CLARICE TANAKA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - Docente
LIM/54 - Laboratório de Bacteriologia, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/54 - Laboratório de Bacteriologia, Hospital das Clínicas, Faculdade de Medicina - Líder
11 resultados
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article Transcranial direct current stimulation is safe and effective in autoimmune myopathies: a randomised, double-blind, sham-controlled trial(2023) SOUSA, L. F. A. de; MISSE, R. G.; SANTOS, L. M. dos; TANAKA, C.; GREVE, J. M. A.; BAPTISTA, A. F.; SHINJO, S. K.Objective We aimed to assess the safety and efficacy of transcranial direct current stimulation (tDCS) in patients with systemic autoimmune myopathies (SAMs).Methods This prospective, randomised, sham-controlled, double-blind, study included 20 patients with SAMs allocated to receive sham or active tDCS (2mA, 20 minutes, 3 days). Electrodes were positioned with the anode over the C1 or C2, whereas the cathode was placed over the Fp2 or Fp1, respectively. The groups were evaluated in four periods with specific questionnaires and functional tests: pre-stimulation and after 30 minutes, three weeks, and eight weeks post-tDCS.Results Two patients from the sham group withdrew after the three sessions. The demographic data, type of myositis, disease duration, and disease status were comparable between the active and sham tDCS groups. After interventions, in the active tDCS group, the physical aspects of SF-36 in week eight, mean and better timed up-and-go test at each evaluation, peak torque of stimulated inferior limb extension improved significantly (p<0.05). The emotional aspect of SF-36 decreased only in the active tDCS group (p<0.001). The patients' adherence to the protocol was 100% and no serious adverse event was reported, including disease relapses.Conclusion This study evidences the safety of tDCS, as well as its potential efficacy in improving muscle strength and function in SAMs patients. More studies with a larger sample and longer tDCS sessions are necessary to corroborate the results of the present study.- Impact of Transcranial Direct Current Stimulation in Pain, Fatigue, and Health Quality of Life of Patients with Idiopathic Inflammatory Myopathies: A Randomized, Double-Blind, Sham-Controlled Crossover Clinical Trial(2024) MISSE, Rafael Giovani; SANTOS, Alexandre Moura dos; BORGES, Isabela Bruna Pires; GRECCO, Marcus Vinicius; FARIA, Marlise Sitima Mendes Simoes; SILVA, Lorenza Rosa Silverio da; CORREIA, Bruna Lindoso; KIM, Ana Woo Sook; TANAKA, Clarice; GREVE, Julia Maria D'Andrea; BAPTISTA, Abrahao Fontes; SHINJO, Samuel KatsuyukiObjectives. To assess the effectiveness of transcranial direct current stimulation (tDCS) for pain, fatigue, physical function, and health-related quality of life in patients with idiopathic inflammatory myopathy (IIM). Methods. This randomized, double-blind, sham-controlled, crossover clinical trial enrolled IIM patients with fatigue and pain who received tDCS (20 min, 2 mA) or sham stimulation for 10 daily sessions. Electrodes were placed according to the 10/20 EEG system. Both the groups underwent aerobic exercise training during the intervention period. The patients were evaluated for disease perception, pain, and fatigue using uni-multidimensional questionnaires and physical tests in the periods before and after the first and second interventions and after 12 weeks of follow-up. Results. After the tDCS intervention, a reduction in the general score of multidimensional pain of 32.0 (1.5-38.0) vs. 0.0 (0.0-13.4) with effect size (ES) of -0.78 was noted, and after sham intervention, a reduction of 26.0 (0.0-37.0) vs. 5.0 (0.0-19.2) with ES of -0.54 (P=0.047) was also noted. Similar results were evidenced with fatigue (22.5 (15.4-33.2) vs. 5.5 (0.0-14.6) with ES of -0.82) and sham intervention (21.0 (15.8-29.5) vs. 4.0 (4.0-17.5) with ES of -0.80 (P=0.012)). There were no differences in the domains of the fatigue and pain questionnaires. Adherence was observed in 88.8% of the patients without adverse events. Conclusion. The association of tDCS with aerobic training promoted additional effects in relation to the group subjected to placebo stimulation on general pain and fatigue scores, as well as on pain intensity, without changes in the subdomains of the pain and fatigue questionnaire. This trial is registered with NCT04678635.
conferenceObject The hip and spine mobility is diminished in enuretic children and teenagers(2013) PEREIRA, Rita Pavione Rodrigues; KOCH, Vera Herminakalika; GONCALVES, Monica Maria Ribeiro; MILHORATTI, Thais de Souza; PACHECO, Daniela Castro; TANAKA, Clarice- Falls and re-hospitalization in COPD patients after hospital discharge: A 6 month follow up(2016) LAVOURA, Patricia; MEIRA, Debora; SILVA, Deise; CURIATI, Jose; LICHTENSTEIN, Arnaldo; CARVALHO, Celso; TANAKA, Clarice
- Timing to out-of-bed mobilization and mobility levels of COVID-19 patients admitted to the ICU: Experiences in Brazilian clinical practice(2024) UHLIG, Suelen E.; RODRIGUES, Miguel K.; OLIVEIRA, Mayron F.; TANAKA, ClariceIntroduction: At the beginning of the coronavirus disease 2019 (COVID-19) pandemic, there was scarce data about clinical/functional conditions during hospitalization or after hospital discharge. Little was known about COVID-19 repercussions and how to do early mobilization in intensive care unit (ICU). Objective: Identify the time to the initiation of out-of-bed mobilization and the levels of mobility (sitting over the edge of the bed, sitting in a chair, standing, and ambulating) reached by critically ill patients with COVID-19 during hospitalization and the factors that could impact early mobilization. Methods: This was a retrospective observational study of patients with COVID-19 in the ICU. Results: There were 157 surviving COVID-19 patients included in the study (median age: 61 years; median ICU length of stay: 12 days). The median time to initiate out-of-bed mobilization in the ICU was 6 days; between patients who received mechanical ventilation (MV) compared with those who did not, this time was 8 vs. 2.5 days (p < .001). Most patients who used MV were mobilized after extubation (79.6%). During ICU stays, 88.0% of all patients were mobilized out of bed, and 41.0% were able to ambulate either with assistance or independently. The time to initiate out-of-bed mobilization is associated with sedation time and MV time. Conclusion: Despite the pandemic scenario, patients were quickly mobilized out of bed, and most of the patients achieved higher mobility levels in the ICU and at hospital discharge. Sedation time and MV time were associated with delays in initiating mobilization.
- Evidence-based umbrella review of non-invasive brain stimulation in anxiety disorders(2023) SA, Katia Nunes; BAPTISTA, Rachel Fontes; SHIRAHIGE, Livia; RAZZAA, Lais B.; NOGUEIRA, Mateus; COURA, Maria Helena Faria; AFONSO-SANTOS, Leonardo; TANAKA, Clarice; BAPTISTAA, Abrahao Fontes; MONTE-SILVA, Katia; BRUNONIA, Andre R.Background and objectives: Although several meta-analyses have suggested the efficacy of noninvasive brain stimulation (NIBS) mainly in prefrontal brain areas to treat mental disorders, no synthetic approach has been performed for other psychiatric disorders rather than depression. The objective is to assess the available evidence of NIBS in the treatment of anxiety disorders. Methods: An umbrella review (CRD42021239577) was performed only looking for reviews with meta-analyses of randomized clinical trials using a source strategy MeSH keywords in MEDLINE through Pubmed by two independent researchers. The effects of different methods of NIBS in anxiety disorders were assessed using the PICO strategy. The methodological quality was evaluated using AMSTAR-2 and certainty of evidence using the GRADE-pro framework. Results: From 136 screening meta-analyses, 16 from 14 studies were included in the final analysis. Generalized Anxiety Disorder (GAD) and Obsessive Compulsive Disorder (OCD) respond best to low frequency repetitive transcranial magnetic stimulation (rTMS), while Posttraumatic Stress Disorder (PTSD) has the largest effect size at high frequency rTMS. Panic Disorder (PD) has no evi-dence for clinical use of NIBS. There were not identified meta-analyses about other anxietydisorders. In general, the included studies had good methodological quality, but low to moderate evidence for clinical recommendation. Conclusion: Available evidence reveals NIBS as an effective and safe approach to treat GAD, PTSD and OCD with low recommendation level to clinical application. A great heterogeneity of studies indicates the necessity to develop new randomized clinical trials applying NIBS to treat those and other mental disorders. \& COPY; 2023 Asociacion Universitaria de Zaragoza para el Progreso de la Psiquiatria y la Salud Mental.
- Functional Recovery Groups in Critically III COVI D-19 Patients and Their Associated Factors: From ICU to Hospital Discharge(2022) SCHUJMANN, Debora Stripari; LUNARDI, Adriana Claudia; PESO, Claudia Neri; POMPEU, Jose Eduardo; ANNONI, Raquel; MIURA, Mieko Claudia; CENSO, Caroline Maschio de; TANIGUCHI, Luzia Noriko Takahashi; REGENGA, Marisa de Moraes; CAMPOS, Elaine Cristina de; RIGHETTI, Renato Fraga; YAMAGUTI, Wellington Pereira; BRITO, Christina May Moran de; LOURENCO, Adriana; AGUERA, Sabrina Castaldi; TANAKA, Clarice; FU, CarolinaOBJECTIVES: To analyze functional recovery groups of critically ill COVID-19 survivors during their hospital stay and to identify the associated factors. DESIGN: Prospective observational multicenter study. SETTING: Demographic, clinical, and therapeutic variables were collected, and physical and functional status were evaluated. The Barthel index was evaluated at three time points: 15 days before hospitalization, at ICU discharge, and at hospital discharge from the ward. PATIENTS: Patients with functional independence before COVID-19 diagnosis were recruited from four hospitals and followed up until hospital discharge. MEASUREMENTS AND MAIN RESULTS: Three groups of functional recovery were described for 328 patients: functional independence (n = 144; 44%), which included patients who preserved their functional status during hospitalization; recovered functionality = 109; 33.2%), which included patients who showed dependence at ICU discharge but recovered their independence by hospital discharge; and functional dependency (n = 75; 22.8%), which included patients who were dependent at ICU discharge and had not recovered their functional status at hospital discharge. The factors associated with becoming functionally dependent at ICU discharge were time to out-of-bed patient mobilization (odds ratio [OR], 1.20; 95% CI, 1.11-1.29), age (OR, 1.02; 95% CI, 1.01-1.04), hyperglycemia (OR, 2.52; 95% CI, 1.56-4.07), and Simplified Acute Physiology Score (OR, 1.022; 95% CI, 1.01-1.04). Recovery to baseline independence during ward stays was associated with ICU length of stay (OR, 0.97; 95% CI, 0.94-0.99) and muscle strength (Medical Research Council test) at ICU discharge (OR, 1.13; 95% CI, 1.08-1.18). CONCLUSIONS: Age, hyperglycemia, and time for patient mobilization out of bed were independent factors associated with becoming physically dependent after their ICU stay. Recovery of physical function at hospital discharge was associated with muscle strength at ICU discharge and length of ICU stay.
- Functional impact on adults and older people after hospitalization by Covid-19(2023) OCHIAI, Gabriela Sayuri; GODOY, Caroline Gil de; SILVA, Erika Christina Gouveia E; OLIVEIRA, Danielle Brancolini de; SILVA, Elizabeth Mendes da; VIANA, Bianca de Oliveira Candido; SILVA, Juliana Magalhaes da; SOUZA, Roberta Oliveira Bueno de; SANTOS, Michelle Didone dos; CAMPOS, Camila Machado de; SCHMITT, Ana Carolina Basso; CARVALHO, Celso Ricardo Fernandes de; FU, Carolina; TANAKA, Clarice; TOUFEN JR., Carlos; CARVALHO, Carlos Roberto Ribeiro de; POMPEU, Jose EduardoBackground and Objectives Hospitalization by Covid-19 can cause persistent functional consequences after hospital discharge due to direct and indirect effects of SARS-COV-2 in several organs and systems of the body added to post-intensive care syndrome and prolonged bed rest. These impacts can lead to dependency in activities of daily living, mainly in older people due to aging process and functional decline. This study aimed to compare the effects of hospitalization by Covid-19 on functional capacity of adults and older people and to identify its associated factors. Methods Cross-sectional observational study of 159 survivors of hospitalization by Covid-19 after 1 month from discharge at Hospital das Clinicas of the University of Sao Paulo, divided into groups: adults (aged < 60 years) and older people (aged >= 60 years). Those who did not accept to participate, without availability or without ability to understand the questionnaires were excluded. Functional capacity was assessed by the Barthel Index and patients were classified according to their scores. Data analysis was performed in JASP Statistics program and the sample was compared between the age groups. Wilcoxon test was applied to compare before and after periods, Mann-Whitney test was used for between groups comparison. We adopted alpha = 0.05. Results The total Barthel Index median score was lower 1 month after hospital discharge than in the pre-Covid-19 period. Older people had worse functional status than adults before and also showed greater impairment after hospital discharge. Both groups showed lower Barthel Index classification than before, and older people presented more functional dependence than adults in both periods. Age, sarcopenia and frailty were associated factors. Discussion Hospitalization by Covid-19 impacts functional capacity after 1 month from discharge, especially in older people. Age, sarcopenia and frailty are associated factors. These results suggest need for care and rehabilitation of Covid-19 survivors.
- Pediatric incontinence questionnaire (PINQ): translation and transcultural adaptation to Brazilian Portuguese(2023) PEREIRA, Rita Pavione Rodrigues; LEITAO, Angelica Quintino; FOTAKOS, Gabriella Silva; REIS, Joceara Neves dos; ROCHA, Flavio Eduardo Trigo; MACHADO, Marcos Giannetti; BOWER, Wendy F.; TANAKA, ClariceObjective: Lower urinary tract symptoms (LUTS) affect approximately 10% of children world-wide and are related to psychosocial manifestations and compromised quality of life, both for children and their families. The assessment of emotional conditions of LUTS in children is recom-mended by International Children's Continence Society; however, there is no specific instrument in the Brazilian Portuguese language. Therefore, the aim of this study was to translate, culturally adapt and assess the internal consistency of the Brazilian Portuguese version of the Pediatric Incontinence Questionnaire (PINQ). Material and methods: This cross-sectional study was performed at two referral centers for childhood voiding dysfunction. The 20-item PINQ was translated into Brazilian Portuguese and culturally adapted according to Beaton, 2000. His-standard methodology consists of 6 phases: translation, synthesis, back-translation, expert committee, and pre-test. The internal consis-tency was assessed using Cronbach's alpha. Results: The PINQ-br version was developed, validated by a committee of experts, and pre-tested on 44 children diagnosed with lower urinary tract symptoms, 23 boys and 21 girls (mean age: 9.7 and 9.6 years old respectively), as well as on their parents. The internal consistency was considered satisfactory, reaching Cronbach's alpha coefficient of 0.74 when applied to children and 0.82 when applied to parents. Conclusions: The PINQ was translated and culturally adapted to Brazilian Portuguese to assess the impact of LUTS on the health-related quality of life in Brazilian children and adolescents. & COPY; 2023 Sociedade Brasileira de Pediatria.
conferenceObject POSTURAL CONTROL IN CHILDREN AND TEENAGERS WITH ENURESIS(2013) PEREIRA, Rita Pavione Rodrigues; KOCH, Vera HerminaKalika; FAGUNDES, Simone Nascimento; ROSSI, Aline; VIEIRA, Juliane de Oliveira Marques; TANAKA, Clarice