RODRIGO DIAZ OLMOS
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Clínica Médica, Faculdade de Medicina - Docente
DVCLME-62, Hospital Universitário
DVCLME-62, Hospital Universitário
20 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 20
- The National Institute for Health Research (NIHR) Global Health Research Group on Atrial Fibrillation management(2019) LIP, Gregory Y. H.; GUO, Yutao; LOTUFO, Paulo; SURENTHIRAKUMARAN, Rajendra; HUMPHREYS, Lindsey; THOMAS, G. Neil; ARASALINGAM, Ajini; BENSENOR, Isabela; BROCKLEHURST, Peter; CHENG, Kar Keung; FENG, Mei; GOULART, Alessandra; GREENFIELD, Sheila; GUO, Yutao; GURUPARAN, Mahesan; GUSSO, Gustavo; HAO, Wang; HUMPHREYS, Lindsey; KUMARENDRAN, Balachandran; JOLLY, Kate; JOWETT, Sue; KIRCHHOF, Paulus; LANCASHIRE, Emma; LANE, Deirdre; LASSERSON, Dan; LI, Xuewen; LIP, Gregory Y. H.; LOBBAN, Trudie; MANSEKI-HOLLAND, Semira; MOORE, David; NIRANTHARAKUMAR, Krishnarajah; OLMOS, Rodrigo; SHANTSILA, Alena; SZMIGIN, Isabelle; SUBASCHANDREN, Kumaran; SURENTHIRAKUMARAN, Rajendra; THOMAS, G. Neil
- Screening for chronic kidney disease and inequity(2016) OLMOS, Rodrigo Diaz
- Terminologia da atenção primária à saúde(2012) GUSSO, Gustavo Diniz Ferreira; BENSENOR, Isabela Judith Martins; OLMOS, Rodrigo FiazINTRODUCTION: The field of primary health care has many terms that are not used properly. It is important to retrieve the root of such terms in order to understand why they are used differently by health workers and lay people. OBJECTIVE: To research and discuss the meanings and uses of terms related to primary health care. METHOD: Review in different sources the meanings of terms such as primary health care, family medicine, general practice, internal medicine, family health program. RESULTS: Different references usually have the same meaning for similar terms. Some terms, such as ""clinical medicine"", which in practice means ""internal medicine"", do not have a clear origin. DISCUSSION: Many terms are used incorrectly due to different interests and historical reasons. This work does not intend to provide an exhaustive discussion about the importance of terminology in primary health care. It is an important field of research because might help communication between patients, health workers and politicians and, especially, support adequate understanding by students of this type of health care.
- Unproven Therapy Algorithms for Early SARS-CoV-2 Infection Are Dangerous(2021) OLMOS, R. D.; ROQUE, F. L.[No abstract available]
- Identifying and understanding the care pathway of patients with atrial fibrillation in Brazil and the impact of the COVID-19 pandemic: A mixed-methods study(2023) GOULART, Alessandra C.; VARELLA, Ana C.; GOODEN, Tiffany E.; LIP, Gregory Y. H.; JOLLY, Kate; THOMAS, G. Neil; LOTUFO, Paulo A.; GREENFIELD, Sheila; OLMOS, Rodrigo D.; BENSENOR, Isabela M.; MANASEKI-HOLLAND, SemiraBackground Atrial fibrillation (AF) is a major risk factor for stroke. To enable improvements to AF diagnosis and follow-up care, understanding current patient pathways and barriers to optimal care are essential. We investigated the patient care pathways and their drivers, and the impact of the COVID-19 pandemic on patient pathways in a middle-income country setting, Brazil. Methods This mixed-methods study in SAo Paulo, included adults (>= 18y) with AF from 13 primary/secondary healthcare facilities. Surveys using baseline, follow-up (administered >= two months after baseline) and COVID-19 questionnaires (quantitative), and three focus group discussions (FGDs) were conducted. Minimum sample size for the quantitative component was 236 and we aimed to reach saturation with at least three FGDs for the qualitative component. Descriptive statistics were used for quantitative data and a content analysis was used for qualitative data to identify themes related to AF diagnosis and follow-up care. Results 267 participants completed the baseline questionnaire: 25% were diagnosed in primary care, 65% in an emergency or inpatient department. At follow-up (n = 259), 31% visited more than one facility for AF care, and 7% had no follow-up. Intervals between international normalised ratio (INR) tests were increased during the pandemic, and the number of healthcare visits and availability of medication were reduced. Seventeen patients participated in three FGDs and revealed that AF diagnosis often occurred following a medical emergency and patients often delay care-seeking due to misconceptions about AF symptoms. Long waiting times, doctor/patient interactions and health system factors, such as doctor availability and the referral system, influence where participants visited for follow-up care. Conclusions Lack of public awareness and underdeveloped primary healthcare lead to delayed diagnosis, which impacts clinical outcomes and excess patient and healthcare system costs. Health system, care-provider, and pandemic factors disrupt timely and effective continuity of care.
- Cerebrovascular risk factors and their time-dependent effects on stroke survival in the EMMA cohort study(2023) GOULART, A. C.; VARELLA, A. C.; TUNES, G.; ALENCAR, A. P.; SANTOS, I. S.; ROMAGNOLLI, C.; GOODEN, T. E.; THOMAS, G. N.; LIP, G. Y. H.; OLMOS, R. D.; LOTUFO, P. A.; BENSENOR, I. M.To investigate the time-dependent effects of traditional risk factors on functional disability in all-cause mortality post-stroke, we evaluated data from a long-term stroke cohort. Baseline cerebrovascular risk factors (CVRF) and functionality at 1 and 6 months were evaluated in survivors from a prospective stroke cohort using the modified Rankin scale (m-RS), which classifies participants as improvement of disability, unchanged disability (at least moderate), and worsening disability. Cox regression models considering baseline risk factors, medication use, and functionality 6 months after stroke were fitted to identify their time-dependent effects up to 12 years of follow-up. Adjusted hazard ratios (HR) with 95% confidence intervals (CI) are presented. Among 632 survivors (median age 68, 54% male, 71% first-ever episode), age and functional disability (unchanged and worsening) 6 months after ischemic stroke had time-dependent effects on all-cause mortality risk up to 12 years of follow-up. The most impacting risk factors were unchanged (at least moderate) (HR, 2.99; 95%CI: 1.98-4.52) and worsening disability (HR, 2.85; 95%CI: 1.26-6.44), particularly in the first two years after a stroke event (Time 1: >= 6 mo to <2.5 y). Worsening disability also impacted mortality in the period from >= 2.5 to <7.5 years (Time 2) of follow-up (HR, 2.43 (95%CI: 1.03-5.73). Other baseline factors had a fixed high-risk effect on mortality during follow-up. Post-stroke and continuous medication use had a fixed protective effect on mortality. Functional disability was the main contributor with differential risks of mortality up to 12 years of follow-up.
- Shadow'' OSCE examiner. A cross-sectional study comparing the shadow'' examiner with the original OSCE examiner format(2019) RODRIGUES, Marcelo Arlindo Vasconcelos; OLMOS, Rodrigo Diaz; KIRA, Celia Maria; LOTUFO, Paulo Andrade; SANTOS, Itamar Souza; TIBERIO, Iolanda de Fatima Lopes CalvoOBJECTIVES: Feedback is a powerful learning tool, but a lack of appropriate feedback is a very common complaint from learners to teachers. To improve opportunities for feedback on objective structured clinical examinations (OSCEs), a modified examiner role, termed the ""shadow'' examiner, was tested. This study aims to present and analyze comparisons between the ""shadow'' examiner and the original OSCE examiner format. METHODS: In 2011, experiments were carried out with modifications to the examiner's role to define the ""shadow'' examiner format. From February 2012 to May 2014, research was conducted with 415 6th-year medical students. Of these students, 316 were randomly assigned to assessments by both ""shadow'' and ""fixed'' examiners. Pearson correlation analysis with linear regression, Student's t-tests and Bland-Altman plots were the statistical methods used to compare the assessment modes. To strengthen the analysis, checklist items were classified by domain. RESULTS: High correlations between the ""shadow'' and ""fixed'' examiners' global scores were observed. The results of the analysis of specific domains demonstrated higher correlations for cognitive scores and lower correlations for affective scores. No statistically significant differences between the mean examiner global scores were found. The Bland-Altman analysis showed that the ""shadow'' examiners' affective scores were significantly higher than those of the ""fixed'' examiners, but the magnitude of this difference was small. CONCLUSION: The modified examiner role did not lead to any important bias in the students' scores compared with the original OSCE examiner format. This new strategy may provide important insights for formative assessments of clinical performance.
- Atrial fibrillation in low- and middle-income countries: a narrative review(2020) SANTOS, Itamar S.; GOULART, Alessandra C.; OLMOS, Rodrigo D.; THOMAS, G. Neil; LIP, Gregory Y. H.; LOTUFO, Paulo A.; BENSENOR, Isabela M.Preventing premature non-communicable disease mortality necessitates a thorough review of one of the most important risk factors for stroke, which is atrial fibrillation (AF). The latter and AF-related stroke are still considered to be problems of high-income countries and are frequently overlooked in low- and middle-income countries (LMICs). In this narrative review, we provide an overview of studies that evaluated at least one of the following determinants of AF burden in LMICs: current epidemiology and trends, stroke prevention, health outcomes, and economic burden. Studies focusing on samples close to the general population (including community- and primary care-based samples) indicate sex-specific prevalence rates up to 7.4% in LMICs. Although AF prevalence is still higher in high-income countries than LMICs, the gap in AF burden between these two groups has been reducing in the past three decades. Oral anticoagulant (OAC) therapy for stroke prevention is underused in LMICs, and there are little data on OAC therapy in relation to stroke risk scores, such as CHA(2)DS(2)-VASc. Available data also points to higher morbidity and mortality for patient with AF in LMICs than their counterparts in high-income countries. Data on the consequent economic burden in LMICs is scarce, but it is reasonable to consider it will follow the same trend as that observed for health outcomes. Raising the visibility of AF as a public health problem in LMICs is necessary as a first step to providing adequate care for patients with this condition.