Navegando por Palavras-chave "efetividade"

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    Avaliação da segurança do teste de caminhada dos 6 minutos em pacientes no pré-transplante cardíaco
    (Sociedade Brasileira de Cardiologia - SBC, 2009-04-01) Cipriano Junior, Gerson [UNIFESP]; Yoshimori, Darlene Yuri [UNIFESP]; Bernardelli, Graziella França [UNIFESP]; Mair, Vanessa [UNIFESP]; Buffolo, Enio [UNIFESP]; Branco, João Nelson Rodrigues [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    BACKGROUND: The 6-minute walk test (6WT) has been used as a means of assessment of the functional capacity, clinical staging and cardiovascular prognosis. Its safety and metabolic impact have not been frequently described in the literature, especially in patients with severe heart failure with clinical indication for cardiovascular transplantation. OBJECTIVE: To evaluate the occurrence of arrhythmias and cardiovascular changes during 6WT. To correlate 6WT performance with clinical staging and cardiovascular prognosis. METHODS: Twelve patients, 10 of whom males, aged 52 ± 8 years were evaluated at baseline. 6WT was performed with telemetry electrocardiography, vital signs and lactate monitoring. The patients were followed-up for 12 months. RESULTS: The patients walked 399.4±122.5 (D, m), reaching a perceived exertion (PE) of 14.3±1.5 and a 34% baseline heart rate variation. Two patients presented more severe pre-6WT arrhythmia which did not worsen with the exercice, four patients presented a significant increase of blood lactate levels (>5 mmol/dl), and three interrupted the test. The distance walked correlated with the ejection fraction (%) and functional class (NYHA). After 12-month follow-up, three patients died and seven were rehospitalized for cardiac decompensation. The D/PE ratio and 2-minute heart rate recovery (HRR2, bpm) were lower in the death group. CONCLUSION: The clinical and electrocardiographic behaviors suggest that the method is safe, but it may be considered too strenuous for some patients with severe heart failure. Variables related to 6WT performance may be associated with the one-year follow-up mortality.
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    Comparação entre ozônio intra-articular e placebo no tratamento da artrite do joelho
    (Universidade Federal de São Paulo (UNIFESP), 2015-08-31) Jesus, Carlos Cesar Lopes de [UNIFESP]; Trevisani, Virginia Fernandes Moca Trevisani [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    In spite of the high prevalence of osteoarthritis, there are no currently approved treatments capable of slowing its clinical progression or delaying the need for total knee replacement 1, 2. Ozone (O3) is a triatomic variety of oxygen, applied to the human organism with therapeutic aims, mainly in chronic diseases like osteoarthritis 3.However, there are only few studies about the use of intra articular ozone in the treatment of knee osteoarthritis and they are just case reports 3, 4, 5, 6, 7, 8. Objectives: To determine if the treatment of knee osteoarthritis with intra articular ozone is more effective than the treatment of knee osteoarthritis with placebo in relation to pain reduction and improvement of function and quality of life. Methods: 98 patients, aged between 60 and 85 years, with knee osteoarthritis according to the American College of Rheumatology, attending the Paulista School of Medicine ? Sao Paulo Federal University (EPM-UNIFESP) Geriatrics and Gerontology Disciplines Clinic, Santo Amaro Medicine College - Rheumatology Discipline Clinic and at Pró-Vida. Participants were randomized to receive ozone (n= 61) or placebo (n= 35), in the most painful and worst functional knee, once a week, during eight weeks. They were done two control interviews during the treatment, with a four-week interval between them, besides the last interview, eight weeks after the last joint puncture. The instruments used to evaluate the results were: 1) Visual Analogue Scale (VAS); 2) Lequesne Algofunctional Index (LEQ); 3) Timed Up and Go Test (TUG); 4) SF-36; 5) WOMAC (?Western Ontario and McMaster Universities Osteoarthritis Index?) and 6) Geriatric pain Measure (GPM). Results: After 8 weeks of treatment, ozone was more effective than placebo, in relation to pain relief, joint function and life quality improvement: VAS (MD = 3,16; p < 0.001); LEQ (MD = 4,39; p < 0,001); TUG = no statistical difference; SF-36 (PH = -37,72; p < 0,001; GSH = -2,40; p < 0,001; FC = -27,70; p < 0,001; SA = -13,29; p < 0,001); WOMAC (PD = 0,47; p = 0,111) e GPM (MD = 23,10; p < 0,001). Adverse events occurred in 3 patients (2 in placebo group and 1 in ozone group) and included just puncture accidents. Conclusions: The study confirms the efficacy of ozone concerning pain relief and improvement of functional and quality of life in patients with knee osteoarthritis.
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    Efetividade de cursos por educação à distância na capacitação de profissionais de saúde, assistência social e líderes religiosos/comunitários para realizar triagem do uso de drogas e intervenções breves
    (Universidade Federal de São Paulo (UNIFESP), 2014-08-27) Carneiro, Ana Paula Leal [UNIFESP]; Souza-Formigoni, Maria Lucia Oliveira de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Excessive use of alcohol and other drugs is associated with health and psychosocial risks. To reduce drug use and associated problems, different techniques have been proposed to deal with users who report to health services, among them the Screening of substance use associated with Brief Interventions (SBI). However, there are no studies showing their effectiveness when applied by professionals trained through Distance Learning courses (DL). Objective: This study aimed at evaluating the use and effectiveness of SBI techniques applied by health professionals or social workers trained by the DL course SUPERA (“Sistema para detecção do Uso abusivo e dependência de substâncias Psicoativas: Encaminhamento, intervenção breve, Reinserção social e Acompanhamento”), as well as to assess the use of SBI by religious or community leaders trained by the DL course Faith in Prevention (“Fé na Prevenção - Prevenção de Uso de Drogas por Instituições Religiosas e Movimentos Afins”). Methods: Both courses were developed by the teams of UDED (“Unidade de Dependência de Drogas”) from the “Departamento de Psicobiologia” and “Departamento de Informática em Saúde” (DIS) of the “Universidade Federal de São Paulo” (UNIFESP), in partnership with the “Secretaria Nacional de Políticas Sobre Drogas” (SENAD), which sponsored them. This study used data provided by the participants when they enrolled in the courses and data recorded in the course website. All professionals approved in the courses SUPERA (1st to 4th editions) and Faith in Prevention (1st and 2nd editions) were invited to participate (N=21,799). From these, 4,354 accepted it and undertook an online survey about their satisfaction with the course, the use of SBI and if they had been acting as multipliers of the knowledge acquired. In a sample of 201 patients (treated in health or social care services by 25 professionals trained by SUPERA course) we evaluated the effectiveness of the SBI applied. Out of these patients, 79 participated in a follow-up evaluation to measure whether there was a reduction in drug use associated problems. Results: Most of the participants in the SUPERA course were health professionals who worked at “Centro de Atenção Psicossocial” (CAPS), in the “Estratégia de Saúde da Família” (ESF) or in the social service network. They were from all Brazilian states and most of them were women, with 36 ± 10 years (average ± SD). The "Faith in Prevention" participants were from religious institutions, therapeutic communities or Non-Governmental Organizations (NGOs), from all Brazilian states, mostly men, with 40 ± 10 years (average ± SD). Most of the professionals (80%) were satisfied with the course, 40-50% had used the SBI techniques and 80% had acted as multipliers of the knowledge acquired. A significant association was observed among the use of SBI, level of motivation, support from leadership and feeling capable to provide SBI after the course. The leadership support was strongly associated with acting as multipliers. Patients who received the SBI applied by those professionals reported a significant reduction in their substance use related problems: Alcohol (before: 15 ± 12 / after: 12.5 ± 10, p = 0.04), cocaine/ crack (before: 13 ± 8 / after: 4 ± 9, p = 0.003) or benzodiazepines (before: 2 ± 6 / after: 0 ± 3, p = 0.01) and evaluated the information and intervention received as satisfactory. Conclusion: The courses were positively evaluated by the participants and the SBI applied by them was effective in reducing problems associated with the use of psychoactive substances, with positive changes in the areas of health, social, personal and/or professional life.