Cintia Conceição Costa

Relato de caso: a importância da atuação multiprofissional na laringectomia supracricóide

This study is about theperfomance multiprofissional on laryngectomy supracricoid. The speech therapy in the hospital was carried out twice a day, after 14 sessions, pasty consistency was released. The patient returned to the disfagia outpatient of the hospital, once a week for two months and now returns once a month. Nutritional therapy nasoenteric probe (NEP) allowed the necessary caloric intake and hydration and, through the release of consistency by oral Audiologist, the nutritionist expanded the options of foods that the patient could eat, favoring the profit of weight and withdrawal of the alternative way of feeding.The multiprofessional intervention enabled the degree of oropharyngeal dysphagia mechanical evolve from severe to mild oropharyngeal dysphagia for liquids only, being the evolution of therapy being verified through the patients oral intake, which evolved from a FOIS 1 for FOIS 3 and is currently third in the FOIS 6. The realization of enteral nutrition therapy enabled the patient to regain his usual weight, on three months period, considering that with surgery, it lost 11 kg. It was noted that through the accompaniment multiprofessional, was possible evolve from an exclusive enteral nutrition to oral diet, which favored the evolution of nutritional status, with the recovery of body weight, addition to providing improved quality of life of this person.

Utilização de protocolos de qualidade de vida em disfagia: revisão de literatura

O objetivo deste estudo foi identificar os protocolos existentes sobre qualidade de vida (QV) em disfagia e verificar a utilizacao dos mesmos no tratamento fonoaudiologico. Realizou-se pesquisa teorica e exploratoria com a tecnica de revisao da literatura nas bases de dados SCOPUS, Trip Database, LILACS, PubMed, SciELO, Google Schoolar, periodicos Capes e MedLine. O periodo de busca compreendeu os anos entre 2004 e 2014 e foram utilizados os seguintes descritores: degluticao; transtornos da degluticao; qualidade de vida; questionarios e os seus respectivos termos em ingles deglutition; deglutition disorders; quality of Life; questionnaires. Foram encontrados na literatura o protocolo Quality of life in Swallowing Disorders-SWAL-QOL, o qual estabelece o comprometimento da degluticao independente da etiologia; o MD Anderson Dysphagia Inventory, que e especifico para sujeitos submetidos a tratamento de câncer de cabeca e pescoco e o Dysphagia Handicap Index,que avalia os efeitos da disfagia sobre a qualidade de vida (QV) em sujeitos com diferentes patologias de base e pode ser utilizado em niveis mais baixos de escolaridade. A literatura propoe diferentes protocolos que avaliam a QV em disfagia, sendo que os mais utilizados avaliam a QV de forma geral, relacionada ao câncer de cabeca e pescoco e de sujeitos com diferentes diagnosticos medicos. A utilizacao desses protocolos pode auxiliar e complementar a avaliacao clinica e objetiva da degluticao, uma vez que, retratam a autoavaliacao referida pelo sujeito, sendo este ponto de vista de extrema importância para o tratamento fonoaudiologico.

Contribuição da ausculta cervical para a avaliação clínica das disfagia orofaríngeas

In order to assist on the functional assessment of swallowing, most speech therapists make use of instrumental resources such as cervical auscultation. Thus, the objective of this study was to search the literature in order to find the contribution of cervical auscultation for assessing dysphagias. To this end, international and national journals were reviewed. These journals were indexed in Springer, Lilacs, Bireme, Medline and Scielo databases, comprising the period between 1992 and 2011. From the analysis of the studies, it was possible to verify that: cervical auscultation has been modernized with the technologic evolution, enabling the realization of quantitative studies of the swallowing sounds; there are still few clear evidence of the connections between the sound components of swallowing and the physiological events of the pharyngeal phase; no differences were observed between the swallowing sounds in children and adults; in some studies, cervical auscultation was positively correlated with the videofluoroscopic assessment of swallowing, and others presented positive correlation between these two assessment procedures. Hence, considering that the swallowing videofluoroscopy examination is still difficult to access, with relatively high cost, it is believed that cervical auscultation constitutes an important resource for the diagnosis and clinical monitoring in cases of oropharyngeal dysphagia.

Qualidade de vida em voz na doença pulmonar crônica

Purpose: analyzing the quality of life related to self-reported voice by individuals with Chronic Pulmonary Disease. Methods: cross, exploratory and quantitative study with information obtained from the application of Quality of Life and Voice questionnaire with users an integrated physiotherapy clinic in a university hospital in the interior of Rio Grande do Sul, in the period from March to November 2012. Results: 19 subjects participated in the study, 12 (63.20%) were males and 7 (36.80%) were females. On the age group, 14 (73.70%) were adults and five (26.30%) elderly, a statistically significant difference. As for the Chronic Pulmonary Disease, ten (52.60%) had bronchiectasis, six (31.60%) had Chronic Obstructive Pulmonary Disease and three (15.80%) asthma. The average of Quality of Life and Voice questionnaire was 85.8 ± 5.8 points. There was no statistical difference between the three areas of Quality of Life and Voice questionnaire and the genre, age and medical diagnosis. Conclusion: percentage predominance of males and adult-aged age group, the latter being statistically significant and medical diagnosis of bronchiectasis. The average of the total questionnaire was 85.8 ± 5.8 points. There was no statistical significance in the comparison in questionnaire areas with the genre, age and lung disease. This can be explained by the development of communication strategies in order to minimize the effects of the Chronic Pulmonary Disease on voice. We suggest the completion of other studies addressing the same theme, but with larger samples to check the statistical significance of the studied variables.

Investigação das práticas maternas sobre aleitamento materno e sua relação com a infecção de vias aéreas superiores e otite média

Mailing address: Cristina Ide Fujinaga Rua João Batista Anciutti, 246 Irati-PR CEP: 84500-000 E-mail: cifujinaga@gmail.com ABSTRACT Purpose: to investigate the practices of mothers during breastfeeding and infant’s position and their relationship with the infection of the upper airway and otitis media. Methods: this is a descriptive exploratory study. Semi-structured interviews were conducted with 60 mothers, with questions about breastfeeding, the position of the infant during breastfeeding and the occurrence of infection of the upper airways (IUA) and otitis. In the infants, otoscopy and otoacoustic emissions were performed in both ears. Results: out of the 60 infants, 49 were exclusively breastfed and 11 were not. Regarding the position, 20 mothers reported breastfeeding their infants in the seated position and 40 in the lying position. The occurrence of IUA reported by the mothers was in 10 infants and from these, 6 were breastfed lying down and 4 infants sitting. As for the occurrence of otitis media, according to the mothers, 6 infants had at least one episode of otitis. Out of these infants, 2 were breastfed sitting and 4, lying down. The results indicate no significance between the position during breastfeeding and the occurrence of upper airway infection and otitis media. Conclusion: the practices of mothers during breast-feeding and infant’s position are not related to infection of the upper airways and otitis media.

Correlation between the reason for referral, clinical, and objective assessment of the risk for dysphagia

PURPOSE To correlate the reason for referral to speech therapy service at a university hospital with the results of clinical and objective assessment of risk for dysphagia. METHODS This is a cross-sectional, observational, retrospective analytical and quantitative study. The data were gathered from the database, and the information used was the reason for referral to speech therapy service, results of clinical assessment of the risk for dysphagia, and also from swallowing videofluoroscopy. RESULTS There was a mean difference between the variables of the reason for the referral, results of the clinical and objective swallowing assessments, and scale of penetration/aspiration, although the values were not statistically significant. Statistically significant correlation was observed between clinical and objective assessments and the penetration scale, with the largest occurring between the results of objective assessment and penetration scale. CONCLUSION There was a correlation between clinical and objective assessments of swallowing and mean difference between the variables of the reason for the referral with their respective assessment. This shows the importance of the association between the data of patients history and results of clinical evaluation and complementary tests, such as videofluoroscopy, for correct identification of the swallowing disorders, being important to combine the use of severity scales of penetration/aspiration for diagnosis.