Navegando por Palavras-chave "Pulmonary Disease, Chronic Obstructive"
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- ItemAcesso aberto (Open Access)Avaliação da aprendizagem de pacientes portadores de doença pulmonar obstrutiva crônica submetidos a um programa educativo(Universidade Federal de São Paulo (UNIFESP), 2009-12-31) Souza, George Márcio da Costa e [UNIFESP]; Jardim, José Roberto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: The education of chronic obstructive pulmonary disease – COPD patients is a fundamental part of pulmonary rehabilitation programs and it aims a better disease management. Objectives: To assess the learning capacity of COPD patients undergoing an educational program. Methods: A prospective study was performed with COPD patients at the Pulmonary Rehabilitation Center of the Universidade Federal de São Paulo/Lar Escola São Francisco, Brazil submitted to a educational program. Results: There was an increase in the number of correct questions to the questionnaire related to knowledge of the disease (59,58% to 91,25%; p < 0,001); a better performance in two activities of daily life (13,6% to 63,6%; p < 0,001 and 9,1% to 36,4%; p < 0,01). We observed a greater number of correct responses after the educational program; the mean went up from 6.5 ± 1.0 to 10.25 ± 0.96 (p = 0.002) when a pressurized nebulizer without a spacer was used, and from 6.7 ± 1.3 to 9.3 ± 0.9 (p < 0.001) when a nebulizer with a spacer was employed; the mean number of correct responses when using a dry powder inhaler increased from 8.9 ± 0.8 to 9.8 ± 0.2 (p < 0.001). We found no alterations in health quality or anxiety and depression levels. Conclusion: We concluded that a structured educational program acts as an important aid in treating COPD patients, providing them with essential knowledge about their disease and possibly leading to a change of improper health habits.
- ItemAcesso aberto (Open Access)Efeito da hiperóxia na oxigenação muscular periférica no início do exercício dinâmico de alta intensidade em pacientes não-hipoxêmicos ou levemente hipoxêmicos com Doença Pulmonar Obstrutiva Crônica (DPOC)(Universidade Federal de São Paulo (UNIFESP), 2009-10-28) Siqueira, Ana Cristina Barroso de [UNIFESP]; Neder, José Alberto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)There is convincing evidence that impaired microvascular O2 delivery (Q LO2mv) to the peripheral muscles limits the rate of increase in pulmonary O2 uptake ( O2p) at the onset of supra-gas exchange threshold exercise in patients with chronic obstructive pulmonary disease (COPD). It is currently unclear, however, whether O2 supplementation could actually improve Q LO2mv thereby accelerating O2p kinetics in patients who are not overtly hypoxemic (PaO2 > 60 mmHg). We therefore investigated the effects of hyperoxia (HiOX= 50% O2) and normoxia (NOX) on the kinetics of O2p and fractional O2 extraction in the vastus lateralis ( [deoxy- Hb+Mb] by near-infrared spectroscopy) in 11 non- or mildly-hypoxemic patients. HiOX increased exercise tolerance compared to NOX (P<0.05). At the on-exercise transient, however, HiOX was associated with faster [deoxy-Hb+Mb] kinetics (= 4.8 } 2.4 s vs. 6.7 } 3.0 s; P<0.05) and a response govershoot h in 7/11 patients suggesting impaired Q LO2mv. Subsequently, however, [deoxy-Hb+Mb] decreased to lower steady-state values compared to NOX in 9/11 patients (P<0.05). As a likely consequence of these opposite effects of HiOX on Q LO2mv (i.e., early impairment followed by later improvement), O2p kinetics were accelerated in 6 but slowed in 5 patients. Interestingly, patients in whom HiOX accelerated O2p kinetics showed consistently-larger reductions in gsteady-state h ..[deoxy-Hb+Mb] compared to their counterparts (HiOX . NOX= -23.4 (-55.5 to -5.8) ƒÊM/cm vs. -0.62 (-22.6 to 10.7) ƒÊM/cm; p<0.05). In conclusion, HiOX can transitorily impair the convective flow of O2 to the working peripheral muscles at the onset of heavy intensity exercise in patients with COPD who are not overtly hypoxemic. This effect, however, might be (over)compensated by a subsequent increase in local O2 availability in selected patients. These data seem to provide a mechanistic explanation for the heterogeneous effects of HiOX on O2p kinetics in this patient sub-population.
- ItemSomente MetadadadosInfluência Da Ansiedade E Depressão Na Taxa De Cessação Do Tabagismo De Indivíduos Com E Sem Limitação Ao Fluxo De Ar(Universidade Federal de São Paulo (UNIFESP), 2018-07-26) Barros, Juliana Oliveira [UNIFESP]; Jardim, Jose Roberto De Brito [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: The High Prevalence Of Depression In Smokers Is A Negative Factor In Smoking Cessation, With More Failures In Cessation Attempts. It Is Possible That Patients With Airway Limitation And Higher Rates Of Anxiety And Depression Have More Difficulty Quitting Smoking Than Individuals Without Airway Limitation. Objective: To Identify Whether Anxiety And Depression Influence The Rate Of Smoking Cessation In Individuals With And Without Airway Limitation. Materials And Methods: Retrospective Cohort Study With 2234 Subjects Who Participated In Prevfumo. The Evaluation Consisted Of Pre-And Post-Bronchodilator Spirometry, Sociodemographic Evaluation, Symptoms, Smoking History, Comorbidities, Psychiatric History And Hads Questionnaire. Individuals Of Both Sexes, Aged " 35 Years, Active Smokers And Motivated To Quit Smoking Were Included. Those Who Did Not Have Spirometry, Did Not Respond To The Hads Questionnaire, Did Not Have The Degree Of Motivation Evaluated, Did Not Have Data On Smoking Burden And Comor
- ItemAcesso aberto (Open Access)Pleural subxyphoid drain confers better pulmonary function and clinical outcomes in chronic obstructive pulmonary disease after off-pump coronary artery bypass grafting: a randomized controlled trial(Sociedade Brasileira de Cirurgia Cardiovascular, 2014-12-01) Guizilini, Solange [UNIFESP]; Viceconte, Marcela [UNIFESP]; Esperança, Gabriel Tavares da Motta [UNIFESP]; Bolzan, Douglas Willian [UNIFESP]; Vidotto, Milena Carlos [UNIFESP]; Moreira, Rita Simone Lopes [UNIFESP]; Câncio, Andréia Azevedo [UNIFESP]; Gomes, Walter José [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: To evaluate the lung function and clinical outcome in severe chronic obstructive pulmonary disease in patients undergoing off-pump coronary artery bypass grafting with left internal thoracic artery graft, comparing the pleural drain insertion in the intercostal versus subxyphoid region. Methods: A randomized controlled trial. Chronic obstructive pulmonary disease patients were randomized into two groups according pleural drain site: II group (n=27) - pleural drain in intercostal space; SI group (n=29) - pleural drain in the subxyphoid region. Spirometry values (Forced Vital Capacity - and Forced expiratory volume in 1 second) were obtained on preoperative and 1, 3 and 5 postoperative days. Chest x-ray from preoperative until postoperative day 5 (POD5) was performed for monitoring respiratory events, such as atelectasis and pleural effusion. Pulmonary shunt fraction and pain score was evaluate preoperatively and on postoperative day 1. Results: In both groups there was a significant decrease of the spirometry values (Forced Vital Capacity and Forced expiratory volume in 1 second) until POD5 (P<0.05). However, when compared, SI group presented less decrease in these parameters (P<0.05). Pulmonary shunt fraction was significantly lower in SI group (P<0.05). Respiratory events, pain score, orotracheal intubation time and postoperative length of hospital stay were lower in the SI group (P<0.05). Conclusion: Subxyphoid pleural drainage in severe Chronic obstructive pulmonary disease patients determined better preservation and recovery of pulmonary capacity and volumes with lower pulmonary shunt fraction and better clinical outcomes on early postoperative off-pump coronary artery bypass grafting.
- ItemAcesso aberto (Open Access)Quality of life and burden in carers for persons with Chronic Obstructive Pulmonary Disease receiving oxygen therapy(Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo, 2013-07-01) Cedano, Simone [UNIFESP]; Bettencourt, Ana Rita de Cassia [UNIFESP]; Traldi, Fabiana; Machado, Maria Christina Lombardi Oliveira; Belasco, Angélica Gonçalves Silva [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE:to assess the quality of life and burden of caregivers to Chronic Obstructive Pulmonary Disease patients on Long-Term Oxygen Therapy and to investigate the factors influencing this burden.METHOD:this is an analytical, cross-sectional study of 80 persons with Chronic Obstructive Pulmonary Disease on Long-Term Oxygen Therapy who used the specialized outpatient center of the Federal University of São Paulo, and their carers. The following instruments were used: Medical Outcomes Studies 36 (SF-36), Caregiver Burden Scale (CBS) and the Katz Index, along with socio-demographic and clinical variables.RESULTS:the most compromised scores on the carers' quality of life questionnaire were for Vitality and Mental Health. On the Caregiver Burden Scale, the domain which created the greatest burden for carers was the Environment. With the exception of Emotional Involvement, all the domains of quality of life were affected negatively by the domains of caregiver burden.CONCLUSION:it was shown that carers' quality of life was compromised and that they were overburdened with care tasks, confirming that assisting persons with Chronic Obstructive Pulmonary Disease is an important element in carers' quality of life.