CHRISTINA MAY MORAN DE BRITO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
10 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 10
conferenceObject How much time is necessary to assess maximal inspiratory pressure by unidirectional expiratory valve method in subjects without artificial airway?(2014) GRAMS, Samantha; KIMOTO, Karen; AZEVEDO, Elen; BRITO, Christina; YAMAGUTI, Wellington- Botulinum toxin type A as an adjunct treatment to radiation-induced trismus(2013) ANDRADE, R. G.; LIMA, M. C.; BRITO, C. M. M.Purpose of study: To report a case of trismus (lockjaw) that began after completion of radiation therapy for head and neck cancer that we treated with botulinum toxin type A. Methods used: Case report. Summary of results: A white woman, 60 years old, was diagnosed with squamous cell carcinoma (SCC) of the left oral mucosa in April 2010. She underwent resection of the SCC in June 2010 with neck dissection and construction of a left supraclavicular flap. Subsequently, she underwent radiotherapy from 25 October 2010 to 14 December 2010. About 30 days after the radiation therapy, she noticed a decreased range of motion associated with jaw pain, and she experienced difficulty with feeding and oral hygiene. She was referred to speech therapy for rehabilitation but had little improvement. In our first physiatric evaluation on 13 June 2011, we identified a maximal inter-incisal distance of 0.5 cm, pain score assessed by visual analog scale (VAS) of 4, and Short Form 36 (SF-36) score of 676. We requested a facial and temporomandibular joint MRI, which eliminated recurrence of disease, osteonecrosis and muscle fibrosis as possible causes of the trismus. We chose to treat her trismus with botulinum toxin type A (Prosigne®, Lanzhou Biological Products Institute, Lanzhou, China), with 60 U in the masseter and 40 U in the temporalis muscle, with resumption of the speech therapy exercises while we monitored the toxin therapy. Two weeks after injection, the patient showed a maximal inter-incisal distance of 2.0 cm, a 2-point improvement in the VAS, an improved SF-36 score of 742, and she reported relief of pain. She even reported complete resolution of a previous headache, which she had not mentioned in her first evaluation. Conclusions: We suggest the use of botulinum toxin type A as an adjunct treatment to radiation-induced trismus, especially in severe cases that are refractory to conventional treatment. Trials with this treatment are indicated in order to evaluate the role of BTX-A in trismus.
- The challenge of including people with disabilities in the strategy to address the COVID-19 pandemic in Brazil(2020) REICHENBERGER, Veronika; ALBURQUERQUE, Maria do Socorro Veloso de; DAVID, Renata Bernardes; RAMOS, Vinicius Delgado; LYRA, Tereza Maciel; BRITO, Christina May Moran de; KOPTCKE, Luciana Sepulveda; KUPER, Hannah
- Acupuncture for chemotherapy-induced peripheral neuropathy: a randomised controlled pilot study(2022) D'ALESSANDRO, Eduardo Guilherme; NAGY, Daniela Ribeiro Nebuloni; BRITO, Christina May Moran de; ALMEIDA, Elisangela Pinto Marinho; BATTISTELLA, Linamara Rizzo; CECATTO, Rebeca BoltesChemotherapy-induced peripheral neuropathy (CIPN) can cause loss of independence and poor quality of life (QoL) due to severe disabilities, but in spite of its importance there is still a lack of data for the management of CIPN. Acupuncture has showed promising results and may be a cost-effective option for the treatment. Objectives To evaluate the effect of acupuncture treatment on neurological symptoms of CIPN and QoL of oncological patients. Methods We performed a clinical, single-centre, randomised and controlled pilot study that involved 33 adult patients with cancer and CIPN randomised into two groups (control and acupuncture treated with 10 sessions, two times per week). Both groups were subjected to a complete physical examination and clinical assessment with National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Scale V.2.0, FIM Scale, European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core (EORTC QLQ-C30) Scale and Visual Analogue Scale for pain before and 5 weeks after treatment. Results There were no adverse events, and we found statistical differences in groups in physical (p=0.03) and function (p=0.04) domains of EORTC QLQ-C30 when comparing control and acupuncture groups. About NCI CTCAE Scale and neuropathy sensory symptoms, we found better results in acupuncture group, comparing pretreatment and post-treatment analyses (p=0.01). In control group, we have no differences after 5 weeks (p=0.11). Conclusion Although these results suggest an interesting effect of acupuncture on this patient population, the clinical significance has remained unclear. Given the tendency towards benefit and the lack of adverse effects, the authors recommend a follow-up acupuncture trial using higher follow-up time and better sample size.
- The influence of a supervised group exercise intervention combined with active lifestyle recommendations on breast cancer survivors' health, physical functioning, and quality of life indices: study protocol for a randomized and controlled trial(2021) COSTA, Luiz Augusto Riani; BARRETO, Raphael F.; LEANDRINI, Sarah Milani Moraes de; GURGEL, Aline Rachel Bezerra; SALES, Gabriel Toledo de; VOLTARELLI, Vanessa Azevedo; CASTRO JR., Gilberto de; FENTON, Sally A. M.; TURNER, James E.; KLAUSENER, Christian; NEVES, Lucas Melo; UGRINOWITSCH, Carlos; FARAH, Jose Carlos; FORJAZ, Claudia Lucia de Moraes; BRITO, Christina May Moran; BRUM, Patricia ChakurBackground: Most cancer patients, under active treatment or not, are sedentary, despite increasing scientific and clinical understanding of the benefits of exercise and physical activity, such as improving quality of life, limiting disease symptoms, decreasing cancer recurrence, and increasing overall survival. Studies have shown that both supervised exercise and unsupervised physical activity programs have low adherence and limited long-term benefits among cancer survivors. Therefore, interventions focused on increasing physical activity levels have clinical and psychological relevance. The present study will examine the feasibility and efficacy of an intervention that combines supervised group exercise with active lifestyle recommendations, analyzing its clinical, psychological, physiological, functional, and immunological effects in breast cancer survivors. Methods: Women aged 35-75 years who have completed chemotherapy, radiotherapy, and surgery for breast cancer will be recruited from the Cancer Institute of the State of Sao Paulo (ICESP) and take part in a 16-week, parallel-group, randomized, and controlled trial. They will receive a booklet with recommendations for achieving a physically active lifestyle by increasing overall daily movement and undertaking at least 150 min/week of structured exercise. Then, they will be randomized into two groups: the supervised group will take part in two canoeing group exercise sessions every week, and the unsupervised group will increase their overall physical activity level by any means, such as active commuting, daily activities, or home-based exercise. Primary outcome includes aerobic capacity. Secondary outcomes are physical activity, physical functioning, self-reported quality of life, fatigue, presence of lymphedema, body composition, immune function, adherence to physical activity guidelines, and perceptions of self-image. Discussion: Results should contribute to advance knowledge on the impact of a supervised group exercise intervention to improve aspects related to health, physical functioning, and quality of life in female breast cancer survivors.
- Identification of relevant categories for inpatient physical therapy care using the International Classification of Functioning, Disability and Health: a Brazilian survey(2019) PASCHOAL, Luciana Narciso; SOUZA, Patricia Nery De; BUCHALLA, Cassia Maria; BRITO, Christina May Moran De; BATTISTELLA, Linamara RizzoBackground: Hospitalized patients are at risk for the loss of function and impairment. Physical therapists aim to improve functionality and prevent disabilities. The International Classification of Functioning, Disability and Health (ICF) propose a universal language to classify the functionality of patients across different health care settings and over diverse health conditions. Objectives: To identify the International Classification of Functioning, Disability and Health categories that describe most common and relevant patient problems managed by physical therapists in Brazilian hospitals in the acute and post-acute care settings. Subjects: The participants were physical therapists who worked in hospitals with a minimum work experience of two years. Methods: A consensus-building, two-round, emailed survey was conducted using the Delphi technique. Results: For the development of an ICF short list, 47 physical therapists from the acute care setting and 30 physical therapists from the post -acute care setting responded to the Delphi exercise. Most of the professionals were from the cardiorespiratory physical therapy area. A 80% level of consensus or higher was established for the selection of the categories of the ICF components (Body Functions, Body Structures, Activities and Participation, and Environmental Factors). We obtained two short lists to be used in clinical practice comprising 39 ICF categories for acute care settings and 53 for post-acute care settings. Conclusion: This study is the first to identify the most relevant aspects for physical therapy in Brazilian hospitals using the ICF framework. Our results can help to promote the adoption of the ICF in physical therapy clinical practice in the hospital setting.
- Early mobilization programme improves functional capacity after major abdominal cancer surgery: a randomized controlled trial(2017) ALMEIDA, E. P. M. de; ALMEIDA, J. P. de; LANDONI, G.; GALAS, F. R. B. G.; FUKUSHIMA, J. T.; FOMINSKIY, E.; BRITO, C. M. M. de; CAVICHIO, L. B. L.; ALMEIDA, L. A. A. de; RIBEIRO- JR., U.; OSAWA, E. A.; DIZ, M. P. E.; CECATTO, R. B.; BATTISTELLA, L. R.; HAJJAR, L. A.Background: Major abdominal oncology surgery is associated with substantial postoperative loss of functional capacity, and exercise may be an effective intervention to improve outcomes. The aim of this study was to assess efficacy, feasibility and safety of a supervised postoperative exercise programme. Methods: We performed a single-blind, parallel-arm, randomized trial in patients who underwent major abdominal oncology surgery in a tertiary university hospital. Patients were randomized to an early mobilization postoperative programme based on supervised aerobic exercise, resistance and flexibility training or to standard rehabilitation care. The primary outcome was inability to walk without human assistance at postoperative day 5 or hospital discharge. Results: A total of 108 patients were enrolled, 54 into the early mobilization programme group and 54 into the standard rehabilitation care group. The incidence of the primary outcome was nine (16.7%) and 21 (38.9%), respectively (P = 0.01), with an absolute risk reduction of 22.2% [95% confidence interval (CI) 5.9-38.6] and a number needed to treat of 5 (95% CI 3-17). All patients in the intervention group were able to follow at least partially the exercise programme, although the performance among them was rather heterogeneous. There were no differences between groups regarding clinical outcomes or complications related to the exercises. Conclusions: An early postoperative mobilization programme based on supervised exercises seems to be safe and feasible and improves functional capacity in patients undergoing major elective abdominal oncology surgery. However, its impact on clinical outcomes is still unclear.
- Barriers to the access of people with disabilities to health services: a scope review(2022) CLEMENTE, Karina Aparecida Padilha; SILVA, Simone Vieira da; VIEIRA, Gislene Inoue; BORTOLI, Maritsa Carla de; TOMA, Tereza Setsuko; RAMOS, Vinicius Delgado; BRITO, Christina May Moran deOBJECTIVE: To analyze the scientific evidence regarding barriers to the access of people with disabilities to health services. METHODS: A scoping review was carried out from the main question: What are the main barriers that people with disabilities face in accessing health services? The articles were surveyed in July 2019 in six scientific literature databases. Of the 1,155 documents identified in the searches, after selection by title and abstract, 170 publications were read in full and, thus, 96 articles were included and categorized according to the theoretical framework. RESULTS: The main barriers indicated by the users of the service were: communication failure between professionals and patient/caregiver; financial limitations; attitudinal/behavioral issues; scarce service provision; organizational and transport barriers. The main barriers presented by service providers were: lack of training to professionals; failure of the health system; physical barriers; lack of resources/technology; and language barriers. CONCLUSIONS: It was evident that people with disabilities face several barriers when trying to access the health services they need and that users and health professionals have distinct and complementary views on difficulties.
- RE: CANCER REHABILITATION EDUCATION DURING PHYSICAL MEDICINE AND REHABILITATION RESIDENCY(2015) FERRAO, Gustavo Carneiro; CECATTO, Rebeca Boltes; BRITO, Christina May Moran de; BATTISTELLA, Linamara Rizzo
- Evaluation of acupuncture for cancer symptoms in a cancer institute in Brazil(2013) D'ALESSANDRO, Eduardo; BRITO, Christina de; CECATTO, Rebeca; SAUL, Maira; ATTA, Jose Antonio; LIN, Chin AnIntroduction Acupuncture has been progressively included in the practice of mainstream medicine in recent decades. The State of Sao Paulo Cancer Institute is a public hospital established in 2008 and its acupuncture service follows the experience and model of several oncology centres in the USA, aiming to optimise the treatment of symptoms such as postoperative pain, oncological pain, neuropathic pain, nausea, vomiting, xerostomia and fatigue induced by chemotherapy. This paper describes the population given acupuncture treatment and the effects of the intervention on symptom management. Methods One hundred and eighty-three patients from our service were enrolled in the study. Baseline and final symptom intensity was recorded using a visual analogue score (VAS) ranging from 0 to 10 cm, with a higher score meaning higher symptom intensity. Results Fifty-four (29.50%) were receiving active treatment with chemotherapy and/or radiotherapy, 29 (15.85%) were receiving hormone therapy and 100 (54.65%) were considered to be in remission. The main symptoms were: oncological pain in 44 (24.04%), chemotoxicity in 34(18.6%), lumbar pain in 53 (28.96%) and chronic postoperative pain in 54(28.4%). The mean (SD) initial symptom score was 7.04 (1.8), which was reduced to 2.56 (2.75) after treatment (p<0.001), an improvement of 63.6% in control of the symptoms. Further analysis of the data showed that the effect was similar in different indications for acupuncture treatment. Conclusions Use of acupuncture may have improved symptom control in patients enrolled in this study.