REGINA CELIA TUROLA PASSOS JULIANI
Índice h a partir de 2011
3
Projetos de Pesquisa
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Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject QUALITY OF LIFE AND LUNG FUNCTION IN CF PATIENTS USING TOBRAMYCIN INHALATION POWDER (TIP)(2016) CUNHA, Maristela Trevisan; JULIANI, Regina C. T. P.; LEONE, Claudio; RODRIGUES, Joaquim C.; ADDE, Fabiola V.conferenceObject Physiotherapy Assistance for Paediatric Cancer Patients in Terminal Care(2016) LANDY, G. A.; LAURI, A. A.; BMCOSTA, A. P.; SANTOS, N. C. S.; MATTOS, T. S.; FORTE, M. L. B. S.; SOUZA, S. H. O.; ANDRADE, B. A.; JULIANI, R. C. T. P.- Characterization of the motor performance of newborns in a neonatal unit of tertiary level(2016) GIACHETTA, Luciana; NICOLAU, Carla Marques; JULIANI, Regina Celia Turola Passos; CARVALHO, Werther Brunow De; KREBS, Vera Lucia JornadaObjective: To characterize the motor performance of newborns in a neonatal unit of tertiary level and compare the results to the values recommended by the Test of Infant Motor Performance (TIMP). Method: Newborns between 34 and 416/7 weeks of corrected gestational age, breathing spontaneously and presenting state of consciousness 4 or 5, according to Brazelton, were included. TIMP was used to evaluate the motor performance. Results: The age groups of 34-35 and 36-37 weeks showed on average TIMP scores similar to the reference values (p> 0.05), while in the age groups of 38-39 weeks and 40-41 weeks TIMP scores were statistically lower than the reference values (p< 0.001 and p= 0.018, respectively). The 34-35 and 36-37 week groups were rated as average, while the 38-39 and 40-41 week groups were defined as low average. Classifications below average and very below average were not observed. Conclusion: The newborns showed average scores compared to the TIMP reference values; however, there were two groups whose performances were within the low average. There was no significant difference in motor performance of newborns in the age groups of 38-39 and 40-41 weeks. This behavior suggests that the sample studied has special features that possibly negatively influenced their motor performance. The results showed that the TIMP is a very useful tool and can be used safely in tertiary neonatal units.
- Repercussões da hiperinsuflação manual em recém-nascidos pré-termo sob ventilação mecânica(2016) VIANA, Camila Chaves; NICOLAU, Carla Marques; JULIANI, Regina Celia Turola Passos; CARVALHO, Werther Brunow de; KREBS, Vera Lucia JornadaABSTRACT Objective: To assess the effects of manual hyperinflation, performed with a manual resuscitator with and without the positive end-expiratory pressure valve, on the respiratory function of preterm newborns under mechanical ventilation. Methods: Cross-sectional study of hemodynamically stable preterm newborns with gestational age of less than 32 weeks, under mechanical ventilation and dependent on it at 28 days of life. Manual hyperinflation was applied randomly, alternating the use or not of the positive end-expiratory pressure valve, followed by tracheal aspiration for ending the maneuver. For nominal data, the two-tailed Wilcoxon test was applied at the 5% significance level and 80% power. Results: Twenty-eight preterm newborns, with an average birth weight of 1,005.71 ± 372.16g, an average gestational age of 28.90 ± 1.79 weeks, an average corrected age of 33.26 ± 1.78 weeks, and an average mechanical ventilation time of 29.5 (15 - 53) days, were studied. Increases in inspiratory and expiratory volumes occurred between time-points A5 (before the maneuver) and C1 (immediately after tracheal aspiration) in both the maneuver with the valve (p = 0.001 and p = 0.009) and without the valve (p = 0.026 and p = 0.001), respectively. There was also an increase in expiratory resistance between time-points A5 and C1 (p = 0.044). Conclusion: Lung volumes increased when performing the maneuver with and without the valve, with a significant difference in the first minute after aspiration. There was a significant difference in expiratory resistance between the time-points A5 (before the maneuver) and C1 (immediately after tracheal aspiration) in the first minute after aspiration within each maneuver.
- Therapeutic Education Program for Children and Adolescents with chronic diseases - Letter to the Editor(2020) OLIVEIRA, Liz Avlasevicius; CARNEIRO-SAMPAIO, Magda Maria Sales; MATUHARA, Angela Midori; COMINATO, Louise; JULIANI, Regina Celia Turola Passos; WAETGE, Aurora Rosaria Pagliara
- Effect that an educational program for cystic fibrosis patients and caregivers has on the contamination of home nebulizers(2014) ZUANA, Adriana Della; GARCIA, Doroti de Oliveira; JULIANI, Regina Celia Turola Passos; SILVA FILHO, Luiz Vicente Ribeiro Ferreira daObjective: To describe the pathogens found in home nebulizers and in respiratory samples of cystic fibrosis (CF) patients, and to evaluate the effect that a standardized instruction regarding cleaning and disinfection of nebulizers has on the frequency of nebulizer contamination. Methods: We included 40 CF patients (22 males), all of whom used the same model of nebulizer. The median patient age was 11.2 +/- 3.74 years. We collected samples from the nebulizer mouthpiece and cup, using a sterile swab moistened with sterile saline. Respiratory samples were collected by asking patients to expectorate into a sterile container or with oropharyngeal swabs after cough stimulation. Cultures were performed on selective media, and bacteria were identified by classical biochemical tests. Patients received oral and written instructions regarding the cleaning and disinfection of nebulizers. All determinations were repeated an average of two months later. Results: Contamination of the nebulizer (any part) was detected in 23 cases (57.5%). The nebulizer mouthpiece and cup were found to be contaminated in 16 (40.0%) and 19 (47.5%), respectively. After the standardized instruction had been given, there was a significant decrease in the proportion of contaminated nebulizers (43.5%). Conclusions: In our sample of CF patients, nebulizer contamination was common, indicating the need for improvement in patient practices regarding the cleaning and disinfection of their nebulizers. A one-time educational intervention could have a significant positive impact.
- Six-minute walk test in children and adolescents with renal diseases: tolerance, reproducibility and comparison with healthy subjects(2016) WATANABE, Flavia Tieme; KOCH, Vera Herminia Kalika; JULIANI, Regina Celia Turola Passos; CUNHA, Maristela TrevisanOBJECTIVES: To evaluate exercise tolerance and the reproducibility of the six-minute walk test in Brazilian children and adolescents with chronic kidney disease and to compare their functional exercise capacities with reference values for healthy children. METHODS: This cross-sectional study assessed the use of the six-minute walk test in children and adolescents aged 6-16 with stage V chronic kidney disease. For statistical analysis of exercise tolerance, including examinations of correlations and comparisons with reference values, the longest walked distances were considered. The reproducibility of the six-minute walk test was assessed using intraclass correlation coefficients. RESULTS: A total of 38 patients (14 females and 24 males) were evaluated, including 5 on peritoneal dialysis, 12 on hemodialysis and 21 who had undergone renal transplantation, with a median age of 11.2 years (6.5-16). The median walked distance was 538.5 meters (413-685) and the six-minute walk test was found to be reproducible. The walked distance was significantly correlated with age (r=0.66), weight (r=0.76), height (r=0.82), the height Z score (r=0.41), hemoglobin (r=0.46), hematocrit (r=0.47) and post-test systolic blood pressure (r=0.39). The chronic kidney disease patients predicted walked distance was 84.1% of the reference value according to age, 90.6% according to age-corrected height and 87.4% according to a predictive equation. CONCLUSIONS: The stage V chronic kidney disease patients had a significantly decreased functional exercise capacity, as measured by the six-minute walk test, compared with the healthy pediatric reference values. In addition, the six-minute walk test was shown to be well tolerated, reliable and applicable as a low-cost tool to monitor functional exercise capacity in patients with renal disease.
bookPart Histórico da fisioterapia em pediatria(2016) GUIMARãES, Maria Lucila de Lima Gonçalves; JULIANI, Regina Célia Turola PassosconferenceObject Six- minute walk test (6MWT) in children and teenages with chronic kidney disease: tolerance, reproducibility and comparison with normal reference values(2013) KOCH, Vera; WATANABE, Flavia T.; CUNHA, Maristela; FERRARO, Alexandre; JULIANI, ReginaObjective: To evaluate exercise tolerance using the six-minute walk test (6MWT) in children and adolescents with stage 5 chronic kidney disease (CKD, to assess the reproducibility of the 6MWT and compare the performance of these children with reference values. Methods: Children and adolescents aged 6 to 16 years with stage 5 CKD were evaluated prospectively using 6MWT, according to the American Thoracic Society methodology. Measurement of Heart rate (HR), respiratory rate (RR), pulse oxygen saturation (SpO2), blood pressure (BP) and dyspnea scale (Borg) at rest (pre) and posttest (post) was performed. The test with the larger walked distance was considered for analysis. Reproducibility was evaluated by t-test and the Bland-Altman methods. Brazilian population reference values were used for comparison with normal children. Results: We studied 38 children and adolescents (14F:24M), 4 on peritoneal dialysis, 12 hemodialysis and 22 post renal transplantation with a mean age of 11.3 ± 2.9 years, mean weight of 32.3 ± 11.7 kg, mean height of 131 ± 17cm and mean BMI of 18.3 ± 3.1 kg/m2. There were no adverse events observed during or after the tests. The 6MWT was found to be reproducible, second walk walked distances were greater than first walk ones (p <0.001). Children with CKD performed significantly poorer (548.9 ± 71.4 m) than reference values of children with similar height (576.46 ±39.76 m) (p <0.001). HR, SpO2, systolic BP (pre), diastolic BP were significantly higherin children with CKD. Conclusion: The 6MWT proved to be safe, reproducible and well tolerated. A learning effect was observed between the first and second test. CKD patients performed significantly poorer than reference values.- Atelectasia pós-extubação em recém-nascidos com doenças cirúrgicas: relato de dois casos de uso de cateter nasal de alto fluxo(2014) PAULA, Lúcia Cândida Soares de; SIQUEIRA, Fernanda Corsante; JULIANI, Regina Célia Turola Passos; CARVALHO, Werther Brunow de; CECCON, Maria Esther Jurfest Rivero; TANNURI, UenisA formação de atelectasias é um dos distúrbios pulmonares responsável pelo maior tempo de internação dos recém-nascidos nas unidades de terapias intensivas e pelo consequente aumento da morbidade. O cateter nasal de alto fluxo tem sido utilizado na faixa etária neonatal, para evitar e/ou expandir áreas pulmonares atelectasiadas, mesmo que até o momento não existam estudos baseados em evidência. Relatamos os casos de dois pacientes do sexo masculino internados por doença neurocirúrgica e abdominal submetidos à ventilação pulmonar mecânica invasiva por 4 e 36 dias, respectivamente. Após a extubação, foram mantidos em oxigenioterapia, quando, então, ambos apresentaram piora clínica e radiológica compatível com atelectasia. Após 24 horas de instalado o cateter nasal de alto fluxo como suporte não invasivo, novos exames radiológicos mostraram a reversão completa da atelectasia. O uso do cateter de alto fluxo mostrou-se eficaz na reversão de atelectasias, podendo ser utilizada como mais uma das terapias ventilatórias não invasivas, evitando, assim, nova intubação.