RITA PAVIONE RODRIGUES PEREIRA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/54 - Laboratório de Bacteriologia, Hospital das Clínicas, Faculdade de Medicina
LIM/54 - Laboratório de Bacteriologia, Hospital das Clínicas, Faculdade de Medicina
10 resultados
Resultados de Busca
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- The effects of repetitive haemarthrosis on postural balance in children with haemophilia(2013) SOUZA, F. M. B.; MCLAUGHLIN, P.; PEREIRA, R. P.; MINUQUE, N. P.; MELLO, M. H. M.; SIQUEIRA, C.; VILLACA, P.; TANAKA, C.Sensory information from visual, vestibular and proprioceptive systems is necessary to control posture and balance. Impairment in proprioception due to repetitive joints bleeding may lead to a deficit in postural balance which, in turn, leads to high joint stress and risk of bleeding recurrence. Despite the increase in attention in this field during the past few years, the data concerning to how bleeds can affect postural control in children with haemophilia (CWH) remain scarce. This study aimed to evaluate the postural balance in CWH. Twenty CWH Haemophilia Group (HG) and 20 age-matched children Control Group (CG) were recruited to this study. A force plate was used to record centre of pressure (COP) displacement under four different postural conditions during quiet standing: eyes open on firm surface, eyes open on foam surface, eyes closed on firm surface and eyes closed on a foam surface. Variables of COP as sway area and mean velocity and in anterior-posterior (y) medio-lateral (x) direction were processed and for each variable sensory, quotients were calculated and compared between groups. No differences were found in visual and vestibular quotients variables between groups. A higher value was found in sway area variable on proprioception quotient in the HG when compared with CG (P=0.042). CWH with repetitive joint bleed on lower limbs showed differences in postural balance when compared with non-haemophiliac children. The identification of early balance impairments in CWH can help us understand better the effects of bleeds inside joints on postural control and plan a more effective preventive and rehabilitative treatment.
conferenceObject PATIENTS WITH ENURESIS MAY HAVE BALANCE DISORDERS(2015) PAVIONE, Rita; PEREIRA, Rodrigues; MACHADO, Marcos Giannetti; FAGUNDES, Simone Nascimento; LEBL, Adriene; AZEVEDO, Leticia; KOCK, Vera Hermina; TANAKA, ClariceconferenceObject POSTURE AND MOBILITY CHANGES IN PATIENTS WITH NOCTURNAL ENURESIS(2015) PEREIRA, Rita Pavione Rodrigues; MACHADO, Marcos Giannetti; FAGUNDES, Simone Nascimento; LEBL, Adriene; AZEVEDO, Leticia; KOCK, Vera Hermina; TANAKA, Clarice- Children with nocturnal enuresis have posture and balance disorders(2016) PEREIRA, R. Pavione Rodrigues; FAGUNDES, S. Nascimento; LEBL, A. Surry; SOSTER, L. Azevedo; MACHADO, M. G.; KOCH, V. H.; TANAKA, C.Introduction Integration of the neuromuscular system is required for maintaining balance and adequate voiding function. Children with enuresis have delayed maturation of the motor cortex, with changes in the sensory and motor systems. Along with various alterations, including the genetic, hormonal, behavioral, and sleep disturbances, and neuromotor and sensory deficits associated with nocturnal enuresis (NE) in children and adults, a consistent alteration in the posture of children with NE has been observed in the current practice. Because posture and the balance control system are strongly connected, this study aimed to investigate posture and balance in children and teenagers with NE. Material and methods A total of 111 children with enuresis were recruited to the enuretic group (EG) and 60 asymptomatic children made up the control group (CG). The participants were divided into two age subgroups: (A) 7-11 years old, N = 77 for EG/A, N = 38 for CG/A; and (B) 12-16 years old, N = 34 for EG/B, N = 22 for CG/B. Balance was assessed using an electronic force plate (100 Hz) to calculate the area of the center of pressure (COP) displacement. The COP is the point that results from the action of vertical forces projected onto the force plate. Sensory integration was analyzed using a 60-s trial with the subject standing under four conditions: (1) eyes open, stable surface; (2) eyes closed, stable surface; (3) eyes open, unstable surface; (4) eyes closed, unstable surface. Posture was assessed by placing reflective anatomical landmarks on the anterior superior iliac spine, the posterior superior iliac spine, the greater trochanter, and lateral malleolus. A photograph was taken while the subject stood quietly. The angles were obtained from landmark connections using software to assess the following posture variables: pelvic ante/retroversion and pelvic ante/retropulsion. Results The EG showed a greater area of COP displacement compared with the CG under all four sensory conditions and both subgroups, except for EG/B in condition 3. Regarding posture, EG showed higher pelvic anteversion angles than CG. Conclusions Enuretic children showed forward inclination of the pelvis and had worse balance compared with control children.
- Impact of a multidisciplinary evaluation in pediatric patients with nocturnal monosymptomatic enuresis(2016) FAGUNDES, Simone Nascimento; SOSTER, Leticia Azevedo; LEBL, Adrienne Surri; PEREIRA, Rita Pavione Rodrigues; TANAKA, Clarice; PEREIRA, Rodrigo Fernando; SILVARES, Edwiges Ferreira de Mattos; KOCH, Vera H.Background Enuresis (NE) is a clinical condition of multifactorial etiology that leads to difficulties in child/adolescent social interaction. This was a prospective study on the impact of multidisciplinary assessment of 6- to 17-year-old patients with monosymptomatic nocturnal enuresis (MNE), including a structured history, clinical/neurological examination, bladder and bowel diaries, sleep diary and questionnaires, psychological evaluation [Child Behavior Checklist (CBCL) and PedsQL 4.0 questionnaires], urinary sonography, blood and urine laboratory tests, polysonography (PSG), and balance evaluation. A total of 140 enuretic participants were evaluated, of whom 27 were diagnosed with NE complicated by urinary disorder, four with hypercalciuria, three with nephropathy and one with attention-deficit hyperactivity disorder. Among the 87 participants who underwent PSG, six were diagnosed with severe apnea. Of the 82 MNE patients who underwent full assessment, 62 were male (75.6 %), and the mean age was 9.5 (+/- 2.6) years. A family history of NE was diagnosed in 91.1 % of first- and second-degree relatives, constipation in 89.3 % and mild/moderate apnea in 40.7 %. Balance control alteration was identified by physical therapy evaluation of MNE patients. Participants' quality of life evaluation scores were significantly lower than those of their parents. Enuresis is a multifactorial disorder that requires a structured diagnostic approach.
- Noninvasive Neuromodulation Techniques in Difficult Tracheostomy Weaning of Patients With Spinal Cord Injury Report of Two Cases(2021) CARVALHO, Priscila De; GOULARDINS, Juliana Barbosa; SOUSA, Danilo Miyoji Nakamura de; BARBOSA, Cristiane Marcela da Silva; CAETANO, Thabata Cristina Candido; SANTOS, Lucas de Macedo dos; ITO, Clara Hikari; HIROTA, Adriana Sayuri; PEREIRA, Rita Pavione Rodrigues; BAPTISTA, Abrahao Fontes; TANAKA, ClariceHigh spinal cord injured patients (SCI) are susceptible to respiratory muscle impairments. Transcranial direct current stimulation (tDCS) and peripheral electrical stimulation (PES) may influence the diaphragm's central control, but until now they are not described as a therapeutic resource for difficult weaning. We present two case reports of SCI patients (P1 and P2) with long-term tracheostomy (>40 days) and hospital stay (>50 days). In association with respiratory exercise, P1 received a combined application of anodal tDCS over the supplementary motor area plus sensory PES in the thoracic-abdominal muscles, and P2 received isolated excitatory PES in the abdominal muscles, applied daily except on weekends. Maximum inspiratory/expiratory pressure, peak cough flow, diaphragm excursion, and thickening fraction were measured in the first and last days of the protocol. Both patients had improvements, with clinical impact such as cough effectiveness, decannulated after 15 applications of stimulation. Augmentation of neural respiratory drive and corticospinal excitability is suggested.
- 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.
- Transcranial direct current stimulation and cough effectiveness in SCI patients: case report(2020) CARVALHO, Priscila de; HIROTA, Adriana Sayuri; SANT'ANNA, Guadalupe Nery; GOULARDINS, Juliana Barbosa; SANTOS, Lucas Macedo; CAETANO, Thabata; ITO, Clara Hikari; MOL, Caroline Gomes; RODRIGUES, Rita Pavione; BAPTISTA, Abrahao Fontes; TANAKA, Clarice
conferenceObject One year experience of a multidisciplinary investigation on Nocturnal Enuresis in a Brazilian Tertiary Care Facility(2013) FAGUNDES, Simone N.; SOSTER, Leticia A.; LEBL, Adrienne S.; PAVIONE, Rita; TANAKA, Clarice; SILVA, Guilherme Souza e; PORTO, Paula; FERRARI, Rafaela; SILVARES, Edwiges; KOCH, Vera H.Objective: To characterize a cohort of children, 6–16 yrs old, with nocturnal enuresis, defined by 2010 ICCS criteria on the basis of a multidisciplinary evaluation including renal, neurological, psychological and physical therapy approaches. Chronic clinical conditions and genetic disorders constituted exclusion criteria. Methods: After IRB approval, families were invited to participate in the project through press releases, 130 children completed quality of life evaluation through clinically validated questionnaires, followed by a one -day multidisciplinary clinical evaluation. Sleep, urinary and intestinal diaries were evaluated. Urinary sonography, nocturnal polysomnography, urinary and blood analysis were scheduled. Results: 96/130 participants (pts)were male (73,8%), mean age 8 ±1 yrs. Twenty two children were excluded due to noncompliance/chronic clinical conditions. 118/130 pts were evaluated. 93/130 parents of children/adolescents, answered the CBCL questionnaire, 25/93 (27%) of which resulted in scores compatible with clinical psychological conditions. Monosymptomatic enuresis (MoE) was diagnosed in 89/118 children (75.4%). In the MoE group, 67/89 pts were diagnosed with intestinal constipation; 7/89 pts with obstructive sleep apnea, 2/89 pts with hipercalciuria and 2/89 were characterized with ADHD. Area and velocity of center or pressure displacement (VM) were used for postural control evaluation and resulted in 3,67±2,95 cm 2 and 20,35±13,04 cm.s-1, respectively; 22/89 pts were also assessed for postural alignment exhibiting pelvic anteversion (10,27±3,71 grades) and head protusion (0,40±1,86 grades). These results corroborate with a smaller range of motion found for hip flexion (94,86±17,14 grades) and hip extension (2±3,89 grades) assessed using a goniometer. Conclusion: Multidisciplinary evaluation of enuretic children may be the key to optimize therapy on the basis of the underlying etiology of the process.- Importance of neuropsychiatric evaluation in children with primary monosymptomatic enuresis(2017) GOULARDINS, Juliana Barbosa; PEREIRA, Rita Pavione Rodrigues; TANAKA, Clarice