Resposta terapêutica a inibidor de bomba de prótons em pacientes com disfonia e doença do refluxo faringolaríngeo
| Ano de defesa: | 2020 |
|---|---|
| Autor(a) principal: | |
| Orientador(a): | |
| Banca de defesa: | |
| Tipo de documento: | Dissertação |
| Tipo de acesso: | Acesso aberto |
| Idioma: | por |
| Instituição de defesa: |
Não Informado pela instituição
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| Programa de Pós-Graduação: |
Não Informado pela instituição
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| Departamento: |
Não Informado pela instituição
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| País: |
Não Informado pela instituição
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| Palavras-chave em Português: | |
| Link de acesso: | http://www.repositorio.ufc.br/handle/riufc/53909 |
Resumo: | The laryngopharyngeal reflux disease (LPRD) is defined as aerodigestive signs and symptoms secondary to laryngeal and pharyngeal mucosa damage, due to gastrointestinal content reflux. LPRD is a new entity and was originally described as an extraesophageal manifestation of gastroesophageal reflux disease (GERD). LPRD is a rather prevalent condition, and dysphonia is an important symptom. This study aimed to evaluate the therapeutic response to a proton pump inhibitor (PPI) treatment, in dysphonic patients with LPRD, applying standardized scores. It was also evaluated if higher levels of the basal scores could predict a better response to the PPI treatment. A group of 21 patients with chronic dysphonia, over three weeks, were analyzed by Reflux disease questionnaire (RDQ), Reflux symptom index (RSI) and Reflux finding score (RFS). Patients were treated with pantoprazole 40mg, twice a day, for eight weeks, and it was considered as response a reduction of at least 50% of the scores, when compared to the basal results. After the course of treatment, there was a significant reduction of all the scores, however the clinical responses were higher than the laryngoscopic response. Higher scores in the RFS items erythema/hyperemia and diffuse laryngeal edema, before treatment, were present is the patients with better laryngoscopic response to the PPI. On the other hand, higher scores in the RFS item erythema/hyperemia, before treatment, were present in the patients with better complete response (clinical and laryngoscopic) to the PPI treatment. None of the scores before treatment was associated with better clinical response to the PPI. As conclusion, this study shows that there is a therapeutic response to PPI in dysphonic patients with LPRD, with the clinical response higher than the laryngoscopic one, after eight weeks. Higher scores of erythema/hyperemia before treatment were present in patients with a better complete response to the PPI. Further placebo-controlled studies, with a longer period of treatment, are necessary to confirm these results. |
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Pompeu, Clara Mota RandalBorsaro, Aline Almeida FigueiredoSouza, Marcellus Henrique Loiola Ponte de2020-09-10T11:43:08Z2020-09-10T11:43:08Z2020POMPEU, C. M. R. Resposta terapêutica a inibidor de bomba de prótons em pacientes com disfonia e doença do refluxo faringolaríngeo. 2020. 67 f. Dissertação (Mestrado em Ciências Médico-Cirúrgicas) – Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2020.http://www.repositorio.ufc.br/handle/riufc/53909The laryngopharyngeal reflux disease (LPRD) is defined as aerodigestive signs and symptoms secondary to laryngeal and pharyngeal mucosa damage, due to gastrointestinal content reflux. LPRD is a new entity and was originally described as an extraesophageal manifestation of gastroesophageal reflux disease (GERD). LPRD is a rather prevalent condition, and dysphonia is an important symptom. This study aimed to evaluate the therapeutic response to a proton pump inhibitor (PPI) treatment, in dysphonic patients with LPRD, applying standardized scores. It was also evaluated if higher levels of the basal scores could predict a better response to the PPI treatment. A group of 21 patients with chronic dysphonia, over three weeks, were analyzed by Reflux disease questionnaire (RDQ), Reflux symptom index (RSI) and Reflux finding score (RFS). Patients were treated with pantoprazole 40mg, twice a day, for eight weeks, and it was considered as response a reduction of at least 50% of the scores, when compared to the basal results. After the course of treatment, there was a significant reduction of all the scores, however the clinical responses were higher than the laryngoscopic response. Higher scores in the RFS items erythema/hyperemia and diffuse laryngeal edema, before treatment, were present is the patients with better laryngoscopic response to the PPI. On the other hand, higher scores in the RFS item erythema/hyperemia, before treatment, were present in the patients with better complete response (clinical and laryngoscopic) to the PPI treatment. None of the scores before treatment was associated with better clinical response to the PPI. As conclusion, this study shows that there is a therapeutic response to PPI in dysphonic patients with LPRD, with the clinical response higher than the laryngoscopic one, after eight weeks. Higher scores of erythema/hyperemia before treatment were present in patients with a better complete response to the PPI. Further placebo-controlled studies, with a longer period of treatment, are necessary to confirm these results.A doença do refluxo faringolaríngeo (DRFL) é definida como sinais e sintomas do trato aerodigestivo, decorrentes do dano à mucosa faríngea e laríngea, por refluxo de conteúdo gastrointestinal. DRFL é um diagnóstico novo e foi inicialmente descrita como uma manifestação extraesofágica da doença do refluxo gastroesofágico (DRGE). DRFL é condição bastante prevalente, sendo a disfonia um sintoma de destaque. O objetivo deste trabalho foi avaliar a resposta terapêutica a um inibidor de bomba de prótons (IBP), em pacientes disfônicos com DRFL, através da utilização de escores padronizados. Ademais, foi avaliado se níveis mais elevados dos escores basais poderiam prever uma melhor resposta ao IBP. Foram analisados 21 pacientes com disfonia crônica, superior a três semanas, com aplicação do Questionário padronizado de DRGE (RDQ), do Índice de sintomas de refluxo (ISR) e da Escala de achados endolaríngeos de refluxo (EAER). Os pacientes foram tratados com pantoprazol 40mg, duas vezes ao dia, por oito semanas, sendo considerada resposta a redução dos escores em pelo menos 50% em relação ao basal. Ao final do tratamento, houve queda significativa dos escores em todos os questionários, entretanto as respostas clínicas foram maiores do que a resposta laringoscópica. Pontuações mais elevadas nos itens eritema/hiperemia e edema laríngeo difuso da EAER, antes do tratamento, estiveram presentes nos pacientes com melhor resposta laringoscópica ao IBP. Por outro lado, apenas pontuações mais elevadas do item eritema/hiperemia, antes do tratamento, foram capazes de predizer melhor resposta total (clínica e laringoscópica) dos pacientes ao IBP. Não houve nenhum escore antes do tratamento que se associou com uma melhor resposta clínica ao IBP. Como conclusão, o trabalho mostra que há uma resposta terapêutica ao IBP em pacientes disfônicos com DRFL, sendo a resposta clínica maior que a laringoscópica, após oito semanas. Pontuações mais elevadas de eritema/hiperemia antes do tratamento estiveram presentes nos pacientes com melhor resposta total ao IBP. Novos estudos placebo controlados, com maior tempo de tratamento, são necessários para confirmar estes resultados.Conteúdo GastrointestinalDisfoniaMucosa LaríngeaResposta terapêutica a inibidor de bomba de prótons em pacientes com disfonia e doença do refluxo faringolaríngeoinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisporreponame:Repositório Institucional da Universidade Federal do Ceará (UFC)instname:Universidade Federal do Ceará (UFC)instacron:UFCinfo:eu-repo/semantics/openAccessORIGINAL2020_dis_cmrpompeu.pdf2020_dis_cmrpompeu.pdfapplication/pdf1278802http://repositorio.ufc.br/bitstream/riufc/53909/1/2020_dis_cmrpompeu.pdfc70a220e0961e8e3873e55cbad23a2d5MD51LICENSElicense.txtlicense.txttext/plain; charset=utf-81748http://repositorio.ufc.br/bitstream/riufc/53909/2/license.txt8a4605be74aa9ea9d79846c1fba20a33MD52riufc/539092020-09-10 08:43:09.074oai:repositorio.ufc.br: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Repositório InstitucionalPUBhttp://www.repositorio.ufc.br/ri-oai/requestbu@ufc.br || repositorio@ufc.bropendoar:2020-09-10T11:43:09Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC)false |
| dc.title.pt_BR.fl_str_mv |
Resposta terapêutica a inibidor de bomba de prótons em pacientes com disfonia e doença do refluxo faringolaríngeo |
| title |
Resposta terapêutica a inibidor de bomba de prótons em pacientes com disfonia e doença do refluxo faringolaríngeo |
| spellingShingle |
Resposta terapêutica a inibidor de bomba de prótons em pacientes com disfonia e doença do refluxo faringolaríngeo Pompeu, Clara Mota Randal Conteúdo Gastrointestinal Disfonia Mucosa Laríngea |
| title_short |
Resposta terapêutica a inibidor de bomba de prótons em pacientes com disfonia e doença do refluxo faringolaríngeo |
| title_full |
Resposta terapêutica a inibidor de bomba de prótons em pacientes com disfonia e doença do refluxo faringolaríngeo |
| title_fullStr |
Resposta terapêutica a inibidor de bomba de prótons em pacientes com disfonia e doença do refluxo faringolaríngeo |
| title_full_unstemmed |
Resposta terapêutica a inibidor de bomba de prótons em pacientes com disfonia e doença do refluxo faringolaríngeo |
| title_sort |
Resposta terapêutica a inibidor de bomba de prótons em pacientes com disfonia e doença do refluxo faringolaríngeo |
| author |
Pompeu, Clara Mota Randal |
| author_facet |
Pompeu, Clara Mota Randal |
| author_role |
author |
| dc.contributor.co-advisor.none.fl_str_mv |
Borsaro, Aline Almeida Figueiredo |
| dc.contributor.author.fl_str_mv |
Pompeu, Clara Mota Randal |
| dc.contributor.advisor1.fl_str_mv |
Souza, Marcellus Henrique Loiola Ponte de |
| contributor_str_mv |
Souza, Marcellus Henrique Loiola Ponte de |
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Conteúdo Gastrointestinal Disfonia Mucosa Laríngea |
| topic |
Conteúdo Gastrointestinal Disfonia Mucosa Laríngea |
| description |
The laryngopharyngeal reflux disease (LPRD) is defined as aerodigestive signs and symptoms secondary to laryngeal and pharyngeal mucosa damage, due to gastrointestinal content reflux. LPRD is a new entity and was originally described as an extraesophageal manifestation of gastroesophageal reflux disease (GERD). LPRD is a rather prevalent condition, and dysphonia is an important symptom. This study aimed to evaluate the therapeutic response to a proton pump inhibitor (PPI) treatment, in dysphonic patients with LPRD, applying standardized scores. It was also evaluated if higher levels of the basal scores could predict a better response to the PPI treatment. A group of 21 patients with chronic dysphonia, over three weeks, were analyzed by Reflux disease questionnaire (RDQ), Reflux symptom index (RSI) and Reflux finding score (RFS). Patients were treated with pantoprazole 40mg, twice a day, for eight weeks, and it was considered as response a reduction of at least 50% of the scores, when compared to the basal results. After the course of treatment, there was a significant reduction of all the scores, however the clinical responses were higher than the laryngoscopic response. Higher scores in the RFS items erythema/hyperemia and diffuse laryngeal edema, before treatment, were present is the patients with better laryngoscopic response to the PPI. On the other hand, higher scores in the RFS item erythema/hyperemia, before treatment, were present in the patients with better complete response (clinical and laryngoscopic) to the PPI treatment. None of the scores before treatment was associated with better clinical response to the PPI. As conclusion, this study shows that there is a therapeutic response to PPI in dysphonic patients with LPRD, with the clinical response higher than the laryngoscopic one, after eight weeks. Higher scores of erythema/hyperemia before treatment were present in patients with a better complete response to the PPI. Further placebo-controlled studies, with a longer period of treatment, are necessary to confirm these results. |
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2020 |
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2020-09-10T11:43:08Z |
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2020-09-10T11:43:08Z |
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2020 |
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info:eu-repo/semantics/masterThesis |
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POMPEU, C. M. R. Resposta terapêutica a inibidor de bomba de prótons em pacientes com disfonia e doença do refluxo faringolaríngeo. 2020. 67 f. Dissertação (Mestrado em Ciências Médico-Cirúrgicas) – Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2020. |
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http://www.repositorio.ufc.br/handle/riufc/53909 |
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POMPEU, C. M. R. Resposta terapêutica a inibidor de bomba de prótons em pacientes com disfonia e doença do refluxo faringolaríngeo. 2020. 67 f. Dissertação (Mestrado em Ciências Médico-Cirúrgicas) – Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2020. |
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