Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-07-26T20:16:37Z No. of bitstreams: 1 AnaLuisaDeBarrosPascoal_DISSERT.pdf: 1689211 bytes, checksum: 370df885675ac064f8be47a40a7d2cf4 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-08-08T21:50:09Z (GMT) No. of bitstreams: 1 AnaLuisaDeBarrosPascoal_DISSERT.pdf: 1689211 bytes, checksum: 370df885675ac064f8be47a40a7d2cf4 (MD5) / Made available in DSpace on 2016-08-08T21:50:09Z (GMT). No. of bitstreams: 1 AnaLuisaDeBarrosPascoal_DISSERT.pdf: 1689211 bytes, checksum: 370df885675ac064f8be47a40a7d2cf4 (MD5) Previous issue date: 2016-03-07 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / Os m?todos tradicionais de confec??o de pr?teses totais exigem uma ampla sequ?ncia de procedimentos cl?nicos e laboratoriais, entretanto, n?o h? evid?ncia cient?fica de que eles produzam resultados superiores aos m?todos simplificados. Objetivo: Avaliar a efetividade de uma t?cnica simplificada (S) para confec??o de pr?tese total, comparando-a a tradicional (T), atrav?s da efici?ncia mastigat?ria e da avalia??o da qualidade das pr?teses. M?todo: Realizou-se um ensaio cl?nico controlado randomizado com 50 pacientes, 25 reabilitados com pr?teses totais duplas produzidas pela t?cnica tradicional e 25 reabilitados por uma t?cnica simplificada. Avaliou-se a efici?ncia mastigat?ria pelo m?todo colorim?trico com o aux?lio de uma c?psula mastigat?ria. A qualidade das pr?teses foi obtida por meio do instrumento desenvolvido por Sato et al. em 1998. Resultados: 39 pacientes conclu?ram o estudo, sendo 18 do grupo tradicional e 21 do grupo simplificado. N?o houve diferen?a entre os grupos para a efici?ncia mastigat?ria (p=0.835). Um paciente apresentou pr?tese com qualidade ruim (grupo S), nove com qualidade regular (T= 3; S=6) e 29 pacientes apresentaram pr?teses com qualidade boa (T= 15; S= 14), sem diferen?as entre os grupos. A qualidade das pr?teses obteve diferen?a significativa para a atura do rebordo inferior (p=0.05). Conclus?o: as pr?teses totais duplas confeccionadas pelo m?todo simplificado foram consideradas eficazes do ponto de vista da efici?ncia mastigat?ria e da qualidade das pr?teses, apresentando resultados semelhantes ?s confeccionadas pelo m?todo tradicional. / Traditional methods for dentures fabrication require a wide clinical and laboratory procedures; however, there is no scientific evidence that these methods can produce better results when compared with simplified methods. Aim: To evaluate the effectiveness of a simplified methods for denture fabrication, comparing it to the traditional one through masticatory efficiency and prosthesis quality. Method: A randomized controlled trial was conducted with 50 patients, 25 rehabilitated with prosthesis produced by traditional technique and 25 rehabilitated by a simplified technique. The masticatory efficiency was evaluated by colorimetric method, using chewing capsules. The quality of prosthesis was obtained using a reliable and reproducible instrument. Statistical analysis of the masticatory efficiency and quality of the prosthesis was obtained by the Mann-Whitney test. Results: 39 patients completed the study, 18 on traditional group and 21 on simplified group. There was no difference between groups for the masticatory efficiency (p = 0.835) and the quality of the prosthesis (p = 0672). The evaluation of the overall quality of the prosthesis according to oral conditions, demonstrated significant difference on the height of the mandibular ridges (p = 0.010) and mandibular muscle attachments (p = 0.039). Conclusion: Complete dentures fabricated by simplified method were considered effective from the point of view of masticatory efficiency and quality of prosthetics, with results similar to those made by the traditional method.

Made available in DSpace on 2014-12-17T15:16:17Z (GMT). No. of bitstreams: 1 IvaniziaSS_DISSERT.pdf: 831811 bytes, checksum: 8d5c9ce3de798ff5fead323295073f95 (MD5) Previous issue date: 2012-12-17 / In asthmatic, the lung hyperinflation leaves the inspiratory muscle at a suboptimal position in length-tension relationship, reducing the capacity of to generate tension. The increase in transversal section area of the inspiratory muscles could reverse or delay the deterioration of inspiratory muscle function. Objective: To evaluate the evidence for the efficacy of inspiratory muscle training (IMT) with an external resistive device in patients with asthma. Methods: A systematic review with meta-analysis was carried out. The sources researched were the Cochrane Airways Group Specialised Register of trials, Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 11 of 12, 2012), MEDLINE, EMBASE, PsycINFO, CINAHL, AMED, ClinicalTrials.gov and reference lists of articles. All databases were searched from their inception up to November 2012 and there was no restriction on the language of publication. Randomised controlled trials that involved the use of an external inspiratory muscle training device versus a control (sham or no inspiratory training device) were considered for inclusion. Two reviewers independently selected articles for inclusion, evaluated risk of bias in studies and extracted data. Results: A total of five studies involving 113 asthmatic patients were included. Three clinical trials were produced by the same group. The included studies showed a significant increase in maximal inspiratory pressure (MD 13.34 cmH2O, 95% CI 4.70 to 21.98), although the confidence intervals were wide. There was no statistically significant difference between the IMT group and the control group for maximal expiratory pressure, peak expiratory flow rate, forced expiratory volume in one second, forced vital capacity, sensation of dyspnea and use of beta2-agonist. There were no studies describing exacerbation events that required a course of oral and inhaled corticosteroids or emergency department visits, inspiratory muscle endurance, hospital admissions and days of work or school. Conclusions: There is no conclusive evidence in this review to support or refute inspiratory muscle training for asthma, once the evidence was limited by the small number of studies included, number of participants in them together with the risk of bias. More well conducted randomized controlled trials are needed, such trials should investigate respiratory muscle strength, exacerbation rate, lung function, symptoms, hospital admissions, use of medications and days off work or school. IMT should also be assessed in the context of more severe asthma / No paciente asm?tico, a hiperinsufla??o pulmonar coloca os m?sculos inspirat?rios em uma posi??o desfavor?vel na rela??o comprimento-tens?o, reduzindo a capacidade de gerar tens?o. O aumento na ?rea de sec??o transversa dos m?sculos inspirat?rios poderia reverter ou atrasar a deteriora??o da fun??o muscular inspirat?ria. Objetivo: Avaliar a evid?ncia da efic?cia do treinamento muscular inspirat?rio (TMI) com um dispositivo externo em pacientes com asma. M?todos: O tipo de estudo utilizado foi uma revis?o sistem?tica com metan?lise. As fontes pesquisadas foram o Cochrane Airways Group Specialised Register of trials, Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 11 of 12, 2012), MEDLINE, EMBASE, PsycINFO, CINAHL, AMED, ClinicalTrials.gov e lista de refer?ncias dos artigos. Todas as bases de dados foram pesquisadas desde seu in?cio at? novembro de 2012 e n?o houve restri??o de idioma. Foram considerados para inclus?o ensaios cl?nicos controlados e randomizados envolvendo o uso de um aparelho de treinamento muscular inspirat?rio externo versus um controle (placebo ou sem aparelho). Dois revisores independentemente selecionaram os artigos para inclus?o, avaliaram o risco de vi?s e extra?ram os dados dos estudos inclu?dos. Resultados: Um total de cinco estudos envolvendo 113 pacientes asm?ticos foram inclu?dos na revis?o, sendo 3 destes ensaios desenvolvidos pelo mesmo grupo. Os estudos inclu?dos mostraram que o TMI aumenta significativamente a press?o inspirat?ria m?xima (DM 13.34 cmH2O, 95% IC 4.70 ? 21.98), contudo existiu um largo intervalo de confian?a. N?o houve diferen?a significativa entre o grupo TMI e o grupo controle para press?o expirat?ria m?xima, taxa de pico de fluxo expirat?rio, volume expirat?rio for?ado no primeiro segundo, capacidade vital for?ada, sensa??o de dispneia e uso de beta2-agonista. Nenhum estudo investigou os seguintes desfechos: exacerba??es que requereram o uso de corticosteroides inalado ou oral ou visita ao servi?o de emerg?ncia m?dica, endurance dos m?sculos inspirat?rios, admiss?o no hospital e dias de falta ao trabalho ou escola. Conclus?es: N?o existe evid?ncia conclusiva para apoiar ou refutar o uso do TMI para a asma, uma vez que a evid?ncia foi limitada pelo pequeno n?mero de ensaios inclu?dos, reduzido n?mero de participantes e risco de vi?s. Mais estudos randomizados e controlados bem xiv conduzidos s?o necess?rios, tais ensaios devem investigar a for?a muscular respirat?ria, exacerba??es, fun??o pulmonar, sintomas, admiss?o no hospital, uso de medicamentos e dias de falta ao trabalho ou escola. O TMI deve tamb?m ser avaliado no contexto de asma mais grave