ORCID Profile
0000-0002-2602-3433
Current Organisations
Universidade Federal de Minas Gerais
,
University of Sydney
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Publisher: Oxford University Press (OUP)
Date: 05-12-2018
Abstract: Chronic pain is known to increase health care use in high-income countries, but in Brazil, little is known. To investigate the association between chronic pain and health care use among Brazilian older adults and explore the relationship between pain severity and health care use. This cross-sectional study was derived from the population-based study Frailty in Brazilian Older People-FIBRA. Chronic pain, pain intensity and pain-related disability were assessed through additional telephone interviews. Health care use was measured by the number of doctor visits, hospitalization events and high health care use (highest quartile of the distribution for number of doctor visits) in the last 12 months. Associations were tested in regression analyses adjusted for predisposing, enabling and illness-level components from the Andersen Model. The 383 participants were predominantly female (71.0%), mean age was 75.6 (6.1 SD). The prevalence of chronic pain was 30.0%. Chronic pain was associated with number of doctor visits [unstandardized B coefficient 1.48 95% confidence interval (CI) = 0.35–2.62] and high health care use [odds ratios (OR) = 2.27 95% CI = 1.39–3.72]. Pain intensity was associated with high health care use in univariate (OR = 1.13 95% CI = 1.06–1.20) but not multivariate analysis (OR = 1.12 95% CI = 0.94–1.33). Pain-related disability was not associated with any outcome. Chronic pain increased health care use among Brazilian older adults. Improving the quality of primary care management of in iduals at greater risk of chronic pain should be a cornerstone of health policies directed towards reducing the personal and societal burden of ageing.
Publisher: Elsevier BV
Date: 03-2019
DOI: 10.1016/J.RESP.2019.01.006
Abstract: To compare the effects of flow incentive spirometer (FIS), volume incentive spirometer (VIS), and sustained maximal inspiration exercise (SMI) on breathing pattern, chest wall motion, and thoracoabdominal asynchrony. Sixteen healthy adults aged 27.63 ± 5.26 years were evaluated by optoelectronic plethysmography in the supine position with trunk inclination of 45° during quiet breathing and during exercise performance. In the comparisons among exercises, VIS promoted a significantly higher inspiratory time and lower mean inspiratory flow compared with FIS. The rating of perceived exertion according to the Borg Scale was significantly higher after the performance of FIS compared with VIS. Regarding asynchrony, none of the exercises caused changes in thoracoabdominal synchrony between the rib cage and abdomen. However, both devices significantly reduced the asynchrony between the pulmonary and abdominal rib cage compared with quiet breathing. SMI exercise was equivalent to incentive spirometers and may be an interesting alternative for clinical use in cases in which it is not possible to acquire the devices.
Publisher: Daedalus Enterprises
Date: 28-08-2019
Abstract: Breathing exercises, such as diaphragmatic breathing and pursed-lips breathing, play a role in some in iduals with COPD and might be considered for those patients who are unable to exercise. However, in the literature are reports of some adverse effects of diaphragmatic breathing in patients with COPD. Thus, the purpose of this study was to assess the effects of diaphragmatic breathing and diaphragmatic breathing combined with pursed-lips on chest wall kinematics, breathlessness, and chest wall asynchrony in subjects with COPD, and also to assess whether the combination of both exercises reduces the adverse effects of diaphragmatic breathing while maintaining its benefits. Seventeen subjects with COPD, mean ± SD, 65 ± 7 y of age, with a history of smoking and clinical stability without hospitalization or symptoms of exacerbation in the past 4 wk, were evaluated. On day 1, participants' characteristics were collected, and they learned diaphragmatic breathing and its combination with pursed-lips breathing. On day 2, the participants were evaluated by optoelectronic plethysmography with the participants in the seated position while performing breathing exercises. Diaphragmatic breathing and diaphragmatic breathing plus pursed-lips breathing promoted a significant increase in chest wall tidal volume and its compartments as well as a reduction in breathing frequency compared with quiet breathing. No significant changes were observed in dyspnea or end-expiratory volume of the chest wall. A significant increase in asynchrony (inspiratory-expiratory phase ratio) was observed during diaphragmatic breathing and diaphragmatic breathing plus pursed-lips breathing compared with quiet breathing, with no differences observed between the exercises. Despite the increase in asynchrony, both breathing exercises were able to improve chest wall volumes without affecting dyspnea. The combination of exercises maintained the benefits but did not reduce the adverse effects of diaphragmatic breathing.
Publisher: FapUNIFESP (SciELO)
Date: 03-2019
DOI: 10.1590/1809-2950/17030126012019
Abstract: ABSTRACT The mini-mental state examination (MMSE) is a screening test used worldwide for identifying changes in the scope of cognition. Studies have shown the influence of education, age and sex in the MMSE score. However, in Brazil, the studies consider only one factor to score it. The aim of this study was to establish a prediction equation for the MMSE. An exploratory cross-sectional study was developed and trained researchers examined participants at the community. The volunteers were evaluated by the MMSE and also by the Geriatric Depression Scale (GDS). The MMSE score was the dependent variable. Age, educational level, sex, and GDS score were the independent variables. Multivariate regression analysis was used to determine the model of best prediction value for MMSE scores. A total of 250 participants aged 20-99 years, without cognitive impairment, were assessed. The educational level, age, and sex explained 38% of the total variance of the MMSE score (p .0001) and resulted in the following equation: MMSE=23.350+0.265(years of schooling)-0.042(age)+1.323(sex), in which female=1 and male=2. The MMSE scores can be better explained and predicted when educational level, age, and sex are considered. These results enhance the knowledge regarding the variables that influence the MMSE score, as well as provide a way to consider all of them in the test score, providing a better screening of these patients.
Publisher: FapUNIFESP (SciELO)
Date: 12-2014
Publisher: Elsevier BV
Date: 03-2017
Publisher: Sociedade Brasileira de Pneumologia e Tisiologia
Date: 06-03-2023
DOI: 10.36416/1806-3756/E20220067
Abstract: Objective: A substantial number of people with COPD suffer from exacerbations, which are defined as an acute worsening of respiratory symptoms. To minimize exacerbations, telehealth has emerged as an alternative to improve clinical management, access to health care, and support for self-management. Our objective was to map the evidence of telehealth/telemedicine for the monitoring of adult COPD patients after hospitalization due to an exacerbation. Methods: Bibliographic search was carried in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, Scopus, Biblioteca Virtual de Saúde/LILACS and Cochrane Library databases to identify articles describing telehealth and telemonitoring strategies in Portuguese, English, or Spanish published by December of 2021. Results: Thirty-nine articles, using the following concepts (number of articles), were included in this review: telehealth (21) telemonitoring (20) telemedicine (17) teleconsultation (5) teleassistance (4) telehomecare and telerehabilitation (3 each) telecommunication and mobile health (2 each) and e-health management, e-coach, telehome, telehealth care and televideo consultation (1 each). All these concepts describe strategies which use telephone and/or video calls for coaching, data monitoring, and health education leading to self-management or self-care, focusing on providing remote integrated home care with or without telemetry devices. Conclusions: This review demonstrated that telehealth/telemedicine in combination with telemonitoring can be an interesting strategy to benefit COPD patients after discharge from hospitalization for an exacerbation, by improving their quality of life and reducing re-hospitalizations, admissions to emergency services, hospital length of stay, and health care costs.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2018
DOI: 10.1097/AJP.0000000000000564
Abstract: To investigate the correlates of a recent history of disabling low back pain (LBP) in older persons. The Pain in the Elderly (PAINEL) Study was derived from the Frailty among Brazilian Older Adults (FIBRA) Network Study. Data were collected through face-to-face/telephone interviews and clinical examination. A series of logistic regressions assessed associations between a recent history of disabling LBP and sociodemographic, physical/lifestyle, and psychological factors. Of the 378 community-dwelling elders included in the study (age±SD, 75.5±6.1), 9.3% experienced LBP that was bad enough to limit or change their daily activities during the past year. Those reporting a recent history of disabling LBP were more likely to be women and under financial strain, to present poor self-rated health, overweight, multimorbidity, low physical activity level, fatigue, depressive symptomatology/diagnosis and fear beliefs, and to report decreased sleep time, prolonged sitting time, chronic pain (in location other than lower back), and frequently recurring LBP. The multivariate logistic regression analysis indicated that overweight (odds ratio [OR], 29.6 95% confidence interval [CI], 2.3-391.0), low physical activity level (OR, 4.4 95% CI, 1.3-15.4), fatigue (OR, 10.3 95% CI, 2.4-43.4), depression diagnosis (OR, 4.9 95% CI, 1.3-18.4), and frequently recurring LBP (OR, 4.6 95% CI, 1.0-20.1) were independently associated with a recent history of disabling LBP. Our study supports the link between disabling LBP and other age-related chronic conditions in a middle-income country with a rapidly aging population.
Publisher: Informa UK Limited
Date: 29-06-2020
Publisher: Elsevier BV
Date: 11-2021
DOI: 10.1016/J.RESP.2021.103724
Abstract: The relationship between rib cage (RC) motion abnormalities, dynamic hyperinflation (DH), and exercise capacity in people with COPD is controversial. To investigate RC distortion and operational chest wall volumes during moderate and high constant-rate exercises in people with COPD. Seven male participants [median(Q1-Q3) age: 63(60.0-66.0) years FEV PhRIB and PhREB significantly increased during both constant-rate exercise tests, without difference between them. In general, Vei of the chest wall significantly increased in both exercise intensities while Vee did not change. The occurrence of RC distortion seemed not to limit the exercise capacity in people with COPD evaluated, and it was present even in the absence of DH.
Publisher: Elsevier BV
Date: 05-2020
Publisher: Informa UK Limited
Date: 02-01-2016
DOI: 10.1080/21551197.2015.1125325
Abstract: Malnutrition is a risk factor for noncommunicable diseases related to ageing, and it can also contribute to musculoskeletal health. This study investigated whether nutritional risk is associated with chronic musculoskeletal pain in community-dwelling older persons. Nutritional risk was assessed by the DETERMINE Checklist. Chronic musculoskeletal pain was defined as the presence of pain in the past six months that did not disappear for at least 30 consecutive days. Multivariate logistic regression including confounding variables was used for the analysis. The s le was comprised of 383 participants (age 75.6 ± SD 6.1) the majority were at moderate-to-high nutritional risk (69%) and approximately one third presented chronic musculoskeletal pain (30%). The nutritional risk score was independently associated with chronic musculoskeletal pain: adding one unit in the risk score produces an 11% increment in the odds of presenting pain (OR 1.109, 95% CI 1.022-1.204). In iduals classified into moderate- or high-risk categories also had substantially higher odds (∼90%) of presenting chronic musculoskeletal pain when compared to those in the low-risk category, although our findings were only marginally significant. This is the first study to demonstrate the association between nutritional risk and chronic musculoskeletal pain above and beyond the contributed effects from relevant confounders.
No related grants have been discovered for Liliane Mendes.