FREDERICO LEON ARRABAL FERNANDES
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- Identification of functional phenotypes in people with COPD: influence of postural balance, physical activity, sedentary behaviour and quadriceps muscle strength(2019) XAVIER, Rafaella; CAPORALI, Ana Carolina; LOPES, Aline; OLIVEIRA, Cristino; FERNANDES, Frederico; STELMACH, Rafael; PINTO, Regina Carvalho; CUKIER, Alberto; CARVALHO, Celso
- The Mini-Balance Evaluation System Test Can Predict Falls in Clinically Stable Outpatients With COPD A 12-MO PROSPECTIVE COHORT STUDY(2019) PEREIRA, Ana Carolina A. C.; XAVIER, Rafaella F.; LOPES, Aline C.; SILVA, Cibele C. B. M. da; OLIVEIRA, Cristino C.; FERNANDES, Frederico L. A.; STELMACH, Rafael; CARVALHO, Celso R. F.Purpose: This study evaluated the accuracy of the Mini-Balance Evaluation System Test (Mini-BESTest) for predicting falls in patients with chronic obstructive pulmonary disease (COPD) and investigated whether postural balance is a risk factor for falls. Methods: Postural balance was evaluated by the Mini-BESTest at baseline, and the incidence of falls over a 12-mo period was prospectively measured by a self-reported falls diary and confirmed by telephone calls. A discriminative power analysis was performed using receiver operating characteristic (ROC) curve and logistic regression analysis. Results: Sixty-seven outpatients with COPD (mean age SD = 67 +/- 9.3 yr) were included. Twenty-five patients (37.3%) experienced 1 fall, and 28.2% of the falls resulted in injuries. The Mini-BESTest predicted falls in patients with COPD at the 6- and 12-mo follow-ups with a cut-off score of 22.5 (area under the curve = 0.85 and 0.87) with good sensitivity and specificity (85.7% and 66.7%; 84% and 73.8%, respectively). Higher scores on the Mini-BESTest were associated with a lower risk of falls at 12 mo (OR = 0.50; 95% CI, 0.36-0.70; P < .001). Conclusions: Postural balance assessed by the Mini-BESTest is a good predictor of falls in patients with COPD. Our results imply that impaired balance contributes to the risk of falling and that balance training and fall prevention programs may be required for this population.
- Exploratory analysis of requests for authorization to dispense high-cost medication to COPD patients: the Sao Paulo ""protocol""(2019) CARVALHO-PINTO, Regina Maria; SILVA, Ingredy Tavares da; NAVACCHIA, Lucas Yoshio Kido; GRANJA, Flavia Munhos; MARQUES, Gustavo Garcia; NERY, Telma de Cassia dos Santos; FERNANDES, Frederico Leon Arrabal; CUKIER, Alberto; STELMACH, RafaelObjective: A resolution passed by the government of the Brazilian state of Sao Paulo established a protocol for requesting free COPD medications, including tiotropium bromide, creating regional authorization centers to evaluate and approve such requests, given the high cost of those medications. Our objective was to analyze the requests received by an authorization center that serves cities in the greater metropolitan area of (the city of) Sao Paulo between 2011 and 2016. Methods: Data regarding the authorization, return, or rejection of the requests were compiled and analyzed in order to explain those outcomes. Subsequently, the clinical and functional data related to the patients were evaluated. Results: A total of 7,762 requests for dispensing COPD medication were analyzed. Requests related to male patients predominated. Among the corresponding patients, the mean age was 66 years, 12% were smokers, 88% had frequent exacerbations, and 84% had severe/very severe dyspnea. The mean FEV1 was 37.2% of the predicted value. The total number of requests decreased by 24.5% from 2012 to 2013 and was lowest in 2015. Most (65%) of the requests were accepted. The main reasons for the rejection/return of a request were a post-bronchodilator FEV1/FVC ratio > 0.7, a post-bronchodilator FEV1 > 50% of the predicted value, and failure to provide information regarding previous use of a long-acting beta(2) agonist. During the study period, the total number of requests returned/rejected decreased slightly, and there was improvement in the quality of the data included on the forms. Conclusions: Here, we have identified the characteristics of the requests for COPD medications and of the corresponding patients per region served by the authorization center analyzed, thus contributing to the improvement of local public health care measures.
- The future is now(2019) FERNANDES, Frederico Leon Arrabal; TANNI, Suzana Erico
- Impact of polymorphisms in genes involved in nicotine dependence pathways on the smoking burden of COPD patients(2019) SILVA, Isadora Costa Da; FERNANDES, Frederico Leon Arrabal; DINARDO, Carla Luana; CARVALHO-PINTO, Regina Maria; FARIAS, Camila; CUKIER, Alberto
- Identifying COPD patients at risk for worse symptoms, HRQoL, and self-efficacy: A cluster analysis(2019) LOPES, Aline C.; XAVIER, Rafaella F.; PEREIRA, Ana Carolina A. C.; STELMACH, Rafael; FERNANDES, Frederico L. A.; HARRISON, Samantha L.; CARVALHO, Celso R. F.Objectives To identify clusters of chronic obstructive pulmonary disease (COPD) patients with distinct beliefs about their illness in terms of symptoms, health-related quality of life (HRQoL), self-efficacy, and daily life physical activity (DLPA). Methods This cross-sectional study included 150 COPD outpatients. The patients' illness perceptions, clinical control, HRQoL, self-efficacy, and DLPA (accelerometry) were evaluated. A cluster analysis was conducted using data from the Illness Perceptions Questionnaire - Revised to establish groups of patients with distinct illness perceptions. Differences between clusters were tested using a T-test or a Mann-Whitney U test. Results The cluster analysis revealed two groups: distressed (n = 95) and coping (n = 55). Despite the fact that both clusters presented similar pulmonary function, between-cluster differences were observed in their self-efficacy, dyspnea, HRQoL, clinical control (p < 0.001), and educational level (p = 0.002). The levels of DLPA did not differ between the clusters. Discussion We observed that clinically stable COPD patients who displayed higher emotional representations and less coherence had heightened symptoms, poorer HRQoL, worse self-efficacy, and lower educational levels. These results emphasize the need to routinely evaluate illness perceptions in COPD patients to target and tailor the proper treatment to improve these important health outcomes.