ROSELI SARAIVA MOREIRA BITTAR
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina
7 resultados
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- Population epidemiological study on the prevalence of dizziness in the city of Sao Paulo(2013) BITTAR, Roseli Saraiva Moreira; OITICICA, Jeanne; BOTTINO, Marco Aurelio; GANANCA, Fernando Freitas; DIMITROV, RivaThe epidemiology of dizziness is essential in clinical practice. Objective: To establish the prevalence of dizziness in the adult population of Sao Paulo, its clinical characteristics and level of discomfort. Method: A prospective cross-sectional study ran from April to October of 2012 by a field questionnaire, totaling 1,960 interviews. The predictor variables assessed were age, gender, type of dizziness and the dizziness disability index. The statistical tools used to assess the significance between variables were the chi-square test, Student's t-test and logistic regression. We used a 95% confidence interval for estimated values. Results: The prevalence of dizziness in the city of Sao Paulo was established at 42%. We found two peak of complaints, 49% in the range of 46-55 years and 44% in the elderly. Vestibular-related dizziness was estimated to affect 8.3% of the population, mainly women (p < 0.001). The symptoms caused disability in 27% of symptomatic interviewees and it is more bothersome to females (p < 0.001), who more frequently seek medical care (p < 0.001). Conclusion: The prevalence of dizziness in Sao Paulo was found to be 42%. It affects daily activities in 67% of symptomatic patients, but only 46% of them seek medical help.
article 14 Citação(ões) na Scopus Vestibular rehabilitation with biofeedback in patients with central imbalance(2011) BITTAR, Roseli Saraiva Moreira; BARROS, Camila de Giacomo CarneiroCentral Nervous System disorders may cause important functional unbalance in the maintenance of balance and posture. There is no effective rehabilitation for these symptoms until now. Objective: The aim of this paper is to evaluate the use of tongue electrotactile stimulation on patients with central imbalance using BrainPort. Materials and Methods: This is a prospective case series study. We evaluated 8 patients with central imbalance, 6 men and 2 women, with mean age of 67.75 years. The patients were submitted to Computed Dynamic Posturography (CDP) and then received 18 sessions of electrotactile stimulation by BrainPort (R) device for 20 minutes, twice a day. Then they were submitted to a new CDP test and to a self-perception scale to assess symptom remission, partial improvement and no improvement at all. Results: 75% of the patients reported being more stable. There was no improvement in the balance control of the mass center in these patients. Conclusion: The patients were able to use the electrotactile stimulus to improve their balance control.- Pathophysiology and Diagnosis of Vertebrobasilar Insufficiency: A Review of the Literature(2017) LIMA NETO, Arlindo Cardoso; BITTAR, Roseli; GATTAS, Gabriel Scarabotolo; BOR-SENG-SHU, Edson; OLIVEIRA, Marcelo de Lima; MONSANTO, Rafael da Costa; BITTAR, Luis FelipeAbstract Introduction Vertebrobasilar insufficiency is defined as transitory ischemia of the vertebrobasilar circulation. Dizziness, vertigo, headaches, vomit, diplopia, blindness, ataxia, imbalance, and weakness in both sides of the body are the most common symptoms. Objective To review the literature regarding the three available diagnostic testing in patients with dizziness complaints secondary to vertebrobasilar insufficiency (VBI): magnetic resonance angiography; transcranial Doppler ultrasound; and vertebrobasilar deprivation testing. Data Synthesis We selected 28 studies that complied with our selection criteria for appraisal. The most frequent cause of the hemodynamic changes leading to VBI is atherosclerosis. The main clinical symptoms are dizziness, vertigo, headaches, vomit, diplopia, blindness, ataxia, imbalance, and weakness in both sides of the body. Even though arteriography is considered the most important exam to diagnose the disease, the inherent risks of this exam should be taken into consideration. The magnetic resonance angiography has been widely studied and is a good method to identify and localize any occlusions and stenosis in both neck and intracranial great vessels. Conclusion Each patient with a suspected diagnosis of VBI should be individually evaluated and treated, taking in consideration the pros and cons of each diagnostic testing and treatment option.
- Dizziness profile and clinical features: a population based survey in São Paulo City, Brazil(2015) BITTAR, Roseli Saraiva Moreira; MEZZALIRA, Raquel; GRASEL, Signe Schuster; OITICICA, JeanneOBJECTIVE: This is a cross-sectional epidemiological survey designed to estimate the prevalence of dizziness among the adult population of the city of São Paulo, Brazil, and to describe the clinical features and level of discomfort. METHOD: This population based study was conductedin the city of São Paulo, Brazil, between April and October 2012. A total of 1,960 household interviews were completed. The following variables were assessed: gender, age, clinical characteristics of dizziness, and dizziness disability index. Chi-square test, Student's t-test,Tukey test and logistic regression were used for statistical analysis. RESULTS: The dizziness prevalence in São Paulo was 42%. Peaks of dizziness were observed in two age groups: 49% among the 46 to 55 year-old, and 44% among the elderly subjects(> 65 years-old). Vestibular vertigo was detected in 8.3% of patients, with a strong female preponderance (p < 0.001). Symptoms caused disability in 27% of the affected respondents and were more frequent among women (p < 0.001). These sought medical care more frequently (p < 0.001). The dizziness disability index was significantly higher (p = 0.0165) among subjects with a lower educational level. There was no correlation between dizziness discomfort and the type of job. CONCLUSION: The prevalence of dizziness in São Paulo, Brazil, was established at 42%. Among the symptomatic subjects, 67% reported interruption of daily activities, but only 46% of them sought medical attention.
- Sensitivity of caloric test and video head impulse as screening test for chronic vestibular complaints(2017) MEZZALIRA, Raquel; BITTAR, Roseli Saraiva Moreira; BILECKI-STIPSKY, Marcia Maria do Carmo; BRUGNERA, Cibele; GRASEL, Signe SchusterOBJECTIVE: This study compared the results of the caloric test with those of the video head impulse test obtained during the same session and evaluated whether the former can be used to screen for non-acute vestibular dysfunction. METHODS: A total of 157 participants complaining of dizziness with vestibular characteristics of varying durations and clinical courses completed the caloric test and video head impulse test. RESULTS: Significantly more caloric test results than video head impulse test results were abnormal. CONCLUSIONS: The results of the caloric test and video head impulse test are distinct but complement each other. Within our sample, the caloric test was more sensitive for vestibular dysfunction. Therefore, the video head impulse test is not a suitable screening tool of the vestibular system in patients with chronic complaints.
- Efficacy of a Vibrotactile Neurofeedback Training in Stance and Gait Conditions for the Treatment of Balance Deficits: A Double-Blind, Placebo-Controlled Multicenter Study(2011) BASTA, Dietmar; ROSSI-IZQUIERDO, Marcos; SOTO-VARELA, Andres; GRETERS, Mario Edwin; BITTAR, Roseli Saraiva; STEINHAGEN-THIESSEN, Elisabeth; ECKARDT, Rahel; HARADA, Tatsuhiko; GOTO, Fumiyuki; OGAWA, Kaoru; ERNST, ArneObjective: Vestibular rehabilitation strategies mostly require a long-lasting training in stance conditions, which is finally not always successful. The individualized training in everyday-life conditions with an intuitive tactile neurofeedback stimulus seems to be a more promising approach. Hence, the present study was aimed at investigating the efficacy of a new vibrotactile neurofeedback system for vestibular rehabilitation. Study Design: Double-blinded trial. Patients: One hundred five patients who experience one of the following balance disorders for more than 12 months were included in the study: canal paresis, otolith disorder, removal of an acoustic neuroma, microvascular compression syndrome, Parkinson's disease, and presbyvertigo. Interventions: Vibrotactile neurofeedback training was performed daily (15 min) over 2 weeks with the Vertiguard system in those 6 tasks of the Standard Balance Deficit Test with the most prominent deviations from the normative values. Main Outcome Measures: Trunk and ankle sway, dizziness handicap inventory, and vestibular symptom score were measured in the verum and placebo group before the training, on the last training day and 3 months later. Results: A significant reduction in trunk and ankle sway as well as in the subjective symptom scores were observed in the verum group. Such an effect could not be found in any of the outcome parameters of the placebo group. Conclusion: The vibrotactile neurofeedback training applied in the present study is a highly efficient method for the reduction of body sway in different balance disorders. Because the rehabilitation program is easy to perform, not exhausting, and time saving, elderly patients and those with serious, long-lasting balance problems also can participate successfully.
- Efficacy of Carbon Microcoils in Relieving Cervicogenic Dizziness(2017) BITTAR, Roseli; ALVES, Nédison Gomes Paim; BERTOLDO, César; BRUGNERA, Cibele; OITICICA, JeanneAbstract Introduction Cervical pain contributes to postural deviations and imbalance. Nanotechnology may be used for the treatment of neck pain by fixing to the skin small rounds silicone patches containing double spiral carbon nanotubes arranged in the form of a coil (Helical), which would then relieve dizziness caused by muscular contraction. Objective The objective of this study is to Evaluate pain and dizziness scores before and after Helical patches effect on cervicogenic dizziness treatment. Methods The selected patients should have neck pain arising from muscle contraction with loss of balance or instability lasting more than 90 days and normal electrooculography. Treatment consisted of placing 10 Helical patches distributed as follows: two in the upper cervical area, two in the lower cervical area (near the 5th and 6th vertebrae), two in the upper trapezius muscle area (between neck and shoulder), and four in the tender point area (as reported by the patient). Using a Visual Analogue Scale (VAS), we matched pain and dizziness scores from Day 1 to those from Day 15 and Day 30 using Mann-Whitney test. Results There was a significant difference between pain score reported on Day 1 and Day 15 (Z = 2.43, U = 5, p = 0.01). We also found significant differences between dizziness scores reportedondays1 and15 (Z = 2.62, U = 3.5, p = 0.01) and days 1 and 30 (Z = 2.36, U = 5.5, p = 0.01). Conclusion The Helical patches seem to be an effective treatment for cervicogenic dizziness.