Navegando por Palavras-chave "health evaluation"
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- ItemAcesso aberto (Open Access)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.
- ItemSomente MetadadadosAverage annual cost of Parkinson's disease in Sao Paulo, Brazil, with a focus on disease-related motor symptoms(Dove Medical Press Ltd, 2017) Bovolenta, Tania M.; de Azevedo Silva, Sonia Maria Cesar [UNIFESP]; Saba, Roberta Arb [UNIFESP]; Borges, Vanderci [UNIFESP]; Ferraz, Henrique Ballalai [UNIFESP]; Felicio, Andre C.Background: Although Parkinson's disease is the second most prevalent neurodegenerative disease worldwide, its cost in Brazil - South America's largest country - is unknown. Objective: The goal of this study was to calculate the average annual cost of Parkinson's disease in the city of Sao Paulo (Brazil), with a focus on disease-related motor symptoms. Subjects and methods: This was a retrospective, cross-sectional analysis using a bottom-up approach (ie, from the society's perspective). Patients (N=260) at two tertiary public health centers, who were residents of the Sao Paulo metropolitan area, completed standardized questionnaires regarding their disease-related expenses. We used simple and multiple generalized linear models to assess the correlations between total cost and patient-related, as well as disease-related variables. Results: The total average annual cost of Parkinson's disease was estimated at US$5,853.50 per person, including US$3,172.00 in direct costs (medical and nonmedical) and US$2,681.50 in indirect costs. Costs were directly correlated with disease severity (including the degree of motor symptoms), patients' age, and time since disease onset. Conclusion: In this study, we determined the cost of Parkinson's disease in Brazil and observed that disease-related motor symptoms are a significant component of the costs incurred on the public health system, patients, and society in general.
- ItemAcesso aberto (Open Access)Can clinical observation differentiate individuals with and without scapular dyskinesis?(Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia, 2014-06-01) Miachiro, Newton Y.; Camarini, Paula M. F.; Tucci, Helga Tatiana [UNIFESP]; Mcquade, Kevin J.; Oliveira, Anamaria S.; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); University of Washington School of MedicineBackground:Altered scapular rotation and position have been named scapular dyskinesis. Visual dynamic assessment could be applied to classify this alteration based on the clinical observation of the winging of the inferior medial scapular border (Type I) or of the prominence of the entire medial border (Type II), or by the excessive superior translation of the scapula (Type III).Objective:The aim of this study was to determine if there were differences in scapular rotations (Type I and II) and position (Type III) between a group of subjects with scapular dyskinesis, diagnosed by the clinical observation of an expert physical therapist, using a group of healthy individuals (Type IV).Method:Twenty-six asymptomatic subjects volunteered for this study. After a fatigue protocol for the periscapular muscles, the dynamic scapular dyskinesis tests were conducted to visually classify each scapula into one of the four categories (Type IV dyskinesis-free). The kinematic variables studied were the differences between the maximum rotational dysfunctions and the minimum value that represented both normal function and a small dysfunctional movement.Results:Only scapular anterior tilt was significantly greater in the type I dyskinesis group (clinical observation of the posterior projection of the inferior angle of the scapula) when compared to the scapular dyskinesis-free group (p=0.037 scapular and p=0.001 sagittal plane).Conclusions:Clinical observation was considered appropriate only in the diagnoses of dyskinesis type I. Considering the lower prevalence and sample sizes for types II and III, further studies are necessary to validate the clinical observation as a tool to diagnose scapular dyskinesis.
- ItemAcesso aberto (Open Access)Versão brasileira da Vestibular Disorders Activities of Daily Living Scale (VADL)(Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, 2013-04-01) Aratani, Mayra Cristina [UNIFESP]; Ricci, Natalia Aquaroni [UNIFESP]; Caovilla, Heloisa Helena [UNIFESP]; Ganança, Fernando Freitas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The Vestibular Disorders Activities of Daily Living Scale (VADL) assesses the impact of dizziness and body imbalance on the everyday activities of patients with vestibulopathy. The scale encompasses 28 activities divided into three sub-scales (functional, ambulation and instrumental). OBJECTIVE: To translate and cross-culturally adapt the VADL to the Brazilian Portuguese language and verify its reliability. METHOD: Questionnaire translation methodological research. Eighty elderly subjects (age > 65 years) with chronic dizziness arising from vestibular disorders were enrolled, of which 40 participated in the pre-testing stage and 40 in reliability analysis. Concordance Correlation Coefficient (CCC) analysis was used to assess reliability. Internal consistency was estimated using Cronbach's alpha (α). RESULTS: Pre-test analysis revealed 15% of incomprehension on two activities; these items had to be adapted. The VADL-Brazil had similar levels of test-retest and inter-rater reliability for total score and presented substantial agreement (CCC = 0.79). Internal consistency was excellent for total score (α = 0.92), good for the functional (α = 0.89) and locomotion (α = 0.86) sub-scales, and poor for the instrumental subscale (α = 0.56). CONCLUSION: The Brazilian version of the VADL was proven adequate, with good levels of reliability and internal consistency. It might be thus considered as an alternative to assess the functional capacity of vestibulopathy patients.