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The effect of lengthening aspiration on speech segmentation ...
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Variation in Spanish /s/: Overview and New Perspectives
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In: Languages; Volume 7; Issue 2; Pages: 77 (2022)
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Competition between whole-word and decomposed representations of English prefixed words
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In: ISSN: 1871-5621 ; EISSN: 1871-5656 ; Morphology ; https://hal.archives-ouvertes.fr/hal-03015833 ; Morphology, Springer Verlag, 2021, Phonological and phonetic variation in spoken morphology, 31 (2), pp.201-237. ⟨10.1007/s11525-020-09354-6⟩ (2021)
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Regional perceptions of the 'ejque'
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In: Borealis: An International Journal of Hispanic Linguistics, Vol 10, Iss 1 (2021) (2021)
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Phonetic & Phonological Salience Effects in Different Speech Processing Tasks
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In: Proceedings of the Annual Meetings on Phonology; Proceedings of the 2020 Annual Meeting on Phonology ; 2377-3324 (2021)
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In-vivo tongue stiffness measured by aspiration: Resting vs general anesthesia
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In: ISSN: 0021-9290 ; Journal of Biomechanics ; https://hal.archives-ouvertes.fr/hal-03039265 ; Journal of Biomechanics, Elsevier, 2020, 114, pp.110147. ⟨10.1016/j.jbiomech.2020.110147⟩ (2020)
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Temporal Characteristics of Oropharyngeal Swallowing in Toddlers with Dysphagia
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In: http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1584994990563623 (2020)
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The *Long-C Constraint and Word-Initial Aspirates in Hateruma Yaeyama, a Southern Ryukyuan Language
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Attention To People Like You: A Proposal Regarding Neuroendocrine Effects on Linguistic Variation
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In: BIOLINGUISTICS; Vol. 14 (2020); 1-20 ; 1450-3417 (2020)
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Attention To People Like You
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In: Biolinguistics, Vol 14 (2020) (2020)
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Clinical swallowing assessment in the diagnosis of silent aspiration
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In: Revista CEFAC, Vol 22, Iss 6 (2020) (2020)
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Factors associated with aspiration pneumonia and preventive measures in hospitalized elderly: a systematic review of observational studies
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In: Revista CEFAC, Vol 22, Iss 6 (2020) (2020)
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The post-schooling transitions of remote Indigenous secondary school graduates
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In: Rutherford, KS, Mccalman, JR, Bainbridge, RG, (2019). The post-schooling transitions of remote Indigenous secondary school graduates. Australian and International Journal of Rural Educaton, Vol. 29, No. 2, p. 8-25 (2019)
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Varied starting points and pathways : a duoethnographic exploration of 'diverse' students' uneven capacities to aspire to doctoral education
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Varied starting points and pathways : a duoethnographic exploration of 'diverse' students' uneven capacities to aspire to doctoral education
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Varied starting points and pathways : a duoethnographic exploration of 'diverse' students' uneven capacities to aspire to doctoral education
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A comparative study of the factors shaping postsecondary aspirations for low-income students in greater Boston and greater London
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Social democracy and education: the formation of party policy on the question of comprehensive schooling in England and Austria
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Preditores clínicos do risco de broncoaspiração em crianças com cardiopatias congênitas ; Clinical predictors of the risk of bronchoaspiration in children with congenital heart disease
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Fernandes, Heloisa Regina. - : Biblioteca Digital de Teses e Dissertações da USP, 2019. : Universidade de São Paulo, 2019. : Faculdade de Medicina, 2019
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Abstract:
INTRODUÇÃO: A deglutição é um processo complexo que se inicia ainda no período intra-uterino e deve ser funcional em neonatos saudáveis nascidos a termo. A etiologia da disfagia orofaríngea em crianças é multifatorial. A presença de cardiopatia congênita, bem como fatores relacionados à sua evolução e tratamento está entre os fatores de risco para ocorrência de disfagia orofaríngea na infância. A incidência de cardiopatia congênita é de seis a dez a cada 1000 nascidos vivos e estima-se que 25% dos acometidos necessitam de cirurgia no primeiro ano de vida. Os recentes avanços na medicina aumentaram a expectativa de vida nesta população, contudo observam-se necessidades especiais nos sobreviventes, entre elas, relacionadas à alimentação. Estima-se que 22% a 50% dos cardiopatas congênitos submetidos à cirurgia cardíaca apresentem distúrbios na alimentação. OBJETIVO: identificar os preditores clínicos do risco para broncoaspiração em crianças com cardiopatia congênita no pós-operatório de cirurgia cardíaca. MÉTODOS: foi realizado um estudo retrospectivo observacional, por meio da análise de dados de crianças entre 1 a 12 meses de idade, submetidas a procedimentos cirúrgicos cardíacos, encaminhadas para avaliação fonoaudiológica e avaliadas com oferta de líquido fino em mamadeira. A coleta de dados envolveu: dados demográficos e clínicos, avaliação específica da deglutição (Protocolo de Avaliação da Disfagia Pediátrica) e classificação do risco de mortalidade cirúrgica (Escala de Risco Ajustado para Cirurgia em Cardiopatias Congênitas RACHS-1). RESULTADOS: a amostra final consistiu de 108 sujeitos. Para análise estatística os sujeitos foram agrupados de acordo com a gravidade da disfagia: 27 no grupo com disfagia orofaríngea leve (DOL) e 81 no grupo com disfagia moderada a grave ou grave (DOMG/G). Foi observado que os sinais mais graves de disfagia estão associados a um aumento do tempo de internação hospitalar (p = 0,005); aumento do número e tempo de intubação orotraqueal (p = 0,022 e 0,005, respectivamente); um aumento do tempo entre a admissão hospitalar e a avaliação fonoaudiológica (p = 0,003); um aumento do tempo entre o procedimento cirúrgico e a avaliação de deglutição (0,043); e um maior número de sessões fonoaudiológicas para retirada da via alternativa de alimentação e garantir uma alimentação oral segura (p < 0,001). Além disso, pacientes com DOMG/G estão mais propensos a receber alta hospitalar sem resolução do quadro de disfagia. Não foram observadas correlações entre o risco de mortalidade cirúrgica e os sinais alterados na avaliação de deglutição. CONCLUSÕES: Em um serviço com alta demanda de pacientes para assistência fonoaudiológica, pacientes no pósoperatório de cirurgia cardíaca com tempo prolongado de internação, histórico de intubação orotraqueal prolongada ou maior número de intubações, e uso prolongado de via alternativa de alimentação deveriam ser priorizados ; INTRODUCTION: Swallowing is a complex process that begins in the uterine period and should be functional in healthy newborns at term. The etiology of oropharyngeal dysphagia in children is multifactorial. The presence of congenital heart disease, as well as factors related to its evolution and treatment are among the risk factors for the occurrence of oropharyngeal dysphagia in childhood. The incidence of congenital heart disease is six to ten per 1000 live births and it is estimated that 25% of those affected need surgery in the first year of life. Recent advances in medicine have increased life expectancy in this population, however special needs are observed in survivors, including those related to food. It is estimated that 22% to 50% of congenital heart patients undergoing cardiac surgery present feeding disorders. PURPOSE: to identify clinical predictors of risk for bronchoaspiration in children with congenital heart disease in the postoperative period of cardiac surgery. METHODS: a retrospective observational study was performed, through data analysis of children between 1 and 12 months of age, who underwent cardiac surgical procedures, referred for speech-language evaluation and evaluated with a thin liquid bottle. Data collection included: demographic and clinical data, specific swallowing evaluation (Pediatric Dysphagia Evaluation Protocol) and surgical mortality risk score (Risk Adjustment for Congenital Heart Surgery 1). RESULTS: the final study sample consisted of 108 patients. For statistical purposes, patients were grouped according to dysphagia severity: 27 patients with mild dysphagia (MD) and 81 patients with moderate-severe and severe dysphagia (MS/SD). Important findings were: the more severe signs of dysphagia are associated to an increased length of hospital stay (p = 0.005); an increased number and duration of orotracheal intubation (p = 0.022 and p = 0.005 respectively); an increased time between hospital admission and swallowing assessment (p = 0.003); an increased time between the surgical procedure and swallowing assessment (p = 0.043); an increased time between the swallowing assessment and the clinical outcome (p = 0.028); an increased number of speech-language pathologist sessions until the clinical outcome (p = 0.001); and an increased number of speech-language pathologist sessions to remove alternate feeding methods and warrant safe oral feeding (p < 0.001). Moreover, patients with MS/SD are more likely to be discharged from hospital without resolving dysphagia. No correlations were observed between the infant's risk of mortality and the altered sings on the clinical swallowing assessment. Conclusion: In a hospital with a high demand for patients for speech therapy, patients in the postoperative period of cardiac surgery with prolonged hospitalization, history of prolonged orotracheal intubation or greater number of intubations, and prolonged use of alternate feeding methods should be prioritized
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Keyword:
Cardiopatias congênitas; Cirurgia torácica; Deglutição; Deglutition; Deglutition disorders; Fonoaudiologia; Heart defects congenital; Pediatria; Pediatrics; Pneumonia aspiration; Pneumonia aspirativa; Speech language and hearing sciences; Thoracic surgery; Transtornos de deglutição
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URL: http://www.teses.usp.br/teses/disponiveis/5/5170/tde-08052019-092444/
https://doi.org/10.11606/D.5.2019.tde-08052019-092444
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