SAMIA ZAHI RACHED
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
11 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 11
- Comparação entre medidas objetivas do tabagismo e tabagismo autodeclarado em pacientes com asma ou DPOC: será que nossos pacientes dizem a verdade?(2015) STELMACH, Rafael; FERNANDES, Frederico Leon Arrabal; CARVALHO-PINTO, Regina Maria; ATHANAZIO, Rodrigo Abensur; RACHED, Samia Zahi; PRADO, Gustavo Faibischew; CUKIER, AlbertoObjective: Smoking prevalence is frequently estimated on the basis of self-reported smoking status. That can lead to an underestimation of smoking rates. The aim of this study was to evaluate the difference between self-reported smoking status and that determined through the use of objective measures of smoking at a pulmonary outpatient clinic. Methods: This was a cross-sectional study involving 144 individuals: 51 asthma patients, 53 COPD patients, 20 current smokers, and 20 never-smokers. Smoking status was determined on the basis of self-reports obtained in interviews, as well as through tests of exhaled carbon monoxide (eCO) and urinary cotinine. Results: All of the asthma patients and COPD patients declared they were not current smokers. In the COPD and asthma patients, the median urinary cotinine concentration was 167 ng/mL (range, 2-5,348 ng/mL) and 47 ng/mL (range, 5-2,735 ng/mL), respectively (p < 0.0001), whereas the median eCO level was 8 ppm (range, 0-31 ppm) and 5 ppm (range, 2-45 ppm), respectively (p < 0.05). In 40 (38%) of the patients with asthma or COPD (n = 104), there was disagreement between the self-reported smoking status and that determined on the basis of the urinary cotinine concentration, a concentration > 200 ng/mL being considered indicative of current smoking. In 48 (46%) of those 104 patients, the self-reported non-smoking status was refuted by an eCO level > 6 ppm, which is also considered indicative of current smoking. In 30 (29%) of the patients with asthma or COPD, the urinary cotinine concentration and the eCO level both belied the patient claims of not being current smokers. Conclusions: Our findings suggest that high proportions of smoking pulmonary patients with lung disease falsely declare themselves to be nonsmokers. The accurate classification of smoking status is pivotal to the treatment of lung diseases. Objective measures of smoking could be helpful in improving clinical management and counseling.
conferenceObject Incremental shuttle walking test: A reproducible and valid measure of exercise tolerance in adult subjects with non-cystic fibrosis bronchiectasis (nCF-BCt)(2013) CAMARGO, Anderson Alves de; RACHED, Samia Zahi; ATHANAZIO, Rodrigo Abensur; AMARAL, Tatiane Soares; LANZA, Fernanda de Cordoba; SELMAN, Jessyca Pachi Rodrigues; CUKIER, Alberto; FERNANDES, Frederico Leon Arrabal; CARVALHO, Celso Ricardo Fernandes; STELMACH, Rafael; CORSO, Simone DalconferenceObject Non Concordance Between Sputum and Pulmonary Explant Fragments Culture in Patients with Cystic Fibrosis After Lung Transplantation(2018) ATHANAZIO, R. A.; RACHED, S. Z.; STELMACH, R.; CUKIER, A.; CARVALHO-PINTO, R. M.; COSTA, A. N.; FERNANDES, F. L.; SAMANO, M. N.; TEIXEIRA, R. H.; CAMPOS, S. V.conferenceObject Clinical, functional and microbiological characteristics of an adult br Tian cystic fibrosis population(2014) RACHED, Samia Zahi; ATHANAZIO, Rodrigo; MAIORANO, Maria Cecilia Nieves Teixeira; FERNANDES, Frederico; CARVALHO-PINTO, Regina; CUKIER, Alberto; STELMACH, Rafael- Can severe asthmatic patients achieve asthma control? A systematic approach in patients with difficult to control asthma followed in a specialized clinic(2016) ATHANAZIO, Rodrigo; CARVALHO-PINTO, Regina; FERNANDES, Frederico Leon Arrabal; RACHED, Samia; RABE, Klaus; CUKIER, Alberto; STELMACH, RafaelBackground: Despite advances in asthma treatment, severe asthma (SA) still results in high morbidity and use of health resources. Our hypothesis was that SA patients would achieve adequate control with a systematic protocol, including oral corticosteroids, budesonide/formoterol maintenance and reliever therapy and a multidisciplinary approach to improve adherence. Methods: Non-controlled (NC) SA patients were enrolled to receive 2 weeks of oral corticosteroids and 12 weeks of formoterol + budesonide. Assessments included asthma control questionnaire (ACQ), asthma control test (ACT), daily symptom diary, lung function and health-related quality of life (HRQoL) questionnaires. Results: Of 51 patients, 13 (25.5%) achieved control. NC patients had higher utilization of health resources and higher exacerbation rates. Both controlled (C) and NC patients had significantly reduced ACQ scores after oral corticosteroid treatment. After 12 weeks, C patients continued improving. NC patients did not have significant changes. A similar pattern was found regarding lung function, use of rescue medication, and days free of symptoms. After 2 weeks of oral corticosteroids, an increase occurred in those who achieved the ACQ cut off; however, 53.8% of C patients had an ACQ < 1.57 versus 21.1% of NC patients (p = 0.03). Both groups had low HRQoL at baseline with improvement after intervention. Conclusions: Despite rigorous, optimized follow-up treatment, 75% of SA patients did not achieve adequate symptom control and presented with impaired quality of life. Conversely, application of a low-cost, easy to implement systematic protocol can prevent up to 25% of SA patients from up-titrating to new and complex therapies, thus reducing costs and morbidity.
conferenceObject Physiological responses to the 6-min walk test and incremental shuttle walk test in adults with non-cystic fibrosis bronchiectasis(2013) CAMARGO, Anderson Alves de; AMARAL, Tatiane Soares; RACHED, Samia Zahi; ATHANAZIO, Rodrigo Abensur; LANZA, Fernanda de Cordoba; CUKIER, Alberto; FERNANDES, Frederico Leon Arrabal; CARVALHO, Celso Ricardo Fernandes; STELMACH, Rafael; CORSO, Simone DalconferenceObject Quantitative Airway Wall Thickness In Severe Asthmatic Patients: An Useful Prognostic Tool But Not Predictor To Therapy(2014) ATHANAZIO, R. A.; CARVALHO-PINTO, R.; JASINOWODOLINSKI, D.; RACHED, S. Z.; MAIORANO, M. C.; FERNANDES, F. L. A.; RABE, K.; CUKIER, A.; STELMACH, R.conferenceObject A Case Of Association Of Pulmonary Actinomycosis And Chronic Cavitary Pulmonary Aspergillosis(2014) RACHED, S. Z.; MAIORANO, M. C. N. T.; ALMEIDA, G. Eler De; ATHANAZIO, R.; CARVALHO-PINTO, R.; FERNANDES, F. Leon Arrabal; STELMACH, R.; CUKIER, A.conferenceObject Determinants of exercise capacity in adult subjects with non-cystic fibrosis bronchiectasis(2013) CAMARGO, Anderson Alves de; AMARAL, Tatiane Soares; RACHED, Samia Zahi; ATHANASIO, Rodrigo Abensur; LANZA, Fernanda de Cordoba; SILVA, Jaksoel Cunha; CUKIER, Alberto; FERNANDES, Frederico Leon Arrabal; CARVALHO, Celso Ricardo Fernandes; STELMACH, Rafael; CORSO, Simone Dal- Evolution of severe asthma during pregnancy(2018) LIMA, Renato; ENDLICH, Blenda; OSMUNDO JUNIOR, Gilmar; FRANCISCO, Rossana; RACHED, Samia; ATHANAZIO, Rodrigo; FERNANDES, Frederico; CUKIER, Alberto; STELMACH, Rafael; PINTO, Regina