Navegando por Palavras-chave "Ensaio clínico controlado"
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- ItemAcesso aberto (Open Access)Comparação do processo evolutivo de crianças do espectro autístico em diferentes intervenções terapêuticas fonoaudiológicas(Sociedade Brasileira de Fonoaudiologia, 2011-03-01) Tamanaha, Ana Carina [UNIFESP]; Perissinoto, Jacy [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To analyze and compare the extension and the speed of the evolutional process of children with Autism Spectrum Disorders in direct and indirect interventions as opposed to only indirect intervention. METHODS: The design of this study is a clinical trial. The sample was composed of 11 children diagnosed with Autism (n=6) and Asperger syndrome (n=5) by a multidisciplinary team, that attended specialized speech-language pathology therapy at the institution were the study was carried out. These children were randomly divided into two groups: Therapy Group (TG) - composed by six subjects receiving both direct and indirect intervention; and Orientation Group (OG) - constituted by five subjects receiving exclusively indirect intervention. It was used the Autism Behavior Checklist (ABC) to interview the mothers, and the Sample of Vocal Behavior (SVB), in three occasions: at the beginning of the intervention process (time 0), six months later (time 1) and 12 months later (time 2). RESULTS: It was observed greater speed and extension in the evolutional process of the TG Group, both in the analysis of the Autism Behavior Checklist (total and partial scores) and the Sample of Vocal Behavior, especially in the item Full Language. The performance of children with Asperger syndrome was considered more positive when compared to that of children with autism. There was greater evolution in younger children and with normal, mild, and moderate adaptive functioning. CONCLUSION: The tendency towards better performance of the children attending direct and indirect intervention showed that this association is fundamental in the therapeutic process of children with Autism Spectrum Disorders.
- ItemAcesso aberto (Open Access)A eficácia da intervenção terapêutica fonoaudiológica nos Distúrbios do Espectro Autístico(Universidade Federal de São Paulo (UNIFESP), 2008-02-27) Tamanaha, Ana Carina [UNIFESP]; Perissinoto, Jacy [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Purpose: Evaluate the efficacy of the speech and language therapy for Autistic Spectrum Disorders. Methods: The design of this study is the Clinical Trial. The sample was composed of 11 children diagnosed with Autism (6) and Asperger Syndrome (5) attended in the Language and Speech Laboratory – Autistic Spectrum Disorders at Federal University of São Paulo. These children were randomly divided into two groups: Six were receiving both direct and indirect intervention (Therapy Group-TG), and five were receiving exclusively indirect intervention (Orientation Group-OG). We used the following parts of ASIEP-2 (Krug et al, 1993): Autism Behavior Checklist (ABC), Interaction Assessment (IA) and Sample of Vocal Behavior (SVB) on three occasions: at the beginning, six months later and 12 months later. Results: We observed there was greater evolution of Therapy Group –TG in the Autism Behavior Checklist, Interaction Assessment and Sample of Vocal Behavior. The mothers and the Speech and Language Therapist perceived behavioral changes. The influence of the multidisciplinary diagnosis, age and measures of the adaptive functioning was analysed. The performance of children with Asperger Syndrome was considered more positive. There was greater evolution in the children with age 73 month or more, and in the children with normal, mild and moderate adaptive functioning. Conclusions: The tendency of better performance of the children attended in direct and indirect intervention showed that this association was fundamental.
- ItemAcesso aberto (Open Access)Estudo prospectivo controlado, comparando fisioterapia e fisioterapia mais descompressão em pacientes com estenose do canal lombar sintomáticos(Universidade Federal de São Paulo (UNIFESP), 2017-12-20) Rodrigues, Luiz Claudio Lacerda [UNIFESP]; Natour, Jamil [UNIFESP]; http://lattes.cnpq.br/4969546467649519; http://lattes.cnpq.br/2912549647475760; Universidade Federal de São Paulo (UNIFESP)The lumbar spinal canal stenosis was first described by Antoine Portal in 1803. However, the first association between changes in the diameter of the spinal canal and its relation to the clinical condition and the neurogenic claudication was made by Verbiest. In this study, we evaluated 63 patients with lumbar canal stenosis, of both genders and age between 50 and 75 years. Of all, 31 were submitted to surgery and physiotherapy and 32 only to physiotherapy. All of them passed through five analyzes, made by a blinded evaluator, and performed a twice weekly exercise program for three months. As an evaluation tool, we used the six-minute walk test; the Roland-Morris, SF-36 and Oswestry questionnaires; and a Likert scale. The mean age of the operated patients was 60.7 years and, among the non-operated, 60.2 years. In the gender division, 8 men and 23 women underwent surgery and 8 men and 24 women belonged to the control group. Systemic arterial hypertension was the chronic-degenerative disease with a higher incidence in the study patients. We observed that, except for Oswestry questionnaire, which evaluated functional capacity, and for the Likert scale, which presented statistically significant results, we did not find significant differences between the groups. The gait capacity did not change after the surgery. Their quality of life, when analyzed by SF-36, did not confer a statistically significant difference, but after one year of follow-up, the operated patients were more satisfied than the others. Isolated physiotherapy did not show improvement in the patients’ condition. We concluded that the surgery with physiotherapy or isolated physiotherapy does not modify, in a statistically significant way, the patient’s quality of life, nor do any of the therapies evaluated effectively improve the distance that they manage to wander. Operated patients have a statistically significant improvement perception in relation to the control group and also presented an improvement in overall functional capacity after surgery. In our study, the surgery proved to be safe, having observed no complication or need for reoperation in the intervention group.
- ItemAcesso aberto (Open Access)Intervenções para o tratamento de infecção de corrente sanguínea relacionada a cateter de longa permanência em pacientes em hemodiálise de manutenção: revisão sistemática Cochrane(Universidade Federal de São Paulo, 2021-10-04) Almeida, Beatriz Moschiar [UNIFESP]; Cacione, Daniel Guimarães [UNIFESP]; http://lattes.cnpq.br/7260876757287907; http://lattes.cnpq.br/0142757200550792Objetivos: Avaliar e comparar a eficácia e efetividade dos diferentes tratamentos para infecção de corrente sanguínea relacionada a cateter (ICSRC) em pacientes em hemodiálise (HD) de manutenção através de cateter venoso central de longa permanência (tCVC), como o uso isolado de antibiótico sistêmico ou em combinação com a troca de tCVC por fio-guia ou a soluções de bloqueio ou a retirada e reimplante de novo tCVC. Métodos: Realização de revisão sistemática da literatura com metodologia Cochrane. Foi conduzida busca no Cochrane Kidney and Transplant Register of Studies, CENTRAL, MEDLINE, EMBASE, e outras bases de dados até 23 de março de 2020 com atualização em 25 de maio de 2021. Foram incluídos estudos completos, randomizados ou quasi-randomizados, que avaliaram o tratamento para ICSRC em pacientes em HD de manutenção através de tCVC. Os estudos foram selecionados para inclusão ou exclusão por dois autores de forma independente, seguido da avaliação do risco de viés e extração de dados. Resultados: Dois ensaios clínicos randomizados e um quasi-randomizado foram identificados envolvendo um total de 760 participantes abordando o tratamento de ICSRC. Nenhum dos estudos comparou as mesmas intervenções - um comparou diferentes soluções de bloqueio de antibióticos associados a antibióticos sistêmicos, outro comparou antibióticos sistêmicos isolados a antibióticos sistêmicos em associação com solução de bloqueio de etanol e o último comparou antibióticos sistêmicos com diferentes manejos de cateter (troca de fio-guia versus remoção e reposicionamento). A qualidade geral da evidência foi muito baixa, devido ao pequeno número de participantes, alto risco de viés em muitos domínios e dados de desfechos faltantes. Foi possível concluir que o uso de antibióticos sistêmicos em combinação com solução de bloqueio de etanol pode ser superior ao uso de antibióticos sistêmicos isolados (razão de risco (RR) 1,61; intervalo de confiança (IC) de 95% 1,16 a 2,23; P = 0.004; evidência de qualidade muito baixa). Não foi encontrada diferença entre os efeitos de diferentes soluções de bloqueio de antibióticos com relação às taxas de cura (RR 0,92; IC 95% 0,74 a 1,15; P = 0.47) ou entre troca do fio-guia do cateter versus remoção do cateter com reposicionamento tardio, expressa pela sobrevida livre de infecção do cateter (HR 0,88; IC 95% 0,43 a 1,79; P = 0.72). Até o momento, não há resultados disponíveis comparando as outras intervenções em que estávamos interessados. Desfechos como estenose e / ou trombose venosa, resistência a antibióticos, morte e eventos adversos não foram avaliados. Conclusões: Evidências de qualidade muito baixa sugerem que pode haver um benefício para o uso de solução de bloqueio de etanol em associação a antibióticos sistêmicos em comparação com antibióticos sistêmicos isolados para tratamento de ICSRC em pacientes em HD de manutenção em uso de tCVC. Atualmente, não há evidências de alta qualidade disponíveis para apoiar um tratamento em detrimento de outro para ICSRC. Portanto, mais ensaios clínicos randomizados são necessários para identificar os benefícios e danos das opções de tratamento para essa patologia. Futuros estudos devem focar na unificação das definições de cura e de ICSRC assim como no aprimoramento do desenho metodológico.