FLAVIO EDUARDO TRIGO ROCHA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
3 resultados
Resultados de Busca
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- A prospective and randomized study comparing the use of alarms, desmopressin and imipramine in the treatment of monosymptomatic nocturnal enuresis(2023) MELLO, Marcos Figueiredo; LOCALI, Rafael Fagionato; ARAUJO, Rogerio Mattos; REIS, Joceara Neves; SAIOVICI, Samuel; MELLO, Luiz Figueiredo; ROCHA, Flavio Eduardo TrigoBackground Monosymptomatic enuresis (MNE) results from a pathogenic triad that may include lack of vaso-pressin secretion during sleep, reduced functional bladder capacity and inability to wake up during sleep. The treatment of MNE can be performed through behavioral therapy, use of alarms or medi-cations such as desmopressin and imipramine.Objective To compare the effectiveness of different treat-ments of MNE.Study design Prospective and randomized study comparing different intervention and a control group (receiving only behavior therapy) for MNE. Inclusion criteria: age between 5 and 16 years old, with MNE, evalu-ated at the pediatric urology outpatient clinic of Hospital Infantil Menino Jesus. At first visit children were submitted to behavior therapy (urotherapy) for 3 months, children were subsequently characterized according to the ICCS as non-responders, partial responders, or full responders. Those partial re-sponders or non-responders received a patient ID and were randomized to four groups: Alarm Group (G1), Desmopressin Group -DDAVP (G2), Imipramine Group (G3) and Control (G4). All groups were moni-tored monthly, for a period of 6 months. After 6 months, the children were reevaluated for MNE.Results 93 patients were enrolled. Mean age was 10.96 years with a standard deviation of 2.28 years, 59,1% were male. All groups had improvement in the number of dry nights (Table). Taking in account success the population full responders and partial responders: Alarm Group (G1) achieve success in 100% of cases, Desmopressin Group -DDAVP (G2) in 63.6% of cases, Imipramine Group (G3) in 73.7% of cases (Table 3). No drugs side effects were observed in both groups (G2 and G3), there was no dropout in patients who used alarms.Discussion Our data suggests that the use of alarms is the most effective treatment of ENM with superior results when compared to imipramine and DDAVP. The small number of participants is a weakness of the study, as well as the lack of a voiding diary at the end of the study.Conclusion All therapeutics options utilized in the treatment of MNE are safe, effective and has a low rate of abandonment.
- 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.
- OCCULT AND SEMI-OCCULT CONSTIPATION IN CHILDREN WITH MONOSYMPTOMATIC OR NON MONOSYMPTOMATIC ENURESIS(2023) MAFFEI, Helga Verena L; VIDOLIN, Eliana; REIS, Joceara Neves dos; FREITAS, Marcia de; CABRAL, Beatriz Helena; TRIGO-ROCHA, FlavioABSTRACT Background: Functional constipation and enuresis frequently coexist. Constipation treatment often results in resolution or improvement of the enuresis. However, besides the classical presentation, patients can present with occult constipation (OC) diagnosed in complementary evaluation; in addition, semi-occult constipation (SOC) can be detected by means of a detailed questionnaire. Objective: To quantify OC and SOC frequency in children with monosymptomatic or non monosymptomatic enuresis (MNE or NMNE). Methods: Otherwise healthy children/adolescents, with enuresis refractory to behavioral therapy and denying constipation after simple questions, answered a structured bowel habit questionnaire and were submitted to a plain abdominal radiological exam. Constipation was classified considering the Boston diagnostic criteria (to allow diagnosis at initial stages), and fecal loading in the X-ray quantified ≥10 by the Barr score. Children with constipation received a standardized treatment (except 26 “pilot” children). Results: Out of 81 children, 80 aged 9.34±2.07 years, 52.5% male, were diagnosed with constipation: 30 OC, 50 SOC; 63.75% had MNE, 36.25% NMNE (six NMNE without behavioral therapy). Demographic data and the Barr score were similar for OC and SOC, but SOC children experienced significantly more constipation complications (retentive fecal incontinence and/or recurrent abdominal pain). Not showing the Bristol Stool Scale (BSS) to 24 “pilot” children, or absence of constipation symptoms accompanying BSS predominantly type 3, in 13 children, did not significantly impact the detection of constipation by the Barr score. Children identifying BSS 3 or ≤2 had similar results. Twenty-eight children, with adequate follow-up after treatment, improved or recovered from constipation at 44 of their 52 follow-up visits. Conclusion: In patients with MNE or NMNE refractory to behavioral therapy, and who initially denied constipation after simple questions, a detailed questionnaire based on the Boston diagnostic criteria detected SOC in 61.7%, and the radiological Barr score revealed fecal loading (OC) in 37.0% of them.