustrated through our experience in implementing the University of Southern California/Rancho Los Amigos National Rehabilitation Center’s collaborative Pressure Ulcer Prevention Project (PUPP). In this research program, qualitative research provided the initial foundation for manualization of a multifaceted occupational therapy intervention designed to reduce incidence of medically serious pressure ulcers in people with SCI.

Selective prevention programs for children from substance-affected families: a comprehensive systematic review

Bröning, Sonja; Kumpfer, Karol; Kruse, Katja; Sack, Peter-Michael; Schaunig-Busch, Ines; Ruths, Sylvia; Moesgen, Diana; Pflug, Ellen; Klein, Michael; Thomasius, Rainer
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Publicado em 12/06/2012 EN
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Children from substance-affected families show an elevated risk for developing own substance-related or other mental disorders. Therefore, they are an important target group for preventive efforts. So far, such programs for children of substance-involved parents have not been reviewed together. We conducted a comprehensive systematic review to identify and summarize evaluations of selective preventive interventions in childhood and adolescence targeted at this specific group. From the overall search result of 375 articles, 339 were excluded, 36 full texts were reviewed. From these, nine eligible programs documented in 13 studies were identified comprising four school-based interventions (study 1–6), one community-based intervention (study 7–8), and four family-based interventions (study 9–13). Studies’ levels of evidence were rated in accordance with the Scottish Intercollegiate Guidelines Network (SIGN) methodology, and their quality was ranked according to a score adapted from the area of meta-analytic family therapy research and consisting of 15 study design quality criteria. Studies varied in program format, structure, content, and participants. They also varied in outcome measures, results, and study design quality. We found seven RCT’s...

25-Hydroxyvitamin D Supplementation and BMI Change: A Meta-Analysis of Randomized Controlled Trials

Mora, N; Rieke, K; Plitcha, J; Segura, AJ; Leehey, D; DeShong, K; Kramer, H; Durazo-Arvizu, Ramon A.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em 09/07/2013 EN
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The impact of 25-hydroxyvitamin D (25[OH]D) supplementation on weight change remains controversial. The objective of this study was to summarize the effects of 25[OH]D supplementation (cholecalciferol or ergocalciferol) on BMI change through a meta-analysis of published clinical trials. We completed a systematic review of English articles, using MEDLINE (Ovid, Pubmed) from January 1, 1998 through January 1, 2013. The articles selected focused on 25[OH]D supplementation and body mass index (BMI) in randomized controlled trials (RCT’s). The association between 25[OH]D and mean BMI change was estimated utilizing a random effects model. A total of 30 studies were reviewed and 9 were included in the meta-analysis. Total participants included 1651 adults (82.6% women and mean age 47.9 years) and mean follow-up ranged between 6 to 196 weeks and mean daily 25[OH]D dose ranged from 200 IU to 1,110 IU. Five of the 9 studies included calcium supplementation in both groups. Average baseline BMI was 30.7 and 30.4 kg/m2 in the intervention and control groups, respectively. Five studies suggested a beneficial effect for 25[OH]D supplementation for BMI change whereas 3 studies showed no effect of 25[OH]D supplementation on BMI change, and one showed a non-perceptible change. Meta-analysis of BMI values at end of trial showed no statistically significant difference in BMI change by use of 25[OH]D supplementation. Based on existing published trials...

The effectiveness of interventions in the prevention and management of aggressive behaviours in patients admitted to an acute hospital setting

Jayasekara Gangoda Arachchilag, Rasika Sirilal
Fonte: Blackwell Publicador: Blackwell
Tipo: Artigo de Revista Científica
Publicado em //2009 EN
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Background: Violence in healthcare has been widely reported and healthcare workers, particularly nurses in the acute care setting, are ill-equipped to manage patients who exhibit aggressive traits. An initial search of the Cochrane Library and the Joanna Briggs Institute did not reveal any published systematic reviews recommending strategies to manage aggressive and/or violent behaviours in patients admitted to an acute hospital setting. Objectives: This systematic review aims to establish best practice in the prevention and management of aggressive behaviours in patients admitted to an acute hospital setting. Search strategy: A three-step search strategy was utilised during this review. Major databases searched included: MEDLINE, CINAHL, PsycINFO, Health source, Web of science, EMBASE, the Cochrane library and Database of abstracts of reviews of effects (DARE) as well as PubMed. The search included published and unpublished studies and papers in English from 1990-2007. Selection criteria: This review considered any randomised controlled trials (RCT) that evaluated the effectiveness of interventions in the prevention and management of patients who exhibit aggressive behaviours in an acute hospital setting. In the absence of RCT's, other research designs such as non-randomised controlled trials and before and after studies were considered for inclusion in the narrative summary to enable the identification of current approaches and possible future strategies for preventing and managing patient aggression in acute care areas. Assessment of quality: Each included study was assessed by two independent reviewers using the appropriate appraisal checklist developed by the Joanna Briggs Institute. Data collection and analysis: Data was extracted from the papers included in this review using the standardised data extraction tools from the Joanna Briggs Institute Meta Analysis of Statistics: Assessment and Review Instrument (JBI-MAStARI) package. The studies included in this review were not suitable for meta-analysis and therefore the results are presented in narrative form. Results: Twelve studies and one dissertation met the inclusion criteria and were included in the review. The evidence identified includes: the benefit of education and training of acute care nurses in aggression management techniques; the use of “as required” medications to minimise harm to patients and staff; and that specific interventions such as music therapy and physical restraint may play a role in managing aggressive and/or violent behaviours from patients in the acute care setting. Conclusion: This review makes several recommendations for clinical practice to prevent and manage aggressive behaviours in acute hospital patients. However due to the lack of high quality intervention studies conducted in the acute care setting there is huge scope for future research in this area.; Kate Kynoch...

Suivi à long terme de l’efficacité d’un traitement de physiothérapie sur l'incontinence urinaire d'effort persistante en période postnatale

Martin, Claudine
Fonte: Université de Montréal Publicador: Université de Montréal
Tipo: Thèse ou Mémoire numérique / Electronic Thesis or Dissertation
FR
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L’incontinence urinaire d’effort (IUE) est une condition fréquente en période postnatale pouvant affecter jusqu’à 77% des femmes. Neuf femmes sur dix souffrant d’IUE trois mois après l’accouchement, vont présenter une IUE cinq ans plus tard. Le traitement en physiothérapie de l’IUE par le biais d’un programme d’exercices de renforcement des muscles du plancher pelvien est reconnu comme étant un traitement de première ligne efficace. Les études ont prouvé l’efficacité de cette approche sur l’IUE persistante à court terme, mais les résultats de deux ECR à long terme n’ont pas démontré un maintien de l’effet de traitement. L’effet d’un programme en physiothérapie de renforcement du plancher pelvien intensif et étroitement supervisé sur l’IUE postnatale persistante avait été évalué lors d’un essai clinique randomisé il y a sept ans. Le but principal de la présente étude était d’évaluer l’effet de ce programme sept ans après la fin des interventions de l’ECR initial. Un objectif secondaire était de comparer l’effet de traitement à long terme entre un groupe ayant fait seulement des exercices de renforcement du plancher pelvien et un groupe ayant fait des exercices de renforcement du plancher pelvien et des abdominaux profonds. Un troisième objectif était d’explorer l’influence de quatre facteurs de risques sur les symptômes d’IUE et la qualité de vie à long terme. Les cinquante-sept femmes ayant complétées l’ECR initial ont été invitées à participer à l’évaluation du suivi sept ans. Vingt et une femmes ont participé à l’évaluation clinique et ont répondu à quatre questionnaires...

Analyses of the motivation for hydrotherapy in users with chronic pain

Murta, Helena Guerreiro
Fonte: Repositório Científico Lusófona Publicador: Repositório Científico Lusófona
Tipo: Dissertação de Mestrado
ENG
Relevância na Pesquisa
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A dor crónica (DC) é uma das principais causas de incapacidade. A hidroterapia (HT) e exercício apresentam-se efectivos na diminuição da DC, contudo continuamos a assistir a uma fraca adesão e manutenção aos mesmos. Este trabalho teve como objectivo analisar a associação entre motivação para HT e a DC, função e qualidade de vida, em adultos e idosos, com base na teoria da autodeterminação, efectuando uma revisão sistemática da literatura (RSL) e avaliando a dinâmica motivacional, durante 13 semanas de implementação de um programa de HT. Realizou-se uma RSL, sobre a evidência da HT na DC, com base em estudos do tipo “randomized controlled trials” (RCT`s) e de artigos sobre motivação e / ou adesão para HT, com diversas abordagens metodológicas quantitativas. Posteriormente foi realizado um estudo longitudinal quasi experimental, dum programa de HT, onde participaram 124 adultos e idosos, de ambos os géneros, com DC. A dor, função, qualidade de vida e a motivação para a HT foram auto-reportados, através de questionários, no início e no fim do programa e realizadas entrevistas individuais para avaliar o nível de dor. Na RSL encontrou-se evidência de que a HT e o exercício têm efeitos estatisticamente significativos sobre o alívio da DC e que o exercício e a motivação intrínseca para o exercício são efectivos no alívio da dor...

Hipotermia terapêutica no pré-hospitalar

Marques, Nuno Fernando Ferreira
Fonte: Instituto Politécnico de Viseu Publicador: Instituto Politécnico de Viseu
Tipo: Dissertação de Mestrado
Publicado em 18/07/2014 POR
Relevância na Pesquisa
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A hipotermia terapêutica melhora a sobrevivência e o resultado neurológico após paragem cardíaca ocorrida no pré-hospitalar, pelo que tem sido recomendada a sua utilização em vítimas com recuperação de circulação espontânea. O objectivo deste estudo foi conhecer o efeito da hipotermia terapêutica pré-hospitalar (HTPH) na sobrevivência e nos outcomes neurológicos das vítimas que sofreram paragem cardíaca extra-hospitalar. Métodos: Foi realizada uma revisão sistemática da literatura sobre estudos que avaliavam o efeito da HTPH em vítimas que tinham sofrido PCR. Foi efetuada uma pesquisa na PUBMED, EBSCO e Google Académico de estudos publicados entre Janeiro de 2007 e 31 de Maio de 2013. Os estudos encontrados foram depois avaliados tendo em consideração os critérios de inclusão previamente estabelecidos. Dois revisores avaliaram a qualidade dos estudos a incluir utilizando a grelha para avaliação crítica de um estudo descrevendo um ensaio clinico prospetivo, aleatorizado e controlado de Carneiro (2008). Na meta-análise utilizou-se o método Mantel-Haenszel, recorrendo-se ao efeito de modelos aleatórios. Resultados: Cinco RCT’s preenchiam os critérios de inclusão, envolvendo 759 participantes...

Ventilação não invasiva no pré-hospitalar : uma revisão sistemática da literatura

Alves, Mónica Isabel Lopes
Fonte: Instituto Politécnico de Viseu Publicador: Instituto Politécnico de Viseu
Tipo: Dissertação de Mestrado
Publicado em 29/12/2014 POR
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A Ventilação Não Invasiva (VNI) tem sido recomendada como terapia adjuvante no alívio da sintomatologia em doentes com Edema Agudo do Pulmão (EAP). O objetivo deste estudo consistiu em determinar a eficácia da aplicação da VNI nas vítimas com EAP, no contexto do Pré-Hospitalar (PH) no que se refere aos resultados da necessidade de entubação endotraqueal e mortalidade. Métodos: Realizou-se uma revisão sistemática da literatura sobre estudos que avaliavam a eficácia da aplicação da VNI no EAP em contexto PH e efetuou-se uma pesquisa na PUBMED, EBSCO, Google Scholar e Scielo, de estudos publicados entre janeiro de 2007 e 31 de dezembro de 2013. Os estudos encontrados foram depois avaliados tendo por base os critérios de inclusão previamente estabelecidos. Dois revisores avaliaram a qualidade dos estudos a incluir aplicando uma grelha para avaliação crítica de um estudo descrevendo um ensaio cliníco prospetivo, aleatorizado e controlado de Carneiro (2008). Na meta-análise utilizou-se o método Mantel-Haenszel, recorrendo-se ao efeito de modelos aleatórios. Resultados: Dois RCT’s preenchiam os critérios de inclusão, envolvendo 329 participantes, sendo 167 do grupo de VNI e 162 do grupo de controlo. A análise dos estudos combinados revela que a aplicação da VNI diminui significativamente a necessidade de entubação endotraqueal comparativamente à instituição em exclusivo do tratamento médico padrão (RR=0...

Aplicação de dispositivos mecânicos na realização de compressões torácicas no pré-hospitalar

Almeida, Vitor Manuel Soares
Fonte: Instituto Politécnico de Viseu Publicador: Instituto Politécnico de Viseu
Tipo: Dissertação de Mestrado
Publicado em 30/03/2015 POR
Relevância na Pesquisa
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As manobras se suporte básico de vida de qualidade são determinantes no sucesso da reanimação cardiorrespiratória. O objectivo deste estudo consistiu em determinar a eficácia das compressões torácicas mecânicas na recuperação da circulação espontânea nas vítimas de paragem cardiorrespiratória (PCR) em contexto de pré-hospitalar (PH) e o bom resultado neurológico no momento da alta. Métodos: Foi realizada uma revisão sistemática da literatura sobre estudos que avaliavam a eficácia da aplicação de dispositivos mecânicos nas compressões torácicas em vítimas de PCR no contexto de PH. Foi efetuada uma pesquisa na PUBMED e EBSCO de estudos publicados entre Janeiro de 2009 e 31 de Outubro de 2014. Os estudos encontrados foram depois avaliados tendo em consideração os critérios de inclusão previamente estabelecidos. Dois revisores avaliaram a qualidade dos estudos a incluir utilizando a grelha para avaliação crítica de um estudo descrevendo um ensaio clinico prospetivo, aleatorizado e controlado de Carneiro (2008). Na meta-análise utilizou-se o método Mantel-Haenszel, recorrendo-se ao efeito de modelos aleatórios. Resultados: Três RCT’s preenchiam os critérios de inclusão, envolvendo 7208 participantes...

O efeito da aplicação da Estimulação Elétrica Funcional na reabilitação em adultos com lesão medular completa. Revisão Sistemática

Baptista, Priscília
Fonte: Instituto Politécnico do Porto Publicador: Instituto Politécnico do Porto
Tipo: Dissertação de Mestrado
Publicado em /10/2014 POR
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Introdução: A Lesão Medular (LM) é um dos mais devastadores e traumáticos eventos que um Ser Humano pode vivenciar do ponto de vista clínico e emocional, demonstrando-se fundamental a disponibilização de recursos específicos para que o indivíduo possa enfrentar e gerir a sua nova realidade da melhor maneira possível. Alguns estudos têm vindo a demonstrar os benefícios de programas de reabilitação com estimulação elétrica funcional (EEF). Portanto, é de importante relevância perceber os reais efeitos da intervenção na recuperação de indivíduos com este diagnóstico. Objetivo: Analisar as evidências de abordagens de aplicação de correntes de estimulação elétrica funcional (EEF) para coadjuvar na reabilitação em adultos com lesão medular completa. Métodos: Foi conduzida uma pesquisa dos artigos preferencialmente estudos randomized controlled trials RCT´s e estudos quasi-experimentais com os mesmos participantes foram admitidos complementarmente aos experimentais compreendidos entre 2004 e 2013, bem como as citações e as referências bibliográficas de cada estudo nas principais bases de dados de ciências da saúde (Elsevier – Science Direct, Highwire Press, PEDro, PubMed, Scielo Portugal, Clinical Key...

Effects of Yoga on Mental and Physical Health: A Short Summary of Reviews

Büssing, Arndt; Michalsen, Andreas; Telles, Shirley; Sherman, Karen J.; Khalsa, Sat Bir Singh
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
EN_US
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This report summarizes the current evidence on the effects of yoga interventions on various components of mental and physical health, by focussing on the evidence described in review articles. Collectively, these reviews suggest a number of areas where yoga may well be beneficial, but more research is required for virtually all of them to firmly establish such benefits. The heterogeneity among interventions and conditions studied has hampered the use of meta-analysis as an appropriate tool for summarizing the current literature. Nevertheless, there are some meta-analyses which indicate beneficial effects of yoga interventions, and there are several randomized clinical trials (RCT's) of relatively high quality indicating beneficial effects of yoga for pain-associated disability and mental health. Yoga may well be effective as a supportive adjunct to mitigate some medical conditions, but not yet a proven stand-alone, curative treatment. Larger-scale and more rigorous research with higher methodological quality and adequate control interventions is highly encouraged because yoga may have potential to be implemented as a beneficial supportive/adjunct treatment that is relatively cost-effective, may be practiced at least in part as a self-care behavioral treatment...

Effects of Yoga on Mental and Physical Health: A Short Summary of Reviews

Büssing, Arndt; Michalsen, Andreas; Khalsa, Sat Bir S.; Telles, Shirley; Sherman, Karen J.
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
EN
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This report summarizes the current evidence on the effects of yoga interventions on various components of mental and physical health, by focussing on the evidence described in review articles. Collectively, these reviews suggest a number of areas where yoga may well be beneficial, but more research is required for virtually all of them to firmly establish such benefits. The heterogeneity among interventions and conditions studied has hampered the use of meta-analysis as an appropriate tool for summarizing the current literature. Nevertheless, there are some meta-analyses which indicate beneficial effects of yoga interventions, and there are several randomized clinical trials (RCT's) of relatively high quality indicating beneficial effects of yoga for pain-associated disability and mental health. Yoga may well be effective as a supportive adjunct to mitigate some medical conditions, but not yet a proven stand-alone, curative treatment. Larger-scale and more rigorous research with higher methodological quality and adequate control interventions is highly encouraged because yoga may have potential to be implemented as a beneficial supportive/adjunct treatment that is relatively cost-effective, may be practiced at least in part as a self-care behavioral treatment...

Canine retraction: A systematic review of different methods used

Kulshrestha, Rohit S; Tandon, Ragni; Chandra, Pratik
Fonte: Medknow Publications & Media Pvt Ltd Publicador: Medknow Publications & Media Pvt Ltd
Tipo: Artigo de Revista Científica
Publicado em //2015 EN
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Canine retraction is a very important step in treatment of patients with crowding, or first premolar extraction cases. In severe crowding cases until, the canines have been distilized to relive the crowding, space to correctly align the incisors will not be available. Correct positioning of the canines after retraction is of great importance for the function, stability, and esthetics. The aim of this systematic review was to examine, in an evidence-based way, which kinds of canine retraction methods/techniques are most effective and which have the least side effects. A literature survey was performed by applying the Medline Database (Entrez PubMed) and Science Direct database covering the period from 1985 to 2014, to find out efficient ways to accomplish canine retraction. Randomized controlled trials (RCTs), prospective and retrospective controlled studies, and clinical trials were included. Two reviewers selected and extracted the data independently and assessed the quality of the retrieved studies. The search strategy resulted in 324 articles, of which 22 met the inclusion criteria. Due to the vast heterogeneity in study methods, the scientific evidence was too weak to evaluate retraction efficiency during space closure. The data so far reviewed proved that elastomeric power chains...