Relationship between mastication and malnutrition in community-dwelling older adults: a meta-analysis.

PURPOSE: To determine the relationship between mastication and malnutrition in community-dwelling older adults. RESEARCH STRATEGIES: To establish the eligibility criteria, the acronym PECOS was used: Population: non-institutionalized older adults; Exposure: older adults with malnutrition; Control: older adults without malnutrition; Outcome: masticatory problems in malnourished older adults; Study types: observational studies. SELECTION CRITERIA: It selected studies assessing malnutrition and mastication difficulties in non-institutionalized adults over 60 years old, of both sexes. Mastication and malnutrition were evaluated with questionnaires on self-reported symptoms and clinical and instrumental assessments. There were no restrictions on language, year of publication, or ethnicity. DATA ANALYSIS: The included studies were evaluated for methodological quality with the Joanna Briggs Institute tool for cross-sectional studies. For the cross-sectional studies included, the odds ratio (OR) was calculated with 95% confidence intervals. RESULTS: After searching the databases, 692 references were retrieved, with three studies selected for quantitative and qualitative analysis. The values obtained in the meta-analysis for association show that malnutrition and mastication difficulties were 2.21 times as likely to occur (OR = 2.21; 95%CI = 0.93 - 5.26; I2 = 94%) as individuals without malnutrition (p < 0.001). The assessment of the risk of bias presented a high-risk, a moderate-risk, and a low-risk study. The certainty of evidence was rated very low with the GRADE tool. CONCLUSION: Individuals at risk of malnutrition are 2.21 times as likely to have mastication difficulties.

Relationship between mastication and malnutrition in community-dwelling older adults: a meta-analysis

ABSTRACT Purpose To determine the relationship between mastication and malnutrition in community-dwelling older adults. Research strategies To establish the eligibility criteria, the acronym PECOS was used: Population: non-institutionalized older adults; Exposure: older adults with malnutrition; Control: older adults without malnutrition; Outcome: masticatory problems in malnourished older adults; Study types: observational studies. Selection criteria It selected studies assessing malnutrition and mastication difficulties in non-institutionalized adults over 60 years old, of both sexes. Mastication and malnutrition were evaluated with questionnaires on self-reported symptoms and clinical and instrumental assessments. There were no restrictions on language, year of publication, or ethnicity. Data analysis The included studies were evaluated for methodological quality with the Joanna Briggs Institute tool for cross-sectional studies. For the cross-sectional studies included, the odds ratio (OR) was calculated with 95% confidence intervals. Results After searching the databases, 692 references were retrieved, with three studies selected for quantitative and qualitative analysis. The values obtained in the meta-analysis for association show that malnutrition and mastication difficulties were 2.21 times as likely to occur (OR = 2.21; 95%CI = 0.93 - 5.26; I2 = 94%) as individuals without malnutrition (p < 0.001). The assessment of the risk of bias presented a high-risk, a moderate-risk, and a low-risk study. The certainty of evidence was rated very low with the GRADE tool. Conclusion Individuals at risk of malnutrition are 2.21 times as likely to have mastication difficulties.

Orofacial and cervical myofunctional intervention programmes for older adults: A scoping review.

INTRODUCTION: Senescent stomatognathic systems undergo anatomical changes that are not always compensated by physiology due to associated factors such as poorly fitted dentures, dental changes, and clinical conditions that trigger sarcopenia. When these conditions are not properly addressed, they can lead to nutritional deficiencies. Hence, this study aimed to map orofacial and cervical myofunctional intervention programmes for older adults, evaluate the current research in this area, and formulate suggestions for further investigation. METHODS: Scoping review is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist. The EMBASE, LILACS, PubMed/Medline, Scopus, Web of Science, and grey literature databases were systematically searched. Studies addressing therapeutic programmes, myofunctional exercises, and their influence on the stomatognathic system of older adults were included. Studies with populations younger than 60 years, residing in long-term care facilities, homes, or hospital care, and with associated comorbidities were excluded, as well as secondary studies. RESULTS: A total of 3098 studies were retrieved. After applying the eligibility criteria, nine studies were eligible for this review. The nine studies were published in English between 2008 and 2021 in the United States, Japan, and South Korea. The participants' mean ages ranged from 64 to 81 years, with a preponderance of females. Six of the studies divided the sample into intervention and control groups. Two studies referred to programmes to promote oral function through facial expression and tongue muscle exercises, salivary gland massage, and swallowing biomechanics. Seven studies report the positive influence of myofunctional exercises on the stomatognathic system. CONCLUSION: The mapping concluded that therapeutic programmes, including educational actions, help prevent orofacial myofunctional disorders, and improve the functionality of the stomatognathic system.

Prevalence of chewing difficulty in older people in long-term care: A systematic review and meta-analysis.

BACKGROUND: Many factors can influence chewing, including age. The ageing process causes morphophysiological changes in the body, including in the performance of the stomatognathic system, which directly affect chewing and swallowing. OBJECTIVE: To determine the prevalence of chewing difficulty in older people in long-term care. METHODS: We searched six electronic databases and the grey literature. Qualitative and quantitative analyses, including risk of bias, were performed on studies that met the inclusion criteria. The meta-analysis of proportions with a random effects model was performed, and heterogeneity was explored by meta-regression. Risk of bias was determined using the Joanna Briggs Institute's Critical Appraisal Checklist. The certainty of evidence was verified using the GRADE tool. RESULTS: Twelve articles were included in the meta-analysis. The pooled prevalence estimate was 35% (95% confidence interval, 0.19-0.54). As heterogeneity still persisted even after sensitivity analysis, the predictors of mean sample age and sample size were meta-regressed to assess whether these covariates explained the variance between effect sizes. The covariable sample size of the study included in the analysis explained 84.3% of the heterogeneity existing in the analysis (R2  = 84.3%; P = .0008). The risk of bias was low in three studies, eight studies had a moderate risk of bias and one study had a high risk of bias. As for the prevalence of chewing difficulty, the GRADE criteria were considered very low. CONCLUSION: About one in three older people in long-term care have difficulty in chewing.

Effects of photobiomodulation combined with orofacial myofunctional therapy on the quality of life of individuals with temporomandibular disorder. / Efeitos da fotobiomodulação associada a terapia miofuncional orofacial na qualidade de vida de indivíduos com disfunção temporomandibular.

PURPOSE: To analyze the impact of photobiomodulation combined with orofacial myofunctional therapy (OMT) on the oral health quality of life (OHQOL) of individuals with temporomandibular disorder, before and after the treatment. METHODS: Blind, controlled, randomized clinical trial with 34 volunteers randomly distributed into two groups: G1, who received OMT combined with photobiomodulation, and G2, treated with OMT combined with inactive laser. The subjects were first assessed with a visual analog scale (VAS) to classify them according to the degree of orofacial pain and with the Oral Health Impact Profile - Short Form (OHIP-14) regarding the impact on the OHQOL. The resulting data were statistically analyzed. The significance level was set at 0.05 (95%). RESULTS: "Physical pain", "psychological discomfort", "physical disability", and "psychological disability" were the aspects with the greatest impact on the OHQOL. The G1 subjects responded positively to their treatment, as well as G2 to theirs. There was a strong positive correlation between VAS and total OHIP-14 score in both groups after the treatment. However, the functional recovery in the control group individuals (G2) was the most perceived positive change in the OHQOL in comparison with the experimental group (G1). CONCLUSION: The people who received photobiomodulation combined with OMT perceived an improvement in the OHQOL, as well as those treated with placebo laser. There was a strong positive correlation in both groups in the improvement of the degree of pain and self-perception of the OHQOL.

OBJETIVO: Analisar o impacto na qualidade de vida relacionada à saúde oral de indivíduos com disfunção temporomandibular, antes e após o tratamento de fotobiomodulação associada a terapia miofuncional orofacial. MÉTODO: Estudo do tipo ensaio clínico randomizado, controlado e cego, com 34 voluntários distribuídos aleatoriamente em dois grupos: G1, que recebeu a Terapia Miofuncional Orofacial (TMO) associada a fotobiomodulação e o G2, tratado pela TMO associada ao laser inativo. Os indivíduos foram submetidos, primeiramente, à avaliação para serem classificados de acordo com o grau da dor orofacial pela Escala Visual Analógica (EVA) e também quanto ao impacto da qualidade de vida relacionada a saúde oral (QVRSO) pelo questionário Oral Health Impact Profile ­ Short form (OHIP-14). Os dados obtidos foram analisados estatisticamente. Foi adotado o nível de significância de 0,05 (95%). RESULTADOS: "Dor física", "desconforto psicológico", "limitação física" e "limitação psicológica" foram os aspectos mais impactantes na QVRSO. O G1 apresentou respostas positivas para o respectivo tratamento, assim como o G2. Observou-se correlação positiva e de grau forte para EVA e escore total do OHIP-14 em ambos os grupos após tratamento. Porém, os indivíduos do grupo controle (G2) evidenciaram que a recuperação funcional foi o aspecto que mais se percebeu de mudança positiva na QVRSO em comparação ao grupo experimental (G1). CONCLUSÃO: As pessoas que receberam fotobiomodulação associada a TMO-perceberam melhora da QVRSO, assim como as tratadas com o laser placebo. Houve correlação positiva e forte em ambos os grupos na melhora do grau da dor e autopercepção da QVRSO.

Accuracy of an epidemiological oropharyngeal dysphagia screening for older adults.

OBJECTIVE: The aim of this study was to determine the accuracy of an epidemiological screening questionnaire for oropharyngeal dysphagia in older people. BACKGROUND: Determining the cut-off point and the accuracy of the self-reported epidemiological questionnaire for screening oropharyngeal dysphagia in older adults is important for mass screening, which may estimate the prevalence of oropharyngeal dysphagia. MATERIALS AND METHODS: This was a cross-sectional diagnostic study with a convenience sample of 70 older adults over 60 years of age of both sexes, aged between 60 and 90 years (mean age 69.2; SD, 7.6). It used a screening questionnaire with nine ordered items response options resulted in a score ranging from 0 to 18. The criterion test was the fiberoptic endoscopic evaluation of swallowing, with analysis of the receiver operating characteristic (ROC), with a 5% significance level. RESULTS: Oropharyngeal dysphagia frequency by the criterion test was 73%, with no significant difference between age and sex. The area under the ROC curve was 0.88 (95% confidence interval: 0.79-0.98) above the cut-off point 3. This screening questionnaire showed good parameters of sensitivity (80%), specificity (89%), positive predictive value (95%), negative predictive value (63%), positive likelihood ratio (7.64), negative likelihood ratio (0.22) and accuracy (83%). CONCLUSIONS: This questionnaire may be a satisfactory screening tool for estimating the prevalence of oropharyngeal dysphagia in older adults.

Sinais e sintomas de disfagia orofaríngea em idosos institucionalizados: revisão integrativa / Signs and symptoms of oropharyngeal dysphagia in institutionalized older adults: an integrative review

RESUMO Objetivo identificar quais são os sinais e sintomas de disfagia orofaríngea mais presentes nos idosos residentes em Instituições de Longa Permanência. Estratégia de pesquisa revisão integrativa realizada em quatro bases de dados: Embase, LILACS, MEDLINE/PubMed e Web of Science, com uso de termos na língua inglesa e aplicação de filtros por idioma e idade. Critérios de seleção estudos disponíveis na forma de texto completo em inglês, português ou espanhol, sem restrição de tempo de publicação, relacionados a idosos residentes em Instituições de Longa Permanência que referiram disfagia orofaríngea. Foram excluídos estudos relacionados a idosos da comunidade ou que estavam em hospitais, e com outras condições de saúde não relacionadas aos problemas de deglutição. Resultados de 389 estudos, 16 foram incluídos nesta revisão, publicados entre os anos de 1986 e 2020. Houve predomínio de participantes do sexo feminino, com média mínima de idade de 71 anos e máxima de 87 anos. Os sinais e sintomas mais frequentes de disfagia orofaríngea foram presença de tosse e engasgo, além de outros relevantes, como pressão de língua diminuída, voz molhada, perda de peso e deglutição lenta. Conclusão de acordo com os estudos revisados, os sinais e sintomas mais frequentes relacionados à disfagia orofaríngea nos idosos institucionalizados foram presença de tosse e engasgo, antes, durante ou após a deglutição.

Abstract Purpose To identify the most prevalent signs and symptoms of oropharyngeal dysphagia in elderly adults who live in old folks' home. Research strategy Integrative review carried out in four databases: Embase, Lilacs, MEDLINE/Pubmed, and Web of Science using English terms and filters for language and age. Selection criteria Studies available in the full-text form in English, Portuguese or Spanish, with no publication time restrictions, related to elderly people living in care homes who reported oropharyngeal dysphagia. Studies related to elderly people in the community or in hospitals and with other health issuesthat were not related to swallowing disorders were excluded. Results Of 389 studies, 16 were included in this review, published between 1986 and 2020. There was a predominance of female participants whose minimum mean age was 71 and maximum, 87. The most frequent signs and symptoms of oropharyngeal dysphagia were the presence of coughing and choking, in addition to other relevant ones, such as diminished tongue pressure, wet voice, weight loss, and slow swallowing. Conclusion According to the reviewed studies, the most frequent signs and symptoms related to oropharyngeal dysphagia in elderly people living in care homes were (the) presence of coughing and choking, before, during or after swallowing.

Prevalence of temporomandibular disorders in musicians: A systematic review and meta-analysis.

OBJECTIVE: To determine the prevalence of temporomandibular disorders (TMD) in musicians. MATERIALS AND METHODS: Electronic database searches and a manual search were performed. Qualitative and quantitative analysis including risk of bias was performed for studies that met the inclusion criteria. A meta-analysis of proportions with a random effects model was performed, and heterogeneity was explored according to the moderating variable through subgroup analysis and metaregression. The certainty of the evidence was assessed using the GRADE tool. RESULTS: A total of 13 articles were included for the meta-analysis. Pooled prevalence estimate was 52.8% (CI 95%; 33.4%-71.7%) for wind instruments, 53.9% (CI 95%; 42.4%-65.2%) for string instruments and 53.9% (CI 95%; 23.5%-82.7%) for string and wind instruments. The average time of use of the musical instrument explained 82.38%, the heterogeneity between the sizes of the effects observed in the analysis (R2  = 82.38%; P < .0001). For prevalence of TMD, the GRADE criteria were considered very low. CONCLUSION: The overall combined prevalence of TMD in musicians was approximately 53.9%, and musicians who use their instruments daily and for a long period of time may have a higher prevalence of TMD. CLINICAL SIGNIFICANCE: Due to the high prevalence of TMD in musicians, health professionals must be careful not to underestimate signs and symptoms and correctly diagnose these cases.

A Spatio-Temporal Analysis of the Environmental Correlates of COVID-19 Incidence in Spain.

The novel SARS-CoV2 has disrupted health systems and the economy, and public health interventions to slow its spread have been costly. How and when to ease restrictions to movement hinges in part on whether SARS-CoV2 will display seasonality due to variations in temperature, humidity, and hours of sunshine. Here, we address this question by means of a spatio-temporal analysis in Spain of the incidence of COVID-19, the disease caused by the virus. Use of spatial Seemingly Unrelated Regressions (SUR) allows us to model the incidence of reported cases of the disease per 100,000 population as an interregional contagion process, in addition to a function of temperature, humidity, and sunshine. In the analysis we also control for GDP per capita, percentage of older adults in the population, population density, and presence of mass transit systems. The results support the hypothesis that incidence of the disease is lower at higher temperatures and higher levels of humidity. Sunshine, in contrast, displays a positive association with incidence of the disease. Our control variables also yield interesting insights. Higher incidence is associated with higher GDP per capita and presence of mass transit systems in the province; in contrast, population density and percentage of older adults display negative associations with incidence of COVID-19.

Validity Evidence of an Epidemiological Oropharyngeal Dysphagia Screening Questionnaire for Older Adults.

OBJECTIVE: This research aimed to identify evidence of validity of a self-reported Oropharyngeal Dysphagia screening questionnaire for older adults based on test content, response processes, internal structure, relations to other variables, and reliability. METHOD: This is a nonrandomized, cross-sectional study employing the concepts and principles of the Standards for Educational and Psychological Testing. Data were collected from 644 community-dwelling older adults (both genders, age: ≥60 years) who agreed to participate in some steps of the validation process. Statistical methods obtained the content representation of the construct, internal structure validation, discriminant and convergent evidence, and reliability, using a 5% significance level. RESULTS: The screening tool was re-specified in nine questions that provided the best fit and robust reliability, with proper discriminant and convergent evidence. CONCLUSIONS: The screening questionnaire presented valid and reliable results to identify oropharyngeal dysphagia symptoms in older adults, highlighting the importance of the validation process based on the standards to construct an epidemiological instrument.

Screening for masticatory disorders in older adults (SMDOA): An epidemiological tool.

PURPOSE: Masticatory changes in the older adult population may cause nutritional impairment, so epidemiological studies are important to allow specific public health interventions. Thus, this study aims at constructing and validating an instrument for screening for masticatory disorders in older adults (SMDOA). METHODS: Validation study. First step: validity evidence based on test content. Defining the construct and elaborating the questions by a panel of experts and evaluating the representativeness and relevance of the items in relation to the construct by a committee of 28 experts. Analysis was performed through the Content Validity Index for Items (CVI-I) and the Content Validity Index (CVI). Second stage: validity evidence based on response processes. The questionnaire was applied to 40 older adults (≥60 years) using the cognitive interview strategy. Quantitative and qualitative analysis of the responses was carried out. Third stage: validity evidence based on the internal structure. The instrument was applied to 295 older adult patients and a confirmatory factorial analysis was performed to fit the model. RESULTS: The first version of SMDOA consisted of 16 issues related to chewing. The CVI and CVI-I were satisfactory, and only one question was excluded. The instrument with 15 questions was well evaluated by the older adults, only requiring minor adjustments to the morphosyntax. After the confirmatory factorial analysis, adjustments were made in its internal structure resulting in the 9-question model in two factors regarding function and masticatory perception. CONCLUSIONS: The SMDOA presented good evidence of validity in its content, response processes and internal structure.

Validity evidence of an epidemiological Oropharyngeal dysphagia screening questionnaire for older adults

OBJECTIVE: This research aimed to identify evidence of validity of a self-reported Oropharyngeal Dysphagia screening questionnaire for older adults based on test content, response processes, internal structure, relations to other variables, and reliability. METHOD: This is a nonrandomized, cross-sectional study employing the concepts and principles of the Standards for Educational and Psychological Testing. Data were collected from 644 community-dwelling older adults (both genders, age: ≥60 years) who agreed to participate in some steps of the validation process. Statistical methods obtained the content representation of the construct, internal structure validation, discriminant and convergent evidence, and reliability, using a 5% significance level. RESULTS: The screening tool was re-specified in nine questions that provided the best fit and robust reliability, with proper discriminant and convergent evidence. CONCLUSIONS: The screening questionnaire presented valid and reliable results to identify oropharyngeal dysphagia symptoms in older adults, highlighting the importance of the validation process based on the standards to construct an epidemiological instrument.

Development of oral sensory-motor functions of preterm and low-birth-weight newborns under speech-language pathology care / Desarrollo de las funciones sensoriomotoras orales de los recién nacidos prematuros y de bajo peso en atención fonoaudiológica

Introduction: Preterm and low-birth-weight newborns may present immaturity in the functions of sucking, swallowing and breathing, speech therapists inserted in the hospital focus on the development of newborns' oral sensorimotor system, promoting a safe transition from tube feeding to breastfeeding and contributing to improving the quality of life of the child population. The present study aimed to analyze the development of oral functions, oral feeding transition time and breastfeeding of preterm and low-birth-weight newborns under Speech-Language Pathology care. Methods: A prognostic study carried out at a maternity hospital, based on the data collected from 121 filed medical records of newborns attended between September 2015 to July 2017. The Kaplan-Meier method, the Log Rank test and the Pearson correlation test were used for data analysis, considering a significance level of 0.05 (95%). Results: It was observed that the lower the gestational age and the birth weight of newborns, the more speech therapy services were required until the establishment of exclusive OF; also, the transition time and the average time of using the orogastric tube were inversely proportional to the gestational age at birth. The non-nutritive sucking technique was the most used for stimulation, and 78.5% of the NBs were discharged from the hospital on exclusive breastfeeding. Conclusion: Moderate to late preterm and low-birth-weight newborns are able to more quickly acquire the oral sensorimotor system functional pattern, and there are indications that Speech-Language Pathology care reduces the transition time to oral feeding, thus increasing the success rate of exclusive breastfeeding

Introducción: Los recién nacidos (RN) prematuros y con bajo peso pueden presentar inmadurez en las funciones de succión, deglución y respiración. Los logopedas en los hospitales trabajan el desarrollo del sistema sensoriomotor oral de los RN, promoviendo una transición segura de la sonda a la lactancia materna, lo que contribuye a mejorar la calidad de vida de la población infantil. El objetivo del presente estudio era analizar el desarrollo de las funciones orales, el tiempo de transición a la alimentación por vía oral (VO) y la lactancia materna de los RN prematuros, y con bajo peso al nacer bajo el cuidado fonoaudiológico. Métodos: Este estudio de pronóstico se llevó a cabo en una maternidad, con base en la recopilación de datos en prontuarios archivados de 121 RN atendidos entre septiembre de 2015 y julio de 2017. En el análisis de los datos se aplicó el método de Kaplan-Meier, el test log-rank y la prueba de correlación de Pearson. Se consideró un nivel de significancia de 0,05 (95%). Resultados: Se observó que cuanto menores eran la edad gestacional y el peso de nacimiento del RN, más necesidad de servicios fonoaudiológicos había hasta el establecimiento de la VO exclusiva, y el tiempo de transición y el tiempo promedio de utilización de la sonda orogástrica eran inversamente proporcionales a la edad gestacional al nacimiento. La técnica de succión no nutritiva fue la más utilizada para la estimulación, y el 78,5% de los RN recibieron el alta hospitalaria con lactancia exclusiva. Conclusión: Los RN prematuros de moderados a tardíos y de bajo peso son capaces de adquirir el patrón funcional del sistema sensoriomotor oral con mayor rapidez, y hay indicios de que la atención fonoaudiológica reduce el tiempo de transición alimentaria a la VO, y aumenta la tasa de éxito de lactancia materna exclusiva

Quality of life related to complete denture.

Full edentulism is characterized by the complete loss of permanent teeth, resulting in aesthetic, structural and functional changes which can negatively impact quality of life, and which are minimized through rehabilitation with complete dentures. The aim of this study was to compare oral healthrelated quality of life in patients with complete original dentures three months after installation of new dentures and two years after fabrication of new complete removable dentures. In this longitudinal comparative study, 15 volunteers of both genders, aged 50 to 82 years, who sought treatment at the Department of Dentistry of the Federal University of Rio Grande do Norte, participated in the preparation of new dentures. The Brazilian version of the Oral Health Impact Profile for edentulous patients (OHIPEDENT) was used to evaluate quality of life. Data analysis was performed descriptively and with hypothesis testing using the Friedman and Wilcoxon tests with 5% significance level. In relation to the OHIPEDENT domains, there was a difference for chewing discomfort and inability to chew between baseline and two years. However, there was no difference between the evaluated periods in the areas of pain and orofacial muscle discomfort, psychological inability and social disability. Improvement indicators in patient quality of life were observed in the area of discomfort and inability to chew between baseline and 2 years.

O edentulismo completo caracterizase pela perda total dos dentes permanentes, resultando em alterações estéticas, estruturais e funcionais, podendo impactar negativamente na qualidade de vida, sendo minimizado através da reabilitação com a prótese dentária. O objetivo deste estudo foi comparar a qualidade de vida relacionada à saúde oral em pacientes com a prótese original completamaxilar e mandibular, três meses após instalação da nova prótese e dois anos depois da confecção da nova prótese total bimaxilar removível. Nesse estudo compara tivo longitudinal, participaram 15 voluntários, com faixa etária entre 50 e 82 anos, de ambos os sexos, que buscaram tratamento no Departamento de Odontologia da Universidade Federal do Rio Grande do Norte, para a confecção de novas próteses. Utilizouse a versão brasileira do Oral Health Impact Profile para pacientes edêntulos (OHIPEDENT) para avaliar a qualidade de vida. A análise dos dados foi realizada de forma descritiva e analítica com os testes de Friedman e Wilcoxon, com nível de significância de 5%.Em relação aos domínios do OHIPEDENT, verificouse diferença para desconforto e incapacidade mastigatória entre a avaliação inicial e após dois anos. Nos domínios Dor e desconforto orofacial, Incapacidade Psicológica e Incapa cidade Social, não ocorreram diferenças entre os períodos avaliados. Foram observados indicadores de melhora na qualidade de vida dos pacientes, no domínio desconforto e incapacidade mastigatória entre a avaliação e a 2 anos.

Quality of life related to complete denture

Full edentulism is characterized by the complete loss of permanent teeth, resulting in aesthetic, structural and functional changes which can negatively impact quality of life, and which are minimized through rehabilitation with complete dentures. The aim of this study was to compare oral healthrelated quality of life in patients with complete original dentures three months after installation of new dentures and two years after fabrication of new complete removable dentures. In this longitudinal comparative study, 15 volunteers of both genders, aged 50 to 82 years, who sought treatment at the Department of Dentistry of the Federal University of Rio Grande do Norte, participated in the preparation of new dentures. The Brazilian version of the Oral Health Impact Profile for edentulous patients (OHIPEDENT) was used to evaluate quality of life. Data analysis was performed descriptively and with hypothesis testing using the Friedman and Wilcoxon tests with 5% significance level. In relation to the OHIPEDENT domains, there was a difference for chewing discomfort and inability to chew between baseline and two years. However, there was no difference between the evaluated periods in the areas of pain and orofacial muscle discomfort, psychological inability and social disability. Improvement indicators in patient quality of life were observed in the area of discomfort and inability to chew between baseline and 2 years (AU)

O edentulismo completo caracterizase pela perda total dos dentes permanentes, resultando em alterações estéticas, estruturais e funcionais, podendo impactar negativamente na qualidade de vida, sendo minimizado através da reabilitação com a prótese dentária. O objetivo deste estudo foi comparar a qualidade de vida relacionada à saúde oral em pacientes com a prótese original completamaxilar e mandibular, três meses após instalação da nova prótese e dois anos depois da confecção da nova prótese total bimaxilar removível. Nesse estudo compara tivo longitudinal, participaram 15 voluntários, com faixa etária entre 50 e 82 anos, de ambos os sexos, que buscaram tratamento no Departamento de Odontologia da Universidade Federal do Rio Grande do Norte, para a confecção de novas próteses. Utilizouse a versão brasileira do Oral Health Impact Profile para pacientes edêntulos (OHIPEDENT) para avaliar a qualidade de vida. A análise dos dados foi realizada de forma descritiva e analítica com os testes de Friedman e Wilcoxon, com nível de significância de 5%.Em relação aos domínios do OHIPEDENT, verificouse diferença para desconforto e incapacidade mastigatória entre a avaliação inicial e após dois anos. Nos domínios Dor e desconforto orofacial, Incapacidade Psicológica e Incapa cidade Social, não ocorreram diferenças entre os períodos avaliados. Foram observados indicadores de melhora na qualidade de vida dos pacientes, no domínio desconforto e incapacidade mastigatória entre a avaliação e a 2 anos (AU)

Screening for Voice Disorders in Older Adults (Rastreamento de Alterações Vocais em Idosos--RAVI)--Part I: Validity Evidence Based on Test Content and Response Processes.

PURPOSE: To identify the validity evidence based on the content and response processes of the Rastreamento de Alterações Vocais em Idosos (RAVI; "Screening for Voice Disorders in Older Adults"), an epidemiologic screening for voice disorders in older adults. STUDY DESIGN: This is a prospective, nonrandomized, cross-sectional, validation study. METHODS: Criteria for defining the domains and elaborating the questions were established to confirm the validity evidence based on the content. A multidisciplinary committee of 19 experts evaluated the questions, and the relevance and representation of the domains were analyzed using the Content Validity Index for Items (CVI-I) and the Content Validity Index (CVI), respectively. For validity evidence based on the response processes, 40 individuals of both sexes, aged ≥60 years, were stratified by demographic and socioeconomic condition. They responded to the RAVI, made suggestions, and their verbal and nonverbal reactions were observed. RESULTS: The first version of the RAVI consisted of 20 questions related to sensations and perceptions associated with the voice. Although the CVI value of 0.80 was satisfactory, the CVI-I and the suggestions of the expert committee indicated that the scale needed to be reformulated. Consultation with older adults indicated a need for further adjustment. The preliminary version of the RAVI consisted of 16 questions. CONCLUSIONS: The two aspects of validity evidence described in the present study were essential for adapting the questions to better fit the construct of the questionnaire. Other aspects of validity evidence and reliability analysis will be described in part II of this study.

Amamentação na adolescência: histórias de vida de mães primíparas / Lactancia en la adolescencia: la historia de vida de madres primíparas / Breastfeeding during adolescence: life history of first-time mothers

Objective: To identify the factors that influence on primiparous adolescent mothers’ breastfeeding and to comprehend the meaning of it to this woman. Method: This is a descriptive, of qualitative nature research. The subjects were 14 primiparous adolescent mothers, invited to participate in the research during the puericulture consulting in a Basic Health Care Unit, in Rio de Janeiro. The data were collected using a recorder with application of Life History technique and analyzed with thematic-categorical content. The study was approved by the Ethics and Research Committee of HUPE/UERJ under the Nº1116/2005. Results: The youngsters revealed the existence of several factors those influence the meaning they attach to breastfeeding as the biological, psychological, social, economic and family aspects, contributing to the construction of a multiplicity of meanings. Conclusion: The adolescent mother, when conceive her first baby experiences the emotion and felling associated with maternity and breastfeeding act.

Objetivo: Identificar os fatores que influenciam no aleitamento materno da mãe primípara adolescente e compreender o significado do aleitamento para esta mulher. Método: Estudo descritivo de natureza qualitativa. Os sujeitos foram 14 mães adolescentes primíparas, convidadas a participar da investigação durante consulta de puericultura em uma Unidade Básica de Saúde do município do Rio de Janeiro. Os dados foram coletados através de um gravador com emprego da técnica de História de Vida e analisado através de conteúdo temático-categorial. A pesquisa foi apreciada e aprovada pelo Comitê de Ética e Pesquisa do HUPE/UERJ Nº1116/2005. Resultados: As jovens revelaram a existência de diversos fatores que influenciam no significado que atribuem à amamentação, como os aspectos biológicos, psicológicos, sociais, econômicos e familiares contribuindo à construção de uma multiplicidade de significados. Conclusão: A mãe adolescente, ao conceber seu primeiro filho, vivencia a emoção e o sentimento associado à maternidade e o ato de amamentar.

Objetivo: Identificar los factores que influyen en la lactancia materna de madres primíparas adolescentes y comprender el significado de la lactancia materna por esta mujer. Método: Estudio descriptivo de naturaleza cualitativa. Los sujetos fueron 14 madres primíparas adolescentes, invitadas a participar de la investigación durante la consulta de puericultura en una Unidad Básica de Salud del municipio de Río de Janeiro. Los datos fueron recolectados por una grabadora con el uso de la técnica de historia de vida y analizados mediante el contenido temático-categorial. La investigación fue aprobada por el Comité de Ética e Investigación HUPE/UERJ Nº1116/2005. Resultados: Las jóvenes revelaron la existencia de varios factores que influyen en el significado que atribuyen a la lactancia materna, como los aspectos biológicos, psicológicos, sociales, económicos y familiares, contribuyendo a la construcción de una multiplicidad de significados. Conclusión: La madre adolescente, a concebir su primer hijo, experimenta la emoción y la sensación asociada con la maternidad y el acto de la lactancia.

A ocorrência de pré-eclâmpsia em mulheres primigestas acompanhadas no pré-natal de um hospital universitário / La incidencia de pre-eclampsia en mujeres primigestas en control pre-natal de un hospital universitario / The occurrence of pre-eclampsia in women pregnant for the first time attending prenatal care consultation at a university hospital

Objetivo: Conhecer o perfil das gestantes primigestas atendidas no pré-natal; identificar a incidência de pré-eclâmpsia em gestantes primigestas atendidas em consultas do pré-natal. Método: Estudo descritivo, quantitativo, retrospectivo, realizado num Hospital Universitário no Rio de Janeiro. Os prontuários de primigestas atendidas de 2008 a 2009 foram analisados com apoio da estatística descritiva. Resultados: Ocorreram 264 (56,3%) admissões de primigestas. Fizeram parte do conjunto amostral 105 prontuários. Neste grupo, 43(40,9%) gestantes não apresentaram edema; 2 (1,9%) tiveram proteinúria; 29 (27,6 %) não tiveram anormalidades nas aferições dos níveis tensionais. Conclusão: Na amostra analisada não houve registro de pré-eclâmpsia, todavia 41 (38,9%) mulheres apresentaram alterações tensionais compatíveis com Doença Hipertensiva Específica da Gestação (DHEG). O enfermeiro tem um importante papel na equipe multiprofissional, para detecção precoce de intercorrências na gestação contribuindo para a redução da incidência da morbidade e da mortalidade materna

Objective: To investigate the characteristics of pregnant for the first time attended at prenatal; identify the incidence of preeclampsia in pregnant for the first time attended consultations in prenatal care. Method: A descriptive, quantitative, retrospective, held at a University Hospital in Rio de Janeiro. The charts of women pregnant for the first time attended from 2008 to 2009 were analyzed with descriptive statistics support. Results: There were 264 (56.3%) admissions of pregnants for the first time. Were part of the sample set 105 records. In this group, 43 (40.9%) women showed in the edema, 2 (1.9%) had proteinuria, 29 (27.6%) had no abnormalities of blood pressure measurements. Conclusion: In the analyzed sample there was no record of preeclampsia, however 41 (38.9%) women showed changes compatible with BP Disease Specific Hypertension in Pregnancy (HDP). Nurses have an important role in the multidisciplinary team, for early detection of complications during pregnancy contributes to reducing the incidence of maternal mortality and morbidity

Objetivo: Investigar las características de primigesta embarazada asistieron prenatales, identificar la incidencia de preeclampsia en mujeres embarazadas primigestas asistió a consultas de atención prenatal. Método: Estudio descriptivo, cuantitativo, retrospectivo, realizado en un hospital universitario de Rio de Janeiro. Los gráficos de primigestas asistió desde 2008 hasta 2009 fueron analizadas con el apoyo estadística descriptiva. Resultados: Hubo 264 (56,3%) ingresos primigestas. Se parte de la muestra establecida 105 registros. En este grupo, 43 (40,9%) las mujeres no mostró edema, 2 (1,9%) presentaron proteinuria, 29 (27,6%) no presentaron alteraciones de las mediciones de la presión arterial. Conclusión: En la muestra analizada no había constancia de la preeclampsia, sin embargo, 41 (38,9%) mujeres mostró cambios compatibles con la enfermedad de la hipertensión en el embarazo BP específico (HDP). Las enfermeras tienen un papel importante en el equipo multidisciplinario, para la detección precoz de las complicaciones durante el embarazo contribuye a reducir la incidencia de la mortalidad y la morbilidad maternas

Fisioterapia em pacientes críticos adultos: recomendações do Departamento de Fisioterapia da Associação de Medicina Intensiva Brasileira / Physical therapy in critically ill adult patients: recommendations from the Brazilian Association of Intensive Care Medicine Department of Physical Therapy

A incidência de complicações decorrentes dos efeitos deletérios da imobilidade na unidade de terapia intensiva contribui para o declínio funcional, aumento dos custos assistenciais, redução da qualidade de vida e mortalidade pós-alta. A fisioterapia é uma ciência capaz de promover a recuperação e preservação da funcionalidade, podendo minimizar estas complicações. Para nortear as condutas fisioterapêuticas nas unidades de terapia intensiva, um grupo de especialistas reunidos pela Associação de Medicina Intensiva Brasileira (AMIB), desenvolveu recomendações mínimas aplicáveis à realidade brasileira. Prevenção e tratamento de atelectasias, condições respiratórias relacionadas à remoção de secreção e condições relacionadas a falta de condicionamento físico e declínio funcional foram as três áreas discutidas. Além destas recomendações específicas, outro aspecto importante foi a consideração de que a prescrição e execução de atividades, mobilizações e exercícios físicos são do domínio específico do fisioterapeuta e o seu diagnóstico deve preceder qualquer intervenção.

Complications from immobility in intensive care unit patients contribute to functional decline, increased healthcare costs, reduced quality of life and higher post-discharge mortality. Physical therapy focuses on promoting recovery and preserving function, and it may minimize the impact of these complications. A group of Brazilian Association of Intensive Care Medicine physical therapy experts developed this document that contains minimal physical therapy recommendations appropriate to the Brazilian real-world clinical situation. Prevention and treatment of atelectasis, procedures related to the removal of secretions and treatment of conditions related to physical deconditioning and functional decline are discussed. Equally important is the consideration that prescribing and executing activities, mobilizations and exercises are roles of the physical therapist, whose diagnosis should precede any intervention.

Physical therapy in critically ill adult patients: recommendations from the Brazilian Association of Intensive Care Medicine Department of Physical Therapy. / Fisioterapia em pacientes críticos adultos: recomendações do Departamento de Fisioterapia da Associação de Medicina Intensiva Brasileira.

Complications from immobility in intensive care unit patients contribute to functional decline, increased healthcare costs, reduced quality of life and higher post-discharge mortality. Physical therapy focuses on promoting recovery and preserving function, and it may minimize the impact of these complications. A group of Brazilian Association of Intensive Care Medicine physical therapy experts developed this document that contains minimal physical therapy recommendations appropriate to the Brazilian real-world clinical situation. Prevention and treatment of atelectasis, procedures related to the removal of secretions and treatment of conditions related to physical deconditioning and functional decline are discussed. Equally important is the consideration that prescribing and executing activities, mobilizations and exercises are roles of the physical therapist, whose diagnosis should precede any intervention.