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
8 resultados
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- Latin America validation of FACED score in patients with bronchiectasis: an analysis of six cohorts(2017) ATHANAZIO, Rodrigo; PEREIRA, Monica Corso; GRAMBLICKA, Georgina; CAVALCANTI-LUNDGREN, Fernando; FIGUEIREDO, Mara Fernandes de; ARANCIBIA, Francisco; RACHED, Samia; ROSA, David de la; MAIZ-CARRO, Luis; GIRON, Rosa; OLVEIRA, Casilda; PRADOS, Concepcion; MARTINEZ-GARCIA, Miguel AngelBackground: The FACED score is an easy-to-use multidimensional grading system that has demonstrated an excellent prognostic value for mortality in patients with bronchiectasis. A Spanish group developed the score but no multicenter international validation has yet been published. Methods: Retrospective and multicenter study conducted in six historical cohorts of patients from Latin America including 651 patients with bronchiectasis. Clinical, microbiological, functional, and radiological variables were collected, following the same criteria used in the original FACED score study. The vital status of all patients was determined in the fifth year of follow-up. The area under ROC curve (AUC-ROC) was used to calculate the predictive power of the FACED score for all-cause and respiratory deaths and both number and severity of exacerbations. The discriminatory power to divide patients into three groups of increasing severity was also analyzed. Results: Mean (SD) age of 48.2 (16), 32.9% of males. The mean FACED score was 2.35 (1.68). During the follow up, 95 patients (14.6%) died (66% from respiratory causes). The AUC ROC to predict all-cause and respiratory mortality were 0.81 (95% CI: 0.77 to 0.85) 0.84 (95% CI: 0.80 to 0.88) respectively, and 0.82 (95% CI: 078-0.87) for at least one hospitalization per year. The division into three score groups separated bronchiectasis into distinct mortality groups (mild: 3.7%; moderate: 20.7% and severe: 48.5% mortality; p < 0.001). Conclusions: The FACED score was confirmed as an excellent predictor of all-cause and respiratory mortality and severe exacerbations, as well as having excellent discriminative capacity for different degrees of severity in various bronchiectasis populations.
- Does home-based pulmonary rehabilitation improve functional capacity, peripheral muscle strength and quality of life in patients with bronchiectasis compared to standard care?(2017) JOSE, Anderson; HOLLAND, Anne E.; OLIVEIRA, Cristiane S. de; SELMAN, Jessyca P. R.; CASTRO, Rejane A. S. de; ATHANAZIO, Rodrigo A.; RACHED, Samia Z.; CUKIER, Alberto; STELMACH, Rafael; CORSO, Simone DalBackground: Home-based pulmonary rehabilitation is a promising intervention that may help patients to overcome the barriers to undergoing pulmonary rehabilitation. However, home-based pulmonary rehabilitation has not yet been investigated in patients with bronchiectasis.& para;& para;Objectives: To investigate the effects of home-based pulmonary rehabilitation in patients with bronchiectasis.& para;& para;Methods: An open-label, randomized controlled trial with 48 adult patients with bronchiectasis will be conducted. Interventions: The program will consist of three sessions weekly over a period of 8 weeks. Aerobic exercise will consist of stepping on a platform for 20 min (intensity: 60-80% of the maximum stepping rate in incremental step test). Resistance training will be carried out using an elastic band for the following muscles: quadriceps, hamstrings, deltoids, and biceps brachii (load: 70% of maximum voluntary isometric contraction). Control: The patients will receive an educational manual and a recommendation to walk three times a week for 30 min. All patients will receive a weekly phone call to answer questions and to guide the practice of physical activity. The home-based pulmonary rehabilitation group also will receive a home visit every 15 days. Main outcome measures: incremental shuttle walk test, quality of life, peripheral muscle strength, endurance shuttle walk test, incremental step test, dyspnea, and physical activity in daily life. The assessments will be undertaken at baseline, after the intervention, and 8 months after randomization.& para;& para;Discussion: The findings of this study will determine the clinical benefits of home-based pulmonary rehabilitation and will contribute to future guidelines for patients with bronchiectasis.
- Predicting high risk of exacerbations in bronchiectasis: the E-FACED score(2017) MARTINEZ-GARCIA, M. A.; ATHANAZIO, R. A.; GIRON, R.; MAIZ-CARRO, L.; ROSA, D. de la; OLVEIRA, C.; GRACIA, J. de; VENDRELL, M.; PRADOS-SANCHEZ, C.; GRAMBLICKA, G.; CORSO, Pereira M.; LUNDGREN, F. L.; FIGUEIREDO, M. Fernandes De; ARANCIBIA, F.; RACHED, S. Z.Background: Although the FACED score has demonstrated a great prognostic capacity in bronchiectasis, it does not include the number or severity of exacerbations as a separate variable, which is important in the natural history of these patients. Objective: Construction and external validation of a new index, the E-FACED, to evaluate the predictive capacity of exacerbations and mortality. Methods: The new score was constructed on the basis of the complete cohort for the construction of the original FACED score, while the external validation was undertaken with six cohorts from three countries (Brazil, Argentina, and Chile). The main outcome was the number of annual exacerbations/hospitalizations, with all-cause and respiratory-related deaths as the secondary outcomes. A statistical evaluation comprised the relative weight and ideal cut-off point for the number or severity of the exacerbations and was incorporated into the FACED score (E-FACED). The results obtained after the application of FACED and E-FACED were compared in both the cohorts. Results: A total of 1,470 patients with bronchiectasis (819 from the construction cohorts and 651 from the external validation cohorts) were followed up for 5 years after diagnosis. The best cut-off point was at least two exacerbations in the previous year (two additional points), meaning that the E-FACED has nine points of growing severity. E-FACED presented an excellent prognostic capacity for exacerbations (areas under the receiver operating characteristic curve: 0.82 for at least two exacerbations in 1 year and 0.87 for at least one hospitalization in 1 year) that was statistically better than that of the FACED score (0.72 and 0.78, P < 0.05, respectively). The predictive capacities for all-cause and respiratory mortality were 0.87 and 0.86, respectively, with both being similar to those of the FACED. Conclusion: E-FACED score significantly increases the FACED capacity to predict future yearly exacerbations while maintaining the score's simplicity and prognostic capacity for death.
- Erratum to: Effects of periodontal treatment on exacerbation frequency and lung function in patients with chronic periodontitis: study protocol of a 1-year randomized controlled (vol 17, 2017)(2017) ROMERO, Sergio dos Santos; PINTO, Erika Horacio; LONGO, Priscila Larcher; CORSO, Simone Dal; LANZA, Fernanda Cordoba; STELMACH, Rafael; RACHED, Samia Zahi; LINO-DOS-SANTOS-FRANCO, Adriana; MAYER, Marcia Pinto Alves; BUSSADORI, Sandra Kalil; FERNANDES, Kristianne Porta Santos; MESQUITA-FERRARI, Raquel Agnelli; HORLIANA, Anna Carolina Ratto Tempestini
- Effects of periodontal treatment on exacerbation frequency and lung function in patients with chronic periodontitis: study protocol of a 1-year randomized controlled trial(2017) SANTOS, Sergio Romero; PINTO, Erika Horacio; LONGO, Priscila Larcher; CORSO, Simone Dal; LANZA, Fernanda Cordoba; STELMACH, Rafael; RACHED, Samia Zahi; LINO-DOS-SANTOS-FRANCO, Adriana; MAYER, Marcia Pinto Alves; BUSSADORI, Sandra Kalil; FERNANDES, Kristianne Porta Santos; MESQUITA-FERRARI, Raquel Agnelli; HORLIANA, Anna Carolina Ratto TempestiniBackground: Chronic obstructive pulmonary disease (COPD) has been associated with periodontal disease (PD), and periodontal treatment (PT) has been connected to reduction of lung disease exacerbations. Bronchiectasis has many clinical similarities with COPD but, although it is also a chronic lung disease, to date it has not been studied with relation to PD. The aim of this study is to evaluate whether PT associated with photodynamic therapy (PDT) reduces the number of exacerbations, improves pulmonary function, periodontal clinical parameters and quality of life after 1 year of periodontal treatment follow-up. Methods: Bronchiectasis patients will undergo medical anamnesis and periodontal examination. Participants with periodontitis will be divided into two groups and PT will be performed as G1 control group (n = 32) - OHO (oral hygiene orientation) + supragingival treatment + simulation of using photodynamic therapy (PDT); G2 experimental (n = 32) - scaling and root planing + PDT + OHO. Lung function will be assessed both at baseline and after 1 year by spirometry, exacerbation history will be analyzed through clinical records monitoring. Three instruments for quality of life assessment will also be applied - Saint George's Respiratory Questionnaire and Impact Profile Analysis Oral health (OHIP-14). It is expected that periodontal treatment can improve the analyzed parameters after 1 year. Discussion: Although only one study evaluates exacerbation in COPD after 1 year of PT, bronchiectasis has not been studied in the dentistry field to date. Trial registration: NCT02514226. Version #1. This study protocol receives grant from FAPESP (Sao Paulo Research Foundation) # 2015/20535-1. First received: July 22, 2015, 1st version. This protocol has been approved by the Research Ethics Committee of Nove de Julho University.
- Home-based pulmonary rehabilitation in patients with bronchiectasis: a randomized controlled trial(2017) CORSO, Simone Dal; JOSE, Anderson; HOLLAND, Anne E.; SELMAN, Jessyca P. R.; CASTRO, Rejane A. S.; CAMARGO, Anderson A. de; OLIVEIRA, Cristiane S. de; FREITAS, Tiago P.; ATHANASIO, Rodrigo; RACHED, Samia Z.; CUKIER, Alberto; STELMACH, Rafael
- Do the inflammatory and oxidative basal statuses modulate the functional capacity response after a pulmonary rehabilitation program?(2017) CASTRO, Rejane Agnelo Silva De; CAMARGO, Anderson Alves de; VIEIRA, Rodolfo de Paula; ANGELIS, Katia De; ARAUJO, Amanda Aparecida de; OLIVEIRA JUNIOR, Manoel Carneiro; JOSE, Anderson; OLIVEIRA, Cristiane Santos de; ATHANAZIO, Rodrigo Abensur; RACHED, Samia Zahi; STELMACH, Rafael; CORSO, Simone Dal
- Brazilian guidelines for the diagnosis and treatment of cystic fibrosis(2017) ATHANAZIO, Rodrigo Abensur; SILVA FILHO, Luiz Vicente Ribeiro Ferreira da; VERGARA, Alberto Andrade; RIBEIRO, Antonio Fernando; RIEDI, Carlos Antonio; PROCIANOY, Elenara da Fonseca Andrade; ADDE, Fabiola Villac; REIS, Francisco Jose Caldeira; RIBEIRO, Jose Dirceu; TORRES, Lidia Alice; FUCCIO, Marcelo Bicalho de; EPIFANIO, Matias; FIRMIDA, Monica de Cassia; DAMACENO, Neiva; LUDWIG-NETO, Norberto; MAROSTICE, Paulo Jose Cauduro; RACHED, Sarnia Zahi; MELO, Suzana Fonseca de Oliveira