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Abstract(s)
Termalismo é definido como o uso da água mineral natural e de outros meios complementares para fins de prevenção, terapêutica, reabilitação ou bem-estar. As águas sulfúricas são as mais adequadas no tratamento das vias respiratórias superiores, tendo ações anti-inflamatórias, antioxidantes e dessensibilizantes. Atuam favoravelmente nas mucosas, aliviando a dor, a obstrução nasal e a congestão nasal, diminuindo a intensidade e duração das agudizações e evitando a evolução para a cronicidade destas patologias otorrinolaringológicas. Em estudos anteriores áreas hipercromáticas foram encontradas no citoplasma das células ciliadas nasais - estrias supranucleares hipercromáticas - em maior abundância em células ciliadas nasais de pessoas saudáveis e em menos abundância em pessoas com patologia otorrinolaringológica subjacente.
O presente estudo tem como principal objetivo estudar a alteração da estrutura e depuração mucociliar antes e após o tratamento termal. Tem ainda como finalidade avaliar se estas alterações alteram favoravelmente a sintomatologia nasal.
Para tal, foram estudados 49 doentes das termas de Unhais da Serra. A todos foi feita por nós uma história clínica orientada para a área otorrinolaringológica, efetuada colheita de exsudado nasal através de citologia nasal e aplicado o teste de trânsito de sacarina, antes e após todo o tratamento termal.
Os doentes, com média de 12,4 dias de tratamento termal, tiveram um aumento na mediana das células ciliadas nasais com estrias supranucleares hipercromáticas, de 2 para 3 (p=0.130). Houve melhoria na depuração mucociliar, traduzindo-se por uma diminuição do teste de trânsito de sacarina de, em média, 6.81 minutos após o tratamento termal (intervalo de confiança 95%: 4.88 a 8.74 min) (p<0.05). Houve melhoria sintomática, que é referida por 100% dos indivíduos da nossa amostra.
Com este estudo, concluímos que a água termal ajuda na limpeza do muco, diminui os mediadores inflamatórios, aliviando a dor e a sensação de obstrução nasal. Assim, há uma depuração mucociliar mais eficaz, no que se traduz num tempo de transporte mucociliar mais curto, não havendo uma variação marcante na contagem de células ciliadas nasais com estrias supranucleares hipercromáticas após os tratamentos.
Hydrotherapy is defined as the use of natural mineral water and other complementary means for prevention, treatment, rehabilitation or welfare. Sulfuric waters are most suitable in the treatment of the upper airway, having anti-inflammatory, antioxidant and desensitizing actions. They act favorably on mucous membranes, relieving pain, nasal obstruction and nasal congestion, decreasing the intensity and duration of acute exacerbations and preventing progression to chronicity of these otorhinolaryngological diseases. In previous studies hyperchromatic areas were found in the cytoplasm of ciliated nasal cells - hyperchromatic supranuclear stria - in greater abundance in nasal ciliated cells of healthy people and in less abundance in people with underlying otorhinolaryngological pathology. This study has as main objective to analyze the change in the structure and mucociliary clearance before and after thermal treatment. It also aimed to evaluate whether these changes alter favorably the nasal symptoms. To this end, we studied 49 patients from Unhais da Serra thermal. We conducted a clinical history oriented to the otorhinolaryngological area, we also collected nasal discharge, through nasal cytology, and applied the saccharin traffic test before and after thermal treatment. The patients, with an average of 12.4 days of thermal treatment, had an increase in the median of the nasal ciliated cells with hyperchromatic supranuclear stria , from 2 to 3 (p = 0.130). There was improvement in mucociliary clearance, resulting in a decrease in saccharin traffic test, on average, 6.81 minutes after thermal treatment (95% confidence interval: 4.88 to 8.74 min) (p <0,05). 100% of patients from our sample referred that there was symptomatic improvement. This study concluded that thermal water helps mucus cleansing and decreases inflammatory mediators, relieving pain and the sensation of nasal obstruction. Thus, there is a more effective mucociliary clearance which results in a decrease of mucociliary transport time, and no remarkable variation in the count of nasal ciliated cells with hyperchromatic supranuclear stria, after treatments.
Hydrotherapy is defined as the use of natural mineral water and other complementary means for prevention, treatment, rehabilitation or welfare. Sulfuric waters are most suitable in the treatment of the upper airway, having anti-inflammatory, antioxidant and desensitizing actions. They act favorably on mucous membranes, relieving pain, nasal obstruction and nasal congestion, decreasing the intensity and duration of acute exacerbations and preventing progression to chronicity of these otorhinolaryngological diseases. In previous studies hyperchromatic areas were found in the cytoplasm of ciliated nasal cells - hyperchromatic supranuclear stria - in greater abundance in nasal ciliated cells of healthy people and in less abundance in people with underlying otorhinolaryngological pathology. This study has as main objective to analyze the change in the structure and mucociliary clearance before and after thermal treatment. It also aimed to evaluate whether these changes alter favorably the nasal symptoms. To this end, we studied 49 patients from Unhais da Serra thermal. We conducted a clinical history oriented to the otorhinolaryngological area, we also collected nasal discharge, through nasal cytology, and applied the saccharin traffic test before and after thermal treatment. The patients, with an average of 12.4 days of thermal treatment, had an increase in the median of the nasal ciliated cells with hyperchromatic supranuclear stria , from 2 to 3 (p = 0.130). There was improvement in mucociliary clearance, resulting in a decrease in saccharin traffic test, on average, 6.81 minutes after thermal treatment (95% confidence interval: 4.88 to 8.74 min) (p <0,05). 100% of patients from our sample referred that there was symptomatic improvement. This study concluded that thermal water helps mucus cleansing and decreases inflammatory mediators, relieving pain and the sensation of nasal obstruction. Thus, there is a more effective mucociliary clearance which results in a decrease of mucociliary transport time, and no remarkable variation in the count of nasal ciliated cells with hyperchromatic supranuclear stria, after treatments.
Description
Keywords
Termalismo Estrutura muco-ciliar Tratamento termal - Trânsito muco-ciliar Depuração muco-ciliar Citologia nasal Células ciliadas nasais - Estrias supranucleares hipercromáticas - Tratamento
Citation
Publisher
Universidade da Beira Interior