SESARAM - Pneu - Pneumologia
Permanent URI for this community
Browse
Browsing SESARAM - Pneu - Pneumologia by Title
Now showing 1 - 9 of 9
Results Per Page
Sort Options
- Chronic Pulmonary Aspergillosis and the Effect of CorticosteroidsPublication . Sousa, Cláudia S.; Mendes, Pedro; Brazão, AntónioChronic pulmonary aspergillosis (CPA) is a rare disease, fre quently affecting patients with current or prior lung disease, leading to the development of air cavities in the middle of lung parenchyma. Chronic cavitary pulmonary aspergillosis (CCPA) is the most common form of CPA, presenting as a single or as mul tiple pulmonary cavities with thickened walls, with or without an aspergilloma inside. etc...
- Differences between FEV6, FVC and VC at the diagnosis of obstructive ventilatory defectPublication . Sousa, C.S.; Coelho, D.B.; Amorim, P.; Viana, P.; Cruz-Martins, N.; Drummond, M.Introduction: The diagnosis of airway obstruction can be made through FEV1/FVC ratio <0.7 or FEV1/VC ratio < lower limit of normality (LLN). Several authors advocate that FEV1/FEV6 ratio is an alternative to diagnosing obstructive ventilatory defect, while others have determined that the best cut-off for this ratio (best combined sensitivity and specificity) is 0.73. Objective: To evaluate the non-inferiority of FEV1/FEV6 ratio < 0.73 when compared to FEV1/ FVC ratio < 0.7 and FEV1/VC < LLN in diagnosing airway obstruction. Methods: A retrospective analysis of the medical records from patients who underwent spirometry or plethysmography in a university central hospital from June 1st to December 31st, 2018 was carried out. Only medical records which included FEV1/FVC < 0.7 or FEV1/VC < LLN were selected, and these results were compared to FEV1/FEV6 ratio. Results: A total of 526 patients with obstructive ventilatory defect were identified by one of the two ratios described. Of these, 95.1%, 87.4% and 88.6% were obstructive by FEV1/FVC, FEV1/ VC, and FEV1/FEV6 ratio, respectively. The positive predictive value (PPV) of FEV1/FEV6 in relation to FEV1/FVC ratio was 99.6% (p < 0.001) with a diagnostic efficacy of 92.8%, whereas the PPV of FEV1/FEV6 in relation to FEV1/VC was 91.0% (p < 0.001) and diagnostic efficacy was 85.2%. Most false negatives, comparing FEV6 with the other two tests, were found in patients with FEV1 > 70% (mild obstruction) and in individuals aged >50 years. Conclusions: FEV1/FEV6 < 0.73 may be a good alternative ratio, as it is non-inferior to FEV1/VC and FEV1/FVC in diagnosing obstructive ventilatory defect.
- Portuguese consensus document for the management of alpha-1-antitrypsin deficiencyPublication . Lopes, A.P.; Mineiro, M.A.; Costa, F.; Gomes, J.; Santos, C.; Antunes, C.; Maia, D.; Melo, R.; Canotilho, M.; Magalhães, E.; Vicente, I.; Valente, C.; Gonçalves, B.G.; Conde, B.; Guimarães, C.; Sousa, C.; Amado, J.; Brandão, M.E.; Sucena, M.; Oliveira, M.J.; Seixas, S.; Teixeira, V.; Telo, L.Alpha-1-antitrypsin deficiency (AATD) is a genetic autosomal codominant disorder caused by mutations in SERPINA1 gene. It is one of the most prevalent genetic disorders, although it remains underdiagnosed. Whereas at international level there are several areas of consensus on this disorder, in Portugal, inter-hospital heterogeneity in clinical practice and resources available have been adding difficulties in reaching a diagnosis and in making therapeutic decisions in this group of patients. This raised a need to draft a document expressing a national consensus for AATD. To this end, a group of experts in this field was created within the Portuguese Pulmonology Society - Study group on AATD, in order to elaborate the current manuscript. The authors reviewed the existing literature and provide here general guidance and extensive recommendations for the diagnosis and management of AATD that can be adopted by Portuguese clinicians from different areas of Medicine. This article is part of a supplement entitled "Portuguese consensus document for the management of alpha-1-antitrypsin deficiency" which is sponsored by Sociedade Portuguesa de Pneumologia.
- A rare case of pulmonary disease combining alpha-1-antitrypsin deficiency and common variable immunodeficiencyPublication . Sousa, C.S.; Teixeira, V.; Pereira, V.; Pinheiro, R.B.; Seixas, S.; Martins, N.
- Reabilitação respiratória : Eficácia de um programa de treino de exercicio .Publication . Castro, Ana; Frederico, Abreu; Sónia, AlvesA reabilitação respiratória é “uma intervenção global e multidisciplinar, baseada na evidência, dirigida a doentes com doença respiratória crónica, sintomáticos e, frequentemente, com redução das suas atividades de vida diária Nici et al 2006 Apesar de ser recomendada na prática clínica por diferentes entidades, mundialmente creditadas, até junho de 2021 não existiam programas de reabilitação respiratória na Região Autónoma da Madeira Conscientes desta necessidade e proporcionando se as condições necessárias para a implementação de um programa de reabilitação respiratória, os enfermeiros especialistas em enfermagem de reabilitação ( em conjunto com os médicos pneumologistas do Serviço de Dermatologia/Pneumologia do Hospital dos Marmeleiros criaram a Unidade de Reabilitação Respiratória (De acordo com as recomendações da DGS 2009 2019 um programa de reabilitação respiratória deve ter uma duração mínima de 8 a 12 semanas com pelo menos 2 sessões supervisionadas por semana Deve incluir vários módulos Estes têm como objetivo habilitar o doente a lidar com o tratamento e prevenir complicações decorrentes da sua patologia, tornando o mais autónomo possível na autogestão da sua doença e no recurso aos serviços de saúde Segundo as mesmas recomendações para o programa ter resultados com significado clinico os doentes devem no final das 12 semanas -Aumentar em média 30 m a distância percorrida na Prova de Marcha de 6 minutos ( 2014 -Aumentar 3 repetições no T este de Sentar e Levantar 1 minuto) Vaidya 2016 Diminuir 2 unidades na Escala de Qualidade de Vida relacionada com a saúde ( Kon 2014- Diminuir 4 unidades na escala de Atividades de Vida D iária ( LCADL)( 2014 - Diminuir 1 5 unidades na escala de Ansiedade/Depressão ( Puhan 2008 Na fase inicial em que o programa de reabilitação respiratória se encontra foi dado maior enfase ao módulo de reeducação funcional respiratória e treino de exercício
- Telemedicine in COPD: An Overview by TopicsPublication . Barbosa, Miguel T.; Sousa, Cláudia S.; Morais-Almeida, Mario; Simões, Maria J.; Mendes, PedroIntroduction: COPD is a major cause of morbidity and mortality worldwide and carries a huge and growing economic and social burden. Telemedicine might allow the care of patients with limited access to health services and improve their self-management. During the COVID-19 pandemic, patient's safety represents one of the main reasons why we might use these tools to manage our patients. The authors conducted a literature search in MEDLINE database. The retrieval form of the Medical Subject Headings (Mesh) was ((Telemedicine OR Tele-rehabilitation OR Telemonitoring OR mHealth OR Ehealth OR Telehealth) AND COPD). We only included systematic reviews, reviews, meta-analysis, clinical trials and randomized-control trials, in the English language, with the selected search items in title or abstract, and published from January 1st 2015 to 31st May 2020 (n = 56). There was a positive tendency toward benefits in tele-rehabilitation, health-education and self-management, early detection of COPD exacerbations, psychosocial support and smoking cessation, but the heterogeneity of clinical trials and reviews limits the extent to which this value can be understood. Telemonitoring interventions and cost-effectiveness had contradictory results. The literature on teleconsultation was scarce during this period. The non-inferiority tendency of telemedicine programmes comparing to conventional COPD management seems an opportunity to deliver quality healthcare to COPD patients, with a guarantee of patient's safety, especially during the COVID-19 outbreak.
- The “Big Five” Lung Diseases in CoViD-19 Pandemic – a Google Trends analysisPublication . Barbosa, Miguel Trigueiro; Morais-Almeida, Mario; Sousa, Cláudia Sabina; Bousquet, Jean
- Ventilação Não Invasiva (Power Point )Publication . Lima, Filipa; Carvalho, João
- What do asthmatic patients think about telemedicine visits?Publication . Sousa, C.S.; Trigueiro-Barbosa, Mário; Aguiar, R.; Benito-Garcia, Filipe; Morais-Almeida, MarioIntroduction. Due to the Coronavirus disease 2019 (COVID-19) outbreak and the national emergency state, virtual visits were implemented as an alternative to in-person visits. With this study we aimed to establish asthma patients' general satisfaction with the quality of health care provided by virtual visits (phone or video calls). Materials and methods. A questionnaire (9 questions) was published on the Facebook page of the Portuguese Association of Asthmatics. It was available online for general self-reported asthmatic patients to answer during one month, starting on 11st May 2020. The survey only allowed one answer per registered user. Results. Fifty-five responses were obtained. Patients were satisfied with communication with providers (> 88%); nevertheless, one-half evaluated the virtual visit as inferior when compared to in-person visits. About one third attributed a classification of 6 or less (0-10 scale, 0 being the worst and 10 the best consultation possible), but still most of the patients would either recommend it or use this kind of medical visits in the future, even outside the actual pandemic context. Patients also referred some important limitations, as lack of physical examination and the fact that the medical visit was more impersonal. Only 27% had technical issues accessing virtual visits. Positive aspects were also named, such as virtual visits being practical and avoiding the need to move to the hospital. Discussion and conclusions. Our survey revealed that small changes could further increase patients' satisfaction, adherence and confidence in telemedicine. Although presenting some limitations, virtual visits seem to be generally well accepted by asthmatic patients and it might be a good alternative for in-person visits, at leastin such difficult times when social distancing is recommended.