Browsing by Author "Alexandrino, Ana Silva"
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- Acta Pediátrica PortuguesaPublication . Alexandrino, Ana Silva; Santos, Ana Rita; Melo, Cristina; Costa, Daniel; Tomé, David; Mesquita Montes, AntónioAs infeções respiratórias agudas são a principal causa de mortalidade e morbilidade em crianças até aos 3 anos, em parte devido às características anatómicas e fisiológicas próprias desta faixa etária mas também muito por conta dos factores de risco a que são expostas A promoção de saúde assume assim vital importância no que concerne a capacitação e empowerment dos cuidadores face a este contexto O objectivo deste estudo foi analisar a influência de uma sessão de educação acerca da prevenção de infeções respiratórias, ministrada a cuidadores de crianças até aos 3 anos, na condição de saúde da criança (nº de infeções respiratórias das vias aéreas superiores (IVAS) e inferiores (IVAI), uso de antibióticos, recurso a serviços de saúde, absentismo das crianças ao infantário e absentismo laboral) metodologia: Estudo quasi-experimental com uma amostra de 57 cuidadores de crianças até aos 3 anos, aprovado pela Comissão de ética da Reitoria da Universidade do Porto Os cuidadores do grupo experimental (GE=35) assistiram a uma sessão de educação acerca da prevenção das infeções respiratórias, desenhada de acordo com as necessidades sentidas dos mesmos Os cuidadores do Grupo de Controlo (GC=22) não assistiram a esta sessão Foi realizado um follow- -up durante 2 meses de Inverno, ao longo do qual os cuidadores de ambos os grupos responderam a um Diário de Registos Online, com uma periodicidade de 15 dias, acerca da condição de saúde das crianças. Resultados: 15 dias após a sessão de educação o GE teve menos IVAS (GE=31% vs GC=64%; p=0,038), menos recurso a serviços de saúde (GE=20% vs GC= 50%; p=0,036) e menos dias totais de absentismo das crianças ao infantário (GE=4 dias vs GC=20 dias; p=0,032), comparativamente com o GC. Após os 2 meses de follow-up ainda se continuaram a verificar diferenças significativas entre os grupos para o recurso a serviços de saúde (GE=25% vs GC= 33%; p=0,039) e verificou-se ausência de IVAI no GE comparativamente ao GC que teve uma incidência de 5% (p=0,035). A sessão de educação acerca da prevenção de infeções respiratórias teve uma influência positiva na diminuição do nº de IVAS e IVAI, no recurso a serviços de saúde e no absentismo das crianças ao infantário.
- Ambulatory chest physiotherapy in mild-to-moderate acute bronchiolitis in children under two years of age — A randomized control trialPublication . Pinto, Frederico Ramos; Alexandrino, Ana Silva; Azevedo, InêsThe aim of this study was to compare the role of a chest physiotherapy (CP) intervention to no intervention on the respiratory status of children under two years of age, with mild-to-moderate bronchiolitis. Out of 80 eligible children observed in the Emergency Room, 45 children completed the study with 28 randomized to the intervention group and 17 to the control group. The intervention protocol, applied in an ambulatory setting, consisted of combined techniques of passive prolonged slow expiration, rhinopharyngeal clearance and provoked cough. The control group was assessed with no chest physiotherapy intervention. The efficacy of chest physiotherapy was assessed using the Kristjansson Respiratory Score at the admission and discharge of the visit to the Emergency Room and during clinical visits at day 7 and day 15. There was a significant improvement in the Kristjansson Respiratory Score in the intervention group compared to the control group at day 15 [1.2 (1.5) versus 0.3 (0.5); p-value=0.005, in the control and intervention groups, respectively], with a mean difference (95% CI) of −0.9 (−1.6 to −0.3). Chest physiotherapy had a positive impact on the respiratory status of children with mild-to-moderate bronchiolitis.
- Avaliação de um programa de saúde sobre asma em meio escolarPublication . Rodrigues, Inês Rocha; Alexandrino, Ana Silva; Santos, Paula ClaraAvaliar o efeito de um programa sobre asma em estudantes Estudo quase-experimental numa amostra de 44 estudantes (12,48±0,698 anos). O grupo experimental (n= 23) foi sujeito a uma sessão de educação sobre asma e grupo controlo (n= 21) não. Ambos foram avaliados através de um questionário na baseline do estudo e reavaliados uma semana após relativamente a conhecimentos e procedimentos. Obtiveram-se diferenças estatisticamente significativas entre grupos relativamente aos conhecimentos (p<0.001) e comportamentos (p<0.001) sendo estes mais elevados no grupo experimental. O programa teve efeitos positivos na mudança de comportamentos e conhecimentos
- Caregivers’ education vs rhinopharyngeal clearance in children with upper respiratory infections: impact on children’s health outcomesPublication . Alexandrino, Ana Silva; Santos, Rita; Melo, Cristina; Mesquita Bastos, José; Postiaux, GuyUpper Respiratory Tract Infections (URTI) are very common in children having no effective pharmacological treatment. This study aimed to compare the effect of caregivers’ health education regarding children’s respiratory infections and the effect of a rhinopharyngeal clearance protocol in children with URTI. A factorial trial was conducted in 138 children up to 3 years, attending day-care centres. Children were distributed into four groups: control group (CG) (n = 38); education group (EG) (n = 34); intervention group (IG) (n = 35); and education and intervention group (E + IG) (n = 31). A Diary of Records was kept by caregivers during 1 month. There were significant differences between groups concerning: Lower Respiratory Tract Infections (CG = 29.4%; EG = 10.7%; IG = 3.8%; E + IG = 0.0%; p = 0.014); acute otitis media (CG = 32.4%; EG = 7.1%; IG = 11.5%; E + IG = 7.7%; p = 0.014); medical consultations (CG = 70.6%; EG = 42.9%; IG = 38.5%; E + IG = 30.8%; p = 0.021); antibiotics (CG = 44.1%; EG = 7.1%; IG = 23.1%; E + IG = 15.4%; p = 0.006); days missed from day-care (CG = 55 days; EG = 22 days; IG = 14 days; E + IG = 6 days; p = 0.020); days missed from employment (CG = 31 days; EG = 20 days; IG = 5 days; E + IG = 1 day; p = 0.021); and nasal clearance techniques (CG = 41.4%; EG = 78.6%; IG = 57.7%; E + IG = 84.6%; p = 0.011).
- Characterization of middle-ear condition of Oporto daycare children up-to 3 years-old: A cross sectional studyPublication . Tomé, David; Alexandrino, Ana Silva; Santos, Rita; Melo, Cristina; Costa, Daniel; Ferreira, JoãoObjective The aim of this study was to determine tympanometric values of children who attend Oporto daycare centers and further analyze any relations with host and environmental factors. Methods Cross sectional study in a randomly selected sample of 117 daycare children up-to 3-years old from Oporto. Tympanometric measures were collected. Results Children presented in left ear (LE) a mean peak pressure (PP) of −156.53 daPa and a mean compliance of 0.16 cm3. Right ear (RE) revealed a PP of −145.61 daPa and a compliance of 0.19 cm3. Normal tympanograms (type A) had a lower frequency than abnormal tympanograms (type B and type C). There was a positive association between age and compliance (LE: p = 0.016; RE: p = 0.013) and between the presence of rhinorrhea and PP (LE: p = 0.002; RE: p < 0.05). Abnormal tympanograms were more frequent in Spring (RE: p = 0.009), in younger children (LE: p = 0.03) and in children that had rhinorrhea (LE: p = 0.002; RE: p = 0.044). Healthy children had a mean PP of −125.19 daPa and a mean compliance of 0.21 cm3 in LE and a mean PP of −144.27 daPa and a mean compliance of 0.22 cm3 in RE. Conclusion Tympanometric measures presented in this paper may be applicable to Oporto daycare children up-to 3 years-old. Most of daycare children revealed abnormal tympanograms. Age, rhinorrhea and season influenced children's middle-ear condition.
- Characterization of the Portuguese pediatric population with Cystic Fibrosis and their parents: cross-sectional studyPublication . Guimarães, Catarina; Alexandrino, Ana Silva; Sarmento, João Antunes; Azevedo, InêsCystic fibrosis is a chronic disease with multiple associated challenges, not only for the children/adolescents but also for their parents/caregivers. To the best of the authors knowledge, to this date there are no published studies characterizing the portuguese pediatric population with cystic fibrosis. To characterize children/adolescents with Cystic Fibrosis in terms of: physiotherapy, hospitalizations in 2018, as well as medication taken in the previous two weeks. We also aimed to characterize the parents/caregivers in terms of sociodemographic data, caregivers’ role (sleep habits, service and work activities) and equipment sterilization habits for medication administration. Cross-sectional study with a total sample of 28 parents/caregivers and 28 children/adolescents (n=28) - 14 were female with an average age of 12,14 ± 3,99 years old. The online question forms – Sample Selection and Characterization Questionnaire and CarerQol - were sent to the parents/caregivers, through the Portuguese Association of Cystic Fibrosis database. Results: 69.23% (n=18) children/adolescents had physiotherapy once or twice a week. Most parents/caregivers sterilized the equipment used for medication admission (53.57%) but 33.33% considered that soap and water washing was an effective sterilization. We found that children/adolescents with Cystic Fibrosis do not undergo physiotherapy at the recommended frequency. Also, most parents/caregivers have appropriate sterilization habits, although some of them do not have the correct information on how to perform effective sterilization.
- Designing and evaluating a health education session on respiratory infections addressed to caregivers of children under three years of age attending day-care centres in Porto, Portugal: A community-based interventionPublication . Alexandrino, Ana Silva; Santos, Rita; Melo, Cristina; Bastos, José Adelino MesquitaAcute respiratory infections (ARI) are common in children, increasing the pressure on clinicians to prescribe antibiotics and affecting public health This study aimed to design a health education session (HES) for caregivers of children, and to evaluate its effects on caregivers’ needs, as well as on their knowledge and attitudes concerning ARI. A generalized model of developing, implementing and evaluating a community-based intervention was followed, including caregivers of children under three years of age. Caregivers were randomly distributed into an intervention group (IG) (n = 41) and a control group (CG) (n = 51) and the HES was administered to the IG. The caregivers’ needs as well as knowledge of and attitudes to ARI were evaluated in both groups, before (M0) and two months after the HES (M1). At M0 the caregivers from both groups had ‘some or great need’ about all HES domains; at M1 the caregivers in the IG expressed ‘no or low need’, whereas the CG maintained ‘some or great need’ about all HES domains (0.011 ≤ P ≤ .047). Concerning caregivers’ knowledge of and attitudes to ARI, at M1 there was a higher frequency of caregivers with right answers in the IG than in the CG (IG =7.5 ± 1 versus CG =6.0 ± 2; P = .000). Those differences occurred in domain (e) nasal clearance techniques, revealing a higher percentage of caregivers who used correctly nasal irrigation (P = .000), nasal aspirators (0.000 ≤P ≤ .001) and nebulization (P = .000) in IG. The HES met the caregivers’ needs regarding ARI and increased their knowledge and attitudes towards ARI, especially regarding nasal clearance techniques.
- Efficacy of low-level laser therapy on scar tissuePublication . Freitas, Carla; Melo, Cristina; Alexandrino, Ana Silva; Noites, AndreiaPhysiotherapy has a very important role in the maintenance of the integumentary system integrity. There is very few evidence in humans. Nevertheless, there are some studies about tissue regeneration using low-level laser therapy (LLLT). Aim: To analyze the effectiveness of LLLT on scar tissue. Methods: Seventeen volunteers were stratified by age of their scars, and then randomly assigned to an experimental group (EG) — n = 9 – and a placebo group (PG) – n = 8. Fifteen sessions were conducted to both the groups thrice a week. However, in the PG, the laser device was switched off. Scars’ thickness, length, width, macroscopic aspect, pain threshold, pain perception, and itching were measured. Results: After 5 weeks, there were no statistically significant differences in any variable between both the groups. However, analyzing independently each group, EG showed a significant improvement in macroscopic aspect (p = 0.003) using LLLT. Taking into account the scars’ age, LLLT showed a tendency to decrease older scars’ thickness in EG. The intervention with LLLT appears to have a positive effect on the macroscopic scars’ appearance, and on old scars’ thickness, in the studied sample. However, it cannot be said for sure that LLLT has influence on scar tissue.
- Exercise-related quality of life in subjects with asthma: A systematic reviewPublication . Pacheco, Diana R. R.; Silva, Manuel J. B.; Alexandrino, Ana Silva; Torres, Rui M. T.The purpose of this review was to analyze, based on a review of the current literature, the effects of physical activity on the quality of life (QoL) of subjects with asthma. The authors conducted a search of randomized controlled trials (RCTs) between January 2000 and August 2010 in a group of major databases of health sciences (Academic Search Complete, Directory of Open Access Journals, Elsevier—Science Direct, Highwire Press, PubMed, Scielo Global, Scirus, Scopus, SpringerLink, Taylor & Francis, and Wiley Interscience) with the keywords asthma, QoL, physical activity, exercise, training, and program in all possible combinations. Citations and references of each study selected were also examined. Of the 1075 studies identified, only 11 were included. Five of these studies were performed in children between the ages of 7 and 15 and the remaining studies were performed on adults. Intervention programs were divided into aerobic training programs and breathing exercises programs. All aerobic training programs showed improvements in QoL, demonstrating a positive influence of aerobic training on asthma. There is a noticeable trend in the benefit of aerobic training programs in the QoL for individuals with asthma. The breathing exercises programs were few and heterogeneous, making it difficult to reach a positive conclusion on whether it could be recommended for the improvement of QoL in this pathology. There is a great need for more RCTs with methodological rigor.
- Immediate effects of a rhino-pharyngeal clearance protocol in nasal obstruction and middle ear condition of children under 3 years of age with upper respiratory infections: A randomized controlled trialPublication . Alexandrino, Ana Silva; Santos, Rita; Melo, Cristina; Tomé, David; Bastos, José Mesquita; Postiaux, GuyIntroduction and objectives Children up to 2 years old are at high risk of respiratory infections and nasal irrigation is often prescribed. Yet, to date there is no sufficient knowledge about its immediate effects on the nasopharynx and middle ear. Therefore, this study aimed to analyze the effect of a rhino-pharyngeal clearance intervention protocol on nasal obstruction and middle ear condition in children under 3 years of age with URTI. Materials and methods Randomized controlled trial in a day-care centre of Porto, including 44 children randomized to Intervention Group (IG) and Control Group (CG). Nasal auscultation and tympanometry were performed at baseline (M0) as well as after the intervention (M1), which consisted of nasal irrigation (NaCl .9%) followed by a forced nasal inspiration in the IG, and after 30 min of normal activities, in the CG. Results In M1 there was a lower frequency of children classified as having an obstructed nasal sound in the IG when compared to the CG (IG = 33.3%; CG = 68.4%; p = 0.042). We also observed an improvement of mean peak pressure (PP) in the IG (Left ear: M0 = −124daPa; M1 = −92daPa; p = 0.022. Right ear: M0 = −102daPa; M1 = −77daPa; p = 0.021), which was not observed in the CG (Left ear: M0 = −105daPa; M1 = −115daPa; p = 0.485. Right ear: M0 = −105daPa; M1 = −131daPa; p = 0.105). There were no significant results concerning the compliance of the tympanic membrane. Conclusions The rhino-pharyngeal clearance improved the nasal obstruction and PP of the middle ear of children under 3 years of age with URTI.