Navegando por Palavras-chave "Pulmonary disease"
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- ItemAcesso aberto (Open Access)Atualização on-line sobre doença pulmonar obstrutiva crônica para enfermeiros(Universidade Federal de São Paulo (UNIFESP), 2015-08-26) Maurino, Isabela da Costa [UNIFESP]; Bettencourt, Ana Rita de Cassia [UNIFESP]; http://lattes.cnpq.br/2074144543142069; http://lattes.cnpq.br/6784141353998242; Universidade Federal de São Paulo (UNIFESP)Introdução: A doença pulmonar obstrutiva crônica (DPOC) é uma enfermidade respiratória prevenível e tratável. A obstrução do fluxo aéreo é, geralmente, progressiva e está associada a uma resposta inflamatória anormal dos pulmões à inalação de partículas ou gases tóxicos, sendo a principal, o tabagismo. É necessária a organização de uma rede de atenção que atenda às pessoas com doenças respiratórias crônicas, com maior ênfase em ações de promoção da saúde e prevenção primária e secundária, com intuito de prevenir e controlar as doenças crônicas. Para a melhora da qualidade do serviço prestado, é fundamental que os profissionais da área da saúde atualizem seus conhecimentos. Um dos recursos tecnológicos utilizados é o ambiente virtual, que proporciona ao usuário o contato com o conteúdo e a participação nas atividades, desde que tenha acesso à internet. A Educação a Distância (EAD) também permite ao aluno a flexibilidade de tempo e espaço para estudo, além da redução de custos dos recursos educacionais presenciais. Objetivos: Desenvolver e avaliar um site sobre DPOC quanto à qualidade das informações, layout e navegação; avaliar e validar o conteúdo das informações. Método: Para o desenvolvimento do ambiente virtual de aprendizagem, foi utilizado o referencial teórico proposto por Filatro, composto pelas fases de análise, design e desenvolvimento, implementação e avaliação. A fase de avaliação foi dividida em 2 partes: avaliação e validação do conteúdo sobre DPOC, realizada por 12 especialistas da área da saúde (enfermeiros, médicos e fisioterapeutas). E para avaliar as operações e o conteúdo do site, foi realizada por 11 profissionais da área da saúde (enfermeiros, médicos e fisioterapeutas) e 3 de informática (informática médica e designer gráfico). Para a análise dos dados, foi utilizada a estatística descritiva. Resultados: Na primeira parte da avaliação do conteúdo, este foi avaliado como excelente e muito bom por 92% dos especialistas. Na segunda, os critérios excelente e muito bom relativos à impressão geral do site (visual, facilidade e navegabilidade) e o conteúdo atingiram a concordância acima de 70% entre os profissionais da saúde; e entre os profissionais de informática, o site foi avaliado como muito bom e bom por 55%. Conclusão: O site desenvolvido está adequado para ser disponibilizado on-line, o conteúdo foi avaliado como de extrema importância para que enfermeiros e profissionais da área da saúde busquem informações atualizadas sobre DPOC de maneira rápida e independente da localização geográfica.
- ItemAcesso aberto (Open Access)Avaliação da capacidade de exercício em portadores de doença pulmonar obstrutiva crônica: comparação do teste de caminhada com carga progressiva com o teste de caminhada com acompanhamento(Sociedade Brasileira de Pneumologia e Tisiologia, 2006-04-01) Rosa, Fernanda Warken [UNIFESP]; Camelier, Aquiles Assunção [UNIFESP]; Mayer, Anamaria [UNIFESP]; Jardim, José Roberto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To evaluate the applicability of the incremental (shuttle) walk test in patients with chronic obstructive pulmonary disease and compare the performance of those patients on the shuttle walk test to that of the same patients on the encouraged 6-minute walk test. METHODS: A cross-sectional study was conducted, in which 24 patients with chronic obstructive pulmonary disease were selected. In random order, patients were, after an initial practice period, submitted to a shuttle walk test and an encouraged 6-minute walk test. RESULTS: The patients obtained a higher heart rate (expressed as a percentage of that predicted based on gender and age) on the encouraged 6-minute walk test (84.1 ± 11.4%) than on the shuttle walk test (76.4 ± 9.7%) (p = 0.003). The post-test sensation of dyspnea (Borg scale) was also higher on the encouraged 6-minute walk test. On average, the patients walked 307.0 ± 89.3 meters on the shuttle walk test and 515.5 ± 102.3 meters on the encouraged 6-minute walk test (p < 0.001). There was a good correlation between the two tests in terms of the distance walked (r = 0.80, p < 0.001). CONCLUSION: The shuttle walk test is simple and easy to implement in patients with chronic obstructive pulmonary disease. The encouraged 6-minute walk test produced higher post-test heart rate and greater post-test sensation of dyspnea than did the shuttle walk test.
- ItemAcesso aberto (Open Access)Avaliação do uso da Escala Modificada de Borg na crise asmática(Escola Paulista de Enfermagem, Universidade Federal de São Paulo (UNIFESP), 2005-03-01) Cavallazzi, Tatiane G. de Liz [UNIFESP]; Cavallazzi, Rodrigo S [UNIFESP]; Cavalcante, Tatiana de Medeiros Colletti [UNIFESP]; Bettencourt, Ana Rita de Cassia [UNIFESP]; Diccini, Solange [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The dyspnea is the biggest cause of incapacity and reduction of the quality of life for patients with respiratory illnesses as it is the case of the asthma. Being thus, the respiratory difficulty is probably the more important isolated factor in the limitation of the capacity of the individual in the basic functions of day-by-day, making with that this looks the health services. The objective of this study was to verify the degree of dyspnea of the patients in asthmatic crisis for the scored on the Modif Borg Scale and the correlation of improvement of the degree of dyspnea for the same one with the improvement of the pulmonary function verified by Peak expiratory Flow (PEF). A total of 40 asthmatic patients in acute crisis taken care of in the service of Attendance in Pneumologia of the São Paulo Hospital, were included, in the period of september to the december of 2003. Before and after the clinical treatment, the subsequent data were colected: cardiac rate (FC), respiratory rate (FR), PEF and peripherical oxygen saturation (SpO2) and the patient was questionado about your perception of the dyspnea for the Modif Borg Scale. The punctuation of this scale varies of 0 the 10 (of none to the dyspnea highest). The results had pointed a trend of the high values of the Modif Scale of Borg to be related to the low values of PEF in the daily pay-treatment, inverting this relation in the post-cure. This scale in them seemed a fast, cheap additional instrument and of easy applicability in the evaluation of asthmatic patients, being able to be used by health professionals who carry through the initial evaluation of the patients in crisis as well as its reply to the treatment.
- ItemSomente MetadadadosCan bronchodilators improve exercise tolerance in COPD patients without dynamic hyperinflation?(Soc Brasileira Pneumologia Tisiologia, 2014-03-01) Scuarcialupi, Maria Enedina Aquino; Berton, Danilo Cortozi; Cordoni, Priscila Kessar; Squassoni, Selma Denis; Fiss, Elie; Neder, Jose Alberto [UNIFESP]; Fac Ciencias Med Paraiba; Univ Fed Rio Grande do Sul; Fac Med ABC; Queens Univ; Kingston Gen Hosp; Universidade Federal de São Paulo (UNIFESP)Objective: To investigate the modulatory effects that dynamic hyperinflation (UFO, defined as a reduction in inspiratory capacity (lC), has on exercise tolerance after bronchodilator in patients with COPD. Methods: An experimental, randomized study involving 30 COPD patients without severe hypoxemia. At baseline, the patients underwent clinical assessment, spirometry, and incremental cardiopulmonary exercise testing (CPET). On two subsequent visits, the patients were randomized to receive a combination of inhaled fenoterol/ipratropium or placebo. All patients then underwent spirometiy and submaximal CPET at constant speed up to the limit of tolerance (Tlim). The patients who showed Delta lC(peak-rest) < 0 were considered to present with DH (DH+). Results: In this sample, 21 patients (70%) had DH. The DH+ patients had higher airflow obstruction and lower Tlim than did the patients without Did (DH-). Despite equivalent improvement in FEV1 after bronchodilator, the DH- group showed higher Delta lC(bronchodilator-placebo) at rest in relation to the DH+ group (p < 0.05). However, this was not found in relation to Delta lC at peak exercise between DH+ and DH- groups (0.19 +/- 0.17 L vs. 0.17 +/- 0.15 L, p > 0.05). in addition, both groups showed similar improvements in Tlim after bronchodilator (median [interquartile range]: 22% [3-60% vs. 10% [3-53%]; p > 0.05). Conclusions: Improvement in TLim was associated with an increase in lC at rest after bronchodilator in HD- patients with COPD. However, even without that improvement, COPD patients can present with greater exercise tolerance after bronchodilator provided that they develop DH during exercise.
- ItemAcesso aberto (Open Access)Capacidade inspiratória, limitação ao exercício, e preditores de gravidade e prognóstico, em doença pulmonar obstrutiva crônica(Sociedade Brasileira de Pneumologia e Tisiologia, 2007-08-01) Freitas, Clarice Guimarães de; Pereira, Carlos Alberto de Castro [UNIFESP]; Viegas, Carlos Alberto de Assis; Universidade de Brasília; Universidade Federal de São Paulo (UNIFESP); Universidade de Brasília Faculdade de MedicinaOBJECTIVE: To correlate the postbronchodilator (post-BD) inspiratory capacity (IC), % of predicted, with other markers of severity and prognostic factors in chronic obstructive pulmonary disease (COPD). METHODS: Eighty stable patients with COPD performed forced vital capacity and slow vital capacity maneuvers, as well as the 6-min walk test, prior to and after receiving albuterol spray (400 µg). Patients were divided into four groups, based on post-BD forced expiratory volume in one second. Several variables were tested to establish correlations with the post-BD distance walked, using univariate and multivariate analysis. Post-BD IC was found to correlated with Global Initiative for Chronic Obstructive Lung Disease (GOLD) staging and with the Body mass index, airway Obstruction, Dyspnea, and Exercise capacity (BODE) index. RESULTS: Multivariate regression analysis revealed that the distance walked, % predicted, correlated significantly with the IC post-BD, % predicted (p = 0.001), long-term oxygen use (p = 0.014), and number of medications used in the treatment (p = 0.044). IC < 70% was observed in 56% patients in GOLD stages 3 or 4 vs. 20% in GOLD 1 or 2 (p < 0.001). IC < 70% was observed in (60%) patients with BODE score 3 or 4 vs. (33%) BODE score 1 or 2 (p = 0.02). CONCLUSION: Post-BD IC% predicted is the best functional predictor of distance walked and is significantly associated with GOLD staging and BODE index. Therefore, We propose that the inspiratory capacity should be added to the routine evaluation of the COPD patients.
- ItemAcesso aberto (Open Access)Doença pulmonar obstrutiva crônica ocupacional(Sociedade Brasileira de Pneumologia e Tisiologia, 2006-05-01) Bagatin, Ericson; Jardim, José Roberto [UNIFESP]; Stirbulov, Roberto; Universidade Estadual de Campinas (UNICAMP); Universidade Federal de São Paulo (UNIFESP); Santa Casa de São Paulo Faculdade de Ciências MédicasOccupational chronic obstructive pulmonary disease, despite having been widely discussed for nearly half a century, is still rarely addressed in Brazil. Various studies, especially those that were population-based, have revealed the relationship between occupational exposure to aerosols and impairment of the airways. This chapter aims to remind physicians of the diagnosis of occupational chronic obstructive pulmonary disease by presenting a succinct review of the literature on the theme, which should be incorporated into the Global Initiative for Chronic Obstructive Lung Disease, in terms of the scope of the diagnostic basis as well as in terms of the questionnaire specific for the disease. Collecting detailed work histories and characterizing exposure to inhaled agents known to have deleterious effects on the respiratory system will surely result in improved approaches to making diagnoses and prognoses of this disease, as well as contributing to its greater control.
- ItemAcesso aberto (Open Access)Influência das características sociodemográficas e clínicas e do nível de dependência na qualidade de vida de pacientes com DPOC em oxigenoterapia domiciliar prolongada(Sociedade Brasileira de Pneumologia e Tisiologia, 2012-06-01) Cedano, Simone [UNIFESP]; Belasco, Angélica Gonçalves Silva [UNIFESP]; Traldi, Fabiana [UNIFESP]; Machado, Maria Christina Lombardi Oliveira [UNIFESP]; Bettencourt, Ana Rita de Cassia [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To evaluate and correlate the quality of life (QoL) of COPD patients on long-term home oxygen therapy (LTOT) with their sociodemographic/clinical characteristics and level of dependence. METHODS: This was a cross-sectional analytical study involving COPD patients on LTOT followed at the Oxygen Therapy Outpatient Clinic of the Federal University of São Paulo Hospital São Paulo, in the city of São Paulo, Brazil. Sociodemographic, clinical, and biochemical data were collected. We assessed QoL and level of dependence using the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) and the Katz index, respectively. Multiple linear regression models were constructed in order to determine the influence of these variables on QoL. RESULTS: We included 80 patients in the study. The mean age was 69.6 ± 9.1 years, and 51.3% were female. The lowest SF-36 scores were for the physical functioning and role-physical domains. All sociodemographic characteristics (except gender) were found to correlate significantly with the SF-36 domains mental health, vitality, role-physical, and social functioning. We also found that body mass index, PaO2, post-bronchodilator FEV1, hemoglobin, and Katz index correlated significantly with the physical functioning, mental health, role-physical, and bodily pain domains. In addition, oxygen flows were found to correlate negatively with the physical functioning, mental health, vitality, and role-emotional domains. CONCLUSIONS: Low scores for SF-36 domains, as well as the variables that negatively influence them, should be considered and analyzed during the development and implementation of strategies for improving the QoL of COPD patients on LTOT.