Papers by Rita Simone Lopes Moreira
Editora ABEn eBooks, Dec 1, 2022
Brazilian Journals Editora eBooks, Jun 1, 2022
O conteúdo dos livros e seus dados em sua forma, correção e confiabilidade são de responsabilidad... more O conteúdo dos livros e seus dados em sua forma, correção e confiabilidade são de responsabilidade exclusiva dos autores. Permitido o download da obra e o compartilhamento desde que sejam atribuídos créditos aos autores, mas sem a possibilidade de alterá-la de nenhuma forma ou utilizá-la para fins comerciais.
Revista de Pesquisa Cuidado é Fundamental Online
Objetivo: avaliar o impacto e a qualidade de vida em pessoas acometidas por acidente vascular cer... more Objetivo: avaliar o impacto e a qualidade de vida em pessoas acometidas por acidente vascular cerebral em seguimento ambulatorial. Método: estudo transversal e quantitativo, de janeiro a abril de 2019, utilizou-se um questionário com variáveis pessoais, sociodemográficos e clínicas; o Stroke Impact Scale 3.0 e a Escala de Qualidade de Vida Específica para Acidente Vascular Encefálico. Resultados: 34 participantes, idade média de 50,3 anos, maioria mulheres (55,8%), cor da pele branca (52,9%), ensino fundamental incompleto (38,2%), casados (47%), tipo isquêmico (73,5%) e no hemisfério esquerdo (44,1%). Em 79,4% foi o primeiro evento de AVC. As comorbidades mais prevalentes foram hipertensão arterial sistêmica (73,5%) e dislipidemia (61,7%). O instrumento Stroke Impact Scale obteve média de 57,75 e a escala de qualidade de vida de 156. Conclusão: o impacto da doença, a qualidade de vida e a percepção da recuperação foram classificados como moderados.
International Archives of Medicine, 2016
: Identify the most prevalent risk factors for developing cardiovascular diseases (CVD) in low-in... more : Identify the most prevalent risk factors for developing cardiovascular diseases (CVD) in low-income women; verify the relation between the prevalence of risk factors to develop CVD and social economic factors and identify beliefs of death without relation to the main diseases affecting females. Methods: Interview of 100 cleaning ladies in São Paulo University Hospital. It was used a quiz composed by 25 closed questions based on VIGITEL/2006 quiz, Health Ministry, a risk factor surveillance quiz. The most prevalent cardiovascular risk factor was hypertension followed by smoking. Most of the women carrying cardiovascular risk factors were over 55 years old. It was also verified the relation between a higher income and higher education to CVD deaths. In order to reduce mortality by CVD, it is necessary to provide more information to these women about the main risks of developing such diseases through prevention programs, specially among groups with more vulnerability
Brazilian Journal of Cardiovascular Surgery, 2020
In this study novel organic-inorganic hybrid nanocomposites were synthesized from modi�ed cellulo... more In this study novel organic-inorganic hybrid nanocomposites were synthesized from modi�ed cellulose acetate propionate (MCAP) via sol-gel reaction at ambient temperature. e inorganic phase was introduced in situ by hydrolysis-condensation of tetraethoxysilane (TEOS) in different concentrations, under acid catalysis, in the presence of organic polymer dissolved in acetone. e chemical modi�cation of CAP was monitored by infrared spectroscopy (IR). e nanocomposites structure was characterized by IR analysis and solid state 29 Si NMR studies. e spectral data revealed that organic and inorganic phases are linked through covalent bound. Surface morphology of the samples and the degree of dispersion of inorganic phase in the polymer matrix were investigated using atomic force microscopy (AFM) and scanning electron microscopy (SEM). e actual incorporation of the inorganic component into the hybrid nanocomposites was deducted from the residual weight according to thermogravimetric analysis (TGA).
Respiratory Care, 2018
BACKGROUND: The use of noninvasive ventilation in patients with left-ventricular dysfunction may ... more BACKGROUND: The use of noninvasive ventilation in patients with left-ventricular dysfunction may increase cardiac performance by decreasing inspiratory effort and left-ventricular afterload. The aim of the present study was to evaluate the acute effects of noninvasive ventilation on centralvenous oxygen saturation (S cv O 2 ) and blood lactate in subjects with left-ventricular dysfunction during the early postoperative phase of coronary artery bypass grafting. METHODS: This study included 100 subjects during the postoperative phase of elective coronary artery bypass grafting. Blood samples, at 5 time points, were collected to assess tissue perfusion markers (ie, S cv O 2 and blood lactate) as follows: (1) the intraoperative period (after anesthesia induction); (2) 20 min after ICU arrival, under intermittent mandatory ventilation; (3) 20 min after extubation with spontaneous breathing; (4) after 1 h of noninvasive ventilation; and (5) 20 min after discontinuation of noninvasive ventilation. RESULTS: A significant increase in the blood lactate and a drop in the S cv O 2 were observed on arrival to the ICU compared with intraoperative values (P < .001). After extubation, during spontaneous breathing, the S cv O 2 significantly decreased (P ؍ .02), whereas the blood lactate increased, although not significantly (P ؍ .21) compared with intermittent mandatory ventilation on arrival to the ICU. During the application of noninvasive ventilation, the S cv O 2 significantly increased (P ؍ .048) and the blood lactate significantly decreased (P ؍ .008) compared with spontaneous breathing values after extubation. After noninvasive ventilation discontinuation, the S cv O 2 and blood lactate did not change compared with measures taken during noninvasive ventilation; higher values of S cv O 2 were maintained compared with those obtained after extubation (P < .001). CONCLUSIONS: The acute application of noninvasive ventilation improved S cv O 2 and decreased the blood lactate in subjects with left-ventricular dysfunction during the early postoperative phase after coronary artery bypass grafting. (ClinicalTrials.gov registration NCT02767687.
Acta Paulista De Enfermagem, 2010
Objetivo: Analisar a qualidade das anotações de enfermagem relacionadas à ressuscitação cardiopul... more Objetivo: Analisar a qualidade das anotações de enfermagem relacionadas à ressuscitação cardiopulmonar, comparando-as ao protocolo validado Utstein, em um hospital universitário. Métodos: Estudo retrospectivo, exploratório, descritivo, de abordagem quantitativa, realizado por meio de consulta a prontuários de pacientes que sofreram parada cardiorrespiratória (PCR) seguida de óbito. A coleta de dados foi realizada no período de 1º de maio a 30 de junho de 2009. Resultados: Dos 144 prontuários consultados, 74 foram dispensados por não haver nenhuma informação registrada dos itens a serem estudados e, 70 constituíram a amostra do estudo. Nestes, não havia anotações referentes à causa imediata da PCR (92%), intervenções realizadas na tentativa de recuperação cardiorrespiratória (RCP) (71%), ritmo inicial de PCR (59%), hora dos eventos (16%), drogas utilizadas (50%) e profissionais envolvidos na RCP (88%). Conclusões: As anotações foram escassas e, frequentemente, não realizadas. A utilização do modelo Utstein favorece a anotação sequencial dos eventos, evitando a perda de dados.
Brazilian Journal of Cardiovascular Surgery, 2016
Objective: To compare pulmonary function, functional capacity and clinical outcomes amongst three... more Objective: To compare pulmonary function, functional capacity and clinical outcomes amongst three groups of patients with left ventricular dysfunction following off-pump coronary artery bypass, namely: 1) conventional mechanical ventilation (CMV); 2) late open lung strategy (L-OLS); and 3) early open lung strategy (E-OLS). Methods: Sixty-one patients were randomized into 3 groups: 1) CMV (n=21); 2) L-OLS (n=20) initiated after intensive care unit arrival; and 3) E-OLS (n=20) initiated after intubation. Spirometry was performed at bedside on preoperative and postoperative days (PODs) 1, 3, and 5. Partial pressure of arterial oxygen (PaO 2) and pulmonary shunt fraction were evaluated preoperatively and on POD1. The 6-minute walk test was applied on the day before the operation and on POD5. Results: Both the open lung groups demonstrated higher forced vital capacity and forced expiratory volume in 1 second on PODs 1, 3 and 5 when compared to the CMV group (P<0.05). The 6-minute walk test distance was more preserved, shunt fraction was lower, and PaO 2 was higher in both open-lung groups (P<0.05). Open-lung groups had shorter intubation time and hospital stay and also fewer respiratory events (P<0.05). Key measures were significantly more favorable in the E-OLS group compared to the L-OLS group. Conclusion: Both OLSs (L-OLS and E-OLS) were able to promote higher preservation of pulmonary function, greater recovery of functional capacity and better clinical outcomes following off-pump coronary artery bypass when compared to conventional mechanical ventilation. However, in this group of patients with reduced left ventricular function, initiation of the OLS intra-operatively was found to be more beneficial and optimal when compared to OLS initiation after intensive care unit arrival.
The International Journal of Cardiovascular Imaging, 2022
Objectives This study aimed to determine the impact of systematic coronary computed tomographic a... more Objectives This study aimed to determine the impact of systematic coronary computed tomographic angiography (CCTA) use following an abnormal non-invasive ischemia test (NIST) on patient selection strategy for invasive coronary angiography (ICA). Background In patients with suspected stable coronary artery disease (CAD), NIST use frequently results in suboptimal diagnostic and revascularization yields of ICA. Methods This randomized clinical trial, conducted at a single academic tertiary center, selected 220 symptomatic patients with mild-to-moderately abnormal NIST results who were referred for ICA. Patients received either the originally intended ICA (n = 105) or CCTA (n = 115). The primary endpoint was the diagnostic yield of ICA in each group. Revascularization yield and major adverse cardiovascular events at 12 months were also assessed. Results The patients were 69 ± 9 years old, 60% were men, and 31% had typical angina. Mean pre-test probability of obstructive CAD was 34%. Overall prevalence of obstructive CAD was 37.7% on the index angiographic procedure. In the CCTA group, ICA was cancelled by referring physicians in 83 patients (72.2%) after receiving CCTA results. For those undergoing ICA, diagnostic (84.4% vs 41.7%, p < 0.001) and revascularization (71.9% vs 38.8%, p = 0.001) yields were signi cantly higher for CCTA-guided ICA than for standard NIST-guided ICA. Mean cumulative radiation exposure was signi cantly lower in the CCTAguided ICA arm than in the NIST-guided ICA arm (12 ± 9 vs 16 ± 10 mSv, respectively, p = 0.024). There were no signi cant differences in the primary safety endpoint rates between the strategies (p = 0.439). Conclusions In patients with suspected CAD and mild-to-moderately abnormal ischemia tests, a diagnostic strategy including CCTA as a gatekeeper is safe and effective and signi cantly improves diagnostic and revascularization yields of ICA.
Brazilian Journal of Cardiovascular Surgery
Objective: This study aims to investigate the ability of the six-minute walk distance (6MWD) as a... more Objective: This study aims to investigate the ability of the six-minute walk distance (6MWD) as a prognostic marker for midterm clinical outcomes three months after coronary artery bypass grafting (CABG), to identify possible predictors of fall in 6MWD in the early postoperative period, and to establish the percentage fall in early postoperative 6MWD, considering the preoperative baseline as 100%. Methods: A prospective cohort of patients undergoing elective CABG were included. The percentage fall in 6MWD was assessed by the difference between preoperative and postoperative day (POD) five. Clinical outcomes were evaluated three months after hospital discharge. Results: There was a significant decrease in 6MWD on POD5 compared with preoperative baseline values (percentage fall of 32.5±16.5%, P<0.0001). Linear regression analysis showed an independent association of the percentage fall of 6MWD with cardiopulmonary bypass (CPB) and preoperative inspiratory muscle strength. Receiver operating characteristic curve analysis revealed that the best cutoff value of percentage fall in 6MWD to predict poorer clinical outcomes at three months was 34.6% (area under the curve = 0.82, sensitivity = 78.95%, specificity = 76.19%, P=0.0001). Conclusion: This study indicates that a cutoff value of 34.6% in percentage fall of 6MWD on POD5 was able to predict poorer clinical outcomes at three months of follow-up after CABG. Use of CPB and preoperative inspiratory muscle strength were independent predictors of percentage fall of 6MWD in the postoperative period. These findings further support the clinical application of 6MWD and propose an inpatient preventive strategy to guide clinical management over time.
Introducao: A reabilitacao cardiovascular (RCV) e definida como atividade necessaria para assegur... more Introducao: A reabilitacao cardiovascular (RCV) e definida como atividade necessaria para assegurar as melhores condicoes fisicas, psicologicas e sociais a pessoas com doenca cardiovascular (DCV), sendo considerada um importante tratamento nao-farmacologico de baixo custo. As novas tecnologias no campo da saude, especificamente em programas de RCV, por meio do uso de realidade virtual (RV) sao mostradas como auxiliares promissores com o objetivo de aumentar a adesao e satisfacao aos programas. Objetivo: Mapear as evidencias disponiveis para fornecer uma visao geral do uso de RV no contexto da RCV. Metodos: Trata-se de um estudo baseado em revisao de escopo, onde foram pesquisados estudos com uso de RV, com interface do tipo oculos, em programas de RCV com pacientes clinicos e/ou cirurgicos. Os bancos de dados utilizados foram: Pubmed, Medline, Lilacs, PEDro, Science Direct, Cochrane Database of Systematic Reviews e JBI Database of Systematic Reviews and Implementation Reports Journa...
Brazilian Journal of Cardiovascular Surgery, 2021
Brazilian Journal of Cardiovascular Surgery, 2019
Brazilian journal of cardiovascular surgery
To report the early results of the BYPASS project - the Brazilian registrY of adult Patient under... more To report the early results of the BYPASS project - the Brazilian registrY of adult Patient undergoing cArdiovaScular Surgery - a national, observational, prospective, and longitudinal follow-up registry, aiming to chart a profile of patients undergoing cardiovascular surgery in Brazil, assessing the data harvested from the initial 1,722 patients. Data collection involved institutions throughout the whole country, comprising 17 centers in 4 regions: Southeast (8), Northeast (5), South (3), and Center-West (1). The study population consists of patients over 18 years of age, and the types of operations recorded were: coronary artery bypass graft (CABG), mitral valve, aortic valve (either conventional or transcatheter), surgical correction of atrial fibrillation, cardiac transplantation, mechanical circulatory support and congenital heart diseases in adults. 83.1% of patients came from the public health system (SUS), 9.6% from the supplemental (private insurance) healthcare systems; an...
Ciência, Cuidado e Saúde
Objetivo: identificar quais intervenções de enfermagem são mais eficazes para a reabilitação de p... more Objetivo: identificar quais intervenções de enfermagem são mais eficazes para a reabilitação de pessoas com intestino neurogênico. Método: revisão integrativa da literatura, no período de março de 2016 a dezembro de 2021, nos idiomas inglês, português e espanhol, nas bases de dados eletrônicasCINAHL, Cochrane Library, Embase (Elsevier) e MEDLINE, com os descritores “Neurogenicbowel” and“Nursing”. Critérios de inclusão: estudos na íntegra, com conteúdos sobre intervenções de enfermagem para pacientes adultos com intestino neurogênico. Resultados: oito estudos incluídos. As intervenções mais citadas foram adequação dietética e ingestão hídrica(62,5%); uso apropriado de medicamentos (50%); massagem abdominal, retirada manual das fezes e estimulação reto-digital (50%); posicionamento para evacuação, prática de exercícios físicos e estimulação elétrica (25%). Considerações finais: a síntese integrativa dos estudos evidenciou que os resultados mais efetivos são os que associam mais de um...
ABSTRACTPurposeto develop and test a prototype of Chatbot with the purpose of applying a question... more ABSTRACTPurposeto develop and test a prototype of Chatbot with the purpose of applying a questionnaire to assess depression in visually impaired individuals.MethodsThis project was carried out in the Federal University of São Paulo. The Chatbot was developed using the platform BLiP®. The social-demography questionnaire and the Center for Epidemiological Scale – Depression (CES-D) were selected to collect the essential data and to identify the presence of depression, respectively. After the development, validation tests were applied to verify the functionality and structure of the chatbot.ResultsThe Chatbot prototype presented an excellent flow of conversation in the tests conducted. The questionnaires were applied in a satisfactory manner during the tests. Software validation tests approved the prototype’s function.ConclusionsThe Chatbot prototype is an affordable and easy way to apply questionnaires that can be used to identify health conditions, such as the likelihood of being dep...
Brazilian Journal of Cardiovascular Surgery, 2016
Objective: The purpose of this study was to evaluate the effect of a cycle ergometer exercise pro... more Objective: The purpose of this study was to evaluate the effect of a cycle ergometer exercise program on exercise capacity and inspiratory muscle function in hospitalized patients with heart failure awaiting heart transplantation with intravenous inotropic support. Methods: Patients awaiting heart transplantation were randomized and allocated prospectively into two groups: 1) Control Group (n=11)-conventional protocol; and 2) Intervention Group (n=7)-stationary cycle ergometer exercise training. Functional capacity was measured by the six-minute walk test and inspiratory muscle strength assessed by manovacuometry before and after the exercise protocols. Results: Both groups demonstrated an increase in six-minute walk test distance after the experimental procedure compared to baseline; however, only the intervention group had a significant increase (P=0.08 and P=0.001 for the control and intervention groups, respectively). Intergroup comparison revealed a greater increase in the intervention group compared to the control (P<0.001). Regarding the inspiratory muscle strength evaluation, the intragroup analysis demonstrated increased strength after the protocols compared to baseline for both groups; statistical significance was only demonstrated for the intervention group, though (P=0.22 and P<0.01, respectively). Intergroup comparison showed a significant increase in the intervention group compared to the control (P<0.01). Conclusion: Stationary cycle ergometer exercise training shows positive results on exercise capacity and inspiratory muscle strength in patients with heart failure awaiting cardiac transplantation while on intravenous inotropic support.
Rev Rene
Objective: to identify the risk factors for surgical site infection in patients after heart proce... more Objective: to identify the risk factors for surgical site infection in patients after heart procedure. Methods: integrative literature review by searching the Medical Literature Analyses and Retrieval System online, Latin American and Caribbean Literature on Health Sciences, Scientific Electronic Library Online, Nursing Database. The search for the articles occurred during the month of February 2022. Results: 24 articles were eligible for the review. In all studies, the population was mostly male, aged between 51 and 70 years, who underwent elective myocardial revascularization surgery. The main comorbidities presented were diabetes mellitus, hypertension, and obesity. The infection rates ranged from 2.4% to 38.9%, and the main pathogen identified was Staphylococcus aureus. Conclusion: the main comorbidities present in patients who manifested surgical site infection were diabetes, hypertension, obesity, and smoking. The risk factors were gender, age, and prolonged preoperative hospi...
Objective: to evaluate the quality of life after acute myocardial infarction, highlighting the di... more Objective: to evaluate the quality of life after acute myocardial infarction, highlighting the differences by sex. Methods: analytical, observational study with 273 patients. For collection, a multidimensional assessment instrument was used for heart attacks. Data collected in a cardiology referral hospital, in which the t Student test was applied for analysis. Results: the majority were male (67.0%), with a mean age of 63.6 years, with a family history of heart attack (64.5%). The average quality of life score was 0.45, with 1.00 being the worst score. Dependence (0.82) and physical activity (0.50) were the worst assessed domains; and side effects (0.27) and diet (0.36), the best. The female gender had the worst averages (0.52, p<0.05), with emphasis on physical activity (0.58), emotion (0.49) and insecurity (0.44). Conclusion: impairments in quality of life were found after myocardial infarction, in which the dependency domain was the most compromised. The female sex had worse ...
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Papers by Rita Simone Lopes Moreira