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1.
J Dent Res ; 102(2): 135-145, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36214096

RESUMO

The aim of this systematic review and network meta-analysis (NMA) of randomized controlled trials was to evaluate the effectiveness of treatments for pain relief of burning mouth syndrome (BMS). Five databases and gray literature were searched. Independent reviewers selected studies, extracted data, and assessed the risk of bias. The primary outcome was pain relief or burning sensation, and the secondary outcomes were side effects, quality of life, salivary flow, and TNF-α and interleukin 6 levels. Four comparable interventions were grouped into different network geometries to ensure the transitivity assumption for pain: photobiomodulation therapy, alpha-lipoic acid, phytotherapics, and anxiolytics/antidepressants. Mean difference (MD) and 95% CI were calculated for continuous outcomes. The minimal important difference to consider a therapy beneficial against placebo was an MD of at least -1 for relief of pain. To interpret the results, the GRADE approach for NMA was used with a minimally contextualized framework and the magnitude of the effect. Forty-four trials were included (24 in the NMA). The anxiolytic (clonazepam) probably reduces the pain of BMS when compared with placebo (MD, -1.88; 95% CI, -2.61 to -1.16; moderate certainty). Photobiomodulation therapy (MD, -1.90; 95% CI, -3.58 to -0.21) and pregabalin (MD, -2.40; 95% CI, -3.49 to -1.32) achieved the minimal important difference of a beneficial effect with low or very low certainty. Among all tested treatments, only clonazepam is likely to reduce the pain of BMS when compared with placebo. The majority of the other treatments had low and very low certainty, mainly due to imprecision, indirectness, and intransitivity. More randomized controlled trials comparing treatments against placebo are encouraged to confirm the evidence and test possible alternative treatments (PROSPERO CRD42021255039).


Assuntos
Síndrome da Ardência Bucal , Clonazepam , Humanos , Metanálise em Rede , Síndrome da Ardência Bucal/tratamento farmacológico , Qualidade de Vida , Dor
2.
Prehosp Disaster Med ; 33(2): 176-181, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29455682

RESUMO

In October 2010, the Haitian Ministry of Public Health and Population (MSPP; Port au Prince, Haiti) reported a cholera epidemic caused by contamination of the Artibonite River by a United Nation Stabilization Mission camp. Interventional studies of the subsequent responses, including a descriptive Methods section and systematic approach, may be useful in facilitating comparisons and applying lessons learned to future outbreaks. The purpose of this study was to examine publicly available documents relating to the 2010 cholera outbreak to answer: (1) What information is publicly available on interventional studies conducted during the epidemic, and what was/were the impact(s)? and (2) Can the interventions be compared, and what lessons can be learned from their comparison? A PubMed (National Center for Biotechnology Information, National Institutes of Health; Bethesda, Maryland USA) search was conducted using the parameters "Haiti" and "cholera." Studies were categorized as "interventional research," "epidemiological research," or "other." A distinction was made between studies and narrative reports. The PubMed search yielded 171 papers, 59 (34.0%) of which were epidemiological and 12 (7.0%) were interventional studies. The remaining 100 papers (59.0%) comprised largely of narrative, anecdotal descriptions. An expanded examination of publications by the World Health Organization (WHO; Geneva, Switzerland), the Center for Research in the Epidemiology of Disasters (CRED; Brussels, Belgium), United States Agency for International Development (USAID; Washington, DC USA)-Development Experience Clearinghouse (DEC), and US National Library of Medicine's (NLM; Bethesda, Maryland USA) Disaster Literature databases yielded no additional interventional studies. The unstructured formats and differing levels of detail prohibited comparisons between interventions, even between those with a similar approach. Only two (17.0%) interventional studies included any impact data, although neither commented whether the intervention improved health or reduced incidence or mortality related to cholera. Agreed frameworks for guiding responses and subsequent reporting are needed to ensure reports contain sufficient detail to draw conclusions for the definition of best practices and for the design of future interventions. Miller J , Birnbaum ML . Characterization of interventional studies of the cholera epidemic in Haiti. Prehosp Disaster Med. 2018;33(2):176-181.


Assuntos
Cólera/epidemiologia , Surtos de Doenças , Terremotos , Cólera/etiologia , Cólera/prevenção & controle , Vacinas contra Cólera/provisão & distribuição , Haiti/epidemiologia , Humanos , Socorro em Desastres , Saneamento
3.
Clinics ; 72(1): 51-57, Jan. 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-840036

RESUMO

OBJECTIVES: Most educational interventions in pharmacovigilance are designed to encourage physicians to report adverse drug reactions. However, multidisciplinary teams may play an important role in reporting drug-related problems. This study assessed the impact of a multifaceted educational intervention in pharmacovigilance on the knowledge, skills and attitudes of hospital professionals. METHOD: This prospective, open-label, non-randomized study was performed in a medium-complexity hospital in São Paulo, Brazil. The intervention involved four activities: 1) an interactive lecture, 2) a practical class, 3) a pre-post questionnaire administered to professionals on a multidisciplinary team, and 4) educational material. The intervention’s impact on the professionals’ knowledge and skills was assessed using the World Health Organization’s definitions. The intervention’s effect on the professionals’ attitudes was analysed by the prevalence of adverse drug event reports (adverse drug reactions, medication errors, therapeutic failure and drug quality deviations) and the relevance (seriousness and expectancy) of the events. RESULTS: One hundred seventy-three professionals were enrolled. A 70-fold increase in the number of adverse drug event reports was observed during the 12 months post-intervention. The intervention improved the professionals’ form-completion skills (p<0.0001) and their knowledge of pharmacovigilance (p<0.0001). The intervention also contributed to detecting serious drug-induced events. The nursing staff reported medication errors, and pharmacists and physiotherapists recognized serious adverse drug reactions. Physicians communicated suspicions of therapeutic failure. CONCLUSIONS: A multidisciplinary approach to drug-safety assessments contributes to identifying new, relevant drug-related problems and improving the rate of adverse drug event reporting. This strategy may therefore be applied to improve risk communication in hospitals.


Assuntos
Humanos , Equipe de Assistência ao Paciente/estatística & dados numéricos , Prática Profissional/estatística & dados numéricos , Atitude do Pessoal de Saúde , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/prevenção & controle , Educação Continuada , Farmacovigilância , Avaliação de Programas e Projetos de Saúde , Inquéritos e Questionários
4.
Rev. bras. cineantropom. desempenho hum ; 16(supl.1): 79-90, 07/2014. tab, graf
Artigo em Inglês | LILACS | ID: lil-713650

RESUMO

The aim of the present study was to establish whether changes in health-related behaviors are associated with changes in the satisfaction/dissatisfaction with body weight in youths. It was a prospective study that performed a secondary analysis of data from Project "Saúde na Boa", which included youths attending night classes in secondary public schools in Recife in the state of Pernambuco and Florianópolis in the state of Santa Catarina. Data on the youths' body type (thinness or excess weight) and degree of satisfaction/dissatisfaction with body weight and lifestyle (level of physical activity, participation in physical education classes, sedentary behavior and snacks, soda and alcohol intake) were collected at 10 schools from each town (five in the intervention group and five in the control group). The percentages of youths dissatisfied with their body weight were 50.5% and 48.6% at baseline and after intervention, respectively. The percentage of youths with body dissatisfaction due to thinness decreased (21.4% vs. 16.5%), while the percentage of youths with body dissatisfaction due to excess weight increased (29.1% vs. 32.1%). Approximately 41.2% of the youths with body dissatisfaction due to thinness and 18.3% of those dissatisfied due to excess weight became satisfied with their body weight after intervention. The intervention targeting health-related behaviors induced changes in the youths' degree of satisfaction with their body weight.


O objetivo do estudo foi identificar se as modificações nas condutas de saúde estão associadas às modificações na satisfação/insatisfação com a massa corporal em adolescentes. Estudo prospectivo, com análise secundária de dados do Projeto "Saúde na Boa", conduzido com estudantes do ensino médio matriculados em escolas públicas no período noturno de Recife/PE e Florianópolis/SC. Nas dez escolas (cinco controles e cinco intervenção) de cada cidade foram coletados dados sobre satisfação com a massa corporal e o tipo de satisfação (magreza ou excesso de peso), e informações referentes ao estilo de vida dos estudantes (atividade física, aulas de Educação Física, comportamento sedentário, consumo de salgados, refrigerantes e álcool). A prevalência de adolescentes insatisfeitos com a massa corporal na linha de base e após a intervenção foi de 50,5% e 48,6%. Verificou-se diminuição da insatisfação pela magreza (21,4% vs 16,5%) e aumento da insatisfação pelo excesso de peso (29,1% vs 32,1%). Parcela de adolescentes insatisfeitos por magreza (41,2%) e por excesso de peso (18,3%) passaram a ser satisfeitos com a massa corporal ao final da intervenção. A intervenção sobre as condutas de saúde provocou modificação na percepção de insatisfação com a massa corporal entre os adolescentes.

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