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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
11

Aspectos físicos, funcionais e qualidade de vida de pacientes com Doença Pulmonar Obstrutiva Crônica após programa de treino resistido com corda elástica /

Bonfim, Rafaela. January 2011 (has links)
Orientador: Dionei Ramos / Banca: José Roberto Brito Jardim / Banca: Ercy Mara Cipulo Ramos / Resumo: Pacientes com Doença Pulmonar Obstrutiva Crônica (DPOC) apresentam comumente intolerância ao exercício físico de intensidade variável e relacionada à disfunção muscular esquelética. Assim, o exercício físico tornou-se importante no processo de reabilitação desses pacientes. Objetivo: avaliar a eficácia de um programa de treino resistido com corda elástica na força muscular periférica, capacidade funcional e qualidade de vida de pacientes com DPOC. Métodos: foram avaliados 34 pacientes (24 homens; 10 mulheres) com DPOC, idade de 62 ± 8,27 anos e IMC de 21,29 ± 3,73, alocados em dois grupos: treino resistido convencional e com corda elástica pelo período de oito semanas e frequência de três vezes semanais. As varáveis avaliadas foram força muscular periférica com dinamômetro, capacidade funcional pelo teste de caminhada de seis minutos e qualidade de vida pelo questionário Chronic Respiratory Questionnaire (CRQ). Resultados: a avaliação da força muscular periférica apresentou melhoras nos dois grupos estudados para todos os movimentos realizados durante o protocolo. O desempenho no TC6 (metros) apresentou melhora após oito semanas de treinamento, tanto no grupo corda elástica... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: In general, patients with Chronic Obstructive Pulmonary Disease (COPD) patients have intolerance to exercise of variable intensity and related to skeletal muscle dysfunction. So, the exercise has become important in the process of rehabilitation. Objective: To evaluate the effectiveness of a program of resistance training with elastic band in peripheral muscle strength, functional capacity and quality of life of patients with COPD. Methods: We evaluated 34 patients (24 men, 10 women) with COPD, age 62 ± 8.27 years and BMI 21.29 ± 3.73 divided into two groups: conventional resistance training and with elastic band for the period of eight weeks and frequency of three times weekly. Peripheral muscle strength was assessed with a dynamometer, the functional capacity for the six-minute walking test and quality of life for the Chronic Respiratory Questionnaire (CRQ). Results: the assessment of peripheral muscle strength had improved in both groups for all muscle groups exercised during the protocol. Performance on the 6MWT (meters) showed improvement after eight weeks of training, both in the elastic band... (Complete abstract click electronic access below) / Mestre
12

Effectiveness of inhaled corticosteroids in preventing morbidity and mortality in individuals with chronic obstructive pulmonary disease and the impact of coexisting asthma

Goring, Sarah 11 1900 (has links)
Background: Chronic obstructive pulmonary disease (COPD) is a devastating illness that affects 4.3% of the population of British Columbia over the age of 45 years. Asthma is known to coexist in 10-20% of individuals with obstructive lung disease, and adds to the substantial burden of illness posed by COPD alone. Inhaled corticosteroids (ICS) are currently recommended for the management of COPD among individuals with frequent exacerbations; however, the ability of inhaled corticosteroids to reduce death and hospitalizations among individuals with COPD is controversial. Less is known about the effectiveness of ICS among individuals who are afflicted with both COPD and asthma. Methods: We used a retrospective cohort study design and administrative data to estimate the relative effectiveness of ICS in reducing hospitalizations or death among individuals with concomitant asthma and COPD, compared with individuals with COPD alone. We used an extended Cox model to estimate this association, with a time-varying measure of exposure to ICS. Results: We did not find any association between ICS and hazard of death or hospitalization among individuals with COPD alone (HR = 0.99; 95% CI: 0.94 – 1.05), however the hazard was 18% lower (HR = 0.82; 95% CI: 0.69-0.99) among individuals with concomitant disease. Conclusions: Individuals with combined COPD and asthma show significant benefit from the use of ICS and are more responsive to the effects of ICS than individuals with COPD alone. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate
13

Effects of Exercise or Physical Activity on Overweight and Obese Individuals With Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-analysis

Ba Armah, Shaymaa M January 2018 (has links)
Rationale: The prevalence of obesity among individuals with chronic obstructive pulmonary disease (COPD) is increasing, which contributes to further ventilatory limitations, and compromised exercise capacity, and health-related quality of life (HRQOL) compared to COPD alone. Objective: To conduct a systematic review to evaluate the effects of exercise interventions on walking capacity, ventilatory parameters, anthropometrics and HRQOL in individuals with COPD and elevated weight. Methods: A search was conducted on March 16, 2018 of Embase, Medline, CINAHL, AMED and PsycINFO for controlled trials of exercise interventions, involving adults with any stage of severity and stability of COPD with concurrent obesity or overweight. Overall effects were determined with standardized (SMD) and weighted (WMD) mean difference, using Review Manager 5.3. Results: Nineteen studies with 1716 participants (BMI mean ± SD 28.2 ± 5.1 kg/m2) were included. Exercise interventions were effective in improving walking capacity measured by the 6-Minute Walk Test (6MWT), Endurance Shuttle Walk Test and Incremental Shuttle walk Test (12 studies, 1215 participants, SMD 0.25 (95% CI [0.06, 0.43]); p=0.01), fat-free mass index (2 studies, 285 participants, WMD 0.33 kg/m2 (95% CI [0.21, 0.46]); p<0.00001), St. George Respiratory Questionnaire (6 studies, 648 participants, WMD -7.49 points (95% CI [-13.01, -1.98]); p=0.008) and Chronic Respiratory Disease Questionnaire Dyspnea (5 studies, 478 participants, WMD 0.51 points (95% CI [0.00, 1.02]); p=0.05), Emotion (4 studies, 404 participants, WMD 0.28 points, 95% CI [0.03, 0.54]); p=0.03), and Mastery domains (4 studies, 404 participants, WMD 0.31 points (95% CI [0.02, 0.59]); p=0.03). There were no effects on ventilatory parameters or anthropometric measures. Conclusions: Exercise interventions were effective in improving walking capacity and HRQOL in individuals with COPD and elevated weight. There is an important opportunity to establish effective interventions to minimize the functional and health effects in this subset of the COPD population. / Thesis / Master of Health Sciences (MSc)
14

Uso incorrecto de inhaladores de dosis medida en pacientes adultos de un hospital de Callao, Perú, 2014: estudio transversal

Cayo Quiñe, Alexandra, Martínez-Vargas, Valeria, Bustamante-Voysest, Rossi 14 October 2015 (has links)
BACKGROUND Inhalation therapy has proven to be the best way to control the asthma and chronic obstructive pulmonary disease symptoms. The most commonly used delivery system to control these symptoms is the metered-dose inhaler. The primary goal of this study is to demonstrate an association between incorrect inhaler use and patient age. METHODS This is a cross-sectional study, performed at Centro Médico Naval “Cirujano Mayor Santiago Távara”, in Callao, Peru, in 2014. Patients older than 18 years that used metered-dose inhalers were included. We used film recordings of patients using a metered-dose inhaler and compared their technique with the recommendations on the guidelines on the correct use of inhalers of the Spanish Society of Pneumology and Thoracic Surgery (SEPAR). The main variables measured were age and incorrect inhaler use. The results were analyzed with the Chi squared test for bivariate analysis, and for multivariate analysis we used the Poisson regression model with robust variance. RESULTS We included 378 patients in the analysis; 167 were older than 60 years. An association was found between incorrect inhalator technique and age (p=0.014) (PR 1.19 95% CI 1.03 to 1.37). The highest prevalence of incorrect technique was found in the young adult population (88%). There was no association between the incorrect technique and the person who taught it (p=0.114). Finally, this study showed that 81.2% of the study population presented an incorrect inhalation technique. CONCLUSIONS The percentage of incorrect inhaler use, in the general population is high. Even if we found no association between an incorrect technique and the person who taught it; still, there is a high percentage of errors and it was even demonstrated that being instructed by a pulmonologist does not guarantee a correct performance of metered-dose inhaler inhalations. / INTRODUCCIÓN La terapia inhalatoria ha demostrado ser la más rápida y eficaz para el control del asma y la enfermedad pulmonar obstructiva crónica. El inhalador de dosis medida es el más usado por la población. El objetivo de este estudio es evidenciar la asociación entre la técnica inhalatoria incorrecta y la edad. MÉTODOS Estudio observacional, analítico, de corte transversal realizado en Perú durante 2014. Se incluyeron pacientes desde los 18 años que utilizaran inhalador de dosis medida. Se utilizó una lista de verificación de pasos establecidos por la Sociedad Española de Neumología y Cirugía Torácica y filmaciones para evaluar la técnica inhalatoria de los pacientes. Las variables principales fueron la edad y la mala técnica inhalatoria práctica. Para el análisis bivariado se utilizó la prueba Chi cuadrado y para el análisis multivariado regresión de Poisson con varianza robusta. RESULTADOS Se incluyeron 378 pacientes; 167 fueron mayores de 60 años. El estudio reveló que el 81,2% de la población presentó una incorrecta técnica inhalatoria. Se encontró asociación entre la edad y la técnica inhalatoria incorrecta (p=0,014) (PR 1,19 con IC 95% 1,03-1,37). El grupo etario con mayor frecuencia de técnica incorrecta fue el de adultos jóvenes (88%). CONCLUSIONES La frecuencia de uso incorrecto del inhalador en la población es alta y esta característica predomina en el grupo de adultos jóvenes. A pesar de no haber asociación entre la persona que enseña la técnica inhalatoria y el desempeño de la misma, se demostró que existe alta frecuencia de errores, incluso en aquellos pacientes instruidos por un médico especialista.
15

Analysis of Pharmacotherapy by patients with diagnosis of COPD

Kartali Kaouni, Marilena January 2013 (has links)
Title: Analysis of Pharmacotherapy by patients with diagnosis of COPD Student: Marilena Kartali-Kaouni Tutor: Prof. RNDr. Jiri Vlcek, CSc Department of Social and Clinical Pharmacy, Charles University in Prague, Faculty of Pharmacy in Hradec Kralove Background: " Chronic Obstructive Pulmonary Disease (COPD) is characterized by airflow limitation that is not fully reversible. The airflow limitation is usually both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases". Tobacco smoking is the major risk factor in the development of COPD. COPD is a leading cause of morbidity and mortality worldwide. Aim: 1st from the current literature to understand the nature of COPD and obtain information about the aetiopathogenesis of the disease, diagnosis options and summarize the current view of strategies for achieving the goals of treatment. 2nd in a pilot study to analyze drug therapy in COPD patients visiting a pharmacy in Greece. Methods: 56 prescriptions with the diagnosis of COPD were collected during a period of 8 months from a Greek pharmacy. Information from the prescriptions with regard to COPD medications prescribed (active substances, trade names, strength, dosage scheme, pack size), patients characteristics (age and gender) and prescribing...
16

An exploratory trial for examining effects of self-management education programme on patients with chronic obstructive pulmonary disease in Macau

Ng, Wai I. January 2013 (has links)
Background: Respiratory disease has been one of the top three causes of deaths in Macau in the past decade. As one of the chronic respiratory diseases, chronic obstructive pulmonary disease (COPD) is incurable, but is preventable and treatable. COPD patients suffer from recurrent and progressive respiratory symptoms, and this impacts the health and well-being of patients. Self-management education programmes (SMEP) provide teaching and learning guidance for understanding COPD, emotional support and behaviour change needed to carry out disease-specific care in chronic patients. Evidence has demonstrated that SMEP can mediate a change in health-related behaviours, improve symptom control and the quality of life of COPD patients, with an associated reduction in health care utilization. However, SMEP has never been conducted in Macau, and experiences of providing any form of chronic care for COPD patients in this place is lacking. Aims: This study aimed to explore the effects of a specifically designed self-management education programme on Stage II to IV COPD patients in Macau. Design: The study was conducted as an exploratory randomized controlled trial in a mixed methods approach. Both illness perception and self-efficacy beliefs were adopted to formulate the theoretical framework. In the quantitative strand, the assessment of primary outcomes included illness perception, self-efficacy and inhaler technique. The secondary outcomes included pulmonary function, healthcare utilization and health-related quality of life. In the qualitative strand, focus groups were conducted to explore the subjective perception and experiences of self-management of COPD patients. Fifty one eligible COPD patients were recruited and allocated to experimental (26 patients) and control group (25 patients) by block randomization. A SMEP for COPD patients was developed and validated according to Medical Research Council (MRC) framework. Results: Quantitative results indicated that the primary outcomes (illness perception, self-efficacy and inhaler technique) improved in the experimental group after the SMEP. In relating to the secondary outcomes, days of hospitalization were reduced and symptom dimension of disease-specific health related quality of life (St. George Respiratory Questionnaire) improved. Qualitative findings identified the emergence of a core theme ‘Essentiality’ and five sub-themes ‘Helplessness’, ‘Mutual involvement’, ‘Support’, ‘Control’ and ‘Beneficial’, indicating perception and experiences of participants for self-management. These findings indicate a potential relationship of illness perception and self-efficacy in guiding COPD patients to adapt to health-related behaviour. Discussion and Conclusion: This study has obtained evidence for supporting the proposed theoretical framework and expected experimental effect through employing the MRC guidelines. The study also confirms the estimates of recruitment for a definitive RCT, demonstrated readiness and positive impact in Macau COPD patients to receive self-management intervention, and SMEP as an acceptable and preferable mode of chronic care for COPD for the healthcare system of Macau.
17

Oxigenoterapia domiciliar prolongada : estudo das características dos pacientes atendidos, das indicações, do fornecimento e uso de oxigênio realizado no HC-UNESP-Botucatu /

Alves, Maria Virgínia Martins Faria Faddul. January 2001 (has links)
Orientador: Irma de Godoy / Resumo: Várias doenças pulmonares são associadas ou apresentam na sua evolução a hipoxemia crônica. A mais comum é a doença pulmonar obstrutiva crônica (DPOC), que é caracterizada pela obstrução ao fluxo aéreo devido a bronquite crônica e/ou enfisema. O tratamento para esta condição é a administração de oxigênio. A oxigenoterapia domiciliar prolongada (ODP) melhora a expectativa de vida, reduz a policitemia, aumenta o peso do corpo, melhora a atividade cardíaca e a função neuropsicológica e aumenta a capacidade para realização de exercícios e atividades da vida diária. Os objetivos desta pesquisa foram levantar as características dos pacientes cadastrados no Serviço de Oxigenoterapia, avaliar as condições de fornecimento e uso do oxigênio e orientá-los quanto ao manuseio dos materiais e equipamentos para o tratamento com oxigênio. Foi realizado estudo retrospectivo e prospectivo no período de janeiro de 1997 a janeiro de 1999, que avaliou o total de 70 pacientes. Foram analisados dados da avaliação clínica e nutricional, de exames laboratoriais e de função pulmonar, questionário geral e de qualidade de vida e visita domiciliar. Os resultados mostraram que maior prevalência era do sexo masculino (59%), idade de 61 ? 12 anos, com mínimo de 20 e o máximo de 89 anos, sendo que a maioria dos pacientes (58%) tinha idade acima dos 61 anos. A avaliação nutricional apontou peso médio do corpo de 63,6 ? 19,3 Kg, o IMC foi de 24,7 ? 7,2 kg/m e a pocentagem do peso ideal era de 103,1 ? 42,1%. O diagnóstico de DPOC ocorreu em 70% dos pacientes estudados. O resultado de gasometria arterial mostrou valores de PaO2 de 46,12 ? 9,10 mmHg, PaCO2 de 44,68 ? 8,75 mmHg e SaO2 de 79,30 ? 11,91%. O resultado da prova de função pulmonar mostrou que a maioria dos pacientes apresentava distúrbios ventilatórios restritivos ou obstrutivos... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Several pulmonary diseases are associated or in it's evolution is presented chronic hypoxemia. The most common is the chronic obstructive pulmonary disease (COPD): witch is characterized by the obstruction of the airflow due to a chronic bronchitis or na emphysema. The long term domiciliary oxygen therapy (LTOT) improves the life expectation, reduces the polycythemia and the neuropsychological and also increases the patient's faculty for exercises and daily activities. This research has as main objectives to study the registered patient's on Oxygen Therapy Services, evaluate the oxygen supplyng and using condictions and orientates these patients for the correct use of the materials and oxygen equipment used in treatment. A retrospective and prospective study was made in the period of January of 1997 to January of 1999; witch evaluated the total of 70 patients. Clinical and nutritional data were analysed and the patient's laboratory exams and pulmonary function, domiciliary visits survey and life conditions were as well analysed. The results shown a prevalence of male gender (59%) ages of 61 ? 12 years with the minimum average of 20 and the maximum average of 89 years, that the greatest part of the patients (58%) had their ages above 61 years. The nutritional evaluations shown a medium weigh average of 63,6 ? 19,3 Kg, the body mass index (BMI) was 24,7 ? 7,2Kg/m2 and the percentile of the patients with the ideal body weigh was 103,1 ? 42,1%. The COPD diagnoses occurred in 70% of the evaluated patients. The arterial gasometry results shown PaO2 levels of 46,12 ? 9,10 mmHg, PaCO2 levels of the 44,68 ? 8,75 mmHg and SaO2 levels of 79,30 ? 11,91%. The results of the pulmonary function testing shown that the greatest part of the studies patients has presented restrictives or obstructives ventilatory disturbs. The patient's characteristics results shown... (Complete abstract click electronic address below) / Mestre
18

Avaliação do retinol no escarro e no soro de tabagistas e pacientes com doença pulmonar obstrutiva crônica e sua relação com o processo inflamatório

Amaral, Renata Antonialli Ferreira do [UNESP] 23 February 2010 (has links) (PDF)
Made available in DSpace on 2014-06-11T19:25:36Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-02-23Bitstream added on 2014-06-13T18:29:06Z : No. of bitstreams: 1 amaral_raf_me_botfm.pdf: 275363 bytes, checksum: 6531c12b1bb2da7ec7e8769316e5d677 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A doença pulmonar obstrutiva crônica (DPOC) e o tabagismo são doenças inflamatórias que interferem no metabolismo da vitamina A; entretanto, o comportamento do retinol nas vias aéreas destes pacientes ainda é desconhecido. Avaliar o retinol no escarro induzido e no soro de tabagistas e pacientes com DPOC e a associação destes valores com os marcadores da inflamação sistêmica e nas vias aéreas. Foram avaliados 50 pacientes com DPOC moderada a muito grave [idade média = 64,0 +/- 9,0 anos; VEF1(%) 49,9 +/- 16,8], 19 tabagistas [idade média = 49,0 +/- 6,4 anos; VEF1(%) 107,2 +/- 15,9] e 31 indivíduos controles [idade média = 48,2 +/- 8,1 anos; VEF1(%) 111,8 +/- 15,5]. Todos os indivíduos da pesquisa foram submetidos à avaliação clínica, espirometria pré e pósbroncodilatador, oximetria de pulso, avaliação da ingestão de vitamina A e do estado nutricional e coleta de sangue. A indução e coleta de escarro foi realizada em pacientes com DPOC e tabagistas. As concentrações de retinol e do fator de necrose tumoral alfa (TNF-a), interleucina (IL)-6 e IL-8 foram avaliadas no soro e no sobrenadante de escarro induzido. A concentração de PCR no soro também foi avaliada. O teste “t” de Student ou de Mann-Whitney foi utilizado para a comparação entre dois grupos. As associações entre as variáveis foram analisadas por meio do teste de correlação de Pearson ou Spearman. Para a comparação de mais de dois grupos foi utilizada ANOVA de uma via seguido do teste de Tukey ou Kruskal-Wallis seguido do teste Dunn. A correção para idade foi realizada através da análise de covariância (ANCOVA). Os valores médios de vitamina sérica foram significativamente menores nos pacientes com DPOC (1,80 [1,25-2,16] μmol/L) quando comparados aos tabagistas (2,40 [1,95-3,14]μmol/L) (p<0, 001); enquanto que, não foi observada diferença... / Chronic obstructive pulmonary disease (COPD) and tobacco smoking are inflammatory diseases that interfere with vitamin A metabolism; however, the retinol status in the airways of these patients is unknown. The aim of this study was to evaluate retinol concentration in the induced sputum and serum of current smokers and COPD patients and to study the association between these values and those of systemic and airways inflammatory markers. We evaluated 50 patients with moderate to very severe COPD [mean age= 64,0 +/- 9,0 y; FEV1 (%) 49,9 +/- 16,8], 19 current smokers [mean age = 49,0 +/- 6,4 y; FEV1(%) 107,2 +/- 15,9] and 31 control subjects [mean age = 48,2 +/- 8,1y; FEV1 (%) 111,8 +/- 15,5]. All subjects underwent to clinical evaluation, pre and post-bronchodilator spirometry, pulse oximetry, evaluation of vitamin A intake and of the nutritional status and blood sampling. Sputum induction was perfomed only in COPD patients and current smoker subjects. Retinol, tumor necrosis factor alpha (TNF-α), interleukin (IL)-6 and IL-8 were measured in serum and induced sputum. Serum concentration of C-reactive protein (CRP) was also measured. For comparison between two groups, we used either the Student “t” test or Mann- Whitney test. The associations among variables were analyzed by means of the Pearson correlation or using Spearman. For comparison of more than two groups we used one-way ANOVA followed by Tukey test and Kruskal-Wallis test followed by Dunn. The correction for age was performed by analysis of covariance (ANCOVA). Mean values of serum retinol were significantly lower in COPD patients (1,80 [1,25-2,16] μmol/L) when compared to current smokers (2,40 [1,95- 3,14]μmol/L) (p<0,001); however, values were not significantly different between control subjects (1,98 [1,82-2,32] μmol/L), current... (Complete abstract click electronic access below)
19

Evolução dos marcadores diagnósticos e prognósticos de pacientes com DPOC no período de três anos

Ferrari, Renata [UNESP] 25 February 2010 (has links) (PDF)
Made available in DSpace on 2014-06-11T19:25:36Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-02-25Bitstream added on 2014-06-13T19:12:36Z : No. of bitstreams: 1 ferrari_r_me_botfm.pdf: 1633942 bytes, checksum: 661f07a6a0fe1c72e7d870e2a8d1b28b (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Estudos mostram a evolução dos marcadores locais e sistêmicos da doença pulmonar obstrutiva crônica (DPOC) e sua associação com o prognóstico da doença. No entanto, não identificamos estudos prévios avaliando a evolução desses marcadores em pacientes brasileiros com DPOC. Além disso, a associação entre as modificações dos marcadores da doença e a qualidade de vida relacionada à saúde não está clara. O objetivo deste estudo foi verificar a evolução dos marcadores diagnósticos e prognósticos de pacientes com DPOC e a associação destes marcadores com a mortalidade, exacerbação e modificações na qualidade de vida relacionada à saúde no período de três anos. No momento basal foram avaliados 133 pacientes com DPOC leve a muito grave, 15 pacientes (11%) morreram durante o seguimento e 23 pacientes (17%) não foram reavaliados. Portanto, 95 pacientes (72%) foram submetidos às seguintes avaliações no momento basal e após três anos: espirometria, composição corporal, sensação da dispneia por meio da escala Medical Research Council (MRC) e do índice de dispneia basal (BDI), qualidade de vida por meio do Questionário do Hospital Saint George na Doença Respiratória (SGRQ), comorbidades (Índice Charlson), tolerância ao exercício (distância percorrida em seis minutos-DP6) e cálculo do Índice BODE. Após a avaliação inicial, os pacientes ou seus familiares foram contatados a cada três meses para verificar a frequência de exacerbações e óbito. A evolução dos marcadores foi feita por meio do teste T para medidas repetidas. Análise de regressão de Cox foi realizada para identificar os preditores de mortalidade. A associação dos marcadores da doença com a frequência de exacerbação foi avaliada por meio da análise de regressão de Poisson. Análise de regressão logística foi utilizada para avaliar... / Studies show the evolution of local and systemic markers of chronic obstructive pulmonary disease (COPD) and its association with the disease prognosis. However, we did not identify previous studies evaluating the evolution of these markers in Brazilian patients with COPD. In addition, the association between modifications in disease markers and health-related quality of life (HRQL) are unclear. The objective of this study was to verify the evolution of diagnostic and prognostic markers in COPD patients and the association of these markers with mortality, exacerbation and modifications in HRQL over three years. At baseline were evaluated 133 patients with mild to very severe COPD, 15 patients (11%) died and 23 patients (17%) dropped out during the follow-up period. Therefore, 95 patients (72%) underwent following the evaluations at baseline and after three years: spirometry, body composition, dyspnea perception using the Medical Research Council scale (MRC) and the baseline dyspnea index (BDI), quality of life questionnaire by Saint George's Respiratory Questionnaire (SGRQ), comorbidities (Charlson index), exercise tolerance (six-minute walk distance-6MWD) and the calculate BODE index. After the initial assessment, patients or their relatives were contacted every three months to verify the exacerbations frequency and death. The evolution of the markers was evaluated using the paired t-test. Cox regression analysis was performed to identify mortality predictors. Association of disease markers with exacerbation frequency was assessed by Poisson regression analysis. Logistic regression analysis was used to evaluate the predictors of improvement or worsening of HRQL. After three years of study, there was no change in the values of FEV1 (p=0.23) and BMI (p=0.38). There was a significant worsening... (Complete abstract click electronic access below)
20

Versão brasileira do Chronic Respiratory Questionnaire: estudo da validade de constructo e reprodutibilidade

Moreira, Graciane Laender [UNESP] 29 October 2009 (has links) (PDF)
Made available in DSpace on 2014-06-11T19:22:49Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-10-29Bitstream added on 2014-06-13T19:08:19Z : No. of bitstreams: 1 moreira_gl_me_prud.pdf: 458066 bytes, checksum: 0ca2abc500e5cd73db10163c69dbcb12 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Verificar a validade de constructo e reprodutibilidade de uma versão em português do Chronic Respiratory Questionnaire (CRQ, ou Questionário sobre Doenças Respiratórias Crônicas) em pacientes com Doença Pulmonar Obstrutiva Crônica (DPOC). Métodos: A versão em português do CRQ fornecida pela Universidade de McMaster, detentora dos direitos do questionário, foi aplicada a 50 pacientes portadores de DPOC (32 homens; 70±8 anos; VEF1 47±18% previsto) em dois momentos, com intervalo de uma semana. O CRQ tem 4 domínios (dispnéia, fadiga, função emocional e autocontrole) e foi aplicado em formato de entrevista. O Questionário Saint George na Doença Respiratória (SGRQ), já validado em português, foi utilizado como critério de validação. A espirometria e o teste da caminhada de seis minutos (TC6min) foram realizados para análise das correlações com os valores do CRQ. Resultados: Não foram observadas diferenças significativas entre a aplicação e reaplicação do CRQ (p>0.05 para todos os domínios). O coeficiente de correlação intraclasse entre a aplicação e reaplicação foi de 0,98; 0,97; 0,98 e 0,95 para dispnéia, fadiga, função emocional e autocontrole, respectivamente. O coeficiente alfa de Cronbach para os domínios dispnéia, fadiga, função emocional e autocontrole foi de 0,86; 0,78; 0,81 e 0,70 respectivamente... / To verify the construct validity and reproducibility of a Portuguese version of the Chronic Respiratory Questionnaire (CRQ) in patients with chronic obstructive pulmonary disease (COPD). Methods: The Portuguese version of the CRQ provided by McMaster University (Hamilton, Ontario- Canada), the holder of the questionnaire copyrights, was applied to 50 patients with COPD (32 men; 70±8 years; FEV1 47±18% of predicted) on two occasions, 1-week apart. The CRQ is composed of 20 questions divided into four domains (dyspnea, fatigue, emotional function, and mastery) and was applied as an interviewer-administered instrument. The Saint George´s Respiratory Questionnaire (SGRQ), already validated in Portuguese language, was used as the criterion for validation. Spirometry and the 6-minute walk test (6MWT) were performed to analyze the correlations with the CRQ scores domains. Results: There were no significant differences between test... (Complete abstract click electronic access below)

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