Abstract: Deleterious oral habits (DOH) have been described as a common finding in pediatric series. Studies have investigated their association with local and systemic health problems. In this study, the association between DOH and asthma was investigated. PubMed, Scopus, Lilacs, Web of Science, Google Scholar, and OpenThesis were accessed to identify observational studies that evaluated the association between DOH (thumb sucking, pacifier use, onychophagia or nail biting, bottle feeding) and asthma in children aged 2–17 years. Information on DOH was obtained from the verbal report of the children’s parents. Asthma diagnosis was performed by a physician or using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. We used a random-effects model to pool the results. The odds ratio (OR) was used as measure of association between DOH and asthma. The National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to assess risk of bias. The GRADE approach was used to assess the quality of evidence. Five studies were included and data from 18,733 children aged 2 to 13 years were analyzed. We found an association between bottle feeding and asthma (OR = 1.25; 95%CI 1.13–1.38; p < 0.001) with moderate level of certainty. Despite the association between pacifier use and asthma (OR = 1.11; 95%CI 1.00–1.24; p = 0.05), the quality of evidence was low. Only one study provided data on nail biting and thumb-sucking, and the individual results showed no association between these habits and asthma. This meta-analysis found an association between bottle feeding, pacifier use, and asthma in children.

SUMMARY We performed an integrative review on the scientific literature about the use of telehealth in audiology care. Through high criteria search of published studies on the “Biblioteca Virtual em Saúde” – Virtual Health Library, PubMed, and Scientific Electronic Library Online databases, nine articles were selected. It was possible to verify that the use of telehealth in audiology is feasible and efficient, because it could promote audiological care for patients from away places. This process reaches more patients and communities by breaking down geographic barriers, and it offers a specific service not available with less cost and more quickly when compared with traditional speech therapy care.

RESUMO A doença de coronavírus (COVID-19) é causada pela síndrome respiratória aguda grave coronavírus 2 (SARS-CoV-2). O vírus é transmitido, principalmente, por gotículas, espirros e aerossóis e pode ser transmitido mesmo entre pacientes assintomáticos, havendo risco de contágio durante os procedimentos do audiologista, que utiliza e reutiliza equipamentos clínicos em uma ampla variedade de pacientes. Este artigo teve como objetivo descrever as etapas que podem ser adotadas pelos audiologistas para diminuir o risco de contaminação cruzada na prática clínica, durante a pandemia de SARS-CoV-2. Recomenda-se, portanto, a esses profissionais, o uso de equipamentos de proteção individual, incluindo respiradores N95, luvas de procedimento, protetores para calçados descartáveis, protetores faciais ou óculos de segurança, gorros e aventais descartáveis, além de seguir, rigorosamente, os protocolos de biossegurança durante os cuidados audiológicos.

ABSTRACT Coronavirus disease (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV2). This virus is transmitted mainly by droplets, sneezes and aerosols and can be transmitted even among asymptomatic patients, so there is a risk of transmission during the audiologist's procedures which, in addition, use and reuse clinical equipment in a wide variety of patients. This article aims to describe the steps that can be taken by the audiologist in order to decrease the risk of cross-contamination in clinical practice during the SARS-CoV-2 pandemic in Brazil. During the COVID-19 pandemic, audiologists are recommended to use personal protective equipment including N95 respirators, clinical gloves, disposable shoe covers, face shields or safety glasses, hair covers and disposable aprons, in addition to strictly following biosafety protocols during audiological care.

ABSTRACT Purpose to evaluate the efficacy of orofacial myofunctional therapy in improving orofacial function and nasal breathing in patients with asthma and rhinitis and, consequently, achieve clinical control of these conditions. Research strategies We used the elements of the PICOT method (study population, intervention, comparison, outcomes and type of studies) to define the eligibility criteria: (1) Population: patients with asthma and rhinitis; (2) Intervention: orofacial myofunctional therapy to improve chewing, swallowing, and breathing; (3) Comparison: control group without orofacial myofunctional therapy; (4) Predefined outcomes: clinical control of asthma and improvement of orofacial functions and nasal breathing; (5) Study type: clinical trials. The data were collected from PubMed, SCOPUS, Web of Science, Science Direct, LILACS, Google Scholar, Cochrane Central Register of Controlled Trials (CENTRAL), OATD, and Open Thesis, in November 2018. Selection criteria Randomized controlled trials published in full-text versions without language restriction, no filter was used. Data analysis Demographic characteristics of study participants, specific diagnosis of asthma and control medication, type, duration, intensity and follow-up of orofacial myofunctional therapy, and outcome data. The risk of bias was assessed according to the Cochrane guidelines for clinical trials. Results One study met the eligibility criteria: although the study has shown an improvement of functional control and clinical scores of asthma, the evidence is very low. Conclusion There is no scientific evidence on the efficacy of orofacial myofunctional therapy in improving clinical control, orofacial function, and nasal breathing in patients with asthma and rhinitis.

RESUMO Objetivo avaliar a eficácia da terapia miofuncional orofacial na melhora das funções orofaciais, na respiração nasal em pacientes com asma e rinite e, consequentemente, alcançar o controle clínico das doenças. Estratégia de pesquisa Utilizamos a estratégia PICOT (população, intervenção, comparação, resultado e tipo de estudo) para definir os critérios de elegibilidade: (1) População: pacientes com asma e rinite; (2) Intervenção: terapia miofuncional orofacial, para melhora da mastigação, deglutição e respiração; (3) Comparação: grupo controle sem terapia miofuncional orofacial; (4) Desfechos pré-definidos: controle clínico da asma e melhora das funções orofaciais e respiração nasal; (5) Tipo de estudo: ensaios clínicos. Os dados foram coletados no PubMed, SCOPUS, Web of Science, Science Direct, LILACS, Google Scholar, Cochrane Central Register de Ensaios Controlados (CENTRAL), OATD, Open thesis, Novembro de 2018. Critérios de seleção Ensaios controlados randomizados publicados em versões de texto completo, sem restrição de idioma, nenhum filtro foi utilizado. Análise dos dados Foram avaliadas as características demográficas dos participantes do estudo, diagnóstico específico de asma e medicação de controle, tipo, duração, intensidade, acompanhamento da terapia miofuncional orofacial e dados do desfecho. O risco de viés foi avaliado de acordo com as diretrizes da Cochrane para ensaios clínicos. Resultados Um estudo atendeu aos critérios de elegibilidade. Embora o estudo tenha mostrado melhora do controle funcional e escores clínicos da asma, as evidências são baixas. Conclusão Não há evidências científicas sobre a eficácia da terapia miofuncional orofacial na melhora do controle clínico, funções orofaciais e respiração nasal em pacientes com asma e rinite.

OBJECTIVE: This study aimed to explore the association between asthma and atopy in a cohort of children living in a large urban center in Brazil. Atopy was defined by the presence of allergen-specific IgE in serum or by a positive skin prick test. METHODS: In a sample of 1 445 Brazilian children, the association between the prevalence of asthma, skin prick test positivity, and allergen-specific IgE in serum was investigated. RESULTS: The prevalence of asthma was 22.6%. The presence of serum allergen-specific IgE was frequent in asthmatics and nonasthmatics, and the prevalence of asthma increased only with levels of allergen-specific IgE > 3.5 kilounits/L. The proportion of asthma attributable to atopy was estimated to be 24.5% when atopy was defined by the presence of allergen-specific IgE. With a given level of specific IgE, no association between skin test reactivity and asthma was observed. Skin prick tests were less sensitive than specific IgE for detection of atopy. CONCLUSIONS: Most asthma cases in an urban underprivileged setting in Brazil were not attributable to atopy. This observation has important implications for understanding the risk factors for the asthma epidemic in Latin America

OBJETIVO: Explorar la relación entre el asma y la atopia en una cohorte de niños que viven en un gran centro urbano de Brasil. En este estudio, se considera atopia la detección de IgE sérica específica de algún alérgeno o un resultado positivo a la prueba de punción cutánea. MÉTODOS: Se estudió la relación entre la prevalencia del asma, el resultado positivo a la prueba de punción cutánea y la detección de IgE sérica específica de algún alérgeno en una muestra de 1 445 niños brasileños. RESULTADOS: El asma registró una prevalencia de 22,6%. La presencia de IgE séricas específicas de alérgenos fue frecuente tanto en los asmáticos como en los no asmáticos, y la prevalencia del asma fue mayor solo cuando el valor detectado de la IgE específica del alérgeno era > 3,5 kilounidades/litro. Se calculó que la atopia definida como la detección de IgE específicas de alérgenos es responsable de 24,5% de los casos de asma. No se observó ninguna relación entre la reactividad a la prueba de punción cutánea y el asma en función de los valores de IgE específicas. La prueba de punción cutánea es menos sensible que la detección de IgE específicas en lo que respecta al diagnóstico de atopia. CONCLUSIONES: La mayoría de los casos de asma que se registran en entornos urbanos desfavorecidos de Brasil no son atribuibles a atopia. Esta observación tiene implicaciones importantes en lo que respecta a la comprensión de los factores de riesgo que predisponen a la epidemia de asma en América Latina

OBJETIVO: Estimar a distribuição dos padrões de gravidade da asma em uma amostra populacional de crianças em Salvador (BA). MÉTODOS: Questionário epidemiológico (International Study of Asthma and Allergies in Childhood - ISAAC) foi aplicado juntamente com questionário elaborado com base em critérios de gravidade adotados na prática clínica (Global Initiative for Asthma - GINA) em 417 crianças de 5 a 12 anos com sintomas de asma nos últimos 12 meses. Com base nas questões do ISAAC, as crianças foram classificadas em asma grave e não grave. De acordo com os critérios clínicos da GINA, quatro categorias de gravidade foram criadas: intermitente, persistente leve, persistente moderada e grave. RESULTADOS: Noventa crianças (22,3%) apresentaram indicadores de gravidade segundo o ISAAC. Com base nos critérios da GINA, havia 143 crianças com asma intermitente, 160 com asma leve persistente, 51 com asma moderada e 43 com asma grave. A concordância entre os dois questionários foi de 81,3%, com índice kappa de 0,5. CONCLUSÕES: A maioria das crianças asmáticas em Salvador possui asma persistente. Há bom nível de concordância na identificação da asma grave, entre a classificação epidemiológica e a clínica.

OBJECTIVE: To estimate the distribution of asthma severity in a population-based sample of children from Salvador, Brazil. METHODS: An epidemiologically oriented questionnaire (International Study of Asthma and Allergies in Childhood, ISAAC) and a questionnaire based on criteria used in clinical practice (The Global Initiative for Asthma, GINA) were administered simultaneously to 417 children aged 5 to 12 years who reported symptoms of asthma in the past 12 months. According to the ISAAC instrument, children were classified into severe and non-severe asthma, whereas GINA clinical criteria produced four categories of severity: intermittent, mild persistent, moderate persistent and severe asthma. RESULTS: Ninety children reported symptoms indicative of severity according to the ISAAC questionnaire. According to GINA criteria, 143 children had intermittent asthma, 160 mild persistent, 51 moderate and 43 severe asthma. Agreement between the two instruments was 81.3% (kappa = 0.5). CONCLUSIONS: Most asthmatic children in the Salvador urban area have persistent asthma. Agreement between epidemiological and clinical classifications of asthma severity was satisfactory.